Dr Betsy Greenleaf, Urogynecology

Dr. Betsy Greenleaf is a trailblazing leader in women’s health, bringing pelvic peace, hormone harmony, sexy sizzle, and crazy confidence to busy women. With over 20 years of experience in female pelvic medicine and reconstructive surgery, she’s a best-selling author, award-winning speaker, entrepreneur, and inventor.

As the first female in the United States to become board-certified in Urogynecology, Dr. Greenleaf has dedicated herself to empowering women through education. She founded Femversity.com, a platform dedicated to holistically healing women and providing practitioners a place to thrive.
Dr. Betsy’s passion for women’s health led her to become the CEO of The Pelvic Floor Store, where she helps women find reliable products for their pelvic health. She’s also the host of “Some of Your Parts” Podcast and the internet show “BODY MIND SPIRIT,” & “The Health Explained Show” which focus on total wellness.

As the best-selling co-author of “You Were Made To Be Unstoppable,” Dr. Betsy inspires women to embrace their power and overcome obstacles. She’s also the mastermind behind The Happy Vagina Rally, an empowering women’s summit dedicated to hormones, pelvic health, and wellness.
Dr. Betsy is also the Chief Business Officer of HousecallVR, a virtual reality company combating health illiteracy for a healthier tomorrow. With her vast experience and dedication to women’s health, Dr. Betsy is changing lives and inspiring women to embrace their greatness.
Dr. Greenleaf takes a holistic body-mind-spirit approach to healing and wellness.  She believes many of the answers to a healthy life are found within. She views her role in life as your wellness guide.

Code: ageless10
pelvicfloorstore.com

Episode Transcript

Speaker 1 (00:10):
Good morning everyone. This is Michelle Hughes from Ageless and Timeless.
I have a wonderful guest today. I know I always
say that I always have great guests. But her name
is doctor Betsy Greenleaf, and she is well. She has
a very interesting story, but we're going to let her
tell it. But she is the first female certified euro

(00:34):
guynecologist in the country, So swallow all that. Betsy, good morning,
how are you.

Speaker 2 (00:43):
I'm so excited to be here. Michelle, Thank you. I'm
so grateful to be talking with you today.

Speaker 1 (00:48):
Well, we have a wonderful mutual friend in Susan Fox,
and Susan is an incredible accupuncturist here in the Bay
Area and Mill Valley next door to me and I
live in Timaran, So I met her and we've been
brainstorming with mutual connections and she'll probably come on the
podcast sometime in twenty twenty six. We're books solid, Betsy,

(01:09):
we got you in, but we're book solid for the
whole year. So congratulations for being one of our guests
in twenty twenty five. So, Betsy, tell us how do
you become a euro guynacologist? What is it end up
being the first woman to get certified.

Speaker 2 (01:28):
Yeah, it's funny because starting back, even in gaynacology, I
never thought that that's what I was going to look
at all day long. And I remember back in residency,
I had a friend who was a podiatrist and we
were eating lunch and she was like, looks at me,
and I'm looking at her, and I'm going, how do
you look at people's nasty feet all day long? And
I thought she was going to choke on her sandwich

(01:49):
because she's like, do you realize what you're looking at
all day long? And I'm like, oh, you know, I
didn't realize it. So interesting enough, I actually started off
in general surgery and then really is attracted to women's
healthcare and switched over to obstetrics and gynecology and didn't
even know that eurogynecology was even a thing. And I

(02:10):
know a lot of people are like, what in the
world is that? And when I told my mom I
was going to do two more years of eurogynecology on
top ofstetrics and gynecology, she thought it was like European gycology,
like euro like euro Disney, like it was some kind
of fancy gynecology. And it actually has to do like
a combination of two professions of urology having to deal

(02:31):
with the bladder and the urinary system and gynecology having
to deal with the pelvic organs. And there's only fifteen
hundred eurogynecologists in the United States, and so it's especially
training beyond just e've been either enter it through having
training in obstetrics and gynecology or you enter it from urology.

(02:51):
So and it's a much needed specialty, especially when we
look at conditions like prolapse, which is where things start
drooping and dropping down like they do everywhere in our
body as we age. But fifty percent of women will
experience a pelvic prolapse at some point in their lives.
So we need a lot more eurog collagists out there
addressing these issues.

Speaker 1 (03:12):
Is there's that fifty number mostly due to aging or
is there are there other reasons why prolapse occur so frequently?

Speaker 2 (03:21):
Yeah, so they happen. It happens for a number of reasons.
And some people are like what might be thinking right now,
like what in the world is a prolapse? Well, what
happens is there's ligaments that hold our organs in our body,
and so like our bladder's being held up by ligaments
and it's kind of leaning on the vagina, the vaginas being
held up, the rectums being held up, and they're so
close together, they kind of all those organs lean on

(03:44):
each other and as age can definitely affect the tissue.
But the most common reason women have that is pregnancy
and childbirth. That's a lot of stressors on the pelvis,
and our pelvis is just basically an open hole to gravity.
So once those ligaments get damaged, there's not a lot
that they can you know, hold them up, so things

(04:06):
kind of just start drooping and dropping and coming down.
But in people, in women who have not had a
pregnancy or child birth, things like constipation can affect this.
Smoking we know, smoking affects all of our ligaments, and
certain medical conditions like autoimmune diseases can affect this too.

(04:26):
But I think the youngest person I've ever seen that's
had problems with a prolapse was actually a thirteen year old.
She was a gymnast, and from the actual impact of
you know, landing as a gymnast all the time, that
that actually affected things too. So sometimes we see that
if people are doing extreme lifting or anything that's going

(04:48):
to put a lot of pressure on their pelvis. We
can see that affect their ligaments.

Speaker 1 (04:52):
And so how do you fix that?

Speaker 2 (04:55):
Yeah, that's that is the key, And this is why
you may have heard a vaginal mesh because that was
a big thing that happened in like twenty twelve, where
there's not a lot of great ways to fix this.
So some of it can be doing your kego exercises
and strengthening your pelvic floor because sometimes the prolapse can

(05:19):
look worse than it is because our muscles have gotten weak,
and what ends up happening is we start losing about
eight percent of our muscle mass for every decade that
we live after the age of thirty. So people always
think about exercising their arms and their legs, but they
don't think about exercising down there. So having strong muscles

(05:39):
can sometimes help keep things in place better or can
help with if somebody ends up having to have surgery.
But even then, like once those ligaments are torn, there's
not a lot that we can do. There's different things
that we can do to affect the appearance, from the
kego exercises to things like vaginal rejuvee nation with lasers

(06:01):
or radio frequency things that will tighten up the tissue.
But even surgery, which we've learned because of all the
problems that happened with vaginal mesh. And the reason why
mesh was being used in the first place is because
even when you go into do surgery, it's not like, well,
like just fix those ligaments, because a lot of times
those ligaments are so thin or so torn there's really

(06:23):
nothing to sew them too. So they started using materials
like mesh to kind of reinforce the tissue. But they realized,
you know, hernia mesh has been used since the nineteen eighties,
and great when you're putting in the abdomen for the
hernia for hernia, but when you put it in the vagina,
it's a whole different area, and the vagina has to
be able to have some movement, and so these meshes

(06:47):
didn't work in that area. So they're still using somewhat
materials like mesh or natural materials to reinforce that tissue.
But we also know that having serve for these kind
of problems isn't like a permanent thing. It's not like, well,
when you have your appendix taken out because there's an issue.

(07:07):
You don't typically grow an appendix back. It's out and
it's done. When we're doing these types of surgeries for
the prolapse, we hope to get five to ten years
out of the surgery because there's just so much pressure
and gravity affecting that area. So we've unfortunately learned that
there's nothing permanent when it comes to treating these areas,

(07:29):
and some people, you know, surgery is an option, but
if somebody doesn't want to have surgery, or if they
are looking for something less invasive, there's also little devices
called pestories that can be worn in the vagina, and
a lot of times they look they come in all
kinds of crazy shapes and sizes, but a lot of
times they look like little frisbees and they kind of

(07:50):
fold up and they in certain just wedge in place
and hold hold things in place. So that's also another
non surgical option.

Speaker 1 (07:58):
So is a pestury kind of like an eye that
you take it in and out when I mean, obviously
the IUD is for burst control, but is that what
happens with the pestory. You would put it in before
your day begins and then take it out in the evening.

Speaker 2 (08:13):
Yeah, some people. Well so they're usually typically made out
of silicone and they can easily come in and out.
Some people don't have the dexterity to take them in
and out on their own. Though, the more you take
it in and out and clean it the better, because
what happens is the vagina, anything that's in the vagina
that's not supposed to be there, the body tries to

(08:34):
get rid of it, and we'll try to flesh it out.
So the longer one stays in, somebody might start making
a heavier discharge with that, and that can sometimes be uncomfortable.
But they're typically left in as long as three months,
where people can come into the office every three months
and have them change. But I always recommend that they
try to come in a little bit sooner. But there's

(08:55):
been no great studies on how how long is the
longest you can actually leave them in. I have to
say the worst case scenario I ever saw was somebody
who left it in it for a year. She was
a patient of another practice and she showed up to
my practice and was like, Oh, I forgot this was there.
And in one case, well one case I had somebody
it was fine. We took it out, we cleaned it,

(09:17):
and she went back to her normal activities. Another lady
that came in a year later where that happened. Her
tissues started to grow around it, and so it was
and she was not somebody that was healthy enough to
have surgery. So we basically left it as an almost
like an implant.

Speaker 1 (09:32):
So, I mean, I'm going to ask a kind of
intimate question, but if you're having you know, sexual intercourse,
isn't they isn't it going to get very grubby and dirty?
With what I mean? I'm just being just really honest,
just thinking, Yeah, from a pragmatic standpoint, so I mean,

(09:53):
wouldn't it be better just to be using these things
more like an apparatus that you take in and out
and clean of course? And yeah, well i'm is that
what you would do with?

Speaker 2 (10:06):
Ideally that would be the better way. But you know,
some people when it comes to sexual relations, some people
leave them in place when they're having sex and their
partners sometimes feel it or don't. And yeah, ideal some
people just take them out completely during intercourse. But yeah, ideally,
the more you can take it in and out and
clean it, the better.

Speaker 3 (10:27):
So are you ready to transform your health and wellness,
join us April twenty fifth to twenty seventh in Dallas,
Texas at the Hilton Granite Park for the twenty twenty
five Changing Life and Destiny Conference, the event of the
year for those passionate about moving our healthcare system to
a preventative and proactive model. Explore forty plus masterclasses and
discover one hundred cutting edge health technologies that are shaping

(10:49):
the future of wellness. Learn from renowned experts like doctor
fab Mancini, doctor Dan Pompa, and doctor Sandra Rose Michael,
and take home powerful strategies to enhance your life practice.
Whether you're looking to boost your health, explore the latest
and functional medicine, or connect with like minded individuals, this
event has something for everyone.

Speaker 2 (11:14):
Yeah. Yeah, It's called a pestory pessori E.

Speaker 1 (11:18):
E S A R Y P E s s A
R Y I A Y. Where do you get where?

Speaker 2 (11:26):
Usually you have to be fitted for them at your gynecologists,
And like I said, they come in all kinds of
crazy shapes and sizes. Typically, the standard one looks like
a frisbee. It's usually like a little disc that folds
up in half and kind of slides in there and
then opens and wedges. But they can be as extreme
as looking like a cube for like very extreme prolapses.

(11:49):
And and typically the the larger and kind of crazier
shapes are a little bit harder to get in and
out on your own. But and that's usually managed by
a gynecologist.

Speaker 1 (11:59):
So you said it's made of silicon. But isn't silicon
dangerous to the body? But I mean, isn't that what
happened with women who had silicon breast implants that they
had to have them removed because of the issues of
the material of silicon.

Speaker 2 (12:15):
You know, So you know, and I being in the
health and wellness and integrated medicine world, I get kind
of crazy about what things are made out of. However,
the what they're these devices, and we kind of say silicon,
I don't know exactly exactly what it is. They are
like BPA free and and but are there like a

(12:36):
perfect healthy version that doesn't have toxins in it? I
don't know if there's one that exists. You know, I'm
always asking about that and the issues with the breast
implants that was actually and that could be argued back
both ways. I have my own personal opinions about it,
but and I've seen my own cases of you know,

(12:59):
breasted plant illness. But from a clinical research standpoint, all
the studies that have been done on breast and plants
actually and like I said, I don't have to agree
with it, but say that they're they're actually the material
is safe. But that's from a traditional research standpoint, which,

(13:23):
like I said, I don't personally agree with all.

Speaker 1 (13:25):
That started out an allopathic medicine. So you know that
very often there's a little poetic license and how these
things are described as quote safe. So I mean, I
don't know. I'm not an expert. I never had any
and thank god, but I do know a lot of
women who had problems with and had to have them

(13:47):
remove because of the material. So anyway, so what part
of your practice is would you say is the most challenging?

Speaker 2 (13:56):
You know, Like right now, what I'm focusing mainly is
on menopause treatment, and I think that really, I mean,
menopause has been around forever, but it's all of a
sudden become this really popular conversation. And I don't know
why it's good because I'm glad that we're talking about
it more because it needs to be talked about. But

(14:16):
where I find it frustrating is now you like basically
open up your phone, social media, the Internet, and everywhere
you go there's somebody that's talking about menopause, and I
don't think they're necessarily coming about it in the right way.
And what I find the most frustrating is I'm seeing
women who are getting overdosed on hormones like left and

(14:38):
right from other places, thinking that hormones are like the
panacea for all the issues in menopause. Where I always
teach you know, doctors and nurses and my patients, that
hormones are a tool in our toolbox, but they're not
the end all, be all answer to everything, and that
we have to still look at life's We have to

(15:00):
look at where inflammation is creeping in into our lives,
whether it's from inflammatory diets or things we're putting on
our skin, and that these are things that could be
affecting our hormones, and then just giving more hormones isn't
going to necessarily fix those problems. So I think it
becomes very, very frustrating. In addition, we have our traditional

(15:24):
medical organizations that are still too scared to talk about
hormones to women, because in two thousand and one, the
Women's Healthy Initiative study came out, where like a day
before that study came out, they were like hormones for everybody,
you know, kind of like the Oprah meme when you're like,
she's like a car for you, a car for you.
They were like hormones for you, and you and you,

(15:46):
And then the next day it was like, everybody needs
to get off their hormones because it causes heart disease
and breast cancer. And what we know today in twenty
twenty five is that that's not necessarily true, and the
problem was not hormones, it was the type of hormones
in those studies. So what people don't realize is that

(16:09):
not all hormones are created equally, and unfortunately, a lot
of the stuff that your insurance covers is incredibly toxic,
and I actually think it should be a crime against
women that those products are still on the market. And
then we have to take a step back and go,
why in the world are those products even on the market.

(16:30):
And it's really purely a business decision, because in medicine,
you can't patent things that are naturally occurring. So our
natural hormones that are in our body are not patentable.
So as a business, there's no money in selling natural
hormones because they can't patent and protect their companies. But
what they can do is take a naturally occurring hormone,

(16:53):
tweak that molecule, means like add something onto that molecule,
change the shape of that molecule, and then they test
it and see like it kind of works like human
you know, human hormones, and now they can patent it
and sell it to women. And that's what's in our
birth control, and that's what's in a lot of the
prescription based hormones. And we know that the Women's Health

(17:17):
Initiative study that showed to increase risk of heart disease
and breast cancer, they were using these non natural hormones
which we now know are very incredibly inflammatory and are
actually processed down a toxic pathway in the body that
can actually increase the risk of cancer and heart disease,

(17:39):
and that natural hormones and balance we don't see those things. However,
we're never going to have any big giant natural hormones
studies because there's no money in it. So it becomes
that it's crazy circle.

Speaker 1 (17:52):
So if you're using compounding pharmacies, and I know they
do not have the same kind of money as the
farmersutical industry, So of course you're right, there's just not
and there isn't going There is not going to be
the kind of financial roi that you get when you're
dealing with chemicals and patentable Like you said, so I

(18:15):
agree with you, But who would ever want to put
if you have a choice of horses urine into your body,
which is what premarin is, and that's what was being
used for that study, right that, Yeah, as one And
there was no such thing as compounding hormones until after

(18:35):
that study, So it seemed like that that was kind
of a wake up call for a lot of these
more natural like using yams as an example for hormonal
which is more natural to the body. So how do
you educate your clients, your patients between using the traditional allopathic,

(18:56):
you know, pharmaceutical approach versus the compounding approach.

Speaker 2 (19:00):
Yeah, so it's really more about trying to find the
sources of the natural hormones. And in fact, there actually
are some prescription natural products on the market, but people
don't really know about them. But I also like the
compounding because you can kind of tweak the doses because
I have also found that some of the doses that

(19:21):
we see on the in that are on the market
that our prescription based tend to be a little bit higher.
But more so even in that study was the the
progesterone was more of an issue. The synthetic progesterones are
probably the main cause of all the issues in that
study than the natural And so that's actually where I
tell people to take a look. If they're getting prescribed progesterone,

(19:42):
they want to make sure they're getting prescribed to something
called micronized progesterone. Because micronized progesterone is the natural version
of progesterone. It usually goes under the brand name of Prometrium.
It gets confusing because there's a madroxy progesterone. Is what
we see see is the synthetic version, the non natural

(20:03):
version that is incredibly inflammatory. It is usually associated with
a lot of the side effects that people think of
with progesterone, like like moodiness and weight gain. That happens
in birth control because unfortunately, we don't have any natural
hormone birth controls that are out there we do have
the option for natural hormone therapies, but not for birth control.

(20:25):
So a lot of the things that people see as
side effects are usually coming from these these synthetic ones.
So it's usually you know, looking what you're getting because
that's the one you can get as a prescription from
your you know, from your doctor, and maybe you know
it might be covered by insurance, it doesn't always.

Speaker 1 (20:40):
See, the great irony of what you just said is
that progesterone is supposed to make you feel less moody,
and you know, if you're using the right form of yes, yeah,
and more energetic and you know, and.

Speaker 2 (20:53):
You sleep better sleep.

Speaker 1 (20:56):
So isn't that an irony that you're taking something that's
doing the opposite of what it's naturally intended to do
if you're using the right the right ingredients. Yeah, So
let's talk about a moment just about bioidentical hormones, because
I think there is a lot of confusion. And you're right,

(21:17):
you can customize if you're going to a compounding pharmacy
to the patient, which is, you know, one size does
not fit all. As a doctor, how do you determine
what dose did she give to a patient? So that
you know that you're doing the right thing by that patient.

Speaker 2 (21:36):
Yeah, the easiest patient is the one that comes into
me that doesn't have has never been on hormones, because
they're the easiest one. What we do is we put
them on the lowest dose and we just adjust it
based on their symptoms. And this is where even my
very first hormone patient, I remember she was somebody where
I was checking her labs and we use the labs

(21:58):
as kind of a reference that we're doing the right thing.
But the labs don't always tell you exactly what to do.
Like for example, this was a woman who was in
her early sixties. She had no sex drive, hot flashes,
she was losing her hair, she was having you know,
vagile dryness, like everything you know.

Speaker 1 (22:17):
You can think of all symptoms.

Speaker 2 (22:20):
Yeah, And so I started her on a hormone called DHA,
which interesting enough is over the counter. But that's that's,
you know, just an interesting fact. And she was taking
it every single day, and I put her on the
lowest dose and I check them in a month later,
and now her hair loss got worse, her sex drive

(22:40):
came back, but she was so pissed off at her
husband that she didn't want to have sex, and her
hot flashes got worse. So we checked the labs and
her testosterone had gone through the roof, her estrogen gone
through the roof, and she was on the lowest dose.
So then what I figured out over time is we
adjusted where she wasn't taking it as frequently, and she

(23:03):
came back, and I think we got her down to
where she finally was just taking it twice a week
and she was reporting no hot flashes, Her mood was better,
her hair had come back, her sex drive was back.
Everything was good. But then when we checked her labs,
her labs looked like she was too low. And so
this is what I when I also teach, I teach

(23:24):
practitioners how to do this. This is where I'm like, the
labs are just a suggestion, a weird a go because
even people your labs, your normal might look completely different
than my normal, and as long as you're feeling okay,
you start to track over time like, okay, well these
are my normal. When I'm in this range, this is
how I do so. Fortunately, too off and I see

(23:48):
practitioners who are not trained well in this. They keep
just adjusting beasts on those laboratory values and then they
never quite get it right in people's hormones all over
the place. You got to kind of take like the
whole picture into a.

Speaker 1 (24:05):
I just want you to know that what you're saying
is like preaching to the choir. But the last podcast
two weeks ago, doctor Amy hornhaman, Yes, but she's the
thyroid fixer, she said something very important and I keep
repeating it to everybody. It's the question how do you feel?

(24:25):
It's not what are your labs saying? That's and that's
like you said, it's a guide, but it's not the
end all and be all. You've got to ask the
patient or the patient has to tell you how do
I feel? And if I start taking something, how do
I feel differently than I did before we started this?
So that seems to be the guiding parameter for using hormones.

(24:49):
So yeah, but you can trate, you know, up and down,
and it also can depend on other things going on
with your body, like microbiome, which we'll talk about in more,
or your stress levels or your immune system and whether
or not you're you know, you're healthy at that time,
and you can go from you know, having the flu

(25:11):
to being healthy again, and it's going to change your
hormonal pathways exactly. This is really tricky. I mean, you're
you're it's almost like you're a detective.

Speaker 2 (25:21):
Yes, the giant puzzle that you're like one piece at
a time.

Speaker 1 (25:26):
Yeah, And the human body is a giant puzzle because
it can be very depending on all those things we
just talked about and others. So well, I asked you
the you know, the menopause question the most challenging part
of your practice. So have you been able to figure
out a protocol from menopausal women that you want to
share with us?

Speaker 2 (25:47):
Yeah? So what I've been able to figure out. And
this has also been great because I've been the test
subject too, because this is all the stuff that I've
been through. I was really surprised at how much. And
you mentioned it before. The microbiome plays into all this,
because you know, people go to their doctors and they're like,
I'm having any symptoms like low energy, low sex drive,
Just give me hormones. And sometimes all the hormones in

(26:10):
the world don't fix the problem because we have to
go back and take a look at what's happening in
our microbiome, which are the bacteria that live on and
in our bodies, and even further, take a step back
and looking at our stress levels. And so because here's
the thing that I found is the pathway by which

(26:31):
we process our hormones is the same pathway that we
process our stress hormones, except for it chooses like it's
either sex or stress, and they can't coexist. So when we,
you know, our immune systems were or our hormone systems
were made perfectly in that as cave people when we

(26:53):
were kind of walking across the savannah and maybe we
were digesting our food and thinking about going to runoff
with our honey into the bushes or something like that,
Like that's all a nice relaxed state. That's good. Our
sex hormones are working, our digestion is working, our immune
system is working. But then all of a sudden, a
lion jumps out of the bush, and this is not

(27:13):
the time to be reproducing, digesting, healing anything. This is
the time to fight or flight. And so when our
stress system kicks in, all of our resources go into
making stress hormones so that we can overcome that stressor
But then what happens is either we fought off that
lion or we ran away from them, or we stayed
so still that the lion like ignored us and walked by.

(27:36):
We're then supposed to go back into that relaxed state
where everything is functioning again. However, in today's day and age,
I say that that our stressors, our lions come in
different different factors. There are you know, are inflammatory diets,
you know, eating the poor standard American diet. It could
be emotional stress, it could be financial stress. It could

(27:59):
be toxins in our environment that we're putting on using
our you know, our cosmetics, and we didn't know that
they snuck in there their illness. We saw it during
COVID during the pandemic. We saw so many people with
their hormones that were stabilized for years and the other
hormones went kind of wacky because COVID is a stressor

(28:21):
on the system, even the vaccine. So either one we
were showing it was throwing off people's hormones. So the
key to like menopause and for men andropause is not
just the hormones, but let's look at where the stressors
coming from. Not getting enough sleep is a big one.
So you know, they found that actually getting less than

(28:43):
six hours of sleep a night actually increases your risk
of obesity by thirty seven percent, and that goes up
to about fifty three percent if you get five or
less hours of sleep. So, and we know it does
throw off the hormones, you know, not drinking enough fluids,
getting enough exercise. So going back to the very basics,

(29:05):
which sometimes we think like, oh, those don't really have
that big of an impact, but lifestyle has a giant
impact on our hormones and our health. And then where
I get where I start to geek out a lot
is on this microbiome connection. And so you know, going
back to these are the bacteria that are on our skin,
they're in our mouth or in our gut, and for

(29:26):
women they're in the vagina. There's a different environment in
each one of those areas of our body, and it
keeps us in balance and keeps us healthy. I found
out the hard way when I entered menopause and I
started having problems with anxiety and depression that kind of
seemed to come out of nowhere, and was being put
on antidepressants that weren't making much of a difference. And

(29:49):
then I was also getting sick all the time, and
I was seeing all these doctors and nothing was working.
And then it was right around that time I started
entering the functional and greative medicine world, and I was
studying this, and all of a sudden, I went, wait
a minute, this all has connection, Like my immune system
and my mood is connected to my microbiome, my gut health.

(30:11):
And so this is where I really dove into myself,
you know, getting off the inflammatory dot foods, like cutting
down on sugars and processed foods and eating more whole foods.
I tell people that the four things you should eat
are if your food has walked, flown, swam, or grew

(30:32):
at some point, that is something you should be eating.
Because doritos don't grow on trees. There's no free ranged twinkies.
So you know, Because why does this connect to the
gut is because ninety percent of your happy hormone serotonin
is made in your gut, and if your gut is off,
you're more prone to anxiety and depression. Right, eighty percent
of your immune system is made in the gut, and

(30:53):
so if it's off, you're more likely to get sick.
So we do know that there's a very strong gut
brain connection and stress from the brain can affect the gut,
so meditation and relaxation and doing things with friends can
help with relaxation that improves your gut quality and your
gut healing, and so then that lawed me down. This

(31:16):
also kind of this rabbit hole of looking at the
research and there wasn't much, but now that we're starting
to see more, is this connection between the gut microbiome
and the vaginal microbiome and sex drive. Because the body
is very smart, it's smarter than we are sometimes. So
if things are off and let's say we have an

(31:37):
overgrowth of bad bacteria in our gut from our poor diet,
or we have an overgrowth of bacteria or yeast in
our vagina, there's this feedback loop through the vagus nerve,
which is one of the main nerves in the body,
going back to the brain and it tells the brain like, Okay,
it's not an ideal time to be reproducing. So the
brain doesn't know the difference between you just want to

(31:58):
have fun with your partner versus you want to actually
try to make a child. So it's the brain. The
process is the whole thing. It's the whole thing. So
the brain goes, okay, well there's inflammation going on in
the gut or the environment in the vagina is not
quite right, so let's dampen all processes of reproduction. And
so this is now again a stressor, and stressed and

(32:20):
sex can't coexist. So now what ends up happening is
we see the hormones get affected, we see sex drive
get affected. In our younger people, we get see their
fertility get affected. And so there is this kind of
brain gut vagina connection all through these microbes, which is
incredibly fascinating to realize how these have such a you know,

(32:42):
a play on how our health is working on an
everyday basis.

Speaker 1 (32:46):
So that is such a good explanation. And you know,
so recently in the last two years, the microbiome has
become the hottest topic in all of functional medicine. And
now the the microbiome, the gut brain connection is you know,
evolved from that. So explaining it the way you just

(33:07):
did is really helpful. And now you've got this other
going down south to the vagina, which is something that
hasn't really been discussed, Like you said, so one question
I had is, you know, if someone is having a
libido issue and they just don't feel that either they
have dryness or they don't feel like having sex. What

(33:30):
are the two things that you would right away do
for that person, for that patient two things.

Speaker 2 (33:36):
I don't know if I can narrow it down to
do things well. I think number one, I would look
at lifestyle. But if it's a dryness issue, Okay, if
it's a dryness issue and their postman apauzle, then we
need to start looking at doing things to rejuvenate the vagina,
because that's the other thing, because what happens is when

(33:58):
the vagina starts to as we age, our vaginal tissue
starts to thin out, and when it thins out, we
start getting more discomfort with it's not as elastic. It
can feel like cut glass. It's dry, it's uncomfortable, and
it's not supporting our microbiome because we need that thick

(34:21):
tissue when we were younger to basically provide a food
source for the healthy bacteria and the vagina. And when
it thins out, the bacteria, the healthy bacteria basically starves
to death because it lives off of the actively sloughed
cells that contain glycogen, which is our food source. So
now we got to talk about doing something to rejuvenate

(34:41):
the vagina. My favorite happens to be lasers. And why
I like lasers is because it uses light energy to
penetrate the tissue and it causes like a microscopic injury,
and the body responds to that by flooding the tissue
with growth factors. So it's almost like a bio where
it's stimulating the vagina to regrow and collagen and elastin

(35:05):
kind of reform and make it back to the way
it was when we were like twenty Why I like
lasers is because you can do it without using hormones. However,
lasers are not always affordable for everybody, and it's not
covered by insurance, so there's a whole range of things
anywhere from using topical hormones, whether they're compounded or prescription.

(35:30):
Though the prescription ones there's only one on the market
called Invexie that is not often covered by insurance, but
the only estrogen ovule that is bioidentical that's prescription. Otherwise
you have to use the non bio or you have
to use compounding pharmacies. But even using testosterone and the

(35:51):
vagile tissue can help keep it healthy or DHA, which
is a precursor hormone to testosterone and estrogen. But you know,
some people get really nervous about you using hormones, and
you know, I understand, especially if they've had any kind
of issues with the history of cancer. And some doctors
are perfectly fine with them using and I would say
to check with your doctor first. But that's when in

(36:12):
twenty fourteen, we had the first vaginal laser that came
to the United States, and it was brilliant because we've
used lasers for skin since the nineteen eighties. So the
fact that they were like, oh wait, we can apply
this to the vagina, like that made so much sense.
And that actually then opened the floodgates to the regenerative world, saying, well,
what else, if lasers work, what are the things that

(36:34):
we're doing regeneratively can work down there? And then we
saw the development of machines that use radio frequency, which
are sound waves, to generate heat that will stimulate that
tissue to regrow using platelet rich plasma where they extract
your blood and take the growth factors out of your
blood and then apply it back into the vagina. And

(36:55):
then there's a couple of different over the counter products.
Because then the pandemic happened and those things that I
talked about are usually practitioner administered treatment, so people weren't
able to get out to their doctors to you know,
have the vagina's lasered. So they then there were companies
that popped up with home therapies. And so there's a

(37:17):
company called Joylux which makes a product called v Fit,
which is a red light wand. And we know red light,
and you see that some people have these big red
light panels that they stand in front of. We know
that the frequency of light from red light stimulates our mitochondra,
which are the anti aging kind of powerhouses of our cells.

(37:39):
So it stimulates our cells to rejuvenate. So we know
that that works when you apply it externally. But now
we also have wands or that can be applied internally,
and even down to there was a company called CO
two Lift that created a carbon dioxide gel product that

(37:59):
can be applied to the tissue. And the where that
came out of in Europe, something called carboxy therapy is
very popular. That's where they inject carbon dioxide into your
tissue and it tracks oxygen and causes rejuvenation and anti
aging in the in the skin. But the woman who
started that company, she was like, I don't want to

(38:21):
have needles stuck on my vaginas. There a better way
to do this, and she worked with scientists that created
a carbon dioxide gel that can I applied be applied
topically to rejuvenate the tissue. So now we have so
and there's new things coming out every day, so you know,
we have the options from hormones to non hormones and
everything in between. So so it's not just it's not

(38:42):
just like keeping you know, as we age, it is
also keeping the vagina healthy so that it supports the
microbiome that then can help our libido, prevent us from
getting urinary tract infections, vent us getting vaginal infections. So
it all kind of connects together.

Speaker 1 (39:00):
What is the name of the laser that you use
in your practice?

Speaker 2 (39:05):
So, well, there's a bunch of different companies out there,
but the laser that I have is the Mona Lisa
Touch and that's the first one, but pretty much most
there's there's so many different companies that then came out
with their own versions, and pretty much a laser is
a laser, So, yeah, there's not one that's better than
the other.

Speaker 1 (39:23):
And is there a downtime when you use the laser
because the skin is being a.

Speaker 2 (39:29):
Bladed Yeah, so when we so, typically when someone's getting
their vagina laser, it's you usually get three treatment protocol
where they come in every like four to eight weeks
for a total of three treatments. If you're just doing
inside the vagina, it's usually just a two day recovery,
meaning no sex or swimming for two days. But if

(39:50):
we're doing the outside lips too, then usually it's like
a week downtime because it's a little more raw. I
will tell you having done it personally myself, and at
some point we're gonna get the video up on YouTube,
not the actual close up. We filmed it from above
when I was getting mine done. Just it's usually during
the procedure itself, sometimes you feel a little crampy. Usually

(40:12):
for twenty four hours you may feel crampy. It's usually
not painful. If the outside of the body is done,
we usually use a numbing gel or numbing medicine cream
on the outside so that it's comfortable, but then typically
like a day or two afterwards, there's not really much
discomfort other than the tissue is you know, kind of
raw and you have to keep some sort of bomb

(40:35):
or salve on it to keep it from getting irritated.

Speaker 1 (40:39):
Yeah, it's just like doing it on your face, except
it and the intermit private area of your body. But
it just seemed like it would be so painful to
have that area be raw.

Speaker 2 (40:53):
You know, It's surprisingly you heel very very quickly down there.
And the thought behind that is is a lot of
people rip and tear during childbirth, and so we're kind
of built to like quickly heal down there to be
able to overcome those things.

Speaker 1 (41:09):
That's a good point. So what about the candida and UTIs,
how do you deal with those and what's the protocol
that you think is best not only let's talk preventatively
and then talk post you know, treatment wise and when
you already have the conditions.

Speaker 2 (41:30):
Yeah. So you know, first of all, if you're postmenopausal,
or if you're on birth control, or if you're pregnant
pregnant in breastfeeding, you're not much you can do to
rejuvenate the vagina. But people on birth control and people
that are postmenoposele are at higher risk because of that thinning.
So number one, we have to do something to kind
of thicken the vaginal tissue so that it supports the

(41:53):
healthy microbiome. But then we have to look at where
is that bacteria coming from. And unfortunately, as women are rectum,
our vagina and our urethrow the tube wepe throw are
very close. And it's not necessarily some people think will
think it's a hygiene issue. It's no matter how clean
you are, it's just we have a tendency to be

(42:16):
able to pass bacteria back and forth. Of course, we
always tell people wipe front to back, and the reason
is you want to wipe away from the buttocks area,
the youal area because you don't want to bring that
bacteria closer to you. I tell people. Some people are like, all, like,
I can't do that. I tell pat just kind dry
in that area. But then the other thing is we're

(42:37):
looking at the pH of the vagina is often getting
thrown off, and that's a chicken or the egg thing.
Is is it off because there is bad bacteria there?
Or is the bad bacteria coming in there because the
pH is off? So actually one of the ways to
treat vaginitis without medication is actually to make the vagina worcidic,

(43:00):
so using products like boric acid, or there's some suppositories
that are made for women that actually have vitamin C
which is a little bit acidic and that helps to
kind of reset the vagina. I love boric acid, especially
in the summertime. If someone's going to be in a
wet bathing suit all day, I'll have someone kind of
throw one in Preventatively. I find that if there are

(43:22):
five patients that are getting recurrent urinary tract infections, especially
after intercourse, I will often have them use a boric
acid suppository after intercourse kind of reset that pH. But
the other thing is when I see women that are
coming with recurrent urinary track infections and recurrent vaginal infections,

(43:44):
then I have to take a step back and go
and look at the gut because we see that a
lot of times it's their gut microbiome that's gotten thrown off,
especially with yeast, because diets that are high in sugar
will have you overgrow yeast in the gut and it
just happens to kind of get into the vagina. And
so we can treat the vagina all you want with

(44:05):
like monastet and creams and stuff. And this is where
we see people where they're doing really well and they
use they you know, they get it itching or burning,
and then they use a medicine, they get better, and
then like two three weeks down the road, it comes
back again. Or this is sometimes a pattern I'll see
with urinary track infections where it's like they go on
like the three to five days of antibiotics and then

(44:28):
they're good, and then two three weeks down the road
it comes back and they keep going through this pattern
where it's back again, and so that ends up having
a source in the gut and then we have to
really go and evaluate what's happening with the gut and
trying to get that back on track. Now, I like
to use like fancy tests where we do what's called

(44:49):
stool microbiome testing where it can exactly pinpoint what's happening
in the gut and then target the treatment. But things
that people can do on their own without having to
do the fancy task is really get on a whole
food's diet, try to get away from the sugars and
yeast is an interesting thing because the presence of yeast
in the gut. They found that some of these microbes

(45:12):
actually have DNA that can control the human body. So
when yeast is present, it actually tends to give you
sugar cravings. And it's because the yeast wants to be fed,
so it likes to live off of sugar. So sometimes
if I have somebody that's getting a lot of sugar cravings,
I'm like, you know what, this is where you've got
to take control and you have to feed, like feed yourself,

(45:35):
not the yeast, and try to ignore those cravings. Eventually
they'll go away. But you know, eating whole foods. Like
I said before, fiber. Everybody hears a fiber is good
for you, No one ever asked, well, why is fiber
good for me? The reason why we need to be
getting twenty five to thirty grams at least a fiber

(45:56):
a day in the form of fruits and vegetables, more
so vegetables, is because that's what the healthy bacteria lives on.
The healthy bacteria lives on fiber. So if we're not
eating enough fiber we know Americans don't, we're not supporting
the healthy bacteria that's then going to fight off the
yeast and the bad bacteria. And the other thing is
getting more fermented foods in our diet. And luckily now

(46:20):
most of us can go to the supermarket and find
them very easily. But if you're really motivated, you can
make them your own. Your own. But there's yogurt, kaffir, kombucha,
which is fermented teaste, sour crowds, kimchi. Eating some sort
of fermented food every single day can actually make a
big change. I had a friend of mine who was

(46:42):
having all these gastro intestinal issues and I'm gonna throw
him under the boat right here, and I said, like,
let me test your gut microbiome, and he just never
got around to it. But he started drinking something called kavas,
which is like fermented beet juice, and he swears to
God it is the kavas that like cured him. And

(47:02):
I'm like, no, he got much better, and thank goodness
he did. Yes, it is the kvas. But it's not
just the fact that you added fermented foods into your
diet and now you basically repopulated your body with healthy
bacterias and that the body is going to work better.

Speaker 1 (47:18):
So well, tell my viewers all the time that if
you look in your refrigerator. Make sure that you have
those exact products, sour kraut, yogurt that's unsweetened, and yes,
you can even buy lactose free yogurt. Now they may
coconut if you don't want to use milk, but definitely

(47:42):
don't do do not do sugar, don't do a fugart.
And then kafir and kombucha. Kim Chi I have a
hard time because it's very spicy, and yeah, well with garlic,
so I never mentioned. I always tell people, Yeah, if
you like that, go for kim chi because that's actually
one of the better ones. And then of course using

(48:03):
things like garlic and you know, the the the the
foods that are going to help to eliminate the bad guys. Yeah,
and then if you can do any thing with avoiding antibiotics, yes,
that's when you said that. Earlier, I thought, oh, the
problem with these yeast infections and these vaccinal that they

(48:27):
always the first thing they want to do is give
you an antibiotic.

Speaker 2 (48:31):
And that's that's what I see all the time with
these urinary track infections too, and like they they practitioners
often reach for cipro, which drives me crazy because one
course of cipro can throw off your gut for a
whole year.

Speaker 1 (48:43):
It's like an atomic bomb.

Speaker 2 (48:45):
Yeah, and so it's and then that's why then you
end up just getting more infections because now you've affected
your immune system. So it's like, I mean, there's a
role in place for for antibiots. We need them, but
we probably don't need them as much as were using.
I think in general we're seeing that people are trying
not to use them as much. But if you're on
that cycle of getting these infections and then getting better

(49:06):
and then getting infected, the antibiotical could be contributing to
throwing off that microbiome that's making you then get these
infections more often.

Speaker 1 (49:13):
And yet that's what they prescribed for the very infection
that the antibiotists could be causing or at least making worse.
What about the the O shot that people talk about.
Have you ever done that and what do you think
of it? Yeah?

Speaker 2 (49:31):
So some of it I think is a little bit
of placebo, but some of it So the O shot
in actually that specific name is actually a licensable name,
but it's many places do it. It's using platelet rich
plasma and using the growth factors from your blood to inject.
They injected typically in the antwer wall of the vagina
to kind of bulk up that area between the vagina

(49:55):
and the urinary system and the butter and the urethra.
And they also inject in and around the the glitterists.
And so the nice thing is it does have regenerative properties.
I think in some ways there's a placebo effect community
that people get it thinking like this is going to
like make their sex life so much better, and like

(50:16):
this is the answer. It works, but it works because
it's rejuvenating and making that tissue young and functional again.
So it's really just kind of stimulating your own body
to kind of heal itself. But and I don't want
to bust on placebo because hey, placibo, if it works,
it works, you know. So but you know, is it

(50:36):
a miraculous cure all for for sex life? It's another
tool in our toolbox. It's not you know, yeah, it's
not this like, okay, this is going to fix everything.

Speaker 1 (50:47):
You know. The other day I was reading an article
and it said never ever douche. And when I was
growing up, that was what they told us to do.
And you know, basically, keep yourself clean. So what happened?
Why Why is douching not recommended now in the current day,
and historically it's always been a protocol.

Speaker 2 (51:09):
Yeah, So, well, number one, it'll throw off the microbiome
because you're like washing away a lot of the good
bacteria that are in there. The other thing that they
get concerned about is for women who've never had any
kind of surgery down there, like a hysterectomy or anything.
We're an open system, meaning that the vagina is kind
of connected to the cervix, which is the opening of

(51:30):
the uterus, and there's just a cavity in there, and
then beyond that, the Filippian tubes are open into the
abdominal cavity. So there is the risk that if you
douche and you put too much pressure on the fluid,
the fluid could go from the vagina through the uterus
out the Filoppian tombs into your abdominal cavity. So you
could be washing bad bacteria and yeast into your abdominal

(51:52):
cavity and that is not a good infection to have.
So that's pretty serious. So, you know, do I use
them on patients medically in certain situations? I do, and
we either instruct them to do it very gently but
in the right and I would not tell people to
do this at home just because. But in a medical situation,

(52:15):
sometimes we'll use like a watered down peroxide because that's
peroxide is actually naturally found in the vagina. When healthy
bacteria is there, healthy bacteria will make peroxide. So sometimes
we'll use a very light like peroxide or even vinegar
is not terrible.

Speaker 1 (52:33):
But baking soda or vinegar is what I've always heard.

Speaker 2 (52:37):
Yeah, the baking soda not so much, because the vagina
is very acidic. The vagina has so like the pach
of water is seven, where the pH of a normal
vagina is three point five to four point five. It's
very acidic, and so baking soda would make it would
lower the acidity, which you know, I still have not

(52:57):
figured out most things in nature. I kind of underst
and why they work. The only thing I have that
figured out is semen is very basic. It's it's seven
to eight on the on the pH scale, which that
and that's why some women have problems if they're having
sexual with men, they get and they can have their
pH or their vagina thrown off if they're if you

(53:20):
know if they have semen inside of them, it makes
their pH which supposed to be a cidic and it
throws them off and can sometimes increase their risk of infections.

Speaker 1 (53:30):
Is that why they tell you to always try to
urinate right after you've had intimacy that you're because you're
trying to get rid of that that semen that could
be damaging.

Speaker 2 (53:41):
Yes, well, that's more so from the friction of any
kind of sexual intercourse because of the vagina and the
urethra show close together that sometimes bacteria from friction can
get pushed up into the urethra the TBP through. So
the ideas by peeing after intercourse, we're fleshing out the
blurinary system and the urethra to try to not get

(54:02):
a urinary track and infection.

Speaker 1 (54:03):
Yeah okay, so tell us about the pelvic store that's
your Yeah.

Speaker 2 (54:10):
Yeah, so the pelvic floor Store dot or pelvifloor store
dot com. Yeah, that is is my baby. So I
was recommending products to patients and I would say, Okay,
go to this website and buy this, go to that
website and buy that. Because a lot of these health
products that are reputable are not sold on Amazon and
The other thing I have to tell you about Amazon

(54:31):
is we know that they're counterfeits. So I tell people,
don't buy your supplements, don't buy your health products off
of Amazon, but you don't know if you're getting the
right thing. Okay, beyond that, So one day I had
a patient that said to me, like, why do I
have to go to so many different websites? Why can't
there just be one where I could just go get everything?
And I went a little light bulb blah blah my head.
I'm like, wait a minute, that's brilliant. I don't know

(54:54):
how to make a website, but I'm going to make
a website. So I made a website, the Pelvic Floor Store,
and I basically put all the products that I recommend
or products that I find that I think are good
in one place.

Speaker 1 (55:06):
So I had to go and source all those products though, right,
So this was a major effort on your part. You
have to have those products in your inventory, and then
you have to deal with all the shipping and the
processing of the financial side. So this is not like
some simple you make it sound so easy, like it
was just an idea, and all of a sudden, the

(55:26):
next day it was.

Speaker 2 (55:27):
Well, I think we started off with like three products,
and then we keep adding them because I keep finding things.
And then I think the most painful thing is when
I've had to let products go. Like I have a
product line that I believe in, but it just isn't selling,
and I'm going to have to let it go. And
I'm like, so that's going to be the harder. That's
going to be the hardest.

Speaker 1 (55:48):
How do you think a product wouldn't sell, Betsy, what
what's your theory on that?

Speaker 2 (55:53):
I think that sometimes like this is a is a
I don't want to baden out the product. So it's
a prebiotic gel for the vagina. So it's basically to
help feed the healthy bacteria. And as a doctor, I
think that's great. I think from the complaints I've gotten
from patients is like they put it in and then

(56:13):
it melts, it becomes very drippy. So I think people
are like, it's drippy, it's uncomfortable, and I think that
that ends up being and they don't necessarily see maybe
the benefits from it as quickly as they see from
like a boric acid or a vaginal probiotic. So I'm like,
all right, you know, maybe it's time to let that

(56:35):
one go.

Speaker 1 (56:36):
So well, is there a lot of our guests like
to offer the viewers or the listeners an incentive. Is
there anything that you feel you would like to suggest?
And like, basically it's to encourage them to know more
about you and what you're doing and your products. So

(56:57):
I don't want to put you on the spot because
if you're not comfortable, it's okay. But if there, if
there is anything, we have them. Michelle recommends, Yeah, so
we we put you know, your name is the wet
podcast Gate and your offer and then they use an
ageless the ageless code, so you know that you're getting

(57:17):
referrals that are going to have whatever your offer is.
So if you want to do that, I'm happy to
mention it here. If not, we can do it later.
It's up to you.

Speaker 3 (57:27):
Yeah.

Speaker 2 (57:27):
And in fact, actually I am just looking and I
do have a code. I have two. I have a
code here. It's ageless ten.

Speaker 1 (57:38):
Oh.

Speaker 2 (57:39):
So if you go, yeah, if you go to the
Pelvic floor store and you use code ageless ten. I'm
just going to make sure when we get off this
that it's working. That will get to ten percent off
anything and everything. Whether you want to buy one thing
or a bunch of things, so that will get to

(57:59):
ten percent off your entire order.

Speaker 1 (58:01):
And tell us the website again for the pelvic.

Speaker 2 (58:03):
Floor celvicfloor storm dot com out.

Speaker 1 (58:07):
That's pretty easy. Yeah, I'm writing this down, but it'll
be on the tape here anyway, but I'll have my
assistance make sure that this goes on our website for you. Okay,
run out of time, and I knew this would happen.
And you're talking to someone who's as exciting and fascinating
as you, and you have so much knowledge. It's just

(58:28):
fun to brainstorm with you. If you in our partying message,
what would you like to share with our viewers today?

Speaker 2 (58:38):
Yeah, you know, I think that the biggest secret to
first of being ageless and timeless is going back to
simple things like lifestyle and total wellness is like a
three legged stool. You can do everything you want to
the body, but if you're not taking care of mind
and spirit additionally, that three legged stool is going to

(58:59):
fall over. So it's going to be a balance of
all free to like live your best and vital life.

Speaker 1 (59:04):
Yeah, that's lovely. Thank you so much, Bettie. Well, I
hope you have a wonderful weekend, and thank you again
for taking time for us today and for ageless and
timeless viewers. I'm sure they're going to be very appreciative.
We will do a couple of reels on Instagram and
Facebook probably, and so we're asking you to collaborate if
you don't mind, and then yeah, definitely, and we'll do

(59:28):
the opposite for you if you want to take any
part of our podcast or the whole thing. Do you
have a social media presence? Yes?

Speaker 2 (59:37):
I do.

Speaker 1 (59:38):
I do.

Speaker 2 (59:38):
I'm doctor Betsy Greenleave in many different shapes and sizes
all over the internet. And I just just finally got
my regular doctor Betsy Green leap back. I got kicked
off Instagram. Oh talking about vaginas a couple of years ago.

Speaker 1 (59:51):
Wow, today with Robert F. Kennedy, I think it's going
to be a lot different. Yeah, yeah, I have a
YouTube channel as well. Do you have you have? Are
you on YouTube? Yeah? Yeah? Okay, great, good, perfect, all right,
we'll do a bunch of mutual reciprocal collaborations. So thank

(01:00:12):
you again, Betsy, have a great, great weekend, and be
well and and and stay as as positive and upleat
as you are.

Speaker 2 (01:00:22):
Thank you, thank you so much. I appreciate it.