If you are a stress-aholic, you need to put more “O” in your life. The “O” in orgasm also is the “O” in oxytocin, the hormone of love and connection, says Anna Cabeca DO, an OBGYN, best-selling author, and expert in hormones and menopause known as The Girlfriend Doctor. In this episode of Healthy Longevity, Dr. Comite interviews Dr. Cabeca about how boosting oxytocin can help women counteract the stress hormone cortisol, lower risk of diabetes, supercharge sexual desire and function, and more!
You’ll learn…
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How Dr. Cabeca turned her life (and health) around after the tragic death of her toddler son and breakup of her marriage, which triggered early menopause.
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Stress messes up our adaptive hormones—as cortisol goes up, oxytocin goes down.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Could you use a little more love hormone in your life?
How about a little less stress?
That's great, because you're in the right place.
Hello and welcome to Healthy Longevity.
I'm Dr.
Florence Komete, founder of Komete Center for Precision Medicine and Healthy Longevity andthe Grok Health app.
Today, I'm really excited to welcome Dr.
(00:20):
Anna Kabeca to the podcast.
Dr.
Kabeca is triple boarded and certified as well as a fellow of
gynecology and obstetrics, OBGYN, integrative medicine and anti-aging and regenerativemedicine.
holds special certifications in functional medicine, sexual health and bioidenticalhormone replacement.
(00:42):
Amazing.
On top of that, she's the bestselling author of three books, The Hormone Fix, Keto Green16 and Men You Pause.
That's fantastic.
And currently, while I remember Anna was in Georgia, she's currently based in Dallas,Texas.
And we're really lucky to have her with us in the studio in New York, as she just arrivedfrom the airport and has big plans, which we'll hear more about.
(01:08):
Welcome, and I'm so happy to have you here.
It's great to be here with you, Florence.
Thank you for having me.
It's been too long.
It has been.
I'd to hear what brings you to New York.
So I am going to the Pré-Gaulienne, which is a...
event, a gala event, an award ceremony for innovators in medicine, biomedical devices, andI'm excited to be here for that.
(01:30):
Plus I'm connecting also with good friends.
So for our podcast here, but also with a couple of good friends of mine, KellyannePetrucci and Tamsyn Fidel.
When you're in New York City, you got to cram a lot in a short amount of time.
Well, I'm thrilled that you made time for us and I know you're extremely innovative.
So
who knows where tonight will go if they're giving out awards.
I hope you win one.
(01:50):
Thank you.
And so before we jump into the oxytocin, the love hormone, I'm going to share a littlebit, and I'd love you to kick that off, more about your background and the genesis of your
handle, the girlfriend doctor.
You know, I was early into women's health because honestly, because of my mom's journey, Isaw her suffering with diabetes, heart disease, postpartum depression, and then from
(02:16):
there, diabetes and heart disease.
And at age 52, she was undergoing heart surgery and I was 16 years old at the time.
And I realized that the research they were basing her surgery on was all done on men.
And so I became very much an advocate for women's health and research in women's healthfrom that early age, so what, 42 years ago now.
So it's been a long time, long journey.
(02:38):
And then part of my love for really understanding a person's story has evolved in theclinical encounter.
People would always say, they feel like Dr.
Anna's my friend, she's my girlfriend, like that kind of connection.
And I think because just being able to, a guide and psychologist, what I wanted for myselfwas a compassionate ear.
(03:04):
someone to just, you know, to listen to, to have a relationship with if they're going tobe part of my healthcare team.
And so I became that person because it's rare and few and far in between.
But the truth is that Sherry Solada, who was executive producer to Oprah, the Oprah show,her final executive producer, she had, we had been working together, talking, and she's
(03:29):
like, you know, Dr.
Anna, you are our girlfriend doctor.
We can ask and tell you anything.
And so she's like, that needs to be your brand.
So when Oprah's producer tells you that, it's like, okay, so that's how the girlfrienddoctor came about.
But I think that for me, that really resonated because I want people to feel at ease andcomfortable and safe.
(03:50):
it's very little in medicine.
It is, you have to open up and as doctors, we're honored to be trusted by patients.
Sometimes we learn things about the people in our lives, the patients we're taking careof.
that their family doesn't know, closest family.
I remember stories from the time I was an intern.
Well, you know, this happened to me or I'm missing a toe, but I always wear socks becauseI don't want anyone to know.
(04:12):
And it's seemingly the little things, but it's the trust that to me it's an honor.
And I kind of feel the same way.
The reason I started doing my work was I always felt that I wanted to know that mypatients became more, I was more like a guide to them and they would be looking at me as
if
that I was somebody in their family.
(04:33):
If they didn't have a doctor in their family to talk to, how do you know that the care andthe compassion is there, especially in today's world?
So it's not dissimilar, but I love the hand-doll.
It's a great hand-doll.
And it definitely fits you.
Thank you.
I think we were in women's health starting around the same era, which is unusual becauseit looks like it's had a new kind of beginning in the last few years and really...
(04:58):
I've been doing it for 30 years, and you've been doing it for just about the same periodof time.
yeah.
Yeah, I figured I'd been in medicine, what, since 1991.
But then you've been a trailblazer in medicine.
I mean, I've learned so much from you and what you've done and all that you've taught andcontinue to develop and learn.
I think that's part of longevity, right?
Being a lifelong learner, too.
(05:19):
Absolutely.
I believe in that.
And if you can't learn, then you shouldn't be in medicine, really, because it's constantlyevolving.
We know what we thought of 10 years ago is,
in a whole new phase right now.
And we have to be able to adjust and look at the human being.
But I started Women's Health at Yale in 1992.
And this is the mothers of the ones going through menopause and perimenopause now.
(05:41):
The field hadn't changed very much.
I kept looking for those changes, but it wasn't to be until very recently.
I think once women started having families, it became really hard because there was nosupport.
Like, what do they do?
Your children need attention, they need to be in the office, they need to publish, publishor perish.
You lose track of it.
(06:01):
I actually had a very close friend at NIH before I came back to Yale, and herfather-in-law was very well known.
He actually was head of one of the institutes, Child Health and Human Development, that Iwas in.
Her name was Debbie Cotton, and she was struggling with her own conditions and had threechildren right in a row.
(06:25):
And I remember going back to visit him, her father-in-law, when I was back at Yale.
And he said, you know, I really think women need special care.
Like, you can't expect to see them around the clock when they have children.
And I remember saying, Mort, I'm going to come back in a few more years when you decidethat the men need to have some role here as well.
(06:45):
It's not just the women who have families.
You know, we're not alone.
It takes a long, time to change our system.
It does.
And I think one of the reasons we're seeing an evolution in women's health care now isbecause those, like when I went to med school too, I graduated 15 women out of a class of
115.
So 100 men, 15 women, right?
But now you have those women going through menopause and realizing this, or perimenopauseand saying, this, what I've been taught doesn't work.
(07:13):
There's gotta be a better way.
So we think that that combined voice.
coming through makes a difference versus...
celebrities too.
And celebrities too speaking up and saying, okay, look, this is what I'm being told orthis is how I was diagnosed and...
I still remember one of the first women I saw told me how she was told it's all in herhead.
(07:34):
And I remember thinking, and this is in the 1990s, you know what?
It actually is in your head because you have hormones and chemicals and neurotransmittersthat are affected.
And yes, you're going to feel different.
You might be the calmest of women and then you turn into your 40s and things begin toshift in your cycle and you can get anxious and scared and you don't sleep well.
And then you're worried because you saw your mom get sick.
(07:55):
She was told it was the dwindles or emptiness syndrome and instead it was a massive heartattack and what she was feeling was pain in a different way than men did.
And so all of that, the cardiology department at Yale had no clue that women had heartdisease.
The first dialogue I remember seeing about heart disease in the cardiology community wasat one of their major meetings.
(08:17):
They had a meeting for women all about your husband's heart.
And we know women are ignored.
It takes much longer to get to them and all of that.
anyway, fathers are important too.
I know that you are going to tell me a little bit about your dad who I had the pleasure tomeet years ago at the age management medicine meeting.
That's right.
(08:37):
My dad was, mean.
You know, he born in 1926.
He went into World War II.
He's a first generation American and a Portuguese American.
And he went into World War II at age 17.
And so then he was multilingual.
So he got attache positions and he was an attache in the Middle East and so speakingmultiple languages.
(08:57):
But anyway, he basically saved to know the personality of my father and you had met him.
So you knew you knew him in his 80s.
And but he was someone he could get you drunk and
talk about anything.
That was my dad's gifting.
He would make you feel comfortable and get you to talk about anything.
So when he was 79 and he came to visit me, this was back in 2005, so he came back to visitme and he lived in Philadelphia.
(09:24):
He flew to Savannah.
We were in St.
Simons at the time.
We picked him up at the airport.
He could hardly walk a few steps without getting short of breath.
So we wheeled him through the airport, brought him...
to our home in St.
Simon's and basically he sat on the couch, irritable and cranky and fatigued, verylethargic.
And I was like, dad, what's going on?
(09:46):
And he said, Anna, you know, I just don't feel good.
I said, you want me to speak to your cardiologist?
And he said, sure.
And so I call his cardiologist, Dr.
Smith, and I said, you know, dad's experiencing these symptoms.
He's, you know, irritable.
And I always say one of the worst things, he was becoming very stingy and we don't likethat when our parents are stingy, that's for sure.
So all these symptoms, but he wasn't feeling good.
(10:08):
And so he said, know, Anna, you're, and I explained all the symptoms, everything, right,Lawrence?
And on the other end of the phone, I hear, Anna, your dad's 79.
What do you expect?
He's lived a good life.
And then there was crickets.
I waited, I waited for him to say, let's do A, B, and C, right?
Let's do the next leg.
(10:28):
Let's figure out these next things.
I'd already been doing age management, functional medicine.
and hormone management said, okay, Dr.
Smith, do you mind if I go ahead and help him out intervene?
And he said, just let me know what you do.
So I go back to my father and I'm like, dad, you done living?
Cause your doctor's done with you.
And he said, know.
that so many times.
(10:48):
Right?
Yep.
My own father.
said, if you want to go to your doctor, you need five minutes cause you'll get aprescription and you can leave, but they don't know your story.
My father said you had to study yourself.
before you go see a doctor.
You need to know your symptoms.
You're living in your body.
They get you for three, five minutes in order to turn it around.
So I was his doctor as well.
That's amazing.
(11:09):
And you know, it's like that empowerment piece.
And I was like that.
He said to me, Anna, he said, I want to see 80.
I want to see 80.
That was his goal from 79 to 80.
And he goes, I'll do whatever you say because I feel so bad.
And so I said, OK, why don't you take away your beer and your bourbon?
That's one thing.
And he's like, OK.
And I had him eat earlier version of what I call now my keto green diet and lifestyle.
(11:30):
I took away three of his prescription medications, three out of the seven prescriptions hewas on, took those away, did omegas, vitamin D, testosterone injections, supported him and
he was an insulin dependent diabetic on 120 units of insulin a day.
As a type two.
As a type two.
And he was at 79 years old on 120 units of insulin in 30 days.
(11:54):
He went down from 120 units of insulin a day to 20 units of insulin a day, monitored hisblood sugar very carefully, and just think the longevity that gave his kidneys.
absolutely.
And so to 20 units, he lost 30 pounds, and not only did he get off the couch, but he wasout on the tennis court playing with the kids.
And he made not just his 80th birthday, but he celebrated 91 good years.
(12:20):
91 good years.
He outlived.
his four younger siblings by decades.
That's amazing.
Well, my father and mother with similar stories outlived all their siblings and theirsiblings had pretty long lives into their 80s.
And I can't stand it when I hear people say, well, my father died at 75, but you he diedof old age.
(12:41):
I'm like, 75 is not old age.
But the fact is we don't dig under the surface.
And what you found with your dad is that he wasn't really being managed precisely.
Nobody was looking at data.
Nobody, they were saying it's enough.
And I've heard that from 40 and 50 year olds.
They go to the doctor and they say, I can't kick the soccer ball the same way.
I'm not feeling myself.
And the doctors in conventional medicine will say, get used to it, you're getting old.
(13:04):
So when I started it was, know, aging, if we could stop the biological aging, we couldkeep people young and vibrant.
And that's why I started down my path, first with women's health, then with men.
So I feel lucky because I saw the same lens as you did.
In fact,
I've only started one human being and he was in his 70s or 80s and had just survivedmetastatic melanoma on insulin as a diabetic, otherwise I completely reverse it.
(13:30):
I don't give anyone insulin and all my endocrinology colleagues would say, you can't dothat.
And then they found me in the last few years and said, we have a refrigerator, we makethem drop off their insulin and we get them off insulin.
Because if you manage diabetes effectively,
then you don't have to get sick, you don't have to decline, and it's ubiquitous.
(13:51):
Everybody has a disorder of carbohydrate metabolism.
It's a reversible condition.
Absolutely, and that leads to almost every disease you mentioned, whether it's dementia orneurodegenerative decline, Alzheimer's, heart disease, stroke.
kidney disease, kidney failure, eye disease, skin disease, because the sugar travelseverywhere.
(14:11):
Osteoporosis, cancer.
Everything.
Yes, cancer with insulin and insulin resistant.
So I'm completely along that you were way ahead of your time.
Your father was lucky and I feel like my father was too because I still remember after hepassed away, I was invited to be part of this moth.
I don't know if you've ever heard of moth.
(14:31):
You get up on stage, you're supposed to do a five minute talk without notes.
And I did a story about my father.
It was centered on parents and what you do.
And I remembered one story, and I hadn't realized it at the time, but I saved my father'slife.
And I'm like, wow, I just wanted to see him well.
And so you look back and you feel, you know, at least medicine made a difference in yourlife.
(14:56):
This way you can help other people as well.
Very critical.
And speaking of that, let's talk specifically about oxytocin.
I love oxytocin.
think one of the things I learned from my parents, my mom was from a warren-turn area inthe Middle East and my dad was this great negotiator kind of person, but he always could
make people laugh.
And so when there was a stressful situation to ease the stress, etc., my mom's sense ofhumor was tremendous, but like we would say jokes that travel around the world.
(15:24):
And that's oxytocin.
That is self-medicating with oxytocin, which is a counter...
you know, it acts counter to stress.
So oxytocin and cortisol, so oxytocin, I always like to clarify, not oxycodone, not likethe pain medication.
We people get mixed up.
We get mixed up, like we want oxytocin and we make it naturally as a hormone ofconnection.
(15:48):
And so as I studied as an OB, of course I knew about oxytocin from injecting pitocin IVRintramuscularly in labor.
to increase contractions.
And that's why women's mood changes when they're nursing because they're secreting a lotof oxytocin so they feel better and happy and they've sometimes turned into different
personalities while they're nursing.
(16:09):
You were saying that happened to you.
did.
Well, it's that connection, that peace and that being ability to relax and you you feelthis connection, oxytocin bonds you.
It's that imprinting hormone.
It bonds you to that child.
So it's so important to have labor delivery and oxytocin for that imprinting, for thatbonding, for that nurturing attachment that occurs evolutionary for the survival of the
(16:38):
species in so many ways.
Oxytocin is secreted with orgasm, with sexual health, with intimacy, with positive touch,with laughter, with gratitude and giving, with generosity and gifting and philanthropy.
There's an increase in.
giving up your time talents and tithes, as it says.
(16:58):
So I really studied as part of my own journey from trauma, from experiencing PTSD when welost my son, who was just a toddler, and that threw me into early menopause at age 39.
And it threw me into, I was completely infertile, early menopause, failed the highestdoses of injectable.
(17:20):
meds and that took me on my menopausal journey way back in 2006.
So as a result of that though, I didn't understand at that time, because we weren'ttalking, I I didn't understand the cortisol-oxytocin connection until I experienced it
that's why it's been my area of research and study.
Because as much as I, you know, try to heal and therapy and grief work and for me travelis my biggest meditation, I mean, travel around
(17:49):
world looking for answers, essentially.
But there was that disconnect.
There was the disconnect, burnout from work, a profession I loved, burnout from mymarriage, a person I loved, really that disconnect, that burnout, that physiologic
disconnect.
And I realized that when cortisol, and I dug into the research on trauma and PTSD, andwhen cortisol is elevated, oxytocin is suppressed, which makes sense, because if you're
(18:18):
Having a fight with someone, it's not the time to hug and kiss and make up, right?
It's got to be a discipline you learn.
So when cortisol is up, oxytocin is down, and when cortisol is up for a long time, thenthe paraventricular nucleus in the brain says, OK, cortisol, this is my conversation that
I have with my brain and cortisol.
it's like, cortisol, you are frying me out, right?
(18:40):
Too much cortisol?
Too much?
You know, it's causing hyperglycemia, it's causing breaking down the cell membranes, it'sleaky gut, leaky brain, leaky heart vessels, all that good stuff.
And so, paraventricular nucleus shuts down cortisol.
So it's not that you have fatigued adrenal glands.
It's that your adrenals are actually being suppressed in production of hormones, andspecifically cortisol.
(19:02):
So you're blocking those pathways.
And now, this is the most dangerous physiology, and we see this a lot post-pandemic,post-stress, post-c...
trauma and post veterans and war, you see this low cortisol, low oxytocin state.
And that feels like disconnect.
That feels like, you know, the physiology of divorce, the physiology of burnout, thephysiology.
(19:24):
I used to love going into my work, but I don't like to go in anymore.
I know I love my kids.
I don't feel love for them.
It is physiology.
We know physiology drives our behavior.
So as I, and this is a very acidic physiology too, checking urine pH.
You're very, very acidic.
And so what I figured out through my own work is that those moments that I did mygratitude journaling, that I did my prayer meditation, that I walked out in nature, walked
(19:52):
barefoot on the beach, that I was more alkaline each day, and then I realized thatcortisol is the most acidifying hormone, creates a urinary acidity.
acidity in the urine.
Exactly, increases hydrogen ion secretion across the renal tubules and oxytocin does theopposite.
It's the most alkalinizing hormone.
(20:12):
they can, you know, it's at war.
So I figured if I can manage oxytocin, I can pull myself out of this abyss.
And so just did, you know, started working to increase oxytocin to periodically supplementwith oxytocin and that
You know, that really has been game changing for me, for my patients.
(20:35):
Again, when I started to see it in myself, it made sense.
Why did I completely shut down?
Why is it that 70 to 80 % of people that lose a child end up in divorce?
Is it the grieving differently or it's that physiology that creates an inability to cope,connect, and bond, and rebond?
(20:56):
It's like also having a very sick child a lot of times.
Parents will split up even if the child gets better because of the physio.
It's all chemical We actually are chemical and energy Yeah And so I completely agree and Iactually worry much more when I see a very low cortisol rather than a high cortisol
because I worry about chronic fatigue I worry about what the adrenal glands are doing andwhat the rest of the body is seeing and it's much harder I think people hit a wall when
(21:25):
they have low low cortisol like two or
as opposed to in the range of six to 12, at least when you wake up or if you test saliva,you see the pattern.
So tell me, how would you detect low oxytocin and determine that you might want to treatsomebody and how safe is it in your hands?
What can we share with our listeners?
(21:45):
Yeah, so first of all, testing for oxytocin levels in the blood is very, very fragile.
There are few labs in the country that do it.
It's fragile, it's difficult.
I have them do a questionnaire.
And they look for the signs and symptoms.
So the questionnaires are like, you know, are you feel detached, know, cold, clammy hands,pale skin, I mean, things like that.
(22:06):
Not excitable, not feeling happy joy, engaged, all of those symptoms.
If you think about, again, the classic autistic patient is a low oxytocin physiology.
That's a low oxytocin.
They don't make eye contact.
So for, let me give you an example.
I had a client and I use oxytocin in sexual health, like for,
sexual function to improve orgasm, to give you that boost and increase orgasm.
(22:30):
So it works in clients that need it.
So I was given this client and because of my own journey, I was treating this patient, oneof my patients who was in her mid 50s, was treating her for chronic depression and also to
help with sexual function and relational issues.
And so I was giving her lozenges of oxytocin and she started to feel better, her mood wasbetter, she was feeling more connected and she said, you know what?
(22:55):
Like my, she said, you know, Dr.
Anna, I have a confession to make to my son who's 21 years old.
He graduated high school.
He was on the football team.
He had, you know, he'd started college, but couldn't finish.
He basically sits on the couch, plays video games to do anything.
So I gave him a, I slept him on oxytocin and all of a sudden he was engaged, got up,helped me make dinner.
(23:15):
And I said, well, first of all, you shouldn't have done that.
you shouldn't have told me.
She goes, but I really want you to see him and you know, evaluate him.
And so I said, okay, bring him to the office.
you know, I always tell young men or men in general when they come to a gynecologistoffice, look, give me a very brave, bold individual.
You're in the right hands, though, don't worry.
(23:37):
And so first of a lot of what we do in men and women are very similar, even though we'recompletely different animals, you know, in some ways, like hormonally, we share a lot of
the same principles, except maybe the prostate, that's about it.
That's it.
Yeah.
I'm ungrateful.
Frustrated and over and at times.
yeah, first thing I did is shake his hand.
So I'm going to shake your hand, Florence.
(23:58):
And the first thing, you know, nice, warm, good handshake for him.
It was cold, clammy, pale hands.
He wouldn't look at me and my eyes, very pale skin.
And and so I did a test.
And this is a very valuable thing as physicians when we're prescribing oxytocin, we'restill on the fringe because it's not FDA approved other than in labor and delivery.
(24:19):
So we're on the fringe.
So I gave him an injection of oxytocin, 10 international units.
I am with some lidocaine, because it burns like stink when you put it in, intramuscularly.
And I gave him an injection.
All of a sudden, he starts to pink up.
His cheeks and chest and ears start to pink up.
He starts looking at me in my eyes and smiling and having a conversation.
(24:42):
That is a positive response to oxytocin.
Yes.
Do you ever experiment with it where you try a small dose of it, like either sublingual oras large in terms to see, because I have a story of a patient here who I tried everything.
She was very depressed.
It was clearly endogenous.
She had been studied extensively.
Her father even had electric shock treatments and she was contemplating it.
(25:04):
Her sexual function was nil and I wish to hear about it because I took care of her husbandas well.
Like, what can you do?
What could you do?
And I said, you know what?
And I told her a couple of years ago.
let's try this because I don't do the testing for oxytocin.
I do it for other reasons.
And I feel like it's extremely safe.
So I gave her a small dose, a sublingual.
(25:25):
So she put it under the tongue and it melts there and it's a direct effect on the brain.
So I'm happy about that.
And she came back and she said, I have never felt as good in my life.
And then I got a call from her husband to say, what have you done?
You've got to get me to catch up because all of a sudden she was interested in
being sexual, she was happy, and she had never, her entire adult life, she was in her 50s,had never really been happy.
(25:51):
So even in endogenous depression, which is coming internally, you can make a differencewith oxytocin.
You can, absolutely.
And I think that, you know, intermittent use of it is very beneficial.
And there's some work, you know, with the benefit, especially in PTSD, which is thatbecame, unwillingly, one of my areas of expertise.
But in that trauma work, what it's showing is that use with oxytocin is variable.
(26:17):
But we know that use with, for example, ketamine, ketamine therapy and PTSD is veryeffective.
And within three months, you can get the results that you don't get in 10 years withcognitive behavior therapy and a very much lower relapse rate.
So the combination, this is like a magic combination just playing with right now, butketamine with oxytocin nasal spray.
(26:40):
And with integrative therapy, a good psychologist, psychiatrist, counselor, coach, etcetera, in the right hands, but being able to use that combination, I think, for trauma
for those individuals in that three, for three months with counseling and integrativesupport is And then do you continue the ketamine or do you continue the oxytocin
(27:03):
periodically?
You don't have to.
don't to.
Interesting.
And you mentioned other ways of naturally, besides giving birth.
naturally raising oxytocin.
It would be nice to hear exactly because you did it naturally for yourself until youstumbled into, maybe I could try it hormonally.
And then the way to test, I always say urine pH testing, like home urine pH testing, justcheck your urine pH every time you would you see like below seven?
(27:30):
How low would you go?
With the acidity, when I first started testing myself, this was the big aha with cortisoland oxytocin.
was that I was as acidic as the pH paper read.
So I basically was pH acid.
Well, the pH paper, the lowest was five.
And you figure our stomach is what, 3.5?
(27:51):
And so it was as acidic as the pH And as your oxytocin recovered, in part because you werewalking on the beach, you were journaling, you recognized that you were traumatized from
the loss of a young, young child.
I still remember that story that you told one year.
And what it did to your marriage and your life subsequently.
And so you're able to come back to life initially doing anything dietary activities.
(28:16):
Yeah, definitely.
So the whole keto green concept that I've created and I've written three books.
So hormone fix, I always say it takes more than hormones to fix your hormones.
Lifestyle is a key factor there.
Keto green 16 and my third book was menu pause.
So the nutritional concepts of being keto green is good alkalinizing plant based.
(28:38):
food like a lot of good veggies, alkalinizing cruciferous vegetables, I say createmedicinal menus, and also high protein, high quality fat, right?
So we want that and low glycemic with intermittent fasting to create more insulinsensitivity and to work on those alkalinizers to feed our gut bacteria with good
diversity.
(28:58):
that keto green eating and lifestyle hack helps with managing that.
cortisol and also resetting your circadian rhythm and cycle.
say catch sunrises and sunsets to get in tune with your circadian cycle and that's goingto help your cortisol curve.
I have one patient who is part of my virtual program.
(29:20):
She's in my magic menopause program and I challenged them to catch sunrises and sunsetsearly on in the program and she like you know two weeks in to doing this she said the only
thing Dr.
Anna that I was doing different
was getting outside for 10 minutes every morning and getting that sunrise in.
She goes, I feel happier.
I feel more at peace.
My urine pH is more alkaline.
(29:41):
I make them test.
it's just the only thing.
That just was game changing difference.
Because all of a sudden, now you've shifted your physiology.
And physiology affects behavior.
So getting out in nature is one of the best things I can write on a prescription pad.
Orgasm is another very good thing to write on it.
prescription pad and I talk about microdosing, to do same thing with exercise.
(30:05):
I would say here's your prescription for treatment.
There you go.
Yeah, I don't think I was as brave as you.
I got hauled into the Dean's office when I started Women's Health at Yale because I wasasking women who I just met about their sex life and what they were doing and how they
were functioning.
And the Dean at the time had been my Dean of Students when I went to Yale Medical School.
(30:25):
He said, Florence, you can't talk to people about sex in that way.
I'm like,
I don't know, it's part of life, isn't it?
Yeah, that's so so I still remember that in the 1990s no less.
man, yeah.
We still have a long way to go.
We do.
not something people are comfortable with.
I have a whole program called Sexual CPR.
It's like seven hours.
(30:46):
It is real, I mean, it's informative because we have to understand when it comes to that,like low libido, when someone says, Dr.
Anna, I have a low libido.
get great lectures in that.
Yeah.
It's like a, seven hour conversation.
Yeah.
because you gotta figure out what's causing it, what's the underlying issues.
how best to, because different issues will demand different kinds of effort and whetherit's the way you're living life or that you do need medication, we women lose testosterone
(31:16):
with age as well.
And so getting some testosterone really makes it, we don't have what men have, but we needthe little we do have to be sustained.
And it actually starts falling in the 30s before we go through any kind of menopausalchange.
So I'm always shocked.
I don't think I've seen a woman with adequate testosterone when she's 35.
What do you consider an adequate serum level?
(31:37):
Well, I don't look at total as much because that could vary depending on binding like sex,zero binding globulin.
I like a free to be no less than six and even up to 20 or 30.
It depends on the woman and how she clinically feels.
But we try to keep it between like 10 and 20.
And some women need more.
I favor more creams for women, but I'm going to start to test
(31:59):
oral treatments, there are new approved oral treatments that I think we can useeffectively that might last longer, that have a long half-life.
I was always worried about first pass to the liver, but the data shows that it doesn'tincrease lipids and it doesn't put a woman at risk.
So that was the main reason that held me back.
I know pellets are available as well.
(32:19):
I think I used to see so many women that, I don't know if you use pellets, I alwaysentertain the notion, but I saw women who had trouble with it.
or didn't want the surgery, even though it's minor surgery.
And the guessing game about levels is a little tougher with the pellets, whereas withcreams you could adjust more easily.
adjust on a regular basis.
Plus, think, I've been an advocate for judicious use short term of pellets, testosteronespecifically, not estrogen.
(32:46):
How in the right client for the of time, it's not something I think people should stay on.
And the reason too, those high, and being very conservative with the levels of
the doses of the pellet, also because what we expect to happen is that's shutting down thebody's endogenous production.
(33:06):
And that's just gonna affect other body systems in significant ways.
And I think that's really important.
You're at those high levels for a long term.
I mean, you've gotta stay on something or be very aggressive about rejuvenating your ownbody's glandular production and utilization of those hormones.
It's too bad our ovaries kind of come to a halt when we're like about 50 because it'sdifferent for men who continue to have function in a different way.
(33:36):
But when our eggs disappear for the moment, although there's research going on at Yalelooking at preserving a piece of your ovary and then replanting it so that you may be able
to keep the eggs alive longer and secrete your own hormones.
But I think it's important to optimize because that's what really keeps us young.
Otherwise aging happens and disease happens.
(33:57):
So women come to you for, and even men come to you for all sorts of reasons.
And I know you believe in keeping them as healthy as possible.
And I love the idea of testing urine because it's so non-invasive to look at acidity andalkalinity and decide whether oxytocin can turn it around and what's going on with
cortisol as well.
Well, and lifestyle too, because you can be eating that perfect green.
(34:19):
diet and be so stressed and so angry or so fearful or so whatever and that cortisol iscausing that acidity and so just becoming that awareness and I love like in our groups
where people get to share about what they're experiencing and be like again I completelyblew the diet but had a great night with my girlfriends went to the musical did this that
(34:41):
and I was so alkaline the next day I'm like
That is so important to that's great.
So there's a lot of changes you can make in lifestyle by enjoying life, like laughter isthe best medicine.
And having fun, which I think some of us have lost the ability a little to do, becausewe're so caught up in social jet lag, not getting enough sleep, especially in New York.
Maybe not so much in Georgia, but maybe to some degree in Texas.
(35:04):
It depends on the choices you make.
But making sure you retain your energy and your interest in life and you community andrelationships are critical.
Social relationships.
whether it's family or friends, actually ideally both.
And it's good medicine.
It is good medicine.
So I'd love to learn a little bit more about how you specifically use supplements andhormones.
(35:24):
I know you have this Menopause kit, and I know I've been invited to be on your girlfriendpodcast and your girlfriend live talks and conversations.
So I'd like to go back to that.
And if I can hear more about it, I'd love to share that with our viewers.
Yeah, thank you.
So one of the things that a part of my journey, you know, way back when I was 39,
had been diagnosed with early menopause, told that the only option would be to considerovarian donation.
(35:49):
And so I was devastated.
I'm OB-GYN, I trained at Emory University.
You get a diagnosis like early menopause, infertility, you fail seven rounds of therapy,right?
And you're like, okay, that's it, there's no chance for me.
But as a result of this journey in the superfoods that I experienced along the way and thegrace of God, to be honest, Florence, that not only did that reverse,
(36:12):
My early menopause diagnosis reversed, but I naturally conceived the child I was told Iwould never be able to have when I was 41.
And then I finally went through real official menopause at age 56.
So from 39 to age 56.
And so that ovarian preservation is part of what I teach.
The superfoods that helped me along the way, I combined into a formula I call Mighty MakaPlus.
(36:35):
So it's 30 superfoods.
Alkalinizing helps address cortisol is detoxifying.
is has adaptogens in there to support the adrenal glands, so supporting our body's naturalproduction of hormones.
Which adaptogens like Ashwagandha, Maca?
Maca, green tea extract, Kersatin, Versvera Chol, Turmeric, I can say all of those,they're genetic adaptogens as well as adrenal adaptogens.
(37:01):
that the, and antioxidants that are in there are so, are powerful.
It's a powerful combination.
And what we've seen,
And we studied clinically, we looked at DHEA sulfate levels in the blood, and we've seenan increase of 70 to 200 % in two months, taking two to three scoops of Mighty Maca a day.
We've seen an increase in day 21 progesterone levels.
(37:22):
But clinically, what people feel is more energy, clean energy, not like hyped upcaffeinated energy, clean energy and reduction in hot flashes, reduction in cravings,
feeling, you know,
better sleep and more energy during the day.
So that combination was really key.
It's an expensive supplement to make, it's a combination of the highest qualityingredients, but it works.
(37:46):
And it also, when we address cortisol, we can improve oxytocin.
So that's one of the key things.
And then part of like oxytocin increasing activity is orgasm and play.
And as women, as we get older, vaginal dryness, rejuvenation, clitoral...
atrophy, urethral atrophy, incontinence, all of those issues come to play if we don't dosomething about it.
(38:12):
So I created my product, Jova, which has DHEA and plant stem cells from the alpine roseand is an amazing product to help turn back the hands of the time.
say, know, clitoris to anus, most important real estate on your body, keep it healthy.
People will talk about.
vaginal estrogen, mean estrogen works on the mucosal layer and it can transfer to yourpartner if he's a male and they don't need any more estrogen per se usually.
(38:40):
so, but DHEA is perfectly safe.
It's safe to use during intercourse.
It's designed to be used daily like a part of our cosmetic regimen and again to addressclitoral atrophy as well to increase sensation and pleasure.
And because DHEA works all the way to the muscularis level, it really does turn back thehands of time.
I had a patient who last year I wasn't even able to do a speculum exam on.
(39:04):
She was so atrophic.
And this year it was like, you know, she didn't even give a blink.
She was like, Dr.
Anna, I didn't have sex with my husband for the last 12 years.
We're having sex and intimacy again.
It has been game changing.
And I have a 67 year old who likes to boast that she has the vagina of a 25 year old.
I'm like, that's a good biomarker.
(39:24):
Is it injected internally like a suppository or can you apply it on the tissue itselfdirectly?
can apply it on the tissue yourself and for clients who have continued vaginal drynessbecause it does get absorbed into the lower third of the vagina.
You can apply it to that area as well.
It does absorb into the upper areas of vagina but that's the area that's really, thehormones work really well in that area.
(39:48):
And the other thing is that clients with significant atrophy still, like what I'll havethem do is on a vibrator to apply it to a vibrator and insert it internally.
So you have the vibration increasing blood flow also with the Joelvine.
That's a, you know, for, you know, difficult atrophy, difficult to treat atrophy we can doWell, that's fantastic.
I think, you know, it'd be something that I would be interested in exploring for ourpatients.
(40:13):
We don't see the degree probably of dyspnea.
difficulty with intercourse pain and dryness because we start very early with optimizinghormones, both testosterone and estrogen, and that systemically, not just locally.
Locally is useful for short while, but you're right, the transference can bedisconcerting, although we direct women timing and how to use it so that it gets absorbed.
(40:38):
But that sounds fantastic, and it's new to me because I don't think this is something youhad.
when we last spoke?
yeah, probably.
I mean, I brought it to market in 2016.
I brought it to market in 2016.
It's just been it was predominantly word of mouth, but it's it's skyrocketing.
Yeah, yeah, it's been great.
It sounds like you're making a real difference in I'm going to send you some.
(41:00):
You're to have to give me a personal testimony.
Actually, I have some here.
will leave you with some.
Definitely.
Do not travel without it.
I usually like to wrap up with like a final question and ask you if somebody ever stoppedyou.
I'm sure you do get stopped.
or you're on a plane and you're talking to someone next to you and they say, what's thesingle most important insight you've had so that you can change someone's life?
(41:22):
Where would you start?
What would it be?
You know, I think it is the concept of microdosing oxytocin.
It's that concept of gratitude is being in the present moment with gratitude, despite whatelse is going on in the world.
And I think, you know, with all the uncertainty, with fear, with trauma, and I say that,
from a place when I had been in severe depression, suicidal in the past.
(41:48):
This is the single most important thing I did to pull myself out of the abyss, is that ina moment, to be in the present moment, to be grateful and to be of service.
I think that is physiologically some of the best things that we can do.
I couldn't agree more and I think to live even with the past traumas and understand that
(42:09):
They're compartmentalized.
You recognize that you lost a vital part of yourself when your child died, unfortunately.
But life goes on and you heal yourself.
think you've done a tremendous job.
Very impressed.
I always have been impressed.
So I'm so glad you came to New York and we could actually do this in person instead ofremotely.
(42:31):
What I like to do is find out how people would reach out and listen to you and hear you oreven come see you, however you want.
to include that.
Yeah, thank you.
So easy to find me at dranna.com.
So dranna.com.
And my websites are great.
On my about page, there'll be information on how you could see me in person.
And I have so many good resources at dranna.com.
(42:53):
I have free 10 day programs, briefs through menopause, have keto green challenges, I haveinformation on, of course, my podcast, The Girlfriend Doctor Show, anywhere you listen to
podcasts.
And my books are available anywhere books are sold.
That's so great.
It's been a hard journey for you, but I'm grateful you figured out how to get through itand thrive and helping so many other women and men to do the same.
(43:17):
So thank you, Anna, for all the work you've done.
It's not been easy, I know.
Thank you.
Could you use a little more love hormone in your life?
How about a little less stress?
That's great, because you're in the right place.
Hello and welcome to Healthy Longevity.
I'm Dr.
Florence Komete, founder of Komete Center for Precision Medicine and Healthy Longevity andthe Grok Health app.
Today, I'm really excited to welcome Dr.
(00:20):
Anna Kabeca to the podcast.
Dr.
Kabeca is triple boarded and certified as well as a fellow of
gynecology and obstetrics, OBGYN, integrative medicine and anti-aging and regenerativemedicine.
holds special certifications in functional medicine, sexual health and bioidenticalhormone replacement.
(00:42):
Amazing.
On top of that, she's the bestselling author of three books, The Hormone Fix, Keto Green16 and Men You Pause.
That's fantastic.
And currently, while I remember Anna was in Georgia, she's currently based in Dallas,Texas.
And we're really lucky to have her with us in the studio in New York, as she just arrivedfrom the airport and has big plans, which we'll hear more about.
(01:08):
Welcome, and I'm so happy to have you here.
It's great to be here with you, Florence.
Thank you for having me.
It's been too long.
It has been.
I'd to hear what brings you to New York.
So I am going to the Pré-Gaulienne, which is a...
event, a gala event, an award ceremony for innovators in medicine, biomedical devices, andI'm excited to be here for that.
(01:30):
Plus I'm connecting also with good friends.
So for our podcast here, but also with a couple of good friends of mine, KellyannePetrucci and Tamsyn Fidel.
When you're in New York City, you got to cram a lot in a short amount of time.
Well, I'm thrilled that you made time for us and I know you're extremely innovative.
So
who knows where tonight will go if they're giving out awards.
I hope you win one.
(01:50):
Thank you.
And so before we jump into the oxytocin, the love hormone, I'm going to share a littlebit, and I'd love you to kick that off, more about your background and the genesis of your
handle, the girlfriend doctor.
You know, I was early into women's health because honestly, because of my mom's journey, Isaw her suffering with diabetes, heart disease, postpartum depression, and then from
(02:16):
there, diabetes and heart disease.
And at age 52, she was undergoing heart surgery and I was 16 years old at the time.
And I realized that the research they were basing her surgery on was all done on men.
And so I became very much an advocate for women's health and research in women's healthfrom that early age, so what, 42 years ago now.
So it's been a long time, long journey.
(02:38):
And then part of my love for really understanding a person's story has evolved in theclinical encounter.
People would always say, they feel like Dr.
Anna's my friend, she's my girlfriend, like that kind of connection.
And I think because just being able to, a guide and psychologist, what I wanted for myselfwas a compassionate ear.
(03:04):
someone to just, you know, to listen to, to have a relationship with if they're going tobe part of my healthcare team.
And so I became that person because it's rare and few and far in between.
But the truth is that Sherry Solada, who was executive producer to Oprah, the Oprah show,her final executive producer, she had, we had been working together, talking, and she's
(03:29):
like, you know, Dr.
Anna, you are our girlfriend doctor.
We can ask and tell you anything.
And so she's like, that needs to be your brand.
So when Oprah's producer tells you that, it's like, okay, so that's how the girlfrienddoctor came about.
But I think that for me, that really resonated because I want people to feel at ease andcomfortable and safe.
(03:50):
it's very little in medicine.
It is, you have to open up and as doctors, we're honored to be trusted by patients.
Sometimes we learn things about the people in our lives, the patients we're taking careof.
that their family doesn't know, closest family.
I remember stories from the time I was an intern.
Well, you know, this happened to me or I'm missing a toe, but I always wear socks becauseI don't want anyone to know.
(04:12):
And it's seemingly the little things, but it's the trust that to me it's an honor.
And I kind of feel the same way.
The reason I started doing my work was I always felt that I wanted to know that mypatients became more, I was more like a guide to them and they would be looking at me as
if
that I was somebody in their family.
(04:33):
If they didn't have a doctor in their family to talk to, how do you know that the care andthe compassion is there, especially in today's world?
So it's not dissimilar, but I love the hand-doll.
It's a great hand-doll.
And it definitely fits you.
Thank you.
I think we were in women's health starting around the same era, which is unusual becauseit looks like it's had a new kind of beginning in the last few years and really...
(04:58):
I've been doing it for 30 years, and you've been doing it for just about the same periodof time.
yeah.
Yeah, I figured I'd been in medicine, what, since 1991.
But then you've been a trailblazer in medicine.
I mean, I've learned so much from you and what you've done and all that you've taught andcontinue to develop and learn.
I think that's part of longevity, right?
Being a lifelong learner, too.
(05:19):
Absolutely.
I believe in that.
And if you can't learn, then you shouldn't be in medicine, really, because it's constantlyevolving.
We know what we thought of 10 years ago is,
in a whole new phase right now.
And we have to be able to adjust and look at the human being.
But I started Women's Health at Yale in 1992.
And this is the mothers of the ones going through menopause and perimenopause now.
(05:41):
The field hadn't changed very much.
I kept looking for those changes, but it wasn't to be until very recently.
I think once women started having families, it became really hard because there was nosupport.
Like, what do they do?
Your children need attention, they need to be in the office, they need to publish, publishor perish.
You lose track of it.
(06:01):
I actually had a very close friend at NIH before I came back to Yale, and herfather-in-law was very well known.
He actually was head of one of the institutes, Child Health and Human Development, that Iwas in.
Her name was Debbie Cotton, and she was struggling with her own conditions and had threechildren right in a row.
(06:25):
And I remember going back to visit him, her father-in-law, when I was back at Yale.
And he said, you know, I really think women need special care.
Like, you can't expect to see them around the clock when they have children.
And I remember saying, Mort, I'm going to come back in a few more years when you decidethat the men need to have some role here as well.
(06:45):
It's not just the women who have families.
You know, we're not alone.
It takes a long, time to change our system.
It does.
And I think one of the reasons we're seeing an evolution in women's health care now isbecause those, like when I went to med school too, I graduated 15 women out of a class of
115.
So 100 men, 15 women, right?
But now you have those women going through menopause and realizing this, or perimenopauseand saying, this, what I've been taught doesn't work.
(07:13):
There's gotta be a better way.
So we think that that combined voice.
coming through makes a difference versus...
celebrities too.
And celebrities too speaking up and saying, okay, look, this is what I'm being told orthis is how I was diagnosed and...
I still remember one of the first women I saw told me how she was told it's all in herhead.
(07:34):
And I remember thinking, and this is in the 1990s, you know what?
It actually is in your head because you have hormones and chemicals and neurotransmittersthat are affected.
And yes, you're going to feel different.
You might be the calmest of women and then you turn into your 40s and things begin toshift in your cycle and you can get anxious and scared and you don't sleep well.
And then you're worried because you saw your mom get sick.
(07:55):
She was told it was the dwindles or emptiness syndrome and instead it was a massive heartattack and what she was feeling was pain in a different way than men did.
And so all of that, the cardiology department at Yale had no clue that women had heartdisease.
The first dialogue I remember seeing about heart disease in the cardiology community wasat one of their major meetings.
(08:17):
They had a meeting for women all about your husband's heart.
And we know women are ignored.
It takes much longer to get to them and all of that.
anyway, fathers are important too.
I know that you are going to tell me a little bit about your dad who I had the pleasure tomeet years ago at the age management medicine meeting.
That's right.
(08:37):
My dad was, mean.
You know, he born in 1926.
He went into World War II.
He's a first generation American and a Portuguese American.
And he went into World War II at age 17.
And so then he was multilingual.
So he got attache positions and he was an attache in the Middle East and so speakingmultiple languages.
(08:57):
But anyway, he basically saved to know the personality of my father and you had met him.
So you knew you knew him in his 80s.
And but he was someone he could get you drunk and
talk about anything.
That was my dad's gifting.
He would make you feel comfortable and get you to talk about anything.
So when he was 79 and he came to visit me, this was back in 2005, so he came back to visitme and he lived in Philadelphia.
(09:24):
He flew to Savannah.
We were in St.
Simons at the time.
We picked him up at the airport.
He could hardly walk a few steps without getting short of breath.
So we wheeled him through the airport, brought him...
to our home in St.
Simon's and basically he sat on the couch, irritable and cranky and fatigued, verylethargic.
And I was like, dad, what's going on?
(09:46):
And he said, Anna, you know, I just don't feel good.
I said, you want me to speak to your cardiologist?
And he said, sure.
And so I call his cardiologist, Dr.
Smith, and I said, you know, dad's experiencing these symptoms.
He's, you know, irritable.
And I always say one of the worst things, he was becoming very stingy and we don't likethat when our parents are stingy, that's for sure.
So all these symptoms, but he wasn't feeling good.
(10:08):
And so he said, know, Anna, you're, and I explained all the symptoms, everything, right,Lawrence?
And on the other end of the phone, I hear, Anna, your dad's 79.
What do you expect?
He's lived a good life.
And then there was crickets.
I waited, I waited for him to say, let's do A, B, and C, right?
Let's do the next leg.
(10:28):
Let's figure out these next things.
I'd already been doing age management, functional medicine.
and hormone management said, okay, Dr.
Smith, do you mind if I go ahead and help him out intervene?
And he said, just let me know what you do.
So I go back to my father and I'm like, dad, you done living?
Cause your doctor's done with you.
And he said, know.
that so many times.
(10:48):
Right?
Yep.
My own father.
said, if you want to go to your doctor, you need five minutes cause you'll get aprescription and you can leave, but they don't know your story.
My father said you had to study yourself.
before you go see a doctor.
You need to know your symptoms.
You're living in your body.
They get you for three, five minutes in order to turn it around.
So I was his doctor as well.
That's amazing.
(11:09):
And you know, it's like that empowerment piece.
And I was like that.
He said to me, Anna, he said, I want to see 80.
I want to see 80.
That was his goal from 79 to 80.
And he goes, I'll do whatever you say because I feel so bad.
And so I said, OK, why don't you take away your beer and your bourbon?
That's one thing.
And he's like, OK.
And I had him eat earlier version of what I call now my keto green diet and lifestyle.
(11:30):
I took away three of his prescription medications, three out of the seven prescriptions hewas on, took those away, did omegas, vitamin D, testosterone injections, supported him and
he was an insulin dependent diabetic on 120 units of insulin a day.
As a type two.
As a type two.
And he was at 79 years old on 120 units of insulin in 30 days.
(11:54):
He went down from 120 units of insulin a day to 20 units of insulin a day, monitored hisblood sugar very carefully, and just think the longevity that gave his kidneys.
absolutely.
And so to 20 units, he lost 30 pounds, and not only did he get off the couch, but he wasout on the tennis court playing with the kids.
And he made not just his 80th birthday, but he celebrated 91 good years.
(12:20):
91 good years.
He outlived.
his four younger siblings by decades.
That's amazing.
Well, my father and mother with similar stories outlived all their siblings and theirsiblings had pretty long lives into their 80s.
And I can't stand it when I hear people say, well, my father died at 75, but you he diedof old age.
(12:41):
I'm like, 75 is not old age.
But the fact is we don't dig under the surface.
And what you found with your dad is that he wasn't really being managed precisely.
Nobody was looking at data.
Nobody, they were saying it's enough.
And I've heard that from 40 and 50 year olds.
They go to the doctor and they say, I can't kick the soccer ball the same way.
I'm not feeling myself.
And the doctors in conventional medicine will say, get used to it, you're getting old.
(13:04):
So when I started it was, know, aging, if we could stop the biological aging, we couldkeep people young and vibrant.
And that's why I started down my path, first with women's health, then with men.
So I feel lucky because I saw the same lens as you did.
In fact,
I've only started one human being and he was in his 70s or 80s and had just survivedmetastatic melanoma on insulin as a diabetic, otherwise I completely reverse it.
(13:30):
I don't give anyone insulin and all my endocrinology colleagues would say, you can't dothat.
And then they found me in the last few years and said, we have a refrigerator, we makethem drop off their insulin and we get them off insulin.
Because if you manage diabetes effectively,
then you don't have to get sick, you don't have to decline, and it's ubiquitous.
(13:51):
Everybody has a disorder of carbohydrate metabolism.
It's a reversible condition.
Absolutely, and that leads to almost every disease you mentioned, whether it's dementia orneurodegenerative decline, Alzheimer's, heart disease, stroke.
kidney disease, kidney failure, eye disease, skin disease, because the sugar travelseverywhere.
(14:11):
Osteoporosis, cancer.
Everything.
Yes, cancer with insulin and insulin resistant.
So I'm completely along that you were way ahead of your time.
Your father was lucky and I feel like my father was too because I still remember after hepassed away, I was invited to be part of this moth.
I don't know if you've ever heard of moth.
(14:31):
You get up on stage, you're supposed to do a five minute talk without notes.
And I did a story about my father.
It was centered on parents and what you do.
And I remembered one story, and I hadn't realized it at the time, but I saved my father'slife.
And I'm like, wow, I just wanted to see him well.
And so you look back and you feel, you know, at least medicine made a difference in yourlife.
(14:56):
This way you can help other people as well.
Very critical.
And speaking of that, let's talk specifically about oxytocin.
I love oxytocin.
think one of the things I learned from my parents, my mom was from a warren-turn area inthe Middle East and my dad was this great negotiator kind of person, but he always could
make people laugh.
And so when there was a stressful situation to ease the stress, etc., my mom's sense ofhumor was tremendous, but like we would say jokes that travel around the world.
(15:24):
And that's oxytocin.
That is self-medicating with oxytocin, which is a counter...
you know, it acts counter to stress.
So oxytocin and cortisol, so oxytocin, I always like to clarify, not oxycodone, not likethe pain medication.
We people get mixed up.
We get mixed up, like we want oxytocin and we make it naturally as a hormone ofconnection.
(15:48):
And so as I studied as an OB, of course I knew about oxytocin from injecting pitocin IVRintramuscularly in labor.
to increase contractions.
And that's why women's mood changes when they're nursing because they're secreting a lotof oxytocin so they feel better and happy and they've sometimes turned into different
personalities while they're nursing.
(16:09):
You were saying that happened to you.
did.
Well, it's that connection, that peace and that being ability to relax and you you feelthis connection, oxytocin bonds you.
It's that imprinting hormone.
It bonds you to that child.
So it's so important to have labor delivery and oxytocin for that imprinting, for thatbonding, for that nurturing attachment that occurs evolutionary for the survival of the
(16:38):
species in so many ways.
Oxytocin is secreted with orgasm, with sexual health, with intimacy, with positive touch,with laughter, with gratitude and giving, with generosity and gifting and philanthropy.
There's an increase in.
giving up your time talents and tithes, as it says.
(16:58):
So I really studied as part of my own journey from trauma, from experiencing PTSD when welost my son, who was just a toddler, and that threw me into early menopause at age 39.
And it threw me into, I was completely infertile, early menopause, failed the highestdoses of injectable.
(17:20):
meds and that took me on my menopausal journey way back in 2006.
So as a result of that though, I didn't understand at that time, because we weren'ttalking, I I didn't understand the cortisol-oxytocin connection until I experienced it
that's why it's been my area of research and study.
Because as much as I, you know, try to heal and therapy and grief work and for me travelis my biggest meditation, I mean, travel around
(17:49):
world looking for answers, essentially.
But there was that disconnect.
There was the disconnect, burnout from work, a profession I loved, burnout from mymarriage, a person I loved, really that disconnect, that burnout, that physiologic
disconnect.
And I realized that when cortisol, and I dug into the research on trauma and PTSD, andwhen cortisol is elevated, oxytocin is suppressed, which makes sense, because if you're
(18:18):
Having a fight with someone, it's not the time to hug and kiss and make up, right?
It's got to be a discipline you learn.
So when cortisol is up, oxytocin is down, and when cortisol is up for a long time, thenthe paraventricular nucleus in the brain says, OK, cortisol, this is my conversation that
I have with my brain and cortisol.
it's like, cortisol, you are frying me out, right?
(18:40):
Too much cortisol?
Too much?
You know, it's causing hyperglycemia, it's causing breaking down the cell membranes, it'sleaky gut, leaky brain, leaky heart vessels, all that good stuff.
And so, paraventricular nucleus shuts down cortisol.
So it's not that you have fatigued adrenal glands.
It's that your adrenals are actually being suppressed in production of hormones, andspecifically cortisol.
(19:02):
So you're blocking those pathways.
And now, this is the most dangerous physiology, and we see this a lot post-pandemic,post-stress, post-c...
trauma and post veterans and war, you see this low cortisol, low oxytocin state.
And that feels like disconnect.
That feels like, you know, the physiology of divorce, the physiology of burnout, thephysiology.
(19:24):
I used to love going into my work, but I don't like to go in anymore.
I know I love my kids.
I don't feel love for them.
It is physiology.
We know physiology drives our behavior.
So as I, and this is a very acidic physiology too, checking urine pH.
You're very, very acidic.
And so what I figured out through my own work is that those moments that I did mygratitude journaling, that I did my prayer meditation, that I walked out in nature, walked
(19:52):
barefoot on the beach, that I was more alkaline each day, and then I realized thatcortisol is the most acidifying hormone, creates a urinary acidity.
acidity in the urine.
Exactly, increases hydrogen ion secretion across the renal tubules and oxytocin does theopposite.
It's the most alkalinizing hormone.
(20:12):
they can, you know, it's at war.
So I figured if I can manage oxytocin, I can pull myself out of this abyss.
And so just did, you know, started working to increase oxytocin to periodically supplementwith oxytocin and that
You know, that really has been game changing for me, for my patients.
(20:35):
Again, when I started to see it in myself, it made sense.
Why did I completely shut down?
Why is it that 70 to 80 % of people that lose a child end up in divorce?
Is it the grieving differently or it's that physiology that creates an inability to cope,connect, and bond, and rebond?
(20:56):
It's like also having a very sick child a lot of times.
Parents will split up even if the child gets better because of the physio.
It's all chemical We actually are chemical and energy Yeah And so I completely agree and Iactually worry much more when I see a very low cortisol rather than a high cortisol
because I worry about chronic fatigue I worry about what the adrenal glands are doing andwhat the rest of the body is seeing and it's much harder I think people hit a wall when
(21:25):
they have low low cortisol like two or
as opposed to in the range of six to 12, at least when you wake up or if you test saliva,you see the pattern.
So tell me, how would you detect low oxytocin and determine that you might want to treatsomebody and how safe is it in your hands?
What can we share with our listeners?
(21:45):
Yeah, so first of all, testing for oxytocin levels in the blood is very, very fragile.
There are few labs in the country that do it.
It's fragile, it's difficult.
I have them do a questionnaire.
And they look for the signs and symptoms.
So the questionnaires are like, you know, are you feel detached, know, cold, clammy hands,pale skin, I mean, things like that.
(22:06):
Not excitable, not feeling happy joy, engaged, all of those symptoms.
If you think about, again, the classic autistic patient is a low oxytocin physiology.
That's a low oxytocin.
They don't make eye contact.
So for, let me give you an example.
I had a client and I use oxytocin in sexual health, like for,
sexual function to improve orgasm, to give you that boost and increase orgasm.
(22:30):
So it works in clients that need it.
So I was given this client and because of my own journey, I was treating this patient, oneof my patients who was in her mid 50s, was treating her for chronic depression and also to
help with sexual function and relational issues.
And so I was giving her lozenges of oxytocin and she started to feel better, her mood wasbetter, she was feeling more connected and she said, you know what?
(22:55):
Like my, she said, you know, Dr.
Anna, I have a confession to make to my son who's 21 years old.
He graduated high school.
He was on the football team.
He had, you know, he'd started college, but couldn't finish.
He basically sits on the couch, plays video games to do anything.
So I gave him a, I slept him on oxytocin and all of a sudden he was engaged, got up,helped me make dinner.
(23:15):
And I said, well, first of all, you shouldn't have done that.
you shouldn't have told me.
She goes, but I really want you to see him and you know, evaluate him.
And so I said, okay, bring him to the office.
you know, I always tell young men or men in general when they come to a gynecologistoffice, look, give me a very brave, bold individual.
You're in the right hands, though, don't worry.
(23:37):
And so first of a lot of what we do in men and women are very similar, even though we'recompletely different animals, you know, in some ways, like hormonally, we share a lot of
the same principles, except maybe the prostate, that's about it.
That's it.
Yeah.
I'm ungrateful.
Frustrated and over and at times.
yeah, first thing I did is shake his hand.
So I'm going to shake your hand, Florence.
(23:58):
And the first thing, you know, nice, warm, good handshake for him.
It was cold, clammy, pale hands.
He wouldn't look at me and my eyes, very pale skin.
And and so I did a test.
And this is a very valuable thing as physicians when we're prescribing oxytocin, we'restill on the fringe because it's not FDA approved other than in labor and delivery.
(24:19):
So we're on the fringe.
So I gave him an injection of oxytocin, 10 international units.
I am with some lidocaine, because it burns like stink when you put it in, intramuscularly.
And I gave him an injection.
All of a sudden, he starts to pink up.
His cheeks and chest and ears start to pink up.
He starts looking at me in my eyes and smiling and having a conversation.
(24:42):
That is a positive response to oxytocin.
Yes.
Do you ever experiment with it where you try a small dose of it, like either sublingual oras large in terms to see, because I have a story of a patient here who I tried everything.
She was very depressed.
It was clearly endogenous.
She had been studied extensively.
Her father even had electric shock treatments and she was contemplating it.
(25:04):
Her sexual function was nil and I wish to hear about it because I took care of her husbandas well.
Like, what can you do?
What could you do?
And I said, you know what?
And I told her a couple of years ago.
let's try this because I don't do the testing for oxytocin.
I do it for other reasons.
And I feel like it's extremely safe.
So I gave her a small dose, a sublingual.
(25:25):
So she put it under the tongue and it melts there and it's a direct effect on the brain.
So I'm happy about that.
And she came back and she said, I have never felt as good in my life.
And then I got a call from her husband to say, what have you done?
You've got to get me to catch up because all of a sudden she was interested in
being sexual, she was happy, and she had never, her entire adult life, she was in her 50s,had never really been happy.
(25:51):
So even in endogenous depression, which is coming internally, you can make a differencewith oxytocin.
You can, absolutely.
And I think that, you know, intermittent use of it is very beneficial.
And there's some work, you know, with the benefit, especially in PTSD, which is thatbecame, unwillingly, one of my areas of expertise.
But in that trauma work, what it's showing is that use with oxytocin is variable.
(26:17):
But we know that use with, for example, ketamine, ketamine therapy and PTSD is veryeffective.
And within three months, you can get the results that you don't get in 10 years withcognitive behavior therapy and a very much lower relapse rate.
So the combination, this is like a magic combination just playing with right now, butketamine with oxytocin nasal spray.
(26:40):
And with integrative therapy, a good psychologist, psychiatrist, counselor, coach, etcetera, in the right hands, but being able to use that combination, I think, for trauma
for those individuals in that three, for three months with counseling and integrativesupport is And then do you continue the ketamine or do you continue the oxytocin
(27:03):
periodically?
You don't have to.
don't to.
Interesting.
And you mentioned other ways of naturally, besides giving birth.
naturally raising oxytocin.
It would be nice to hear exactly because you did it naturally for yourself until youstumbled into, maybe I could try it hormonally.
And then the way to test, I always say urine pH testing, like home urine pH testing, justcheck your urine pH every time you would you see like below seven?
(27:30):
How low would you go?
With the acidity, when I first started testing myself, this was the big aha with cortisoland oxytocin.
was that I was as acidic as the pH paper read.
So I basically was pH acid.
Well, the pH paper, the lowest was five.
And you figure our stomach is what, 3.5?
(27:51):
And so it was as acidic as the pH And as your oxytocin recovered, in part because you werewalking on the beach, you were journaling, you recognized that you were traumatized from
the loss of a young, young child.
I still remember that story that you told one year.
And what it did to your marriage and your life subsequently.
And so you're able to come back to life initially doing anything dietary activities.
(28:16):
Yeah, definitely.
So the whole keto green concept that I've created and I've written three books.
So hormone fix, I always say it takes more than hormones to fix your hormones.
Lifestyle is a key factor there.
Keto green 16 and my third book was menu pause.
So the nutritional concepts of being keto green is good alkalinizing plant based.
(28:38):
food like a lot of good veggies, alkalinizing cruciferous vegetables, I say createmedicinal menus, and also high protein, high quality fat, right?
So we want that and low glycemic with intermittent fasting to create more insulinsensitivity and to work on those alkalinizers to feed our gut bacteria with good
diversity.
(28:58):
that keto green eating and lifestyle hack helps with managing that.
cortisol and also resetting your circadian rhythm and cycle.
say catch sunrises and sunsets to get in tune with your circadian cycle and that's goingto help your cortisol curve.
I have one patient who is part of my virtual program.
(29:20):
She's in my magic menopause program and I challenged them to catch sunrises and sunsetsearly on in the program and she like you know two weeks in to doing this she said the only
thing Dr.
Anna that I was doing different
was getting outside for 10 minutes every morning and getting that sunrise in.
She goes, I feel happier.
I feel more at peace.
My urine pH is more alkaline.
(29:41):
I make them test.
it's just the only thing.
That just was game changing difference.
Because all of a sudden, now you've shifted your physiology.
And physiology affects behavior.
So getting out in nature is one of the best things I can write on a prescription pad.
Orgasm is another very good thing to write on it.
prescription pad and I talk about microdosing, to do same thing with exercise.
(30:05):
I would say here's your prescription for treatment.
There you go.
Yeah, I don't think I was as brave as you.
I got hauled into the Dean's office when I started Women's Health at Yale because I wasasking women who I just met about their sex life and what they were doing and how they
were functioning.
And the Dean at the time had been my Dean of Students when I went to Yale Medical School.
(30:25):
He said, Florence, you can't talk to people about sex in that way.
I'm like,
I don't know, it's part of life, isn't it?
Yeah, that's so so I still remember that in the 1990s no less.
man, yeah.
We still have a long way to go.
We do.
not something people are comfortable with.
I have a whole program called Sexual CPR.
It's like seven hours.
(30:46):
It is real, I mean, it's informative because we have to understand when it comes to that,like low libido, when someone says, Dr.
Anna, I have a low libido.
get great lectures in that.
Yeah.
It's like a, seven hour conversation.
Yeah.
because you gotta figure out what's causing it, what's the underlying issues.
how best to, because different issues will demand different kinds of effort and whetherit's the way you're living life or that you do need medication, we women lose testosterone
(31:16):
with age as well.
And so getting some testosterone really makes it, we don't have what men have, but we needthe little we do have to be sustained.
And it actually starts falling in the 30s before we go through any kind of menopausalchange.
So I'm always shocked.
I don't think I've seen a woman with adequate testosterone when she's 35.
What do you consider an adequate serum level?
(31:37):
Well, I don't look at total as much because that could vary depending on binding like sex,zero binding globulin.
I like a free to be no less than six and even up to 20 or 30.
It depends on the woman and how she clinically feels.
But we try to keep it between like 10 and 20.
And some women need more.
I favor more creams for women, but I'm going to start to test
(31:59):
oral treatments, there are new approved oral treatments that I think we can useeffectively that might last longer, that have a long half-life.
I was always worried about first pass to the liver, but the data shows that it doesn'tincrease lipids and it doesn't put a woman at risk.
So that was the main reason that held me back.
I know pellets are available as well.
(32:19):
I think I used to see so many women that, I don't know if you use pellets, I alwaysentertain the notion, but I saw women who had trouble with it.
or didn't want the surgery, even though it's minor surgery.
And the guessing game about levels is a little tougher with the pellets, whereas withcreams you could adjust more easily.
adjust on a regular basis.
Plus, think, I've been an advocate for judicious use short term of pellets, testosteronespecifically, not estrogen.
(32:46):
How in the right client for the of time, it's not something I think people should stay on.
And the reason too, those high, and being very conservative with the levels of
the doses of the pellet, also because what we expect to happen is that's shutting down thebody's endogenous production.
(33:06):
And that's just gonna affect other body systems in significant ways.
And I think that's really important.
You're at those high levels for a long term.
I mean, you've gotta stay on something or be very aggressive about rejuvenating your ownbody's glandular production and utilization of those hormones.
It's too bad our ovaries kind of come to a halt when we're like about 50 because it'sdifferent for men who continue to have function in a different way.
(33:36):
But when our eggs disappear for the moment, although there's research going on at Yalelooking at preserving a piece of your ovary and then replanting it so that you may be able
to keep the eggs alive longer and secrete your own hormones.
But I think it's important to optimize because that's what really keeps us young.
Otherwise aging happens and disease happens.
(33:57):
So women come to you for, and even men come to you for all sorts of reasons.
And I know you believe in keeping them as healthy as possible.
And I love the idea of testing urine because it's so non-invasive to look at acidity andalkalinity and decide whether oxytocin can turn it around and what's going on with
cortisol as well.
Well, and lifestyle too, because you can be eating that perfect green.
(34:19):
diet and be so stressed and so angry or so fearful or so whatever and that cortisol iscausing that acidity and so just becoming that awareness and I love like in our groups
where people get to share about what they're experiencing and be like again I completelyblew the diet but had a great night with my girlfriends went to the musical did this that
(34:41):
and I was so alkaline the next day I'm like
That is so important to that's great.
So there's a lot of changes you can make in lifestyle by enjoying life, like laughter isthe best medicine.
And having fun, which I think some of us have lost the ability a little to do, becausewe're so caught up in social jet lag, not getting enough sleep, especially in New York.
Maybe not so much in Georgia, but maybe to some degree in Texas.
(35:04):
It depends on the choices you make.
But making sure you retain your energy and your interest in life and you community andrelationships are critical.
Social relationships.
whether it's family or friends, actually ideally both.
And it's good medicine.
It is good medicine.
So I'd love to learn a little bit more about how you specifically use supplements andhormones.
(35:24):
I know you have this Menopause kit, and I know I've been invited to be on your girlfriendpodcast and your girlfriend live talks and conversations.
So I'd like to go back to that.
And if I can hear more about it, I'd love to share that with our viewers.
Yeah, thank you.
So one of the things that a part of my journey, you know, way back when I was 39,
had been diagnosed with early menopause, told that the only option would be to considerovarian donation.
(35:49):
And so I was devastated.
I'm OB-GYN, I trained at Emory University.
You get a diagnosis like early menopause, infertility, you fail seven rounds of therapy,right?
And you're like, okay, that's it, there's no chance for me.
But as a result of this journey in the superfoods that I experienced along the way and thegrace of God, to be honest, Florence, that not only did that reverse,
(36:12):
My early menopause diagnosis reversed, but I naturally conceived the child I was told Iwould never be able to have when I was 41.
And then I finally went through real official menopause at age 56.
So from 39 to age 56.
And so that ovarian preservation is part of what I teach.
The superfoods that helped me along the way, I combined into a formula I call Mighty MakaPlus.
(36:35):
So it's 30 superfoods.
Alkalinizing helps address cortisol is detoxifying.
is has adaptogens in there to support the adrenal glands, so supporting our body's naturalproduction of hormones.
Which adaptogens like Ashwagandha, Maca?
Maca, green tea extract, Kersatin, Versvera Chol, Turmeric, I can say all of those,they're genetic adaptogens as well as adrenal adaptogens.
(37:01):
that the, and antioxidants that are in there are so, are powerful.
It's a powerful combination.
And what we've seen,
And we studied clinically, we looked at DHEA sulfate levels in the blood, and we've seenan increase of 70 to 200 % in two months, taking two to three scoops of Mighty Maca a day.
We've seen an increase in day 21 progesterone levels.
(37:22):
But clinically, what people feel is more energy, clean energy, not like hyped upcaffeinated energy, clean energy and reduction in hot flashes, reduction in cravings,
feeling, you know,
better sleep and more energy during the day.
So that combination was really key.
It's an expensive supplement to make, it's a combination of the highest qualityingredients, but it works.
(37:46):
And it also, when we address cortisol, we can improve oxytocin.
So that's one of the key things.
And then part of like oxytocin increasing activity is orgasm and play.
And as women, as we get older, vaginal dryness, rejuvenation, clitoral...
atrophy, urethral atrophy, incontinence, all of those issues come to play if we don't dosomething about it.
(38:12):
So I created my product, Jova, which has DHEA and plant stem cells from the alpine roseand is an amazing product to help turn back the hands of the time.
say, know, clitoris to anus, most important real estate on your body, keep it healthy.
People will talk about.
vaginal estrogen, mean estrogen works on the mucosal layer and it can transfer to yourpartner if he's a male and they don't need any more estrogen per se usually.
(38:40):
so, but DHEA is perfectly safe.
It's safe to use during intercourse.
It's designed to be used daily like a part of our cosmetic regimen and again to addressclitoral atrophy as well to increase sensation and pleasure.
And because DHEA works all the way to the muscularis level, it really does turn back thehands of time.
I had a patient who last year I wasn't even able to do a speculum exam on.
(39:04):
She was so atrophic.
And this year it was like, you know, she didn't even give a blink.
She was like, Dr.
Anna, I didn't have sex with my husband for the last 12 years.
We're having sex and intimacy again.
It has been game changing.
And I have a 67 year old who likes to boast that she has the vagina of a 25 year old.
I'm like, that's a good biomarker.
(39:24):
Is it injected internally like a suppository or can you apply it on the tissue itselfdirectly?
can apply it on the tissue yourself and for clients who have continued vaginal drynessbecause it does get absorbed into the lower third of the vagina.
You can apply it to that area as well.
It does absorb into the upper areas of vagina but that's the area that's really, thehormones work really well in that area.
(39:48):
And the other thing is that clients with significant atrophy still, like what I'll havethem do is on a vibrator to apply it to a vibrator and insert it internally.
So you have the vibration increasing blood flow also with the Joelvine.
That's a, you know, for, you know, difficult atrophy, difficult to treat atrophy we can doWell, that's fantastic.
I think, you know, it'd be something that I would be interested in exploring for ourpatients.
(40:13):
We don't see the degree probably of dyspnea.
difficulty with intercourse pain and dryness because we start very early with optimizinghormones, both testosterone and estrogen, and that systemically, not just locally.
Locally is useful for short while, but you're right, the transference can bedisconcerting, although we direct women timing and how to use it so that it gets absorbed.
(40:38):
But that sounds fantastic, and it's new to me because I don't think this is something youhad.
when we last spoke?
yeah, probably.
I mean, I brought it to market in 2016.
I brought it to market in 2016.
It's just been it was predominantly word of mouth, but it's it's skyrocketing.
Yeah, yeah, it's been great.
It sounds like you're making a real difference in I'm going to send you some.
(41:00):
You're to have to give me a personal testimony.
Actually, I have some here.
will leave you with some.
Definitely.
Do not travel without it.
I usually like to wrap up with like a final question and ask you if somebody ever stoppedyou.
I'm sure you do get stopped.
or you're on a plane and you're talking to someone next to you and they say, what's thesingle most important insight you've had so that you can change someone's life?
(41:22):
Where would you start?
What would it be?
You know, I think it is the concept of microdosing oxytocin.
It's that concept of gratitude is being in the present moment with gratitude, despite whatelse is going on in the world.
And I think, you know, with all the uncertainty, with fear, with trauma, and I say that,
from a place when I had been in severe depression, suicidal in the past.
(41:48):
This is the single most important thing I did to pull myself out of the abyss, is that ina moment, to be in the present moment, to be grateful and to be of service.
I think that is physiologically some of the best things that we can do.
I couldn't agree more and I think to live even with the past traumas and understand that
(42:09):
They're compartmentalized.
You recognize that you lost a vital part of yourself when your child died, unfortunately.
But life goes on and you heal yourself.
think you've done a tremendous job.
Very impressed.
I always have been impressed.
So I'm so glad you came to New York and we could actually do this in person instead ofremotely.
(42:31):
What I like to do is find out how people would reach out and listen to you and hear you oreven come see you, however you want.
to include that.
Yeah, thank you.
So easy to find me at dranna.com.
So dranna.com.
And my websites are great.
On my about page, there'll be information on how you could see me in person.
And I have so many good resources at dranna.com.
(42:53):
I have free 10 day programs, briefs through menopause, have keto green challenges, I haveinformation on, of course, my podcast, The Girlfriend Doctor Show, anywhere you listen to
podcasts.
And my books are available anywhere books are sold.
That's so great.
It's been a hard journey for you, but I'm grateful you figured out how to get through itand thrive and helping so many other women and men to do the same.
(43:17):
So thank you, Anna, for all the work you've done.
It's not been easy, I know.
Thank you.
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