Have you ever wondered why you are prone to hormone problems?
In this episode of the Hormone Prescription Podcast, we talk with Dr. Aviva Romm about why women are more likely to experience hormone imbalances and what we can do to prevent them.
Dr. Aviva Romm is a leading authority on natural health and holistic medicine, and her insights will help you understand your own body better. She is a midwife, Yale-trained MD and Board Certified Family Physician who specializes in Integrative Gynecology, Obstetrics, and Pediatrics, with a focus on women's endocrinology. She's also a world-renown herbalist, and author of the textbook, Botanical Medicines for Women's Health, as well as 7 other books, including The Adrenal Thyroid Revolution and her new book, Hormone Intelligence, an instant New York Time Bestseller, which explores the impact of the world we live in on women's hormones and health, and brings us a new medicine for women that is holistic and natural, while being grounded in the best science and medicine, have to offer. A practitioner, teacher, activist, and advocate of both environmental health and women's reproductive rights and health, she has been bridging traditional medicine, total health ecology, and good science for over three decades.
In this episode, we discuss the importance of listening to your "hormone intelligence" and how it can guide you to making better choices for your health.
You will learn:
-Why women are more prone to hormone problems
-What you can do to prevent hormone imbalances
-How to listen to your "hormone intelligence"
-The importance of making choices for your health
And much more!
[01:01] Welcome back to another episode of the hormone prescription podcast with Dr. Kirin. Thank you so much for joining me today. We are going to jump into some hormone deliciousness today with Dr. Aviva Ram. Some of you probably already know her because she is one of the queen bees of hormones. She's a medical doctor. She's also a nurse midwife. Her background is in nurse midwifery. We actually found out that we went to the same high school in New York City, Bronx science.
[01:56] So maybe you will learn some tips on how to tune back into what she's telling you and transform your hormones and your health. I think that that quote really exemplifies what Dr. Aviva Ram is all about. She shared this quote with me before we met for her interview. And it's really what she wants for you. It's what I want you. I think that you will get lots of information that can help you to thrive and not just survive in this life. Cause if you're just surviving, you're not doing it right.
[02:55] So Dr. Aviva Ram is a medical doctor and a midwife. She's Yale trained for her medical degree and she's a board certified family physician who specializes in integrative gynecology, obstetrics and pediatrics with a focus on women's endocrinology. She's also a world renowned herbalist and author of the textbook botanical medicines for women's health as well as seven other books, including the adrenal thyroid revolution and her new book, hormone intelligence and instant, New York times bestseller, which explores the impact of the world. We live in on women's hormones and health and bring us a new medicine for women that is holistic and natural while being grounded in the best science and medicine have to offer a practitioner, teacher, activist and advocate of both environmental health and women's reproductive rights and health.
[04:16] I am super excited to talk to you about hormones in, oh my gosh. I freaking love your book and agree with really everything that you say. And I love how honest you are and you're honest. I mean, it's unfortunate, but we've gotta face some hard truths right now about the care that we are giving women or should I say not giving women. And I love that you are honest and that you really stop the medical gas lighting that's going on. And you say women, you are right. You are not being taken care of. You're not being nurtured. So talk about how you became so passionate about women's health.
[04:56] Well, it started out really early for me. I, as we were chatting about before, um, Karen and I, you all, we, we both went to the same geeky science high school in New York. We both went to Bronx high school of science and I knew I wanted to be a physician even as early as ninth grade, but I wanted to get out of New York and I was living in a housing project.
[05:53] And we're talking back to 1981. So this was a long time ago. And when I started to look at the history of women's health, the fact that at that time in 81, the C-section rate was already becoming a concerning issue, how high it was getting. And at that point, it hadn't even hit 19% yet. Now we're at like 34% nationally in 1981, it was still legal for black and brown women to be sterilized at childbirth without their consent in California, for example.
[06:57] So it kind of goes pretty far back deep in my roots of the things that I was just very blessed and ballsy enough to like that combination of like stepping out there to dare, to take some chances. And then those people were in my path to help me understand. So that really kind of just pushed me to a whole new commit, to deeply understanding healthcare. And I became a home birth midwife.
[07:49] And at that time too, you know, we're talking like 81 all the way into the mid two thousands. Believe it or not things like herbal medicine, nutrition, midwifery, these were really fringe. I mean, really, really fringe. The medical model was not giving any of these things, even lip service at that time. It was like you were either in the system or you were out of the system.
[08:52] So I also wanted to be a voice and an advocate for people needing it, but like increasingly my mission is now to also just be a voice and an advocate for changing healthcare because healthcare providers are getting burned out on how healthcare is too. So that's kind of, you know, in a nutshell, the journey and where I've come through and come to. And then, you know, I was part of that. I went to medical school. I mean, I went to Yale, I got my MD and did my internship in internal medicine, women's health. And I did my residency in family medicine, cuz I wanted to add in the OB and the pediatrics, which most internal medicine docs don't do. I couldn't do the OB. I started the interview, no like I to interview in OB programs. And I actually withdraw my applications because I was like, I am gonna be so unhappy as a midwife doing OB in that system. So I really give you credit for doing that. For me, family medicine was a softer way to be able to stay aligned with what I, who I was and where I was going.
[09:56] You know, it's interesting that, you know, you point out that a lot of herbal medicine was on the fringe home. Midwifery was fringe. When I came out of residency in 96, a couple years later, I actually started being the backup for the midwives locally. And they had applied for privileges at the hospital to do liver decades before and been blocked repetitively.
[10:37] And that's for the nurse midwives. Right. So that was for CMS. It wasn't even like the traditional direct entry midwives. And they had the CMS had an obstacle and they're trained in the medical model.
[10:50] Right. And even after the commission and the suit, they say the hospital has to entertain their application. When they reapply, they would always lose their application and bottom line, they weren't gonna let them in. And then I came and the tides had turned politically and it was then in Vogue to have birthing suites yeah. And allow the family in and have midwives.
[11:22] Yeah. That's amazing. You know, in Georgia, there are over 90 countries that have no OBGYN at all, no hospital access at all. So we were really trying to advocate. In fact, I just spoke this past year to the, um, Georgia state legislature. And we did a lunchtime hour for them still trying to get a home birth midwives licensed. It's very difficult for nurse midwives to attend home births because they're under the auspices of the OB GYN. So if the OB GYN don't approve it, they can't do it or they'll lose their licenses and privileges. So they can't do it.
[12:18] It is insanity. And I may be a little liberal on this, but I really think that it doesn't take all the training that we OB GYNs have to deliver a baby. And this medicalization of the process, really, I think the majority of births would be handled by midwives.
[12:35] That's my, yeah. I mean, we've seen that in every, I mean, we're not talking, you know, in the middle of the Outback somewhere and you know, Australia, we're talking about the middle of like the Congo. We're talking about Western nations that have demonstrated that year after year after decade, after decade, Canada, Germany, UK, Sweden, et cetera, et cetera, that home birth is optimal for otherwise healthy women.
[13:31] And I think like, you know, along with the medicalization that you mentioned an overmedicalization, we see this incredible and infantilization as if adult women should have to be told what we're allowed to as opposed to like, may I, or is it okay if I do this procedure or check you? And it's not just in birth, it's pelvic exams, breast exams, how we're talked to in the doctor's office.
[14:24] It is, you are so right. It is so true. And I really think it's time for a complete revamping of women's healthcare, really a revolution. And I think your book is a great place to start because you cover a lot of these kinds of sociopolitical issues in there. So can you tell everyone what hormonal intelligence means?
[14:46] Yeah. So to me it means a couple of things. So one this idea that we have actually an innate biological blueprint that really hasn't changed over eons of time when women menstruate, the same way we get pregnant, the same way we give birth the same way internationally. We go into menopause basically at the same age that may have changed a little bit historically over time, the age that we did, what these processes repeat over and over and over same hormones, the hormones haven't changed, you know, since we first started walking on two feet and actually even before.
[15:39] We can't just say, oh, well, that's because you're a woman or that's because you have estrogens because you have a uterus. We haven't always had all of these problems. And certainly not at the scope and magnitude and amount of women that and people with a womb that experience them now. So hormone intelligence on the one hand is understanding that we have this innate biological blueprint, hormone intelligence is also having the intelligence or wisdom to understand that blueprint.
[17:05] It's so true. In my medical training, I really was taught and got the impression that we were little men and, and that we had this little extra accessory pack, like a little black bag you might wear to a black tie event. That was our female hormone pack that conferred oh, interesting. The ability to reproduce. And that was like a separate department and it really didn't affect who we are foundationally. And you know, in my journey I've learned that nothing could be further from the truth we are.
[17:46] Totally. And I think sometimes too, because as women, you know, we all know the statements. What are you on your period? I mean, we had a president that said to a reporter, is that you're, you know, is that blood coming out of your hoots or whatever right now, you know, it's like the, to admit that our hormones have an impact on our life and our actions and thoughts and behaviors.
[18:32] Yeah. And you know, I love how you talk about just the words that we use to describe our anatomy. Can you talk a little bit about that and kind of moving towards a less violent nomenclature that is more nurturing and supportive of us.
[18:49] Yeah. We tend to have a very male centered and militaristic approach to health in general. I mean, we all hear, you know, in this moment of the pandemic, right? Like your immune system fighting and battling, and we're very keyed into this war mentality and with, with women's bodies, I mean, all the parts are named after men, even pelvic floor exercises were for women were originally named after Dr. Keel. You know, we have our Bartels glands, we have all these pouches of Douglas.
[19:45] So I really like to reclaim body parts whenever we can use an Ana correct name. That's great. But I do think we need to rethink some of those names and maybe rename things. But you know, when we can just call things what they are pelvic floor instead, you know, pelvic floor exercises, instead of Kas, you can say birth canal, if you want to, instead of vagina and not everyone who has one wants to get birth. So how do we rethink it? It's so funny, but because my oldest daughter is here visiting me right now and she's 33 and she was saying how funny it was.
[20:30] And my daughter was like, it's so funny, mom. Whenever I hear it, she's like I cringe cuz it was so embarrassing when I was a kid. But she's like, it's so popular now. And it's not necessarily the perfect word, but it is at least a respectful term for women's really means the VVA. That's another thing too.
[21:25] It's so true. Ava and I used to, when I practiced basic OB GYN, which I don't do anymore, I used to keep a mirror in my exam rooms and I would show everyone when we would have the speculum exam, this is what your cervix is and show them their anatomy. And I was surprised how many women had never looked yes. At their anatomy.
[21:47] And when do they're like, oh, that's amazing. Or that's really cool or wow, that's not what I thought. Yeah.
[21:54] I am for anatomy and biology education, age appropriate all the way through our training. Just so I think we'd have a lot fewer health problems. I love how you explain cuz this is so I harp on and I love how you describe this. Hormones are messengers, symptoms are messages. So I don't think a lot of people understand what is the role of hormones? What are they doing? Can you talk a little bit about that as messengers and then symptoms?
[22:38] Yeah. For sure. Well, as you and I both know, I mean even in basic medical school, basic endocrinology, we learn that hormones are chemical messengers and that's what they literally are. They are produced in one part of the body, in a gland. So that could be your hypothalamus, your pituitary, your thyroid, your adrenals, your ovaries, and then those chemicals are released. And usually like when we're talking about female hormones, we're talking about estrogen or progesterone testosterone, but many others play an important role like cortisol on thyroid, hormone and insulin. And so they're released from wherever their origin place is.
[23:38] And then they rip in one and they cause it to mature and it releases and then that place that's left over produces hormones. So they're just these beautiful signaling molecules. And really, they shouldn't make too much noise. I mean, we shouldn't really be that aware of their presence in any significantly UN uncomfortable way. They should just do their job. But some of the jobs that they do, for example, estrogen does make our breasts get fuller each month.
[24:35] But the kind of crossing over into the line of where a, now it becomes a symptom is when it's causing you discomfort in your life. So your breasts are killing you. Like you can't even put your bra on premenstrually. That may be a symptom of too much estrogen. And for some women that can be a risk factor for fibro cystic, uh, for cystic breast disease, but also for breast cancer, having too much estrogen that causes you to have a lot of really heavy periods of really a lot of pelvic discomfort may be also a risk factor for uterine fibroids because of that too much estrogen we've been taught as women that all of these signs that we get each month, you know, restfulness PMs, heavy periods, late periods, cravings, incredible mood swings are just kind of par for the course of being women.
[25:41] They actually tell us when things aren't going quite according to that hormone, an intelligent blueprint. So if we ignore or suppress those little symptoms and signs, even if they're just causing us, you know, minor discomfort, but definitely discomfort, we're potentially suppressing opportunities, stall other problems later on. So that's why it's so important to listen to these little symptoms and these little messages and take them seriously often when we don't listen to them. When they're small, they start getting louder and louder and louder until they're in full, full blown condition. So that's why I say that symptoms are important messages from our hormones.
[26:24] Yes, absolutely. And you know, I love how you say don't care. Know the messenger.
[26:31] Because the symptom is there to tell you something, you know, I always, I call our body, she and she's telling you.
[26:44] Right. And Tylenol may be great for the moment, right. But if we're doing that day in and day out, we are missing an opportunity. And a lot of the gynecologic conditions that are very common, whether it be PMs or whether it be menstrual cramps or polycystic ovary syndrome, or a lot of breast tension, you know, cyclically, skipped, irregular, all those things are harbingers of later conditions in the sense that many of them are triggered by excessive inflammation or insulin resistance or blood, blood sugar. I balance.
[27:47] Great. Well, and I know everyone should get the book, but can you give them a little kind of overview of wherever they are at whatever stage of life, whatever they're dealing with, maybe heavy irregular, painful periods, P C O S whatever it is, what kind of would be a general overview of the path that they should take to start addressing these problems?
[28:11] Yeah. So I think the first thing is really just to acknowledge that you're having them and then be forgiving of yourself. I know we both love quotes. And one of my favorite quotes is Maya Angelus. Like the font of she's the quote goddess. So she really is my source of often my favorite quotes, but she says, I'm gonna paraphrase. But you know, we do what we can with the information we have when we have it. And when we know better, we do better. So the first thing is just to be really honest with yourself about the symptoms you're having, cuz as women, we are taught to ignore them, suppress them, pretend they're not happening to gloss right over them.
[28:56] So if you don't know your body parts, if you don't know what your uterus is, your bladder is your intestines. The difference between your vagina and your VVA, where your ovaries are. Look at a good image, go to my book, go online and start to identify, you know, what are those symptoms? What are they associated with? And if you can find a wonderful provider, that's always a great step to have someone you can really partner with in exploring what's going on.
[29:48] And then, so with my book, for example, and in my medical practice, I help women identify not just what the medical symptoms are and the medical condition is. But what are the things that we know that may be contributing to those that we can do something about? So for example, we know that women who have really painful periods often have more inflammation and we know that movement, some dietary changes like reducing red meat, reducing dairy, increasing fruits and vegetables, not even rocket rocket science can really make, really make a difference.
[30:55] So for example, one study that I thought was really interesting, looked at a group of teenage girls who were using body products that were very high in S which is a form of plasticizer. It makes plastics soft and they were also drinking out of plastic, water bottles and plastic cups. So the researchers measured their blood level of thas had them go. I think it was one week only of no body products that had added those in it. So like clean body products or no body products and just no more drinking out of plastic. And within that week period of time, their th levels plummeted. Well, we also know those fallates and many environmental chemicals act as what are called endocrine disruptors.
[32:03] But I love and often repeat to my patients. And in, when I teach is your body has the capacity to heal beyond anything you've ever been led to believe. And I don't mean that just, you know, if you just change your thoughts, your fibroids are gonna go away or you're not gonna get breast cancer. Health is much more complicated than that. And disease is much more complicated than that. But in conventional medicine, we're taught that our medical conditions are basically genetically programmed and they're fixed and they're inevitable.
[32:59] But then of course, you know, sometimes it does need a little bit more. So that's where partnering with a good integrative practitioner, your conventional practitioner who knows integrative therapies may help you. And of course that's where my book and articles that I have. I'm sure you have articles too. Can really come in handy to learn from people that you trust. What supplements, what specific foods, what specific, you know, we know that there are a few specific yoga postures that really have been found in research to help with menstrual cramps as an example. And this is so with my book, but also, you know, when we think about women's reproductive health, my book covers the first time you have a period all the way till through Perry menopause.
[33:57] It is. Thank you for outlining. All of that. I know when I was reading the book and you told you have a section called women, women unseen and unheard, and you quoted if just one doctor had listened to me, I wouldn't have lost years of my life to this end quote. And I talk to women every day. I know you do too, who they're just so there's so much frustration. They're not being heard. They read your book, they hear us talking online and they know that a higher standard of care is available for them, but they're really having trouble accessing it.
[35:05] Yes. And you have to, I mean, it's so hard because we're so taught to be polite and not question authority, but it's your body, you know, your body best. If you're really, if you're experiencing something, don't let someone else Gaslight you and tell you you're not, or dismiss it as just stress. I mean, stress may play a part in what's going on, but if you're experiencing anxiety, depression, period problems, fertility challenges, heavy periods, menopausal symptoms. Don't just let somebody tell you, that's just normal.
[36:02] Like being more bold or being more sexualized or like a, you know, in an empowered way. And so I always, I say to women, I even have an article about this on my website, learn to channel your Sasha fierce, like whatever that is for you, it can be any name. You, it can be a wonder woman. It can be Sasha fierce, whoever you, it is for you, but channel her when you go into a physician's office and hold your power. And there's so many things you can do to make notes about what your questions are.
[36:46] I mean, you are sometimes vulnerable when you go into a system and your doctor has seven or 10 minutes to see you amongst the 50 patients. He or she may be seeing that day and is trained in a system to dismiss women and absolutely not trained at all to recognize that there's more to healing and health and wellness than just, you know, here's a pill. Here's that pill here is a surgery or whatever, whatever.
[37:25] Yeah. I love that. Channel. Your inner Sasha fierce, put your big girl panties on and yep. And just do it. One of the things that I really work with, all the women I work with on with their health is their energy body, I and their story and their hi her story. And I love how Carolyn me says that your biography becomes your biology. And so it's really an integral part of the work I do with women. I love this quote you shared from Clarissa Pinola, Estees the doors to the world of the wild self.
[38:30] Couldn't agree more about our stories and how we think of our stories and how we tell our stories. And in fact, in hormone intelligence, in my medical practice, the book and, and what I do with my patients, one on one, one of the things that I do share is a practice on writing your story, reading your story, and rewriting your story so that you are the heroine of your, so many of us have stories that include mistreatment or trauma or being in the dark about something that was going on in our bodies.
[39:25] And nobody said, uh, you could have endometriosis, no matter what, that's not normal. You shouldn't suffer like that. So astonishing. So really writing your story, whether that is your life story and how you are, where you are right now, or just your gynecologic and reproductive health story. And the other thing, and the reason I ask women to read that and rewrite our story is that very few of us are ever taught that we can be the author of our story.
[40:14] You know, if you had a gynecologic variant that was victimizing, for example, 7% of women now report birth trauma. There's a percentage of women in the United States now having such significant birth trauma, that it is diagnosed as PTs D women who struggle horribly with endometriosis or P C O S who become so identified with the trauma are so identified with the diagnosis that they feel victimized by their own bodies or by the health system.
[41:29] And rather than seeing them as a deficit, how can we see them as our superpower? And it's a little bit like that Japanese artist, I think it's called Kenui where you take the wounds of a broken piece of pottery and you paint them with gold so that they're like they're actually sealed back together with gold so that the broken vessel becomes even more of you beautiful and more of an art piece than maybe even the original one as it was sort of created to be.
[42:28] And so for me, I'm very, very alert to my environment. I'm also incredibly about what's going on in my environment. I had to learn to read faces and expressions easily as a child for my own physical and emotional safety. But I'm also deeply aware of the facial expressions and sense of safety of my patients and others, and able to just read subtle nuance. So how can you reframe so that those parts of you are now a gift that you can bring forward to the world and also recognize when you're activated. So those parts are driving you in a not healthful way.
[43:33] I love that. Thank you so much for sharing it. You're welcome. And I could just go on talking, talking, talking to you, but I do wanna be respectful of our listeners' time and attention. Thank you so much for joining us today, Dr. Aviva Romm, do you have any, where can people find you? Where can they find out more? I know they can get the book, hormone intelligence, wherever books are sold, but tell the 'em all the places that they can find
[43:57] You. Okay. So I love hanging out on my Instagram. I am one of those weird people. I don't love social media in general and all the bad things about it, but I do love connecting with my community. So if you go to Dr. Aviva RO on Instagram, you will find me. And that's really me and the comments and DMS. So, you know, it's just quick, like little tips and, and things I'm thinking about and a little glimpse into my life. That's a great place. And then if you want tons of articles, podcasts, videos, eBooks information, my website is the place to go. It's just Aviva rom.com and it's very easy to navigate.
[44:38] Awesome. Thank you so much for those great resources. Thank you for the work you do. Thanks for helping with the revolution when it comes to women's health. I have to ask you this one last question. Yeah. What is it gonna take for us to really overhaul the way women's health is handled, uh, in the mainstream,
[44:56] You know, it's already happening, you know, when you talked about mid, you talked about midwives, right. And midwives create a presence. I mean, it was really women in a sea change kind of way speaking up for and demanding what they want. And sadly, the medical system is also a, it is an industry and it's driven by consumer demand. So the more we all actually channel our Sasha fierce, the more we actually do say to our providers.
[45:40] We, we, we actually can change it with where we are, where we put our money in healthcare. You know, the more we're going to get other forms, the nutritionist that we're seeing, the health coaches that we're seeing that creates that sea change also.
[45:53] Right. Great. Thank you so much for that. Thank you for joining us today, Dr. Aviva Romm,
[45:57] You are so welcome. Thank you for having me.
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