#1 Hormone Expert: STOP Crashing at 3PM! THIS Secret Habit that Will CHANGE Your Life

[Music]. What are hormones and what is a hormonal. imbalance? Hormones are these chemical messengers.

in the body and I I think of them like. text messages. They tell different parts. of the body to do something. There's. five ways that the body communicates. with itself. Hormones, first and. foremost, peptides, proteins, nutrients, and the genome. We want to be working. with these different systems and not. against them. So, what is hormone. imbalance? It's when this exquisite. state of homeostasis in the body gets. out of balance. And so, that can happen.

in women with endometriosis or. polycystic ovary syndrome. It can happen. in men with low testosterone. It can. happen with your cortisol if you're. someone who's chronically stressed and. you're not attending to it. So, there's. ways that hormones get out of balance, but there's also ways to easily get back. into a state of homeostasis. What are. some of the most common ways that we end. up with a hormonal imbalance that you. see in the modern day? Well, I would say stress is number one. So, we've got this stress response.

system and I think a lot of people. consider stress sort of this feeling, but the truth is you can measure stress. You can measure your cortisol. You can. do it in the blood in the morning. You. can also measure it at four points. during the day and look at your stress. response to see if there's a way that. it's getting pulled out of balance. There's lots of ways to deal with that, but I would say measurement is really. critical. So, that's one piece. Another. is genomics. So, some people have a. greater risk of developing something. like polycystic ovary syndrome where.

you've got too much androgen or. testosterone. There's also hormone imbalances that are. related to other sex hormones like your. testosterone, your estrogen, your. progesterone. It can lead to. infertility, can lead to acne, and other. problems. Do we have the tools to. measure stress at home or do we have to. go take a test? No, you can do it at. home. So, I usually start by doing it a. lot because I think working with a. clinician who's knowledgeable about.

hormones is the best way to begin. Otherwise, you're getting all this. information, you may not know what to do. with it. But, increasingly, we're. disintermediating. the medical system because I would say. the medical system is really failed a. lot of people with hormone imbalances. And so, testing can be a valuable way to. do. to look at it at home in addition to. what you can get at the lab. And what. are you learning at the lab? Like, what. are they testing? What chemicals are. they seeing? What are you hoping to see? Like, is it a percentage scale? Is it a.

rating of one out of 10? Like, where are. we trying our stress to land throughout. the day? It depends on what hormone. you're measuring. So, when it comes to. stress, cortisol is the main stress. hormone, but there's others, too, like. DHEA. So, what we're looking for, if you measure a blood cortisol in the. morning, you want it to be about 10 to. 15. That's the optimal range, which is. different than the normal range. So, normal is what we tend to use in. mainstream medicine. It's what I was.

taught to use, but I don't necessarily. want to be like the average American. I. want to be in a more optimal state. So, that's the optimal state. If you measure. it in the afternoon, it's more like you. want your level to be about 5 to 10. So, that's what we want with cortisol. DHEA and other hormones often vary. depending on age. So, generally with. DHEA, I like to see more than 100 in. women, more than 150 in men. Got it. And.

if you're seeing yourself outside of. that 5 to 10 in the morning, I'm assuming above? We want to see it. about 10 to 15 in the morning. >> And so, above that is negative or below. that is bad? Both. Both, okay. So, with. all hormones, I can't think of a single. exception, you want it to be in the. Goldilocks zone of not too high and not. too low. Mhm. And when I first started. measuring my my cortisol, this was in my. 30s, I found that it was about three. times what it should be. >> Wow. So, I was someone who was a bit of.

a stress junkie. I would, you know, I. was just sort of used to running on. adrenaline and running on cortisol. And. so, if it's too high, that can be. causing too much wear and tear in the. body. And if it's too low, that could be. a stress response system that has become. exhausted. Understood. Understood. And so, stress is one of the first ones when. we're talking about hormonal imbalance. What was the second? Well, your sex. hormones can get out of balance. Another. system that's critical is your metabolic.

system. So, this includes hormones like. insulin, glucagon, but insulin is really. the star of the show here. Um talk to me. about the importance of insulin and the. impact that it has. I think we've all. heard about it. We may understand a. little about it, but not enough. Yeah, insulin is like the bouncer to. club that determines whether to let. glucose into the club or not. So, the. club here is your cell. If you're someone who has insulin that's. working well, it's in that Goldilocks. position, fasting of about five to.

seven, then you're letting glucose into the. cell, you're able to use it as fuel. You. feel good. You're not storing excessive. fat. But, if you are someone who has. insulin resistance where your cells. become numb to insulin, your insulin can. climb. and that leads to more fat storage. It. leads to. uh glucose not getting in the club and. so, the streets are full with glucose. Your bloodstream is full of glucose and. that's where fasting glucose starts to. rise. And you can pick that up in a.

blood test. You can also pick it up on a. continuous glucose monitor. And what's. the negative effects of having glucose. on the streets? Well, there's a lot. So, having high glucose causes damage to. your blood vessels. That's especially. important in women because lower levels. in the pre-diabetes range of, you know, somewhere between 100 to 125. can set you up for high blood pressure. and cardiovascular disease later on. And. that's different than what we see in. men. So, they tend to have vascular.

damage at a higher fasting glucose. So, I think women especially need to pay. attention to this. What's the difference. between hormones for men and women? What. are the key differences that you see. because. I think that's again something we're not. that well versed in at the moment. There's a lot of differences. I mean, it's important first of all to realize. that we all have all of these hormones. Women and men just have different. amounts. So, if you think of what's. classically thought of as a male. hormone, testosterone, women have about.

1/10 what men have, but still. we're exquisitely sensitive to it. And. so, we want that Goldilocks zone when it. comes to women. With other hormones like estrogen, men. make it, too. If your estrogen's too. low, that can lead to problems with bone. loss for men. And then for women, it has. about 400 jobs. So, it's related to. brain health, it's related to memory, it's related to. whether you are growing things inside.

your uterus like fibroids, uh endometriosis elsewhere in the body. So, you want these hormones to be in a. balance and generally, they they vary. depending on your sex. What what are the hormone deficiencies. you're seeing in women the most at the. moment and in men? Well, for both men. and women, for people who've got a. stress response issue, this can start to. rob you of some of the sex hormones that. you really need to function well. So,

what I see especially for. people in their 20s, starting around 27. to 28, if you are a high stress person. like I used to be, that can lead to. problems with falling testosterone. And. so, increasingly, we're seeing low. testosterone in men. We can see that in. women as well. So, it can start as early. as your 20s. Other hormone deficiencies or. insufficiencies include with your. thyroid. So, thyroid is one of those.

hormones that is kind of like the gas. pedal. Almost every cell in your body. has a receptor for thyroid hormone. And. if you're low, then that can lead to. fatigue, weight gain, constipation, feeling like um you just don't have the. energy that you once did. You might lose. the outer third of your eyebrows, have. hair loss on your head. So, that's a. common. issue that we see in terms of hormone. imbalances, women much more commonly. than men. It's about.

seven to nine times more common in. women. And the root cause of low thyroid. function most of the time is autoimmune. Hashimoto's thyroiditis is the typical. cause. I mean, these are things that I feel. like so many people are struggling and. suffering with today and I don't know. how quickly we're able to pinpoint that. it's a hormonal imbalance. It seems like. we're trying to solve it in different. ways, whether that be weight gain or. hair loss or whatever it may be. We. often think that we're almost not always. working to the root cause of the issue,

but I feel like what you're saying is. the hormones are the root cause. Yeah, and I would say start there. You. know, what happens for a lot of folks is. that they feel tired. They feel like. they just don't have the energy when. they wake up in the morning. They don't. feel fully restored after they sleep and. they assume that it's some sort of moral. failing or that they they need to change. their mindset. And I would say, let's. start with your biology before we go to. the place of moral failing.

Let's start with measuring your hormones. and measuring the right hormones. Looking at your stress response. So, you. can look at cortisol, but you can also. look at heart rate variability, the time. between each of your heartbeats. That. tells you a lot about your stress. response system and about your ability. to regulate your nervous system. Yeah, it's so interesting. I was saying this. to you before we started. I feel like I. was I've always been somebody who's. tried to solve things at the mind. And. that's been very good for me. I feel. like it's strengthened my mind in.

incredible ways. But, it was only when I. started to unlock the potential and. capacity of the body that I was able to. actually able to have this. two-pronged approach to making a shift. in my life. And I remember in the past. if I I remember even when I was a monk. and I sometimes struggled to wake up in. the morning to meditate, I always felt. it was a moral failing. And I think so. many people today could relate to the. fact that you wake up and you don't want. to go to work and you think, "Oh, it's. because I hate my job." Or you wake up. in the morning and you're feeling rushed.

and frazzled and you're thinking, "Oh. gosh, I just have so much to do and I'm. failing at it." And the reality is that. there could be a hormonal imbalance. that's actually making you feel that way. that is then making it harder to love. your job, find meaning, or support your. family. And it's a much stronger place. to start because you'll actually feel. the benefits quicker. How how quickly. can we create a shift in a hormonal. imbalance to being back into the. homeostasis?

Well, I so appreciate this framing. because I think the answer is both. The. answer is both and. So, look at the. mindset, look at the way your mind is. functioning, look at your cognition, but. also look at your look at your biology. Put them together. So, how quickly can. you turn this around? It depends on the hormone. When it comes. to a hormone like insulin, you can. change it with your food and exercise in. 3 days. 3 days? >> So, food is such an important driver of.

what your body is doing. So, going back. to, you know, these five ways that the. body communicates with itself, hormones are number one. There's. peptides, proteins, your genome, and. nutrients. So, nutrients here drive so. much of your hormonal balance. Now, other hormones like estrogen, progesterone, those two are kind of like. a tango. Sort of tango partners. Those take longer to adjust. They take.

more like 4 to 6 weeks. Okay, but that's. still not that long. >> That's not that long. That's not. terrible at all. I think sometimes when. you hear about these things, you go, "Oh. god, it's going to take me like 3. years." It's it's refreshing to hear. that 3 days and 4 to 6 weeks. I mean, that's doable. That's realistic. It's. doable. And there was a study also. looking at folks with high testosterone, women with high testosterone. And they. found that by reducing the carbohydrates. in your diet, within 7 days, you can actually change.

your testosterone levels. So, some of. this can happen sooner with the right. messages, with the right orchestra. that's happening in the body. What are. the main reasons in our 20s and 30s do. we see a decline in estrogen, testosterone, and progesterone? They're. each a little different. So, if we take. estrogen first, the most common reason I. see for decline is women who are not. eating enough. They're not getting the. nutrients that they need. >> Interesting. >> They're not getting the calories that.

they need to have the control hormones, luteinizing hormone in particular, help. them ovulate each month. So, their. estrogen might be lower. We also think that exposure to toxins. and endocrine disruptors can affect your. estrogen levels and also thyroid levels. Can also affect testosterone. The other reason I see is women who have. premature ovarian insufficiency. So, this is mostly focused on women in their. 20s and 30s. So, premature ovarian.

insufficiency is not immune process. where the ovaries are attacked by your. immune system. And you can start to have. symptoms of early perimenopause and. menopause, including low estrogen. So, these are women in their 20s and 30s who. have hot flashes, night sweats, mood. swings. And you have to check labs to. see if that's the cause. When it comes to testosterone, the. number one thing I see that leads to low. testosterone in women is having a.

heightened stress response. So, high. stress, being kind of run by cortisol. like I was in my 30s, that can then rob. you of the production of testosterone. Another factor that affects testosterone. is insulin. So, if you're someone with high insulin. levels, that can affect the ovaries and. lead to dysregulation of testosterone. Usually high testosterone is something. we see with one of the the types of. polycystic ovary syndrome. Progesterone is an interesting one for.

people who are not ovulating every. single month. Their control system is a little wonky. We see something called late luteal. phase disorder. And that's where you're. just not making as much progesterone and. it can be related to the health of the. eggs that are in your ovaries. It may be. helpful to look at your egg quality, to. do a day 3 FSH, follicle-stimulating. hormone, and estradiol level. And then a. day 21 or 22 progesterone. So, normally.

on day 21 or 22, if you ovulated around. day 14, you want your progesterone to be. about 10 to 15 or higher. So, if it's. lower, that can be because your egg. quality is potentially declining or. there's some kind of nutrient that needs. to be addressed. Increasingly today, this super interesting that I I've been. um reading a lot about. The the cells in your body that have the. most mitochondria, those powerhouses of.

the cell that produce fuel, produce the. energy, the cells that have the highest. concentration is your eggs. In men, it's. the sperm. So, when your mitochondria. are not working well because you're. sedentary, you've got too much stress, you're not getting the right nutrients, it can show up in your eggs first. And. you might see it with like a low. progesterone level. So, tracking your mitochondria, getting. things like morning light when you first.

wake up in the morning, managing your. stress response so that it's not running. the show, getting all the nutrients that support. your mitochondria, maybe even some. supplements like CoQ10, that can be a way to support your. mitochondria to prevent some of these. problems. For someone who's struggling. with weight loss, what hormonal imbalance could they be. experiencing? First, I think about. insulin because insulin is really the. the king of metabolism. So, I would say.

look at your insulin. Look at your. glucose. Insulin changes first. It can. change 7 to 14 years before your glucose. changes. And probably the best way to. look at insulin is to do what's called a. 2-hour glucose challenge test where you. look at your. insulin and glucose fasting, an hour. later, and 2 hours later. You give a. 75-gram carb load to see how your body. responds. So, fasting insulin can. change, but it changes typically after.

postprandial insulin. So, measuring is really critical. When. it comes to weight, another factor is. in women, having excess testosterone. In women, high testosterone is similar to low. testosterone in men. So, it can lead to. metabolic dysfunction. It can lead to. cardiovascular risk. It can lead to. uh fatigue and mood changes. So, I like. to look at androgens, testosterone,

DHEA. And then another factor, especially in. women, is having estrogen and. progesterone out of balance. So, if. you've got too much estrogen, typical. story, compared to progesterone, that. leads to something called. disestrogenism. If you have excess estrogen in the body, it can lead to. more mood swings. It can lead to. more eating habits that you may not want. to be supporting. It can lead to more. structural changes in your body. So,

it's important to have these in balance. Thyroid is another critical one. And. then I would say cortisol is really. important when it comes to weight gain. because a lot of people don't realize. that the stress that they have in their. system, in their body, could be driving. their deposition of belly fat. It could. be driving um food cravings. It could be changing, you know, we know. people with depression, about half of. them have high cortisol levels. And that.

can then. affect the way that you eat, the way. that you move, the way that you think, and the risk of weight gain. As a. normal human being who. is struggling to deal with work. responsibilities, commitments to our partners, challenges with intimacy, someone who's trying to take care of. their kids, it already feels like you. have so many. factors of your exterior world that.

you're struggling with. You're juggling. all of these things. And then at the. same time, now you've opened. to us this interior world. of all of these other things that we're. like, "Oh yeah, I probably need to. figure out my cortisol and I. sure there's some insulin stuff I need. to work on. And it sounds like I've got. too much or too little testosterone.". Whatever it may be. Like there's this. There's almost like this waking up to. the fact that all of this exterior. difficulty is matched with some sort of.

interior imbalance. Where would you recommend someone to. start if they're starting from zero and. thinking this feels like a lot, feels. overwhelming? Start with cortisol. There's a few reasons for that. Cortisol is the great unifier because. it's involved in all of these other. systems. So, if you're a high cortisol. person, it might be affecting your. insulin. It might be dropping your. progesterone levels. It could be. affecting your testosterone levels as. early as your 20s. So, I would say start.

with cortisol. Like the measurement. there is critical. Mhm. And you made an. important. link here, Jay, between. your external world and your inner. world. And hormones drive so much of your inner. world. The more that you have a sense of. the landscape of your inner terrain, the. more that you're going to be able to. work with it, befriend it, allow these. hormones, these messages, these signals.

to become your friend. and not be, you know, some villain that. you're blaming for the way that you're. feeling. Mhm. What are the top three. things someone could do today to. decrease stress? What should they be. focused on? Well, I would say number. one, measure. Like know what you're. dealing with. What you measure improves. So, know where you're starting. I think. a benchmark is critical. Number two, you know, I I started learning yoga from. my great grandmother when I was 5 years. old. I started practicing meditation.

when I was 17 in college. I think. there's nothing more effective than. meditation, breath work as a way of. working with your cortisol. And then number three, I would say. there's supplements that can really make. a difference. I don't think you can out supplement a. bad diet. I don't think you can out. supplement a stressful life. But you can really work with supplements. like phosphatidylserine, very effective at reducing cortisol at a. dose of 400 mg, omega-3s, so taking fish.

oil or a more plant-based source of. omega-3s. Those are really critical. And then. fourth, I would say look at your. relationships. They're often a common source of stress. in the body. And a lot of people don't. put those things together. So, when. you've got a relationship with someone. that is coregulating, that allows your nervous system to calm. down and reduce your cortisol to that.

Goldilocks position, that is so effective. There's just a. study that got preprinted, so it's not. published yet in a peer-reviewed. journal, but it's really interesting, Jay. It's about the hassler. So, people who. provide some support, but also cause a. lot of hassle in your life, and I have a. few of those. Those tend to be. associated with shortening your life. and raising your cortisol. So, you want. to get a sense of, okay, who are the.

people that help me stay in hormonal. balance? Because the people you surround. yourself with can affect your hormones. One thing I've been reflecting on lately. is how even the smallest choices can. create a big impact over time. Whether. it's choosing to spend a quiet night in. to recharge or making a decision that. brings you closer to a long-term goal, those moments of intention really. matter. And when it comes to the choices. we make with our money, that same. mindset applies. I've learned that.

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negative word. In medicine and science, we call it. eustress. So, eustress, e u stress, is a. healthy form of stress. It's known as. hormesis. It's like a positive um. intervention on the system of your body. So, your body is designed to deal with. stress. Like you developed Our genome. developed on the savanna. a long time ago. in response to stressors that would.

occur, you know, once a month, once a. quarter, something like that. But we're. not designed to deal with the stressors. that we get, you know, from checking our. email inbox every morning. So, we're designed to have a healthy. amount of stress, and you can even. imagine. there's um. a U-shaped curve where you want to find. just the right amount of stress that. allows you to be the most productive, allows your system to work really well, allows you to deal with a stressor and.

then bounce back. You don't want so. little stress that you're. you know, not being of service and not. contributing and not discovering your. gift and sharing it with the world. But. you also don't want so much stress that. cortisol is running the show and leading. to disrupted relationships, not being able to um. really deliver on your talents and um. getting this wear and tear process in. the body. Can you change the way.

stress impacts you by how you see it? So, could I change. distress to eustress. by viewing it differently? So, for. example, my wife was taking care of her. grandma who sadly passed away last week. for the last 4 months. As soon as we. heard that she was unwell, she flew back. to London to take care of her and be by. her bedside every day. It was stressful in the sense that she. didn't sleep a lot. She didn't have.

It wasn't like she was supported in the. support. She was, you know, doing a lot. of things with her and her family. They. were all taking turns, but it was. stressful for her physically, mentally, emotionally. It's her favorite person on. the planet. But she was doing it as a. form of showing love. to a person she was trying to repay for. all the gifts that she'd given her her. whole life. Does that change how that. stress impacts her. or does it not? Oh, it does, definitely. At first, I'm really moved by this story, and I'm.

so sorry for her loss. You know, there's a way that when we're. serving. in a place of love, even if it is leading to sleep. disruption, even if it's leading to more. wear and tear, the connection, the loving connection, can offset. the potential downstream consequences of. having higher cortisol levels. So, it's not so much, you know, a week. or two or a month of taking care of.

someone who's dying that causes a. problem in the body. It's more people. who become adapted to a chronic stress. state that goes on for months to years. That's where we have problems. >> Mhm. So, yes, you can definitely turn it. around, and you can buffer it. You can. blunt the effects of stress. What would. you recommend to someone who comes home. from a stressful day of work? They had a. stressful morning. We've talked about. morning routines for so long, but I feel.

people just struggle. They wake up, they've got to start making lunch. They've got to get their kids ready for. school. They've got to drop them. They've got to go to work. What can they do after that long day. that will actually help, that will. actually make a difference? Well, I love. to have rituals when the day is closing. Like especially to separate work from. family time and personal time at your. home. So, just like I I love a morning ritual, I think we need to bookend the day.

So, there's a lot of different ways to. do that. And I like to think of an a la carte. menu of what works the best for you. So, I can tell you what doesn't work. Like what I used to do is I would come. home from a busy day of seeing 30. patients, and I would have a glass of. wine. And that does not work. So, that lowers. your testosterone, it raises the the not. so good estrogens in the female body, and it is toxic to the brain. It shrinks.

the brain over time. So, I don't think. that's effective, but the very thing. that we are trying to get from a glass. of alcohol is what we want to create in. a ritual. So, there are advanced beings, maybe you're. one of them, Jay, who can come home from. a busy day of work and meditate. They. can do, you know, just like touch have. that touch point of 5 to 10 minutes just. to regulate themselves before they go. into, you know, kind of the second half. of the day.

So, I would say by whatever means necessary. So, for me, breath work and meditation. is really effective. I love to go on the. deck of my house and going to look at. the view and trace the horizon, which. relaxes my eye muscles. I like to read something really. beautiful and mean and meaningful. I love to connect with someone that I. adore, someone who co-regulates me. So, I would say develop a a menu of a few.

things that really work. But I would say the glass of wine that. raises your cortisol even further, the. very thing that you are trying to avoid, that's not a solution. What do you. think? Like what what helps you? No, I I. I love everything you recommended. I I. think that. the natural response people have and and. and me, admittedly. I mean, I'm in this. group sometimes as well, where I'm like, I have no energy to do anything. And I mean, one of my favorite things is. playing pickleball. I play a lot of. sport in the evening, and it's something. I look forward to and I'm like so.

excited to get to, and I found that does. a lot of things. Me and my friends have. a have a formula that we try and stick. to of fitness, friendship, and fun. And. it's like, how do we do something active. together? How do we hang out? Uh and how. do we do something that's playful and. makes us feel like kids again? And so, I. have a group of great male friends where. we just, you know, three, four times a. week where just playing sports, hanging. out in the evenings, and having a great. time. That to me is my ideal evening. Now, I can't do that every night. Uh. when my when my wife and I are at home.

together, definitely connecting with her. is. a high priority to me, having dinner. together. I agree with you on that. Connection is so important. But there. are those days where I just want to sit. and turn on a show. Sure. And it's. usually after I finish it where I go, I. don't know if I that was worth it. Like. I I will sometimes do it, and then I'll. feel like, well, I don't feel more. connected to my partner. Unless the show. is really good and we're really talking. about it and we're really engaging over. it, it can almost feel like, oh, well, that was a waste of time. And I think at.

least what I've noticed is that I think. the menu idea that you gave is really. good, because there are some days I just. want to switch off and watch a show, because I don't want to think, and I. don't want to use my body or my brain, because I'm exhausted. And then there are certain days where. playing sports does it, and then there. are certain days where connecting does. it. And I think the thing I worry is, and I think what you're saying is when. we get into chronic behaviors where it's. like, I come home every night and have a. glass of wine. I come home every night. and I just watch TV. And it's like when. you don't have a menu, and you don't.

have this variety to select from, and it. just becomes one of these patterns that. doesn't refuel you and doesn't renew. you, that's when it starts to get really. unhealthy. Whereas the once a week that. you twice a week that you felt like. watching a show or whatever isn't the. end of the world, and it's fine, and. it's but but it's, hey, do you have. other options? I I couldn't agree with. you more about looking out into the. distance. I I find that to be one of the most. powerful things for my eyes, especially. as we're living in such a short-sighted.

world now where everything is up in our. face, whether it's a Zoom screen, our. phones. Instead of actually being able. to look into the distance and. and this is not about sounding poetic or. spiritual. I literally think it's a. physical thing that our eyes need of. like looking far at a cloud or looking. at a bird in the sky, and you don't have. to find it mystical or beautiful or. special. Just the act of looking into. the distance is an important thing for. our mind and brains and our ability to. slow down, I think.

When people talk about being with. nature, a lot of people are like, oh, well, what does that even mean? And. sounds a bit woo-woo. And it's like, well, no, there's science to prove it, but I think being with nature is moving. at the pace of nature. >> That's right. >> And, you know, watching a tree flow is good for your. breath, because you can breathe in and. out of it. You would never breathe in. and out of watching traffic, right? And. you should. You should breathe healthily. when you're watching traffic, but what I. mean is, you would never breathe at the. pace of traffic, right? It's It would be jarring. Whereas. if you breathed at the pace of watching.

a bird in the sky or watching the ocean. or watching a tree sway in the wind, that would feel a lot more natural and a. lot more therapeutic. And and probably. feels like a better thing to try, at. least from my perspective. Totally agree. with you. And maybe we could riff to. come up with a menu for folks just to. have some ideas, because. you mentioned another piece that I think. is critical today, which is. to notice when you try these things, how. do you feel in your body? Like where do.

you notice a shift? So, if I watch a show, and I'm watching Homeland right now with. my partner, and it it's very triggering. You know, there's just so many scary. things that happen in every episode. I don't feel that great by the end of. it. Like I don't like to watch it before. I go to bed. If that desire because I. feel low in energy and I want a. transition like watching a show, if I. instead roll out my yoga mat. and do,

you know, 5 minutes pigeon pose or even. just shavasana. for 5 minutes, that's a low energy way. to integrate and to regulate. So, I feel. so much more regulated after that, but. that may not be true for you or for the. next person. >> Mhm. I also love cooking. And I really. consider making food to be a sadhana, to. be this sacred practice. You know, it's. not just chopping arugula and throwing. it together with some nuts and some goat.

cheese, but. you know, just very intentional and. slowing it down and breathing and. regulating as I do it. So, tell me about. some of your other rituals. I love this. fun, fitness, and friends. I think. that's a beautiful one. That's. definitely one of my go-tos. I I mean, my wife and I love going on long walks. in the evening or even a short walk in. the evening. Sometimes we'll just be. like, let's have dinner together and. then just have a 15- to 20-minute walk. together, and that feels like a really. low impact. It's not intense. It's not.

crazy. And, you know, of course, you've. got to have. good enough weather wherever you live to. be able to do that, and I appreciate. that. And it helps your insulin and your. glucose. Even a 10-minute walk. Exactly. Exactly. So, we're like, this this. solves a lot. It solves our connection. We get to talk about our day. We get to. catch up, but at the same time, it's. helping our our body digest and and. everything else as well. So, that for us. is a really, really special practice. I've I've definitely found that sitting. with for me, sitting with scripture or.

sitting with some spiritual text is. really powerful, and I found that in the. evening, it's not a time when I can do. academic study or a lot of writing or a. lot of memory work, but it is a time. where I can sit with something and just. meditate on it for 10 minutes or let it. sink in and let it be there. I almost. feel like what we're missing is, and I. think this has happened by working at. home for a lot of people. I feel like. your commute played a really powerful. role in preparation in the morning and.

decompressing in the evening. So, most. people had an hour commute on the way to. work, and maybe you still have one, and. some people had an hour commute on the. way back. And what that allowed you to. do subconsciously was decompress from. the day. You thought about the day. You reflected. Maybe you had a little. nap if you were on the train, or if you. were driving, maybe you listened to a. podcast, or maybe you're listening right. now, and you're reflecting about things. Whereas the challenge right now is if. you literally walk out of your bedroom. or your home office and walk straight.

into the dining room, you've had zero. minutes to decompress, and I find that. creating a little 5- to 10-minute. decompression ritual of sitting by. yourself, that's what you did on the. train or in the car. You sat by yourself. for an hour. Yes. And so, you may think. you don't know how to meditate, or you. may think you don't know how to spend. time on your own, but chances are you've. been doing it for a long time. And now. creating some intention around it and. saying, hey, I'm going to spend 10. minutes and just see how my body feels, see how my mind feels, and maybe I'll. make a better decision of what to do.

tonight. I think that's what it is. sometimes. If I don't do that. decompression ritual, I go into my. default. But if I almost spend a moment. doing that, I'm like, oh, I actually. want to go on a walk, or I do want to go. and play sport tonight, or actually, you. know what, I will go out and go out for. dinner with my friends tonight, because. even though I think I'm out of energy, sometimes I only need 5 to 10 minutes to. regroup. >> That decompression is so critical, and I. would add regulation. >> Mhm. Like the the decompression often. needs to come first, and then the.

regulation. So, I'm going to add a. couple of things if I may. >> Please. So, one is a vibe check. So, I've been doing this quite a bit with my. partner recently where you just spend 5. minutes just like, hey, how's our vibe? Like what could I be doing more to. support you? Is there anything going on. this week that I could help you with? You know, how can I how can I be the. best possible partner? It creates an. atmosphere of giving and service that I. think can help with decompression and.

also with the regulation. You mentioned going for a walk. I live. in a forest in uh Marin County in. California. And we know that just 5. minutes. 5 to 10 minutes in the forest can. regulate your cortisol. So, we talked. about how a walk after having a meal can. make a difference in terms of insulin. and helping you with your glucose after. you eat. These hormones can come into balance. even with these really short rituals. Mhm. I love that. I love that. So, it it.

it always strikes me how simple the. solutions are to what seems like very. complex problems. I think that's one of the hardest things. for people because I feel like so often. the people we love or the people we grew. up with, our family, can often be the. greatest cause of stress in our life. And I don't mean when they need help or. support. I mean. they can say all the wrong things, they. can rub us the wrong way, they can make. us feel disappointed, they can make us.

They can make us feel almost the hardest. emotions because they know us the best. >> Yes. Are there hormonal impacts that. come with divorce? And are they. different for men and women? Such a good question. So, I completed my. divorce a couple of years ago. And so, I've been looking at the data on men and. women. Men tend to have. health. effects adverse health effects sooner. than women. Women often have health effects that.

show up later. But. 69 to 70% of divorces are initiated by. women. The most common age is women who are 40. plus. Most of the women that I work with say. that. the level of autonomy and kind of. healthier psychobiology. is worth the. short-term dysregulation that's caused. by divorce. And who deals better hormonally with.

divorce, men or women? I don't know from. a research perspective. Anecdotally, from what I've observed in myself and. patients is that women do better. Wow. What does it What does it do anecdotally. to men's hormones? There was this meme. that went around like a decade ago. It. was a a Stanford psychiatrist who wrote. an email that got spread around the. world, which was, "If you're a man and. you want to improve your health, be with a woman. Be married. If you're a.

woman and you want to improve your. health, be with your girlfriends." Like, it doesn't help women to be married. And so, I think. what we see is that men often don't have. a community of people that they're close. to, and they often rely on their wives. for that. Whereas, women are much more. likely to be leveraging oxytocin, the. hormone of connection and love, and. they've got more of a support system. Mhm. Now, there's economic consequences.

that tend to hit women harder, and I. think that maps to health, but I would. separate that. How do we create hormonal. distance even if physical distance is. not an option? Yeah, I love this. question. So, I'm going to riff with you. on it because I think you've got some. answers as well. So, I think understanding where your. vulnerabilities are is a good place to. start. You know, I think a lot about um. my daughters. So, I've got one daughter. who's 20, another that's 25. And.

I want them to be aware of their. sensitivities and vulnerabilities. They're both highly sensitive. I'm. highly sensitive. About 20% of the. population is highly sensitive. 80% is. not. So, we live in a world that is not. designed for people who are highly. sensitive. When you're highly sensitive. and you're around some of those people. that tend to trigger you or um tend to. pull you out of a state of balance, then. that's where you have to have some extra.

tools to allow you to not become. overstimulated. Or if you get triggered. by a family member or someone else, to. have the self-awareness and these. boundaries to be able to work with it. You know, one of the things that I think. is so helpful is. to never waste a good trigger. So, when. you're with someone and you're getting. triggered, then. that's showing you a place where you. still need to heal, right? It's showing. you a shadow side, some part of you. that's disowned, that you need to work.

with, some old childhood wound that she. still need to address and heal. What do. you think? How do you How do you deal. with this? >> Yeah, I know. I did I think that's a. really, really beautiful point and a way. of looking at it, and I think that. that feels like an evolution from the. first step, which is just I'm exhausted. and I need space. I think a lot of us. before we can look at what we can. change, we almost just need to change. our environment. And for me, whether.

it's. crafting alone time, space with people. who do lift us up. I've always said to. everyone that for every one person you. have in your life that causes you. stress, have three people that don't. And you can't change that person or that. situation, but you can change the. proportion of energy that you're exposed. to. And so, if you're exposed to three. people who lift you up and are good. energy and make you feel calm and are. good for your nervous system, even if. you have to spend 25% of your time with.

the other individual that does the. opposite, it's now in perspective. It's. It's It's a bigger group of people that. are lifting you up. Think Another thing. for me, I mean, I've been a big, big, big proponent of boundaries for people. because I think a lot of the time it's. our guilt that keeps us connected to. people who block our growth. If someone's holding you back, chances are you're holding on to them, trying to people please them, trying to.

make them know you're a good person, trying to make sure that they respect. and value you. And sometimes you have to. let go of those things. I think I've had. to be okay with letting people down. I've had to be okay with letting people. think whatever they want to think of me. I've had to let go of that perception. because it frees me from my own people. pleasing tendencies and allows me to. start crafting the life that I need. And. then that gives me the space to then. re-approach them with more respect, with.

more perspective, with the ability to. say, "Oh, maybe there's healing that I. need to do and evolution that I need to. have.". But that setting of boundaries has been. unlimitedly useful for me because I. found that I'm always the one getting in. my own way. And sometimes I need to move. far away from the person that I'm. blaming to realize that. Because while. I'm close to them, I keep pointing the. finger at them. But actually, when I. step away, I realize it was me. compromising my own values. It was me.

sacrificing my own boundaries. It was me. going against myself. And And then the final thing I'd add is. I think it comes down to really taking a. look at. what. really matters and what feels like a. waste of time. And I often find that so. much of what we get wrapped up in in our. human. feelings are so based on ego and envy. that don't really get us anywhere. And I. think for me,

I try and get to that point as quickly. as I can where I'm like, "Does this. matter? Do I really care? Is this going. to change my life?" And I realize that. even if I solve this situation, it would. not change my life. And so, why would I. waste any more energy on it when I could. be building something beautiful over. here? And that's usually my personal. go-to where. I realize that whether it's someone. disrespecting me or whether it's some. sort of fallout, even if I solved it, first of all, I don't think I could. solve it even if I tried. Even if I did.

solve it, wouldn't change the quality of. my life that much. So, why give it so. much weighting and why give it so much. value? >> It's so profound what you're describing, Jay. And it's reminding me a bit of your. um Princeton commencement speech because. I think you you had that opportunity. with these graduates in 2025 to share. with them some of the things you've. learned. And that piece of people. pleasing, I want to highlight for a. moment because. a lot of folks learned people pleasing.

as a way to adapt to a chaotic home. environment. >> Yes. Especially if you were quite young. when you were exposed to some sort of. traumatic experience. And. you know, 60% of men. have that. 70% of women have that as. children. The stress response comes out in. different ways. We think of it as fight. or flight, but it's actually much. broader. It's fight, flight, freeze, and. fawn. People pleasing is a form of. stress response where you are abandoning.

yourself. to be in relationship with someone else. So, it's an old pattern that we often. have to unlearn. And it's It's through. this process that you're describing of. coming up against that um. frustration, being triggered, like with. a family member or friend, that you. start to see that pattern. And then. I love how you described what I think of. as radical self-responsibility.

To look at your side of the street and. to look at what you can clean up. You know, I I've gone through um. a 12-step process with food. I used to. have a very dysregulated relationship. with food until I turned 40. And part of 12 step is really looking at. your side of the street and cleaning it. up. And another thing that we learned. that was so. um surprising to me was that. [Music].

if you have to choose. in a situation with someone else between. guilt or resentment, you should choose guilt. Now, as a mother, that was really hard. for me to do, because that's not what I. chose. for most of my life. And yet, it's a it's a way of of. witnessing the way that you tend to make. decisions, especially decisions that lead to.

resentment, that then are. a signal you might need to set a. boundary. Mhm. As a as a mother of two yourself, I. wanted to ask you about the hormonal. shifts that we all go through from being. teenagers. to 20-year-olds, to 30-year-olds, to. 40-year-olds. What are the. decades that have the biggest hormonal. shifts in our lives that we're not. paying enough attention to? Yeah, well, the first decade is 10 to 20, and that's.

when most of us are going through. puberty, if you're healthy or not. exposed to excessive endocrine. disruptors. And that's. that's a time of a lot of volatility. So, boys become men, they go through the. puberty process, they start making more. testosterone, their voice deepens. Women, girls go through puberty and they. start to menstruate. The systems that. control this, which are mostly in the.

brain, the hypothalamus, pituitary, and. how they talk to the adrenals and also. the gonads, so for recent women, uh. testes in men, that system is immature 10 to 20. Now, we often intervene in that that. time period, which I don't agree with. So, I like to give a lot of room for. this control system to get set up. I'm. not a big fan of giving birth control. pills, as an example, to girls who have. acne or regular periods or painful.

periods. There's so many other ways that. we can work with lifestyle first to. address that. So, right now, millions of girls between. 10 and 20 get started on birth control. pills. Hopefully, we'll talk more about. this and why I think that is the number. one hormone disruptor that we have in. this country. And then, if you look 20 to 30, that's the period where your control. system for hormones becomes more. stabilized. So, women often have more. regular menses. Men reach their peak.

testosterone, and so they often have a. lot of vigor. It's why athletes, you. know, I take care of um NBA players, and. 20 to 30 is really when they're at their. peak. So, performance, it's a time where you recover better. from exercise. It's a. a great place to establish critical. habits, like with food, with sleep, because if you don't sleep well, you're. going to fall down a hormonal flight of.

stairs at some point. So, that's when I. think people really need to dial in some. of the boring basics that really set you. up for the kind of hormonal homeostasis. that we're talking about. Now, in your late 20s, some hormones can. start to decline. In some of us, fertility can start to decline, egg. quality, sperm quality. So, 30 to 40 is when I like for people. to really focus on. um noticing any early signals of change.

So, that might be in a woman looking at. her day three of the cycle, estradiol, and follicle-stimulating hormone. FSH is. one of those control hormones from the. brain. Looking at your estrogen to make sure. it's not too high, not too low. Looking. at testosterone. So, for men, they may. want to check their sperm quality at. that time. They may want to look at a. baseline testosterone level, free and. total. So, that's when things start to get out.

of whack. And then, after 40, that's. when women especially start to have. symptoms of perimenopause. And there's. more than 100-plus symptoms associated. with that, mood swings, irritability, sleeplessness, um. noticing that uh your memory might be. changing. You know, you lose your phone, you lose your keys. So, perimenopause is. another critical piece to think about, but there's a smith that your hormones. don't change until you go through.

perimenopause and menopause or. andropause for men. The truth is, it. changes. decades before that. So, we want to be. paying attention throughout. What was. the male hormone word change? I've never. heard that ever. >> Andropause. >> I've never heard that word. >> Well, I'm glad you haven't heard of it, because that probably means your. testosterone is good. So, a lot of. people call andropause male menopause, and it's when testosterone starts to. decline. We're seeing this in younger. and younger men. Why? We think it's related to stress, like.

the amount of stress that we're. managing. We think it's also related to. toxins, endocrine disruptors, things. like bisphenol A is an example of. something that can lower your. testosterone, being exposed to forever. chemicals. I know you talked to Darshan. Shah about these. So, uh when it comes to men, the hormonal change of andropause is. gradual, and it can sometimes fly below. the radar. Whereas for women, the change. in progesterone that kicks off the start.

of perimenopause and then the decline in. estrogen is much more sudden. So, that's. why it tends to trigger so many more. symptoms. I wanted to dive into. something you mentioned earlier, which. was around birth control, because I. think this is a big topic for our. community and our audience. And you. mentioned there that so many. uh teenage women get given birth. control, especially for acne. Why was. birth control ever given for acne or. anything else that wasn't connected to.

birth control? Yeah, the number of. reasons that clinicians prescribe birth. control pills has broadened over time. So, when it was first developed, it was. for contraception, and it's very. effective for contraception. It's about. 90%. effective. You have to be a perfect user, like take. it at the right time each day. But what happened was that the. pharmaceutical companies that make birth. control pills started to look, especially as their their pills became. um off patent, look for other reasons to.

prescribe it. And I'm an OB/GYN, so I. was taught all these other indications. besides contraception to prescribe it. So, that includes acne. Why does it help. with acne? Because. the birth control pill raises this. intermediate hormone, sex. hormone-binding globulin, and that drops. the body's testosterone level. And that reduces acne that's related to. high testosterone. Now, a lot of. teenagers, women in their 20s and 30s,

have breakouts, they have acne. Some of. it is driven by testosterone, not all of. it. And so, going on the birth control. pill can help. But there's also lifestyle medicine that. you could do to address that. It's given for painful periods. It's. another reason that makes me crazy, because we know that. the reason why women have painful. periods is something called. prostaglandins are produced in the. uterus, the muscle of the the womb, and.

you can reduce the prostaglandins by. having more omega-3s in your diet. So, eating smash fish, for instance, salmon, anchovies, um. mackerel, uh sardines, herring, all of those. things help to reduce prostaglandins, and if you reduce inflammation, it can. help you with painful periods. Wait, so. you're saying that women don't always. have to have painful periods? No. And. this idea that pain is a normal part of.

being female and cycling is a myth that. we totally have to bust, because it's. not normal for your periods to hurt. Wow, I mean, that that feels like pretty. shocking information. Like, I mean, I. feel like that's a myth that or that's. at least a belief that has been around. for a long time and It's been around for. a long time, and I feel like if. if boys and men suffered the way that. women do with painful periods, we would. have solved it a long time ago. So,

the way that you eat, the supplements that you take, can. really make a difference in terms of. painful periods. So, even taking. omega-3s. at a dose of 1,000 to 2,000 mg can help. Having a diet that reduces inflammation, not just when you have your period, but. really for the week or two before, really makes a difference in terms of. painful periods. What are the lifestyle. choices that people could change for. acne and irregular periods instead of. going on the pill? When it comes to.

acne, I mean, first of all, know the. root cause. So, run a hormone panel and. see is it PCOS? Is it something else. that's driving it? But when it comes to. acne, you know, a common cause of acne. is having too much inflammation in the. body. I think of it, Jay, kind of like a. frat party, you know, sort of this party. that's happening in the body that's. going on too long. The party was fun. initially, and then it causes a problem. when it goes on for more than three. days. So, having an anti-inflammatory. diet, cutting out gluten, cutting out.

dairy, reducing sugar, can make a big. difference when it comes to acne. With painful periods, we think about the prostaglandins as a. driver of painful periods, but there's. also 10% of women who have endometriosis. as a cause of painful periods or. adenomyosis, which is where you have. um. endometrial cells growing in the muscle. of the uterus, and it causes pain. In those situations, you want to get a.

diagnosis, and you want to get it. treated. And there's lots of ways that. you can deal with it using lifestyle. medicine. You may end up on the birth. control pill. That might be the best. solution. But there's also surgical. options, even. um. laparoscopic methods that can treat the. underlying cause. So, there's lots of ways of dealing with. it. You don't have to jump to the birth. control pill. And I think the part that. bugs me the most, that troubles me the. most deeply, is that. we prescribe birth control pills to.

girls and women without giving them full. informed consent about the consequences. What should women know about the. long-term consequences of birth control. pills? They need to know first that it. reduces sex hormone binding globulin. So, that SHBG, something you can measure. in your blood, is kind of like a sponge. in the blood. So, it soaks up your free. testosterone. When you go on the birth control pill, some women don't notice any problem with.

their testosterone dropping as a result. of sex hormone binding globulin going. up, but other women do. So, about 25%. have decreased libido or vaginal dryness. because their testosterone is lower. Now, in women with acne that's caused by. testosterone, that's potentially a good. thing to drop their testosterone. But. here's the part that most women don't. know. When you raise sex hormone binding. globulin by going on the birth control. pill, and then you come off of the pill,

a year later, the sex hormone binding globulin is. still elevated. Not quite as high as it was on the birth. control pill, but it's still high. So, we're changing the hormone balance. in women in a way that may not be. completely reversible. So, that's one piece. Another piece is. that the birth control pill can raise. inflammation. So, if you use a marker of inflammation. like high-sensitivity C-reactive. protein, I know you run function tests, so I I.

know you measure your hs-CRP. >> Yeah, yeah. So, we know the birth. control pill can double to triple the. level of inflammation in the body. And a. lot of women don't realize that. A third. factor is. micronutrient depletion. So, that means. the birth control pill, just by blocking. some of these normal hormonal pathways. in the body, can deplete you in certain. nutrients that are really important. Magnesium, CoQ10, vitamin B's like B2,

B6, B9, B12. It can cause problems with mitochondrial. function. And so, this is never part of the informed. consent, and I think it should be. Like, we should have eyes wide open going in. and seeing what this what can result. Now, the microbiome can also be affected by. the birth control pill. In fact, um one autoimmune disease, Crohn's. disease, the risk of it is increased by. going on the birth control pill. But.

women who get diagnosed with Crohn's. disease often don't get asked, "Hey, did. you get started on the birth control. pill when you were 16?". So, I think women deserve to have. choice. I'm not removing the choice of. birth control pills. There's time and a. place for it. But I think women need to. know what the risks are. I mean, hearing that feels scary. I. mean, the amount of. you know, there's not just one or two or. three side effects. I mean, there's so. many consequences that you've just.

reeled off. If a woman has been on the. birth control pill. since she was a teenager, and she wants to reverse some of this. that's happened to her, what should she. be doing? Well, there's a lot of things. you can do. So, first with the. micronutrient depletions, that's. probably the easiest place. Start a. multivitamin. Now, you could measure and. see if you're depleted in any of these. micronutrients, and then adjust. supplements to address that or your. food. But I would say.

the simplest hack is to take a. multivitamin. The other uh thing that women can do is. they can. measure inflammation in their body. And. if their inflammation is increased, they. can address it. You can address it with. an anti-inflammatory diet as an example. If you're someone who is having. low testosterone symptoms, you can. measure your free and total. testosterone. You can measure your sex hormone binding.

globulin. See if you're one of those. women who's affected. Now, there are. some women who can stay on the birth. control pill, and they can address some. of these side effects. But then there. are other women who say, "I'm done with this." Like, the one that. really gets women is that the birth. control pill can shrink the clitoris by. 20%. 20%. Now, most women do not want that. So, if I have a woman who's on the. fence, she's not sure if she wants to. continue the pill, that often seals the. deal.

So, what I usually advise women who are. interested in coming off of the birth. control pill, but they still need. contraception, is to choose something that's. non-hormonal. like the copper IUD. It seems like a. hormone is something that shouldn't be. artificially messed with because there's. so much going on anyway, and there's so. many shifts that are going on decade by. decade by decade, that when you start. playing around with it, there are so. many long-term effects. And I wanted to. ask you, does the birth control pill affect. fertility? So, the effect on fertility.

is mixed. There are some women, you. know, I've been taking care of women for. 30 years. There are some women who come. off the birth control pill, and it takes. them a year longer to get back into a. normal ovulatory pattern where they're. producing an egg each month. There are other women who come off the. pill, and they get pregnant right away. I mean, there are women who get pregnant. on the pill. So, there are some women in. whom fertility is affected, and some. women for whom it is not. And what do. you think that is?

What do we know that that is? What. what's making a difference there? Is it. health in different areas? Is it. I don't know that we understand it. completely, Jay. I mean, this is part of. the work I do in precision medicine is. trying to understand, you know, when you start a pill for. somebody, whether it's the birth control pill or a. statin, who are the people who are going. to benefit the most with the fewest side. effects? Now, I was taught in mainstream medicine. that you make a diagnosis, you know,

someone who wants contraception or has. um endometriosis, and then you prescribe. a pill. But. that is really a way of practicing in. precision medicine. In precision. medicine, we personalize. We understand. the measurements for the individual. We. understand your values and understand. what might work the best for you before. we have that knee-jerk response to write. a prescription for a pill. I mean, I. mean, you you mentioned function there. That was one of the reasons why I.

invested in Function Health was because. I wanted people to have more precision. in how they took their health into their. own hands. And I just found it was so. hard for people to get those kind of. tests done and find access to it and. give people the ability to have their. results and be able to talk to their. doctor and say, "Hey, here's what I'm. seeing. Here are my 200 lab results. What looks odd and what doesn't?" And. And And it's hard. It's it's hard for.

people to have to own that process. because if you're not educated and. trained as a doctor or as a. professional, it's even as For me, I. find it so complex to look at all of. these data points and make sense of it. And I feel fortunate enough to have good. doctors and good professionals around. me, but I felt at least as a starting. point, Function Health allowed people to. have that and and have the right. conversation. It's a critical starting. point, and it's, you know, I think that. putting the power of testing in the.

hands of the individual is critical. because there are so many people who are. failed by mainstream medicine. And I'm. not throwing mainstream medicine under. the bus. I trained in it. Some of my. best friends are still working in the. mainstream system. But there are a lot of people who are. failed, who don't get an early diagnosis. of autoimmune disease, who don't know. that their thyroid is not working, who. don't know that their cortisol is two to. three times what it should be. So, to. put that testing in the hands of the.

individual, I think is so important. And. you mentioned something else that I. think is is critical here, and that is. yes, there's complexity to the hormone. system, but there's also an exquisite. simplicity. And a lot of the things that, you know, come back to the foundational. aspects of a life well lived, of. lifestyle that's managed for the. individual,

help you with your hormones. So, yes, there's complexity, but there's also a. simplicity here. You know, getting the. right amount of sleep, 7 to 8.5 hours. every night, tracking your deep sleep, tracking tracking your REM sleep, knowing how long it takes you to fall. asleep. Normal is 10 to 20 minutes. If. you're falling asleep before 10 minutes, you probably have sleep debt. Mhm. Knowing what's going on with your heart. rate variability, knowing about relationships and how. critical they are to your hormonal. balance, knowing about your metabolic.

health because more than 93% of. Americans are metabolically unhealthy. So, not outsourcing that to your doctor. because you're really your best your. best doctor, right? I mean, you spend. less than 1% of your time in a doctor's. office. So, living your life and kind of. tracking how these measurements can. reflect the way that you're living your. life, and then allowing you to course. correct and code switch, that's very empowering. You're so right. That what you just said really hit me. The idea that you only spend 1% of your.

time in your doctor's office and to. expect that 1% to positively impact the. 99% of life. Well, that and I mean the. cool thing here is that I feel like. younger people are changing this. >> 100% yeah. Which I totally love. You. know, like I'm I'm Gen X and my. my generation was okay with being. dismissed by physicians. I mean not. totally, but baby boomers especially. But it's the younger generation that is.

really wanting to own their health and. participated in a way that. we've never seen before. Millennials, Gen Z. They're saying, you know, this. idea that I go to see a doctor once a. year and that's when I get a few hormone. test hormone test or they get told by. their too much." No, they're they're. like, "That's not how I want to live my. life. Yeah. I want a different path.". Absolutely. Absolutely. For those I mean.

this this question I thought was really. important that there's a growing. movement for natural birth control. especially amongst younger people. or or ditching the pill. So, what are. the most effective forms of natural. birth control and are they as effective? The key way of doing natural. contraception, natural family planning. is what is called is to be able to track. your cycle. So, this is assuming that women have a. healthy regular menstrual cycle. And if. that's the case, then you can track your. temperature, you can use wearables to.

understand when your fertility window. is. And then you can have outer course. during that time of your fertility. window. This is a family show, so I'm. going to be careful about my language. That's it. >> So, that's one way. But I would also. say, you know, something like a copper. IUD and we're seeing younger and younger. women use a copper IUD. That is a form. of natural contraception. And here's the. part that is so important. I want to. shout this from the rooftops. Women who have an IUD are more satisfied.

with it than any other type of birth. control pill. And what way and why? They're just they don't have to think. about it. They don't have to take a pill. every day. It's not messing with their. hormones. It's not. um you know, they don't have to worry. about uh unprotected sex. They There's a. level of security. There's level of. being symptom-free. So, it is the highest level of. satisfaction. And yet it has the lowest usage. So,

there's a total disconnect that we have. to change. Wow. I mean and and is it. growing fast or is it not? I'm not as. fast as I would like. I feel like an IUD. crusader. So, yeah, let's get more. people to get their IUDs. >> Yeah, well you're telling everyone here, so. I think. I think you're going to see a lot of. searches Excellent. on ChatGPT and and. Google with it. There are so many women. that are scared of getting an IUD. because of how painful the process can. be. What are your suggestions for that?

You've got to find a doctor who's. willing to give you some numbing. medicine. So, I've put in probably 5,000. IUDs over the course of my career. I. always do a cervical block. Why? Because. the uterus, the cervix in a woman. is our deepest, most sacred part. So, to. go stick an IUD through the cervix up. inside the uterus with no pain medicine, that's criminal. Like I I don't agree. with that at all. So, find a doctor who.

will give you some numbing medicine. And then. another strategy, I'm a big fan of using. other ways besides medications to help. you relax and be able to adjust to. having an IUD inside your uterus. So, meditation, hypnosis, breath work, having a clinician who's talking through. what they're doing so something doesn't. happen all of a sudden and set off a. fear response, fight, flight, freeze. Use some of these other strategies.

Use breath work. Use hypnosis. It's been. studied to help with pain and to reduce. the pain response. You can also use some. of the lifestyle strategies that reduce. inflammation so that you don't get as. much inflammation to having the IUD. inserted. And the other thing I wanted. to ask you is about is there a. difference between. the hormonal IUD and the hormonal birth. control pill? Would you still recommend. the IUD in that consideration?

I would. I mean my preference first and. foremost, probably my first three. choices would be copper IUD, copper IUD, copper IUD. But there are some women who. have really heavy periods or they've got. some other reason that a hormonal. IUD is a better choice. So, it doesn't. mess with your hormones quite as much as. an oral contraceptive does. It still has. um in about 5 to 10% of women, up to.

20%, it can have systemic effects. What. the makers of the hormonal IUDs say is. that. the hormones are local. So, they're just. released inside the uterus and they. don't affect the hormones in the rest of. body. That's true for some women, but. not all. So, I still think that the. hormonal IUD is a a second choice to the. copper IUD and definitely better than. the oral contraceptive.

If there are women that are struggling. to. transition from the birth control pill. to being able to conceive, what. lifestyle changes would you encourage to. help with fertility? Like what what what. can people do if they're struggling. right now? Well, this is where what I like to think. of as the boring basics are so. important. So, really dialing in your. sleep, tracking your sleep, understanding your stress response. because. when you want to have a baby, when.

you're heading toward that phase of. fertility, you want to make sure that. cortisol is not impacting the way that. your hormones are produced. And these. hormones are not a democracy. It's not. like cortisol is equal power as. progesterone and estrogen. Cortisol is. really at the top of the hierarchy. And. so, you will make cortisol no matter. what. Your body doesn't actually need to. make estrogen and progesterone to. survive, but you have to make cortisol. So, when you're getting ready to. conceive and you're transitioning to it,

nutrition is so important. So, one of. the things I like to do especially to. avoid micronutrient deficiencies, which. become more of a problem if you've been. on the birth control pill, is to make. sure you get five to seven colors of the. rainbow with your vegetables and fruits. each day. That's one of the ways that. you can avoid micronutrient. deficiencies. Nutrition is so important. It can sometimes be helpful to look at. some of your genes, your genomics. because some of us, myself included,

need more certain B vitamins. You may. want to start a a prenatal vitamin for 3. to 6 months before you start trying to. conceive and that helps to replace those. micronutrient deficiencies that could. potentially cause a problem in a. pregnancy. So, you want to avoid that. Another piece that I think is really. important is to measure your hormones as. soon as possible. Like don't wait until. you've been trying in earnest for 6 to. 12 months before you get your hormones. tested. And this is one of those.

situations where women who are trying to. conceive have been trying for a year or. they've been trying for 6 months and. they're over the age of 35, we check every hormone. Now, women who are not trying to. conceive, that's a situation where they. often are told, "Oh, no, they vary too. much. We don't check them." That's a. double standard. So, I I think all women. deserve a hormone panel regardless of. whether they're trying to conceive or. not. The other question I wanted to ask. you is I'm seeing a lot about balancing. hormones and cycle syncing for women on.

social media. Are these trends. scientifically grounded? Like is there. value in that? So, the data is pretty. limited. You know, I'm I'm a researcher. I I really think about the hierarchy of. evidence, Jay. You know, the the highest quality. evidence that I was taught at Harvard. Medical School is the randomized trial. The problem is randomized trials are. really designed for looking at drugs. like statins. What I was also taught at Harvard is. that even better than the randomized.

trial is the end of one experiment where. you serve as your own control and you. have an intervention like cycle syncing. So, there's not a lot of data on cycle. syncing. I think it's something that you. could try for 4 to 8 weeks and see if it. makes a difference. Got it. Now, when we. think about some of the hormones and and. sort of the natural cycle of your. estrogen production and your. progesterone production if you're. female, your testosterone production, which tends to peak around day 9, 10, 11,

what we know is that it makes sense to. change your fitness goals as an example. depending on where you are in the cycle. It may also make sense to change how. many carbohydrates you're consuming. depending on where you are in the cycle. So, I think there's better evidence for. that. But in terms of, you know, seed. cycling or some of the other strategies. that are used, I would say not as much. evidence, but lack of proof is not proof. against. So, do the end of one. experiment. I'm hearing that more and.

more now and it's so refreshing to hear. you say as well with all your incredible. expertise, research, the amount of work. you do with individuals of just how. focused it has to be on you. and and the individual and what your. experience is and trying things out. And. I think we all get mad at diets or fads. or trends or whatever it may be. And the. truth is that might work really, really. well for one person. And they're sharing it and saying that. it helped them. And hey, there may be. thousands of people that it helps, but.

that doesn't mean it's going to help. you. And that doesn't mean that trend or. diet or whatever didn't work. It's just. that it didn't work for you. And when we. take our. health into our own hands, I think we. get into that feeling. I mean, I I had. that experience with protein recently. I. was taking as much protein as everyone's. being recommended to take, and it was. just too much for me. I didn't enjoy it. physically. I didn't enjoy it from a gut. perspective. I felt bloated and heavy. all day. And I'm so much more happier. having 100 g of protein a day than I was.

having like 120 or 130 or whatever it. was. And it was just too much. And And. it was only something that I had to do. by testing. I I couldn't have known. that. And I don't think the number. that's out there is wrong or bad. It's. just that it didn't work for me. I I. wanted to ask you if if there were women. right now who want to transition away. from the birth control pill, how do they. do that safely? I would say first, run. some measurements. So, look at. micronutrient deficiencies, what's going.

on with your testosterone. Look at the sex hormone-binding globulin. level. Take a look at your thyroid function cuz. the birth control pill can affect that. as well. And then I would come up with a bridge. Like, what's the transition plan? If. you're going to come off the birth. control pill, you might want to get an. IUD inserted before you come off the. pill. Like, make sure the IUD is a good. fit for you before you come off of it. So, I think coming up with a bridge, talking to a collaborative clinician.

who's not just going to do power over. and saying, "Oh no, you have to stay on. the pill." But someone who says, "Yeah, I get it. I understand. You don't want. the inflammation. Yes, the micronutrient. deficiencies are real. Let's track your. hormones and see what might be a better. fit for you." So, I would say build that. bridge. And it can take some adjustment. It's kind of like shoe shopping, Jay, where you know, sometimes you buy the. shoe and it's the perfect fit and you. buy three more pairs because they're. fantastic. But sometimes you have to.

futz a little bit and find the right fit. for you. I feel like Sarah, talking to. you, you have such a medical. research-based background, but you also. have such a spiritual, awakened self. And I wanted to ask you, what how have. those both together worked in your. favor? And how have they supported and. complemented each other? Well, I feel. like spirit is such a critical part of. how I take care of patients. It always. has been. There was a way that. it would be more suppressed when I was.

in a conventional medical system. You know, a big part of the way that I. take care of people is from the heart. You know, so many of the the patients. who come to me. are in a state of fear. or a state of dysregulation. And they don't want, you know, the top. 10. cognitive strategies for how to get. their insulin back in a balance. There's a way that they need to be met. and seen and heard first.

So, it's not everything because people come. to me because they want some answers or. they they at least want to talk through. the problem and kind of solve it for. them. But it's a through line of everything I. do. And then. secondly, another piece, and I would. love to hear your comments about this. I'm someone. probably because of childhood patterns. I had a lot of early childhood trauma.

before age three, which tends to lead to. more dysregulation than other people are. exposed to trauma. I'm someone who would burn out. constantly. So, this was mostly in my 30s. Like, especially once I started having kids. I. had my first kid at 32. And I would work hard, hard, hard, come. home exhausted, have that glass of wine, didn't work. And I would be facing. burnout. And in my 30s, I would plan.

these increasingly more elaborate. vacations as a way of trying to bypass. the burnout. But what I needed to bring in was spirit. and meaning and purpose and this heart. connection and really seeing the person. in front of me, not, you know, doctor-patient, but. here's this beautiful person and my job. is to serve them and to understand what. their gifts are and to understand their. values and not to impose my values, but.

to to really bring a sense of wholeness. And to help to activate their own. healing capacity. So, that's different than the model that. I was taught. in medical school and at UCSF in. residency. But it's what works for me. and it helps me avoid the burnout that I. had in my 30s. It's incredible. It's It's so wonderful. to hear and. so much of what's needed, I feel. They're two worlds that are seemingly.

opposite to each other and are often. pitted against each other. And there's a. debate about which has more value to. offer. But I I really do believe it's. the the synergistic approach. and the synchronistic approach that. actually helps people the most because. there's value in both of them. And. yeah, you asking for me, I I relate to. everything you're saying. I feel like. spirituality, spirit, philosophy gives. me the map of. why I'm going where I'm going and where. I'm going and why I'm here.

But then the. more physical aspects tell me what to do. each day and how to function in the real. world and. what it takes to. work in the real world, but not be of. this world. And And I think that is the paradox and. the juxtaposition of everyone's life. where we know we are more than what we. see and. what's here, but we're living here. And. knowing the skills to operate where we.

are. and the perspective to recognize this is. not all there is. You need both of those to function. I think if you only have the skills to. function here, it can feel meaningless. You can be overworked, overwhelmed. You. can feel purposeless. And if you only. have purpose and you don't know how to. function here, you kind of feel. disconnected, unrelated, and can kind of. create a lot more problems as well in. the immediate world. And so, I think. both have to go together. And. trying to walk those two paths in.

parallel looks like a paradox, but. it actually creates great harmony. It does. There's a synergy. that I think you're speaking to that's. so critical. And I love how your voice. got a little deeper and slower and. quieter as you talked about this because. that cartography that you talked about, you know, kind of the map of purpose and. how that evolves over time, spirit is such a critical part of that. And it's, you know, it's not.

I don't wake up in the morning saying, "Okay, here's what my spirit is going to. do." Like, it's getting quiet enough and. regulated enough to let it flow through. me. I appreciate that. >> Yeah, love that. Me, too. Uh Sarah, we end every episode of On. Purpose with a final five. These have to. be answered in one word to one sentence. maximum. Uh so, Sarah Sal, these are your final. five. The first question is, what is the. best advice you've ever heard or. received? Get curious, not furious.

I like that. That applies to so many. things. That's great. Uh question number. two, what is the worst advice you've. ever heard or received? Hormones can't be measured. They change too much. They fluctuate too. much. It's a waste of time and money. Question number three, if you. could encourage everyone who's listening. and watching right now. to change one habit over the next 30. days, what would you ask them to do? Or practice one habit over the next 30.

days, what would it be? Look at your stress response. Track it. Maybe start with heart rate variability. I think it's important to know what's. true for you. And then to set up these little. experiments and have one experiments. Like, I find, for instance, certain Zoom. meetings raise my HRB. I want more of. those people. As you said, three to one. Yeah. Yeah, I know. That That's such a. great answer. I I. couldn't agree with you more. I'm. constantly trying to figure out where my.

stress is coming from and. how you can do less of that and move. away or get curious about why it's. stressing you out and what it's. triggering. Question number four, what's something. you used to believe to be true about. health, but you don't agree with. anymore? I used to believe that. you should suck it up and stay, no. matter what. Especially when you have kids. And there's a health cost for some of us.

that we need to acknowledge. To suck it up and stay. Yes. >> It's okay to leave. It's okay to leave. When you suck it up and stay, often. there's a self-abandonment. that occurs. That is not good for your spirit. It's. not good for your hormones. Has a lot of. downstream consequences. Don't sacrifice authenticity for. connection. Yeah. Uh fifth and final question. We ask this. to every guest who's ever been on the. show. If you could create one law that.

everyone in the world had to follow, what would it be? Regulate yourself. And then decide. Don't make decisions from a dysregulated. state. Like, start to really learn what your. body feels like, what you notice when. you're disregulated, when you're in fear. So, regulate first, then decide. It's a great answer. I love that. Uh Dr. Sara Sall, thank you so much for joining. me today. Uh the book that Sara.

recommended, if you loved this. conversation, is called The Hormone. Cure. Go and grab a copy if you want to. learn more about how to take your. hormones into your own hands to actually. be able to have an impact and control on. your health and well-being. Please go go. get tested. It's never too early to get. tested. I think it's so important to be. working from a place of data and. insight, rather than guessing and. wasting so much time and money and. energy trying to figure it out. And. again, Sara, I hope you'll come back uh. to share more great insights with us. I.

learned so much from you today, and I'm. so grateful for your work, your heart, and this your spirit, and the way you. show up. So, thank you so much, truly. Thank you, Jay. Such a pleasure. Thank. you. If you loved this episode, you'll. enjoy my interview with Dr. Daniel Amen. on how to change your life by changing. your brain. If we want a healthy mind, it actually starts with a healthy brain. You know, I've had the blessing or the. curse to scan over a thousand convicted.

felons and over a hundred murderers, and. their brains are very damaged.