Dr. Felice Gersh: Beyond the Pill: Rethinking Contraception

Episode Transcript
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Speaker 1 (00:12):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guests should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.

Speaker 2 (00:31):
Birth control, it's sometimes needed, but are there side effects?
And is there a safe alternative? Welcome to Accelerated Health
of Sara Banta, where I cut through the noise and
fast track your journey to better health. I'm your host,
founder of Accelerated Health Products and certified by the National
Association of Nutritional Professionals, and I'm here to share the

(00:52):
latest unsupplements, wellness x natural health solutions that actually work,
from boosting energy to detoxing to balancing hormones and everything
in between.

Speaker 3 (01:04):
I will help you reach your optimal health.

Speaker 2 (01:07):
And I'm so excited to have doctor Fully Skirch back.
She's my go to guru on all things holistic with
that Western take as well on medicine and how to
heal the body, be your optimal self, especially as us women.
Right and we've talked about estrogen dominance, We've talked about

(01:30):
birth control safety, We've talked about gosh pcos We've talked
about so many things and the amount of knowledge, Doctor
Gersh you have is just mind blowing. I actually go
back and listen to our own podcasts over and over again.
I've got young daughters, so I'm concerned about their age group.

(01:51):
I'm concerned about the women that are in that fertility zone,
and I'm also worried about the perimenopause and menopausal women.
But today I want to pick your brain about beyond
the pill and rethinking contraception, the pros, the cons, what's

(02:11):
the best alternative. Why haven't we come up with a
safe alternative? What they can do to our natural hormones
in a world where our hormones are completely whacked out already,
and which we've talked about before.

Speaker 3 (02:26):
So let's dive in.

Speaker 4 (02:29):
Well, you hit on a lot of the essential issues,
you know, and the problems. And the first thing I
always want people to take away as a very key
foundational issue of life is that fertility is a vital
sign of health of the reproductive age person and in

(02:50):
women of course, reproduction, hormones, fertility are all completely intertwined.
I mean, that's the problem and the beauty, you know,
So we can't separate them and have no impact. So
once we recognize and accept that the prime directive of
life itself is the creation of new life, and that

(03:13):
only humans of all animal species on the planet, actually
try to control our reproductive destiny. There's no other animal
that says, oh, let's not conceive this year. You know,
like you put a bunch of whatever it is, you know, bears, monkeys, kangaroos, cats,

(03:33):
you know, and you get them together during so called
mating season, and they will mate, they will make babies,
and that's, you know, what we try to do. The challenge,
of course in zoos is getting animals in captivity to
actually feel like they want to conceive. That's you know,
when you have a totally abnormal setting, but when they're

(03:53):
in the wild and everything is right with the world,
that is what animals do. That's what teenagers want to do. Unfortunately,
and without there's no like thinking about having a baby.
When animals mate, they just do it. It's all instinctual.
And the thing about humans is that we really do
want a time when we have kids or don't have kids.

(04:15):
And I am like the ultimate feminist. I don't want
women to have babies when they're not wanting them, or unready,
or when it's a risky business. Because pregnancy is the
ultimate stress test for women, and we don't want unhealthy
women conceiving. We want to wait until we get them
optimally healthy. That's such an important issue. So the bottom

(04:36):
line is that we do want to control our reproductive destiny.
But when you understand that fertility is a vital sign
of life and health in the reproductive aged woman. So
by taking fertility away, you know, you're not trying to
sterilize women who aren't ready to be truly sterilized. But

(04:57):
by putting a pause, we'll say, a pause on fertility,
you can't do that without some repercussions. So what's become
like the most mainstay, well, hormonal contraceptives and we'll go
into that. You know, and that we know that there
are the main one that is used just prolifically and

(05:20):
around the world are oral contraceptives, and of course it's cousins.
You know, you might say the contraceptive vaginal ring and patches. Right,
So these are all delivering what I mean, have you
talked about this before with all your listeners, Like what's
in these now?

Speaker 3 (05:38):
With you?

Speaker 2 (05:39):
Did we talk about birth control for helping with periods
and painful menstruation, and that was what we We dove
into it a little bit, but we did not talk
about all of the other options. And I love what
you said about how your your fertility is a sign
that your body is healthy or not, and how stress

(06:02):
can affect your fertility for a reason because your body's saying, hey,
you're not in a position to support another baby, and
if you're not in a healthy position to get pregnant,
it drains you. It sucks the life out of you,
because your body's going to give that baby everything that
it needs taking it from you. So I just wanted

(06:24):
to emphasize that you really do need to look at
your fertility as a sign of health.

Speaker 4 (06:30):
That's right. And if we think about, well, what's in
an oral contraceptive pill, like what is that? Well, technically
officially they are labeled endoquine disruptors. So what is an
endoquine disruptor. It's any molecule. It could be natural, it

(06:51):
could be chemically created, but it interferes in some way
with the normal everything or something of a hormone, So
that would be its production, its distribution, its receptor binding,
the receptor itself. It's degradation, its elimination. So any or

(07:13):
all aspects of how a hormone is produced exists and
leaves the body is totally under the control of you know,
all different aspects of the body, and an endocrine disruptor
is going to interfere with one or all of those
different different functions of a hormone. So that's the whole goal.

(07:35):
It's important to recognize what the goal is of a
contraceptive pill. It's to make you infertile. So to do that,
the way they work, a normal contraceptive pill, a typical
contraceptive pill that has we call them combined contraceptive pills.
They combine both an estrogen and a pro stin, So

(08:01):
progestin is a made up word for a mimic of
sorts of progesterone. And we'll go into like what are
these substances. So combined oral contraceptives have both an estrogen
and a progesting component. So what actually is A doing
in the body. What's A doing to you? It's not

(08:22):
regulating your hormones, it's not regulating your cycles. And I
mentioned that because oral contraceptives are used for more than
just birth control, They're also used in women who have
problems with their periods, like very painful periods, very heavy periods,
very irregular periods. And often the words like that are

(08:43):
used are really actually wrong, Like you know, like I
just said, they're regulating your cycles. They're like, you know,
doing something to make things right.

Speaker 2 (08:54):
Now.

Speaker 4 (08:54):
What they're doing, and this is really important, is it's
a bit of smoke and mirrors. I cannot argue you
symptom improvement, but it's important to understand how is it
creating these symptom improvements. It basically shuts down your ovariant
function all together. It's the progestine component of a birth

(09:15):
control pill that creates the contraceptive effect. So what happens
is when you have these progestines in rather high amounts
they have to be a high amount, it actually triggers
your whole you know, the hypothalmis of the brain to
stop signaling, the pituitary to signal the ovaries, and the

(09:38):
ovaries just shut down. Okay, they stop making hormones. Now,
what's a similar mechanism pregnancy? So in pregnancy, you have
natural human identical progesterone, not a fake thing called a progestine,
but the high levels of natural progesterone in pregnancy will

(09:59):
shut down the ovaries so that in the middle of
a pregnancy you don't ovulate and get pregnant again. I mean,
you know, I do you ever think about that? Like,
how come your ovaries don't let you get pregnant in
the middle of a pregnancy? Like again, okay, Well, because
it's the progesterone, okay, And that's the understanding of that

(10:20):
is foundational to the development of the birth control pill.
It's that it's the progesterone or the fake progesterone that's
in a birth control PILs. Now, why don't they use
real progesterone in a birth control pills instead of these
fake mimics Because progesterone has a very short half life, okay,

(10:41):
So you couldn't take a pill a day. You'd have
to take multiple pills in order to keep those levels
high enough. Because remember this is artificially being put into
your body, and to take real progesterone orally would convert
in the liver to other the dominant one being alo pregnantolone,

(11:03):
which is very activating on the gather receptor, which would
make you a sleep you know. So a lot of
women who are pregnant feel very sleepy in the beginning. Okay, well,
that you can't do a birth control pill where you're
basically sedating the entire population with the metabolite and you'd
have to be dosing multiple times during the day. I mean,

(11:24):
there's really rational reasons why you cannot use bioidentical progesterone
in a birth control pill. And it was the development
of these fake mimics, these progestints that allowed for the
development of something like a birth control pill. Now in
the birth control pill that just has the progestine. Where

(11:46):
do these progestins derive from. The majority are derived all
but one of them are derived from testosterone. It's called
nineteen nor testosterone. So they're actually testosterone derivatives and they
maintain some of that testosterone function. And they have different

(12:06):
generations they call them first, second, third generation. The third
generation has the least androgenic or testosterone like effect, and
that would be like this type of progestine that is
found in for example, what the original brand name was,

(12:27):
ortho tricyclin or ortho cyclin Okay, norgestamy. Now, in the
like other birth control pills, you have other more powerfully
testosterone like effects, and those would be the ones that
have like norothyin drone or levo norgestrol, things like low estrin,

(12:50):
you know those pills have and the original like orthonovum
one thirty five and those kinds of pills. They have
these other progestins that are like the first phase, okay,
and they are more androgenic. Now they add an estrogen.

(13:12):
The most common estrogen that's added to a birth control
pill is called ethanol estradil, so it's not bioidentical estradyl.
There actually are a few birth control pills, very few
that have a more natural human type estradil, but they

(13:32):
get converted through the liver predominantly to estrone, so it's
still not like getting estradyl into your bloodstream. They get converted.
And then there's one form of birth control pill that
has a very different estrogen that's combined called estetol, and
that one is nextellis, and the estatol is actually a

(13:54):
fetal estrogen, as weird as that may sound, there's a
few months during fetal hood that the liver of the
fetus makes an estrogen, both in males and females for
some purpose. Or other that it has in the fetus
and that estrogen which has different binding capabilities and so on,
but it's actually been able to be replicated by you know, chemists,

(14:18):
and they actually put it in a birth control pill.
So there you go, interesting, isn't But the estrogen in
a birth control pill has nothing to do with its
contraceptive efficacy. Like you can have a birth control pill
just like the ones, but they don't have any estrogen
in it at all. Then you can say, but why

(14:38):
do they add the estrogen number one to somewhat ameliorate
the androgenic component? Because if you had these testosterone derived
birth control pills, okay, and you didn't have any estrogen,
you would lower sex hormone binding globulin and sex wom

(15:00):
Globulin binds testosterone so that you don't have as much testosterone.
If you don't have the estrogen, then you have too
much androgenic effect. Most women would not accept it. They
might start growing a beard or they might start losing
more of their hair. They would not be happy campers.
So by adding the estrogen component, you're damping down the

(15:23):
androgenic effect, so it makes it more tolerable, and it
also in some helps to create. Well it does. It
creates a fake menstrual period, okay, so that you're a
little bit less likely to have breakthrough bleeding, which you
might get a little bit from being on an androgen

(15:45):
only pill, but not androgen you know, androgen derived progestin
only pill. But it gives by adding the estrogen, you're
creating this fake cycle. You know, it's a real cycle
in that you bleed, but it's fake in that it
has nothing to do with ovulation. That's where the smoke
and mirrors come in. So it makes the birth control

(16:07):
pilled more tolerable because you're adding some estrogen back. Otherwise
you'd have virtually no estrogen in the body. Like you'd
be giving this to women. They have no estrogen, they
have no cycles, maybe a little spotting randomly now and again,
and they're very androgenic, so they're having all this facial

(16:27):
hair and acne. This would not be popular at all,
So that's why they have these combined oral contraceptives. Now,
there are some two types of oral contraceptives that are
not combined. They're often known as the mini pill. Okay,
Now they have just a progestine only one has nor

(16:50):
a thin drome. That's a progestint. The other has levo
nor gestrol, a different progestint now, and one of them
is over the counter, the other one still a prescription.
Now they have to be taken a little bit differently
because they have a much lower progestine component. It's much lower.

(17:10):
So the mechanism of a combined oral contraceptive is to
shut down ovulation. It shuts down the ovary, Okay, basically
it's pretty much shut down. Okay, when you take the
low dose pill that's like often called like the mini pill,
then that actually only maybe fifty percent of women will

(17:33):
have their ovulation stopped, and that could be unpredictable. So
the actual mechanism of preventing pregnancy is more that the progestine.
The fake progesterone changes the cervical mucus the way progesterone
does in a normal woman who's having a cycle. Some
of the women who do natural family planning are trained

(17:55):
to check their cervocal mucus, and after ovulation, when progesterone
is made, the cervical mucus goes from thin and stretchy
and clear to thick and more globby. Okay, So that's
what happens to the cervical mucus all the time when

(18:16):
you're on the mini pills, and the cervical mucus becomes
very much of a barrier and very inhospitable to sperm
getting through. But you have to take those pills every
single day. Okay, if you miss a pill or you're
even more than three hours late on taking the pill,

(18:37):
you might have breakthrough ovulation, whereas a conventional combined oral
contraceptive pill which has a much higher, much higher dose
of the progestin that it actually shuts down the ovary
and not like it does sort of half hearted a
little now and again with the mini pill. So in

(18:58):
those women, because the effect is longer lasting. Typically you
could miss one pill of one day and you still
have to double up the next day. You have to
be careful and use condoms, but you're much less likely
to actually ovulate or get pregnant, unlike the mini pill,

(19:19):
where even three hours being late in terms of taking
that pill and you may break through ovulate. Okay, So
it's not anywhere near as powerful, but for people who
are very regimented, they're really pretty effective. And once again
you can now buy one over the counter without a prescription,

(19:42):
which for some women is really important because they can't
get anyone. And in a way, it's kind of interesting
because the mini pill doesn't shut down the ovaries. You
continue to make estrogen. That's why there's no estrogen added
to those. The estrogens that are in the pill, remember,

(20:03):
are not human estrogens. They're different. So if I was
going to pick which pill I would recommend for someone
who is really responsible, I would say the mini pill
because it's not shut in most cases, it's not really
shutting down your ovaries altogether. You still have your making

(20:24):
your own natural hormone, and some women will not shut
down the ovary at all. The entire effect is through
the cervical mucous changes and they continue to have regular
menstrual cycles and so there it's like less altering to
your own natural body hormones. And they're not prescribed hardly ever,

(20:48):
you know, because you know I understand. I mean there's
a reason, like I just told you, if you're even
late more than three hours taking the pill, it may
not work, and then you you know, you could get
pregnant by accident. So it's really for people who are
really dedicated to the cause of not getting pregnant and
so on, and so it's really important that you actually

(21:09):
are regimented when you're on the mini pill, but it's
actually less changing to your body's own natural hormones, and
you're not adding in that thick estrogen, ethanol, estrodyl or
other weird hormones that aren't really ideal. They're not the
same as having your own ovaries make your hormones, which
you can still have when you're on the so called

(21:31):
mini pill. So that's sort of an overview now in
terms of like some of the side effects of the
standard or combined oral contraceptive, Well, the progestines that are
in those pills not only are androgenic, but they actually
have been studied and they they're in some ways they're

(21:53):
anti progesterones, so they're sort of they're progesterone endocrine disruptors,
so they act like powerful progesterones in one area, but
they can actually block progesterone in another area. So we
know that chronic use of oral contraceptives increase the risk

(22:15):
of cervical cancer and breast cancer, and it is related
to duration of use. Now they're not huge increase risks,
but you know, people made this crazy like craziness came
out of the Women's Health Initiative. It's about the same
level of risk as that you know, so it's not

(22:37):
a high risk. That wasn't a high risk either, but
it is a risk, and it does increase with duration
of use. The thing that a lot of women know
there may be some increased risk with breast cancer, but
most don't know about cervical cancer that it does increase.
And this was discovered about twenty years ago, that it

(22:59):
increases and especially increases when you're on the pills for
five and then you know over like ten years, which
isn't rare. Oh my gosh, I see women who've been
on twenty five thirty years straight. And here's another really
important thing. Birth control pills shut down the conventional combined

(23:20):
oral contraceptives. They shut down your own ovaries, so you're
not making any natural hormones from your ovaries, and the
testosterone level is way reduced, which is nice in one
respect for women with acne, but testosterone isn't there for
no purpose. It's also important for growing bone. Estra dial

(23:42):
is important for growing bone. So what have they and
so is progesterone. They all work on many different aspects
of overall health, brain health, vascular health, bone health. Women
who start on birth control pills in their teens, and
this is the combined oral that's where most of the
research is but never not enough anyway, And we don't

(24:03):
have data in the twenties. Not because it's much safer.
We just have no data, you know, because like ninety
percent of women are or have been on birth control
pills once they get into their twenties, so you can't
even find a control group, right. But in the teens
and now, it's considered okay to start birth control pills

(24:23):
if you've been out one year twelve months since your
first period, although I've seen girls started on it when
they've had their first period six months earlier. But they
I mean, as a general rule, they say, if your
period was one year earlier, you can start on the
birth control pills. And that could be age thirteen, it
could be age twelve, and then you could be on

(24:44):
it for the next twenty something years. Because some women
they start on birth control pills they're thirteen, fourteen, fifteen,
and then they get off of them and they're thirty
four or thirty two. Now they want to have a baby.
You know, look how many years they've been on it.
You know, it's like wow. You know, you don't have to.

Speaker 2 (25:02):
Be a doctor or a researcher to just think about
the fact that during your teenage years, the body's going
through so many changes, and the hormones have so many jobs.

Speaker 3 (25:12):
They're there for a reason.

Speaker 2 (25:14):
I mean, I've watched all three of my children go
through their teenage years with their hormonal ups and downs,
and the body's trying to regulate itself.

Speaker 3 (25:22):
But that's normal. And a lot of these girls.

Speaker 2 (25:25):
Have painful periods and they get put on these birth
controls just to squash it, not knowing what they're doing
to their bone health and their fertility and their risk
of cancer later on in life. And they don't think
that it's going to mess up their hormones during perimenopause
and menopausal years either.

Speaker 4 (25:44):
Well, these are all huge things that you're bringing up. Absolutely,
so we have published data like one study, you know,
because nobody even wants to collect this data. But like
you said, so these have very strong ramifications throughout the body.
So in terms of the cardiovascular system, young girls who

(26:04):
start on birth control pills in their teens have a
higher lifetime risk of heart attacks and strokes. And you
mentioned bone, there was studies showing they will grow bone,
but not anywhere to the same degree as if they
have their own natural hormones. Okay, And also like the

(26:26):
International Society for Sexual Health, they came out years ago
showing that women who start on birth control pills the younger,
like below the age of nineteen, they're more likely to
have overactive bladder because their bladders never get that estra
dial is very important for creating elastin stretchiness. Their bladders

(26:47):
become like stiffer for life, and so they feel like
they have to empty their bladders when the bladders are
not very full, you know. So I call them bathroom mappers,
like wherever they go, where's the bathroom, where's the bathroom?
Then they can't like a dog and a hydrant, It's
like they can't pass a bathroom without going. It's like
didn't you just go? It's like, yeah, I always have

(27:09):
to go, you know. So because their bladders won't stretch properly,
so they have overactive bladders, small bladder capacity, and their
testosterone levels have been low all the years are on
birth control pills, and they don't do, and which is important.
There are androgen receptors on the vulve and the vagina.
They're more likely to develop lifetime painful intercourse and altered

(27:34):
vaginal like development because they don't have the androgens which
have receptors in those tissues as well. And of course
the estrogen is not even the right human estrogen. Most
of the the beta receptors are not activated by estrone,
which is what the ethanol estradiole turns into a different

(27:56):
form of estrogen called estrone, which doesn't act on the
beta reset and most of skin and in the vagina
they have a lot of beta receptor. So the vagina
kind of acts like it's old, you know, like when
you're twenty. You know, we don't want that. So it's
like painful intercourse, it's dry, you know. So there are
women on birth control pilsus are using vaginal estrogen. It's like,

(28:18):
does not seem a little weird, right, And so you
can have sexual changes and those women may never have
the same orgasmic sensations.

Speaker 3 (28:30):
Right.

Speaker 4 (28:30):
Sure, we don't even have good data, but it's like
they don't have the same orgasms, sexual life, bladder function,
all of the genitourinary tract isn't quite right, the bones,
the cardiovascular system, and we know that in younger women
and they go on oral contraceptives, they have higher rates
of depression and even suicide.

Speaker 2 (28:53):
It makes sense because when you are taking an oral hormone,
whether it's the men taking testosterone or you know, whatever
it is, your body's going to say, oh, well, I'm
getting it from somewhere else. I'll shut down production. And
then who's to say that it's going to come back
online when you stop the birth control pill. I mean,

(29:14):
your hormones aren't going to just wake up and snap
right to it because they've been asleep for five to
ten years.

Speaker 3 (29:22):
Am I right?

Speaker 4 (29:23):
Well, with men with testosterone, oh my gosh, that is
absolutely true that they may never make testosterone again, which
that's why it's a very risky business to give testosterone
to young males. When we talk about women, the fact
is that most of them will make their hormones again,
but they may not be the same. You know, we

(29:44):
have very very little data on this, really little data,
but we know that the hormone receptors can degrade to
some degree or just like or altered. If the hormone
isn't in them, and we don't have the same hormones
like we would have if you had your own natural
ovar and produced hormones. So what I am finding, and

(30:06):
I haven't seen any published data on this, so this
is my own observation, is that when women are on
birth control pills for at least ten years and then
they go off of them, they often develop polycystic ovary syndrome.
It's like, what the heck is that all about? They
didn't have it before they went on it. And the
usual reply is, well, you see, you really were going

(30:27):
to get it, you just hadn't gotten it yet when
by the time you went on the pill. But the
reality is that there's something that seems to happen in
the ovary and the production of estradial from testosterone is
hampered in some ways, like the whole system has been
shut down for so long it doesn't seem to be
working properly, or the receptors are like the equivalent of rusty,

(30:48):
they're not working right. We know that women who spent
most of their lives, sometimes all of their reproductive lives
on birth control pills when they ultimately go off and
they're in me pause. They're the most challenging ones to
give hormone therapy too, because there's something with their receptors
that haven't been like online for decades and they're just

(31:12):
not like functioning properly, and we don't know how long.
There's no data on this. This is the wildest thing.
There is no published data. Nobody's looking at this, but
in observation, many of us see that it's there. They
don't do as well. It's harder to it takes longer
to try to get them properly regulated on hormone therapy.

(31:35):
Some women will snap back and get pregnant right away.
But what we don't know and nobody's looking at it
the microbiomes. So we know that the microbiomes of all
organ systems, the skin, the vagina, the cervix, the uterus, placenta,
you know, the gut, all of these microbiomes are very

(31:57):
dependent on proper hormone levels and rhythms, and you don't
have that with birth control pills. So I am concerned
when women do successfully get pregnant right after they go
off birth control pills, are they are nobody's following this?
Are these women more likely to have pre term labor,
dysfunctional labors, pregnancy related complications. We know that we have

(32:22):
an exponential rise in all of these things, pregnancy related problems,
you know, with higher miscarriage rates, gestational diabetes, hypertension, pre
term labors, malpositions, a lot of dysfunctional labors leading to
c sections because the cervix never dilates properly, and the

(32:45):
uterine muscle is contracting but it's not right, or it's
not the proper rhythm of the contractions, or it seems
like it's fine, but the cervix never dilates. What the
heck is that all about? I can't prove it, but
I am concerned that being on birth control pills is
altering these microbiomes which have a relationship to all of

(33:09):
these functions. And we know that when they've done studies
of the microbiomes that's the you know, the collective of
all the microbial life forms of something. It is called
the microbiome. We know that when they do tests of
the microbiome of placentis of women who have pregnancy complications,
they're not normal microbiomes. But why is that? Can birth

(33:33):
control pills change things around so that the placental microbiome
will be abnormal. I can't prove it one way or
the other because no one's studying this stuff. But when
you're in practice for a long time and you're seeing
what's happening, you can't help but be suspicious that something
is going on here. And by the way, the microbiomes

(33:54):
of the vagina and the uterus and so on, we
know this because has been tested. We know are changed
by IUDs. Okay, so that is not an if and
or whatever. That is a proven fact that the microbiomes
are altered, and that women, for example, who have IUDs

(34:18):
have a higher risk of vaginal infections because their natural
vaginal microbiome is off. We know that women on birth
control pills have altered vaginal microbiomes too, because they don't
have the proper estrogen content, and I mean, it's just
not right. But what we don't know is how this

(34:38):
translates to pregnancy related issues. But we do know that
it can translate to vaginal dryness and like less protection
against HIV, maybe HPV and certainly BV and yeast infections.
So there's you know, the microbiomes are altered, and we

(35:00):
don't really know how to fix them. I mean that's like,
it's not like, oh well, let's just give the reverse
and it all just goes to perfect. I wish it
doesn't work that way. This is still very very in
the infancy of understanding vaginal microbiomes. And then there's the
like I said, cervical microbiome, uterine microbont there's even fallopian

(35:22):
tube and ovarian microbiomes, and we have no clue what
we're doing to any of those. We really don't.

Speaker 2 (35:30):
Now, it's amazing because even Karen Krishnan has come on
my show multiple times microbiome expert. He will tell you
we know a fraction of what's going on in the microbiome.
It is such uncharted territory. And so you're touching on
something that just opens a can of worms. We have
no idea what's happening. So we I mean, I cannot

(35:50):
believe how quickly we talk.

Speaker 3 (35:53):
I could go on for hours.

Speaker 1 (35:54):
Now.

Speaker 4 (35:54):
We didn't get to everything. Because now it's a huge topic.

Speaker 3 (35:57):
It's a huge it is a huge topic.

Speaker 2 (35:59):
But let's touch on the alternatives and what would be
the lesser of the evils.

Speaker 3 (36:07):
If they don't want to call it that.

Speaker 4 (36:09):
It's absolutely it takes motivation, right. The reason that the
larks so larks are the initials for long acting reversible contraceptives.
Those are the implantable rods like you know implan on,
you know the rods and you know they have implan
on the explanon there. But it's the rods that are

(36:31):
implanted in the in the like arm here. And then
of course we have you know, the iu ds. So
there's the ones that are embedded. There are no such
thing as a progesterone i u D. They're called it's
called lebo noor gestral.

Speaker 3 (36:47):
People call them.

Speaker 4 (36:48):
Well, you can have a progesterone iu D. There is
no progesterone in a single IUD that exists on the
market today. There it's a progestin. It's lego noor gestral. Now,
the reason I mentioned this is that these are very popular.
And then there's the copper i u D. Of course,
now just as a quick overview, the the levoorgestrial IUDs

(37:10):
come in multiple strengths. The most common is the one
that's the name brand is Morina that can last inside,
you know, like for eight years. You can use it
and keep it in place. And the reason is that
the amount of levonorgestral inside embedded in the iu D
is very high during the first year or more. It's

(37:30):
so high that it gets absorbed systemically quite significantly and
can actually shut down ovulation. You get systemic levels, so
it's definitely given in a way that it gets all over.
So it actually has warnings on the box of you know,
if you get it, you have on the package you know,
insert and so on for depression for acne. That's because

(37:54):
it's absorbed, okay, And so it's important to understand it's
not just a local effect at least for the first
year or two, and then as you dissipate the amount
it goes down. The copper IUD creates a lot of
localized inflammation, that's one of its mechanisms. But it also
creates inflammation in the cervix, and it also increases the

(38:16):
risk of catching vaginal infections and doesn't protect again sexually
transmitted diseases. None of them do, of course, but even
less so, okay, it makes you more vulnerable, and as well,
there have been many cases now reported that when it's
removed the copper IUD arms, one or both of the

(38:38):
arms break off. When you're trying to remove it that
instead of the arms are opened up so they go
out like this. They're like this when you put it
in and then you release the sheath and then they
go out. And then it's supposed to flex up to
pull it out right, because otherwise you can't get it
out through the cervix, you know. So what happens when
people pull on it instead of the arms like flex

(39:00):
sing up like this to get it out, they break off.
They break off, and then you have to have a
surgical procedure to go in and fish around and find
them and remove them. And that's actually a real thing
associated with the longer it's been in. And then the
implantables have a lot of breakthrough bleeding and a lot
of other potential unpleasant side effects. But those are super

(39:23):
popular because you don't have to think about them because
they're put in and they're there for like three years
for this and then you know ten years or twelve
years now for the copper IUD, eight years for Marina.
That's why they're very popular. The opposite is true for
the ones that are the safest there. You have to

(39:45):
use them on an as use an as use basis,
so they're only used when you have sex. So, in
other words, unlike the long acting things where they're put
in and then you never think about contraceptives for years
because it's embedded in you in some form, these take active,
conscious decision making that you're going to use a condom,

(40:09):
you're going to put in a diaphram, you're going to
put in a spermicide or EFFECTSI, which is like an
acid that changes the pH You have to do it
every time you have sexual intercourse or it will do
you no good. Now if used just as you're supposed to,
these are very effective methods. They're very effective. The reason

(40:34):
they get a bad rap is people don't always use them,
and that's why we have two ways of measuring effectiveness
with a contraceptive. One is called use effectiveness, the other
is called theoretical effectiveness. Theoretical means you use it perfectly
every time, okay, Use effectiveness is how is it really

(40:57):
used in the real world. So condoms, if you used
perfectly every time, is at least ninety eight percent effective. However,
if not used at all or used improperly, it drops
use effectiveness. It's like real world use is eighty percent
because people just don't do it. Okay, and that's true

(41:19):
for pretty much all these barrier methods. That's what they're
called barrier methods. Now, if you use two barrier methods,
like say you use a diaphragm and a condom, and
the diaphragm can be put in up to two hours
before sex. The condom is really last minute, okay, But
if you use both of them, you're at least as
good as a birth control pill, which also has a

(41:41):
different use effectiveness, because sometimes people forget to take the
pills right, and that's good. That's why the lark, the
long acting reversible contraceptives are so popular now in the
gynecological world because it doesn't rely on doing anything on
a daily basis. Right. The shots, which I'm not even

(42:02):
gonna like, the depo pravo shots have really fallen out
of favor because they're associated with well osteoporosis. That's pretty bad,
and it's really their very poor choice because madroxy progesterone
acetate is a known carcinogen and it's bad for your
cardiovascular system. All of the progestines actually will reduce vascular

(42:28):
health by blocking the production of nitric oxide. And just
as a quick mention, the other birth control pill, progestine
is a derivative of spyrono lactin. It's called just spharnone
and it's in that's what's in birth control pills called
the branded name YAZ and Yasmin okay, and the progestin

(42:50):
only pill called slint. That one does not derive from testosterone,
so it's more like real progesterone, okay. So it's it's
actually somewhat beneficial as a standalone. That's why it can
be used as SLINT as stand alone because it doesn't
have all that testosterone like effect. So that's why it's

(43:14):
like anti. It's like more like an anti testosterone. So
that's why just as a mention of that one. Now,
in terms of the best, the best are the are
the ones that you use on a day to day,
use whenever you have sex. So it be condoms a diaphragm.

(43:35):
Then there's fecsi, which is like I mentioned, it makes
the environment to acid for sperm to livet sperm like
an alkaline environment, not over overly acid, and it will
just knock them out. And then of course there are
sperm direct killers like sort of like pesticides. You know,
there's bermicides that can be used, and all diaphragms, which

(43:59):
is like a barrier ring, need to be used with
a spermacide because those little sperm are so sneaky they
can slip right next to the diaphragm to that little space.
So that's why you have to add in the spermacide.
And especially if you use two of those barrier methods
at the same time, you have phenomenal good birth control.

(44:22):
And of course you can use Plan B or similar
as a backup if there's some accident that could happen,
you know, with other things too. No, no method is
full proof. I mean, actually, people have had abdominal pregnancies
after hysterectomy, rarely fortunately, but you know, even I've had many,
not many, but you know, considering I've been in practice

(44:43):
a long time, I've seen quite a few pregnancies after
a tubal ligation, which is a sterilization procedure. You know,
those little sperm and eggs they'll like book the odds
sometimes to get together and create a you know, an embryo.
But it's any thing that you can do that doesn't
change your hormones would be a preferred option. Hormones are life.

(45:07):
Hormones are a gift for us. That's why when women
lose them, they they should mourn their loss of their hormones.
And yet we spend many women decades of their life
getting rid of their beautiful hormones. We love our hormones.
That's why if I had to rank them, if you
wanted something long acting and reversible, even though there are

(45:30):
some negatives, I mean everything has some negatives, I would
go with the copper iud over. I would go with
that over the progestin IUDs with the levonogestral. But if
you do want to progestin one, get the one that
has the smallest life span, you know, like Skylab you know,
and you know, or Kalina. The ones that are shorter

(45:52):
than you have to replace them more often because the
amount of the livonogestul is less. I would take one
that I have to replace more often that it has
less of the levo nor gestral, because you'll have less
absorption systemically, and then you might even be able to
maintain ovariant function, which you don't have. Over half of

(46:13):
women on the Marina IUD stop ovulating, so you're not
going to have normal hormones. You don't let them trick
you and think it's not going to do that, but
you'll have less of that. And we have very little
data on the smaller dose i u ds with the levoigestyl.
Nobody's doing data collection or studies. Nobody wants to know,
but it would be intuitive that if it's a lower dose,

(46:35):
it's going to be less absorbed because we know the
longer the marina is in the less systemic levels you
know you'll achieve. So I would go with the shorter
lifespan levoonorgestrial IUDs or the copper iu D. If you
need something that's long acting, if you feel you want
a birth control pill, then and this is off label,

(46:58):
but I would use the which is the d spharaone,
not the testosterone can type of the the progestine. And
then you could actually give back bioidentical topical transdermal estradial,
because remember the estradyle has nothing to do with the
contraceptive efficacy of an oral contraceptive, and you could actually

(47:23):
do that, give back estra dial transdermally along with the SLIND,
which is the dress sparennone derived from spyronolactone progestine and
you know, if you have to do such things because
you're in college or you're you know, a non responsible,
poorly responsible high school student. I mean, I don't want unwanted,

(47:47):
unplanned pregnancies. Then for the shortest time that you have to,
you go on one of these more we'll say safer methods.
Safer because you don't have safer not in terms of
body health, but safer if you think of body health
as preventing pregnancy, okay, and that you're not going to

(48:08):
get less likely to get pregnant, and you don't have
to remember to do something every single time, and you're
not dependent on the guy to do something like use
a condom that you have to like beg him every
time if you know, because he just won't do it,
and you don't want to dump him for whatever reason
because to me, if he won't help and do his part,
then he's not a good partner. But that's my opinion.

(48:30):
And you know, and you really want something that you're
in total control, and then I would try to use
the smallest dose levon or gestreal IUD or the copper
iu D or the slind with added back estra dial

(48:52):
topically and you know, I don't want unwanted pregnancies. You know.
I'm sure you all know that you can have fun
without intercourse, right, Yeah.

Speaker 2 (49:02):
Well, the one thing I wanted to bring up that's
just a no brainer is do we really want to
be put on a pill or hormones that are going
to kill our libido for the rest of our life?
And the goal is to have a libido and have
a sex drive and enjoyment from intercourse. That's what we're

(49:23):
trying to prevent the pregnancy from. But later on in
life it may be hindered because of what we're doing
with our hormones.

Speaker 4 (49:32):
Yeah, that's why I'd say the shortest amount of time
until you become responsible and can actually insist on the
guy using his condom fit. I know their old fashioned,
but they do work. I fit diaphragms all the time.
I hate to think it's a lot of skill. It's

(49:52):
not that hard to pick up. And you know, and
if you do FEXI, there's no you know, some of
the stuff is a little the Fexsi is kind of price. See,
that's part of the problem too. But condoms are very
non obtrusive and that they're very thin. Some of them
are actually marketed as enhancers of sexual response, and they're

(50:16):
like they you're gonna feel better, like it's going to
make things even more like like upbeat and so on.
So you know, don't don't pan condoms at all. They're
not like your great grandfather's condoms exactly.

Speaker 2 (50:30):
Well, oh my goodness, we could talk forever. Thank you
so much, doctor Gersh. Can you tell people where they
can follow you and work with you?

Speaker 4 (50:39):
Sure? So? I'm a you know, brick and mortar practice
and duck and my office is in Irvine, California. That's
in the Orange County, southern California area, and my practice
is called the Integrative Medical Group of Irvine. I also
have a lively Instagram, live and YouTube channel and hopefully

(51:04):
you'll follow me and you know, watch some of my
shows and as well. I have three books out hopefully
more to come, two on PCOS, one on menopause, and
you know, I'm just here to help educate but also
to help women of all ages, one at a time,
the old fashioned way.

Speaker 3 (51:25):
You're amazing you, truly.

Speaker 2 (51:27):
Your your breadth of knowledge is unlimited and so I
always love diving in deep with you. Thank you so
much for joining us again today my pleasure. Oh my goodness,
every time she comes on, I just my mind is blown.
And you, guys, I was put on birth control as

(51:50):
a teenager, for my skin, for my acme. I did
all the wrong things. There is a way to recover,
but you have to remember that your hormones don't live
in a vacuum, dancing around with your thyroid, with your liver,
with your stress hormones, even your minerals. And so I
just wanted to talk about a couple supplements that are
really important for your hormonal balance population progesterone metabolism.

Speaker 3 (52:14):
Number one is iodine.

Speaker 2 (52:16):
It's so important for the brain fog, the depression the thyroid.

Speaker 3 (52:21):
Your thyroid is your masterendocrine gland.

Speaker 2 (52:23):
And what we didn't even touch on is that the
thyroid affects your gonads, your sex hormones, your ovaries, your
testosterone if you're a man, and if the liver is sluggished,
the used up hormones, especially estrogen, don't get packaged and
get out. And here we are dumping in artificial hormones
or exogenous hormones, and our liver is saying I can't

(52:46):
do anymore because you're also drinking fluoride and eating processed
foods and breathing air that's full of smog. Our livers
are overwhelmed, and so you throw in some of these
exogenous hormones and it says, I don't I can't do anymore.
And then you have water retention, irritability, heavy cycles, stubborn

(53:07):
fat around the belly and the hips. So that's where
number one you want the acceleradine.

Speaker 3 (53:13):
Iodine.

Speaker 2 (53:13):
It is the raw material. Idine is the raw material
for your thyroid hormones T four and T three, these
teeny messengers that set your bodies paste, your energy, temperature focus.
Do you remember that when you're trying to get pregnant
and you want to find out when you're ovulating and
you take your temperature. Body temperature has a lot to
do with your hormones, and it's regulated by your thyroid,

(53:36):
so they are intertwined. Focus, fat, burning, hair, and skin.
All of that sell stuff, your cycle, regularity, your PMS symptoms.

Speaker 3 (53:47):
Iodine. So acceleridine idine is the.

Speaker 2 (53:49):
Only singlet form designed for the easiest absorption throughout the body,
no toxins, no radiation, paired with non gm organic.

Speaker 3 (54:00):
To underproof alcohol. Why is that important?

Speaker 2 (54:03):
It is the cleanest and most effective carrier to get
the eyeline to all of the cells. Then you want
to pair it with the accelerated liver care. Like I said,
your liver's got to process all of this, whether it's
the birth control or your food or all the things.

(54:23):
It's where your conversion of your thyroid hormone T four
is converted into T three. And when your liver's overwhelmed,
all of the wheels come off. Your thyroid hormones don't
work your your libidos down. I mean, here we are
talking about birth control doesn't really matter if you have
no libido, right, So you want your liver clean, and

(54:46):
that's where the Accelerated Liver Care is and it comes.
It moves all the toxins out through the bile, kidneys,
and gut. It helps with any sluggishness, fat digestion phase
one into detox micro surch throughout the liver.

Speaker 3 (55:01):
All of that.

Speaker 2 (55:02):
You can take it once a day for maintenance, twice
a day for a therapeutic dose. So really important is
the thyroid and the liver. And then also you know,
make sure you're supplementing with an unrefined salt like accelerated
ancient salt. It plumps up the blood to flesh out
those toxins from the liver and with that iodine. So

(55:23):
I hope you got something out of today. Oh my goodness,
this is an episode to share with your teenagers, to
your young moms, to the moms that have teenagers that
don't want their teenagers to get pregnant. But you also
need to maybe have a responsibility conversation with them and

(55:43):
say these are the side effects of birth control. It
is a serious conversation. I have two daughters. I wish
it was an easier conversation. I wish there was a
really safe birth control, but as of today, in twenty
twenty five, there really isn't other than condoms and the

(56:03):
things that you need to use right at the moment.
So thanks for tuning in today. I hope you got
some tools and inspiration and you can search Sarah Banta
health dot com for my articles. Join the free group
coaching on Telegram.

Speaker 3 (56:16):
It's free and.

Speaker 2 (56:17):
You can find the supplements we talked about at Accelerated
Health Products dot com. Use coupon podcast in on your
first order. If you like today, subscribe. I post three
times a week, so make sure you don't miss Any
and make sure you share this because when you do,
it will help those you share with, but it will
also help this podcast grow so I can bring in

(56:41):
more expert guests like doctor Gersh. You can find me
on over one hundred different podcast platforms. Just search Accelerated Health,
the Sarah Banta and remember I'm live every Monday, Wednesday
and Friday. So join me next time for more ways
to unlock your health potential s

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