Episode 23: Let’s Talk About Sex – In Conversation with Dr. Trina Read

Today, Dr. Toni is talking all about sex in perimenopause and beyond with Dr. Trina Read, sexologist and CEO of the Business of Sex. They discuss: why you need to “use it or lose it”; the importance of mixing things up in the bedroom, especially during perimenopause; how to feel more sensual; and why libido tanks and what you can do about it.

Dr. Trina has an unique perspective as a sex and relationship expert who has a corporate background in marketing and PR and who is also a perimenopausal mom.

In this episode, we cover:

  • How to use self care to bring libido back
  • Why you need to know your happy triggers for sex
  • The importance of knowing what you want out of sex and communicating it
  • Why you might want to take intercourse and orgasm off the table for better sex
  • How to have those awkward conversations around sex
  • Why personal lubricant makes all sex better
  • The importance of working your pelvic floor muscles

Where did my libido go?

In perimenopause and in stressful times, you may find your libido is flatlined and don’t feel like sex.

Your body can only produce either cortisol (your stress hormone) or testosterone (your sex drive hormone). If you’re producing cortisol, you can’t produce testosterone.

In situations with great change, it’s important to connect with your partner and look for ways to be together, so that you don’t drift apart. Being proactive and finding pockets of time to be close with your partner helps your relationship, as well as feeling more powerful yourself.

How to feel more sensual and “get in the mood”

You can back into the groove and bring your body back to a place where you feel more centred and sensual by:

  • Taking a bath
  • Listening to your favourite music
  • Giving yourself some me time alone in your bedroom with a vibrator
  • Just making up your mind to connect with your partner (even if it feels forced at first)

The Centre for Menstrual Cycle and Ovulation Research (CeMCOR) was founded at the University of British Columbia (UBC) by endocrinologist Dr. Jerilynn Prior. There is lots of information about their research around menstruation and hormones at https://www.cemcor.ubc.ca/

UBC is also home to the Sexual Health Laboratory run by Dr. Lori Brotto that focuses on research around women’s sexual health. https://brottolab.med.ubc.ca/

Research shows that sexual desire is similar to happiness. For most women, in order to feel sexual desire, you needed to be triggered. You can learn positive triggers around sex and negative triggers around sex. You need to set up your positive triggers for sex.

Unfortunately, you may have been brainwashed to think that only 2 things available for sex is having intercourse and having an orgasm.

Sexual intercourse all the time can be a negative trigger for a lot of women, especially if you feel like it doesn’t quite do it for you.

When you can anticipate doing something that you want to experience, a happy trigger for sex can be created. Working on triggers for sexual desire and increasing your repertoire for sex are important for your sexuality to evolve.

There are studies that prove that meditation improves your sex life!

Self care like meditation, yoga and tai chi lowers stress and cortisol and can increase your libido.

Perimenopause is like reverse adolescence with wild ebbs and flows of estrogen and progesterone that can create mood swings, anxiety, hot flashes and insomnia. No wonder you don’t feel like having sex!

Sex in your 40s and beyond: now is the time be selfish, use lubrication and practice Kegel’s!

Once you hit 40 years of age, you produce less oxytocin. Oxytocin is a bonding hormone. With less oxytocin, you start being more “selfish” and focus on yourself. With more wisdom, self confidence and self care, you can feel more deserving and able to explain to your partner what you want.

This is your opportunity to create something different and better in your sex life! Your partner will be on board with you becoming a more engaged partner…it could result in you actively wanting sex more often.

If you’re experiencing vaginal dryness sometimes or all the time, sex can be painful. Trying out a few different brand of lubricants (silicone based, water based or a combo) can be a game changer for your sex life. Lubricant makes all sex better. You might even want to try a lubricating suppository.

If you don’t use it, you lose it! If you don’t use your vaginal canal, you could experience vaginal atrophy. Exercising your pubococcygeus muscle increases blood flow. Research shows that post-menopausal women who do Kegel exercises have bigger, better orgasms than women who don’t do Kegels. 

Is sex painful? You may have a prolapsed uterus:

Every woman’s uterus will prolapse to a certain extent. Greater levels of prolapse can create painful sex. 

There are options to address uterine prolapse other than surgery:

  • Herbal medicine like black cohosh
  • Pelvic floor physiotherapy
  • Bioidentical hormone replacement therapy
  • Laser rejuvenation

You can slide or decide: slide into painful sex or decide to do something different and exciting.

How to talk to your partner about foreplay and sex:

Too scared to talk to your partner about doing something different and new?

How can you start talking to your partner about sex when you feel awkward and uncomfortable. Dr. Trina’s website http://trinaread.com/ has many different articles you can share with your partner to stimulate conversation around sex and your own sex life.

Connect with Dr. Trina Read on Facebook at https://www.facebook.com/trina.read and Twitter at @DrTrinaRead

Watch for the release of Dr. Trina’s self help fiction book, “Amy Finds Her Sex“!

Today’s Mama Must Have: 

Dr. Toni is a huge fan of her local neighbourhood buy and sell groups on Facebook. These can be a lifesaver for moms on a budget. 

Thank you for joining us today! 

Find the show notes at stephanies48.sg-host.com or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe everyone!

Episode 22: What’s a Normal Period, Anyway? Part 2

In today’s episode, Dr. Lisa and Dr. Toni continue discussing menstrual cycles and periods.

In this episode, we cover:

  • Tracking your menstrual cycle
  • How to figure out when and if you are ovulating
  • Different methods of testing hormonal imbalances causing period problems
  • Traditional Chinese Medicine patterns linked with period issues
  • Some benefits of using menstrual cups over tampons and pads
  • How you can use the four phases of creation to maximize your high productivity times over the month 

How do you figure out if you’re having a normal period and menstrual cycle?

You can track your menstrual cycle using:

  • Basal Body Temperature (BBT) – your temperature generally increases sharply after ovulation by about 0.5oC or 1oF
  • Ovulation signs – your cervical fluid becomes wetter and tends to have consistency of raw egg white, position of your cervix rises up in vaginal tract and becomes softer with feeling like the tip of your nose
  • Ovulation Predictor Kits – measure luteinizing hormone (LH) in your urine – generally rises 12 to 36 hours before you ovulate, but not 100% accurate, as you can have LH surge without ovulation
  • Progesterone Ovulation Kits – measure progesterone – generally rise 24-36 hours after ovulation
  • Less used are different fertility monitors like Clearblue (that uses detecting estrogen and LH levels) and Daysy (that uses your basal body temperature and period tracking)
  • Salivary ferning tests looking at increased levels of salt in your saliva before ovulation due to estrogen, monitors to measure electrolytes in your saliva and vaginal sensors to detect ovulation  – will these become more common in the future?
  • Period tracker apps like Period Tracker or MyFlo, or just mark your Google calendar when you start your period 

How do you figure out what is causing your period problems?

Further testing for hormonal imbalances and nutrient deficiencies:

  • Blood vs. saliva vs. urine (such as DUTCH or CHI)
    • Test on 7 days before your next period (around day 21 depending on the length of your menstrual cycle) or throughout the month if you have irregular menstrual cycles
  • Blood Sex Hormone Binding Globulin (SHBG) and thyroid panel (TSH, free T4 and T3)
  • Blood sugar balance and insulin resistance: fasting glucose, fasting insulin, hemoglobin A1c
  • Blood vitamin D
  • Blood iron status: hemoglobin, iron/transferrin saturation, ferritin (iron stores)
  • Consider getting abdominal and transvaginal ultrasound imaging requisitioned by your family doctor or gynecologist to rule out issues with your uterus or ovaries if you have abnormal bleeding or abnormal menstrual cycles

Traditional Chinese Medicine patterns impacting your menstrual cycle: 

Liver Qi Stagnation – associated with PMS, menstrual cramps and clots, type A personality, overwork, stress, anger, excessive cold exposure

Spleen Qi Deficiency – associated with changes in digestion and bowel movements like loose stools around period, excessive alcohol intake, too much raw/cold food, anxiety, worry

How can you improve your flow of Qi and blood (plus save money over time)?

You can try the Diva cup or other menstrual cups!

It is normal for you to have different metabolic needs, creative juices and levels of energy and productivity over your menstrual cycle!

Dr. Christiane Northrup first talked about this concept in her groundbreaking book Women’s Bodies, Women’s Wisdom https://www.drnorthrup.com/

Her daughter Kate Northrup discusses more about the four phases of creation and how to tap into the different phases of your cycle to maximize productivity and efficiency at https://katenorthrup.com/phases-creation-part-one-visibility/

The phases of your monthly cycle plus the energy of each phase are as follows:

Menstrual (Dark of the Moon): Looking within, reflecting on what’s working and what’s not working in your life, letting go, course-correcting, deeper connection to intuition

Follicular: Creativity and new beginnings, high physical energy, desire to be out and active

Ovulation (Full Moon): Open to maximum cross-fertilization, connecting with community, heightened communication skills, magnetism

Luteal: Decline in physical energy, energy turns inward, nesting, administrative, detail-oriented tasks feel like priorities, slowing down

If the year were the macrocosm of the month, the phases line up like this:

Winter = Menstrual

Spring = Follicular

Summer = Ovulatory

Fall = Luteal

Adjusting to the different phases of the menstrual cycle is being used by the U.S. Women’s soccer team and is covered in the MyFlo app created by Alisa Vitti https://www.floliving.com/ 

Today’s Mama Must Have:

Dr. Toni loves her Diva Cup as an easy and economic alternative to pads and tampons.

Dr. Lisa is enjoying some cheesy reality TV shows, including Four Weddings and Seeking Sister Wife as a little break from real reality. Dr. Toni fully supports this, as she is a longtime Survivor fan (yes, it is still on TV) and got sucked into Love is Blind on Netflix recently.

Thank you for joining us today! 

Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe everyone!

Episode 21: What’s a Normal Period, Anyway? Part 1

In today’s episode, Dr. Lisa and Dr. Toni are discussing some of the basics around our menstrual cycles and periods. 

In this episode, we cover:

  • What a normal period is
  • The hormones involved in your menstrual cycle
  • The four phases of your menstrual cycle
  • Common (but not normal) things you could be experiencing with your period and menstrual cycle that are signs of abnormal function

Menstruation could be considered your 5th vital sign, after heart rate, blood pressure, breathing rate and body temperature.

What are your first memories of your period? 

Most of us in North America don’t experience some of the celebrations around the appearance of a girl’s first period, unlike some cultures around the world. You might think about your period as an annoyance, something to hide or embarrassment.

As a woman, you are a cyclical being. You experience ebbs and flows of different hormones throughout the month – estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, as well as prostaglandins (chemical messengers that stimulate uterus to contract).

Your menstrual cycle is impacted by moon cycles, since the different phases of the moon shifts the movement of fluids, especially salt water. It can also be impacted by stress, blood sugar, liver and gut health. These can cause different imbalances and problems that are common, not normal!

If you are taking a birth control pill or have an IUD with hormones, you need to be aware that it is masking your natural menstrual cycle. 

The age range for menarche, or your first period, is 9-18 years of age. Back in 1840, the average woman’s menarche was 16.5 years of age, while now it’s between 12-13 years of age.

Why has this changed? It’s possibly impacted by different environmental toxins you are now exposed to that your grandmother wasn’t exposed to, and a lot of these new chemicals are hormone disruptors.

Normal menstruation includes:

  • 4-7 days of flow
  • 26-32 days long
  • Average flow is 30-50ml (1 regular pad or tampon can hold up to 5ml)
  • Starts bright, cranberry red in colour and ends bright, cranberry red colour
  • No PMS or cramping
  • No clots
  • No spotting
  • Viscosity of jello that hasn’t set
  • Cervical fluid (aka vaginal discharge) changes
  • Consistency  and predictability is key

4 Phases of the Menstrual Cycle:

  1. Menstruation: previously released egg doesn’t become fertilized, estrogen and progesterone drop, your endometrial lining is shed. Day 1 = 1st day of your period flow
  2. Follicular (proliferative) phase: overlaps with menstruation
    • Starts on Day 1 – your brain releases FSH to tell your ovaries to create follicles, or sacs with immature eggs in them
    • The healthiest egg will be released during ovulation
    • You are born with all of your eggs (vs. sperm made every 2-3 months)
    • You used to be an egg in your mother’s ovaries before your mother was born and in utero in your grandmother! See here to learn more.
    • As the follicle matures, your body releases estrogen to build your uterine lining so you’re ready to implant a fertilized egg if there is sperm available 
  3. Ovulation: typically between day 10-17 of your menstrual cycle WHEN FERTILE
    • Rising estrogen triggers your brain to release LH, which stimulates one of your ovaries to release the mature egg 
    • Mature egg travels down the fallopian tube to the uterus and can be fertilized anywhere during this journey for up to 24 hours. It’s possible for another egg to be released after (like Dr. Lisa and her fraternal twin!)
    • Your cervix starts moving up your vaginal canal and opens up, releasing your cervical fluid with a consistency like raw egg white that can hang out! This quality of cervical fluid supports fertility as it helps sperm swim up to egg
    • Your basal body temperature (BBT) changes – on average, you could have an increase of 0.5oC 12-24 hours after ovulation. You may also get a slight temperature dip right before you ovulate
    • Ovulation predictor strips test LH, not necessarily ovulation! You can have LH surge without an egg release
  4. Luteal phase: 
    • If your egg isn’t fertilized, the follicle turns into the corpus luteum, which releases progesterone to keep uterine wall thick and gets uterus ready for implantation, 
    • The length of your luteal phase is based on how long progesterone is maintained, rise in temperature from progesterone
    • Estrogen remains low
    • In perimenopause, you may have low progesterone levels and may not ovulate with every menstrual cycle
    • If the egg isn’t fertilized, the corpus luteum is dissolved into your body, levels of estrogen and progesterone drop, and you get your period (restarting the menstruation phase)
  5. If you get pregnant, the fertilized egg tells your body to release hcG and stimulates the release of progesterone to support the thickness of the uterine lining

Abnormal Menstrual Issues You May Be Experiencing:

Brown flow:

  • Old menstrual blood from your last period
  • Caused by stagnation, low progesterone, possible scarring from past C-section, D&C, abdominal surgeries or trauma
  • Can be helped by:
    • Arvigo abdominal massage or other bodywork like osteopathic, craniosacral, yoga therapy
    • Castor oil packs or topical use (not during period, as it can speed up flow)
    • Progesterone support with vitex, B vitamins, oral micronized progesterone or progesterone cream
    • Addressing root causes of low progesterone, like stress!

Heavy bleeding, clots, spotting or your period keeps starting and stopping:

  • Often linked with high estrogen and could be a sign of fibroids, endometriosis or polyps (get ultrasound imaging and further assessment from family doctor or gynecologist!)
  • Can also be caused by low iron or low thyroid function
  • Consider iron supplementation or estrogen detoxification support for the liver with DIM/I3C, herbs like yarrow, capsella, milk thistle, curcumin/turmeric, green tea, NAC/GSH
  • Support bowel movements, increase fibre to bind extra estrogens and other toxins
  • You might need extra bile support if your gallbladder was removed
  • Limit your beer intake due to the estrogenic effect of hops

Short flow, light flow, missed periods, longer cycles:

  • Can be caused by low estrogen, most likely in late perimenopause as you are nearing menopause!
  • Can happen if you are underweight and/or overexercising; typically in younger women
  • Consider: 
    • increasing your intake of protein and fat, including cholesterol for hormonal building blocks from eggs, or plant sterols
    • Ground flaxseeds, traditional forms of soy (like miso, tofu, tempeh)
    • Bioidentical hormone cream, or herbs like caulophyllum, cohosh, red clover

Your period comes every few weeks/ you have shorter cycles:

  • Low thyroid function and low progesterone are both likely in perimenopause

Cramping:

  • Can be from high levels of estrogen or inflammation 
  • Helped by castor oil packs, liver detoxification pathway support, magnesium, cramp bark, ginger

Why should you avoid NSAIDs like naproxen (Aleve) and ibuprofen (Advil, Motrin)?

They negatively impact liver function, can cause leaky gut and deplete your body from critical nutrients like folic acid, melatonin and iron.

Tylenol is not better! It reduces your levels of glutathione, which is a crucial antioxidant for your brain and liver.

PMS: things come out that may be unaddressed or suppressed – no filter!

  • Symptoms: headaches, breast tenderness, bloating, stool changes, sleep disturbance, breast tenderness, food cravings, fatigue, mood swings, change in libido, hot flashes/heat symptoms during sleep (perimenopause)
  • What’s your hormone imbalance? Low progesterone, high estrogen, low thyroid
  • Don’t forget about possible low iron!

Supplements and herbal support for PMS:

  • Reduce caffeine in coffee, tea, chocolate 
  • Consider low-dose iodine for breast tenderness

Today’s Mama Must Have:

Dr. Toni has used the Period Tracker app for many years to track her menstrual cycle. It was super helpful when she was working on getting pregnant, as well as when she was working on not getting pregnant! 

Dr. Lisa is a big fan of the Geratherm thermometer for its accuracy for tracking basal body temperature. She also loves the Real Coconut Coconut Flour Tortilla Chips….yummy!

Thank you for joining us today! 

Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe everyone!

Episode 20: Migraines: Not “Just in Your Head”! Getting to the Root Causes

In today’s episode, Dr. Lisa and Dr. Toni talk about migraines, something that too many women experience.

It’s not in your head! The pain is real!

In this episode, we cover:

  • Possible causes of your migraines
    • Stress causing magnesium deficiency and muscle tension
    • Structural alignment of neck and tailbone
    • Insomnia
    • Weather or barometric pressure changes (example: Chinook winds in Calgary)
    • Dehydration
    • Blood sugar imbalance
    • Food sensitivities and histamine intolerance, including alcohol, caffeine, cheese, food additives like nitrites
    • Brain inflammation and nerve irritation
    • Hormones: estrogen/progesterone imbalance
  • Dr. Toni’s personal experience growing up with migraines and they are linked with her diagnosis of mitral valve prolapse, a common heart murmur (hint: magnesium!)
  • Current and new conventional treatments for migraines offered by family doctors and specialists
  • The importance of figuring out the factors that are impacting your migraines
  • Natural ways to address your migraines:

Today’s Mama Must Have:

Dr. Lisa relies on her home gym, which has simple and inexpensive equipment including an exercise ball, free weights and resistance bands.

Thank you for joining us today! 

Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe everyone!