Is Your Doctor Gaslighting You? The Power of Tracking to Reclaim Your Health with Laura Federico and Morgan Miller

In this insightful and deeply validating episode, Lauren Bernick speaks with Morgan Miller, CPM, LM, IBCLC and Laura Federico, MS, LCSW, CST—therapists and authors of The Cycle Book: An Interactive Step-by-Step Guide to Tracking Hormones and Knowing Your Body.

Together, they explore the power of body literacy across the lifespan, from puberty to menopause and beyond. The conversation covers PMDD, fertility, endometriosis, fibroids, and the emotional terrain of aging. Laura and Morgan share how tracking your physical, emotional, and hormonal cycles—not just for fertility but as a form of self-knowledge—can transform how you advocate for yourself in healthcare and relationships.

Whether you're dealing with reproductive health issues, curious about sex therapy, or simply trying to understand your changing body, this episode offers clarity, compassion, and tools you can actually use.

Key Takeaways:

• The Cycle Book is more than a tracker—it’s a framework for tuning into your body’s patterns and needs.
• PMDD can disrupt every aspect of life, including fertility and mental health.
• Sex therapy supports both sexual and emotional connection—it’s not just about “fixing problems.”
• Many infertility struggles are linked to a lack of cycle awareness and body education.
• Hormonal tracking helps you make more informed choices in everything from medical care to relationships.
• Menopause is a unique journey; tracking symptoms can guide more personalized care, including hormone therapy.
• Conditions like endometriosis and fibroids are common but often overlooked—self-tracking can be key to getting a diagnosis.
• Cultural myths around aging limit women’s potential; curiosity and risk-taking can redefine the experience.
• Self-awareness is a form of power—and every woman deserves access to it.

Resources Mentioned:

• The Cycle Book https://www.itslauraandmorgan.com/
• https://www.instagram.com/thecyclebook/

Follow us and reach out at:
Email: lauren@agelikeabadassmother.com
Facebook: @WellElephant
Instagram: @agelikeabadassmother

#HormoneHealth, #PMDDawareness, #PerimenopauseSupport, #CycleAwareness, #WomenOver40Health, #TheCycleBook, #DecodeYourCycle, #EmpoweredHormones, #BodyLiteracy, #AgeLikeABadassMother, #GenX, #Podcast,

Transcript

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Hi, friend. If you've ever felt like your body was speaking a language that no one taught you, this episode is your Rosetta Stone. My guests are Laura Federico and Morgan Miller, the brilliant minds behind the cycle book. And they're here to help you decode the mysteries of your cycle at every age and at every stage. Whether you're battling PMDD, navigating perimenopause, or just trying to figure out why everyone in your house is enraging you all of a sudden, this is a conversation that you'll want to hear and maybe even share with a friend. If you're a regular listener, you've heard me talk about how I reversed my heart disease and lost 20 pounds by following a whole food plant-based diet. If you're ready to add more plant-based meals to your life, head over to my website, wellelephant.com. After this episode, and download my free cookbook. It's my gift to you. And if you're really ready to get serious about your health, check out my online class while you're there, Ace Plant-Based Eating. There's a discount code on my website for you. Thanks for listening. You know how much I appreciate you. Now here we go. Hi friend, I'm Lauren Burnick and I'm flipping the script about growing older. From rebels and rule breakers, to wellness warriors and wise women. My guests have been influencers since before that was even a thing and we're not even close to finished. Welcome to Age Like a Badass Mother. Laura Federico is a psychotherapist and ASEC certified sex and relationship therapist in private practice. Morgan Miller is a certified professional midwife, lactation consultant, activist, and birth center founder in private practice. Their website is it'slaurainmorgan.com. Their Instagram is at the cycle book and the cycle book can be found anywhere you buy books. Please welcome Laura and Morgan. Hi. Thanks for having us. so thrilled you're here. uh Because I mean, I read your book, The Cycle Book, and honestly, I am just kind of floored at how little I understand what's happening to my body. And it's embarrassing. I mean, I have some stupid questions for you. So get ready. But first, just I want to talk about uh You know, I love that you guys were friends first. Can you talk about, you know, your friendship and how you knew each other and then how you started writing this book? Yeah. Also, no stupid questions. None of us were taught literally anything about our bodies. Morgan and I have been friends since we were in our early 20s. We met in New York City and uh we met because Morgan was part of this group of really cool women that I was living across the hall from in like a very sketchy building in Williamsburg. And I just kind of tried to like make my way into this friend group. And Morgan was this like very cool artist and she was always like totally together and she always had cool jobs. She worked in art galleries and I was like, can we be friends, please? And then she let me. uh And, you know, through a series of tragic relationships and bad choices and matching tattoos, here we are in our 40s. Wait, you got matching tattoos or you had? What are they? Such a good question Laura, do you remember? You don't know what your tattoos are? Well, we have you a lonely wildcat. Wait, say that again, what? You're making us talk about our embarrassing tattoos. You said nothing was off limits, I asked you before! Our first matching tattoo says, welcome to the new paradise, you a lonely wildcat. m And then it's from an art installation that was in Brooklyn when we were living there. It was on a billboard. It was on a billboard on the street that we lived on. And in our 20s, we were very moved by this. That's the thing about tattoos. I still think it's cool. I do not. don't have any. For sure. But the thing is now my skin is changing and I'm like, well, I don't even know where I'd put it. Probably just on my wrist because it's only thing not creeping out on my body. Maybe my ribs. don't know. Yeah, for sure. just never thought like of anything. Well, you know, just of what I really want to have on my body forever and ever. I think I gave it too much thought and now here we are. But so, okay, what are your other matching tattoos? What's your other ones? We do have some tattoos that were late night decisions in the Bahamas, Laura. Stick and pokes, yeah, we have some stick and pokes. uh It's a true testament to the like deep relationship that we're working with before we became professionals and existing in the world in other manners as well. my gosh, I love it. And you guys are typically, I guess you're a little younger than, um you know, people I usually have. How old are you guys? 40. Okay, that's such a good age. I loved being 40. I did. loved all of my, well, you know what? I've liked all my ages, to be honest. I'm 56. I'm about to be 57. And I've loved all my ages, but 40 was so good. And I had such a fun party for my 40th. I went to Vegas with my friends and it was really fun. mean, well, I go to Vegas with my friends often, so that's maybe not often, but. It's not so unusual. But um okay, so you became friends and then how did you know that there was this lack? What is that story? Yeah, I mean, I think Laura and I entered into our respective professions as sex therapists and as midwife, really on trying to fill gaps in care that we experienced for ourselves. Like Laura said, as friends, we do the things friends do, which we share the difficulties in relationships that we're having and confide in one another. We talk about how our bodies are changing and what it means and how to understand it. And for whatever reason, we went into that professionally as well. So Laura and I were really able to use that friendship in a networking, real professional way where we could really rely on each other when we had clients and do amazing consultations and really expand our care. And as we did that over the years together, there just was always this common thread of people, often in a moment of crisis, coming to us for some level of clarity around their. health experiences or being in the world in their body. And Laura and I just over and over again, we're like, we gotta hit people before this moment of crisis. Like, how do we do this and avoid people having to get into that place? But one of you was having, uh was it infertility or who was that? Yeah, that was me. So I have uh PMDD, which is premenstrual dysphoric disorder. And there's so much we don't know about what that means. And when we're talking about PMDD today and this idea of prevention, something that comes up a lot for us is PMDD as it relates to fertility medications, PMDD as it relates to perimenopause, PMDD as it relates to when we're kind of hitting the tail end of perimenopause, there's just so much information that we don't have. Not only do we not know enough about premenstrual disorders, but we definitely don't know how a person with a premenstrual disorder might be impacted by some other hormonal experience that they're going to go through, including HRT. And so for me, when I was coping with infertility, And I was reliant upon the doctors that I was seeking care from. And the only option they had for me were medications that impacted my hormone levels. And I was saying to them, I am pretty sure this is not how I'm supposed to be feeling. Like I feel absolutely horrible. I feel physically ill. I feel deeply mentally unwell. I'm not getting my period anymore. I'm pretty certain I'm not ovulating anymore. how can this be getting closer to pregnancy when it feels like all of my systems are shutting down and there weren't any options for me and there isn't any research out there. And so that's actually how I came to cycle tracking and how I came to this concept of, hey, there's a lot of information about my own body that no one ever taught me. I mean, I came to Morgan crying and saying, I'm so lost. I do not know what to do. And she was like, my God, what's wrong with you? Why didn't you come to me earlier? But I was really full of shame and I was really embarrassed and I was really lost and I honestly didn't know what to do. And it was learning about my body that changed absolutely everything for me. Not only did I learn how to say no to treatment options that weren't working for me, but I learned how to have enough information about my body so I could better tailor the treatment options that were out there. And ultimately, I ended up working with a reproductive endocrinologist who said to me, oh, let's try this intervention without fertility medications. And I got pregnant the first try years into this process. Wait, say that again. You got pregnant without fertility medic. What did they do? So we did an IUI without fertility meds. Wait, what's an IUI? Morgan, would you accept? And you're beautiful midwife way Okay, wait, hold on. Before we say what's in, and don't let me forget what's in IU. Okay, well just say what it is, and then I have a question. IUI stands for intrauterine insemination. So it's a way of taking like a sperm sample and placing it directly in the uterus, very close to the uterine tubes where like an egg would be and conception would occur. Okay. I figured it was going to be intrauterine something based on IUD. You got it. I figured that one out. um okay, I want to go back to PM, what is it? DD? Yes. How did you know you have this or what is it exactly? Yeah, so what we think today with the research that we have is that there are likely a cluster of symptoms, uh excuse me, a cluster of conditions under a kind of premenstrual disorder umbrella, including PME, premenstrual exacerbation of an already existing condition, and PMDD, which is slightly different. So really what we're saying is that there are a number of conditions that people have where they have hormonal sensitivities. uh a hormonal shift can create a change in how they feel. And it's not because their hormones are unbalanced. It's not because there is something wrong with the hormone levels that they have in their body. It's that with a typical hormonal cycle, the menstrual cycle, changes that happen over the course of someone's lifespan with their hormones, that the way that those shifts impact them causes a series of symptoms that we're kind of categorizing. And so for PMDD, that would be uh major mood shifts, uh physical pain. uh It includes rage, uh rejection sensitivity. uh People's relationships are often deeply impacted. For me, I can say what happened was my moods were so different that at the age of 19, the people in my life had a literal intervention. And they were like, Laura, something is not okay. You need to figure out what is going on, but this is not normal. And I'm actually quite lucky that I got this diagnosis when I did because for most people, takes years of suffering. multiple visits to multiple providers before they actually get this diagnosis, and then they can figure out how they want to treat it. But it's a really intense experience for a lot of people. And there's also a higher risk of uh suicidal ideation for people with MDD because we're feeling such different feelings. And it's usually from ovulation through the luteal phase. for a lot of people for two weeks out of every cycle, they're feeling like a different person than they do for the others. So for me, I was like breaking up with people and then being like, when I started my period, being like, my God, what did I do? And at the time I was like, this is over. Like, I can't believe I was ever in this, like move out, you know? And it was, it was really tough. Okay, so here's stupid question number one. um Is this so back when, I guess my generation, called it PMS, is this the same thing? No, it's different. Okay. So it's a completely different thing. Cause that, you know, rage and all that, I feel like that's a thing that I associate that with. Is PMS still like a thing? Is that just a different thing? So uh what researchers are attempting to do in categorizing this differently is uh create a spectrum of intensity of some of these symptoms. And so for PMS, we would say, hey, there's going to be some changes that happen because of hormonal shifts. And what we're trying to do through this book is give people the language to identify what those are for them. And then to also say, with pain, with emotional changes, with mood changes. Hey, some of this, we might say, that sounds pretty typical, but if you are like on the floor crying in pain, throwing up from pain, maybe that's not PMS. And maybe we're talking about something different for PMDD. If you are blowing up your life for two weeks out of every month and then waking up the day you start bleeding and saying, oh, like, I don't know why, like, you know, walked out on my lease and kicked out my boyfriend and like move to a new state. Like, you we might be like talking about something a little Yes. Okay. That sounds different. um I want to ask you, okay, so you got pregnant right away with this new treatment. Okay. um And I want to come back to this and then I guess how that relates to the cycle book. But before we get too far away, I want to ask you, um for being a sex therapist, what's the most common reason that people come to you? I love that question. I love the work that I do. And I would say the most common reason people come to see me, and I can't speak for other sex therapists, but is that people want to feel free and they want to feel more pleasure in their lives. And they are stuck and they don't know how to make that happen. Is it couples usually or? Yeah, I see couples, see individuals, I see people who are in uh polyamorous relationships, so multiple uh parts of that relationship. uh Yeah, and it's people who, honestly, they want to feel good and they're tired of feeling stuck and it can show up in a lot of really specific ways with sex, but it can also show up relationally and in the rest of their lives. uh You know, people are out there like doing. amazing work and really like living these amazing lives. It's very inspirational. Hmm. Is it? Are they usually stuck in other areas of their life too? Yeah, I would say so. I think something that I've learned, ah you know, the more I do this job, the less I know because people are so different. ah But something that I've learned is that this stuff is also connected. And if we're feeling trapped in one part of our life, it isn't a reach to say that we might be feeling stuck sexually as well. Yeah, I would think so. I think like in a, I mean, I guess I can only speak about a hetero relationship since that's what I've been in is that I feel like it's a barometer for the whole relationship, you know, your, your sex life. It's not everything, but it's a lot. mean, it definitely keeps you emotionally connected too. And I feel like that's if you're sex life is off or you don't want that person. It's not because maybe you don't want sex. It's because you're maybe resentful of that person or, you know, it's just like I said, it's like a barometer. Do you find a lot of that with your clients or? Yeah, I think what you're saying is so spot on because it's not just arousal and libido that we're talking about. We're talking about how someone feels in every aspect of the relationship. I mean, you mentioned like resentment. Like what are some of the other things that you've noticed in relationships that like lead to sex or not being like a priority or not working or not feeling good or not being present? Like, I mean, these things are so important. if we're not feeling taken care of, we're not going to be feeling generous when it comes to like sharing our bodies, you know, if we're not feeling seen in other parts of the relationship, we're not going to be ready to see someone else in this area, right? Like it's, it's, it's so connected. Yeah, that's interesting. then, um Morgan, so can you talk a little bit about infertility and that, what we were just kind of talking about? Yeah, mean, I think commonly in my practice, I do quite a bit of like the full spectrum of people's care throughout, you know, their reproductive cycles and in and around before and after. But a lot of people come to care when they're trying to conceive and maybe have one of these like unexplained infertility diagnoses or they've been trying and it's not working. And it's really unfortunate that a lot of the common threads that happen when people walk into the room are really around people not having information about their bodies and how they work. And that's, that's like one of the biggest hurdles that we have where people have been relying on information that was either a little faulty and not accurate or just there wasn't the information there and then they've been trying to conceive for like years potentially and that's time that you don't get back but we you know are able to connect and find out if the method that they've been using whether it's timing intercourse or taking certain medications or anything like that have been effective or not that we can kind of switch gears and find a better path. for them, but the most common thing that happens is that we have to backpedal and do a little bit of this 101, how do our bodies function and how does yours individually function and how does your body communicate what its needs are in and around life, but also things like fertility and start there and just find that framework and learn that language. That's usually the biggest hurdle that we have to hop into with clients right away is just that baseline understanding. Because not all of us are even getting a sex education in middle school or whenever. And if you got one, probably sucked. And that's, so I guess that's why Laura came to you when she was experiencing this. then, you know, I guess, would it be helpful for you guys to give us a little primer and, you on our bodies to start with? Yeah. mean, and tracking. Yeah, I mean I think Go ahead, Morgan. You're so good at this. And something that Morgan said to me, which truly changed my life, is she was like, your hormones are communicating something to you. She was like, the way that they show up in your body is telling you something. This is not a problem. It is not something that needs to be fixed. It is literally a direct system of communication. And I was like, you know, that just like changed how I thought about hormones, like from that point on. Yeah. so just to finish your story, Laura, so you got pregnant and then I guess had a baby from that, hopefully. Yeah, I have two daughters and yeah, mean, it feels also so important when you think about all of the people who are new in this world who are also not going to get this information unless something changes, that this is something we are desperate to correct. And we're really not talking about rocket science. And when Morgan explains this in a second in such an approachable way, it feels extra criminal that we're just not getting this particular part of our body knowledge in any sort of useful educational setting. Yeah, I agree. Okay. So Morgan, I'm going to say take it away, maybe gear it towards a little bit more perimenopause for this audience, think. context is people maybe can pull up in their mind or remember being shown like a uh chart that shows you're changing hormones during the menstrual cycle. There's kind of this idea that they go up and down these basic hormones that happen. Unfortunately, when we're growing up in most communities, we're told things like you can get pregnant at any moment. It's, you know, be prepared, be afraid to sit on a toilet, like whatever it is. So we all walk around in fear of like, my God, it could happen at every moment. But then later in life, there's this realization that it's actually just this tiny little window that that exists in. And it's because of these hormones and these normal fluctuations that happen. The piece that I think is left out from the beginning that kind of changes how we process this information as we're given it when we're growing up and going to the doctor and things like that, is it's always wrapped around fertility, it's always wrapped around reproduction, it's always in the context of pregnancy. And for most of people's lives, all those hormones have nothing to do with pregnancy. There's just, maybe you have kids, maybe you don't, but that's not your entire life, that's just a little blip of it. And those hormones are still in your body, doing many different other jobs and functioning and communicating in all of these amazing ways. And it's such a lost opportunity if we've been ignoring them this whole time, because like Laura was saying, like all these things are, are chemical messengers. They're just communicators. And when you have, you know, something like a bleeding phase in your life where you have this like cycle that comes and goes, you get these phenomenal, like physical, literal, like tangible biomarkers to say what those hormones are doing and what they need. And as we enter phases in our life, like perimenopause and intimenopause, that hormonal communication remains true. And so if you're only used to learning like bleeding phase means this, like I pay attention to bleeding because I have to have tampons on board and not, you know, ruin my pants. And I may be preparing myself for like the PMS that I know that comes before. If that's the only context you have with those hormones and those hormonal cycles, things like perimenopause can like rock your socks off. because those hormones do so much more and interact with so many other aspects of our day to day throughout our cycles. And as they begin to shift into their new levels of norm, you're gonna feel all these wild communication that the hormones are doing, but not have any context for what they're trying to say or how they're saying your body needs new support systems that will work with you better at this phase. So that's where I really love to contextualize these hormones. outside of reproduction and say there are some key players, you know, for a person who has a uterus and has these hormones on board, it's like estrogens, progesterone, testosterone, all of the things that people associate with like feel-good hormones like serotonin, dopamine, and norepinephrine, like all of those things fluctuate regularly throughout a lifetime. regardless of having a baby and understanding how and when that happens as we enter through perimenopause into menopause and post menopause. We can have so much more grounding for knowing how to support what our body needs and what our mind needs and all of it. And so what do we need to know about? Why do we track and how do we know what it's communicating to us? There are some basic biomarkers that really delineate certain hormonal roles in our body. One that most people are familiar with is bleeding. So if you track bleeding, a lot of people have done that in the past for convenience. That does tell us a lot about what hormones are doing. But one of the other ones that's really helpful for a lot of people is tracking other body fluids, things like cervical fluid. That tells us about different hormonal shifts that happen between estrogen and progesterone and some of the other players on board. So really being able to identify what cervical fluid looks like in your body and how it presents itself is huge. And it doesn't take going back to school and taking like microbiology to understand what this magical fluid is. It really just another fluid that you might notice on your underwear or feel just walking around that it feels a little more slippery or moisturized. Or you might notice it on toilet paper. It's kind of like a clear, ooey gooey, slippery fluid, really similar to arousal fluid that people have, but it's outside of the context of any of that. When people are able to notice the trends and patterns of that cervical fluid presence, It can really give you a lot of grounding for those hormonal shifts. And then the other big biomarker is temperatures. Temperatures are like a really easy check for what's happening, especially with a hormone called progesterone. And in perimenopause, temperature is usually like on people's minds because you're experiencing those like temperature fluctuations on an hourly basis, whether it's- We're sweating. Yeah, hot flashes in the day or like- waking up in a pool of sweat and you're like, what is even happening? And a lot of that has to do with progesterone. So if we can pay attention to those temperature changes in a structured way, we can start to understand how our body is changing its needs with progesterone, whether supplemental hormones is helpful for us, whether supplemental hormones is working for us, if we need to change that dose, or if we need to change a couple things in our lifestyle to help balance progesterone. its own without a self. Yeah, would. OK, I my mind is racing because I want to go back just for one second, but I want to talk to you about progesterone. But, you know, I I loved in your book that you said there's like shame around bodily fluids. And I was like, oh, that's just so good to just even say that, because I guess we've just been, you know, conditioned to think that. And I mean, they are trying to tell us something. So like, what's the difference? between when it's slippery and when, like in the book you said, creamy. Like what are the, is it trying to tell us between those things? When it changes. There's normal vaginal discharge. Like discharge is just like not a cool word. So not only does that like add to the shame, nobody wants to talk about it. But all that discharge is, is like your vagina being so smart and sexy and it's like keeping that space clean and cool. And so there's a regular cell slough off. Like it just cleans that space. Little cells leave cause it's like refreshing up in here. And that's all that that is. And a lot of people experience it as like creamy or lotiony, kind of like a white that you see on your underwear. That's kind of that regular cleaning system, keeping things tidy. Yes, yes. It's a great system. And so that's a different feeling. think of how like toilet paper feels on your vulva when you're wiping. That creamy lotiony feeling is different than slippery and slick and really much more, um I guess like slippery is really the best description that I can find for that cervical fluid. So that is a different one. Cervical fluid tends not to be as white. It tends to have clear. It looks really similar to egg whites, truthfully. And so why is that coming out? Is that cleaning or is that different? that is a fluid that is a hormonal piece of preparing the body to ovulate, to release that egg. So that is something that's really helpful to identify when people are in the life cycle of potentially being able to get pregnant or trying not to get pregnant. It's a key indicator of that fertile window. And it's something really amazing to identify in perimenopause because those are things that shift and change. on the frequency that ovulation is actually occurring and the body is attempting to ovulate or stopping ovulating. So having that identification of that fluid tells you a little bit more insight of how much of that is happening and what kind of rhythm is going to change with each of the other hormones associated with the cycle. Okay. And then back to progesterone. So you were saying like that is when people are saying like, I'm having hot flashes and I'm sweating, that's due to progesterone, lack of progesterone. It's tricky because it's actually estrogen, but estrogen and progesterone have this like bestie relationship dynamic and Yeah, they matching tattoos from living in Brooklyn together. They go way back. um But progesterone is this hormone in our body that actually changes our baseline temperature, like our core temperature. And so that's a normal fluctuation that happens in the menstrual cycle where in the first half of the cycle, the follicular phase, your temperature is usually a little bit cooler than the second half of your menstrual cycle. where you're in the luteal phase, your temperature raises. So if you're taking your temperature regularly, you will notice that you have two different baseline temperatures depending on what phase you're in. And having that information when you're going into perimenopause is huge because you will start to notice when some hormones are less present than they used to be, that you might have less of that temperature fluctuation which matches the hormonal fluctuation. Or you might have way more of it where we're going up and down and it's really erratic and it feels less controlled in this way. So that will really steer people towards what type of support or therapy that they're interested in as they're, you know, sidewaying with perimenopause. Can you kind of give me an example? if you're trying to listen to your body and you're trying to track this, tell me what that's trying to tell you. So it depends because those hormones are related to everything. Something that Laura and I feel really adamant about is that people understand that everything is connected. It's not just about your uterus and your ovaries. It's about everything else in the world and in your body. So a lot of those hormones can be responsive to life circumstances as well as things inside your body. Morgan, really quickly, something that you share with me that comes up in your clinic frequently is around uh people's digestion, uh is around uh the ways that people are experiencing pain. And I would say something that I see in my work a lot is uh how people relate in terms of their mental health. to the world around them. So when we're trying to support people in using cycle tracking to help them understand what their hormones are telling them, the systems that they show up in most prominently can be different for every person. So for the person who's showing up to Morgan's office and it's like, I've been to like seven different GIs, like there's definitely something going on. I've tried like 10 elimination diets, like maybe it's IBS, but nobody can tell me what's going on. Morgan will do cycle tracking with that person often, and Morgan, maybe you jump in if I'm telling this in a way that's not correct. But it's not uncommon to see that certain stages of someone's cycle correlate with an exacerbation of GI symptoms, for example. And then we know that what's happening is a hormone communicating something about what the body needs in that moment. Morgan, you correct what I've just I mean, that's exactly it. So if we're tracking simple, easy to understand, like physical biomarkers, like the temperatures in the body fluids, then we have this grounding to understand how hormones show up in our body. But then if we start to track some of the other things that are important to us, whether it's, like Laura said, stomach upset or mood, brain fog. the night sweats, whatever these things are in our body, like the ability to access pleasure, like intimacy and relationships, all of these things. We can start to see how they interplay with those hormones. And if it feels like the hormonal changes that we experience through perimenopause are affecting those aspects of our life in a way that no longer feels good or serves us, then we need to learn new ways to set up supporting those hormonal changes. such as. uh that can look different for everybody. I mean, a big one, a big one, would say in perimenopause, which would be my like, scream it from the rooftops is that the relationship with these big hormones like progesterone and other things like cortisol is very sensitive and it becomes more present in perimenopause. Cortisol is a hormone that gets like a bad rap because people think of like, it's the stress hormone. But cortisol is like your best friend. Cortisol is what actually levels you out when you are stressful. So we like cortisol, it's good. But when you are feeling so stressed that your body just like keeps making cortisol and keeps doing it, some of the other hormones like progesterone have a harder time doing their job. They get kind of overloaded. And so you have a little of that more erratic sensation that people describe through perimenopause that doesn't feel as steady as it once did in their life. I read anxiety. Middle of the night pan. you going through this? Laura, you're having, both of you are? Yeah. I don't even think I knew I was in perimenopause. I think I told you this when I booked you on the show, it was several months ago. I told you I'm still getting my period at 56. I just started going through menopause. Like I haven't had my period in three months. And honestly, I'm like sailing. I haven't even noticed anything except I don't have my period. It's so different for everybody and the research has been so, limited because we particularly study male bodies and male cells. We don't study things that are difficult to control like fluctuating hormones. And so there's a lot that we don't know, but what we have learned and are expanding on now today is the understanding that for a lot of people, the perimenopause window prior to... stopping bleeding altogether for a lot of people is 10 to 15 years. And for many people starts in their mid thirties and that is normal, not early, but having more of this awareness of what that like steady, like gradual changes gives people so much more grounding than kind of waking up one night and being like, Oh my God, what's happening? had no idea because it's not like a light switch. It's just part of the evolution of being a human. And also to be fair, feel like Morgan and I, we've self-selected here a little bit, right? Like I've got PMDD, Morgan has pretty terrible endometriosis. it's not like we were like in the category of people who were like, I never had to think about this at all because everything felt great. So like maybe we're representative of like a certain group of people, but there are enough of us and enough people walking through our doors that we were like, this is just like, everyone needs to know this, you Yeah. It's, it's well, as you brought that up, um, and can you tell us a little bit what's endometriosis and what's, do have a big fibroid uterine fibroid tumor that my OB-GYN said, this is like embarrassing to say, but she said it's the size of a grapefruit. I always look like I'm like three months pregnant. I'm like tiny with a, m does she said no. It doesn't give me any problems. didn't even know it was there, but I was like, my stomach's so poochy. And she said, well, thought you knew you had this whatever giant fibroid tumor. I was like, she said, when you start going through menopause, this is like a few months ago when I saw her, she said it because when you don't have as much estrogen or I think that's what she said, it should shrink. She's like, so let's leave it if it's not bothering you, which is what I would. pick. I don't want to start doing invasive things for no reason. It's not bothering me. But do you think that's correct, that it'll go down? It does for a lot of people, for other people it doesn't, so it's a matter of if it causes you discomfort or not. But I think that's a potentially great path to go on if it's not causing any issue. Keep an eye on it, see if it goes. What is it from? What causes it? Fibroids are so much more common than people realize. They're really like thinking about what that word means. It's like fibrous tissue. It's like stiff tissue. It's basically like lumps and bumps. Like as human beings, as we age, we get a little lumpy and bumpy. That's just like what happens. And it happens on the inside a lot, but we didn't really know about it before we were doing ultrasounds all the time. That it's like part of a thing that happens. There are certain groups of people that are more disposed to fibroids and certain family histories can lead to more of them, but it's fairly common to get fibroids as we get older. And for the most part, they are totally benign and don't do anything as long as they don't get so big that they're not like pushing on other things and affecting, you know, the function of things nearby, like your bladder or your bowels or anything like that. Okay, so I guess just, so all right. And then what's endometriosis? Yeah, mean endometriosis is another fairly common condition that affects people. is the most part presents as painful periods or pain around menstruation for people. But it's a condition where the cells that are typically inside the uterus that are part of that endometrial lining. They're the part of your uterus that like fluffs up every cycle and gets ready to bleed. And then that's the bleeding that you have each cycle. Those cells right there for people with endometriosis exist in other parts of their body. So most commonly, really close to the uterus, around it, maybe around their intestines, maybe around their bladder, maybe around their pelvis and their ligaments in that area. And those cells do really similar functions to the ones that you have with your bleeding phase in your menstrual cycle. But the problem is that they don't have anywhere to go. So every time you go through those hormonal fluctuations, they fluff up and get all nice and pretty, and then they want to go somewhere, but there's nowhere to go. So over time, that can cause inflammation, stiff, you know, kind of like scar-like tissue in those areas. and that can present as a lot of pain for people. there's multiple, it's a chronic condition, so it doesn't get cured, it doesn't just go away, but there's multitude of management that people will use, including pain management with medications that are prescribed or over the counter, supplements, lifestyle, doing pelvic floor therapy, abdominal massage. uh And then there is a surgery that's also associated with some relief for people where they actually go into the abdominal cavity and then remove those sites where those cells are. It is something that uh even when they remove them, they don't ever totally go away. You always have endometriosis, but it can relieve a lot of the symptoms. And then, um so, God, there's just so much to cover. I w have you guys seen, have you guys read Miranda July all fours? So for those of you haven't read it, I think that's kind of a, people either love this book or they hate this book. don't, and I loved it. I thought it was like, did you guys like it? I just thought the writing was so fresh, but There was, and just so like honest and crazy and it was, I liked it. But there's a chart in this book. Do you know the chart I'm referring to? Can you talk about that? Like Laura, do you want to talk about it? Do you know? Well, you know, the the um I mean, we also love this book, by the way. It was so free. know, this idea of watching someone just like really engage in every instinct that most of us totally shut down and having that happen in such a fun way was so great. But the the way that she's the character in the book is. having conversations with her friends and looking at this chart, it's basically like menopause and then everything shuts down. It's like off a cliff. like sex drive, like happiness, like pleasure, joy, arousal, libido. Just like here we are, we're climbing, climbing, climbing, and then we hit peri-menopause, menopause, and bam, like the end. And she's kind of contending with that in the book in this very funny way. uh But I... I really hope that that's not how we have to view this. Like my dream and I'm struggling just in the beginning stages of this with myself to actually do this in the right way. I was at acupuncture um earlier today and I was complaining about feeling so fragile as a human being and having stress impact me in this way that I... do not expect it to that leads to like hot flashes. If I'm not getting enough sleep, then I'm like dealing with all these other symptoms. And I was like, this is just such weak bullshit. And she was like, Laura, that's not really what's going on here. And she asked me a lot of like very pointed questions about my identity and what I associate like, you know, dealing with stress with. And she was like, listen, this is all we're, we're, going to get into a Laura 2.0. And she was like, This is going to be a transition for you. This is a new time, a new stage of your life. You can fight it, but your body's going to move forward whether you fight it or not. And so what might it be like to do things differently? And I feel like in the book, I really do not want to spoil anything because I feel like people should read this. By the way, my book club, half of them liked it and half of them. Yeah, same with my book club. Half hated it and half loved it. I don't know. was like, huh. I just couldn't put it down. was like, what is going to happen next? This is crazy. Yeah, I don't know. I thought it was just, like you said, it was really free and she was acting on impulses that a lot of us would be like, you can't do that. That's crazy. Calm down. So we talked about em a little bit. No, I don't want to go there. Let me think. What do I want to talk about next? There's just so much to talk about. em I want to talk about going through menopause on birth control, because I know a couple of people who have done that, like, so that they don't experience. First of all, I have a friend who wanted me to ask you, she's on the Mirena IUD, and she's like, is this safe? I don't even know what I'm doing. It has hormones in it. And can you ask about that? So first, like, let's talk about the Mirena and is it safe and what is it? And then talk about going through menopause on hormones or on birth control so that you don't have a period and you don't. know what's happening and I had a friend who did that and she seemed to have liked it, but I don't know is that safe? Okay. I mean, it's so individualized to somebody's particular history. There are people who aren't good candidates for using hormones like that to add hormones into their body from elsewhere. And so those people should explore other methods. Like who would not be a good candidate. I'm not a good candidate. I'm a great example. I have a pretty strong family history of blood clots that lead to scary things like DBTs and pulmonary embolisms. And I myself was prescribed hormonal birth control for a long time, stayed on a high dose one for a long time, eventually got a blood clot on my own as well, luckily caught it and then okay and here right now. But I'm not a great candidate for some of those things. There are certain ways that people doing paramenopause will use hormonal contraceptives as a hormonal therapy. So it's not as a contraceptive necessarily. Sometimes people are multi-using it. They're also not trying to get pregnant while they're at this stage of life. But that is another form of hormonal therapy is using the birth control pill. It's a different level. hormones and it's typically depending on what method you use a steady level that kind of balances out and ceases the body from ovulating and that would be similar to the Mirena so that's like a steady line of those hormones and for some people that's really effective that for them means that they're not having those fluctuating hormones or symptoms that are associated with it. And for other people, they maybe don't like the feeling of being on those hormones, so that hormones don't feel good in their body for other reasons. can present in so many different ways. Some people cope with low libido as a result of that. Because of the... Because of levels of hormones that they have in their body with some of these forms of hormonal birth control. These are some of the things that we hear where people are wondering, are there other options? I'm not sure this is the right one for me because I'm noticing it affects my mood in a certain way or it affects my libido in a way that doesn't really match. what I want my life to look like at this stage. ah So people just kind of considering some of those side effects of some of the levels of hormones and that kind of like steadiness that Morgan's describing. Okay, because my friend's like 40 and she's using it as birth control and I think she's happy with it. So it's good for her. She's fine. And then so what about like I had this other friend and her doctor put her on some kind of birth control where she wasn't getting a period at all. And she just sailed through menopause. She didn't even know she had menopause. then I was like, is that safe for you to be on? These things as you're like 55 years old, don't you think you should be getting off of that? And, you know, not really knowing a whole lot, just offering my opinion. And so, you know, but it seemed to have worked for her. What do you think about something like that? Yeah, it's a fairly common experience. think a lot of people actually don't regularly menstruate these days. A lot of people are put on a hormonal birth control at age 13, only get off it to have a baby and then get back on it and then wait till menopause. And that is a choice that people can make and totally reasonable. And I think people are sometimes using hormonal birth control for things other than birth control. They're using it to manage symptoms of PMDD or endometriosis. Those are also tools that sometimes are helpful for small groups of people. But it can be utilized in that way. then often, you know, nowadays, like I said, people have not been researching this stuff. So we don't have a ton of information, but there are people starting to, and we're starting to understand what hormonal therapies can look like. for perimenopause and postmenopause and whether it's helpful to keep adding hormones in as the body has decreased levels. So there are some schools of thought that believe that continuing to add this in can have positive benefits for people. So staying on something like a hormonal birth control and then switching over to some more. fine-tuned tailored estrogens and progesterones in the postmenopausal phase is sometimes a good therapy for people depending on how their body is showing, how menopause shows up for them. Okay, and I've had, um just so you know, like I'm whole food plant-based um and I did that to reverse heart disease. And I think that that is one reason that I've sort of sailing through this. I don't know, I've heard this from like doctors and they say that that could be really beneficial because you eat a lot of. organic soy and you eat healthy and you eat a lot of fiber and um flax and things like that that probably helps your body. that's one thing about um me. And I had this whole food plant-based OBGYN on and she talked about hormone therapy and so forth. And she said that the latest, information out there is that really vaginal estrogen is probably like the safest way to go. Do you guys agree with that? That is what the research is showing. It's a way to have a much smaller dose of these exogenous hormones and have it be more directly related to where a lot of symptoms are for people and the processing of those hormones. So even if you're not like concerned about vaginal dryness, as an example, still placing that hormone in that space is a really great space for absorption and allows your body to have much lower doses to have really effective responses for other symptoms, even things like hot flashes by doing vaginal administration, you can have a lower dose with better symptom coverage. So there is a lot of that. And I think also you have great intuition and you're the OB that you have been seeking to before around, you know, taking care of yourself in these other ways through nutrition and through whole foods that that does affect how our body responds to things like hormonal fluctuations. I think that's where Laura and I really feel strongly that when you're a person who menstruates, you kind of have this amazing like insight into your overall health. So your reproductive cycle, this like menstruating cycle, perimenopause, all of that, that's a system like system in your body that is lower on the like hierarchy of needs for existence. And so if there's anything in your system, that needs energy and recovery, whether it's high cholesterol, blood pressure, heart disease, stomach issues, cardiovascular issues, like whatever it might be, your body will often show that there is strain and need to pull energy elsewhere. Show it through the menstrual cycle. Show it through how it's processing those hormones related with the cycle. And when you're able to track and see what's happening there, you can sometimes. find a diagnosis for something totally unrelated and figure out, my God, it was my blood pressure. And now that I'm taking care of it, the symptoms that I was having around my menstrual cycle or the symptoms that I was having with perimenopause that felt so strong are suddenly not there. And like when Laura was talking about, know, Laura 2.0, which I love, uh the like provider saying, you know, like, let's like totally do a reframe here. It's not a weakness. not being able to respond to this, I feel like when you are able to see those shifts of how your body is communicating its needs in perimenopause, the greater theme is always not like, it's not like, you can't handle stress anymore. It's that your body 2.0 is like, screw this, I'm not gonna put up with this baloney anymore. Like I have graduated to 2.0. And I don't have time for this nonsense. So I only take top tier in my life and I don't put up with the rest. And that's what the body figures out often before our like, you know, socialized mind does. I've heard that before. Actually, with that plant-based doctor, we talked about that, um the plant-based OB-GYN. We were talking about that a lot of it, um it's not even that it's like low libido. It's like, don't want to put up with mediocre sex anymore. Laura, do you find that in your practice? Oh yeah, who wants to have sex that doesn't feel good? Like that doesn't mean that you have a low libido or a decreased arousal or desire. It means who would want that? And the prioritization around that totally changes as you age, thank God. Right. You just get smarter and you're willing to put up with less bullshit, you know, when you're that's, I think that's Laura 2.0. You'll see that's coming up. Okay, wait, I have, here's my stupid question that I wrote down that I was like, and I asked my friends and they didn't know either. So it is a stupid question, but it's stupid that we don't know this. Okay. Get ready for this one. um When you go through menopause, does that mean that you're out of eggs or do you go, are you out in menopause because you're out of eggs or does that not have anything to do with, okay, explain me. It's often related. I mean, there are other reasons that that happens, but that's a commonality of you're born with a certain amount of follicles and that reserve changes as you age, as you've ovulated more and more, but it's also the availability of the function of ovulating. So all of those things change with hormonal shifts. I asked Morgan so many questions about eggs when we were writing this book. was like, I was like Morgan, you ovulate and you don't get pregnant. I was like, where does it go? Like I asked so many questions about this that Morgan had to answer. I had no idea. Nobody ever, ever, ever in any sort of meaningful way, talk to me about any of this, even when I was dealing with infertility and the entire reminiscence of the treatment I was receiving was to try to like make more eggs and have more eggs released so that they had a higher chance of getting fertilized. Like still no one was saying anything to me about like this equation of eggs and like what we're talking about in any way here. And, but yeah, you're just born with a certain amount of eggs, right? So, and I guess they come out in the lining of your period, right? Is that where they come out? Is that? This is the big question. us about eggs. Go! I mean... I don't understand, are we out of eggs when we finish, when we go through menopause? Does that mean we have no more eggs left? Most people, lose their ovarian reserve. It's tapers down, running out of eggs. But it can happen in a myriad of reasons. um As far as like where does the egg go during the regular menstrual cycle, it usually, it's a tiny cell. It's actually one of the largest cells that you can see by the naked eye, but you usually don't see it in your menstrual period. But it is something that just kind of like dissolves. It just goes poof. It's not like a chicken. Well, my book club was at my house last night and we were in my pool and we were drinking and my neighbors have chickens and you could hear like one was laying an egg because that makes that like, don't know if they make that noise or their friends do to distract. nobody's stealing eggs. don't know. But my friends had a lot of questions about those eggs too, the chickens. And they were like, Do they have a rooster? And I said, no, they don't have a rooster. But I said, she has like eight chickens. And she said she gets like half a dozen, each one lays like a half a dozen a day. I don't know if she gets a total of a half a dozen eggs a day. And each one has its own color, like blue, brown. And she gave my husband three dozen eggs, because she had so many. And so my friend said, well, if they don't have a rooster, how are they getting eggs? And I'm like, it's like you, you have eggs, you have no rooster. And she's like, my God. She's like, how does this all work? I tried to make much, much smaller. Yeah. So, okay. So we are out of eggs. Yes or no? Yes. At menopause. Yes. Okay. But that's not why we stop having our period. It is generally associated with stopping that reproductive flow of preparing for pregnancy. Damn. That's really very, that's a lot. I love in your book, you talk about um body neutrality and then you say that my body does things for me that has nothing to do with my appearance. I love that. That's such a, I want people to like really take that in and think about it because we do focus on our appearance so much. And I just love thinking about all the things that our body does for us without us knowing, like without us thinking about it. just so many things like, I mean, obviously, when you talk about all the systems in your body and all the hormones, and it's just such a good book about tracking. um so I guess once you're through menopause, you don't track your temperature though, right? Or is it perimenopause? Well, for lot of people, you can learn to track some of these biomarkers of hormones and do it for a short stint, for a short period, so that you start to learn how that presents itself in other ways in your body. And for people going through perimenopause, it's often really helpful to do temperatures and things like the body fluids. And then once you are post-menopausal, continuing to track, but there's not necessarily the same necessity and framework of those two biomarkers. For a lot of people, becomes much more helpful to track how hormones present in their body through things like sleep, feelings, intimacy, brain fog, to figure out if they're feeling like their body is functioning the way that feels good to them and feels best. Okay, so those are good things to track at this point for perimenopause. Yeah, I think what we really want to empower people to do is to name what is most important to them and to create categories of tracking around that. So there's common symptoms in perimenopause that people may think are the symptoms that they're supposed to be tracking. But we really want to ask people, what bothers you the most or what do you want to feel more of? And those are what we would encourage people to track. So it's pot flashes are indeed one of the symptoms that bother you the most. And if increased arousal is in fact what you would want to feel more of, those are great categories. Those are really common categories, but those are not all of the categories. So if you're feeling different in your relationships with your older children, for example, or if things are feeling different in your relationship, or if you're feeling more depressed, or if you're feeling like a lack of excitement about things that previously brought you joy, like anything at all. Sometimes we might even have people tracking behaviors that they feel are a bit addictive or habitual. So like, what's your shopping like? What's your drinking like? You know, what's your smoking like? Like any of these types of things that we might also expect to see shifts with, like, do you want more or less of those? Like to really ask yourself, if I were to like, take a step back, look at my life, what are the things I want more of? Pick one or two of those. What are the things that are bothering me the most that I would want less of? pick one or two of those. These are what we would encourage people to be tracking so that we can see, are there hormonal patterns here related to those? If so, cool, really good information to have. If not, also great information to have. And then if you really want to do like a really powerful perimenopause tracking chart, add in one of the interventions that you're trying. So HRT, acupuncture, a weighted vest, a sleep aid. uh, therapy, like anything you're trying, include that. And so then you're going to be able to see over a few cycles are the things that I want to feel more. Am I feeling them more because of this intervention? Is it actually making me feel less hot flashes? And if it's not after a few cycles, then you can really make some educated choices for yourself. What we hear all the time, and this is what we have felt as well is like, you're throwing spaghetti at the wall here, you know? And that is a terrible place to be when you are trying to direct your care. And when a lot of providers have different opinions right now, when the research is kind of like, you know, lacking and we're doing our very best to catch up, but like, maybe we don't have enough information. So we want to give people a solid, powerful data set about what's happening in their body so they can go to a provider and say, hey, this thing isn't really doing what I want it to do with my sleep or with my libido or with my hot flashes or to be like, hell yeah, this is working so well. I'm gonna keep this up or maybe I'm gonna make sure that I don't miss a week or maybe I'm gonna make sure that I like budget for this or whatever it is so that you can figure out what's actually working for you. Oh, that's really good advice. like it. And you, I want to mention in your book, there's a lot of like charts or things for you to track, like a, what do you call it? It's already there, like a template. Yeah, we really wanted to create a system that was easy. like you, it's just, mean, it takes so little time out of your day. It's such a nice little moment. It's like a book to keep on your bedside table and just have this small moment with, but then have a really functional tools with it. So there's a really easy way to break down all the information and the amazing like repository of all this cool data you've gathered. We can hold your hand through the process of understanding it. and then using it and deciding like, do I want to do something with this information? Does this mean I'm going to go to my provider and advocate for a different system of care than I've been getting? Or I'm going to take it to my acupuncturist or I'm just going to know this pattern about myself that I didn't know before and now I can feel better because I know what's coming or I know how this functions. There's a whole kind of program in there for you to really make it your own. Also, Lauren, like everything that you're describing about these changes that you made with your health, for people who maybe are curious about something like that, but haven't yet tried that, this is a really great way to implement something like that. So you would be able to see like, like not just like, you know, kind of like a general sense of trying to remember how you felt over the past, you know, like 60 days or whatever. But to be able to be like, I went plant-based and like, that's the thing you're tracking, you know? And then you're like, my God, all of these things got better for me. And like, to have that, it makes the investment in some of these things a lot like more powerful for people. it's, we like to see this on paper, you know? We like to see this in front of us. We like to really know this is what's happening. For me, I would say that we are... so immersed in cycle tracking. Like I couldn't be more saturated in cycle tracking at this point. And still, when I look back on my past cycle, what I see on paper is so different than what I've remembered in my mind. Every time I'm like, holy shit, like I totally thought I was feeling, you know, hot flashes for this entire period. And I only had two days of very bad hot flashes. That is such important information for me to take to my doctor who's prescribing me hormones. Mm-hmm. That is. What happens, what is the physiological thing behind a hot flash? What is happening? Aside from you're just getting hot. uh I mean, it has to do with how your body processes estrogen. And so it's often a fluctuation in that estrogen that can cause this like, vascular temperature control issue in the body. Okay, well I'm gonna leave that at that. I wasn't gonna ask you guys this because you're only 40, but you're aging, everybody's aging, you're aging from the day you're born, but what's your, do you have a best piece of advice for aging well, each of you? you I mean, I guess mine that I'm trying to hold on to is not settling for the past being the best version of yourself. Like my body has always been changing. Just as you said, we're aging from the day we're born. Like I am enjoying aging as I stay curious to see what the next level up looks like for me. So that's my advice to myself is to stay curious and keep trying to get to know myself as I keep leveling up. I love that. Very good, Morgan. My advice is to take more risks. I think that's it. Yeah. I'm always trying to remember that, the older I get, the more information I have, that it's okay to do things differently and to do things that scare me. And so many of the things that I was terrified to do have brought me the most joy in my life. So trying to remember that. Yes, very good. You guys are, you're doing good. You're aging very well. Good job. Well, thank you so much. mean, we really didn't even get to touch on so much, but I think, you know, everybody should just grab a, grab a copy of the cycle book and check it out. And thank you for being here. Thanks. you so much for having us. Take care, bye bye. Thanks for listening, friend. From my heart to yours, be well until we meet again.