Dr. Carrie Jones is functional medicine women's health and hormone doctor who talks with us this week about basic vaginal health, the anatomy of the vagina, the relationship between our gut and our vagina, endocrine disruptors and hormone testing.
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FULL EPISODE TRANSCRIPT of VAGINA!
Dr. Carrie Jones: When the Vagina is happy, like everyone's happy.
Aleks Evanguelidi: Whatever you're putting in your vagina you are technically putting in your mouth.
Dr. Carrie Jones: If you can't pronounce it doesn't go in a vagina!
Aleks Evanguelidi: As women can we have a healthy sex life lives?
Dr. Carrie Jones: Yes, yes!
Patti Quintero: Welcome to the hood I'm Patti and I'm Aleks.
Aleks Evanguelidi: And today we had the pleasure to talk to Dr. Carrie Jones. Carrie is a functional medicine doctor who specializes in women's health and hormones, who believes in the importance of both men and women understanding their hormones so that they can feel more empowered to take control of their own health, especially when they're told everything is normal, but they don't feel normal.
Dr. Carrie Jones: She also knows quite a bit about the ins and outs of the vagina, or as she likes to call it, our golden opening.
Aleks Evanguelidi: I got a chance to talk with her about the basics of vaginal health. A very exciting topic for us. We went into the anatomy of the vagina. You would be surprised how many of us don't really know our own anatomy. We discussed the amazing things that our bodies are capable of and the relationship between our biome and our vagina. We went really deep under the hood on this one.
Patti Quintero: Let's take a listen.
Aleks Evanguelidi: Even the idea that this could be a sexy vaginal conversation is exciting. So I think we're off to a good start already.
Dr. Carrie Jones: I just think so many women are afraid of a vagina. I'm like you girls it's capable of magic.
Aleks Evanguelidi: Just that alone is exciting. When we were putting this series of recordings together, one of the things that occurred to me was that if 30 years ago someone had told me that I would do a podcast talking about vaginas I would have been horrified. And I realized that there was just a lot of shame for me around this part of my body and I'm wondering if you come across that in your practice?
Dr. Carrie Jones: Definitely. I do, I should say I did a lot of gynecology. And so I would I would have to do pap exams or STD checks or whatever check out lumps and bumps that women come in, with but they're mortified.
Dr. Carrie Jones: They would get on the table knowing they needed me to examine them and then they would be like oh my gosh I'm so sorry I whatever. I haven't shaved or I didn't do this or I didn't do that or you know oh please forgive. I'm like, it's fine! It's no big deal. Or the number of women who will say do I look normal. Does my vagina look like other vaginas? Do my labia look like other labias?
Dr. Carrie Jones: I mean I heard it so often that I almost automatically just told women like before they could ask. Like everything looks perfectly normal. And then they would be like, really? Are you sure? Which either tells me women you know don't look at other vaginas, they don't know what other ones to look at to compare to, or the ones they're looking at are very sculpted so to speak and model-esque and that's what's taught that's normal, when in fact it's such a variety, like hair color and hairstyles. It's like there's so many options it doesn't matter.
Aleks Evanguelidi: I love this. So let's talk more about the anatomy of the vagina.
Dr. Carrie Jones: Yes! You know we call it the vagina, but really there's multiple moving parts. So the outside part is the vulva, technically. And that's where all the outside stuff is, like your labia, which are your inner and outer lips and your clitoris. And then when you get to the opening of the vagina, sort of like the you know the hole that leads inside that's actually called the introitus, and the vagina itself is the canal, the tube that leads up into, up inside and it ends at your cervix. And the cervix is the lower part of your uterus that has to get bigger when you deliver a baby. So the vagina is actually that tube part but the outside, the opening and the you know we sort of collectively call it the vagina. It's much more than that.
Aleks Evanguelidi: And it's not a black hole is it?
Dr. Carrie Jones: It is not a black hole, although funny enough women are surprised when I tell them, when there is nothing in the vagina the walls touch. It's a collapsed tube. But when something goes inside of it it expands. Whether it's a finger or a penis or a baby or a tampon like it totally can expand and morph its way around it. No problem. Usually no problem.
Aleks Evanguelidi: Right. And so what about the pelvic floor? What part of the vagina would that be?
Dr. Carrie Jones: Absolutely. So we have, everyone's heard the pelvic floor we talk about Kegel exercises and so you know the main muscle and it's many branches are ligaments as the levator ani, and it really helps to support the vaginal wall and then the vaginal you know opening to keep it closed or to keep it tight per se. And so pelvic musculature for vaginal health is important. So as women are having, sometimes they'll get prolapse which is when the vaginal wall gets sort of weak. So women will say I feel like something is coming out of my vagina or I feel like there's tissue coming out and it's really part of their vaginal wall. And it happens especially after childbirth. Or even though it's not part of the vagina, but women will say, you know, I have a hard time holding my urine in. I sneeze or I cough or I you know jump and a little bit of urine comes out. And it's all that same musculature down there that is responsible for keeping things up, tight and right where it should be.
Aleks Evanguelidi: Elevated.
Dr. Carrie Jones: Not droopy.
Aleks Evanguelidi: No! There's a lot of exercises that women are kind of buying into these days like spinning and cardio, running. Can you maybe talk a little bit about how those things might be affecting our pelvic floor in the musculature?
Dr. Carrie Jones: Yeah definitely. And so what I tell women especially if you already have sort of feel like a more lax musculature so maybe you've had a baby or a couple of babies and you find that you know when you do cardio and you go for a run you sort of have this pressure feeling, or you feel like you know women will say I feel like something's falling out, or even the women who say I leak a little bit of urine. I don't tell 'em to necessarily avoid cardio or exercise or spinning or what have you.
Dr. Carrie Jones: But I do say you know, but there's things that can be done for that, like you should consider seeing a gynecologist who specializes in the pelvic floor physical therapy or a pelvic floor physical therapist which I think a lot of people are mortified because they're like well I see a physical therapist for my knee but for my vagina? I'm like yeah still a muscle.
Dr. Carrie Jones: It's still you know that pelvic floor. You can help strengthen it so you don't have all these symptoms when you do go for a run, or when you are doing a class that requires a lot of jumping. And so, you can be proactive about it.
Aleks Evanguelidi: I remember getting on a trampoline after giving birth and wondering if I was ever going to be able to jump again.
Dr. Carrie Jones: Yeah. And I think a lot of women feel that way. And so it restricts them right? They'll say oh I can't take that class. I can't do that thing that exercise and it can be very disheartening and discouraging for women who maybe are trying to get healthier, to branch out and do other types of exercises. And instead they don't. And they don't know that there are options to help support their muscles and to strengthen their muscles and to really tie in their pelvic muscles with Kegels. And All women hear about doing Kegels but believe it or not you could actually do them wrong because Kegels are squeezes or contractions.
Dr. Carrie Jones: But if only half of your musculature is strong and it just gets stronger and the other side maybe doesn't know how or when or where to contract. So I find by referring women to physical therapists who specialize in women's health then they can actually identify like how to recruit all the muscles appropriately and tighten em up, get them stronger.
Aleks Evanguelidi: That would really seem that once those are all in alignment you would feel like how you move in the world is also shifted.
Dr. Carrie Jones: Yeah and if you think about it your pelvic floor muscles support so much. I mean your core strength and back health in upper legs stuff. I mean it's just so many and so many women complain of those things. People women will say I feel like my core is weaker. I have chronic low back pain or problems or weakness. And the pelvic muscles are directly involved.
Aleks Evanguelidi: Going back to the shame conversation for just one more second. For a lot of women they have concerns about what is actually coming out of their vagina, smells or fluids. And I think in a society that doesn't necessarily honor that primal essence that a woman has. I mean we don't really necessarily honor it in ourselves. So I don't know that society is going to do such a great job of doing anything other than reflecting to us how we feel about ourselves. But what could you tell us about what is actually coming out of our vaginas on a regular basis and what it might actually be telling us about our overall health?
Dr. Carrie Jones: Yeah and I so love this question because you know the vagina is capable of so much. I mean it's just like you said, there's a lot of shame. A lot of women in my experience they've never even looked. They've never looked at their vagina. They don't know what it looks like. Some women have never felt it. You know they've never discovered their own anatomy.
Dr. Carrie Jones: And so I have had women in my practice say, I get this discharge every month and it turns out it was around ovulation. You know it was their fertile mucus, and they just didn't realize that. And so the vagina has a lot of glands and cells that make lubrication. I mean it's important for a healthy vagina, for one. It's important to help keep it the right Ph. It's important for, believe it or not you have bacteria in your vagina that are healthy. We call it the vaginal microbiome. You have one in your intestines, in your gut but you have one in your vagina too.
Dr. Carrie Jones: And so we need this lubrication throughout our month throughout our cycle so we don't feel dry. So inserting things you know during sex or even tampons is a lot easier for women. Now what then gets concerning is women say well how do I know what's not normal. Because I'm not even sure what's normal, so what's not normal, and what's this smell. And so I always say if you're ever concerned go talk to your health care practitioner and they can either test it or evaluate and say oh this is completely normal or nope, this looks like maybe you've got some sort of infection going on.
Dr. Carrie Jones: But if it starts to smell bad, if it starts to smell fishy. If it's a particular color like green or something here's something that you're thinking this isn't that sort of clear mucus I normally get, or whitish mucus that happens. And if you're having other symptoms- itchiness, burning, pain. If you're noticing bumps, or just you know anything out of the ordinary then definitely go get it evaluated. But having that discharge, having a mucus come out, is pretty normal. And then of course babies come out of the vagina. When women get their period blood comes out comes out of the uterus and down through the vagina. And so it's capable of so many things.
Dr. Carrie Jones: It's our opening it's her golden opening. The vagina is magic,it does so much.
Aleks Evanguelidi: A golden opening, I love this. Do you have a protocol for healthy vaginas. Happy, healthy vaginas.
Dr. Carrie Jones: So what I would say the vagina is acidic, and it likes its microbiome to be healthy. So definitely I tell my women, you have to be very choosy when you're putting things into your vagina. Whether it's a thing or a person or a lubricant or whatever, you have to be very choosy. Because you can upset the acidity and you could upset the microbiome. And I also tell women, number two. Don't wear tight things 24/7, because as much as I love me my yoga pants and my skinny jeans, I feel, I am a big believer that you kind of have to you know air it out and don't wear those tight constrictive things all the time. Let the vagina breathe a little bit, let her little self-cleaning mode turn on with some loose pants or loose shorts or you know go commando and sleep naked.
Dr. Carrie Jones: Sleep naked and let her do her thing! So she's sort of healthier the next morning. And so between the microbiome and the acidity and be choosy which put in there, that's what I tell women are the basics for a healthy vagina.
Aleks Evanguelidi: You mentioned that in pregnancy, things change and shift. I've heard in people who study the microbiome of pregnancy, that there are bacteria that are present at the time of the end of pregnancy that are only there at that time. How does the body shift like that? Like how does it know to colonize different microbes strains at different times of our life in order to support the act of giving birth and really implanting a new set of microbiome for the baby to have as part of their biota.
Dr. Carrie Jones: Isn't that's so cool? Our bodies are so good, they're so smart. And I think there's still so much that we don't know, especially when it comes to the microbiome, but it's just all a huge part of the pregnancy signaling, the hormonal changes and you know the signaling that between the baby's system and the mom's system, And then the microbiome in the vagina makes the shift as it's getting towards the end and it's assuming it's going to be a vaginal delivery.
Dr. Carrie Jones: Obviously it's not always, but the vagina is prepping for that. And so what makes this shift in bacteria that may have been very low or too low to count or to see amounts. Then they step up to the plate. They get the signal, they get the turn on to grow and to multiply so that when the mom gives birth and if she does a vaginal birth that's the microbiome that's then basically put all over the baby and implanted into the baby when they get it in. So absolutely, that's very true that that can happen.
Aleks Evanguelidi: There's a really big movement right now in vaginal seeding. Are you familiar with this?
Dr. Carrie Jones: A colleague of mine is doing like fecal matter transplant in the gut but I haven't heard is followed as much in the vaginal stuff.
Aleks Evanguelidi: So for women who are having Cesareans, I've actually seen doctors do this now and the OR where they will swab the woman's vagina before the delivery and then they will wipe that cotton all over the baby's face and the orifices and stick it in its mouth, so that they can get this critical precious bacteria implanted in their baby, regardless of how the baby is born.
Dr. Carrie Jones: Which I think is so amazing because the bacteria that a baby picks up via Cesarean are somewhat different than what a baby that would come through a vaginal delivery.
Dr. Carrie Jones: And they're doing as you know they're doing research on that. Like babies who are adults who have gone through caesarean like what does their microbiome look like. What condition symptoms diseases are they more affected by as opposed to maybe somebody who had a vaginal birth. So I think that's great, doing the vaginal seeding.
Aleks Evanguelidi: What shifts happen when we use tampons versus pads versus cups, like is there some evidence to indicate that the Ph will change or that bacterias shift with the use of different feminine products?
Dr. Carrie Jones: Absolutely. So every time you insert like a traditional tampon, maybe as opposed to a an organic or you know an unbleached tampon. First of all, anything you introduce into vagina introduces air and so the vagina is very acidic. It's supposed to be acidic to fight infections, it likes to be acidic. And then when you introduce air. And then when you introduce other kind of bacterias, whether it's from sexual play, whether it's from tampons, maybe it's from a cup that you haven't necessarily kept all that clean, then you shift the Ph, and it tends to be go up and it becomes more basic.
Dr. Carrie Jones: And as you get more basic, now you can't fight off any infections and it can lead to things like you know women will get B.V. bacterial vaginosis. It can potentially lead to things like Candida or yeast infections, sort of chronic irritation from other bacterias. E-coli can grow up and cause a lot of irritation.
Dr. Carrie Jones: And so absolutely every time a woman does this and if she's not careful or some women are just very sensitive, then she's more risk than somebody else. So you do have to be careful if you choose to use tampons in the kind of tampon you use. And if you choose to use cups making sure that if you are doing a thorough job of cleaning it and keeping it clean before insertion and then of course with anything you do around sex, sexual intercourse, toys. It doesn't matter the lubricants you use. You know you have to read the label and be aware that what you put in there is going to affect your Ph and therefore your bacteria.
Aleks Evanguelidi: Are there products that are better than others? Do you have any suggestions or recommendations?
Dr. Carrie Jones: First of all your own lubrication as I understand some women have a tough time with lubrication, but you know foreplay is absolutely super important. If she can. If she can get her own lubrication up there that's great. Unfortunately though the women's lubrication is very very tied to our hormones, and it's tied to things like stress. So even if her, maybe estrogen is quite healthy, if she's fairly stressed out and has a lot of cortisol, she may feel drier. She may have a tougher time building up that lubrication. So then I tell women OK I read labels and avoid things, I mean if it's like has sugar in it or it's flavored you know you'll see lubricants for oral sex and they taste like strawberry. I'm like maybe maybe not the best thing you want in your vagina. I don't know that the vagina wants strawberry flavored lubricant or whatever watermelon up in there. Be careful especially if you're sensitive.
Dr. Carrie Jones: So then I'm I could try to avoid things like a lot of labels now will say no parabens, no petrochemicals, no extra added stuff. A lot of lubricants now are aloe-based. So aloe-based lubricants are safe to use. Pretty much with any condom. Things that are oil based like coconut oil can break down certain condoms. So you have to be careful if you're using oils or any kind of oily type based lubricant and you're also using condoms.
Dr. Carrie Jones: So speaking of condoms a lot of women and men use latex condoms which is great. But of course latex. Again be careful of the flavored. Condoms are obviously lubricated so what are they using as the lubricant already in the condom. And if you're a latex sensitive then your other option is polyurethane or poly isoprene which are the two other most common- there are lambskin condoms out there that men and women can buy. Unfortunately lambskin does not necessarily protect against sexually transmitted infections because it's a membrane quality so the infection can just sort of roll right through.
Dr. Carrie Jones: But believe it or not it does protect against pregnancy. So that's sort of like guidelines for women. No sugars no flavors. Try to get minimal stuff in your lubricant try to go for more natural like an aloe based lubricant. With condoms if you're latex sensitive go for the polyurethane go for the poly isoprene and then hygiene of course when it comes to lubricants and in sexual play making sure you know your toys are clean your fingers are clean you know your partner is clean and by clean I mean like don't go gardening and then necessarily have sex, just be careful.
Dr. Carrie Jones: Make sure you'd urinate before and after just sort of that typical hygiene that we know and we've been taught for a long time but we forget or we're caught up in the moment and then next thing you know we're like I'm a little irritated down there. I feel like I'm getting kind of a weird odor. You know, what have you.
Aleks Evanguelidi: Hygiene is it's a great conversation piece. I have a burning question around that. Yes. No pun intended. What is the deal with douching?
Dr. Carrie Jones: Oh my gosh.
Aleks Evanguelidi: Can we just settle this one now?
Dr. Carrie Jones: I am not a big fan at all of douching. In fact I tell women not to do it because first of all if you've ever read the ingredients of a lot of those on the market you know douche companies, it's just ridiculous and it will affect your Ph. It will affect your bacteria, if it increases inflammation, then you know you might get micro tears which can put you at risk for sexually transmitted infections because even out of these little micro tears in your vaginal wall or up against your cervix and it's actually not- you don't need to smell spring fresh you just you just don't. Like my mentor used to say the vagina is self-cleaning. So it's like an oven. She just sets her own timer and cleans herself so you don't need to do douching.
Dr. Carrie Jones: Now what I will have women do, I will say, the one thing I do have them sometimes do a rinse. But in certain situations. For example with B.V. with bacterial vaginosis, hydrogen peroxide can often be used as a vaginal rinse to address BV.
Dr. Carrie Jones: And so if I have a woman that I've tested and she for sure has B.V. then I might suggest like hey we're going to do hydrogen peroxide or hydrogen peroxide mixed with water, just water and rinse that vaginally. But I don't recommend women just go buy the over-the-counter douches. I think it's pretty bad.
Aleks Evanguelidi: Yeah. Well I think there's so many things we actually can put in our vagina. You know not. Let's step away from commercial products.
Aleks Evanguelidi: I've used food grade peroxide with water to clear up lots of infections and pregnancy and sometimes I'll even recommend women put some probiotics or a clove of garlic for sure you know.
Dr. Carrie Jones: Absolutely. Vitamin E oil. I'll say get pure Vitamin E.Especially women having irritation, or you know menopausal women who were or any woman that feels really dry, they have low hormones therefore they're having a lot of dryness Vitamin E can be great, and like just stick it up there. If you can read the label and understand it then it's probably okay and when you read the label and it's you can't, it's all chemistry words like. Probably not a good thing.
Aleks Evanguelidi: If you can't say don't eat it. Is that the rule?
Dr. Carrie Jones: Exactly. If you can't pronounce it doesn't go in a vagina.
Aleks Evanguelidi: And I think that's an important thing to just be clear about is whatever you're putting in your vagina. You are technically putting in your mouth right.
Dr. Carrie Jones: Yeah. It's not local. And unfortunately some companies will advertise that they like oh you're just you know when you put it in and it just stays locally in the tissue and while it does but it gets absorbed and it sends signals through the whole body. So if you're doing something that has a lot of sort of chemicals then we call them endocrine disruptors and it goes in your vagina. It's going to affect your vaginal tissue but the rest of your body is going to know about because your whole body talks.
Aleks Evanguelidi: OK. Endocrine disruptors. I don't want to get too crazy sciencey, but lots of women are experiencing hormonal issues. I believe that's a fact. That we can all own that. What is your, let's just ease into this conversation. What are they and what are they doing in our bodies?
Dr. Carrie Jones: So this is my easiest example. Everyone knows what BPA is right. We all because we see the signs BPA free plastic, BPA free baby bottles, BPA free whatever. So BPA, Bisphenol A is an endocrine disruptor and what it does is when you ingest it, when you eat it, swallow it, get it in you. It binds to a hormone receptor.
Dr. Carrie Jones: So you have hormones and then the hormones have to bind to a receptor. And when you bind into the receptor it does the things. So the receptor is what turns on the things that are going to happen. Unfortunately endocrine disruptors like BPA bind to the very same receptors like an estrogen receptor and it causes your body to do the things a whole lot you know. Or maybe you don't want it to do the thing but is doing it anyway because the BPA bound to it and has turned it on. And so now women get all of these high estrogen symptoms, their PMS is worse their periods are heavier their boobs are tender.
Dr. Carrie Jones: They have a higher risk for say estrogen breast cancers, or uterine cancers. Even in men. Men are getting bellies, they're having erectile dysfunction, they're getting breast development. It's all these estrogen dominant symptoms caused by these chemicals in the environment that are turning on the receptors way too much or more than the body wanted.
Aleks Evanguelidi: So what are some other endocrine disruptors that we may or may not know that we're using every day.
Dr. Carrie Jones: Still in the plastic family or thing called phthalates that starts with a P. But phthalates are another big one. So when you drink out of water bottles that have sat in the heat. When you heat up takeaway food in plastic containers. Or use plastic wrap over your food in the microwave. When you put a hot drink in a cup and then you put the plastic lid on top and drink it.
Aleks Evanguelidi: Oh that's huge.
Dr. Carrie Jones: Huge. Yeah. And you know like there's a I'm not going name names but a big company has said they're going to start phasing out straws, what they're going to use instead as a super special plastic cap on top and it's like well but, I'm glad you're getting rid of straws. But it's still a plastic cap and so you have to be careful still touches your lips and you so it heats up and then releases chemical.
Dr. Carrie Jones: But the other one BPA is super common in things like thermal receipts. You know when you go to the grocery store you know you go to the drugstore and you get that huge long receipt and they rip it off and hand it to you and it's the printed ink that's on it. It's its thermal is what they call it, and it has BPA is mixed in there and when it's hot, when the receipt's hot, as it comes out of the register and you then you touch it on your fingers. It translates into your body. And so it is micro amounts when you get on your fingers. But if you're doing this quite often you know if you do it everyday or if you're in a job that handles receipts all the time, then it accumulates over time and so you can have a lot of problems.
Dr. Carrie Jones: Or if you're a plastic water bottle drinker and maybe you don't like your plastic water bottle get in the heat. But let's say you bought it at the store and in the store it's been sitting in the warehouse which is quite hot and now it's already leached into the water that then you didn't take home and put in your fridge but it's too late it's already in the water. So scary. So I tell women don't panic and freak out. Just do the best you can. If you can ppt for glass, if you can opt for stainless steel, if you can tell the person at the register you know just put it in my bag or no thank you actually need a receipt you can not printed or recycle it. So we can make conscious decisions. When you buy you know coffee or tea with the plastic lid on top. Try to take the lid off drinkg just right from the cup or bring your own container and transfer it.
Aleks Evanguelidi: If you are having hormonal issues, or even if you're not, is there a way to find out if you've been exposed to these BPA's and if there is a way to find out if you've been exposed, is there a way to get them out of your body?
Dr. Carrie Jones: That's a really great question. So it's kind of tough. There are a few sort of specialty labs. In fact there's one in particular that does urine testing for some environmental chemicals.
Dr. Carrie Jones: And so when I have a woman and their estrogen is high and estrogen goes through it has to get detoxed.It goes through detoxification and you can go through detoxification a healthy way or there's a there's a pathway that's kind of a bad pathway.
Dr. Carrie Jones: So if I see that somebody is estrogen dominant and they're going down the wrong pathway and we can't figure it out or she's very symptomatic I might suggest her getting this test like hey look let's find out how much of these quote endocrine disruptors you have in your body and see what we're up against.
Dr. Carrie Jones: Now testing can sometimes be limiting for a lot of people because it does require a specialty test. And insurance doesn't often cover it. So they would have to pay cash for it. So on the flipside then what I'll try to do is maybe assume. Like Hey look. Moving forward from today we're going to work on trying to get this out of your body. So again it's a lot of lifestyle changes. I was saying glass and stainless steel and you know avoiding don't touch the receipt and be careful of just plastic and you know reading labels if you can't pronounce it, it's probably not that great. Just being more aware. But then yes, I mean trying to get your body to excrete, because when you when you take something in New other it's a good thing or a bad thing you know. Good food or bad chemical, your body detoxes through lots of ways.
Your skin detoxes, your lungs detox, you urinate it out. It comes out here you know in your poop. And so making sure that all of those we call them emunctories, they're like open channels to get out of your body - are healthy. Like making sure you're sweating and you sweat you can sweat it out. So for some people they may start doing more saunas. Sweating it out and then showering afterwards do in liver support doing liver detoxification to improve their Phase One their phase two and their Phase 3 detoxification.
Dr. Carrie Jones: So a lot of people have a lot of gut issues. They're like Oh I actually you know have a bowel movement every couple days or you know I'm pretty constipated. That clogs the system literally. So we're working on ways like let's get this out of your body making sure they're hydrated, so that their kidneys are able to excrete. You know sometimes we're doing things like good fiber so it'll bind up some of these excess hormones that he or she doesn't want. So there's definitely a lot of ways to help encourage the body to eliminate and get rid of these chemicals just those sort of similar ways we deal with too much hormone as well.
Dr. Carrie Jones: But don't try it yourself. See you practitioners who's qualified. Although I'm out you know get yourself you know drink hydrating and if you do Saunas and if you get yourself having daily bowel movements like that's all good healthy things. But as far as like putting yourself on a quote liver detoxification should probably see somebody who knows what they're doing.
Aleks Evanguelidi: And from my understanding just going to your doctor and having your blood drawn for hormones is really just like a sliver of a snapshot of what changes happen.
Dr. Carrie Jones: It is. And so when women get their blood drawn I remind them you have to go at a particular time of your cycle. So if blood is the way you're going, if blood is the way your doctor is going to do it. Then you want to be in the second half of your cycle in the luteal phase. So for a woman who has a 28 day-ish cycle we're looking at like day 19 day 20 or 21. And what's frustrating to me is I'll have women that will get their blood drawn. Bring me their hormone results and I'll say where were you in your cycle and she'll go, I don't know it was Tuesday at 3:00.
Dr. Carrie Jones: Now that doesn't help me I need to know what day you were in your cycle because your hormones change as we know throughout your cycle. But in particular progesterone is what we're trying to catch. We do hormone testing and progesterone only comes out after you ovulate in the second half of your cycle. So pay attention to where you are in your cycle when you get your blood drawn. But it is just a sliver it's one snapshot one second in time on that day. It may not give you the entire picture you need for hormones.
Aleks Evanguelidi: And you work for the Dutch hormone panel correct.
Dr. Carrie Jones: I do. Yes. So I work for a company where I'm a specialty hormone company. Dried urine test for comprehensive hormones. That's what Dutch stands for. So we are a lot more comprehensive, to use our own word. When we're looking at hormones we look at a lot more pathways. We have the ability to do testing to look at your entire month. So women who say I have symptoms around ovulation I have symptoms from ovulation to until I get my period, I have symptoms everyday. We have the ability that they can test and we can graph it out for them. So instead of just one snapshot blood draw, we can we can dive a lot deeper. For those women who need it.
Aleks Evanguelidi: And these tests really are not. I did the Dutch hormone panel probably about three months ago with a functional medicine doctor and I was both surprised at how affordable it was and how much information came up. Shocking. I think the whole test was maybe 250 dollars and we looked at testosterone and cortisol. And again the pathways really do tell you so much about what the body is actually doing at different times of the day.
Dr. Carrie Jones: Yep absolutely.
Aleks Evanguelidi: So these these are the ones that we have control over. Right. Like we can make choices every day that limits our exposure. And the effects that these are going to have on our body. But there are some endocrine disruptors that we really have no choice. And that's environmental. That's the things that you know. Do you want to speak on that just a minute?
Dr. Carrie Jones: Yeah absolutely. I mean it's things like a good example they are called PAH's - poly aromatic hydrocarbons and basically it's the stuff that's been emitted from cars, and planes and in fires, forest fires and things like that. It's airborne and so we breathe it in and things like that. We can do our best again to limit exposure. But it's really hard. If you live in a city or around a city that you don't really have a choice. If you drive your car and sit in traffic you don't really have a choice. And then of course the chemicals that companies use on our food get in our soil and are used as part of farming that maybe you don't even realize. You Think what you're eating is it's a vegetable it's perfectly healthy. But what you didn't realize was back at the farm they were spraying it with pesticides and herbicides and now that's getting into your body and binding to receptors and causing your hormone system to react when your body didn't want your hormone system to react at least as much as it is.
Dr. Carrie Jones: And so it's sort of this hidden level of disruption that can happen. And not all companies have to disclose it unfortunately. So even if we want to know we may not know entirely what's happening.
Aleks Evanguelidi: Going through so much.
Dr. Carrie Jones: So it's crazy. It's crazy for our poor little bodies. And it's causing all sorts of problems as you know with fertility and reproduction and just hormones stuff in general. You know endomitriosis PCOS fibroids it's just contributing. It's not the, the all causal, but it's just one more thing that we have to think about as men and women.
Aleks Evanguelidi: I like how you've included men in the conversation. I think it's important. You know I know this is a primarily female based radio show. We talk a lot about what's happening under women's bodies under the hood of women's bodies but we don't realize that the men too are having their own responses and that estrogen has become a greater issue for them as well.
Dr. Carrie Jones: Yes. In fact there's several studies that show again that Bisphenol A in men. Every time it lowers their testosterone, it raises their estrogen, it affects their thyroid, it affects their prolactin, which people are like why do men have prolactin. I'm like, that's a great question. But they do and it affects it in a negative way. I think a lot of people forget about men because men don't often speak up or they don't go to the doctor. You know women go to the doc they talk to their friends and they get on chat boards and they listen to podcasts they go to the doctor and and it's usually the women it's usually the women in a man's life. That's like that's not right. You need to get help. Or we're making changes in here, in our in our household and here's why. And so I'd like to include the men so that the women listening will go huh. My partner, husband, father, brother, best friend has that and I need to educate them too. I need to let them know.
Aleks Evanguelidi: And part of that education really is about going to see somebody like naturopathic doctor or maybe somebody who specializes in functional medicine. That's what you do right?
Dr. Carrie Jones: I do. Yeah. I'm a naturopathic doctor. Yep functional medicine.
Aleks Evanguelidi: And so how is that different from standard doctors.
Dr. Carrie Jones: So I'd like to say that we're definitely maybe more holistic and integrative. So I went to medical school and I had to learn all of the conventional things first, such as maybe what an M.D. or D.O. what an osteopathic doctor would learn. But instead of going deeper into the drugs and the surgery and hospitalist stuff, I went the other way.
Dr. Carrie Jones: I went in a whole systems, diet, nutrition, herbs, vitamins, minerals biochemistry in that route. And so when I'm evaluating a patient I have the ability to act like a conventional doctor. I can prescribe medications and I can order bloodwork and I can do things I can do exams. But I often choose to go maybe the more natural the holistic the integrative route instead and trying to get the body back into balance. Instead of saying oh you have PMS here take this antidepressant. I'm like oh you have PMS. Let's figure out why and then try to get that back.
Aleks Evanguelidi: And I have a question about some of the tests because I often hear people say yeah I went to my doctor. I don't feel well, but everything looks good on the test. I mean it seems to me that maybe they're not testing for everything or that insurance companies do not recognize certain tests. I mean-
Dr. Carrie Jones: Yes to both. And it's I think the biggest frustration and even the biggest frustration that I hear from my conventional practitioner friends you know they have eight to maybe 15 minutes with each patient. And you can't accomplish a lot in eight minutes, really.
Dr. Carrie Jones: So if you come in as a man or a woman and you're like I'm really tired and I'm moody and I can't sleep at night. You know in eight minutes you can't talk about well how's the stress in your life and what do you- what are you eating and what's been going on. Tell me about your routine and what other symptoms are your having that might tie it together.
Dr. Carrie Jones: And so you just can't do that in eight minutes. And so I find that in functional medicine and with naturopathic medicine you know we tend to employ a whole lot longer time, 30 minutes, an hour, sometimes an hour and a half for a brand new patient because you're just trying to get together everything and from head to toe everything and what they're eating what they're doing to get to the bottom of it.
Dr. Carrie Jones: Now on top of that though you know insurance companies. You're right. They don't want to pay for a lot of quote unnecessary testing but I'm finding more and more people and more and more countries are sicker and they're having a harder time getting over being sick or not feeling good compared to years ago. But yet medicine and insurance maybe hasn't caught up to hey I think we actually need some more testing some additional testing or some full spectrum testing. If you're looking at the thyroid, a lot of practitioners will just run one marker. But yet there's multiple markers to the thyroid that give you the whole picture. And any of them can be off. And if any of them are off it can cause thyroid symptoms. Not just the one marker of the TSH that's commonly ran.
Dr. Carrie Jones: And so it's it can be frustrating for patients to go to a doctor and say I don't feel good and then they get just a few tests run like well you're normal it's OK well that's a few out of a lot. But it's also frustrating for the practitioner who says I can't do a lot in 8 minutes. I can't educate I can't ask and I can't. I just don't have the time because that's how insurance dictates. So it's not a good system but a very healthy system which is where functional medicine comes in. So patients do have an option. They can't see somebody who can spend a lot longer time and go a lot deeper.
Aleks Evanguelidi: Back to the vaginas. What could you say about the shifts of women's vaginas. Both at the time of adolescence. And then at the time of menopause. It's always a question that I'm you know I would love to be just taken on that journey as it applies to each stage of our lives as women.
Dr. Carrie Jones: Yeah absolutely. So I mean the vagina, the microbiome of the vagina is changeable for sure. So as women enter into their adolescence and they're entering into puberty the changes. Believe it or not they're not nearly as noticeable at all as with women heading into menopause.
Dr. Carrie Jones: Now what can happen as women get into sort of puberty in the teenage years in the young 20s is a lot of women will that when they start to notice of course they're getting yeast infections or BV infections because they're they're getting their period for the first time they're having sex for the first time that they're using tampons for the first time. And so it's all this like new stuff to the whole microbiome of the vagina and it takes some adjusting to how to make that happen.
Dr. Carrie Jones: And then as women get into menopause it's the reverse. And so now the hormones are low, her estrogen and progesterone have dropped down and you actually need that estrogen to help make the food that supports the microbiome in the vagina. And to make the lubrication. And so as women head into menopause, they often say instead of feeling really lubricated they're like oh my gosh I feel so dry and it hurts. What's going on. It's reverse puberty. As you go into puberty you get all your lubrication and you get ovulation mucus and you know you get everything nice and plump and healthy. And then as you head into menopause you slowly back out of it.
Dr. Carrie Jones: And whoever designed that feature I'm not a big fan of. And I would like to talk to. But the number of menopausal women who say oh my gosh I'm so dry. Sex hurts. It just hurts in general. Like I just feel a lot of sort of dry itchiness down there like I know it's it's hormones shifts and subsequently microbiome shifts and you're losing your lubrication and so there are things we can do. Absolutely. For women in menopause some of the things we talked about like virginal probiotics are taking oral you know swallowing probiotics. Again the coconut oil Vitamin E. But even considering sometimes with women when it's pretty severe we do use hormones, we do use a particular estrogen it's called E3 or estriol. And I'll have news that gradually it helps pump the cells back up and helps reinstate some of that lubrication.
Dr. Carrie Jones: And man there so much happier. When the vagina's happy like everyone's happy.
Aleks Evanguelidi: I'm definitely happier when my vagina's happy too.
Dr. Carrie Jones: Aren't we all. And like I said in menopause. It's definitely not fair for a lot of women. And their tissue shrink up you know estrogen is very plumping and as we lose estrogen into menopause we women will notice like my labia are changing my vulva is changing and I feel you know things are kind of shrinking down. Yup.
Aleks Evanguelidi: Going out of their homes.
Dr. Carrie Jones: Yeah. I mean unfortunately we don't want it to go out of business but that's sort of how it feels.
Aleks Evanguelidi: Questions about sex. Let's just go back to this.
Dr. Carrie Jones: Yes.
Aleks Evanguelidi: As women can we have a healthy sex life for our whole lives?
Dr. Carrie Jones: Yes! I think so but I think it depends on a lot of things. I mean I think first of all I think women... Let me say this.
Dr. Carrie Jones: Like women will talk about sex maybe with their friends, but they won't talk about sex with their doctor. And so I have found a lot of colleagues where I'll ask do you talk about sex with your patients. They're like oh no I don't bring that up.
Dr. Carrie Jones: I'm like man I talk about sex with all my patients. I want to know like are you getting sex. Does it hurt when you have sex can you orgasm. Like you know like how is your sex drive how's your sex drive comparatively. Because so much goes into sex, sex drive. Bringing out lubrication, orgasm everything from our hormonal balance at the time the amount of stress that we're under the partner that we're with, our stage in our life. And I think I think it's it's just a matter of balance. And if nobody's talking about it then women tend to think oh this must be normal and it drives me nuts when women come to me and they say I don't have a sex drive and I talked to my general practitioner about it and they were like well yeah you have two kids under the age of 5 that's normal. Like well. OK. Like on the one hand I get that stroma on the other hand the man having a healthy sex life would probably go a long way in improving your mood and you know how you feel about yourself and maybe in your relationship. And that's all good things.
Dr. Carrie Jones: So let's work on this. So yeah I think women need to talk about it more. I think practitioners did talk about it more with their patients.
Aleks Evanguelidi: And it would be safe to say if you have no sex drive get tested. Right. Let's take a look at your hormones.
Dr. Carrie Jones: Yeah and there's a difference between you know there's some women who truly were born with, they didn't have very much sex drive to begin with. And I always ask. So if I have a woman who's in front of me and I say how is your sex drive. And she says nonexistent. I will ask well how is your sex drive when you were younger how was your sex drive last year five years ago ten years ago. Because if she says oh I've never had a sex drive ever.
Dr. Carrie Jones: Then that's different than the woman who says well ten years ago I had a huge sex drive and now it's low. So is it just a fallen sex drive as opposed to maybe somebody who was just didn't have it doesn't have sex drive, wasn't born with the sex drive or something happened early in her life to cause her to not feel sexy or desire a sex drive.
Dr. Carrie Jones: And so you have to ask these probing questions which I know is, Can be embarrassing for some patients who don't want to talk about sex but also maybe for practitioners who have their own hangups around sex and I'm like No no we got to talk about it. It's like the Salt and Pepa song Let's Talk About Sex. I want to know, because I want like I said earlier if the vagina is happy then you're happy. And I want women not to be afraid of their vagina. So let's let's talk about it.
Dr. Carrie Jones: It could be other things too it can be you know from infections that they might have pain because of tight muscles and they don't even realize it. Again infection or some inflammation stuff. I mean the reason their sex drive is low or the reason they can't orgasm. The reason sex is painful. Might be something really simple but because it's surrounding sex and the vagina they don't want to talk about it or they just assume quote for their age or given their situation it's normal. And you know that's just the way it is the rest of their life. And it doesn't necessarily have to be. So I talk about it.
Patti Quintero: For more information on Dr. Carrie Jones visit her Web site at Dr. Carrie Jones dot com and follow her at Dr. Carrie on on Instagram at Dr. Dutch Test on Twitter.
Aleks Evanguelidi: Is there something you think we should take under the hood? Are you someone you think we should talk to? Head to our Web site at under the hood podcast dot com and send us your thoughts.
Patti Quintero: For more information on our upcoming new episodes and upcoming events, sign up for our newsletter and follow us on Instagram at under the hood underscore podcast. If you're enjoying our podcast it really helps if you go to Apple Podcasts or wherever you're getting your podcast and rate and review this episode.
Aleks Evanguelidi: Many thanks to our executive producer Chelsea Levy and her producer Jennie Josephson for editing and recording this episode.
Patti Quintero: We'll see you next time.