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How to Optimize Fertility, Hormone Health, and Longevity

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For women in their thirties and forties seeking to optimize fertility, hormone health, and longevity, the most impactful immediate steps involve avoiding smoking, understanding natural biological changes, and addressing severe menstrual issues. Smoking is particularly detrimental not only to lung and brain health but also directly harms ovarian function. It is equally important for individuals to be educated about the inevitable decline of ovarian reserve over time, rather than fearing fertility treatments unnecessarily. Furthermore, women should recognize that debilitating period pain or excessive bleeding are not normal conditions to simply endure; seeking medical treatment for these symptoms is crucial for overall well-being and quality of life. A significant misconception regarding perimenopause is the belief that pregnancy is impossible once a woman reaches this stage. In reality, as long as a woman is still ovulating and releasing eggs, there remains a chance of conception, although the probability decreases with age. Therefore, if pregnancy is not desired, contraception must be used during perimenopause because fertility has not completely ceased. This distinction is vital for women to understand so they can make informed decisions about their reproductive health without being misled by the assumption that menopause marks an absolute end to the possibility of getting pregnant. The video also highlights a powerful anecdote where treating a woman's autoimmune issues and gut health led to her becoming pregnant with twins at age forty-two, illustrating how lifestyle changes can positively affect fertility outcomes. This story underscores the importance of open communication between patients and doctors regarding how interventions might influence reproductive potential, as some women may initially feel angry when their cycles regularize unexpectedly. Additionally, it is essential to clarify that having a low quantity of eggs does not equate to infertility or poor egg quality; many women with diminished ovarian reserve can still conceive naturally, dispelling the fear that a low egg count guarantees an inability to have children.
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Um, if a woman in their 30s and 40s wants to optimize fertility, hormone health, or longevity, what are the three highest impact things that they could do right now? >> Number one, don't smoke. I think, you know, we've known this for years how bad smoking is for our lungs and our vessels and our brain, but it's equally as bad for our ovaries. Number two, be aware of what's going to happen to your body, right? Like, I'm not saying that you have to do fertility treatment, but know that your ovarian reserve is going to decline. So, have edge get educated, have knowledge. And number three, if your periods are so bad, so painful that you can't go to work or school, or if you bleed I had a friend of a friend text me yesterday being like, uh I've soaked through like, you know, my clothes five times over, what should I do? I'm like, you should see your doctor. Like, that's not normal, right? So, we have to recognize that we're not just supposed to like tough it out and be like, okay, I'll bring seven changes of clothes and get an ulcer from all the Advil. Like, that's not normal. Use your voice, speak up, and get yourself treatment. >> Mhm, love that. Cuz yeah, there are women suffering. I feel like the hormonal issues, the infertility, everything is increasing because of stress, environmental exposures, and all these things. Um, what's the biggest myth about perimenopause? Like, what are people not thinking about that they should be thinking about? >> I guess the biggest myth, I mean, you can get pregnant in perimenopause, right? You're not in menopause. So, once you if you are still ovulating, still releasing eggs, yeah, the chances go down, but the chance is still exist. So, you have to be aware of that. Not because again, that nobody's trying to scare you and tell you like, oh my god, like, you know, you're never baby. But, the point is be aware that it can happen, and if you don't want it to happen, you should use contraception. >> Yes, I'll never forget one of my first or second years of practice, I had a lovely woman in her 40s and we treated her autoimmunity and her gut health and all of her good stuff, got her eating right and sleeping well and she came back very angry because we had fixed her irregular cycles and she was pregnant at 42 with twins. Now, in the hindsight, it's the best thing that ever happened, of course, in the end, but it was so because at first she was so angry like, "Why didn't you tell me that changing my lifestyle could affect fertility?" And I didn't even think of it cuz it was so obvious and I learned I'm like, "Wait, we have to talk about these things." >> Yeah, exactly. It's so funny. >> Yeah, I'm sure you've had cases like that, too, where they, you know, not expecting and then >> Well, you know what I've seen a bunch is what our women who I've said, "Oh, your egg quantity is low." Women who are coming to egg freezing and I say, "Doesn't mean your infertile, means your quantity is low." And then they call me the couple months later and they're like, "I got accidentally pregnant." And I'm like, "Well, what happened?" [laughter] They're like, "You told me my eggs were bad." I was like, "No, no, I did not tell you that. I said your quantity was low. I never said your quality. This is not on me." >> Yeah, exactly, exactly. It is funny. And then usually it's a good thing, but not, you know, it's so interesting.