This week we are talking about periods and women’s health!  Dr. Saru Bala joins me to talk about what’s normal when it comes to period pain, what we are supposed to track (and why), what causes PMS and more! 

Dr. Bala is a licensed naturopathic doctor specializing in women's hormonal health. As I mentioned in a previous episode, I believe that if we don’t have our physical health together, it is really hard to focus on our mental health. I hope you enjoy this episode and my conversation with Dr. Bala!!

Oh and in case you missed it, an updated and revised edition of my book How to Stop Feeling Like Shit is coming in December! 🎉  We have some amazing bonuses and giveaways planned, so head over HERE to pre-order and grab those! 

Some of the topics Dr. Bala and I discuss in this episode include: 

  • What is normal in terms of period pain, cramps and bloating (4:01)
  • The causes of PMS and why women have it worse than others (14:48)
  • The main things that women should track for their period (20:41)
  • Some of the effects of birth control on women’s health and bodies and why Dr. Bala doesn’t like the idea of using birth control for the treatment of hormonal or health issues (22:41)

Supplements that women should absolutely be on to have better menstrual cycle health (29:27)

Dr.  Bala’s website

Book recommendations:
You know how I love a good personal development book, right? I’ve compiled a list of book recommendations, as mentioned in past episodes. Check out these amazing book recommendations here. Happy reading!


Dr. Saru Bala is a licensed naturopathic doctor specializing in women's hormonal health. Her focus is from your first period to your last and her work centers around education for you and finding you options other than birth control for your hormonal issues.



Dr. Bala  00:00
I get a lot of people who come to me and they're like, I don't know if this is normal, I was told it's not. But if it feels off in your body, you know your body better than anyone else, so just trust that.

Andrea  00:12
You're listening to Make Some Noise Podcast episode number 490 with guest, Dr. Saru Bala.

Welcome to Make Some Noise Podcast, your guide for strategies, tools and insight to empower yourself. I'm your host, Andrea Owen, global speaker, entrepreneur, life coach since 2007, and author of three books that have been translated into 18 languages and are available in 22 countries. Each week, I'll bring you a guest or a lesson that will help you maximize unshakable confidence, master resilience and make some noise in your life. You ready? Let's go.

Hey, everyone, welcome to another episode of the podcast. I am so glad that you're here. Do you want to know something that I'm a little bit self-conscious of? I mean, you probably don't, but I'll tell you anyway. So I know I'm not the only podcast that you listen to, I'm aware that there are others and I listen to other podcasts. And you know, when the podcast host, or even the guests have a really great microphone, which is better, right? It sounds better. This one that I'm using is one of the best in podcasting. The bad news is that it picks up everything. Every little wetness in your mouth, or not wetness enough. Sometimes. It's like the sticky stuff that you can hear. And some people really hate that I'm kind of neutral. I don't doesn't really bother me all that much either way. But there are some podcasts that I listened to and if you get to know, the little idiosyncrasies of the person's speech, and I've noticed when I'm listening back to my show, for whatever reason, I don't listen back to every episode, but I do this thing where I breathe in… I'm not even gonna say it. I'm not going to explain it because then there's going to be people who were like, I never noticed that before but now I do and it's annoying. introduce you to a sound that you might not have previously heard about. But anyway, I'm self-conscious of it. And so I try to make sure that I drink enough water and I don't have like that gross, sticky sound.

You know what else is happening today? That doesn't have anything to do with anything, but it's on my mind. Have you ever had a pimple right below one of your nostrils? It…what…why? Why is that spot so tender? And like, you know, you can feel it coming the day before? You're like, oh, no, this is coming. I swear, I feel like I'm being punished. That's that. And when they're on your lip line? Those are the worst spots? Oh, oh, my God, that hurts. Yikes. I wouldn't wish that I wouldn't wish that upon anyone.

Anyway, back to…back to what we're supposed to be talking about today. We're on women's health. And we're talking about periods today. You know, what's funny is there's kind of a joke that I have, where people ask, what do you talk about on your podcast, or what do you talk about during your retreats? And I will say we talked about our feelings and our periods. And I'm just kidding. Like, we don't we talk about our feelings. And actually, at the last retreat that I hosted, we did talk about our periods because I told you guys my period was like two months late. Yeah, that was happening. At any rate. Now we are talking about our periods, or lack thereof on today's episode, because we're on women's health, and I wanted to have someone on to talk about things like what's normal in terms of period pain? Are there any supplements we should be doing? What are we supposed to track? Is it just the days? And anyway, so those are some of the questions that I asked Dr. Bala today.

And I'm excited to keep going with this particular theme, because as I mentioned, I believe it was last week. The reason that I wanted to do a specific theme on women's health is because I do feel like if we don't have our physical health together, if we're not well, then it's really hard to focus on our mental health. And the two go hand in hand. I am noticing that now as I am in a season of my life, where my physical health isn't the best and it's been consistently a challenge for on and off for a matter of years now and so selfishly I taking you along this journey with me as I get to the bottom and try to learn more about women's health in general. So I really hope that you're enjoying these. I've really enjoyed having these guests on and making these connections and introducing you to these amazing people's body of work.

And if you missed it, in case you missed it, there was an announcement last week that How To Stop Feeling Like Shit has been updated And rereleasing December 27, 2022. It has a bright yellow cover this time around. I've added excerpts to every single chapter in that book. New tools, new insights, new techniques and I'm really excited. There's a bunch of free stuff. If you go to AndreaOwen.com/HTSFLS, if you purchase the updated copy, there is a free workbook. There is a private secret podcast series that has everything to do with this revised updated book. What else? We're doing a giveaway. There's a sharing thing where if you share on social media, you get entered to win a drawing, it's super easy. And we're giving away lots of amazing prizes, including a one-on-one session with me, candles for my favorite candle places. Go check it out. There’s some really awesome things. I appreciate you supporting this book, and supporting it so much that I was able to do a revision and it's kind of a dream come true. I think for any author as the years go by, and we gain new insight and things happen and we have additional things to say that we wish that we could put in the book. I'm getting that opportunity and I appreciate you so much supporting How To Stop Feeling Like Shit.

Alright, that being said, let's get on with the show. Let me tell you a little bit about today's guest. Dr. Saru Bala is a licensed naturopathic doctor specializing in women's hormonal health. Her focus is from your first period to your last and her work centers around education for you and finding you options other than birth control for your hormonal issues. So without further ado, here is Dr. Bala.

Dr. Bala, thank you so much for being here.

Dr. Bala  07:14
Absolutely. Thank you so much for having me.

Andrea  07:18
I again found you on TikTok and I say again because so many of my guests in 2022 have been from TikTok and I love… The algorithm like definitely knows, like the things I'm struggling with. And it's very much like, like my audience. But I think the thing that…this may have been like the very first video of yours that I saw where you were talking about how it's not normal, like we grew up thinking, you know, those of us that have uteruses and periods like we grew up thinking, I think the majority of us, like period pain and period cramps, it's just normal. It's just a part of…it's common and normal. And so I am pretty sure your video said that it's not actually normal to be in pain every time we have our period. So did I understand that correctly. Is that right?

Dr. Bala  08:02
Yes, that is right. Absolutely. Yeah. So we, I think are just taught by society, like, yeah, it's normal. You have a period, it's supposed to be painful. You're supposed to be doubled over. You're supposed to feel miserable. It will….

Andrea  08:15
It’s called the curse, right? Do they still call it that?

Dr. Bala  08:18
I don't know. I don't know. I hope they don't because I don't want anyone to think. Yeah, I know. I don't want anyone to think that being a woman and having a period means you're cursed. Because that's so sad.

Andrea  08:27
It’s not right. Okay. But yeah, okay. So it's not like… What's the difference between just like mild cramping, and then something that we should get checked out?

Dr. Bala  08:37
So here's the way that I like to describe it to people. So if you are going to the gym and working out, and then you're a little bit sore the next day, you're not taking ibuprofen. You're not, you know, calling out sick from work, you're not laying on the couch with a heating pad all over your muscles, right? I mean, maybe but if you are, we probably need to talk about people at the gym. But that's probably not what you're doing. That's the level of soreness that is expected and normal for a period, right? Your muscles are contracting, your uterus is contracting, it's expelling that lining. It's going to be uncomfortable, you're going to experience some discomfort, you're definitely going to have a little bit of, of, of cribbing and soreness. But it shouldn't be anything more than that. You shouldn't be in pain. You shouldn't be having to cancel your plans. You shouldn't be having to stay home because of your period. You shouldn't be having nausea or dizziness or having to pop pain pills around the clock because you're in so much pain. So none of that is normal. Soreness, absolutely. Of course you're gonna be a bit sore, but it shouldn't interfere with your day-to-day activities.

Andrea  09:40
That's interesting. I never knew that. So what…I mean… I know it's you're not going to be like okay, here's what here's what's wrong with you. I'm gonna drag this imaginary person but…and I don't want to scare people but what are like some things that it could be like everything from you know this mildly…. Could be going on to like, yeah, this could really be a problem. Like what are what are some possibilities?

Dr. Bala  10:05
Usually when you have period pain, it can be a few different things. It could have a hormonal component, it could also have that inflammatory component. It could be endometriosis, there could be infections, or fibroids or something else causing it. So there's a lot of things that we want to consider, right? And once you had kind of those bigger things rolled out, we know it's not a fibroid, we know it's not an infection, we know there's nothing major going on, then we like to think, okay, how are your inflammatory levels doing? What are your hormones doing? Especially with people who have endometriosis, we really want to look at overall inflammatory levels and estrogen levels, because estrogen is what is stimulating those endometrial lesions. So what we see is, people who have endometriosis end up having a lot more pain when their estrogen levels are really high. But it's also an inflammatory condition so overall, inflammatory levels also make a really big difference. Those prostaglandins, which are these chemical like hormones in our body, or sorry, hormone like chemicals in our body, that are responsible for the smooth muscle contraction. And so that is what is causing your uterus to contract in the first place. And when we have too much of that, it's going to cause a lot more pain for some people. So that's where I like to say, Okay, well, if everything else looks good, what are your hormones doing and how are your overall inflammatory levels?

Andrea  11:21
Okay, and so I was it was kind of a toss-up in my head of whether or not I was going to ask you about this, but since you mentioned prostaglandins, what is…Because I learned about that when I Googled a couple of years ago, is period poop of thing, because I just thought it was like a joke among my girlfriends, like, oh, I’m on my period right now, and I have period poop. It's the worst. And so it's actually a thing and it's caused by prostaglandin. So is that another thing that's normal, like period poop which kind of borders on diarrhea, but it's not diarrhea?

Dr. Bala  11:54
Right. Yes, very similar. And it's because of those prostaglandin. So often, so many people say that they have period poops in conjunction with their period pain and that's just a big red flag to me that hey, you're prostaglandins are probably pretty high. And that is because prostaglandins, like I said before, they are responsible for that smooth muscle contraction. Your uterus is a smooth muscle and you know what else is a smooth muscle, your colon. So the more prostaglandins you have, the more stimulation you're going to get for your colon as well. So that's why sometimes right before your periods and times right around your period, you're going to notice this increase in poop.

Andrea  12:30
I am going to have to…I'm gonna send you a tick tock that actually went viral. Do you remember the TikTok sound that was going around where it was all we're done? You're done. It was that one. And I said something like when the coffee and the period poops collide, and then have like the large intestine with the face on it. And I guess a lot of people could relate.

Dr. Bala  12:55
Oh, my God, I cannot even imagine having to do coffee and have a period at the same time.

Andrea  13:02
I'm very sensitive to caffeine and sometimes when I have too much of it, and when it's, you know, first day, my period, my large intestine thinks that's hilarious. But anyway, enough about that, so okay. So just so we're clear, so some period poop is normal just because of the presence of the extra prostaglandins? Is that fair?

Dr. Bala  13:22
Yeah, exactly. Yep.

Andrea  13:24
Okay, so can we talk about bloating for a minute because is it similar to cramps where we can have like some bloating, but too much bloating could be a problem?

Dr. Bala  13:33
Yes. So the reason that you get bloated right before your period starts is usually because of progesterone and if your progesterone levels are really good, sometimes you're gonna have more bloating. That's also why when you're pregnant, you just feel so uncomfortable and bloated and just like, heavy and full, and yeah. Aside from you know, the baby being…you're also just got so much progesterone, and that's also causing a lot of that bloating and constipation as well. So that hormone, unfortunately, is the one that is responsible for that.

Andrea  14:01
It's also fascinating to me, because Mitel is one of those over the counter things that feels so amazing, because it hits all of these things that become problematic for people who are having their period. You know, it helps with headaches, bloating, mood. And so to me, the fact that… I always grew up like the fact that they make a medication specifically for that means that it's so common that all of this is normal for it to have this pain. Now, it's nice that I'm now knowing this like as I'm moving towards the end of my period career, but I want to ask you about PMS and why do some, and I'm assuming this is also a hormonal thing, why do some women have it worse than others?

Dr. Bala  14:48
PMS is kind of a broad term for a lot of different symptoms. I remember reading a research article that said there were 90 different symptoms associated with PMS. So it can look different for everyone needless to say. Typically, it's kind of starts with those mood symptoms, right? Like the irritability, the mood swings, the depression or anxiety for some people. It can also be the physical symptoms. So the pain and headaches and the breast tenderness and the bloating and migraines or the quote unquote, period flu. All of those are also PMS symptoms. And so again, caused by those hormonal shifts and fluctuations. Typically, what I see most associated with the majority of PMS symptoms is that estrogen level being so high. So when your estrogen levels are too high, or your progesterone levels aren't there to kind of match those estrogen levels, sometimes I see a combo of both where estrogen is really high, and progesterone is pretty low, that shift. So right before your period starts, all your hormones kind of drop off and that drop off is what causes a lot of those symptoms for most people. And you know, the higher your estrogen levels are and the more they have to drop, the bigger the crash. So that's kind of where a lot of those symptoms are coming from. Those that drop in that estrogen can trigger those migraines or headaches can trigger that high levels of estrogen can trigger the breast tenderness, it can trigger mood swings. So that's typically what I usually see most often is that high estrogen and low progesterone.

Andrea  16:19
Hearing you say all this for the last few minutes, I'm thinking to myself, like women are amazing creatures. Like honestly, that we hope are so resilient, that we can survive this fluctuation in our hormones, not just when we go through puberty, or give birth, or go through menopause, every single freaking month.

Dr. Bala  16:38
All over the place. And it's like, I just finished breastfeeding a couple of weeks ago, and I can't even tell you the hormonal shifts I've been having. I'm like, what is this and you think like, I'm 13 months postpartum, you thought it was over. And like the first few months after giving birth, and you've had that shift and your hair falls out and you feel all over the place. I'm like, okay, I made it through that hump, like now and then it happens all over again with breastfeeding when you stop, or when you wean. And it's just like, there's so many things that our bodies do that never have to go through. They never have to experience and they'll never understand. And it's like, how? How does our body do it? I'm like, how can I possibly handle any more of this? It's kind of crazy.

Andrea  17:22
It's fascinating. And just, it's also just really awe inspiring too.

If you'd like to consume podcasts, which I'm assuming that you do because your year, if you do, I think you would love audiobooks, if you have not found them already. Audible has a free trial, you can try it for 30 days for $0 and then you can get two free audiobooks with Premium Plus, all three of my books are over there on Audible. 52 Ways To Live A Kick Ass Life, How To Stop Feeling Like Shit and Make Some Noise. Plus most of the books I recommend here on this show, and my guest's books are over there as well. After 30 days, you get one audiobook a month for $14.95 a month and you receive 30% off the price of additional audiobook purchases, and you can cancel it anytime easy peasy. Your books are yours to keep even if you cancel, go to AndreaOwen.com/audible to sign up for your free trial. That's AndreaOwen.com/Audible.

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Okay, so you know, on your social media, you talk about tracking your period and so you talk about you know, it's more than just tracking like what day your period is on. So can you talk about the additional things that women should track?

Dr. Bala  20:41
Absolutely, yeah. So there's a few things that I like to make sure your track, not only the first day that you start bleeding, and that includes the first full day of bleeding, not spotting. So I want to make that clear, because a lot of people will start counting as soon as they start spotting. I want to full bright red blood, that's when we count our first day. So that's the first thing I want you to count. And then the other thing is, how many days are you bleeding? That does include spotting at the end. So even if you kind of took off and you're spotting towards the end, I still want you to count those days, just not the spotting in the beginning. And then you're also going to track how much you're bleeding. How many pads are you filling up? How many tampons are you going through? How often are you going through them? How many times are you emptying out your menstrual cup? Those are all things that I want you to track too, because that tells me how heavy your bleeding is, and typically also gives me some insight into your estrogen and progesterone levels. If you have a really heavy bleed, I can assume that your estrogen levels are probably pretty high because your estrogen is what stimulates that uterine lining. And what's getting shed during a period is your uterine lining. So how much blood you're losing is also very important. And then any symptoms you have and when do you have them in your cycle? Some people actually experience more of their symptoms around ovulation. There is that spike in that estrogen right before you ovulate so again, that that's rise in estrogen and that fall again, that is what stimulates a lot of those symptoms for people. So when in your cycle are you noticing those symptoms? What day of your cycle are you having them? And what symptoms? Are you having breast tenderness? Is it headaches? Is it migraines? Is it mood symptoms? And then anything else associated with your period. Do you have blood clots? Or do you have like really dark brown blood the whole time? Or is it bright red? Is it more pink? Like what color is your blood? So as much information as you can gather, I appreciate it. I like to know every single last detail about your period. I want to feel like I'm there with you believe me. So I really, really like to have as much information as possible, because it really gives me so much more insight into what's going on with your body.

Andrea  22:41
Interesting, okay. And then what about kind of, you know, shifting gears all over the place here, but I want to make sure that we cover everything and I'm curious about…you made a video how you wouldn't it was like the four things I wouldn't do looking back or something like that. And it was about birth control pills and it was interesting to me. So I have a daughter, she's 13 now, but when she was 12, she had just I think she just turned 12 and she had just started her period and I took her to the dermatologist and the dermatologist for acne. And the dermatologist said, you know, we can do this and we can do this. And she's like, we can also I can prescribe the birth control pill for her acne and like my jaw hit the floor. And I was like, I never like absolutely not like she's 12. And but I was on the pill from age 15 to 31 for birth control. And so it makes me wonder if I have a couple of questions like a Why do you not want that to…like, let's talk about it. Like why is that like a go to, and also, are you seeing or do we know or like, is there any research done on like long term studies on women who might be in their, you know, 40s 50s and 60s who were on birth control for, you know, over a decade and doesn't have any long term effects that that researchers know of.

Dr. Bala  24:02
So, currently, we haven't seen quote unquote, the long-term effects, but we do know that it can affect your microbiome, it can affect your gut health, there are some nutrient depletions with like B vitamins and a lot of the stuff that we need for liver support that it can cause issues with. So there are some like the obese functional things that we're seeing that birth control can cause issues with. Not only that, a majority, pretty much everyone I see are people who either didn't want to be on birth control or tried it and they just felt miserable honest, there are side effects when you're on it, right? So I had a lot of people who were like I had tons of hair loss when I was on birth control or my moods were all over the place.

Andrea  24:40
I had some friends that had some pretty significant side effects that just could not, could not be on it.

Dr. Bala  24:45
Right. And that was me too. I tried birth control for a few months and I was miserable. I was so depressed, I was so anxious, I wanted to cry all the time. And I was like this just doesn't I feel awful. I don't I don't want to feel like this. I would you know rather are the alternative and so I had to get off of it too. And I know you know, so many other people struggle with that too. I'm always a proponent of if the only reason you're using it is for preventing pregnancy, that's one thing. But I really don't like it being used for covering up the symptoms that you have with your hormones because there's something going on right? Why are we just slapping a bandaid on it and calling it a day. We want to really look into why are you having period pain? Why are you why are your periods coming twice a month? Why are they so heavy? Why do you have such big clots? Why are you having irregular periods? Why are you having trouble with whatever it is that you're having trouble with? Right? There's a reason behind it and I don't want to tell people like it's fine, take birth control till you want to get pregnant, we'll deal with it then. Because that's just not fair to them. Those problems are getting worse.

Andrea  25:48
That's interesting, because like, I just wanted to say like, yeah, I know, people. And this was probably back in the 90s and 2000s, I had friends that were in their 20s and teens and 20s, who were having either really heavy periods or irregular periods that got put on birth control to quote unquote, fix the problem. But that's what you're talking about. Like, that’s not the solution.

Dr. Bala  26:09
And it's still happening. It's still happening every single day, it still happens. I have so many patients that come to me. And they're like, I was told that I could take birth control and wait until I get pregnant and then do fertility treatment, then. Like, those are the options that they're given. And there's just so many more things that we can do to figure out well, why are you having those problems in the first place? Most of the time, none of that was explored.

Andrea  26:31
I look back and I'm like, I had pretty bad anxiety. Never in a million years, would I have connected it with birth control pills?

Dr. Bala  26:38
Did it get better when you got off of birth control?

Andrea  26:40
Yes, and no, because I got off and then and then had two babies like pretty much back-to-back and then had really bad postpartum anxiety with my first one. And I had just gotten off of it, but not with my second. So and it's been like world's better. And I just chalked it up to like, well, I'm in a much better relationship now. And like, I'm more secure in my career, which those things are true but thgere are a lot of variables.

Dr. Bala  27:04
There are. So that's hard to say. But if you are on birth control and experiencing a lot of anxiety, and you're like, is it in my head? Most often, it probably isn't in your head and it may totally be related to that. That's where I want to, you know, make that clear to people because I think a lot of people are like, well, it's not supposed to be causing these issues. Like I think it's just me, and you know, a lot of times it might just be the word control.

Andrea  27:31
Okay. I was actually thinking about this, you know, as my 15-year-old son, too. So now like my children, teenagers, and I am probably going to have to have the conversation about birth control. And I thought to myself, like, I don't think I have any good friends that have teenage girls. So I'm like, what are young women using these days for birth control? Like is it is the birth control pill still kind of like the number one go to?

Dr. Bala  27:57
It seems to be that way. I think a lot of women are still scared to get the IUD because it can be a painful insertion. I worked in a high school for a while in the health center when I was in med school, and it seemed like a lot of the kids, I mean, this is it seems like a lot of the kids were using the next one on the arm implant, because you can actually see it and feel it. And so then this like, honestly made me cringe when I heard why they were like, oh, well, the guys can see if I actually have it or not so they know I'm not lying. I was like, oh my God. Yeah, it was a very cringe worthy moment when I heard what's happening behind, you know, in the teenage world. So yeah, it seems like that is kind of a popular one as well. But it seems like birth control is still kind of first line.

Andrea  28:42
That and like the shot that's basically the same as birth control pill right? Just given in another format.

Dr. Bala  28:51
Very, very high doses. Yeah. I would say that probably is the one that has the most side effects for people because it's such a high dose all at once.

Andrea  28:58
Interesting. Okay. Fantastic. Anyway, moving on. I feel like my gosh, the birth control pill came out what in the 60s was the 1960s? The 60s? Yeah, it's been a minute, but you would think we’d have better options.

Dr. Bala  29:12
You would think we would have had men's birth control by now. We've been you know, like we get some people to the moon and back and all other planets, but we can't get men's birth control.

Andrea  29:27
Okay, well, let's talk about supplements. So are there any supplements that you recommend that women should absolutely be on to have better menstrual cycle health?

Dr. Bala  29:37
So period pain in particular one that I have found across the board that everyone loves and works really well and is very like safe, effective, gentle, is raspberry leaf tea. If you haven't tried that one…

Andrea  29:50
I tried that one out I was pregnant?

Dr. Bala  29:52
Yes. Yep. A lot of people to take it in their third trimester to help prepare for labor as well because it's a uterine tonic. So it helps to strengthen and grow lacks the uterine muscles and so it can be really helpful to prepare for labor it can also be really helpful for period pain. So I love using that one as a tool for pain sometimes even works for heavy bleeding but for most often I use it for pain. Did you like the taste of it? A lot of people no complain about that.

Andrea  30:21
I absolutely do not and I drink it with my second pregnancy. My first pregnancy was a cesarean section. He was a frank breech presentation and so I started high blood pressure. It was best that he was a C section and with my second one, I really wanted to have a VBAC vaginal birth after cesarean and so I hired a doula. And she was the one who recommended it. Just like we wanted to do everything that we could to set ourselves up for, for easy as possible labor and delivery, and it ended up going really well.. Yeah and we're all very happy with the outcome. And yeah, so that's but no, I can't remember if I added honey to it, or something. I'm sure I did.

Dr. Bala  30:59
Yeah, you might want to, I don't, yes, I if you're not a big tea drinker, it might be a little earthy for some people, but I don't know, I really loved it, I always drink it with other herbs in it. So I think that helped the flavor too. So but it is a really a really great one to add it in for period pain. So that's one of my go twos. Another one is also magnesium. Again, very simple, very effective, really helps to relax you, I typically like to use the malaise or glycinate form, if you're going to use to treat or oxalate, those are the ones that are most often found over the counter. Those ones are more…they're not as well absorbed. So they sit in your gut, and they pull all the water in. And it helps if you're constipated, but you're not going to get as much of the muscle relaxing properties of it. So if you're going to do it for the pain, I would say do it in the glycinate or the maleate form.

Andrea  31:53
Okay, so what about when women start to reach their, you know, their late 30s into their 40s and maybe they're seeing some changes in their, their period or their skin or… When should one see a doctor and like what kind of doctor should we see? I think there's a lot of confusion in that and like what's normal because like, sometimes we hear, oh, you might skip a period here and there and like, grow some face hair and like you're fine. Like it's just part…

Dr. Bala  32:19
You might turn into a gargoyle.

Andrea  32:23
That’s right. Like a little mustache. It's okay. Yeah.

Dr. Bala  32:26
That's a good question. Because I get a lot of people who are like, just hitting 40 are like very early 40s and they're like, yeah, I'm like going through menopause and perimenopause. No, you're really unless… And even that is still kind of rare. Like, unless your mom also went through menopause at a very early age, it's really unlikely that you are going through menopause or even perimenopause and your early 40s. It's not until your late 40s, that you should be experiencing those symptoms. So if you're noticing changes to your period, and they're getting lighter, and further apart, and irregular, and just anything, in general is changing with your period, and you're not quite in that late 40s, I would say go get it checked out because there's something going on, right? There's something that's changing. So if someone's telling you that it's just normal, and they're just chalking it up to menopause, I would say they are not doing their due diligence in looking a little bit further on what might be going on.

Andrea  33:21
Okay, that's what my doctor, my OBGYN said because my we're getting closer together, I think we were around when I turned 46. They were just like, I was always like clockwork, you know, 26, 27 days, and then it was like 25 days, 24 days, and then I had one that was 17 days, but then it went back to being like 24 days, 25 days. And she said, if you completely miss one, then give me a call if you have any other symptoms but you know, this is pretty normal, like what you're seeing, as long as they're not like all over the place. And mine were also getting lighter. But I always had kind of a light period anyway. But instead of four days, it was three days. And then I finally totally, I totally missed one. I think I've told the story on the podcast before but I can't remember if I did or not. No, I did. I did tell it. I called the office and the nurse said, so had been like two months since I had my period. And my husband had a mastectomy nine years ago. And she said, okay, well, you took a pregnancy test. And I was like, no. Why? And I had googled it and the chances of getting pregnant or a failed vasectomy is less than 1%. And then I also Googled chances of conceiving naturally at age 47. And it was 5% or less. And so my husband looks at me and he's like, so there's a chance…it's not 00 Imagine and then because the you know technology is the way it is I started seeing TikTok’s of women who were like 46,47 who got pregnant. He went immediately to Dollar General and got a pregnancy test. It did come back negative. But that feeling of like, oh, am I going to be that 47 year old mom?

Dr. Bala  35:09
Yes, I know. I know. It does happen. It does happen. But that's why they say it. I know.

Andrea  35:15
Yeah. Anyway, all that to say, I am not pregnant everyone. And also I just am at that phase in my life where yeah, my period is kind of like, oh, we forgot. We forgot that we needed to, to show up. But is there anything else in terms of, you know, when we get to that age and like, I don't know, like, my joints are hurting a little bit more like, is there anything else in terms of… I hear a lot of kind of conflicting information about like, what exercise is best, and like, eating and gut health and everything. So what's your opinion on advice, like getting into menopause just like, even like, you know, late 40s, when things kind of start to change, and we can't kind of, you know, eat the same that we were before and just tired more easily, like… Are there any additional supplements or advice that you have for that for just feeling better?

Dr. Bala  36:03
Like before I even get into that, I will say, and this is kind of for the younger crowd, but it also works for the older crowd is that there is a lot of research to show that your muscle mass in your 20s is actually the predictor of your overall health in your 50s. So that is just a plug for, you know, make sure that you are taking care of your body getting in that exercise getting in that activity while you're young, because that is what carries you through in menopause. Especially because at around menopause when your estrogen drops that is what is that predictor of that bone density, right, our estrogen is not there to help with that bone anymore and that's where our muscle mass is really, really important. The reason that hip fracture is so prevalent in women in their 60s and 70s is because that muscle mass is just not there anymore. So if you can go into your menopause age, with a good set of muscles on your bones, that is obviously the best thing we could do. That's prevention.

But if you're already here, I would say working on strength training before you get to that point, it's also very helpful, it's never too late to start, right? The best time to start is always yesterday, the next best time is today. So you know starting with strength training, resistance training, just building muscle on your frame, it's going to be really helpful. That's also going to help with your overall metabolism. As you start to feel like things are slowing down, adding in that muscle mass is going to help with your metabolism, it's going to help with your gut function, it's going to increase blood flow to your gut, it's going to help you feel like the foods you're eating are not just sitting there. So I would definitely say don't underestimate how much exercise can do not only for your mental and like physical health, but just your Hormonal Health and like how you feel overall, your gut health, like all these little things that you don't think are quite related to maybe exercising can definitely make a difference there. So any strength training exercises that you love doing, definitely add that to your list.

And then another thing also that I have found really helpful for my, like pre-menopausal, and like menopausal age women is liver support. So as those hormones are just going sometimes, you know, you'll get big pushes of estrogen and that's where those hot flashes are coming from. And it's just your hormones are doing all kinds of crazy things are all over the place to help regulate that, your liver is what is metabolizing everything in your body, including your hormones. And so when everything's just like too much too little all over the place, you want that liver to make sure that everything is getting metabolized, especially when it's too much. So when you're having hot flashes and night sweats, that usually means estrogen is on the higher end. And so if we support your liver and getting rid of that estrogen, usually people start to feel better.

Andrea  38:37
Interesting. Okay. That's pretty much like the consensus of what I've been hearing. I don't know what I'm like waiting for somebody to be like, so, you should actually be napping as much as possible.

Dr. Bala  38:47
Just take naps, eat pizza, relax.

Andrea  38:52
Yeah, it's pretty much…that's the consensus. And I think the thing that actually made me feel so much better is that as I got into like my mid 40s, I was finding that the hard cardio workouts that I always done, were so much harder and they would take so much out of me. And now what I'm hearing is like, just go on a walk. Like that’s plenty. Like weight train and just like low impact cardio…you know, if your heart rate like does not go above 120 That's fine. That's fantastic. Like just great low and yes. Yeah. It's like the Golden Girls workout. Yes.

Dr. Bala  39:28
I love it. I know I saw on TikTok, they were calling them hot girl walk. I was like yes, hot girl walk.

Andrea  39:34
Walking. Yeah, I used to think it was really boring. But that was when I could do a really hard workout and it was fine.

Dr. Bala  39:41
Right? I know. Yeah, now that I'm so much more tired, now that I have a daughter that I have to entertain. I'm like, Let's go for a walk. It's great. Two birds, one stone.

Andrea  39:49
Be outside if you can and all of that good stuff. Well, thank you so much. I appreciate this. And I'm trying to get like a range of experts talking about women's hormone from different perspectives of you know still being in the phase of life where we have a regular period and we're talking to people who specialize in in menopause and I just appreciate your perspective and your time today. Is there anything you want to circle back to make sure that you say so you can feel complete before we close up?

Dr. Bala  40:14
I feel like we touched on a lot of topics so you know, just know that if something feels off in your body like don't discredit that I think I get a lot of people who come to me and they're like, I don't know if this is normal, I was told it's not but if it feels off in your body, you know your body better than anyone else. So just trust that.

Andrea  40:32
Yes, I hear that just that's a whole other conversation about yourself interesting. You're happy and I appreciate you so much. Your link to your website is going to be in our show notes Dr. Saru Bala and then also your social media as well. And you're @DrSaruBala on TikTok as well right and Instagram?

Dr. Bala  40:52
Yep, yep. TikTok and on Instagram.

Andrea  40:53
Okay. I have found your videos, your social media so helpful. I just I love those like bite sized nuggets of of information. And thank you again so much for your time today.

Dr. Bala  41:03
Absolutely. Thank you so much for having me.

Andrea  41:07
Yeah, and everyone listening. Thank you so much for your time. I'm so grateful that you choose to spend your time with me and my guests. And remember, it's our life's journey to make ourselves better humans and our life's responsibility to make the world a better place. Bye for now.

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