Episode 084: Beyond the Pill: Post Birth Control Syndrome and Women's Hormonal Health with Dr. Jolene Brighten

Episode Beyond the Pill: Post Birth Control Syndrome and Women's Hormonal Health with Dr. Jolene Brighten

In this very important episode, I'm joined by Dr. Jolene Brighten. Dr. Brighten is a Functional Naturopathic Medical Doctor and nutritional biochemist with a focus in women’s endocrine health. She is recognized as a leading expert in Post-Birth Control Syndrome and the long-term side effects associated with hormonal contraceptives.

Dr. Brighten is the author of Beyond the Pill, a 30-day plan to support women on birth control, help them transition off, and eliminate symptoms of post-birth control syndrome.

We discuss:

  • Why the pill is problematic

  • What is Post-Birth Control syndrome & what to do about it

  • How it’s connected to mental health, heart disease, cancer, as well as acne, poor gut health, Leaky Gut Syndrome, adrenal and thyroid dysfunction, SIBO, overtraining and more



+ Click Here to Read the Episode Transcript...

Naomi Nakamura: Welcome back to the Live FAB Life Podcast, I'm your host Naomi Nakamura, and today I have a very important episode for you.

While I believe that every episode of this show is valuable and important, this one, this one holds an extra special place in my heart because if you are familiar with my story, then you know that in my own journey I have experienced adrenal dysfunction, hypothyroidism, which is a low functioning thyroid, poor gut health and leaky gut syndrome, acne, over-training, poor liver function, SIBO, which is small intestinal bacteria overgrowth and there's probably a handful of other things that I'm forgetting right now.

And over the years as I have dugged into these things to try, and understand what was going on with my body and I came to discover functional nutrition and taking a functional approach to health, I have searched for what the root causes are for all of these things and try to figure out how they are all connected, which by the way they are.

And it has taken a lot of time and energy to piece together all of the information and learnings that I have come to collect along the way. And this is years and years of work, but I'm really happy to tell you that you don't have to do that, because there is a book that came out earlier this year called Beyond the Pill, and in my opinion it is the gold standard on women's health because it connects all these things together for you, so that you don't have to go through all of these different resources that I went through and try to figure out how they all work together. It's all connected for you in this book.

And today on the show we are so fortunate to have the author of this book, Dr. Jolene Brighten joining us on the show. Dr. Jolene Brighten is a functional and natural pathic medical doctor and a nutritional biochemist, and she focuses in on women's endocrine health. She's recognized as a leading expert in post birth control syndrome and the longterm side effects associated with hormonal contraceptives.

Dr. Brighten is the author, like I said, of this book Beyond the Pill: a 30-day plan to support women on birth control, help them transition off and eliminate symptoms of post birth control syndrome. She is a speaker, a woman's health advocate, and a medical advisor for one of the first data driven apps to offer women personalized birth control recommendations. So in this episode and you guys, it is such a good one, doctor Brighten explains how and why birth control pills are problematic for women's health. She explains how it's connected to things like mental health and brain function and cardiovascular disease, and even cancer as well as all of the things that I mentioned that I struggled with myself. Be acne, the poor gut health, the leaky gut syndrome, the adrenal and thyroid dysfunction, SIBO and even over-training, which I think I have not done a good job of explaining how that's connected and she so eloquently pulled it out together.

And she also explains what steps to take to help your body recover from post birth control syndrome and all of these things that are associated with it and a whole lot more. So as you can imagine, there is so much information that we cover, so much more that could be covered and really our interview just really just skim the surface of everything that could be talked about. I mean, I probably could talk to her for hours about all of this, but since we can't, I highly recommend that you check out this book, is the book that I recommend to all of my health coaching clients and you can find the link to it over on the show notes as well as how to connect to doctor Brighten. She's active on social media, her website's fantastic with resources and she also has book bonuses for those who purchased her book, and all of that information is linked over on the show notes at www.livefablife.com/084, for Episode 084.

I cannot convey to you how important this episode is to me given my own health history, but also how important it is for you too. So with that, let's get to the show. Hi doctor Brighten, welcome to the show.

Dr. Jolene B.: Hey there, thanks so much for having me.

Naomi Nakamura: I am so excited to have you, because I've followed your work for quite a few years. I was first introduced to you through, I studied under Lara Adler and Andrea Nakayama, so I feel like this is a like a celebrity moment for me.

Dr. Jolene B.: Oh man, you know it's really funny, I was just hanging out with Lara Adler yesterday and we were, yeah, I was hanging out in a friend's basement with her. We actually, we lost a dear friend that we just hang out on Monday, so we had girls powwow. And it's funny to me that you're saying this is celebrity moment because for everybody listening, there was actually a meltdown by my child before this happened. And I'm talking to you right now, I have wet hair, I have no makeup on and I'm managing a six year old on my own. So it's kind of funny that you're like, "This is a celebrity moment." And I'm like, "Well, I hope I didn't disappoint because this is real life."

Naomi Nakamura: These are my favorite kinds of interviews.

Dr. Jolene B.: I know I was on, yesterday did an Instagram live, and I simultaneously did YouTube live, and my son had a meltdown. So for people who don't know, he has PANDAS, which is a pediatric autoimmune neurological disorder. So his immune system flares his brain, and then he has issues, and he had a meltdown and was screaming and I just, I'm like, "You know what? I could try to have a perfect life, and you know, only go live and do everything I need to do when everything is perfect." But like life is so unpredictable that I'm like, "You know what? We're just going to be real, and we're just going to live our lives, and I'm going to show up and do what I can in this world, in this work that I do." And then, you know, I've actually had a lot of people reach out that are like, "Thank goodness that your life is like as crazy as mine." I'm like, "Oh cool." Like, it's not just me.

Naomi Nakamura: No, I think we all appreciate that.

Dr. Jolene B.: Yeah, totally.

Naomi Nakamura: So earlier this year you published this phenomenal book and this is the book that I wish I had, because I can't even tell you how much it describes my own personal health journey. But your book Beyond the Pill: A 30-Day Program to Balance Your Hormones, Reclaim Your Body and Reverse The Dangerous Side Effects of the Birth Control Pill. This is the book that as a health coach, I recommend to almost every single one of my clients. And I'm so excited to have you on just to share about it, because this is information that women need to know.

Dr. Jolene B.: Yeah, no, totally. And you know, you are not the first person to say to me, this is the book that I wish I had. And whenever women say that, I'm like, "Yeah, me too." And because you know, when we got taught about sex ed and by we, I mean women, like the extent of the, and really the undercurrent was this dogma and the story that being a woman is inherently awful. That we, our bodies are betraying us, that getting your period is something to dread and your hormones just hate on you. And the reality is, is that, and a lot of focus on the period, right? And not a lot of focus on ovulation, which is really the main event. I mean, that is why we have periods is because we ovulate and then we don't conceive.

And it's very much like a turning of the tide that's right now, where you know, when I started talking about birth control, you know, several years ago there was really no one else out there talking about it. And when I started up the conversation, I mean as far back as like eight years ago, I got a lot of haters. Like people were like, "What are you doing?" Even questioning this. And I would say, you know, I would say much of what I say today, like we don't know a whole lot. Like we are giving women birth control for decades on end and not questioning what happens in their bodies longterm. We are interrupting young women's menstrual cycles at a very, very young age not questioning what does that do, what are the later outcomes of that? And we are disrespecting women's bodies. It's like before medicine even attempted to really understand what's going on, they tried to conquer and suppress us first.

And once they have the tool to suppress our hormones, they were like, "Job done, we won." And I think a lot of women are waking up. I mean, I certainly woke up in my late twenties to like, "Wait a minute, I'm supposed to be having a period. Like there are all these natural things that my hormones do for me and they, I think they can work for me and yet I'm suppressing them every day. Is this really the best thing to be doing for my body?"

Naomi Nakamura: Yeah. I was put on, actually I was put on antibiotics and other medications for acne when I was 14 years old. And I stayed on those things for about 15 years until they stopped working. And then I was put on birth control, because my acne medication wasn't working and I stayed on birth control for 10 years and during that time I did not have my period at all in 10 years. And I thought it was the greatest thing, because it was something that I didn't have to deal with and I kind of knew it was something that maybe wasn't right. And I did have that conversation with my doctor and she said, "Oh, you're fine, you're fine." And it was like you said, it was an awakening for me because I, you know, as I started to have things like leaky gut and gut issues and SIBO and thyroid. I kind of started, I didn't have your book so it was a whole bunch of piecing together information on my own-

Dr. Jolene B.: Totally.

Naomi Nakamura: And realizing like, "Wait, all this stuff is connected," and then wondering what to do next.

Dr. Jolene B.: Yeah, and what you're talking about right there, your experience is so much like so many other women's experiences, which is why we all need to start sharing our stories and get our voices collectively a lot louder, because it's just an upstream issue here. There's what doctors are taught and what they're not taught, and it is not founded in science to tell women that putting your body on mute, your reproductive system for decades on end or you know, skipping a period for 10 years because you're shutting down brain ovarian communication, there is no data, there is no evidence based medicine to say that's totally fine.

Now when you're on hormonal birth control you're not having a real period. So you know, it's true that like, okay, what's the point of the bleed when you're not actually having a period? But it does lend itself to the question of like, what happens when you don't ovulate for 10 years? What happens when you don't ovulate for your entire reproductive life? Like we have not answered that question, yet doctors are taught, this is fine, this is safe. And it's a disrespect of the reproductive system that women have, is that, "Oh, all these other systems in the body are super important, but your reproductive system, that is something to be shut off and discarded." And I think it's a little bit from the mindset and the idea that like there will come a time, there is a season when all of our ovaries will quit with the ovulation, like that comes. But that doesn't mean that, that artificial induced state of, you know, essentially like a menopausal state. And I'm not saying birth control is menopause, but it is this artificial hiatus of ovulation, we don't know. We don't know.

And it's something that really when I started talking about all of this, and that was one of my big concerns. Is that I spent 10 years on the pill, there was so much I didn't know it was doing to my body and there's so much we don't know and we've never questioned, and it has been almost as if questioning is anti-women and so we hear that from like our sisters, from our people, our tribe, where they're like, "Oh, questioning, what are you questioning women's rights?" Then we go to the doctor and we question these things and our doctor's like, "Well, excuse me, I have this dogma I'd like to feed you now, I will say evidence based medicine over here as I dis your diet, but when it comes to birth control, I really don't have the evidence but I'm going to go ahead and tell you that it's totally fine. It's totally safe to do this."

And there's this big question in my mind. I mean, only in the last handful of years have we started to explore what is happening with the brain while we're on birth control, and this is something where I have to pause in saying, okay, well we know that 66% of the patients who have Alzheimer's are women. What role has hormonal birth control played in neurodegenerative disease? Because without our natural hormones, we don't have the same benefits in building the Myelin Sheath neuroplasticity, like all of these things that lend itself to bring longevity. The other thing we don't have evidence on is how does birth control affect the mitochondria? Now this is important because, so you know, and there's a lot of things that when I talk about it, people are like, "This is just, you know, this is you speculating." And it's like, "Yeah, that's where we begin."

We begin with asking questions, we begin with building curiosity. Then we dive deeper and we understand, we know that hormonal birth control depletes CoQ10. We know that if CoQ10 is low, women have advanced aging of their eggs, so we're talking infertility. We also know that the mitochondria need CoQ10. We know that hormonal birth control acts similar to antibiotics in terms of its impact on the microbiome. So for people who are wondering what the heck is a mitochondria, mitochondria are these organelles that are powerhouses in your cells, so that means they make energy. As a woman they're concentrated in your brain and they're concentrated in your ovaries. They rely on CoQ10, which is an antioxidant and several other nutrients to be able to do their job. They're also from the lineage of bacteria. So we understand on the evolutionary perspective, they actually developed from bacteria, which is why antibiotics can be so harmful to your mitochondria.

As we age and our CoQ10 declines, our mitochondria run into some dysfunction and their aging as well, and they're not producing energy the same way in our ovaries, which is part of why there's that link between aging and difficulty conceive or infertility. So if we know this, when we know that birth control is decimating our microbiome and wrecking with our CoQ10, then we can start to ask questions around what else could it be doing in the body in terms of brain health. And we have to start asking why is it some women struggle with fertility when they come off of birth control. And this is the biggest thing that is told it, we're all told it's a myth. We are all told every day, all day, "Yo, this is a myth that it could ever impact your fertility." But in reality there are some mechanisms that may very well lend itself. Not that birth control causes infertility, but that it can contribute to why it's difficult to conceive.

Naomi Nakamura: So let's just get into all of that. So when it comes to birth control pills, what are some of the biggest issues that can happen for someone who is taking the pill, especially for such a long, prolonged period of time?

Dr. Jolene B.: Yeah, well some of the things that most women think about are stroke, heart attack, cancer. So those are the three big scary ones. We start to think about alarm, but there's these other ways that birth control works on your systems. So even though, I want women to understand, although it's designed for your reproductive system, it actually impacts every single system in your body. So it can lend itself to gut issues. So it induces intestinal hyperpermeability, which is one of the three things that we need to induce a autoimmune disease. So I'm not saying specifically that hormonal birth control caused autoimmune disease, but it can be a contributing factor. We know hormonal fluctuations can trigger an autoimmune disease.

We know from a Harvard study that came out that women who use hormonal birth control for five years or more, and they have a family history of Crohn's disease, are at 300% increased risk of developing Crohn's disease. So that is no joke, clearly something that women need to be aware of. The other thing that's really startling is the effects on insulin resistance and diabetes. So six months or more on hormonal birth control, and we're over 30% more likely to develop diabetes as we enter into menopause. So this is one of those things of like what you did in your 20s or as a teenager can catch up with you in terms of what your health is like as you age.

Naomi Nakamura: So related to insulin resistance and all of that, one of the biggest, I guess, I think we all kind of know this when we consider like, "Oh, should I go on the pill?" It's the whole is it going to make me gain weight. So can you talk to us a little bit about that? Is it a myth or is it not?

Dr. Jolene B.: Oh, totally. So this is another one of those things where people say, "Oh, it's a myth. It's a myth that birth control caused you to gain weight." Sometimes you even hear, and I think this is a very unkind thing to hear "Experts" saying is that, "Well you started birth control because you were in a monogamous relationship, and so because that you just let yourself go." I'm like, "What did you just say? That did not just come out of your mouth." So here's the reality. When you look at the research on the surface level, it's very easy to draw a conclusion and say, "Oh, it's a mild increase." So some research studies will say it's like five to 10 pounds increase in weight gain when women are beginning hormonal birth control. So one is they conclude that it's mild, well five to 10 pounds, I am not even 5.5, you will notice if I put 10 pounds on, like it depends on your frame.

Like if you're a woman whose six foot, you may not notice 10 pounds as much as somebody who's five foot. Like there are those discrepancies. Now, next to surface layer. If we get in deeper, we actually find that in the research what they did is they just took a group of women, they measured their weight, they put them on birth control. Then they added up the total weight gain and included the weight loss and divided by the number of women. So what this did is it made it look like, okay, it's a mild increase in weight except that some women lost weight because they were so nauseous they weren't eating and other reasons. Some women gained up to 70 pounds. So to say that like, "Oh, there's no effect whatsoever," with what we know now, I mean it's just silly to me.

Like how do studies work? They cherry pick a population, they put them through a nice, neat little funnel so they can get the statistical significant outcomes that they want. Then they apply that as general, to the general population except that we know way too much now to be making general inferences like that. So when it comes to birth control weight gain, the very much, there are women who have significant weight gain, I'm talking like 50 pounds when they begin hormonal birth control and it can't all be just chopped up to, "Well, they just let themselves go." You know? What we can understand of how birth control affects our metabolic health overall. Let me take you through a few of the reasons why it could contribute to weight gain, and this is the thing, like do we need a research study to say definitively what women or that women are telling the truth when it makes sense physiologically? The answer is no.

Do I want the research? Heck, yes they want the research, like I do want the research, then we don't need to, you know. We need to stop this thing of where hundreds of thousands of women are reporting the same story, but when we dismiss hundreds of thousands of women, because we don't have a study to prove that they're telling the truth, that is ridiculous to me. Now, if you experienced weight gain with birth control, here's a few of the reasons that might happen. So number one is weight gain. It's inflammatory and it's filled with progestin, which is not progesterone. Progesterone is your natural hormone that is a diuretic. So you may be holding on to water weight, that's one reason. The other issue can be the insulin resistance and what I call metabolic mayhem that happens. So women on hormonal birth control, they can have their inflammatory proteins measured, start hormonal birth control, and some of them will have three times the rise in that inflammatory proteins. So we're talking inflammation.

So inflammation causes our cells to become rigid. When our cells become rigid, we don't dock our hormones on the receptors as easily. So from a Star Wars people, you want to just think about, like you've got to open up the port and allow the ship to come in because otherwise the ship is just out there floating around ready to run out of fuel and it's not doing you any good. Now we most, you know, most of us understand insulin resistance. That's where you make insulin, but your cell doesn't care. Insulin comes knocking and your cells like, "I ain't even try to hear that, like go away." This can happen with any hormone and if it can happen with any hormone then we have to start looking at, well, what is one of our main hormones of our metabolism, our thyroid. So with women, so in beyond the pill, there's an entire chapter dedicated to adrenal and thyroid health.

And for women listening, this book is called Beyond the Pill to give you root cause solutions to your hormones beyond birth control, and to help you know there's life after birth control. It is not just about birth control. But really what I saw was missing in the entire women's health industry when it came to books is every book was talking about, let's just talk about autoimmune disease. Let's just talk about hormones and everybody would pay a little lip service to birth control, yet birth control is so central to women's health overall. And so I wanted to cover autoimmune disease, thyroid disease, adrenal issues, and then talk about sex hormones as well, as well as gut health. So with that, there's this chapter on thyroid and adrenal health where I explain to you how hormonal birth control could cause HPA dysregulation. That is your brain and your ovary are exceeding, your brain and your adrenals don't speak so well. It's also known commonly as adrenal fatigue, that can lead to weight gain.

So too much cortisol will have belly fat and why would we have too much cortisol? Because you're taking an inflammatory medication and cortisol has got to dampen that inflammation. It is not that your body is betraying you or you need a boatload of medications to fix that. It is adaptive physiology. And so much of women's health, it's called dysfunction when really its adaptive physiology, ladies it is survival. So that cortisol belly fat, that is your body looking out for you even though society is like, let me judge you for that. So we have to frame that. Now with thyroid, we know that hormonal birth control depletes nutrients that can affect thyroid function. Your ability to synthesize it, your ability to actually convert it to active form and then to take it up in the cells. What is one of the main symptoms of hypo, not having enough thyroid, hypothyroidism, weight gain. And it's one of those things where women are like, "I'm gaining weight for no reason."

So the absolutely seen patients in my clinic where they have their thyroid testing done. They though and go and start hormonal birth control and they start gaining weight. Their doctor dismisses them, they find their way to me, we retest their thyroid and it's like, "Well, lo and behold you are hypothyroid." Is it that you are truly hyperthyroid or is it that birth control is contributing to this? That is a very individualized question that we have to answer. Most of the time they taking away birth control and seeing what happens and supporting the system through that. So other reasons that women can see weight gain is testosterone. Now, a lot of women will say like, "I don't want testosterone, that's a man's hormone." Ladies, you make testosterone as well. And when it is balanced, just like every other hormone, it is amazing. It makes you want to wake up, kick ass repeat. Like it is amazing.

It gives you energy throughout the whole day and it protects your heart and your bones among other things. But the deal with testosterone and birth control is that a lot of women, so like you, you had acne, your doctor turned to birth control Langley because you had excess androgens. Now these are those male sex hormones is what we think. If you guys could see me, I'm doing air quotes around that male sex hormone action. But with that testosterone is, it's a very important hormone for muscle mass. And when we are put on birth control, we decrease ovarian and adrenal production of testosterone and we increase a protein called sex hormone binding globulin. This is why we lose our libido on hormonal birth control. This can also be why women start losing muscle mass and they're finding that I've got cellulite, I've got flabby upper arms, what's happening? Like I'm still working out, I haven't changed my diet. Nothing's changed and it may very well be that the decline in testosterone is no longer stimulating, so you're not getting that muscle mass stimulation.

Muscle is a very energetically expensive organ and what that means is, is that if you want to shift your metabolism and like rapidly so that you just lay on the couch and do nothing and you burn more calories, build muscle. And we've seen from the studies that there is an impact on female athletes who are on hormonal birth control in terms of they're quicker to fatigue during their workouts and for a long time, you know, there was again this story that was going around that like, "Oh your period and your menstrual cycle makes you a weaker or you're weaker of the sexes and you're weaker when it comes to physical activity." And so it started being a recommendation, "Oh, if you're an athlete, just go on birth control." It is by the way too, if you are over-training and losing your period because you're, you know, not putting in the calories you need to match your training, well we can induce this artificial bleed and it will protect your bones.

Then the research came out, "Oh, in fact it's not actually protecting your bones and it may actually be in hindering your athletic performance and that the menstrual cycle itself doesn't actually hinder the, your athletic performance. Instead, if you work with your menstrual cycle and you honor like where you're at in the different phases, you can make greater gains." So that was a whole lot of information, that was like a fire hose on what could possibly be going on with weight gain, but it's another one of those things that we get dismissed as women. Then with the body positivity movement, which I think is, you know it's a wonderful thing to accept your body where it's on, but something that a lot of women are expressing to me is they also feel shamed-

Naomi Nakamura: Yes.

Dr. Jolene B.: For questioning their weight and they feel shamed because if they're like, "I've gained weight, I'm uncomfortable that people are like, you should just love your body where it's at." And however we cannot negate that weight gain and weight loss can both be symptoms of a greater underlying issue.

Naomi Nakamura: There's so many things you said there that I'm like, we're just skimming the surface, but going back to the whole quicker to fatigue, I was pretty good athlete and then when I got switched to birth control, I was also getting at that time just starting to get into long distance running. And I ran, trained for marathons like non-stop and I was always injured, I was always fatigued and there is so much of that. It took a hit on myself control because I thought I wasn't the athlete that I used to be. As I began to piece together all of these pieces from many different sources, it kind of all came together. But I'm so glad you said that, because they've tried to explain that to some of my clients and some of my friends who are still in that world and it's really hard for them to understand. So thank you for pointing that out.

Dr. Jolene B.: Yeah, and I think that there are, so here's the reality for everybody listening is that when you go to improve your life or you start to question, you know, all the salmon are swimming up stream and they're getting scooped up by the bears left and right and you're like, "Yo, maybe I want to do something different." Like people are going to get challenged by that because they have stories, they have stories that they tell themselves that allow them to continue to participate and to live the life that is comfortable for them. And so understand that like listen, if you start to change your life and someone starts to bag on you for it, that is not about you, that is about them and something else. And so just you know, just do you, be true to you. You are the only one who knows how to live your life best for you.

Naomi Nakamura: Now for women who are on birth control right now and they're just learning about this and they're thinking, "Oh my gosh, I need to do something about this." How do you recommend or do you have any helpful tips on how does someone come off of birth control in a way that's going to be, I guess the least disruptive as possible to their body.

Dr. Jolene B.: Right, so step one is make sure you have a backup method before you come off. I was making this joke or like years ago, oh gosh, I'm like that was a long time ago this joke started and why I say oh my gosh, is because I'm like now I'm that parent who just tells the same jokes over and over. Yeah, that just, that just, if you guys could see my face, I'm like, "Oh, you're that person." But the joke that I would make is that like I don't want a generation of Brighten babies. Like I don't want history to look back and be like, "Oh that was when that doctor Brighten lady was going around telling everybody like, oh, birth control has these side effects and you should know about." And then everybody just was like, "I'm going to jump off birth control, they got pregnant." But now we are seeing actually Brighten babies of women who are using Beyond the Pill who were having trouble conceiving and now they're getting pregnant, and so it did work out in a positive way.

But step one is we've got to have a backup method, because even if you do want to become pregnant, you need to prep your body for at least six months. And as you'll read in the fertility chapter of my book, there's a lot of things birth control has done that can make your pregnancy harder, can make it harder to get pregnant, that can, you know, give your kid like the short end of the stick so to speak and make your postpartum a whole lot easier. So it's worth doing your due diligence to prep your body as you come off. Now we've got to have the backup method and then we've got to decide as I talk about in the principles of getting started in my book, why did you start birth control and what might it look like for you to come off of it? If you started it because you had horrendous acne or periods and they were super painful, you may want to prep your body for a good three months before you transition off and I teach you how to do that in my book.

And that is something that I will say I've seen a lot of women have success. Like if they started birth control because of acne, they have a much milder case of acne. It's almost like it's a necessary part of the healing that, that acne has got to come back a bit. But if you do prep your body and do this work, it shouldn't be as extreme as it has been before. And I say this because I've had women come to my practice and they've tried to go off birth control like three times and every time there, and acne post pill is not limited to the face. This is the part that really sucks, is that it ends up on your neck and your back and your chest and your button. It goes like everywhere. And so it's worked with patients whom they've had acne, you know, so many times after coming off of birth control, we prepped their body and they come off and it's way milder than it was before.

Now, if you're a woman who started birth control because you have endometriosis, that's a bit of more of a special case and not something that I say, you know, that it's usually like three to six months of prepping your body and building your health care team. Because the worst thing when I see this on social media, and it happens a lot where women will say, which by the way everybody listening, you guys, birth control is a medication. So when you go and you tell somebody how to take that medication that's practicing medicine without a license, unless you're a licensed provider. You don't know that, but you want to be careful with that. Like we wouldn't tell people, just stop your antidepressants or just stop your heart medication. And so every woman can choose to stop it herself. But in terms of like giving medical directive around that, that you need to meet with your prescribing provider.

But I will see sometimes women are posting like, you know, "I have to be on this because of my endometriosis," and women are like, "Just come off of it and change your diet. You'll be fine." And it's like, "Well maybe. Or maybe she'll be writhing in pain and vomiting and missing out on life and super miserable for like months on end." Like we don't know. And the thing we do know about chronic pain and chronic pain in general is associated with poor mood and depression and there's a lot of issues that come with it. But the extra layer of being a woman is you are more likely to have your chronic pain dismissed. And that medicine that is, has a biased, it's well documented in the research to where if you have chronic pain you are less likely to receive adequate treatment with that. So I just want to say that piece from my endo ladies, make sure that like they feel supported in this as well.

Now as you go to make that transition off, you're going to need to one, replenish nutrients store. So this is really the fundamentals of the Brighten Protocol that I take you through in the book. We have to replenish nutrients store. So it talks about CoQ10 at the top of this. If you guys missed it, rewind and listen again. CoQ10, vitamin C, Vitamin E, selenium, zinc, magnesium, B12, folate, like I could keep going. There's all these nutrients that are depleted by hormonal birth control. So I hate to break it to you, but if you've never done work to replenish nutrients stores and heal your gut, you have to do that now because that's not just going to happen on its own. Unfortunately, we just don't absorb nutrients via osmosis. You have to actually eat and consume the foods and have a gut that can absorb those foods. So we've got to do some work around that.

We also need to reverse the metabolic mayhem that has happened. So the inflammation, the insulin dysregulation, the possible electrolyte shifts and the things that are putting you at higher risk for cardiovascular disease. When you start hormonal birth control, that may very well be the root cause of why your cholesterol climbed. So cholesterol, you guys, it's not the devil, okay? It's actually how we build our hormones. It's really, really important. But cholesterol meets oxidative stress and inflammation. Hello? What birth control induces can put you at higher risk for cardiovascular disease. So we've got to work on all of that. And I don't care if you're 14 or you're 40, like you've got to work on that because you need your heart. It's like really important you guys. We got to have that, so that's another step that we need to take.

Now the other thing that you're going to want to do as part of healing the gut, healing the metabolic system and healing what is going on with your nutrient stores in making sure that you're making dietary shifts. So eating more of an anti-inflammatory style diet, bringing in high quality proteins, high quality fats, that means saying goodbye to junk fats. And so that means getting rid of canola oil, soybean oil instead, bringing in avocado oil, macadamia nut oil, olive oil, even coconut oil as well to really help support the inflammation, the hormone metabolism, and start feeding your gut good stuff like turmeric and ginger. So I've gone through the three, we've got replenish your nutrient stores, heal your gut, reverse the metabolic mayhem, and we also need to identify your hormone imbalance. So that is, where are you at right now as you come off of hormonal birth control?

I have a quiz for you in the first chapter of my book, because this is really where it has to get individualized. For some women, it's all about the adrenals. For other women, it's all about insulin. For other women it's just progesterone and estrogen dominance and that's really driving everything. And we've got to figure out what's true for you so that you can find tune the protocol, and I teach you how to do that. Beyond the Pill is teaching you how to test things and build your own hormone user manual to understand what's going on in your body. Because if you don't really get to the root of which hormone is the main troublemaker, you're going to find that, like you can do everything right but you're not being targeted so you're not getting the results.

And then the last thing that we do, which is the first step actually that we do as you go through Beyond the Pill, we actually combined all of these things. So you don't have to think about like, "Oh, I have to do this and this," you know, these each steps I make it so it just becomes part of your lifestyle and your routine. But that is the birth control hormone detox. And that is not that when you come off of hormonal birth control your body has an inability to detox, it is that being on hormonal birth control impairs your natural detox capacity by way of its impact on your gallbladder, on your liver, on your gut, and even on your electrolytes overall affecting your kidneys. And so we have to support your natural detox process and we have to let up the liver, and why there's a 14 day detox that we roll into right away in Beyond the Pill is because this is what I tested time and again in my clinic with patients.

And what we found, I used to put patients through a 21 day detox and that got great results and then, but people were like, "Ah, 21 days is kind of a lot." So I'm like, "Well let's refine this. Let's see if we can do 14." And we figured it out, we fine tuned it. And we're like, "Sure enough, we can do a two week resign and get tremendous results with that." And this is really the secret sauce to like getting your libido back, clearing your skin, getting your gut working optimally again and making sure that all of your hormones are balanced. If you are on a medication that suppresses ovarian function and you come off of that medication expecting that you'll just ovulate again, you might, but you might not. And if you don't, you're going to find yourself in a situation of estrogen dominance, which is pretty much what birth control has been inducing. So by supporting your liver, your gut, your gallbladder on all of the ways that you move this out, this estrogen out, we can help mitigate some of those symptoms of estrogen dominance.

Naomi Nakamura: And I will just say as someone who I just, I didn't know all of this, I didn't have your book back then and I went cold turkey off of birth control after being on it for 10 years. I guess I was fortunate in that my cycle came back regularly, but all those other things you just described are things that I'm still dealing with today. Poor liver function, low thyroid, weight gain, all of those things. I had SIBO three times and I cannot stress to listeners how important this book is. It's really a handbook on women's health. And I wish I had this when I was going through that period of my life and I'm so thankful that I have it now. So thank you for writing this book for us.

Dr. Jolene B.: Yeah, well, you know, I set out to write this book. This is everything that I've been developing and working on with my patients. We then moved it into an online program when I realized I couldn't serve everybody. You know, one on one, not everybody who can see me. And I really just want to say like, you know, we're really grateful to my patients who trusted me and tracked their data and reported back so that we could build these protocols and have all of this. Because when I came off of hormonal birth control, it was the same for me. I had 28 day cycles, I come from a very fertile family. I was the first one not to have a baby before age 20. And when I came off the pill, I lost my period altogether. My doctor was totally unconcerned, was like, "You're, yeah, this doesn't happen. There is no evidence that it does this, you have PCOS. And that was without ever working me up or doing testing, and I really wish I had that information.

And so in a lot of ways, you know, writing this book was part of my own healing journey as well to be like, this is what I learned and as you read in the book, like I tell my story and I talk about like, I mean, I struggled. I could probably write a whole book on all of the side effects I experienced while on hormonal birth control, because there were just so many things that went wrong and I thought I was broken. And this is something that so many women have said to me as well. It actually had women in their sixties writing me who have read Beyond the Pill. And you know, although this book is really targeted for menstruating females, there's a lot that a woman who's no longer menstruating can gain as well, because we're talking about liver and gut and thyroid and adrenal. It's like we all have those for life and your cardiovascular system is very, very important stuff.

But these women have written me and they've said, "You know, I finally at my age feel validated by a doctor that I wasn't making stuff up. That like I finally understand what was happening in my body and it's unfortunate that I couldn't have like, you know, I didn't know you then, I couldn't have healed then." However, they are now gifting this book to other women in their lives, which I think is just such a beautiful thing to see that Beyond the Pill is really affecting multiple generations of women, and helping them know that it's not in their head, they're not broken and that they've never once gotten it wrong about what is and is not normal for themselves.

Naomi Nakamura: Gosh, that made me feel a little bit emotional there.

Dr. Jolene B.: I get really emotional. There are times like I have like, I mean, when I just did this virtual book club and we went chapter by chapter and I just start crying when I was going through the metabolic chapter, it was honestly the hardest chapter for me to write. One, because I didn't want to scare anyone, like the book, I don't want any, we have way too much fear based decisions happening in women's medicine and I am done with it and a lot of women are done with it, and I didn't want to scare people but it's hard, because I'm talking about cancer and heart attacks and strokes. And like that, that gets scary quick and there are definitely people who have lashed out at me and are like, "You just are, you know, trying to scare all these women." And it's like, you know, it's scary. This is scary. But what is scary to me is not knowing-

Naomi Nakamura: Yes.

Dr. Jolene B.: And that's why I provide you right away. It's like if you're scared right now, go get this lab testing done. So if you're on birth control, you can know, am I at risk with this? And before you start birth control, you can know, do you have a higher risk of having a cardiovascular event. But the other thing is that as I went through that chapter, you know there was, I think I could write an entire book based off of each chapter. That's how much went into this book and then how much had to get cut out. But just going through women's stories and the research and how many women have died on birth control and has been brushed under the rug. Women who could have had a simple blood test to know that they had a genetic mutation like Factor V Leiden or MTHFR, which like 40% of the population has.

And the stories of women who graduated college, met the love of their life, didn't want to get pregnant, started birth control and then died. And that is not being talked about enough and that is dishonoring that woman's journey and her life, and like I get that it's uncomfortable that we don't talk about on couple of things. We have to talk about that and it's part of the dedication in my book, is to the women who went before us so that we could know there was a better way. Because the history of birth control was, I mean, they were doing trials on women without informed consent. Women who didn't know what they were signing up for and women who are dying and it wasn't being reported. Some of the trials were forcing female medical students. You want to be a doctor? You are in our trial. If you're not in our trial, you can't get a degree, you can't advance.

And so while 100% hormonal birth control has been a tool in an instrument for the women's movement, it's also been an assault on some women's lives and we have to honor and acknowledge that. And it isn't to say that like, "Oh, we should just throw off birth control altogether." No, but we need to have these conversations because we can't lose another sister to misinformation. We just can't be tolerating that anymore.

Naomi Nakamura: We can't, and I know we covered a lot of information in this interview, but I want people to understand that this is just high level. We're just scratching the surface here, so if you don't already have a copy of this book, go to Amazon. I got my book off of Amazon. Definitely go to it and get your copy. Like I said, it'll be your hand guide to your health as a woman. Now, how can people connect with you and just learn more about all that you have to share?

Dr. Jolene B.: Yeah. Well I want to say if you do grab Beyond the Pill, go to beyondthepillbook.com because they've got a lab guide there for you, more recipes. You've got some exclusive interviews and all kinds of gratitude bonuses, because if you are buying this book then you are part of the change that we need in women's medicine and I just want to express my gratitude for that. So definitely grab those goodies. You can find me at drbrighten.com, my last name is tricky, so it's D-R-B-R-I-G-H-T-E-N.com. Tons of free resources There for you, tons of articles and videos. You can also catch my videos on YouTube, I publish those weekly and then of course I'm on Instagram at Dr. Jolene Brighten. You can find me there, you know, I just had a woman write me and she's like, "I go to your page every day, because every day I learn something." And she's like, this last weekend she decided to go through my entire Instagram page and she was like, "Oh my God, there's like four more books in just your Instagram page." And I'm like there really is.

Naomi Nakamura: That's true, there is. It's funny because in my own family, I have a lot of cousins who are in their twenties and early thirties, you know, they're not going to listen to me because we're related.

Dr. Jolene B.: Oh, no. Totally.

Naomi Nakamura: But I send them to you and I told a couple of them that I'm interviewing doctor Brighten and they're like, "Oh my gosh. Oh my gosh." And I'm like, "Yeah, pay attention to what she's saying."

Dr. Jolene B.: Yeah. That, and you're like, "I'm interviewing doctor Brighten," and they're like, "Oh my gosh, she's so cool." And you're like, "Yeah. And her child made a little cameo, so you guys didn't catch that. I like muted it." I actually managed my child during this interview and sent him on his way. I have wet hair, no makeup in this real life and you got to witness that.

Naomi Nakamura: I love it. I love it. So thank you so much for being here and I will have links to all of the things we talked about and doctor Brighten's website, her Instagram, her YouTube, and the site for the book to get the book bonuses over on the show notes. And so thank you so much for taking the time, I appreciate it. I appreciate everything that you do, especially taking the time to come on and talk to us.

Dr. Jolene B.: Oh, of course. It is such an honor to talk with you today and thank you so much for the work that you're doing. We need more women talking about this, more women out there raising the awareness around this because medicine in women's health needed to change like yesterday. And I, for one, I'm getting impatient.

Naomi Nakamura: We're trying. We're a small army, but we're growing and we're going to do it.

Dr. Jolene B.: Oh no, we're not trying, we are doing.

Naomi Nakamura: We are doing.

Dr. Jolene B.: We are doing.



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Naomi Nakamura is a certified Holistic Health Coach who takes a holistic approach through functional nutrition. Through her weekly show, The Live FAB Live Podcast, coaching programs, and safer skincare solutions, she helps people with acne and other chronic skin issues clear up their skin by teaching them where food meets physiology and how food, gut health, stress, and toxins are intricately connected to the health and appearance of our skin. Naomi resides in the San Francisco Bay Area and can often be found romping around the city with her puppy girl, Coco Pop! Connect with Naomi at: Facebook | Twitter | Instagram | Pinterest.