259: Jolene Brighten | Finding Balance Beyond the Pill

Transcript for Jolene Brighten | Finding Balance Beyond the Pill (Episode 259)

Jordan Harbinger: [00:00:02] Welcome to the show. I'm Jordan Harbinger. As always, I'm here with producer, Jason DeFillippo. On The Jordan Harbinger Show. We decode the stories, secrets, and skills of the world's most brilliant and interesting people and turn their wisdom into practical advice that you can use to impact your own life and those around you.

[00:00:18] If you'd told me a few months ago that I'd be doing a show on birth control, I'd probably have looked at you sideways, but that's exactly what this is. And this topic is fascinating. Dr. Jolene Brighten is an expert when it comes to the birth control pill and how it affects your body. Spoiler alert, this pill has done more good than harm, of course, but, wow, it's been used here for a loop. We'll learn how the birth control pill can change who you're attracted to and why there are higher instances of divorce when women go off the pill after getting married than while on the pill.

[00:00:49] I know, this is so interesting, just how these hormones affect the brain. This pill can also mask symptoms of other serious health problems, even infertility. That, of course, is no good and we'll learn a bit about how to mitigate these issues as well. There's a lot in this show and I really hope you get a lot of value out of it and yes, there's plenty of good stuff in here, even for men or for women who aren't taking the birth control pill or other hormones. By the way, I make this episode not a bunch of dumb-guy questions, but there are absolutely a handful or two of dumb-guy questions in here, so fair warning. This is not medical advice, see your doctor, et cetera, et cetera. But I've really enjoyed this conversation in this episode. I think it's fascinating.

[00:01:27] And I met Jolene through my network and if you are not familiar with Six-Minute Networking, where have you been? This is a course that I'm teaching you for free on how to manage great people, great connections using systems in just a few minutes a day. Check out Six-Minute Networking. It is free at jordanharbinger.com/course. And by the way, most of the guests on the show, they subscribed to the course and the newsletter. So come join us. You'll be in great company. All right, here's Dr. Jolene Brighten.

[00:01:56] Okay. Birth control, the pill is something...Well let me just put it this way, a lot of guys are probably hovering over the skip button right now, because they're like, "Eh, this doesn't have anything to do with me. I'm not concerned about this." So give self-centered guys, us self-centered guys, a reason to stick around and listen to an episode about something that I think, unfortunately, many guys think, "This isn't my problem."

Jolene Brighten: [00:02:17] Totally. So first thing is you may not be attracted to the right mate. So if she's on the pill, that may change how you're actually attracted to her and how you perceive her. And secondly, it doesn't matter how good you look, if she's on the pill, she may not care about that. And I will be sharing in this episode what she does actually care about.

Jordan Harbinger: [00:02:36] Hmm, good. So yeah, if that doesn't scare you, nothing will. We'll go ahead and skip it. But if you want like a functional, healthy relationship or possibly just some sex in your life, then you should probably listen to this episode.

Jolene Brighten: [00:02:46] Yeah. And if you're wondering why she's not that into you, it might be the pill.

Jordan Harbinger: [00:02:50] Yeah. That's kind of crazy. I don't think most people know anything about that. So that was one of the main reasons I wanted to have you on the show because I thought, wow, if this can change social aspects, then...Because most people just think, "Oh, good, I just can't get pregnant. And the rest of me is completely the same as it was before I started taking this." And that's not true.

Jolene Brighten: [00:03:07] Totally. Well, that's the story we're told. And we're told don't talk about side effects and other issues because you might scare women from taking birth control. I don't think women are that dumb, though.

Jordan Harbinger: [00:03:15] No.

Jolene Brighten: [00:03:15] It's just me.

Jordan Harbinger: [00:03:16] Yeah. I think that's a fair statement. You know, people take things with side effects all the time, like every drug ever. I'm drinking coffee right now. There are side effects but I--

Jolene Brighten: [00:03:26] Cheers.

Jordan Harbinger: [00:03:26] --am choosing to drink more. Yes, and I never thought I'd do a deep dive on birth control pills, female hormones, but this stuff is really fascinating. I think, if I ever had to become a doctor -- I was forced to become a doctor -- I would be like an endocrinologist or something like that. This stuff is fascinating. By the way, the audio book, I loved it. And it's funny because the book reflects your personality, but the narrator is kind of like this clinical person, so I can just see her being like, "So do you really want me to read that zinc is necessary for bow-chicka- wow-wow."

Jolene Brighten: [00:03:55] Yeah, it started out that I was supposed to narrate the book and then I didn't get to narrate the book. I had a big ugly cry about it because I lay down some heavy stuff in this book and I wanted it to come from me. If women listen to me on social media, on podcasts all the time, and then I want them to feel held and supported and also I think I'm kind of funny and the narrator was so not funny.

Jordan Harbinger: [00:04:20] They were like, "It's a medical text," and she's like, "Great, I'm really dry and I can read medical narration. No problem."

Jolene Brighten: [00:04:27] I know! The va-va-voom estrogen boom. Or that I say "Yo" when I talk.

Jordan Harbinger: [00:04:31] Yeah. So just pay attention, yo. It was like Hillary Clinton trying to be relaxed and cool. It just didn't work.

Jolene Brighten: [00:04:39] Thank you for being real about it because everybody knows the story. Like how I cried. I was in Paris. I cried so hard and so loud on the floor in like, child's pose because I was like I really....Every time I edited the book, I read it out loud because I'm like, "This is going to be an audio book." Like, how do people consume? They consume audio. And my downstairs neighbor like came up and he's like, "It's too loud, I can't work." And when he realized what was going on, and he looked at me, he's like, "Oh my God, I'm so sorry." And like he's trying to get out of the conversations. It's like a woman crying...The door....Just don't [crosstalk]

Jordan Harbinger: [00:05:11] The period is the fifth vital sign, you said.

Jolene Brighten: [00:05:12] Yeah.

Jordan Harbinger: [00:05:12] Never heard that before. Well, I'm a guy, so of course I don't talk about that stuff very much. Because doctors think this isn't related to us, which is another reason why I'm doing this episode. But explain what this means because I think a lot of people just think it's like this isolated thing that nobody talks about.

Jolene Brighten: [00:05:27] Totally. We always think about the period, blood, crazy emotions, but we have to look at the entire menstrual cycle. And it's really an indicator of health. So when you go to the doctor, they're going to check your blood pressure and your pulse. So understand, like,where are you at right now? What's your vitality? These are your vital signs. How healthy are you? And you know, of course, those ones are like, "Are we going to die soon?" That's a big scary. We always want to rule out big scaries. But the menstrual cycle as a whole has kind of just been overlooked altogether. I get it. It's confusing. It's tricky. Women are complicated. So I like women's health, and in that though we can tell a lot about what's going on with a woman, what's going on with her health. Should we do lab testing based on her menstrual cycle?

Jolene Brighten: [00:06:08] The interesting thing is that this year Scientific American actually had Dr. Elizabeth Kissling make this statement and it's so on point that long-term menstrual suppression...this is the longest and biggest uncontrolled experiment we've ever done. And a lot of this is born out of the fact that of men really steering the ship in medicine, women not being included in studies and so the narrative is gone. It is like, "Women, you're just baby makers. And if you don't want to make a baby, then you don't really need a period." This is something expendable. And it's almost the way the entire reproductive system is treated in women's health.

Jordan Harbinger: [00:06:45] That's interesting. Right? So like, "Oh this thing is optional because I'm not trying to have kids right now."

Jolene Brighten: [00:06:50] Totally.

Jordan Harbinger: [00:06:50] But it's not, it's kind of like saying I don't need a pulse because I'm--

Jolene Brighten: [00:06:53] Yeah, I mean when like you don't have pulse, you're going to die. You won't die if you don't have the periods. So you know from suppressing it--

Jordan Harbinger: [00:06:58] But it screws up all this other stuff.

Jolene Brighten: [00:07:00] There's other stuff going on. But it's also masking really important data. So you know what happens sometimes is women come off the birth control because they wanted a baby. Now they're infertile and they look to birth control and say "That caused my infertility," when in reality, it may have been masking PCOS, endometriosis, hypothyroidism. These other conditions that we know lead to infertility. And it's problematic because with hypothyroidism that goes undiagnosed and untreated, we can see cardiovascular issues. PCOS, we see--

Jordan Harbinger: [00:07:26] What's PCOS again?

Jolene Brighten: [00:07:26] Sorry. Polycystic ovary syndrome. Thanks for slowing my roll in that.

Jordan Harbinger: [00:07:32] It's literally my next question in the notes anyway because it comes up a lot in the book.

Jolene Brighten: [00:07:38] Totally. Yeah. Well, polycystic ovarian syndrome, this is a metabolic and inflammatory condition with hormonal side effects. So what that means is we've got insulin dysregulation. Adrenal glands are misfiring. We've got inflammation going on. Excess androgen, so too much male sex hormones, but women have testosterone as well. And these women, they grow hair on their chin, chest, abdomen. Nobody likes that. And you know, as a woman, they lose hair on their head, they get cystic acne, and their periods are very irregular. And they can even show up later. So one of the hallmarks of the syndrome is that you don't ovulate regularly, so anovulatory cycles. And so if you don't ovulate regularly, then you're not going to have a regular period. And so the fix is to put a woman on the pill.

Jordan Harbinger: [00:08:23] Ah, right, you're not fixing the traffic issue, you're just making it regulated in this weird artificial way.

Jolene Brighten: [00:08:29] Totally. And so you get a withdrawal bleed. This has been called a period, which is a mistake for a long time. If you stop the pill and you bleed, that's a withdrawal bleed from a medication. It's not the actual period. There was no ovulation that ever took place.

Jordan Harbinger: [00:08:43] And people don't really pay attention to this necessarily until they go, "Why can't I get pregnant?" And it's like, "You probably have been infertile for five years or like however long you've been on the pill and you never fixed the issue."

Jolene Brighten: [00:08:53] A very interesting thing and I talk a lot about this, that you shouldn't have to go to medical school to understand your body. And yet it wasn't until I was in naturopathic medical school, learning about infertility and how women get pregnant, that I'm like, "Wait a minute, I'm only fertile one day out of the month because that's when I ovulate, and that's what's going on." And that's the reality for most women is that they don't actually learn how their body works until they want to have a baby, which is a big problem in society as a whole.

Jordan Harbinger: [00:09:19] Hmm. Yeah. I actually didn't know that either. But if you didn't know that and you went to medical school for that, then that's a problem also. Like, I figured most women know more about getting pregnant than most men do. And I hope that's the case, but if you didn't know that until you went to medical school, that's probably something that society should talk more about.

Jolene Brighten: [00:09:37] Yeah. Well, you know, when you look at the statistics, very few states mandate scientifically accurate sex education. We're not even teaching scientifically accurate information about our bodies. And so many women have written to me about the book and they're like, "I've never used birth control." We call them the unicorns out there because the majority of women have at least tried it once. And in that they're like, "I actually understand my body for the first time in my life." I knew a woman in her 60s, she was like, "I read your book. I haven't menstruated in over a decade, but I finally don't feel crazy. Like I know why I had these symptoms. I finally understand how my body was working all of those years." And that to me, I'm like, this is a big issue. Like women deserve to understand their bodies. They need to understand their bodies so they can communicate to their doctor. And when you know what's going on with your body, you can always give your partner a heads up of like, "Hey, this is where I'm at in my cycle. I'm going to be a little more tired. I'm going to have a little less bandwidth for BS, and like I just maybe need to be left alone for a little bit." That's okay.

Jordan Harbinger: [00:10:36] I mean, I get that way too. Just maybe not for the exact same reasons. I think everybody has that mode, right?

Jolene Brighten: [00:10:41] Oh totally, totally.

Jordan Harbinger: [00:10:41] Mine might happen more often than most people. The pill did change the world for women though, which is awesome.

Jolene Brighten: [00:10:48] Yes.

Jordan Harbinger: [00:10:48] Like it's done so many awesome things. So I want, for a lot of doctors listening, they're like, "Oh, you're bashing this thing that's been really helpful." That's not really what we're trying to do today.

Jolene Brighten: [00:10:57] No, people always want to be like an us-versus-them camp like us who are pro-pill or pro-birth control no matter what, and them who would hold it back. And you know, really my whole jam is like we can advocate for access and informed consent and education for women at the same time. And the truth of the matter is for as long as we've had birth control available, we really haven't been studying it. Consider that 100 million women worldwide are using hormonal birth control and we have very little data on what it does to the brain. We have really no idea how this impacts us long term, but we've been told, "Just be grateful you have it. Shh! They might take it away from us to don't question it." And it's been kind of in this stuck place because I'm a first generation college student. Used the pill as a tool for 10 years. Yay! Really grateful to have access to it. I come from this big Hispanic family. I was the first gal not to get pregnant before age 20.

Jordan Harbinger: [00:11:51] Oh my gosh.

Jolene Brighten: [00:11:52] Like that's huge for me.

Jordan Harbinger: [00:11:52] That's a life-changing setup.

Jolene Brighten: [00:11:54] Yeah. My family was like, "She must be infertile," because I didn't have a baby until my 30s. I would never advocate for loss of access or that women just discard this, but we should enter into this eyes wide open. Spending years in clinical rotation at a homeless youth clinic, these are women at high risk--

Jordan Harbinger: [00:12:12] Oh man, you must have seen some shit.

Jolene Brighten: [00:12:15] I will tell you that is a really good way to build your confidence of the average patient of like, I know it's not going to be that bad. But you know something we take for granted is the fact that we have doors that we can close at night and we can lock and these women don't have that. So they're high risk for sexual assault. Like at the end of the day, I don't know what's going on in that woman's life. How can I ever tell her "Just don't take hormonal birth control. " That might be the best option for her. And then you know with this population as well, menstrual inequality affects them greatly.

[00:12:46] They have to choose whether they eat or buy a tampon with a luxury tax on it. How do we have a luxury tax?

Jordan Harbinger: [00:12:54] Oh, is that true?

Jolene Brighten: [00:12:54] Yes.

Jordan Harbinger: [00:12:54] That's obscene.

Jolene Brighten: [00:12:54] Yes.

Jordan Harbinger: [00:12:54] I just can't get out of it.

Jolene Brighten: [00:12:54] Menstruating is very, very expensive. Which is another reason women might want to shut down their period altogether, 100% their right. They should know though how that might affect their body, what to look out for, and when to go have that conversation with their doctor. Like the choice to take birth control, that is an individualized choice and you should have a discussion with your physician. It shouldn't be something that you just listen to an influencer on Instagram or because like your sister did it. It really needs to be what's best for me as an individual. What's true for me. And if you have side effects, know to talk to your doctor sooner than later.

[00:13:31] But most women don't even know, "Oh, I started the pill, now I'm feeling depressed. Well it must just be me." We get this message in society that like we're always broken in some way but in reality it could be birth control. So get to your doctor and have that conversation because there's lots of formulations. We could try something different.

Jordan Harbinger: [00:13:48] Are the hormones then in the pill, the same thing that our body makes? I'm guessing not really.

Jolene Brighten: [00:13:51] No, that would be great. But if they were exactly the same, you couldn't patent it. Like you can't patent natural things. The biggest distinction is that we make progesterone only after ovulation. It stimulates GABA receptors in the brain, which helps you feel chilled out and calm. It actually helps with neuroplasticity. So we can learn new things, we can learn new languages. Progestin doesn't have those same benefits and--

Jordan Harbinger: [00:14:15] That's what's in the pill.

Jolene Brighten: [00:14:16] That's what's in the pill. That's what's in the IUDs. That's what is in the Depo shot. So this is synthetic progesterone. It acts nothing like natural progesterone except for the fact that it can shut down the brain from talking to the ovaries, which is how birth control works on the brain.

Jordan Harbinger: [00:14:31] I didn't realize that.

Jolene Brighten: [00:14:31] I didn't realize that for 10 years on the pill.

Jordan Harbinger: [00:14:33] Wow. Wait. So it shuts down the connection between the ovaries and the brain.

Jolene Brighten: [00:14:39] Essentially what you do, if we're talking about the pills specifically, we take a large enough dose of hormones. The liver takes a crack at it because that's what the liver does. It says, "Let me try to detox some of this out," but it's still high enough that it's a feedback loop to the brain and tells the brain, "We've got more than enough hormones," and it's trying to psych it out like it's pregnant now, but it's not 100% like you're pregnant. It's not the same hormones and it will stop the brain from triggering the ovaries to produce estrogen, progesterone and triggering an egg release, which is beautiful. We don't want to ovulate if for taking it.

[00:15:10] The progestin-based IUDs in some women, they'll stop ovulation and some women, they don't stop ovulation. In some women ovulation stops two years into that IUD. But when that IUD came out, there was this story in medicine that wasn't grounded in science that was, "Oh, the progestin stays localized." Now,I don't think you have to be a scientist or have a medical degree to know the uterus isn't a vacuum container. What goes in can come out. And so with that, it wasn't until years later that, yes, indeed those progestins do affect the brain. In fact, when it comes to depression, we vilified estrogen. We love to vilify the synthetic estrogen. Like if you look through a medicine, you know, the big Danish study came out with over a million women. Thank you to the Danish researchers who do so well in collecting data.

Jordan Harbinger: [00:16:01] I feel like whenever we see a really good study that's not full of like, sponsored BS. It comes out of Scandinavia.

Jolene Brighten: [00:16:08] Yeah.

Jordan Harbinger: [00:16:09] They must have rules against like tampering with--

Jolene Brighten: [00:16:11] Well, they're monitoring their people. I mean we've got socialized medicine, you know, so they're monitoring. It's through their research that we started to understand how iodine can actually aggravate Hashimoto's thyroiditis, which can elevate the antibodies. Before they introduced iodized salt into their population, they were like, let's look at this baseline data and then let's follow up. And lo and behold, more hypothyroidism, more Hashimoto's diagnosed. I think they do really great work. So but the one with depression, the combination pill was associated with -- and these are associations, we don't have any studies to say causation at this point -- with about a 23% increase in depression.

[00:16:53] Now we thought, okay, this is a problem with the combination pill. But as it turned out and we went further into the research, the progestin only had higher incidences of depression, like looking at over 30% of women newly diagnosed with depression. We also saw that in younger women, like teenagers, they would have higher risk of suicide, so suicidal ideation. So higher risk of mood changes and the possibility of taking their life. And so think about how many young women can go and get birth control without their parents knowing. Now that may be a very good thing and so I wouldn't say--

Jordan Harbinger: [00:17:30] I'm thinking in some populations that's a good thing.

Jolene Brighten: [00:17:31] Yeah, 100% and so you know with that when critics are like, "Would you just not have them take it?" I'm like, "No." I would have their doctor inform them and then I would have them tell their BFF or someone close to them: "I'm starting this. If I start ignoring your text messages, if I stop hanging out with you, if you notice I'm crying all the time, I break up with my boyfriend -- if these things start happening, can you please remind me I need to go talk to my doctor?" And you know, teenagers, their brains haven't totally formed yet. So we want to judge them a lot. In a lot of ways, they do have each other's backs and this is one way that like girls can stick together to take care of one another.

Jordan Harbinger: [00:18:05] You also don't think, "Gee, my life is in shambles. Maybe it's this medicine that I'm taking for what I thought was completely unrelated reasons."

Jolene Brighten: [00:18:12] Right. Because what we're told, birth control is affecting just the reproductive system. Every system in our body is affected by our natural hormones. Every system in our body is affected by synthetic hormones as well and the brain is no exception.

Jordan Harbinger: [00:18:26] You've mentioned in the book beauty products and things like that can be endocrine disrupting. That's terrifying. Because I'm shaving and put lotion on my face and I'm like, "Wait a minute. What is this now going into my skin and screwing with my hormone levels?" I mean it's kind of horrifying.

Jolene Brighten: [00:18:40] Yeah, it's totally a possibility too. So we know that there are endocrine disruptors that are in our products. Anybody who's listening to this right now in the UK is like, "We don't have all that business." No, because the UK is like, "We can't have all of that stuff in our makeups." So you actually see US-based companies make a completely different line for Europe than they make for the US because what is allowed to be in our products and what they'll look at and say is like, "Okay, well it's a very small dose, so it will be safe because it's a small dose," except compound that over the 10 years that she uses it every single day plus the 17 other products she's putting on her body, and it may not be that small of a dose. And for men it absolutely impacts them as well. It impacts our children and impacts our pets.

[00:19:24] So these are things that we don't need to freak out about it, but we do need to be more educated. And it's unfortunate that we're not protected. There's no regulations to protect us, and so it all falls on the consumer to take that on, to educate themselves. And you know, in the book I talk about ways to start kind of detoxing your home and taking it one day at a time so you're not overwhelmed, so you're not freaking out.

Jordan Harbinger: [00:19:49] Throw out everything in every cupboard you have!

Jolene Brighten: [00:19:51] That gets expensive quick. Especially when you talk about personal care products, it's 60 bucks a pop and then you're throwing them all out and you're like, "Great, so now I've got to go spend $3,000."

Jordan Harbinger: [00:20:00] Worst book ever, Dr. Brighten. This book sucks! $12 for the book, $3,000 to replace everything that you have to throw away.

Jolene Brighten: [00:20:07] Totally. Well, that's why the book's designed to like get in and get out. So chapter one is like a quiz. So like if you're estrogen dominant, you're like "Quiz done," go to the protocol, get that going and--

Jordan Harbinger: [00:20:16] Yeah, I didn't take the quiz because I'm not on birth control and never--

Jolene Brighten: [00:20:19] And yeah, you don't have a period, you'd be like, "Yeah, I don't know how I bleed."

Jordan Harbinger: [00:20:23] As far as you know I've never ovulated, as far as I know. Let's talk about this attraction thing because that's obviously super fascinating. You mentioned that it affects attraction in faces. What's going on here? How does this work?

Jolene Brighten: [00:20:37] Oh my god, you know, like I could write a whole book on this a lot.

Jordan Harbinger: [00:20:40] I think you should actually.

Jolene Brighten: [00:20:40] I find this so, so fascinating and really why there isn't a ton of research around neurological health and everything. As I was starting to put it in, I'm like, "I just don't have enough yet to not freak people out without having some conclusions to these stories."

Jordan Harbinger: [00:21:00] You're just going to rip open all the Band-Aids and then be like--

Jolene Brighten: [00:21:02] Totally.

Jordan Harbinger: [00:21:02] --part two coming soon. Nobody likes that.

Jolene Brighten: [00:21:04] Part two coming three to five years from now? Because that's how books roll. So with that, you know, there's been some really interesting research done. So there was one study where they brought women in and they gave them basically computer images of faces and said, "Manipulate it to make it look more attractive." So they got men's faces and women's faces to play with. On the screen, all these women are not on birth control, they are making the faces look more masculine. Just think Gaston from Beauty and the Beast, like that strong jaw. He sings all about how he's so masculine. And so in that they then put half the women on birth control and had them come back. And what they found is the women, three months later on birth control, started to make the faces more feminine.

Jordan Harbinger: [00:21:48] They all like the teapot, or whatever.

Jolene Brighten: [00:21:49] Like the teapot!

Jordan Harbinger: [00:21:51] Is there a teapot in that movie? Yeah.

Jolene Brighten: [00:21:53] There's a teapot. You have a child; in about three to five years, you're going to be in the know on Beauty and the Beast.

Jordan Harbinger: [00:21:56] Yeah. Gaston? Doesn't ring a bell. The teapot, however--

Jolene Brighten: [00:22:00] I have younger siblings that were obsessed with Disney. So that's where I get my Disney characterization.

Jordan Harbinger: [00:22:05] Gotcha. You don't have to excuse your Disney prep! I'm a fan. So they wanted more female--

Jolene Brighten: [00:22:09] So more feminine looking, so the feminization of men's faces. So what do women select for when they're on birth control? They actually select men who have more feminine features than masculine features, which is really interesting. So why would we like to select a man who looks more masculine? Well, it's very telling of their hormones. So robust testosterone, strong man defends the tribe, protects you from a predator, like goes out and gets the food. Now modern society isn't set up quite that way anymore, but we're still primal animals. Even though we like to think we're so evolved. Women on the pill will actually select for men that look more feminine. But you know what they're really interested in, what they're really selecting for is intelligence and money.

[00:22:55] And the next study I'm going to tell you about is even more interesting. So they've done MRI scans of women's brains and there are these reward centers that light up when a woman sees an attractive man, masculine looking face. If you're on the pill, it doesn't actually light up. But you know what does light it up? Looking at money.

Jordan Harbinger: [00:23:13] Really.

Jolene Brighten: [00:23:13] Yeah, now, before we play like you know...this is where I hear like Kanye's Gold Digger on.

Jordan Harbinger: [00:23:18] Right, I'm thinking about that, something along those lines.

Jolene Brighten: [00:23:24] So let's think about that though. Why would women be selecting for that? Well, in modern society that is how we stay safe. Right? So a man who's intelligent, a man who can provide for the family, like these do have advantages. The problem is that in these scenarios, these women are actually less satisfied in their, in fact, if a woman on the pill is going to get divorced, it's like over 80% likely she'll be the one to initiate it. It's like 85%; a non-pill user is about 73%. So there's less satisfaction in the relationship. And we know birth control crashes libido. I'm sure we're going to get to that. And you think like you're going to come off of it and I'll just come off of it and things will get better. Women who come off the pill actually report higher dissatisfaction in their sexual health and their sexual life. And maybe that's because they're afraid of getting pregnant or maybe it's because they've actually been mismatched all along with this partner.

Jordan Harbinger: [00:24:25] So their preferences changed, like they were on the pill and they marry their boyfriend and then they come off and they're like, "What the hell do I see in this schmo?"

Jolene Brighten: [00:24:31] Well. Yeah, and that's what we'll see and I've seen this with patients as well, and I talk about a story in the book where a woman is on the pill, she selects a mate and then she comes off the pill to have a baby and she's like, "I don't want a baby with this guy. I don't want to be with this guy. Like what am I doing?" And vice versa. Women get into a relationship and then they start the pill and now they're like, "I'm not interested anymore." And you know, yes, we can be getting anxious and depressed and our libido can be declining, but it seems that there's something more going on in all of these. This is the parts of the pill that like nobody's talking about.

Jason DeFillippo: [00:25:08] You're listening to The Jordan Harbinger Show with our guest Dr. Jolene Brighten. We'll be right back.

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Jason DeFillippo: [00:27:50] Thanks for listening and supporting the show and to learn more and get links to all the great discounts you just heard from our amazing sponsors, visit jordanharbinger.com/deals. Don't forget we have a worksheet for today's episode. So you can make sure you solidify your understanding of the key takeaways from Dr. Jolene Brighten. That link is in the show notes at jordanharbinger.com/podcast. If you'd like some tips on how to subscribe to the show, just go to jordanharbinger.com/subscribe. Subscribing to the show is absolutely free. It just means that you get all of the latest episodes downloaded automatically to your podcast player so you don't miss a single thing. And now back to our show with Dr. Jolene Brighten.

Jordan Harbinger: [00:28:29] It makes sense though that we're messing with mate selection because you hear about, well, chemistry literally and figuratively, right thing between partners but also like immune systems and genetic diversity and all this stuff, that I vaguely remember from--

Jolene Brighten: [00:28:43] Well, we should talk about that.

Jordan Harbinger: [00:28:44] --Anthropology in college. Are these things kind of changing too?

Jolene Brighten: [00:28:48] Yeah.

Jordan Harbinger: [00:28:48] Because you're messing with the hormone systems that I don't know, the smell pheromones or whatever.

Jolene Brighten: [00:28:53] Totally. So pheromones play a really big role in this. And so when, I don't want to name drop any products. Let's just drop the colognes and the scents heavily because actually you being a little stinky from the gym will attract a really like, your right mate. I know these things that we're told, like males are told, "You're stinky, you take a shower, you should cover that up." I work in women's health, so I see a lot of the shaming in the media and things, but men get that as well and it actually goes against the biology of attracting a mate. So women need to smell you so they can smell those pheromones. But what they're smelling is the major histocompatibility complex, the MHC. And what that is -- so we're going to get a little nerdy.

Jordan Harbinger: [00:29:33] That's fine.

Jolene Brighten: [00:29:33] I'll keep it simple. You just tell me if I need to break it down. So the MHC complex basically takes proteins and puts them on the cell and shows them to the immune system. The immune system then comes over and says, "Is this us? Is this not us?" Non-self if we attack. Self, we let it be. This is how this plays a big role in autoimmunity because in autoimmunity, immune system confusion attacks self. So with that, this MHC that we're smelling, we are attracted to a mate when we are off of birth control that is more genetically different from us. Now, what benefit is this? If you have a baby with this partner, they get a robust array of genes and they get a better immune system and so there's more genetic diversity, and we get to basically pick and choose the best of everything and make this small human. But if you're on the pill you actually will select for mates more genetically identical to you. So it's like you're more attracted to your cousin than you are from someone outside of your family.

Jordan Harbinger: [00:30:29] Oh, damn. Nobody wants that!

Jolene Brighten: [00:30:30] Nobody wants that. That's when everybody goes, "Ugh. Did she just say that?" Why would we do that? We don't know. But what researchers think is because there are ideas that the pill is like pseudo pregnancy. I don't really think that's a fair way to say that, but you would be attracted to people whom are similar to you because that'd be a family who would protect you, keep you safe while you're pregnant. But this is a big problem if we are on birth control, selecting for a mate who it's just based on how much money do they have, and how smart do we think they are, and they're more genetically identical to us. And then we come off and we make a baby with that person. What long-term effect does that have?

Jolene Brighten: [00:31:09] I don't want anybody right now to be like, "That was me and I had a baby. Did I do the worst thing in the world?" Because your wife just had a baby. And I'm sure mom's guilt is already starting to creep in because it's so real. I mean, this is why the human race, in the species, has existed is because moms are so good at being like, "Let me just go through the day of everything that I've done wrong and try to do better tomorrow and think about everyone else first and then let me just get really guilty about those things." Don't get guilty about what you didn't know and everything that I share here -- everybody take a breath-- like understand that like it's not like a make or break kind of situation, but it is the information that's being glossed over and ignored. And as we enter into an age where autoimmunity, asthma, eczema, all of these issues are on the rise, it's something where we have to question what role did this play? It is not that birth control caused these things. It's not what I'm saying, but it could be one variable in a whole host of variables that are contributing to what we're seeing today.

Jordan Harbinger: [00:32:05] That's fascinating. I know there's a lot of health implications that we don't have to go down each rabbit hole, but the pill can bring about diabetes or contribute to diabetes. It Interacts and is more dangerous when people have certain genes. So like I'm assuming at some point in time people will get those DNA tests and they'll be like, "Hey, you shouldn't take birth control and you should," and companies that make birth control are going to try to argue that that's not true and it's going to be a whole thing.

Jolene Brighten: [00:32:28] Well, actually the companies that make birth control, if you actually read the package insert, I think they do a very fair job.

Jordan Harbinger: [00:32:34] That's good.

Jolene Brighten: [00:32:34] They're very transparent and it surprises me where sometimes physicians push back and they're like, "You're making all this up. I was never taught this. Where are you getting this?" I'm like, "It's the package insert, right there." There's some formulations that list higher stroke and clot risks and it's all in there. I actually think they do a pretty fair job. And you know it's really interesting? It was back to school season. I was writing an article because what happens back to school season, we send women off to college with their birth control prescription. And so I wanted to then, you know, if they're a college student, like I was a poor college student, can't buy a book. Then they have access to like, "Okay, here's some information on my website about how do you stay safe on birth control."

[00:33:14] And what was interesting, as I was going through this medical database, it's a conventional medical database of where you reference drugs, and I noticed that there were different disclaimers and cautionary parameters in Canada versus the US. Same pill formulation. And where in the US doctors are pretty dismissive of a genetic mutation called MTHFR, which is an enzyme involved in processing folate, very important in pregnancy. And with that, the research has shown that if you have this genetic mutation, which somewhere around 40% of the population has, you can be at higher risk of a clot or a cardiovascular event. And so in Canada, it's something where they're like, "Okay, slow the roll, if she has this mutation," but in the US we're not caught up yet talking about that. I hear this all the time because in the book I give, here's the genetic test to screen for it.

[00:34:03] And doctors are like, "That's not what we do. That's not standard care. We don't screen that and we don't screen it in asymptomatic people." And I'm like, "Well, waiting until someone is symptomatic is a clot, a potential pulmonary embolism, which 20% to 25% of people die of when they have a pulmonary embolism." Like that's no joke. Women die of strokes at a higher rate than men. We know this as well, but why? Why do we have this idea? Because birth control was made for healthy young females to be used for a period of time to space pregnancies or to delay pregnancy. It actually was never designed to be taken from the day we start our period until menopause--

Jordan Harbinger: [00:34:42] Yeah, from age 14 until you're 29 or forever.

Jolene Brighten: [00:34:42] Or until you're 59. Right? And so, and that's why I brought up that quote of like, we actually don't know what happens when we do this. And so again, the answer isn't just throw out birth control, no one takes it. But it's to say we need to be curious. We need to educate women and we need to listen to women's stories. So you know, women are, as I talked about in the book, they die of heart attacks at a higher rate because they're dismissed going into the ER, told that they're having a panic attack, they're stressing too much. I have had so many women write me saying, "I had a clot." There's just this Amazon review that went up. I cried so hard because the woman had a clot and was turned away. She's like, "If I hadn't read this book, I wouldn't have known to advocate for myself and I did and I lived because of it."

Jordan Harbinger: [00:35:28] Unbelievable.

Jolene Brighten: [00:35:28] It's a crazy time. Women are not expendable and we can't afford to lose another woman to something that we could have prevented. And how can we prevent it? We can screen some genes, but we can also educate her of what to look out for and when to go to the doctor. Most women don't know when to go to the doctor and what's a birth control side effect and what's not. And just to be clear, birth control doesn't cause clots, but it can elevate the risk because of all of that estrogen that you're on, but most of the time when we see -- so the parents who've written me and they've lost their daughters to birth control because of a clot, they all had the genetic risk factors, but they were never screened and it was never brought up.

Jordan Harbinger: [00:36:05] Yeah, it's ridiculous. If there was something for men and you take it and they're like, "Hey, there's a rough chance this will kill you. We could screen for it, but we'll do that if it starts killing you." People would be like, "Hold on, I'm going to go ahead and take that $98 genetic test before I take this one in 100 cyanide pill that might kill me randomly."

Jolene Brighten: [00:36:24] Yeah. And what you just hit on is the medical gender bias that exists of like, why don't we have a male birth control yet? Some women have written either very angry at the fact of like how I talk about it in the book and they're like, "Why aren't you advocating and pushing for that?" And I'm like, "Well, one, I understand it's a business and it's a business decision. If men aren't going to buy it and take it, you can't dump millions in developing this drug. There's no ROI there." So if we can just stand back and recognize that at the end of the day, the pharmaceutical company as a business, I can understand why they make the decisions they do. But the other thing is not, I have a son; I am married to a man. Would I advocate just to put them on hormones before we totally know what it does? Not necessarily. I think we should have them available. We should have these options. But I don't get into the camp -- you're going to notice I'm very gray. People are confused by me because they're like, "Why isn't it black and white?" And I'm like, "Because it depends!" And that's where we're at. So it depends. Like, "Would this be the best thing for them?"

Jordan Harbinger: [00:37:24] Birth control pills in the water supply. That freaked me out. I have reverse osmosis at home. I hope that gets that stuff out of there. So let me take people through this. Someone takes the pill, goes to the bathroom as we all do. And then that just somehow ends up in the drinking water because there's so much of it. How does this happen?

Jolene Brighten: [00:37:42] Yeah, well it's the same in the antidepressants showing up in the drinking water.

Jordan Harbinger: [00:37:45] I just never heard of that.

Jolene Brighten: [00:37:47] We take these medications and then they go into the water supply. You know, our urine is one of our emunctories -- one of the ways we excrete and we detox -- and that's one of the pathways estrogen goes through. It was really interesting. It was actually way before I was contemplating medical school that I was at Cal Poly SLO, getting my degree and learning about how fish and amphibians, like their sex was changing because of how they were being exposed to hormones in the environment through the water, through what women were taking and what went into the water supply.

Jordan Harbinger: [00:38:17] I'm freaking out, and I'm also thinking about that crackpot Alex Jones, who yells, "They're turning the frogs gay." Probably he read some article about that and freaked out.

Jolene Brighten: [00:38:25] Please nobody misinterpret my message, Because I have had people say like, "So what you're saying is that's why people are gay is because of this." I'm like, "That is not what I'm saying and we're not going to do that. We're just not going to go there."

Jordan Harbinger: [00:38:39] But I mean, to have a glass of water, which I have had from many a faucets, especially when I lived at home in Michigan, and to know that I'm not possibly, but almost certainly drinking hormones excreted by someone else is really gross.

Jolene Brighten: [00:38:56] But I mean, there's also the antidepressants, there's the antibiotics. I mean just in the UK, they put out a study showing how much antibiotics was actually in the water supply. So you know, as much as you're like, "Ew, someone excreted this," there's a whole lot in that water that people excreted.

Jordan Harbinger: [00:39:15] Look, I think we're better off drinking clean urine than dirty water, right? From the sound of it.

Jolene Brighten: [00:39:20] Yeah. Well let's just recognize our privilege that we do live in a country where we even have reverse osmosis and all of these things and access to birth control.

Jordan Harbinger: [00:39:27] Yeah, no it's okay. Net/net, it's a positive, but it still freaks me out that there's stuff that others -- because I'm like, I don't take medication. Meanwhile, I'm taking somebody else's used and digested medication. That's not good either.

Jolene Brighten: [00:39:40] No. I've had friends ask me like, "You know, I was traveling here and I was drinking the water and I started feeling depressed and I started feeling weird things. And do you think it was because something was like medication was in the water?" I'm like, "Did you collect samples? Because I have no way to know right now," I mean there is so much about environmental toxins, environmental waste, so we're just guessing about that we don't really know.

Jolene Brighten: [00:39:59] Yeah, I've got neuroscientist friends that are like, "Don't drink things out of plastic. It's not all plastic, but just be safe. Don't drink out of plastic too much." And that's terrifying also, because you're just like, wow, okay, this plastic is going into my body and acting, doing things that hormones do. That's just, it's all terrifying.

[00:40:19] Those, and straws. Look at me with a paper straw. I was like, "I hope that guy gives me a paper straw. Otherwise, I have to say 'No thank you.'"

Jordan Harbinger: [00:40:25] It's California. Everywhere, they're giving you a paper straw.

Jolene Brighten: [00:40:27] Oh, really? Is that like a thing now?

Jordan Harbinger: [00:40:28] Oh my god, everywhere has paper straws now, pretty much.

Jolene Brighten: [00:40:31] In Portland, we actually travel with our own metal straws.

Jordan Harbinger: [00:40:34] I have my own metal straw too. Yeah, it's literally in my backpack.

Jolene Brighten: [00:40:38] Yeah, they even have like big ones for boba now.

Jordan Harbinger: [00:40:42] I know, I have one of those too. You know, it's funny, I'll go to certain places and they're like, "Do you have a metal straw, you weirdo?" And then you go to another place in California and they're like, "Do you want a straw? I'm like, I have a metal straw." I kid you not, I went into a mall and I told this boba place that I had my own metal straw and they all started clapping because they were all clearly hippies like me.

[00:40:58] Epigenetics and gene response. That is something fascinating. Epigenetics, explain what this is because basically long story short, all the dumb shit I did as a teenager is now affecting my offspring for generations. Like sorry y'all, I made terrible decisions.

Jolene Brighten: [00:41:14] Not so much like, so epigenetics is more of how your environment turns on and off genes. So you know we did the whole human genome project and we were like, "We are going to crack the code of humanity, and then we're like womp, womp! It wasn't what we thought it was. This is the most amazing discovery and at the same time, the thing that anytime someone's like, "Diet and lifestyle does nothing," but how could it not? It's the choices you make every day. Not just like what you put on the end of your fork, but also how you talk to yourself, how you move your body, how you sleep, your relationships, and all of these things can impact our genes, turn them on and off.

[00:41:54] They can impact our hormones as well. Like you have the new baby, you get your cuddle on for like 20 seconds and your oxytocin is like, "Yes." And that helps against excess cortisol -- which you're an entrepreneur -- so your cortisol is like, "Let's go." And you're like, "Give me more." And then oxytocin comes in, it's like, "Let's not age too fast."

Jordan Harbinger: [00:42:11] Oh man, I took a gut panel and functional medicine doctor was like, "You have really low cortisol." And I was like, yeah. And he's like, "Because you're burning it out at about 11:00 a.m. each day." And I was like, that's not good.

Jolene Brighten: [00:42:22] Yeah, yeah. No, that's not uncommon for entrepreneurs. Yeah. And then what's going to happen, I don't know how much you're up at night, but for your wife, she's up at night with baby, is that her cortisol curve is probably going to start switching because baby's going to train her to be up at night and then going to sleep during the day. Oh, if babies could just sleep through the night and we'd have more of them.

Jordan Harbinger: [00:42:41] Tell me about it. We had an incident last night where I was like, this is not good. Yeah, good all day. Come on man.

Jolene Brighten: [00:42:47] I'm glad to hear that though. Because I got up at four o'clock this morning to be here. And so we're like, that's like same, same.

Jordan Harbinger: [00:42:55] You're welcome.

Jolene Brighten: [00:42:55] But with the epigenetics in the pill...You know what's interesting about that is that when you're on birth control, it actually changes the genetic expression of sex hormone-binding globulin within your livers. So sex hormone- binding globulin, it's a protein that grabs on the sex hormones. Now, this is where people come in and say, "This is your body betraying." No, this is your body protecting you. In fact, what incentive does your body have to betray? No. So with that you're taking these big doses of hormones to shut down the brain from talking to ovaries. And that's dangerous if it was just touching every cell, top and down, stimulating them all.

Jordan Harbinger: [00:43:31] So your body's like, get rid of this. It's causing a problem.

Jolene Brighten: [00:43:33] Bind if up, we've got too much of it. But the problem is, is that the pill is down-regulating testosterone production in women by about 50%, and then grabbing on to any testosterone that's around. So bye-bye libido, that's how the pill really works if you don't want to have sex and you're attracted to the wrong guy. But with that , it down-regulates libido, but also testosterone involved in muscle mass. So you see, I've worked with athletes, patients who come in and they're like, "Sorry, birth control. Everyone says I'm crazy, but I swear I can't lift as much weight. I can't sprint as hard. Like what's going on?" Yeah, you're fatiguing faster because you don't have your testosterone stimulating your muscle mass. And there might be some insulin resistance going on. Like we need to investigate that.

[00:44:17] In addition, I call testosterone the wake-up-kick-ass-repeat hormone. Because when you get up in the morning and you have testosterone, you're going to have energy throughout the day. It gives you that edge and not that edge of like where society likes you're a bitch. That edge of like, this is my boundary, this is what I want in life, this is what I don't want, and like I'm going to run this, whatever it is like I'm the CEO. And it's also important in bone mass as well. When women don't have enough testosterone, it's not just libido, their mood tanks. This is when you're like, I have no energy all day and I cry all the time for like no reason. It's not cyclical. That can be a low testosterone issue.

[00:44:56] And when we talk about muscle mass, it's also the muscle mass of the pelvic floor. So urinary incontinence and then that's where like orgasms get weaker. Some women's orgasms get painful on the pill or they lose orgasms all together. They have vaginal dryness. I've spoken with physical therapists, I refer patients to, and they're like, your patient is like 20 something and her vagina is like 50 something. It looks like a postmenopausal woman because of the muscles and the atrophy of the tissue. It doesn't happen in all women, but it happens in some and we need to know about it because...This is the other thing is like it's not polite to talk about your period, your body, your lady parts. And it's also very embarrassing when you're like, "Is this normal? I don't know if this is normal, who do I talk to about this?"

[00:45:39] And your doctor may not always be helpful in this conversation, but to be able to have these conversations, like we need to start normalizing these things. If half the population is having a period like or is menstruating or has menstruated and like why are we not having these conversations. I mean it's like 2015 Newsweek is like 2015 is the year of the period. The periods gone public. I'm like 2015, 2015 like--

Jordan Harbinger: [00:46:05] 20,000 years later.

Jolene Brighten: [00:46:06] And for people who are like, we have a quality and we're like, we've got it all as women. Let me ask you this. Like you could pay for parking from an app on your phone. Right? And like if you want to go to a vending machine and get food, you can use a credit card. But if you go into a public bathroom to get a tampon, you better have a quarter. Like what is that? We're not innovating.

Jordan Harbinger: [00:46:26] Like if you don't have one and you don't have a quarter, I want you to have that. I think everyone around you wants you to have that. The place that you're in wants you to have that. It just seems like a kind of thing that you could supply.

Jolene Brighten: [00:46:44] Well, you go in the bathrooms. And there'll be women standing there sometimes being like, "Do you have a quarter? Do you have a quarter?" My husband is always like, "Why? You're not on your period. Why are you carrying tampons in your purse, your bag?" And I'm like, because you never know who's going to need one. And I swear to God, it happens all the time where I am at an event and someone sees me and is like, "Do you have a tampon?" I'm like, I happen to have one here you go.

Jordan Harbinger: [00:47:03] Guys never think about this stuff obviously. I mean for obvious reasons. Nobody--

Jolene Brighten: [00:47:11] Well think about how much energy are women expending on thinking about their periods on planning for their periods, monetarily, purchasing everything they need for their period. How much energy are we putting into troubleshooting our hormones? How distracted are we by all of these things? And don't misunderstand me, anyone listening that I'm saying this makes the lesser. I'm saying that society needs to step up and do better because imagine if every woman freed up that bandwidth to contribute to society. Like wow, the world we'd be living in.

Jordan Harbinger: [00:47:41] Yeah, no kidding. I look at some of these things from the book.

Jolene Brighten: [00:47:44] I love how you're just scribbling too.

Jordan Harbinger: [00:47:46] Yes, so I have all of my notes from the book and then as we cover things I cross them out.

Jolene Brighten: [00:47:52] You went there.

Jordan Harbinger: [00:47:52] Yeah, yeah, pretty much. Hmm, kinda covered that, or that's less interesting now that I look at it in the context of the conversation. But the next thing that I saw here and I am skipping around a little bit--

Jolene Brighten: [00:48:04] It's all good.

Jordan Harbinger: [00:48:04] --because it's so interesting. One recommendation that you had, which is such a good idea, is to get lab tests and blood panels when you're fine so that when you feel like crap, you can go, all right, I know that this looks normal, but here's me healthy, here's all my metrics when I'm healthy from six months or a year ago, my metrics now you say are in the normal range, but they're not normal for me because I have a baseline. Most people don't get tests until they get sick.

Jolene Brighten: [00:48:31] Totally, I mean that comes down to the bio-individuality. The way we set reference ranges for labs is scientifically flawed because what we're doing is we are testing, whoever's coming in and then taking the average and looking at that and saying, okay, here's the reference range of what's normal. But who's getting lab testing? Like you just said, sick people and also elderly people. And so with that, I mean thyroid is a perfect example. If we're looking at the elderly population, their thyroid should be declining, but you can't take that and compare it to like a 20 something and say, oh well, you're within the normal range. So I had a practice in California and a practice in Oregon and the labs there would have different reference ranges, different reference ranges because of the population. So like vitamin D much lower in Oregon than it is in California in the reference range.

Jordan Harbinger: [00:49:20] Because of the sun.

Jolene Brighten: [00:49:21] No sun up there. That's why I lived there.

Jordan Harbinger: [00:49:23] That's why I don't live there.

Jolene Brighten: [00:49:23] Yeah, I know, I know everyone in California is like, how do you live there? I'm like, I'm actually Cali born and bred and I was like, I need to get out of the sun. Like, I need to go somewhere.

Jordan Harbinger: [00:49:35] I'm Michigan. So I've had enough no sun in my life.

Jolene Brighten: [00:49:37] Totally. So you know, I think it's really important that we do start getting these baselines. This is preventative medicine. This is where we need a paradigm shift. And people are always surprised when I talk about all this. And then they're like, wait, you actually have patients that go on birth control? Yeah, because it's not my job to make the decision for them. It's my job to support them and educate them. So if a woman says to me, "I'm going to go on any birth control." I'm like, "Okay, can you track your cycle for at least a month, if not three months." So we know you're normal. What are your headaches like? Do you have headaches? What are your emotions like? When did they come up? What's your skin like? What's your bowel movements like? We talk a lot about periods and poop in my life.

Jordan Harbinger: [00:50:17] Yeah sounds like my growing up in my family.

Jolene Brighten: [00:50:17] So we get that baseline and then we do baseline lab testing and then she goes on birth control of her choosing and we continue to monitor. And I have the, hey, this is when you call me up or when you come back and see me. Like if your mood starts to tank, we've got to think about changing this. And then we go through the big scaries. Like what does it look like to have a heart attack as a woman? It's different than a man. What does a clot look like? So this is where it's like don't call me, you know, call 911 or get to the hospital immediately kind of situation.

[00:50:45] So we're going through all of that and I've done the genetic testing so I can counsel her and screen for these things. And so just for people listening, it's also a Factor V Leiden is another thing that we look at. That's a very high risk.

Jordan Harbinger: [00:50:59] Factor?

Jolene Brighten: [00:50:59] V Leiden.

Jordan Harbinger: [00:51:02] Okay.

Jolene Brighten: [00:51:02] If you have a mutation in that, it's a very high probability. You're going to form a clot wall on birth control.

Jordan Harbinger: [00:51:08] So, you should know that before you go on the pill.

Jolene Brighten: [00:51:10] You should know that. And what doctors will do is say...Well sometimes they don't always ask these questions because the narrative is that birth control is safe. That like the side effects are so minimal and like we don't really have to discuss it and that might be true for like a 17 year old you're putting on it. But what happens when she's a 37 year old? These risks now change, there's different conversations we have to have. So in patients, we get the baseline labs, they monitor their data, that fifth vital sign, and then we retest and certain labs are going to be six months later. Cholesterol might be a year later where we're looking at what changes have happened and is this really working for you. And if we see several things start coming up, we can start to intervene so that she can be successful with that birth control choice. It might be that, okay, we're starting to see, you're having some issues with thyroid function. So let's make sure that we've got good nutrients going. Are you moving your body every day? We need that to activate our hormone. Like, how's your digestion? We start looking at all of these things, but I don't see this really being done with birth control otherwise.

[00:52:13] Most women are just given it and send on their way. This is one way that we can do better in women's medicine. Some people say, oh well these labs, it's like that's just adding extra cost. Having a cardiovascular event, having a clot, having--

Jordan Harbinger: [00:52:27] Yeah, having a stroke is expensive.

Jolene Brighten: [00:52:27] Having depression is not only expensive in doctor's visits and medications, but on society as a whole. So we have to look on at...There's also this quality of life factor as well. And everybody, you know, this is every doctor's goal is for you to be as healthy and vibrant as possible, and birth control may not work for you in achieving that goal and it might. And that's what I was saying, there's other formulations, so not all pills are equal. And some women, they don't do well on the pill, but they get an IUD and they're like, "This works, this is fantastic." So we need more research to understand what the heck is going on. But we have to stop bickering, whether or not women are telling the truth. Like women have been complaining of depression since the introduction of birth control and it's been dismissed, dismissed, dismissed, big 2016 study comes out, we're like, Whoa, this is a lot of really quality data. And then we saw in news outlets coming out dismissing it. No, no, it's just an association and so many women--

Jordan Harbinger: [00:53:23] And causation is not the same as correlation.

Jolene Brighten: [00:53:26] True. But how many women finally validated by science and then had that just like the rug pulled out from under them. And so we need to believe women's stories and we don't have to have a study to prove that what she's saying about her experience is true, but we do need to advocate for the studies and we need to start asking the question of why her and not her. Like how do we get better on that individualized counseling. Like how can I as a doctor be more predictive in what might happen when I prescribed the pill?

Jason DeFillippo: [00:53:55] You're listening to the Jordan harbinger show with our guest, Dr. Jolene Brighten. We'll be right back after this.

Jordan Harbinger: [00:54:00] This episode is sponsored in part by GoCar Tours. Okay. So it's not really sponsored by GoCar Tours, but my friend runs GoCar Tours and I love this. I routinely take every sort of visitor from out of town to San Francisco on a GoCar Tours. So you zip around the city with an automated GPS guide. So the car itself has a personality. It gives you a tour of the city. It's the best way to explore a city in a short amount of time. Jenny and I did one of our early dates in San Francisco and we explored the city before we moved there. I recently went with another couple of friends. I took my dad on this tour. It goes fast. It goes like 35 miles an hour and it goes anywhere a car can go except for highways and bridges and trust me, you probably should avoid those. It can even dominate the deep slopes of San Francisco.

[00:54:47] People wave at you, tourists will take photos of you. It's really, really a lot of fun. You can see it in San Francisco, Monterey, California; San Diego; Madrid, Spain; Barcelona, Spain; Lisbon, Portugal; Porto, Portugal; and Bordeaux, France. They've got electric cars that are going to go even faster coming soon. This is the best way to see a city. You'll find stuff that tour buses can't even get to, a bunch of stuff that you won't find on your own, and it does the route for you so you're not trying to figure out, "Do I make a left? Do I make a right?" You're going to all these cool little hidden spots that the car tells you how to get to and then when you get there, it tells you some of the history and you zip around. It's a hell of a lot of fun. gocartours.com.

[00:55:25] This episode is sponsored in part by DesignCrowd. Crowdsourcing, it's how busy people and business owners get stuff done these days. You can focus on running your business and you don't have to worry about design logo, web design, t-shirts. Hand that over to designers from around the world. DesignCrowd, crowdsources custom work based on your specifications. You pick the design you like best. Here's how it works. Go to designcrowd.com/jordan. Write a brief describing what you want from the art that you need. So yeah, I need a logo that incorporates penguins, red and purple, and also something that looks like the penguins covered in hand cream. I don't know, whatever. Maybe you should actually just start from scratch if that's your logo, but you can hand those specs over to a designer from DesignCrowd. DesignCrowd invites 725,000 different designers from Sydney to San Francisco to respond to your spec sheet within hours. You get a few designs over the course of three to 10 days. A typical project, we'll get 60, a hundred, maybe even more than a hundred designs or different pieces, spec designs from designers around the world. You pick the ones you like best, then you pay the designer and if you don't like anything that's submitted, DesignCrowd offers a money back guarantee. Jason?,

Jason DeFillippo: [00:56:42] Check out designcrowd.com/jordan. That's D-E-S-I-G-N-C-R-O-W-D designcrowd.com/jordan for a special $100 VIP offer for our listeners or simply enter the discount code, Jordan, when posting a project on DesignCrowd.

[00:56:57] Thanks for listening and supporting the show. Your support of our advertisers keeps us on the air to learn more and get links to all the great discounts you just heard so you can check out those amazing sponsors, visit jordanharbinger.com/deals. And don't forget the worksheet for today's episode. That link is in the show notes at jordanharbinger.com/podcast. If you're listening to us in the Overcast player, please click that little star next to the episode. We really appreciate it. And now for the conclusion of our episode with Dr. Jolene Brighten.

Jordan Harbinger: [00:57:26] Are there evolutionary reasons for things like PMs or irregular periods or something like that, or is that just a disorder, so-called disorder?

Jolene Brighten: [00:57:34] Well, you know, it's something that I really like to see women's medicine move away from like calling us dysfunctional and stuff because usually what it is is a physiological adaptation to what's essentially like an evolutionary mismatch. Like again, animal you haven't evolved to catch up to like carrying a computer in your hand all day and just looking at that. Those lights disrupt our melatonin in our brain, disrupt our cortisol, and have an effect on our sleep. And all of that has an effect on our hormones. So when we see symptoms of PMs, that's usually coming up in the luteal phase, so just before your period after ovulation. So, and it's usually about, give me three days, five days, seven days. If it's more than seven days, that might be something more significantly PMDD going on. So, which is a highly controversial one because there are people who are like, that's just a diagnosis because they got a drug for it. And other people are like, no, this is legitimate. And I'm like, at the end of the day, I just want to know that we have done our due diligence in working you up and I want you to feel better. And I'm not going to argue what is going on here.

[00:58:36] So with PMs, we often see estrogen dominance going on, so excess levels of estrogen and either that's relative to having low progesterone or just endocrine disruptors coming in. We're not moving our bowels or drinking enough water so we don't eliminate the estrogen. There's something going on with our liver. Maybe we're not getting enough B vitamins and nutrients to support our liver in packaging up the estrogen correctly. So for the super nerds, you can go to the birth control detox 101 chapter of the book, which is...You know those things, like when you write a book and you're like, ah, I'm in it. People understand this, and then it comes out, and you're like, I would've done that differently because people have taken it. And now, there are supplement companies running with it and saying you can't detox birth control out of your body, these hormones, unless you do a supplement protocol. And I'm like that's not what that chapter is. That chapter was about how you naturally detox your hormones and how you naturally detox the synthetic ones and how to support your body in doing that.

Jordan Harbinger: [00:59:33] So the pill depletes vitamins and things like that already, right? According to--

Jolene Brighten: [00:59:36] So many.

Jordan Harbinger: [00:59:37] --your work.

Jolene Brighten: [00:59:37] Not according to my work. According to like tons of studies.

Jordan Harbinger: [00:59:40] Yeah. I just mean I read that in your book. I didn't already know that. So according to the book, I have learned that it does deplete vitamins. I mean it causes all kinds of stuff. I just don't want to scare people away from it because there are plenty of good things about it. Although I will say one thing that was really interesting was that you're less able to pick up on subtle social cues potentially. What is going on?

Jolene Brighten: [01:00:01] Oh my god, so good. Let me just say though, like if you have PMs, there's a reason why. Investigate that. Just to like not leave people hanging there. drbrighten.com got you covered. You can go check it out or grab you on the pill. But to talk about the subtle social cues, this study just came out and it is very interesting. So it's not the interpretation of like, are you happy or are you mad? It's like, are you proud? These more complex emotional expressions on our face. Now we know from other research studies that humans are not just verbal communicators. Like this is why on social media it's so easy to misunderstand a comment.

Jordan Harbinger: [01:00:37] Yeah. You get a text and you're like, screw you. They're like, no, it was a compliment. Oh, got it.

Jolene Brighten: [01:00:42] Yeah, yeah, because you're not there. You're not reading the social cues. So, you know, in this, it was about a 10 percent deficit and the researchers like it's really mild. And by the way, if it was something substantial, we would have noticed it by now in women, which I laughed and I said to my husband, right? Like how you guys notice our hair cuts. You won't even notice if we chop off our hair, but you notice that I don't have empathy.

Jordan Harbinger: [01:01:06] Sure. And then 10 minutes later he goes, did you say something? I was reading. Yeah.

Jolene Brighten: [01:01:11] So you know, with that not picking up on these subtle social cues, we may be less empathetic. We may be more aggressive in how we engage because we're not understanding the messages. And this doesn't just impact like our romantic relationships. But researchers are calling into question, how does this affect how we mother, how we are a boss, how we are a coworker, like how we are in a mom in a mom's group or a teacher like these other ways that we interact in society. And in addition to that, there's this part of being a woman that men never really have to think about and that's like every day that we leave our house, there is a potential threat of violence against us. And it's something that we run in the background of our minds. And what is interesting about being on birth control is that we've also seen the way it affects the brain. We're more likely to engage in risky behavior, that we are more likely to put ourselves in more dangerous situations because we're not picking up the danger signals in the same way.

Jordan Harbinger: [01:02:09] That's super scary.

Jolene Brighten: [01:02:11] And it messes with our HPA axis, hypothalamic pituitary adrenal axis. So that we can be in a constant state of like, it looks like we're under stress but we're not getting the appropriate fight-or-flight cues, and not tuning into that. So these subtle social cues, it's like when a woman's like I don't know what made me decide not to walk down that street when I saw that guy, but then you know, I found out the next day a woman was assaulted on that street. Like things like that where women can't articulate why they made the decision and we get these logical male counterparts. Women are very logical as well. But the logical male counterparts who are like, well no, like you know that because you thought X, Y, and Z. There is something very primal going on in terms of what we're picking up and how we're scanning our environment. And it makes sense from an evolutionary perspective because our role wasn't to go out and hunt and kill the meat and bring it back. Our role was to survey. How is everybody doing in the tribe? How do we make harmony? How do we keep everyone moving together? What's going on with the food supply right now? How do I like to monitor this? What's going on? Like we were multitasking on these things. That's why the female brain is different than the male brain.

[01:03:18] I love how, you know, we saw what was like the '80s and '90s like who's better? No one's better. They're complimentary. Well, no one's meant to be better than somebody else. We're meant to work together. That's like one of the biggest mistakes we've made in society. It's like not bringing both genders brains to the table to be like let's solve these problems. Because women's left lobe, right lobe is better connected than men's and especially at certain points in her menstrual cycle. So it's one of those things that like when we start to look at that, whoa, we always see this with these early studies like these are not robust enough for us to really know. And nobody wants to vilify birth control. Of course, like nobody wants to do that like it's undeniable. We couldn't graduate college at a higher rate, we get paid more. We're CEOs. We're CEOs of tech companies now.

Jordan Harbinger: [01:04:06] Yeah, it's crazy. It's amazing.

Jolene Brighten: [01:04:06] These things are huge. I mean there's been a benefit, but we do have to start to question of like, "Wow, how is this impacting how we show up in the world and how is this impacting our community?" Because we know the community is huge in health, but also longevity.

Jordan Harbinger: [01:04:21] Yeah, and I think we're finally getting three steps forward, one step back and just go, oh hey look, we don't have to throw the baby out with the bathwater, but maybe we should make sure that while you're being as an awesome CEO, you're also not giving yourself higher risk of stroke and screwing up all of your fertility options for the next couple of decades. Last but not least. What if my, well, not my doctor, but what if I'm listening to this as a woman and I'm going, my doctor, I went to him or her and he was laughing at me or said like, "Oh, Jolene Brighten. She's a freaking quack. What if they won't listen to me."

Jolene Brighten: [01:04:55] Oh, I had a friend say, if they're not calling you a quack, you're not thinking for yourself. I think it always cracks me up because it's one of the most irrational ways to try to set...I'm like, what are you eight on a playground name calling now? Like let's just have a dialogue. And maybe in 20 years, I was wrong about some of the things I thought, but that's science. Staying humble and curious and saying like, we don't know everything and that's okay, but we can learn.

Jordan Harbinger: [01:05:22] There's going to be an old dude doctor out there who goes, "Oh, young lady, you don't know what you're talking about. I went to medical school in the '60s. You're full of crap. This doesn't affect the brain, it's just birth control."

Jolene Brighten: [01:05:33] Yeah. You know, and it's this funny thing that like when you look through the evolution of women's medicine of how quick people are to dismiss. They're like there's no evidence of it, it's totally safe. And I'm like, they've said that before. What drugs have we been put on that's actually harmed our fetuses? Like you know, what about like when they were sedating us and barbarically removing babies from our bodies because they thought that was best for us. There's been a lot of times...I mean, we were hysterical for like, I mean even back in the 1960s, there were still doctors being like, no, this is hysteria. Like I think my uterus wanders my body as just saying now my brain, pissing me off. No, it's you, it's actually, you know.

Jordan Harbinger: [01:06:08] Is hysteria is one of those like medical definitions that's just not a real thing.

Jolene Brighten: [01:06:14] It's not a real thing. No. Not a lot of people know this. I love old medical textbooks. So actually for my honeymoon, my husband like took me in...The first place we went is a rare book room full of old medical textbooks. And I just sat in there all day and went through them. So they actually own some of these. And I crack up that like I have one, it's like in the 1950s, it's endocrinology. It still has hysteria in there. It still has these incredibly sexist ways that like women's bodies were viewed and treated by medicine. And so it's something that like, if we can't learn from our past, that we need to be humble, we need to stop trying to conquer the female body, and they get just a smaller version of a man. I mean, there's so many doctors are like, that doesn't happen in women.

[01:06:56] There's no study actually because all we ever did was a drug trial on men. And then we were like, same, same, give it to a woman. So we just grow, the human in our body. I mean, that's got to be the same, right? I mean it's the same thing with birth control. Like we were talking about. If men knew this, they wouldn't do it. And yet what we do with birth control is we basically shut down our ovaries. It's a form of reversible chemical castration, so to speak, of like you've stopped the sexual organs from functioning. And imagine if we said that to men with, you know, we were going to give you this and it's going to stop your testicles from working--

Jordan Harbinger: [01:07:31] Or just you can never have an erection. Like we have a whole industry of guys that are trying to make sure that that never happened

Jolene Brighten: [01:07:38] And totally covered by insurance and no one ever debates that. But to your point about like what do we do about these doctors? So, okay, so one thing is that, maybe that's just not the right doctor for you, and you need to get a second opinion. I have had women tell me, "I took the book in, I actually printed out the studies that you have in the book, and my doctor wouldn't even read the studies." And so I'm not going to read those. So first they go with, there's no studies and next they go with, well, I'm not going to read those studies. I'm like that's anti-science. You just can't do that. Like there's a bit of ego in medicine and that certainly exists. And I think that we need to recognize that. And it's why so many women feel frustrated.

[01:08:14] There are people there that are like MDs are enemy. I'm like, they serve a very important role in society, um, no. And some of my best friends are medical doctors and like, and they're like I wasn't taught all this stuff, nutrition then. I'm like, yeah, but you were taught to save lives and that's really, really important. So again, just male brain, female brain, no one's better. Everyone has a place, same in medicine. So it may be that you didn't need a different OB/GYN. It may be that you need to go to a different kind of doctor. So if you're looking for root cause medicine...I like to use the analogy of like if you go to the sandwich shop and you ask for ice cream, you're going to get pissed. They're going to get pissed.

Jordan Harbinger: [01:08:51] You go to the what shop?

Jolene Brighten: [01:08:51] Sandwich shop. let's just talk about food. My analogy is really always about food. Let's go to the sandwich shop and ask for ice cream, right? Well, they don't serve ice cream, so now you're mad at them for not serving my ice cream and they're mad at you for asking for it. What you needed to do was go to the ice cream shop so you could get what you want. It doesn't mean the sandwich maker is bad. So then just to say is not if you're like, I want to work on my body from a root cause perspective, I actually want to understand it. I want to work with nutrition. Your medical doctor is very unlikely to have any substantial nutrition education, if any at all. It's the wrong place for that. Like you need to go to a different doctor, find a naturopathic physician, find a functional medicine doctor to do that work.

[01:09:33] Does that mean that your OB/GYN is bad? No. They might be great to go for your well-woman exam, get your Pap smear, talk to them. I mean certainly if you're my patient, I'm like, yeah, you're going to have a gynecologist as part of your team because if I think you need an endometrial biopsy, I have to send you to them. Like that's what they do really well. So, and maybe that you need a different doctor in the same genre or you need a different doctor all together in this. The other thing is that encourage women based on what you're trying to achieve, get into Beyond the Pill. And chapter four is what I call the Dakota Ring. Like you should've gotten that with your cracker jocks and when your period came so that you're like, oh, this period problem.

[01:10:11] That's what it means. And so with that, if you get into the book and you're like, "I have heavy periods, that's my problem. My doctor says birth control is all I can take. Why wouldn't they want to give that to you by the way? If they're like the pill for every female ill and it works the majority of the time and it makes these symptoms go away, fantastic. Right? They would definitely want to offer you. There is another way. I mean that's part of why it's called Beyond the Pill. And so in that chapter I go through, here's quantifiable data. So always talk to your doctor and quantify a little data whenever you can. That is, I have heavy periods. What does that mean to them? You need to explain, I change a tampon every hour for like two days out of my period or my clots are bigger than a quarter.

Jordan Harbinger: [01:10:49] Every hour? Is that a real thing?

Jolene Brighten: [01:10:51] Yeah. That's menorrhagia. That can happen.

Jordan Harbinger: [01:10:54] How inconvenient.

Jolene Brighten: [01:10:54] Very inconvenient. Not to mention that like you could be anemic and it could have driven you to anemia and then anemia can make that worse. So, and that's the kind of thing like you get into the trapdoor, you get, okay, here's what I should be recording. Here's the lab test to talk to my doctor about and here's what might be going on. So you can go to your doctor more educated for a more productive conversation. Like, Hey, I know you said I could take birth control and having these really heavy periods. This is what they look like. Could it possibly be fibroids? Like what would you think about maybe doing an ultrasound? Or could I be anemic? Could we possibly do blood work with that? That works a lot better to get what you want and that situation, there is this movement of unlicensed professionals out there who like to say your doctor works for you. Go in, tell them what to do, like they work to you or you fire them. And I'm like, don't talk to any human like that. Because what happens when we talk to humans like that, fight, flight or freeze. Those are the options. We get a stress response. So your doctor is going to push back, maybe yell at you, laugh at you, make you cry. Maybe they leave the room as fast as they can. So they take flight and they're fleeing or they shut down and they're no longer listening because now they froze. And it's not because they're a bad person. It's because they are a person, like they're a human at the end of the day. And so with that, if you know how to communicate to your doctor, you can be a lot more productive. Did your doctor ever laugh at you about your concerns? That's a terrible bedside manner. Like I can see like there might be times where you're like, Oh yeah, like I giggle because I've been there too. Like I totally know that feeling, but not to be like you're seriously concerned, ha-ha-ha, you're so silly and stupid for that.

Jordan Harbinger: [01:12:28] Yeah. I think if your doctor laughs at you and it's not because you're actually trying to be funny, you should probably switch doctors. Thank you very much. This has been really enlightening even for a guy who does not menstruate as far as you all know.

[01:12:43] So interesting was not lying right. The whole birth control pill and your body thing. I think I'm going to do another one of these about just how it affects the brain. That's so fascinating. Just the way that medicine and hormones and pills and things that are supposed to do one thing, can change our behavior. Wow. That is my jam.

[01:13:00] Great big. Thank you to Dr. Jolene Brighten. Her book is called Beyond the Pill. I'm going to link to that in the show notes. There's a video of this interview on our YouTube channel at jordanharbinger.com/youtube. And there are also worksheets for each episode so you can review what you've learned from Dr Brighten at jordanharbinger.com and that's in the show notes.

[01:13:18] We're teaching you how to connect with great people and manage relationships using systems and tiny habits. That's our Six-Minute Networking course and it's free. It's over at jordanharbinger.com/course. Dig the well before you get thirsty. Don't try to make relationships when you need them because that's when people go, of course you're only calling me because you need something. You got to dig that well before you get thirsty. Start those relationships now. Help other people now get what they want. Create that network. Procrastination leads to stagnation when it comes to personal and especially business relationships. The drills, again, they take a few minutes a day. I wish I knew this stuff 20 years ago. You'll find it for free at jordanharbinger.com/course. And by the way, most of the guests you hear on the show, they subscribed to the course and the newsletter. So come join us and you'll be in smart company. Speaking of building relationships, you can always reach out and/or follow me on social. I'm at @JordanHarbinger on both Twitter and Instagram.

[01:14:17] This show is created in association with PodcastOne and this episode was produced by Jen Harbinger and Jason DeFillippo, and edited by Jase Sanderson, show notes and worksheets are by Robert Fogarty, music by Evan Viola. I'm your host, Jordan Harbinger. Our advice and those of our guests are their own. And yes, I'm a lawyer, but I'm not your lawyer. Jolene is a doctor, but not your doctor. So do your own research before implementing anything you hear on the show. And remember, we rise by lifting others. The fee for the show is that you share it with friends when you find something useful or interesting, which is hopefully in every episode. So please share the show with those you love and even those you don't. Share this show with people that have been on the birth control pill or currently are married or dating to somebody who is. In the meantime, do your best to apply what you hear on the show, so you can live what you listen, and we'll see you next time.