Period Repair Manual with Author Dr. Lara Briden!

Tallene: Welcome Cysters to another episode of a Cyster & Her Mister.

Today, We have Dr. Lara Briden with us. She is a naturopathic doctor and she’s leading a period revolution. She has a strong science background and over 20 years of experience and her book, the Period Repair Manual, teaches women how to naturally treat their hormones for better periods and provides actionable solutions using nutrition and supplementation.

This episode will be life-changing for you if you’re having period problems. We’ll chat about what the pill is doing to your body, her top tips to get your period back, and the top natural contraception methods aside from birth control. Welcome, Dr. Briden.

Sirak: Welcome.

Dr. Briden: Thank you. Thanks for having me.

Sirak: Your book, the Period Repair Manual, has been on our coffee table for the last few months as we’ve been reading it and studying it to prepare for this podcast as well. So thank you for writing that amazing book.

Dr. Briden: Thanks so much.

Tallene: Yeah, it’s super interesting for me because I’ve had PCOS for a while now, and I used to have really irregular periods. My sister has PCOS too, and she’s in the process of getting off the pill and regulating her period.

And there are just so many good tips in this book that can be easily applied to our lifestyle. However, it’s not as mainstream as when women who have PCOS go to the doctor and they’re prescribed birth control, or they tell their doctor they want to go off birth control. They’re not really handed any natural solutions, of course, because that’s not the gynecologist’s specialty.

But we’re lucky to have women like you in the field, you know, leading the way and creating a path for us to learn more and take charge with our bodies.

Sirak Yeah.

Tallene: What pushed you towards writing a book about natural ways to regulate periods instead of birth control?

Dr. Briden: My patients. My work with patients, even though I love speaking and I love writing, my, day-to-day work with patients for the last 25 years has been my first love. I get to hear all their stories. I get to hear, you know, what works for them, what doesn’t work for them. And after about 20 years of doing that, I thought, I just need to share some of this with women who can’t be my patients so that they know there are other solutions that work for PCOS and also other conditions, endometriosis, and other problems like that.

Sirak: Yeah. That’s like similar to why Tallene created her Instagram. She saw many, many women like her go through the same problems with PCOS. So she wanted to kind of open up a pathway for people to learn and get better resources than what’s been happening.

Dr. Briden: For sure. Yeah. Because as you’ve pointed out, there are not a lot of solutions forthcoming from the doctor’s offices right now. I just wanted to comment on that, I might just jump right into it. Being prescribed the pill for PCOS, in my view, is pretty crazy actually, because – I’ll just say why –  PCOS is a condition of not being able to ovulate regularly and tending to insulin resistance.

Contraceptive drugs suppress ovulation and promote insulin resistance. So even though they mask the problem by giving fake pill bleeds, they don’t – and they can suppress androgens too, we can talk about that, certain types of pills can – but they don’t correct the underlying problem at all. And I was so disappointed to see when the international guidelines for PCOS treatment came out a couple of years ago, that the pill was still very central in that.

And I just thought this is going to take a while for this to change. But there are – I’ll just assure you – there are other ways of thinking coming, even in the conventional mode. I just co-authored a paper with a scientific colleague of mine, who’s looking at non-pill options for PCOS. So there are things coming and even in the international guidelines, I don’t know if you know this, but for PSOS treatment, they mentioned Inositol.

Tallene and Sirak: Oh yeah!

Dr. Briden: Inositol has made it – it’s crossed the threshold into what’s called evidence-based medicine, so it should be there in the gynecologist’s office, you know, as an option. Even with PCOS, the gynecologist’s office is not really where this condition should be discussed anyway. It’s an endocrinology condition. So for any of your viewers and listeners, if you’re going to see a specialist for PCOS, it really should be an endocrinologist, which means a hormone specialist, rather than a female anatomy specialist

Tallene: Would they also prescribe birth control? Would you find that an endocrinologist goes down the same route?

Dr. Briden: My experience is no. So I work and I live in New Zealand. A lot of my clinical years were spent in Sydney, Australia, where there were some actually quite good endocrinologists. And if my patients were lucky enough to get in with one of the hormone specialists, they would come back with phrasing like, “Oh, my doctor said the pill is not good for PCOS – I’ve been given Metformin instead”. I actually think Metformin is a reasonable option. It’s better than the pill, at least it’s trying to correct an underlying driver of the condition.

Tallene: Can you tell our audience – because I’m sure many women out there right now are treating PCOS with birth control – can you talk more about what it’s doing to our bodies as women with PCOS?

Dr. Briden: Yeah. So we’re locked in this strange narrative or paradigm where I think future generations will look back and call this the strange era of contraceptive drugs that went on for 70 or 80 years. I guess that’ll probably be the time when these drugs come to an end – and I call them drugs because they’re not real hormones that are in the pill or the ring or the patch. They are hormone analogs that interact with our hormonal system. They’re drugs. Most of them work by primarily by shutting down ovarian function – essentially switching it off, essentially creating temporary chemical menopause, which, you know, in men would be equivalent to shutting down testosterone and then replacing it with a drug that’s kind of like testosterone, but a little bit like estrogen. And, you know, you just see how you go on that. That’s kind of what we do to women right now.

And so in an attempt to address the symptoms – I get it, you know, the symptoms of facial hair and the symptoms of irregular periods –  these drugs are being given. But they’re not fixing the underlying problem.  In the case of PCOS, they’re often worsening the underlying problem. And then, unless you’re going to stay on those drugs all the way through till menopause, you’re eventually going to have to come off them. And the PCOS is still there. And in the case of some of the drugs, the PCOS is arguably quite a bit worse from having been on them,

Sirak: It creates like a snowball effect.

Dr. Briden: Yeah. And the other part of it is just the wording. It’s very important. Words are very important to me. So one of the things I say in the book, and I’ve just said today on Instagram again, is pill bleeds are not periods. So if the goal is to have a menstrual cycle – a regular menstrual cycle –  which most women kind of want, they know, intuitively that’s a sign of health, that’s something they want. Having a monthly dosed pill withdrawal bleed means nothing. Like you’ve gained nothing. It’s just an induced bleed. So even in the literature, even the official scientific literature, they talk about giving a monthly bleed to reassure women, which is a false reassurance. It’s not a period. A menstrual cycle is a cycle in which ovulation is the main event.

And then you make progesterone, which is very different from the progestin drugs in hormonal birth control. The beautiful thing about progesterone is it’s anti-androgen. So it has a beneficial anti-testosterone and anti-androgen effect. So actually, having strong ovulations, regular ovulations, and making lots of progesterone is the way out of PCOS for a lot of women, right? Our progesterone is supposed to kick in, in our, you know, late teens, and let’s say you get to quite high levels by our twenties. And that is a self-correcting mechanism to correct an underlying tendency to progesterone. You can actually also take that tip to PCOS. You can also take progesterone, which is interesting. We can talk about it a little bit later on.

Tallene: Well, women with PCOS struggle to make enough progesterone and ovulate. Then you take birth control and that just strips you away from the opportunity to even fix that problem.

Dr. Briden: Exactly.

Tallene: You can just forget about it.

Dr. Briden: It robs you. Birth control robs you of progesterone. It’s just to say again, the progestins, the drugs in hormonal birth control are not progesterone. I feel like if that one piece of information could get out there into the world – and even doctors don’t kind of seem to understand that – that would start to change the conversation around it.

Tallene: I read in your book, how progestin, which they’re using in birth control instead of progesterone as you said, actually influences our mood and depression, whereas progesterone would have uplifted your mood and made you feel less depressed.

It’s part of the reason why birth control is affecting women’s moods and they’re still not coming out and saying it as loudly as we’d like them to that birth control has such an influence on women’s moods over the years. Women take it for like 10 years. They have no idea that it’s affecting them so profoundly until they get off. And it’s like the clouds parted.

Dr. Briden: The clouds parted. I’ve collected some of the quotes from my patients getting off the pill and different things. They’ve said, like, I came back to myself. My favorite was “I came off the pill and it felt like a curse was lifted” which is quite profound.

Tallene: Yeah. Yeah.

Sirak: And I believe, correct me if I’m wrong, but birth control, the conception – the thought behind it was to kind of control, you know, birth rates. It wasn’t really meant to balance hormones and things of that nature, but I guess that  became the strategy behind the marketing later on. Correct?

Dr. Briden: Yeah. Well, it was never invented to balance hormones. I mean, it was invented as contraception. There’s a bit of a history, there are different motivations for that. But definitely, its purpose was to help women avoid pregnancy, which is achieved. But then weirdly, you know, decades later we’ve got this whole narrative around it that it can regulate periods or hormones, which is absolutely crazy because they could never do that.

Tallene: Right.

Dr. Briden: And the early doctors knew it couldn’t do that.

Sirak: Yeah.

Tallene: You have a great quote in your book that I grabbed and I just want to say it for our audience. You said birth control is a relic from the 1950s when people had different ideas about things. For example, they thought smoking was okay. Why should we have to shut down our whole hormonal system just to prevent pregnancy?

Dr. Briden: Exactly.

Tallene: That’s amazing. That was a great quote.

Dr. Briden: Yeah!

Tallene: What are some other options that you would encourage women to try – even women with PCOS? Because it’s so hard to ovulate and detect ovulation when you’re struggling with PCOS. So what type of contraception would you prefer or recommend?

Dr. Briden: Well, yeah, well, listen. There are a few non-hormonal methods of contraception. I always say at the outset: there needs to be more. We have a few non-hormonal methods and we need more, you know, the fact there’s a big – actually –  I would say there’s a gap in the research. Like where have the scientists been? And the different reasons for that.

There’s not a lot of funding for alternative methods. You know, a lot of the ideas seem to be, “well, we’ve got hormonal birth control. We’re good now. We don’t have to invest in other methods” but there should be other methods. One of the examples I like to give is – it hasn’t come to market – but there’s a drug that’s been proposed that would work by altering sperm motility so men would take it. It wouldn’t affect men’s hormones at all. It wouldn’t shut down their testicular function because why would you do that? That’s cruel! Instead, it just works on, you know, it’s  more fine-tuned for what’s involved in fertility.

And like, there could be so many different things like that that could avoid pregnancy without shutting down the hormones of anyone. So, yeah. I’d really like to see some new methods come. I think they will come eventually, but currently – just quickly, you know, cause I want to make sure we’ve got time to talk about other things – but there are obviously condoms, which do work.

For what it’s worth – I’m putting it out there because I have a lot of young women, at least in my Australian practice who have this idea. I don’t know where they got the idea, they seem to have been told that condoms don’t work.

Like, condoms work. They have to make sure they fit,  that it’s a good quality one, that it’s not, you know, past its expiry date and all those normal things. But then condoms work. And I think it’s reasonable to have the morning-after pill as a backup plan to condoms. Like, I think the morning-after pill is just a big dose of a progestin. So my thinking is if you have to take the morning after pill never, or once in two years, it’s still better than taking the same drug daily.

Tallene: Yeah. What about the Daisy fertility tracker – would you recommend that for women who have PCOS?

Dr. Briden: Yeah. It’s in my book. So that’s one method of what’s called fertility awareness-based methods of avoiding pregnancy, of which there are several, but Daisy has a little computer device. Do you have a Daisy?

Tallene: I have one! Do I use it though? I need to start using it.

Dr Briden: Okay. Yeah. So it’s based on the idea that as women, we’re fertile only really only one day per cycle, but actually, six days because sperm lives for five days so you definitely have to allow for that. So men are fertile every day, and women are only fertile for a few days. So it’s based on the idea that you can identify those days.

I always say –  I’m very careful to say – you need to take steps to properly identify those days. You can’t just look on your, like, period app and go “oh, it says I’m ovulating approximately now” like you cannot rely on that. You need to either learn how to do it by tracking what’s called cervical fluid or checking temperatures, which is what Daisy does, and knowing when you’re fertile and when you’re not.

And then the efficacy rate is very high. So then when you’re fertile, then the next step is when you are fertile, you have to either abstain or use condoms. And then on the other days, when Daisy gives you a green light you don’t have to use anything, which is definitely an advantage, it means you’re only using condoms some of the time.

Tallene: So let’s unwind for a minute for the women with PCOS who are struggling to ovulate and are having anovulatory cycles or irregular periods. What can a woman with PCOS do about it and why are our periods missing? Because it seems like the second we start our periods, you know, we’re 16 years old or something, and then it starts going regularly, and then we’re given birth control. We don’t even have a chance to figure out what’s happening and we’re starting to become body literate at 25 or 30 maybe later. So can you, you know, explain what’s happening?

Dr. Briden: Yes. Okay. So as you know, in my book, the Period Repair Manual, l come at it with different kinds of functional types of PCOS. So,  the question is, you know, you’re not ovulating with PCOS often. Obviously, there are some cases where you can have high androgens and qualify for a diagnosis of PCOS, but you are ovulating regularly. That’s less common, but usually, there’s no regular ovulation. You know the high androgens are part of that. The high male hormones are impeding ovulation. Those high male hormones can get set up from different mechanisms, right? Like there’s a genetic component. There’s, you know, there’s some exposure to environmental toxins in utero, probably. I think that’s actually one of the big ones that’s happening.

Like as a fetus inside your mom, you were potentially exposed to what are called endocrine disruptors or things that alter the calibration of the hormonal system. That seems to be where the evidence is pointing, which is nothing your mom did wrong, right? It’s just our modern world. So then, and also if your mom tended to high androgens herself, then that amplifies it.

So we are seeing more of it, I think generation by generation, kind of amplifying. So if you’ve got that tendency to higher male hormones already, that’s going to already put the brakes on ovulation, not completely. I mean, you could still ovulate, but it takes a little bit more, I won’t say work, but like you have to have everything else working really well to overcome that obstacle of the high androgens.

So it’s about identifying why you’re not ovulating. And in my subtypes, in my book, I go through them. The big one, of course, I’m sure all your viewers know all about insulin resistance, which is a major driver of anovulation.

So that needs to be addressed – reversed. All of this is reversible. I would argue that PCOS in its entirety is reversible as you can reverse the symptoms. You’ll always have the tendency, which you might outgrow to some extent, but it doesn’t mean you’ll always have the condition. Would you agree? Like, you know, I think once you’re done with the symptoms, you don’t really qualify for a PCOS diagnosis anymore.

Tallene: Right? I feel like that’s my situation. However, if I start changing my lifestyle and going back to what I used to do, eating gluten, and dairy, and not managing stress, these are the things that really drive my symptoms. So it can just come right back.

Dr Briden: Yeah, it can. And I think a lot of women will, depending on the driver, – you know – it’s possible, you’ll outgrow it to some extent, like as you get later into, you know, into your later thirties and forties, especially if you don’t have insulin resistance, you’ll probably be less and less prone to PCOS symptoms. I would think it’s often what happens.

So the drivers are: you’ve got an underlying tendency to high androgens for different reasons. Then the drivers that I’ve identified in my clinical work are insulin resistance, and a temporary post-pill situation, which of course ties into our earlier conversation, especially after Yasmin – that category of anti-androgen drug. You can get a surge of androgens that is temporary, usually just for a couple of years.

Tallene: It is a long time,

Dr. Briden: Unfortunately, that is a long time. Then the third type, which fits in very much to your work that I did is what I call inflammatory PCOS. There’s definitely a group, a category of PCOS, where the main driver seems to be this kind of immune and flip type of inflammation that you get from the gut or immune-upsetting foods like gluten and dairy. Certainly, in some women, that seems to drive a higher androgen state. So that’s what I call the inflammatory type. Then there’s a whole other category, which you may have encountered with your clients, but like this adrenal type of PCOS, which is actually really quite different. They often ovulate regularly. They’re pumping out high levels of adrenal androgens.

It’s a little bit different. They can also respond to anti-inflammatory treatment, but they usually need some anti-androgen supplements in place kind of all the time. And that mention of adrenal PCOs just makes me want to say part of all of this process of treating PCOS is to really make sure you’ve been given the correct diagnosis.

I just have to say this because, as you know, there’s a lot of confusion around PCOS diagnosis and there are certainly lots of women out there who have PCOS and don’t know it, and that’s a problem. And at the same time, there are women who’ve been told they have PCOS and don’t. And some of them are listening right now.

So I’m speaking to them, you know, one category would be it’s to do with the adrenals. So there’s another condition called adrenal hyperplasia, which is a genetic condition, which causes high androgens. The doctors are supposed to rule that out and they sometimes don’t.

So if you’ve been, you know, really struggling, not getting results, nothing seems to be working for you that’s supposed to work for PCOS. You could say to your doctor: have you ruled out adrenal hyperplasia, just checking. It’s a simple blood test, right? And then, because if that’s the situation you need to change course and go down that path. That’s one example.

The second example of women who’ve been told they have PCOS and they don’t is under-eating or hypothalamic amenorrhea. I have to say this because I don’t want to overstate it but it’s a pretty disastrous situation. If you’ve lost your period to under-eating and then you think you have PCOS and you’re eating less to try to fix the problem, you’re never going to get your period.

And I see it quite a lot. And so I just really want to mention that. And I just want to say the reason the confusion is happening, is that some doctors – fortunately not all doctors, but some doctors  – make the mistake of diagnosing PCOS based on an ultrasound findings of polycystic ovaries. And you can’t do that, as you know. You know, with my patients, I basically take the position that the ultrasound finding of polycystic ovaries means nothing, essentially.

Anyone can have ovaries that appear polycystic because as you know, they’re not cysts. It’s really just the high number of follicles or a high number of eggs, which are normal for the ovary, normal when you’re young, especially. It’s really just showing the picture of a cycle in which you did not ovulate in that cycle and make the dominant follicle in that cycle. So your ovaries look like you didn’t ovulate, but it doesn’t mean they’ll always be like that, right? Like you having a cycle where you didn’t ovulate just means you didn’t ovulate that cycle. And hopefully, in three months, you will ovulate and your ovaries will look normal.

So I really can’t emphasize that enough. It’s created a lot of confusion and probably as you know, a lot of controversy about even the name of the condition, because the name polycystic ovary is the name of the condition, which it shouldn’t be, because it’s not about that. It’s actually just a condition of high male hormones. So yeah, hopefully, that helps.

Tallene: You said in three months, it can change – the nature of your ovaries. And I read this part in your book, how you said it takes a hundred days for that follicle to mature and that it needs the proper nutrition, proper insulin balance, and proper lifestyle within those hundred days for that follicle to mature, and ovulate, and have healthy ovaries. Women with PCOS don’t even realize, because they’re not told this,  that you can be healed of the ovarian cysts, like the string of pearls, these polycystic ovaries, it can all reverse. They don’t even know that because it’s so terrifying when they’re diagnosed. And yeah.

Dr Briden: True. What you said is exactly true. I just want to, cause I get it. It’s back to me being very kind of picky about what words I use. They’re not cysts. They’re really not.  Like, just to put it in perspective, there is such thing as an ovarian cyst, as you know, which is larger than a normal follicle, which can happen. There are all different kinds of ovarian cysts, some of them are kind of more serious, and some of them are not so serious. But a lot of your viewers may have had an ovarian cyst at some point in their past. That’s not what we’re talking about here.

These are not cysts. They truly are just follicles or eggs, which are normal for the ovaries. So it’s kind of a snapshot count of how many eggs are you producing that cycle? And it means nothing in terms of this condition or this diet or any diagnosis.

Tallene: It’s just a snapshot that says you didn’t ovulate for the past three months or whatever.

I used to think when I was diagnosed, I used to think because I had a ruptured ovarian cyst, that I had a bunch of ovarian cysts that were going to rupture. And then I was going to be sent to the hospital again, like I had no idea what this looked like, a string of pearls, like a string of a bunch of cysts that was going to rupture?

Dr. Briden: I know, that’s a common experience. I get lots of patients saying “Oh, just take it out. Take the cysts out.” I’m like, no, no, no, the ovary has eggs. That’s what an ovary is. It’s full of little, if you want to call them cysts, I mean eggs or cysts – it’s yeah. It’s a really good example of how one time you had an ovarian cyst, which is a thing, and then got confused about this diagnosis. So I hope that helps.

That’s why in my book, I have a flow chart of what type of PCOS do you have. And the very first step is, is it truly PCOS? And just to say again, PCOS is defined as-  it has a very simple definition, really –  it’s a condition of high male hormones when all other causes of that have been ruled out.

And other causes of that could include adrenal hyperplasia, which we talked about. It could include thyroid problems or high prolactin or, the doctor needs to rule those out.

Tallene: And none of them – I’m telling you when I got diagnosed –  none of that was ruled out. It was just like, Oh, cyst, oh, your ovaries look polycystic. Here’s some birth control, done. Yeah. It’s, it’s so common.

D Briden:  It’s concerning. And I mean, I, work with lots of different kinds of period problems. I would say PCOS to me in some ways, is one of the most heartbreaking in that such confusion in the messaging from the medical community is doing such harm, I would argue, and freaking women out. A diagnosis that although, you know, real and, you know, serious and needs to be addressed is concerning. It’s not kind of what women are taking it to be. So, yeah.

Sirak: And when you couple that with the diagnosis, taking a long time to kind of reverse, like it’s not a quick fix with PCOS. So you need, like, we’re talking about a hundred days, but usually, you know, three to six months, maybe a year changes. So that takes a lot of toll on a person who doesn’t know enough already to wait that long.

Dr Briden: Exactly. And the research has shown actually that the anxiety, the mental distress, that women go through because of the diagnosis is a concern. Like even, you know, scientists are concerned that that’s, that this activism and, you know, I guess diagnosis is creating such arguably unnecessary mental distress. And also women think they can never become pregnant.

Sirak: Yes.

Dr Briden: Totally not. Like, just completely not the case. Like, most women with PCOS diagnosis can become pregnant naturally.

Tallene: It’s exactly right. Maybe at the moment when you were diagnosed. At the doctor’s office, maybe at that moment, you’re not fertile. You’re not ovulating and stuff. But that doesn’t mean in three months, you won’t be. But then you leave there thinking that you’re completely broken. You have no idea what to do. And it’s just so heartbreaking. Yeah.

Sirak: That’s what they told you. They said, they told you, you’ll never be able to have a baby again.

Tallene: They didn’t say never ever again, but she’s like, you can’t have kids, but she, maybe she meant that as “right now, you can’t have kids”.

Sirak: Yeah. But you need to, like explain.

Tallene: Elaborate!

Sirak: She went back to the doctor later and they said, what was it? You’re as fertile as a salmon going up the river?

Tallene: You’re as fertile as salmon swimming upstream.

Sirak: Yeah. So how funny those two different statements are, but no explanation on what can actually improve. That’s what we’re talking about right here.

Tallene: I remember going back and getting an ultrasound and she’s like, oh, you don’t have any ovarian cysts anymore. And she was surprised. And I was like, why don’t you know that I could have reversed it? Like, yeah. Now you’re shocked. I don’t have ovarian cysts.

Dr. Briden: Well, not that they’re not cysts.

Tallene: Sorry, they’re follicles!

Dr. Briden: They’re follicles. It’s like you have a different set of follicles in the cycle compared to three months ago. That’s totally normal because the follicles of the eggs are constantly being made and then reabsorbed and yeah. It’s just a very dynamic system in the ovary.

Tallene: Yeah. In your book, you state that they’re thinking of changing the name of PCOS. And one of the names that they’re thinking of is Metabolic Reproductive Syndrome. And I would love if they named it that because it makes women with PCOS feel like it’s more about their metabolism, and their weight gain isn’t their fault, it’s not because they ate too much and they got PCOS. You know, in practice, it really highlights the metabolic problems happening.

Dr: Yeah. I agree. It’s a hormonal condition that promotes weight gain.

Tallene. Yeah. Yeah. For some women. I saw in the first chapter of your book, you talk about an example of a patient who had skin conditions like psoriasis, as well as irregular periods. And she went gluten-free and her symptoms resolved and her period regulated. I loved that that was in the first chapter. Do you often see these types of results with patients who go gluten or dairy-free?

Dr. Briden: I’m trying to put a number on it. I would say it works fairly predictably well when someone has a gluten or dairy sensitivity. So I don’t want people to think that’s going to be a foolproof fix for whoever you are.

But if there’s evidence of – particularly gluten sensitivity or celiac or non-celiac gluten sensitivity –  for those women, removing gluten is a total game-changer for periods. Like it affects everything and goes really deep. So signs of gluten sensitivity would be psoriasis, like in that patient story that I gave – actually any autoimmune condition, autoimmune is the situation where your immune system attacks your own tissue.

It’s actually pretty common in women. So another example is autoimmune thyroid, or what’s called Hashimoto’s. So for any of your viewers, like if they’ve been told they have a thyroid problem, the very first thing to ask is, is it autoimmune? Is it Hashimoto’s? Because that shines a light on the fact that gluten is not a cause, but a driver of that condition. And therefore gluten is almost certainly affecting periods as well. I’d say like a true kind of gluten sensitivity, it’s the minority of women, generally.

In the PCOS population, I’m not so sure. I’d say it’s even, it’s not the majority –  it’s I don’t know. Maybe a third or quarter of women might need to think about that. For the majority of women with PCOS, it’s insulin resistance, which is kind of the mainstream view. So with insulin resistance,  I just have to emphasize that it’s really important to test for that. This is what you definitely don’t want to do. You don’t want to say I have PCOS, therefore I have insulin resistance. And you don’t want to say someone saw polycystic ovaries, therefore I have PCOS, therefore I have insulin resistance. Like that logic does not work at all. So the test for insulin resistance is to measure the hormone insulin. We talk about that in the book and not just assume you have it.

So you can see it’s important for choosing a treatment because if you have insulin resistance, then you focus on that. If you don’t have insulin resistance, then that’s when you’re in the territory of thinking, “oh wait, do I maybe have that inflammatory type of PCOS that responds to gluten-free dairy-free” and you can have both to some extent too.

Tallene: Yeah. Yeah. You could have both and gluten and dairy can impact your insulin levels as well.

Dr. Briden: Yes, it’s true.

Tallene: It’s just worth giving it a try and seeing if it’s going to help you. And it’s one of the easiest ways to figure out what’s happening. You don’t even have to like, you know.

Dr. Briden:  I would agree. I mean, I’m a naturopathic doctor, so gluten-free dairy-free is kind of our 101. It’s what we do for patients a lot of the time, not all patients, but yeah. It can quite helpful.

Tallene: Yes. Oh yes. Great.

Sirak: I think one of the last questions we had was about magnesium and I think we’re thinking magnesium is one of the best supplements for PCOs. So why don’t you maybe expand on that for us?

Tallene: You stated that it’s the number one supplement for PCOS

Dr. Briden: Yes, yes. It improves, well, it improves insulin sensitivity. Like quite dramatically, I would say

Sirak: A lot of symptoms that have to do with like, like menstrual cramps and like with PMs and things like that,

Dr Briden: For sure. Like, it’s helpful for periods generally. Oh – I’ll keep talking about magnesium briefly, but I just want to say pain, cause you mentioned menstrual cramps. So that’s really good to bring up. One of my other messages is pain is not a symptom of PCOS. You can have both, commonly. You can have period pain and PCOS, or you could have a condition called endometriosis and PCOS. But the treatments for PCOS, – they can sometimes as a side benefit, help pain, and certainly, dairy-free helps the pain –  but just to understand if pain is your main symptom, there’s something else going on. It’s not just PCOS.

So just wanted to kind of put that out there, but in terms of magnesium, yeah. It’s great for PMS as well, mood, it’s safe and it’s inexpensive and I prescribe it a lot. I would argue it has anti-androgen benefits. So does zinc, actually. Those two simple minerals can have anti-androgen benefits. So yeah, there are simple to say again, inexpensive. A lot of my work I’ve been wanting it to be supplements that most people can access and buy and it’s not complicated. So magnesium fits that category. Yeah.

Sirak Awesome.

Tallene: Well, before we wrap up, I want to ask one last question. What would be your first piece of advice for a woman with PCOS who is listening right now? What can she do to make an actionable step towards bettering her health right now?

Dr. Briden: Have to say, confirm your diagnosis, like make sure you haven’t been misdiagnosed with PCOS. And beyond that, I guess I would say make us a strategy that doesn’t involve contraceptive drugs because they’re holding you back in terms of recovering from this. And probably Inositol. That’s three things. But my final message will be, and we said this earlier, but the closing message, it’s almost always reversible. So trust your body, understand that, you know, it’s a functional state that you can move out of and have normal periods, normal fertility.

Tallene: Yeah.

Sirak: And if people want to reach you or get in contact with you, is there, is there a resource that they can find online?

Dr. Briden: Yeah, I’m easy to find. So my blog on which there are several PCOS topics is my blog is Lara Briden dot com. All of my social media, Instagram, Twitter, or Facebook is at Laura Briden, and my book is the Period Repair Manual.

Sirak: Awesome. Awesome. Well, we’ll put that in the podcast subscription. So Cysters, if you want to get in contact or go to the blog, just go to the description of the podcast,

Tallene: Right? Thank you so much for joining.

Dr. Briden: Yeah. Thanks, guys. It was great to meet you.

Tallene:  It was nice to meet you too.

Sirak: Have a great day and speak to you soon. Bye bye.