286: Is This Normal? (Rashes "Down There" + Hormones Edition) w/ Dr. Jolene Brighten

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My audience is people who are struggling with rashes and, let's be honest, there are some rashes that appear in areas that you're not going to want to, you know, show to a Facebook group.

Not only are they uncomfortable physically, but it can be very hard for some to talk to their provider about it. That's why I'm so grateful to today's expert, who is an open book on this topic! She walks us through the age-old question of “Is this normal”?

My guest today is Dr. Jolene Brighten, NMD, women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology and a clinical sexologist, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones through her website and social medical channels. She is the best-selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth and now is releasing another book called Is This Normal?: Judgment-Free Straight Talk about Your Body. As an international speaker, clinical educator, and medical advisor within the tech community, she's considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and the American Association of Sexuality Educators, Counselors, and Therapists. Dr. Brighten serves as a faculty member for the American Academy of Anti Aging Medicine.

How do you feel if you have ever had issues down below? Did it ever bring you shame? Let me know in the comments below!

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

In this episode:

  • Why it's so important to talk to your doctor about rashes “down there” and what type of doctor you should talk to
  • Signs from your body that something's off
  • Hormonal imbalances — why usually more than one hormone is off
  • How poor sleep impacts SO many hormones
  • Thoughts on melatonin supplementation — worth trying or avoid at all costs?


“Even the imagery they use, it's just this really horrible imagery until we have some kind of medical intervention to come in and save us from being women. And all of that's wrong. It's all wrong!” [10:14]

“Yeast infections could also be a sign. If you're having repeat yeast infections, it can be a sign of insulin dysregulation, blood sugar imbalance; and it may be the first way that diabetes is showing up for you.” [16:35]


Find and Follow Dr. Brighten on her website | Instagram | Facebook

Order your copy of Dr. Brighten's newest book — Is This Normal? (available now!!!)

Get your copy of Beyond the Pill

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286: Is This Normal? (Rashes “Down There” + Hormones Edition) w/ Dr. Jolene Brighten FULL TRANSCRIPT

Jennifer Fugo: Dr. Brighten, it's such an amazing pleasure, to have you back, especially because we've got so much to talk about today about some embarrassing things. But I know that you don't shy away from that. You like dive headfirst into it and I love that about you. So thank you so much for coming back to the show.

Dr. Brighten: I'm so glad to be here. It's always wonderful to chat with you. I think you have such an amazing audience and it was so much fun last time. So let's do this.

Jennifer: Yeah. So as you know, my audience is people who are struggling with rashes and let's be honest, there are people who get rashes in areas that are not places that you're gonna wanna, you know, show on Facebook to your Facebook group there. A lot of times, we'll say below the waistline in the down there area, men and women, it happens to kids. Um, we're focusing on adults today for the most part. And I, I wanted to add that I think dermatologists do acknowledge that there is a lot of discomfort, um, around talking about rashes in this area. When I was at Integrative Dermatology Symposium 2022, they mentioned this. They had a whole talk about how they feel like the percentage of people that even present with these issues and tell the dermatologists that they have these issues is probably a lot less than those who actually have rashes in the genital area. Um, what are your thoughts about this? Because I mean, I can imagine people feel really uncomfortable.

Dr. Brighten: Yeah. Well, you know, I open the book, so my book “Is This Normal?”… I know almost no one reads introductions, right? They just wanna jump into the meat of it. But I actually touch on the point that from the earliest days we learn about our body, one of the things that we are taught is shame. That it is a source of shame and something to be ashamed of. And so it's very natural to feel shame as it is when things are functioning normally when we're talking about down there. And then when they're not normal, we don't talk about it. We don't normalize the conversations and we're not given tools. So you've already got a shameful experience. And I think it just gets compounded by that. And not a lot of people think about going, so when we think about take off your pants doctor, we think gynecologist.

Right? That's who we think about. And we don't think about dermatologists for that. But when you look at some of the research, I mean, there's estimates that like two thirds of those with psoriasis actually have genital psoriasis. So it's showing up, um, you know, on, on the backside between the cheeks or on the front side between the labia or um, between your thighs. Between the thighs and the genitals. And it's not something that people will seek help for. And then we also know that there's all kinds of other rashes that can show up. And you mentioned kids, we are talking about adults, but I think about the fact that I have a toddler and if he had yeast, uh, showing up and he had a, you know, yeast infection on his skin, we'd call it diaper rash and it'd be no big deal. Right.

And we would treat it right and there would be no, like something was wrong with you. Something happens as we move through puberty. Well now if you have something like that, ooh, you're gross, you're weird. Like we feel the shame. And I think it's not just from peers and society, I think there's a big lack in our education system about normalizing that these organisms exist. They're normal and they get out of balance. But I think on top of that, there's a lot of marketing that we see online, on TV that really makes it to where like you feel they really hook into shame because shame is such a strong emotion, such a strong feeling. I mean technically it's not a feeling but it, it arouses feelings. Right. But that shame is so easy to hook into at that will get you to purchase things.

And that's a lot of the marketing. It's like that's their job. It's like hook into that emotional aspect. So I think for all of those reasons we feel like we just shouldn't talk about this. Yeah. Um, and that's really a big reason why “Is This Normal” was born is it's all the things that we've been told is TMI, icky, you shouldn't talk about it. It's not polite. Um, and the things that my patients say to me behind closed doors or people anonymously online write to me and say like, Hey, is this normal? And you're like, people don't wanna share this in Facebook. I do sometimes get DM's of people showing me body parts down there and I'm like, friend, Instagram is not secure. Please do not send these things. Yeah. And also it's very troubling to me that people are more comfortable sharing this information with me online than they are with their own provider.

Jennifer: Yeah. And if you do so, from your experience, if you do have rashes in the more genital area, who, who do you talk to?

Dr. Brighten: Yeah, well I think if you already have a preexisting issue, so let's say you have psoriasis, you have eczema, you have autoimmunity. I think dermatologists are much better at catching autoimmune conditions of the genitalia meeting with you if you're already under the care of a dermatologist, you should be speaking to them about that. But seeing anybody who can do a pelvic exam. So people usually think gynecologists. There are physicians assistants who work in women's health. There's me, I'm an athletic physician, I can do these exams. Um, there's also your primary care doctor, they can do these exams. So I think this is important because as the statistics are coming out, there's a lot of areas where there aren't gynecologists in this country. So when we're talking about the United States, there's not a gynecologist, but your primary care doctor should be able to examine that and steer you in the right direction. Cuz it could be as simple as like this is yeast. Um, you might be having discharge pointing to bacterial vaginosis. That's something that like can be really easy to clear up and your doctor can handle that. But then things as they get more complicated skin issues, that's when you really wanna meet with a dermatologist.

Jennifer: Hmm. Can I ask too, just from the patient perspective, so let's pretend I have this issue and I go to, I'm really uncomfortable and really nervous and really afraid that, you know, my derm or my doctor is gonna think I'm weird or gross, I think, do you think part of the experience that you've had with patients is that when they maybe come to you with something that is uncomfortable or they feel shameful or embarrassed about, do you feel like the act of kind of like sharing this with your doctor can a lot of times help because at least it gets you out of that place of doing nothing? Like being stuck?

Dr. Brighten: I think the first question you need to ask yourself is why you're not comfortable sharing with your provider. Like if your first thought is not to see your provider, what is about that relationship that you're not comfortable with? And I think so often I, you know, I get interviewed and these questions they come up with like, what can the patient do? What can the patient, what is your doctor not doing? That's my question. What is your provider not doing? Because it's our job to make a safe environment where you feel comfortable to bring those things up. And I think that you, that's a good question to ask if you don't feel comfortable with your provider, is it something your provider's doing or is it maybe something that you're feeling about yourself? And it's really important just to examine that either way you do need help and you're absolutely right.

Doing nothing is not a good answer when you've got something going on down there. Because you know, sometimes there's things that are clues to bigger issues. So like vitiligo might show up there. So hypopigmentation might actually start making the appearance below the waist. Maybe it's just on your inner thighs. That can be linked to Addison's disease. Like we could be going down a pipeline of autoimmunity that's quite scary. You might notice that you're getting a lot of hair growth on your thighs and hyperpigmentation, so it's getting a lot darker on your thighs and in that area and in the folds there, well that might lead you to also inspect other folds that could be signs of insulin resistance and diabetes or PCOS. So there is a good case to be made to not watch and wait. And then there's the things that we do get scared. I think the things they do say in sex ed, which is like if you have a sexually transmitted infection that could lead to pelvic inflammatory disease that could lead to, um, infertility. Like there's these sequelae that are very, very concerning. And I think, you know, in the United States, the entire topic of um, healthcare is way too complex to dig on in a podcast, but there's a lot of reasons why people are not seeing a provider or taking to TikTok to search for answers.

Jennifer: Yeah. Yeah. And it happens a lot. I mean, one thing that you mentioned and “Is This Normal”, which by the way is an amazing book and for everybody listening I highly recommend it. Um, you talk about signs that, you know, for women we have issues, some of us may have issues and maybe we're not sure if it's normal with our cycle length. How heavy, uh, your menstrual cycle and, and especially when you bleed, that period is uh, vaginal discharge. Like why are these important to pay attention to it? And are there any like key things that if you're not, if you're feeling like just the way you are is the way you are is normal, maybe you should start listening to these things as part of like the the check engine lights so to speak?

Dr. Brighten: Absolutely. You know, I put all kinds of charts and tables in the book. Like there's even one for like down there rashes and discharge and like what are these bumps like and what it might be and what you can do about it. Um, and the same is true when it comes to the hormonal stuff as well. So we are given this narrative that, you know, being the woman, um, getting periods is basically the worst thing that could happen to you. PMS is totally normal. Painful periods are to totally normal. I mean even if like your mom hasn't passed this down or you know, your health ed teacher didn't pass this down, you will find a commercial for Midol letting you know that like, oh it's so awful that you have to just take this. Um, and even the imagery they use, it's just this really horrible imagery until we have some kind of medical intervention to come in and save us from being women.

And all of that's wrong. It's all wrong! If there are issues with your cycles getting shorter with your cycles becoming too long with your periods being so painful you can't get out of bed with you feeling like you're gonna bleed through your pants every time your period comes. Like these are signs that there are bigger issues going on. And while you know, there are 1,000,001 period jokes and PMS jokes out there, these things are not really funny. They're affecting individuals and because we act like, oh just, you know, it's so common, it must be normal. It delays people from getting the help they need. I mean even I talk about the bias around pain around healthcare practitioners. Um, I mean the bias is so strong that we, we don't get diagnosed as women with heart attacks because we present differently, but our pain is just not even taken seriously.

So when it comes to things like painful periods, it took a man on the internet saying periods are as painful as a heart attack, which is kind of silly cuz we don't actually usually present with the chest pain that like our male counterparts do. But for people to finally be like, oh yes, period pain is significant. What, what have we been saying like this entire time? And like also like how amazing are the people that like do have period pain and still keep going in their life and the things they accomplish, but that kind of dismissal. And you and someone might be like, well just take ibuprofen except for like, you might be, be someone with endometriosis spending more than a decade to just find a provider to give you an adequate diagnosis. You might be someone with PCOS that's gotta get to three providers before they actually listen to you and take you seriously. And don't just tell you something like, well if you didn't eat so much and you move more, you'd be fine. Which is not true. It's just another bias in women's medicine.

Jennifer: And with these types of symptoms that can occur, um, especially like I think with discharge and odor that can happen by the way.

Dr. Brighten: Yeah.

Jennifer: What, what should we pay attention to as women, um, in terms of those two things? I know it's a weird question to ask for all of you listening. You're like, what? Why are we talking about this? This is important!

Dr. Brighten: No, it's not weird. No, it's not weird at all. And especially when you consider the trends that we've seen in social media lately, which is like, eat all the pineapples so that your vagina smells better or tastes better. And like that's not how any of that works. Um, but what is really the undercurrent of all of that is that your normal natural smell is not okay. This is actually born out of like the 1800s when doctors started being like, oh you should douche and everything. Ironically doctors are like, you should wash your vagina but we're not gonna wash our hands before we deliver your baby. Like or do surgery. Like what in like what is actually happening in medicine? Um, you know, not in that, I mean all together, right? But, um, there is this ubiquitous messaging of you are inherently unclean in your smell.

There's something wrong with your smell, right? We've got, we've got products that are like, you should smell like a fruit, you should smell like a clementine. We've got vaginal melts where it's like, you should insert this because you should taste like a creamsicle. And I'm like, that's a, that's a fast track to like, you know, an infection of some kind. The reality is, is that vaginas should smell like vaginas and smell like vaginas and they will handle themselves including themselves. So if you have discharge going on that's outside of the, you know, egg white discharge that you see around ovulations, that raw egg white discharge by the way I outlined, I outlined all of the cervical mucus and discharge things that you need to be looking for and really help you dissect what could be going on. And two areas I really focus on is yeast and bacterial vaginosis.

Cause there are the most common issues women deal with and bacterial vaginosis that can give you a fish like odor. You know, I wanna back up because there's so many jokes that like men really tell 'em themselves how little they understand the female body. Cause they're like, oh it's smells like fish. And I'm like, no, she doesn't smell like fish. The amines from the bacteria that are normal flora that are overgrowing are producing that odor and they got to overgrow because of a pH imbalance. And by the way, if she decided to engage with you, um, Semen is alkaline and it's actually your fault, you actually disrupted her pH. So that's really what's going on there is you've got normal Flora that is creating this odor. It's kind of like when you pass gas and you're like, oh man, that's, that's actually bacteria. Um, and these critters are like really, really important.

Um, but in the case of bacterial vaginosis, it does need treatment and it's usually brought on by anything that can raise your pH. So the vagina, it lies more on the acidic, in terms of the pH scale. Yeast can thrive in that acidic environment. And when we usually see yeast overgrowth, sometimes you won't even have like that thick white cottage cheese discharge. People think about sometimes it's thin and it's white, but it's really, really itchy. And then depending on your skin tone, it can appear red if you have lighter skin. And it may not be red, but it may be more of a purplely color if you have darker skin. So I think that's important too because, um, sometimes providers, I mean they're not, not every medical school is being inclusive about skin color. So when it comes to these rashes and the way they present, that can be a hindrance to getting the diagnosis.

Especially if you're like, things are itching down there, but there's not that thick white discharge. This is where like doing a swab can change everything. Yeah. And we can just look under a microscope. Um, but with that yeast situation, it's very common to come up when you take antibiotics. And we know there's skin conditions where like acne for example, where antibiotics are prescribed, we know that skin conditions and gut dysbiosis can go together. And so now we're doing things that are shifting the vaginal ecology and yeast or opportunistic, they'll overgrow like you give them a chance, they'll overgrow. Yeast infections could also be a sign. If you're having repeat yeast infections, it can be a sign of insulin dysregulation, blood sugar imbalance. And it may be the first way that diabetes is showing up for you. And I know, you know, whenever we're talking with, um, it seems that like younger populations seem to be resistant to the idea that like diabetes is like something that could even exist in their world. They're kind of the same about menopause. They're like, what menopause, I don't even need to know about that. Um, and yet we know that diabetes is increasing in our population and blood sugar dysregulation is really at the crux of not only so many chronic diseases, but also hormone imbalance as well.

Jennifer: Yeah. And, and to, to kind of like, I guess discuss that a little bit further. I thought one really interesting point you made in is this normal is uh, that usually when we have hormone imbalances, it's not just one hormone that's off. Cuz I think most people are like, oh, just my thyroid. It's just my thyroid. My, my TSH is a little wonky. My doctor said I just have a thyroid issue, but nothing to seriously worry about. I'll just take some medicine. And that's it. Why do you say that? That it's not just one hormone?

Dr. Brighten: I think if we all just picture in our mind right now a spiderweb and that you understand that a spiderweb, if you strum on any one part of it, that whole system is gonna reverberate. Right? And the spider's gonna fill it. This is your endocrine system. It's really like a spiderweb. So if you strum on the thyroid and you're strumming there, the whole system is reverberating and, and communicating this is what hormones are. They're chemical messengers and they're saying the thyroid is off, we don't wanna die. Okay. Like that's always like, body is always like stay alive. Like, but also we wanna feel good, we gotta get up, we gotta do things. And uh, the system will shift. So if your thyroid is off, you are absolutely going to see adrenal issues. And if your thyroid is off, you're absolutely going to see ovulatory issues without, so hypothyroidism is the most common autoimmune condition that affects women is Hashimotos that leads to hypothyroidism.

So this is why it's the most common thyroid condition that we see with women. That thyroid hormone is needed to mature a follicle so that you can ovulate. If you cannot ovulate, you cannot produce progesterone. If you cannot produce progesterone, you will not sleep. You will feel anxious. You will have excess estrogen stimulation now because now progesterone's not blocking that, it leads to a whole cascade of problems. Not to mention that, you know, your body's gonna react by saying let's increase TSH and the same mechanism that causes TSH to go up causes prolactin to go up. Now that prolactin is great if you're breastfeeding, but it's not so great if you want to be able to run your cyclical hormones. And that can lead to missing periods, ovulation issues as well. And now we're back to all of those other issues. Now, if you're not sleeping, if you're feeling anxious and stressed because progesterone helps you sleep, helps you feel chill, you don't got that, well now your cortisols like we're on high alert.

Your adrenals are like, must fire off stress hormones. Now they're firing off stress hormones. They're liberating blood sugar. Cuz we might have to run from something insulin's like what the heck are we doing here? Like, the pancreas just makes more insulin. Um, and do you see how like it all just feeds into one thing after another? And now because we're all stressed, even when we start to recalibrate the thyroid hormone, we're still gonna struggle with ovulating and having sufficient progesterone. Cause even when we get back ovulation, the system like those little mitochondria are gonna be interfacing with the brain and they're gonna be like, no, no to the progesterone cuz we are stressed, we need cortisol. So we're gonna keep, keep the progesterone down. And so this is why I think it's really problematic when I see people say, you just have an estrogen issue- focus on that.

And I give a pyramid in my book where you'll see the, the adrenals and um, so adrenal gland hormones, which is there's several that they make. And insulin, which comes to the pancreas is the base. And those have to be right because if those two glands aren't functioning, not getting the right, um, you know, nutrients and feedback and environmental input that they need, what's above that is the thyroid and the thyroid will start to struggle. And what's at the tippy top is sex hormones. And we always want those sex hormones, right? Like that's the thing we chase, right? We're like, we don't, I don't wanna be bloated, I don't wanna be cranky, I don't wanna be screaming at my family. Um, even when like sometimes they weren't, it warrants like that they, they've done things but like, you know, I wanna sleep. Like there's all these things that we want and we fill those sex hormones so hard because cyclically, the body's gonna be like, here again, hello, help me.

I think it's like a dog jumping over the fence, like in the neighbor like, hello, I need help. Hello. Like, it just keeps coming back. And so people go in and they want to address just that. And I am so in the plan and in Is This Normal, I'm like, yes, let's take care of that. I want that to feel better right away. But I also want you to not need those short-term strategies. So I've got a whole cyclical symptom relief where it's like headaches, PMS, like all of these things, what you can do, those are short-term strategies to come in and like fix it, fix it so you can start feeling better. But to really repair the system and get it so you don't need those things and you feel great over the long run. We have to start at the base and work this system.

Jennifer: Yeah. And speaking of sleep and working, I think at a more basic level, people forget the importance of sleep. We think that we can go long periods of time on very little sleep. I think most people in my audience who, and especially clients who are struggling to sleep because they're up all night itching or they wake up and they can't go back to sleep. People have, uh, TSW a lot of times have a very disrupted HPA axis. You have this beautiful and it's not just for sleep. You have all these different charts, which I really loved where you say, okay, well here's what happens in a high cortisol state. And then you have all of the hormones listed out that get that become dysregulated. And with sleep I was shocked like how many hormones? So just so people understand, and this is not, if you're not sleeping right now, the reason I want I wanna ask this is because I don't want you to feel bad that all of these things are off, but I want you to understand why you don't feel well and why it's so important to prioritize sleep.

So if you're not sleeping well and night after night after night for months, this is going on where you are not sleeping well, how does that impact your hormones?

Dr. Brighten: Well I do wanna say this is, uh, so firstly this is where symptom management is absolutely important. I think that we kind of see two camps in medicine. The people that are like just symptom management and then people who are like just root cause and I'm like let's root cause it, but you gotta ease some symptoms cause these people need to sleep, right? They have to be able to get sleep. And I feel, you know what you were saying, a lot of people when I start talking about sleep are like, yeah, yeah, yeah, yeah, yeah. I heard this before that image in the book, I actually have presented that at several conferences. Um, and it's not as pretty in the book. I actually hired someone and it was like, hey, um, I put up this sloppy slide. Um, it looks sloppy in comparison to this.

Like when I talk to practitioners, this is not the average individual. These are practitioners. I am speaking with licensed medical professionals. You are seeking help from, and I put this up and I go through how sleep will cause insulin dysregulation, increased inflammation just on its own. You will have increased inflammation. Um, it will cause dysregulation of the adrenals like DUH, right? Like that makes sense, but your thyroid. And then we also see anovulatory cycles, we see infertility, we see a myriad of period problems come up. So, um, from this and you know, if you miss the whole like spider web talk and you're like, go listen to that again because that's exactly like where sleep becomes a stressor and can be pulling on all these systems and all of these issues. Is your body trying to compensate to what it's perceiving as an incredibly stressful environment?

I put this up for practitioners and how many practitioners say to me, I really need to be counseling sleep more. And what comes up inevitably is patients being like, yeah, yeah, yeah, you're just telling me to sleep. Okay. One, it's not helpful. It's not helpful to tell a woman who doesn't have adequate progesterone just get more sleep or something that HPA dysregulation or somebody who is up all night itching to just sleep, that's not helpful. We need to give them tools. So I talk in the book about like, you know, here's like basic sleep hygiene stuff, like how you need to um, be able to get better sleep. Like how to actually get there. Um, but the number of practitioners who are like, well my patients just kind of like, so there's the, like you're just telling them to sleep, that's not helpful. But then there's also the, my patients just kind of glaze over.

They don't think it's that important. And I'm like, you have to understand we've been inundated for years and I really think the pandemic broke people from this of hustle culture of how many times have we heard people say you'll sleep when you're dead. And I'm like, so you're trying to get there faster because you can sleep now and live this long lovely life. Or you can skip on all of that and you will fast track yourself. Because I'm talking with the hormones here, but we haven't even talked about neurodegeneration, cardiovascular issues. Um, there are cardiometabolic issues that come up when you are chronically sleep deprived and that doesn't have to look like just not getting eight hours. I wear an Oura Ring. Not everybody needs to do that, but I think you need to have some sense of tracking these things because it is very eye-opening of when you're actually getting deep restorative sleep.

Like it's your quality of sleep that we're not talking enough about. So in the book, like I, I go through some things, um, also because like there are people that ask me like how can they're, they're like, I heard about this phenomenon where people orgasm in their sleep and like, how can I do that <laugh>? And I'm like, opportunity to get you to sleep better. Cause it actually happens in REM sleep and you've got to not be eating super close to bed. Of course if you have blood sugar issues that might be different for you. But like you, this is where where the intermittent fasting kind of comes in where it can be helpful. It's just basically like giving yourself some time before you go to sleep to digest your food and then go to sleep. Avoiding alcohol in the evening, making sure you're avoiding those blue lights and really trying to wind yourself down at night.

Because I will say that, um, as tracking, tracking my data and having an infant who didn't sleep and going like having six hours of sleep but still waking up feeling pretty good, looking at me getting two hours of deep sleep, I'm like, well that, that explains it. Like how I can feel good with that. Um, so being able to get that quality sleep I think is what we need to be talking about more. And what I always say to people who are like, yeah, I already know about sleep or this is nothing new because like everybody talks about sleep and the question is always how well are you tending to that? How, what is the quality of your sleep? Like there are so many things like that are true and that we're not doing. And I think so often patients will say, and I'm sure you get this as well, like Yeah, yeah, yeah, I know about this diet stuff.

Yeah, yeah, yeah, I know about that. And I think that if you were someone really looking at optimizing your health and being a forever learner, the question you always ask is, yes, I know this and how well am I doing this because my patients know they know a lot of the stuff that they should be doing, right. The shoulds, um, and yet they're just not doing it. And so that's where as you know, practitioners, we can really come in to help and give them tools, but also as individuals we can take some responsibility in that. And I say that in an empowering way because the majority of what you do to heal your body will never happen in your doctor's office. It will never happen in there. And while doctors are helpful and practitioner, I mean you and I are practitioners. I see value in us. I think we're valuable, but we can't take credit for the healing because it is truly the patient that heals themselves.

Jennifer: Yeah. And I can actually attest to, we've had a number of clients who cannot, could not sleep, where just their progress was even just so slowed. And then we finally figured out with, you know, in in like you said, coaching them around sleep. Finally they're getting sleep and within a week, just a week of getting good night's sleep consecutively there was a huge improvement in their skin. Like photographic, improve like we are. Wow. That is pretty stunning.

Dr. Brighten: And does not speak to the resiliency of the body. It is. And give it what it needs. I'll say Netflix makes it hard. Um, there are definitely times where it just rolls into the next episode.

Jennifer: That is true.

Dr. Brighten: I'm like, ah, I have to go to sleep.

Jennifer: I wanted to ask you one last little question because I think people might be curious. Um, there's a lot of hate, uh, right now on doing melatonin for, and I, it's interesting because you mentioned, I think we need to look for the root cause but we also need those things now the tools, the helpers Yeah. And whatnot and obviously I'm sure there's more about that in the book, but like yay or nay on melatonin. Do you think it's like the worst thing in the world that some people are no claiming it to be?

Dr. Brighten: I don't think it is. People, so why people get concerned about melatonin is because it is a hormone and we do wanna do everything we can. So I talk about ways to get melatonin up in the book and like we wanna do everything we can, right? To have that natural circadian rhythm. However, melatonin's also really potent antioxidant and I think that we really need to be cautious in telling people like never use melatonin. Um, if you do something like a Dutch Test, you can actually see where your melatonin levels are and ideally we want to correct that, but if your melatonin levels aren't sufficient or let's say like you're traveling, the part of the inflammation of not sleeping is because there's, there's going to be free radicals, there's going to be oxidative stress. Your brain and your ovaries are very, very concentrated with mitochondria, as is your heart.

But nobody talks about how concentrated the ovaries are with mitochondria. They need that antioxidant production that melatonin offers as well. This is why we will actually use this as part of fertility protocols is to help protect the quality of the eggs. And so this is something that I think about. I think the conversations right now about melatonin, they're, they're very myopic and they're very much just focused on like, oh, what's happening with the circadian rhythm? And we're not talking about the bigger piece, which is like, what about antioxidant protection for the brain? Um, as you know, my son had PANDAS, which is an autoimmune condition of his brain. And with the brain inflammation, we had to use melatonin as part of the protocol because of it's antioxidant capacity. Not because I'm just trying to put my kid to sleep, but in talks with his neurologist. I'm like, what do you think about melatonin because it's an antioxidant?

And my neurologist was like, absolutely, let's protect the brain. And so we have to consider how protective it is. If you cannot sleep without melatonin and that's going on for long periods of time, we've got an issue. Um, if you are using melatonin, then you're waking up, you're like, I need three cups of coffee in the morning to keep going. Yeah. Like, you've got an issue, right? So I don't think that we should just be like, oh, melatonin for everyone, but I think we should be considering that it is also an antioxidant and it can help people get to sleep. It won't necessarily help you stay asleep. That's where GABA stimulation comes in. Um, that's where progesterone helps. So whether it's your natural or maybe you take oral progesterone because you are perimenopause or menopausal. Um, and also things like Passionflower can actually help with gaba and so you can have passionflower tea at night. And so there's a lot of things I like to try before we necessarily get to melatonin if there's sleep stuff going on. But for example, um, with endometriosis, melatonin can be incredibly helpful for Endo because it has that antioxidant capacity that's gonna be helping with an inflamed system, um, ammunition, it's gonna help people sleep at night. And so maybe we're using it twofold for that. Yeah.

Jennifer: I I just love, I have to say number one, thank you for your answers that take into account. Like I know that there's it, there's a thing out there online and on TikTok and Instagram, like everybody wants to seek yes or no black and white answer. But yeah, there's a lot of gray and

Dr. Brighten: I'm annoyingly nuanced <laugh>

Jennifer: And, and it's what I loved about Is This Normal because it offered the nuance that oftentimes is missing from the conversation that leaves a lot of people feeling like they're not normal and afraid To ask those questions. So number one, the book…

Dr. Brighten: Ahead. Oh, I was just gonna say that the TikTok accounts that grow the fastest are the ones that go and hate on other people. They're the ones that are like, this is wrong, this person's stupid and this is why. Um, because we really have that tribal instinct of the us versus them. However, I wanna say the fallout from that are people feeling like, well wait a minute. Like I just saw something about crunchy moms. Like you're either all in crunchy or you're not. There's no in between. And I'm like, why can't I just like not wanna have endocrine disruptors in my life, which is considered crunchy? And I'm like, that's dumb because like we all should be wanting to save the planet and save our hormones, especially facing a fertility crisis. But also, like I think about these practitioners who are doing that, that's part of the problem of why people feel like they can't approach their practitioner because they're being like, it's this or it's that.

Like, this person's dumb and this person like the worst. And it's like if you treat, if that's how you treat people on the internet, like that is going to translate in it's who you are and real, this is who you are at your core. Um, and so I just tell people to be very cautious of that because you might resonate with one thing they say, but then it may start spiraling into you feeling like you are now in the Out camp and something's wrong with you. And that's really, I really wanted to make it clear, I think one of the most powerful things that we can tell people about their bodies and about all these things that are normal is that yes, you are in fact normal and give you permission to just be, but I cut you off. You were gonna say something else?

Jennifer: I was gonna say that the thing that I thought about when I was reading through the book was that this is a book that I wish that I had like 20 years ago. I mean, you know, I'm 42 now and I wish that I had had this at a younger age. And even now reading the book, I was learning things and feeling, oh, okay, this is actually a normal thing that I probably didn't feel ever comfortable asking my OB before. And maybe that was a me thing. Maybe it was the, I definitely had some not great providers that did not create a space where I felt comfortable asking questions. But I think this is an excellent book for every woman out there and and I don't think it matters the age that you're at because we all struggle with this question “is this normal”? And there's literally no guide to tell you that. And then we're going online into Facebook groups and on sometimes sketchy websites.

Dr. Brighten: It's so true. The sketchy website

Jennifer: And trying to get information that is probably not correct, that may lead mm-hmm <affirmative> to delayed diagnosis of something more serious. Um, and also how we feel about ourselves that that negative feeling never really gets dissipated because we don't get that validation ever. We don't ever hear that it's normal that it's okay. So I just, I love the book and I'm so grateful that you were willing to join us today to share some tidbits of, uh, what's in it. And um, for everyone listening, you can go and grab it. Uh, it's either, I think it's on on sale now. Yeah?

Dr. Brighten: Yeah, yeah. You can grab it anywhere the books are sold, support your local book shop. Um, yeah. And if you are grabbing it, you can also take advantage. We have a book bonus, so a meal plan that accompanies the program in the book, which you can grab at drbrighten.com/isthisnormal. It is all gluten-free with dairy-free options in all of those recipes and they're really meant to support your hormones. They, they go week by week in terms of your cycle, which makes total sense when you get the book and you're like, I know what's going on with my hormones. And if you are not cyclical, it's going to support you either way because the recipes are also aimed at getting your adrenals and your thyroid what it needs to function while keeping your blood sugar maintained.

Jennifer: Awesome. Well thank you so much for coming back to the show. I love having you on and I'm sure you will be back again.

Dr. Brighten: Yes. Well thank you so much and um, I really look forward to seeing you in person now that we can do that.

Jennifer: I know. Awesome.

"Even the imagery they use, it's just this really horrible imagery until we have some kind of medical intervention to come in and save us from being women. And all of that's wrong. It's all wrong!"