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PCOS Period Q&A With Dr. Lara Briden

Welcome to Episode 3 of Season 6 of The PCOS Revolution Podcast:

PCOS Period Q&A with Dr. Lara Briden

As we all know, it’s extremely common to use the pill to “treat” PCOS. Although, it’s not the only way. On today’s episode, we explore PCOS, your periods and the pill.

This week on PCOS Revolution Podcast, I am joined by Dr. Lara Briden, a naturopathic doctor and period revolutionary who has been working in women’s health for almost 25 years. She’s leading the change to better periods and his the author of “The Period Repair Manual”. Her book is a manifesto of natural treatment to improve hormones and periods.

In this episode, Dr. Lara Briden and I have insightful conversations regarding PCOS, your menstrual cycles and the effects that the pill can have on them. We explore the motivation Dr. Lara Briden had to explore women’s health and the work she does as well as various important topics related to PCOS. From defining PCOS to treatments, lack of research and birth control alternatives, we tackle a great deal of crucial information. Trust me, you don’t want to miss this!


 


Read Full Transcript

Farrar Duro 0:00
Well, hello, everybody and welcome back to the PCOS Revolution Podcast. I’m here today with Dr. Lara Briden, who is a naturopathic doctor, and a period revolutionary. She’s leading the change to better periods. We’re going to talk today about some topics she discusses in her book “The Period Repair Manual”. For those of you who don’t know her or haven’t read her book, I would strongly encourage you to check out her website. We’ll definitely list the link for that here. So The Period Repair Manual is actually a manifesto of natural treatment for better hormones and better periods. It provides practical solutions for using nutrition, supplements and natural hormones. It’s now in the second edition and it has been an underground sensation working to quietly change the lives of thousands of women. So very excited to talk about this today. Welcome, Dr. Briden. So let’s start off with what really sparked your interest in working with the cycle and women’s health and PCOS as well.

Dr. Lara Briden 1:04
Hi, Farrar, thanks for having me. Yeah, well, I’ve been working in women’s health as a naturopathic doctor for almost 25 years. I guess it’s a long time. I’ve been working with women with period problems, all that time spending back to the days when, in the 90s, no one was really yet talking about how diet can affect PCOS. That means surgery back then was something called ovarian drilling, which is a surgical procedure, which is really bizarre to think about now, but even back then I said it from a naturopathic perspective, we’ve been taught that there can be an element of blood sugar or insulin. I’ve been sort of coming at it in different ways, for the last couple of decades and of course, seeing great results because it’s the kind of condition that responds better to natural treatment lifestyle treatment than it does to really any conventional medicine.

Farrar Duro 2:01
Definitely, it’s so rewarding to see improvements with the cycle just by making a few changes here and there. We were talking a few minutes ago about what is going on with the whole landscape of women’s health and how you’re seeing and I see sometimes my practice that PCOS might be becoming over-diagnosed. Could you talk a little bit about about why that is?

Dr. Lara Briden 2:26
The problem is the ultrasound finding. So here’s the takeaway, which I’m sure has been said on your podcast before but it needs to be said again needs to be stated. PCOS is a hormonal condition that cannot be diagnosed or ruled out with ultrasound. Yeah, it’s some it’s quite a problem. There’s both an over-diagnosis problem with this condition and an under diagnosis problem, as you probably know, so on the over-diagnosis side of things, you get a lot of younger women, especially young women, who are being mistakenly told they have PCOS based on the finding of polycystic ovaries which can be used that way because one of the big changes is that since the Rotterdam guidelines were made in 2003, the sensitivity of the ultrasound technology has increased hugely. So now it’s much easier to pick up to see more follicles and their follicles or eggs which are normal for the ovary, they’re not cysts, the way we have other kinds of abnormal ovarian cysts. It’s common, it’s normal for young women to have more eggs in their ovaries. Almost by definition, being young, you’re going to have polycystic ovaries. There’s one statistic where I think up to 86% of normal women will show it polycystic ovaries on an ultrasound at one time or the other. As soon as you combine that finding, which is essentially a normal finding, with doesn’t take much, having irregular periods for some other reason, maybe it’s post pill or, more commonly under-eating. One of the things that concerns me the most is see women who actually have under eating or hypothalamic amenorrhea, that’s the term for losing your period due to under eating, being mistakenly told they have PCOS and going down the wrong track. That’s on the over-diagnosis side. I’ll just finish up by saying on the under-diagnosed side, I also see women who have insulin resistance, and obviously, anovulatory cycles, no ovulation, irregular cycles, signs of male hormones, and I say, “Well, I think this is PCOS”, and they’re like, “Oh, no, my doctor ruled that out. I have my ultrasound is normal, so that’s been ruled out”. It’s like no, no, you can have the condition the full blown condition and have normal ovaries and ultrasounds. So I really hope that’s clear. I would like to see that the ultrasound finding removed completely from the diagnostic criteria. I think that’s going to help a lot going forward.

Farrar Duro 4:54
Yeah, that’s so good that you said that because also its not recommended to do ultrasounds to diagnose PCOs in adolescence either, so that shouldn’t really be a criteria.

Dr. Lara Briden 5:05
Thank goodness, of course. The reason is because they have multiple eggs or follicles in their ovaries because they’re young.

Farrar Duro 5:15

There’s still a lot of confusion out there about diagnosing PCOS. It’s not easy. And the hallmark is definitely when you look at your period, and it’s over 35 days, like you mentioned, there’s, that’s that’s definitely a warning sign that you need some further investigation, I’ve seen some times where the hormone levels look almost normal as well, but all of the symptoms are there. So that’s interesting, too.

Dr. Lara Briden 5:42

In The Period Repair Manual, and on my blog, just about to release a new blog post about this, I talk about the different types of PCOS, what I call functional types. These are different than the phenotype diagnostic types that have been put forward. This is looking at what are some of the main underlying underlying drivers, which of course insulin resistance is the most common. But when you look at it from that perspective, I’ll just give the example of adrenal PCOS which affects its accounts for about 10% of PCOS diagnoses. That’s quite a different condition in that there can be regular population, which is like can be longer cycles, but regular population which is quite different than the classic type of PCOS but yet have these high androgens or male hormones from adrenal function, excess adrenal production, and if you start to think about it that way, it makes the diagnostic criteria even a little bit murkier than they were to begin with. The way I would define PCOS these days, I think the most maybe foolproof way to define the condition is it’s a condition of excess male hormones. When all other causes of excess male hormones have been ruled out, that would include, of course, something called adrenal hyperplasia, which you have probably heard about, its a genetic condition of adrenal overproduction of androgens, and that it’s actually quite common. It’s about 1 in 100 women who are almost always misdiagnosis PCOS to begin with. It’s a different condition, it needs different treatments. The other things that can kind of cause a high male hormone picture and high prolactin. The other situation of high male hormones that does get diagnosed as PCOS and I think is quite a particular special case is post-pill. So in my work I talk about that as post-pill PCOS that’s typically when try to come off Yasmin or Yaz  pill or ones which you don’t have in the States but instead we have Diane and Brenda’s. To try to come off those pills can cause a temporary surge in androgens or male hormones during which time, that could go on for six months or 12 months. Irregular periods, quite severe acne, what I call pill withdrawal acne. That is because PCOS is really just diagnosed based on symptoms. I mean that puts women under the diagnostic umbrella of PCOS. And yet it’s a temporary situation and a lot of people have talked about this women can be in a temporary state of PCOS because they’re young, or post pill, and that is actually not the same as the full blown condition which is really a lifelong condition.

Farrar Duro 8:43
Right. So that would be interesting if somebody actually was told to go on birth control because cycles are irregular, acne, or slightly, just maybe just acne, and that’s sometimes that’s enough reason to be put on birth control and they come off the pill. Their cycles are irregular. They’ve got more acne, more weight gain. And now they’re saying, well, maybe I have PCOS, but you’re saying it could take probably six months to a year for your body to kind of normalize off the pill depending on how long on it?

Dr. Lara Briden 9:13
With my patients in that situation I would say, okay, right. So we have this PCOS diagnosis for whatever it’s worth, let’s just kind of leave that on the back burner. For now deal with this more as a pill withdrawal situation, see where we can get you in terms of cycle length and skin over the next 12 months and then see if the diagnosis still applies. And the other thing to say when you’re putting young teens or teenagers on the pill for skin and irregular cycles. Here’s the thing because you mentioned about the 35 day cycle is kind of the cutoff for what would be considered normal cycle that’s true for adult women. So for teenagers, I’d say really anywhere younger than like 22 or 23,  up to 45 days is normal. You have a longer follicular phase as a young woman, teenager. So that’s why the guidelines are now really that the diagnosis almost should not be given to teenagers because most of us are in a temporary state of PCOS when we’re teenagers. That said, of course, some teens are in a much more serious state with a high degree of insulin resistance. That would be different but all of us are a little bit insulin-resistant, a little bit high estrogen, anovulatory cycles, longer cycles. As teenagers, some people, some researchers talk about it as puberty is, it’s the kind of PCOS-state of puberty is sort of a natural, it’s part of the developmental stages of the menstrual cycle. So first, you go into the slightly androgen-dominant state, not ovulating regularly and then once you start to ovulate, your estrogen and progesterone kick in and both of those have regulating effects and actually anti-androgen effects that help to mature the menstrual cycle. One thing that’s interesting about the menstrual cycle, and the communication between the brain and the ovaries is that it takes 12 years to mature that. So from the time you start your periods at 13 it’s not until you’re 25 that you progress through all those stages and are making optimal levels of progesterone ovulation, and hopefully down-regulated androgens, things like that. So that’s actually a really strong argument, to not give the pill to teenagers because it interferes, potentially interferes with that maturation process.

Farrar Duro 11:38
That’s very interesting, as you’re talking about that the wheels started turning like, okay, I remember learning that you are more insulin-resistant during the second half of your cycle.  So then birth control, also potentiates insulin resistance. If we are on birth control for the time of our lives, our bodies are still adjusting to our estrogen levels, what does that do to us?

Dr. Lara Briden 12:08
It’s actually long been known and there’s numerous studies to show that the pill worsens or causes insulin resistance. More than one expert has chimed in saying, “why are we giving a drug that causes insulin resistance to a condition that is driven by insulin resistance.” So yet another argument, it actually really makes no sense to get the pill for PCOS. I want to say something else about that. I mean, the pill’s a band-aid for each and every period problem. That’s the paradigm we live under currently. That’s the women’s health narrative that we exist under currently. That’s not how future generations are going to manage period problems, absolutely not. Because the pill was invented before anyone really understood how the menstrual cycle works, we’re using an outdated drug and that’s a problem for almost every type of period problem. It’s just a bandaid which potentially worsens some of the underlying conditions. But that’s actually really true for PCOS because A: it worsens some of the underlying drivers including both inflammation and insulin resistance. B: it’s supposedly given to regulate the menstrual cycle, which just think about it for a minute, it can’t do because a menstrual cycle is about having ovulation and the production of progesterone and the functioning of the ovaries on a cyclic basis. The pill bleeds are just a withdrawal bleed from contraceptive drugs that are taken arbitrarily that there was never a reason to bleed monthly on the pill. It makes no sense, it means absolutely nothing. And that’s actually true in some countries now, especially in the UK.

Earlier this year, they introduced new official recommendations that there’s no reason to bleed monthly on hormonal birth control. So we can dispense with that whole myth or idea. So it really raises the question “Why on earth are we giving women this drug-induced bleeds when it means nothing and is worsening the underlying condition?”  The other way I like to say it sometimes is PCOS is a problem with usually insulin resistance and failure to ovulate regularly. Supposedly we’re treating that with a drug that causes insulin resistance and suppresses ovulation so it really does nothing for the condition and that doesn’t mean that…I’ll just put it in the broader context, that doesn’t mean that I’m anti-pill for everything. I know there are other conditions out there like endometriosis where there’s pain and other symptoms that do require sometimes some suppression, hormonal suppression, but PCOS isn’t in that category. The only thing that the pill can do for PCOS, is potentially depending on which pill you take, can suppress androgens, male hormones, which, of course is welcome because it can clear up skin and suppress facial hair to some degree, but only as long as you take it.

Farrar Duro 15:26
But it also causes hair loss, right?

Dr. Lara Briden 15:28
It’s only as long as you take those drugs, because actually, when you stop them, those symptoms come back worse than they were before. I’m just at the point where I am just like, “what have we been doing these drugs for this condition?” There’s just so many other treatments that work better, including just simple Metformin. I mean, I still think that the lifestyle treatments and some of the supplements work a lot better even than Metformin, the diabetic drug that’s given but at least that even the Metformin is at least doing something to treat the underlying problems.

Farrar Duro 15:31
Definitely. I was on an interview with Dr. Christiane Northrup and she mentioned women’s health is still in the dark ages. We are doing something that like you mentioned is 50 years old and we haven’t thought of anything new. What’s going on?

Dr. Lara Briden 16:29
Yeah, A quote of Christiane Northrup that I use in some of my presentations quite often, which is that she put it like “Because we think of the standard version of human as male, we’ve all been conditioned to think there’s something wrong with the female body,” which is so profound because it’s true. The reason there’s been such a lack of research into how menstrual cycles work is because scientists have sort of been treating the male as the normal and then the menstrual cycle as this kind of add on. If anything, a liability…kind of complicated thing, and I’m trying to flip that whole script and just say, having a functioning menstrual cycle where you ovulate, and make progesterone and everything’s happening with the ovaries, that’s how the human body works. That’s how I would say the standard version of the human body, which is I say, is the female body, how we work. It’s time for a massive revolution in women’s health.

Farrar Duro 17:29
I love that you’re doing this work, because it’s so needed. I think what’s happened is that women are waking up to this and going, “Wait a minute, I not sure if this is actually good…” We were speaking about a study that surveyed almost 700 women with PCOS and they said, the question was on the survey, “If there was another alternative to birth control, would you be interested?” 99% said yes, that they were interested in alternative solution to PCOS. I think that women need to be listened to, to be heard and also to be educated that there are other solutions. A lot of women will come to us and say, “Well, I am using this for contraception also, and I just don’t know of any other solutions.” There are other ways, let’s just talk about some alternatives to birth control. If you’re using it as a contraceptive, but you are noticing that the side effects are happening, or you just don’t want to be on it any longer and kind of want to see what your cycle can do. And definitely, there’s a big fear of coming off birth control as well for a lot of women. Those are two big issues. But what would you say your favorite form of contraception would be, you know, for women?

Dr. Lara Briden 18:44
Okay, that’s a really good question. I’m just gonna start by saying one of the big side effects. I sort of mentioned the big side effects of birth control. You mentioned hair loss, that’s one of them. The other big one is mood right. Depression and anxiety which women and some scientists have known about for 60 years, but it keeps being…oh, no, no, that’s not a thing, you’re just imagining that sort of thing. Then finally, end of 2016, there was this massive study out of Denmark where they demonstrated that pretty clearly and even stated that it’s probably an underestimate. I would say that most women who take the pill notice some effect on mood. As far as I’m concerned, that is just not acceptable, the pill changes the shape of the brain, for example. Now, in terms of alternatives for birth control, the other thing to say is this is another outcome of 60 years of these contraceptive drugs is that just has not been the research into alternative methods of birth control that there should have been.  For example, we should have more male methods than we do because if you just think about it, men are fertile every day. Women are fertile only six days per cycle. So the obvious target for birth control are men. We already do have condoms, of course, which I am a huge fan of. I’m trying to revive condoms because, I don’t know if your listeners know, but there’s this new technology in condoms that is more comfortable, that is thinner. This one brand of condoms where they have 60 different sizes so that your partner can find one that actually fits and feels okay. It doesn’t slip, it doesn’t break. Condoms need a bit more of a revival, I think, but there should be other male methods, including this one coming, which I do have a blog post called “The Five Best Types Of Natural Birth Control” that’s on my blog. I mentioned this one there, I think it’s called vasalgel. It’s a reversible contraceptive method for men. It’s not hormonal. It’s a one-time injection of a gel into the vas deferens. It’s kind of like a reversible effect to me, but it’s just a little office visit, it’s just an office visit with a needle. It’s not surgery like women would have to do to have something like this done. There’s that, it hasn’t come to market yet, but I’m really hoping that will come to market because it could change everything. Beyond that, we have fertility awareness based methods, including the device, Daisy, which I am a huge fan of Daysy, a little computer thermometer has an algorithm. So all you have to do is take your temperature until you get your period. And it can tell you when your fertile days are and when your non-fertile days are. And this is the basic principle of the fertility awareness method. If you know when you’re not fertile, and if you’re in a committed relationship, you can have unprotected sex on those days. And this is even true for women with PCOS. I know that often the argument is well, women with PCOS have irregular cycles and can’t rely on a method like that. But my approach is that most women with PCOS can reestablish natural, regular cycles, at least close to regular cycles, and you can use then methods like Daysy, your fertility awareness method even with longer cycles, you ovulate later, but that’s okay, you can still figure out what that is.

There’s the copper IUD, which are Paraguard, which has no hormones, which doesn’t interfere with hormones or ovulation or anything like that, it works locally. I don’t hundred percent love it, probably some of your listeners are thinking, “Oh, the IUD can make periods heavier.” And yes, those things are true. I just refer to my blog post again, all this sort of free information. I have a blog post called The Pro’s and Con’s of the Copper IUD. You can read through some of the numbers and stats on different potential side effects, but still, lots of women do love it. It’s worth mentioning there is a new diaphragm out there now. There’s a few things, It’s not just hormonal birth control or nothing. That is part of the narrative of birth control that has got to change because we currently have other methods and scientists should seriously be working on some other methods because to have to shut down a woman’s hormonal system with contraceptive drugs to avoid pregnancy is just massive overkill. Wouldn’t you agree? In 2019, surely we can come up with another way to avoid pregnancy, that doesn’t involve shutting down hormones or sometimes I say, castrating women because that is what those drugs do. They shut down ovarian function.

Farrar Duro 23:35
I agree and I think it’s time for that. Until then, we have to look at what we have. I think that starting to know your cycle and knowing your body is very important and your fertile window for sure. It’s kind of fun to learn about your temperature. Our patients say, Okay, this is a lot of work, but maybe I don’t have to do it forever. And maybe you just do it for a couple of months just to figure out what the heck your hormones are doing, and then we can sometimes identify other things that were hard to see. We’ve looked at temperatures and said, Well, we need to test your thyroid, all kinds of things. You can learn how these supplements are working that you’re taking and about your luteal phase and so many things. I think it’s worth exploring, maybe it’s a good time to do it when you’re on a regular schedule, if you’re traveling and all that it might not be the right time. But do you encourage your patients also to chart their temperatures?

Dr. Lara Briden 24:34

Yeah, I do. And, like you, I do hear some women saying that feels like a lot of work. Some of it love it and just embrace it from day one and just people who are really active in the fertility awareness method community make the point, it just takes a minute in the morning and you gain all this information and they really kind use that cycle tracking as kind of an anchor to know where they’re at with their health, and I think that’s fantastic. At the same time, I think, yes, there’s some women who just don’t want to do it that often. What I would do in that situation with my patients is first, I don’t want them tracking temperatures when they first come off the pill and aren’t cycling. Yeah, because that can just be an exercise in futility and feel really frustrating. So I would usually say, come off the pill, use barrier methods, or withdraw. I will mention withdrawal is actually a method for what it’s worth, you can read about some of the stats on that on my blog post, but here’s some other methods. Then once you’ve had a couple of ovulation cycles start checking temperatures because then you’ve got something to look at. Because, and this is particularly true with PCOS, the hallmark of the condition when is kind of full-blown, there would be mainly what are called anovulatory cycles, so you’re still bleeding maybe irregularly every couple months or something like that, but then they’re not cycles in that ovulation didn’t happen. In that case is nothing to see with the temperature because the temperature tracking is tracking ovulation and the temperature change that occurs with that. I hope it gives a beginning of a guideline, the first step is to start ovulating, which is usually highly doable with diet, lifestyle and supplements, then start tracking and have a look at when that luteal phase was happening, that post-ovulation phase.

Farrar Duro 26:17

I think that’s such a great insight to teach girls too about this. I feel like that should be taught for sure, and you have sex ed but you’re learning about your cycle and how great would that be? That’s probably not going to happen…

Dr. Lara Briden

Radical idea isn’t it? Like to teach girls about checking fertile mucus and temperatures and teach girls that ovulation is a good thing. It’s how we make hormones, it’s how we mature our menstrual cycle.  The phrase for that is body literacy, which I love. Tracking, understanding what the what the body does. What I’ve said a few times is that if men had to ovulate or cycle to make their hormones they’d never stop talking about it. The menstrual cycle would be a major event because it’s how you make hormones.It’s how we make hormones, it’s how we mature our menstrual cycle. The phrase for that is body literacy, which I love. Tracking, understanding what the what the body does.

Farrar Duro 26:17
And Wasn’t there a male birth control pill? I thought there was…it was taken off the market?

Dr. Lara Briden 26:51
There is one trying to come to market and it’s having mixed results. Men don’t like the side effects and my view is why should they? I actually don’t really want men using hormonal birth control either.

Farrar Duro 27:52
If you are trying to come off birth control, your book talks about certain strategies you can do but what are some symptoms to look for? What are some good strategies that you use with your patients?

Dr. Lara Briden 28:07
I think the first thing is to know which pill you’re trying to come off. If you try to come off Yasmin or Yaz, that’s got a drug that can cause a particularly vicious kind of post pill acne. Because you get this surge and androgens and skin oils, so and that usually starts about three months off the pill, peaks about six months off the pill. And that your listeners, I mean, they may have tried coming off and experienced that before. Or they may just need to know this. If you had skin problems when you were younger, and you’ve been on Yaz or Yasmin, and you’re going to try to come off you need to think about your skin straight away because the skin problem is going to be worse than it was before you took the drug. I have a blog post called “How To Treat And Prevent Post Pill Acne” where I talk about putting in place strategies including a dairy-free, sugar free diet. I use the supplement DIM or diindolylmethane quite often as an androgen suppressing-supplement, mild antigen-suppressing, combination of those, quite reasonably high dose zinc. Not just a little bit of zinc and a multi or something but some proper zinc.That combination plus possibly some other supplements can make a huge difference. You might still get some pill withdrawal or post-pill acne but you probably come through it a lot easier than you expected. Also knowing that at the six-month mark, six months off the pill, most women turn the corner and the skin starts to improve anyway, especially if you’re having regular cycles by then and making estrogen because estrogen is really good for skin.

Farrar Duro 29:58
Okay, yes, we’ve had this for some of our patients when they’ve come off birth control. They’re concerned because the acne is just like boom…full force, and it happens very quickly. And it’s like within days, sometimes.

Dr. Lara Briden 30:13
Within days? I feel it within days is less common. I usually see maybe a little bit within days, but usually it starts to really ramp up about the three-month mark. And then at six months, like peaking around the time most women would think, ooh, okay, must be something really wrong with me, this is out of control, I must need these drugs, I’m going to have to go back on. At least knowing this timeframe can help, can encourage you to keep going and get because once you get through that withdrawal process of coming off drugs then the skin all is kind of normalized to get more normal hormones. To say again,  both estrogen and progesterone have anti-androgen effects. Once we really get going in our cycle, our own hormones are going to help our skin.

Farrar Duro 31:05
You talked a little bit about micronized progesterone, when would you use that?

Dr. Lara Briden 31:09
That’s an interesting one with PCOS. So that’s natural progesterone capsules. It can be good for skin, has an anti-androgen effect. The other way that micronized or natural progesterone capsules gets used, and I don’t routinely do this, but I’ll mention it because I mentioned it in my book. There’s been a couple articles written recently by Professor Jerilynn Pryor. She’s a reproductive endocrinologist with great insights into the menstrual cycle. She has what she calls cyclic progesterone therapy where she gives her recommendation which is two weeks on two weeks off with the progesterone capsule. And it helps to regulate cycles, potentially. What it does is it actually helps to normalize the communication between the brain and the ovaries. Your listeners you probably know the classic feature of PCOS is having quite high, chronically high or elevated LH, that pituitary hormone. Because normally you should have quite low LH in the cycle except just before ovulation and then it shoots up. So that’s having this chronically, overproduced, LH stimulates androgens or male hormones and the other thing that interferes with the normal process leading to ovulation so progesterone suppresses LH, is the gist of what she’s doing with that. So it’s something I’ve used.  I’ve recommended it occasionally. I actually find depending on the age of the woman, I find younger women respond just as well to getting the sugar out, taking magnesium, taking zinc, doing exercise, doing all those things can make kind of a difference. I don’t necessarily know that everyone with PCOS needs to go straight to cyclic progesterone therapy, but it’s worth knowing that it exists. And that Professor Pryor’s writings about that exist.

Farrar Duro 33:07
Very helpful. Yeah. And will link to that as well. I think that is a question that we get asked. Sometimes we do use bio-identical progesterone cream or drops and especially for PMS or for very irregular cycles, and working together with herbs, and a good healthy diet and, and just a short term thing, not always not long term because we don’t want anyone to be reliant on on hormones and other things. We want your body to actually start producing things on its own. It can be, like you mentioned, a solution for someone. I think that’s a good discussion to have with your practitioner. For those of you who are looking for more of these suggestions and trying to kind of get some sort of hold on what’s going on with your cycle, I think that Dr. Briden’s book, The Period Repair Manual, it’s a good place to start for sure and really dig deep into your hormones. I think that we all need to experience a healthy cycle. One of the biggest things for women with PCOS is that when you don’t have regular cycles, you just sometimes don’t feel like yourself. And this is very important work that you’re doing, I think.

Dr. Lara Briden 34:23
And regular cycles are important for long term health and this is worth mentioning. Regular cycles where we ovulate and make progesterone, it’s really important for the long term health of the reproductive system, actually protecting the uterus from thickened uterine lining. Also, bone health, brain health, helping to reduce the risk of breast cancer, all of those things are helped by having cycles where we ovulate and make progesterone.

Farrar Duro 34:52
Definitely in Scientific American, it’s been my favorite issue. If you saw it, was all about women’s health and the whole article is, do we really need a period? What’s the purpose of a period? And the conclusion was yes.

Dr. Lara Briden 35:09
To a quote it, saying it’s good for long term health to have a regular cycle, not a pill bleed.

Farrar Duro 35:24
So I think this is just such good information. If you are currently struggling with PCOS, or you have, perhaps your daughter is considering going on birth control or you’re wrestling with what to do, definitely pick up this book, start to educate yourself on other alternatives first, just know that they’re out there. And, of course, that’s definitely a personal decision, there’s no right or wrong way. But definitely consider the side effects and also the pros and cons. That’s that’s all we’re asking. Thank you so much, Dr. Briden, for being on our show. I really look forward to reading more and more about your work. I love your blog, and we’ll definitely be sharing your posts that you mentioned as well.

Dr. Lara Briden 36:09
Thanks so much for having me. It was a great conversation.

Farrar Duro 36:12
Thank you so much. Have a great week, everybody. We’ll see you next time.


Episode Spotlights:

  • The spark that motivated Dr. Lara Briden to explore women’s health (1:04)
  • The landscape of women’s health and the overdiagnosis of PCOS (2:31)
  • Misdiagnosis of PCOS due to Ultrasound (4:10)
  • Functional types of PCOS (5:54)
  • Defining PCOS (6:50)
  • Difference between short-term states of PCOS and actual PCOS (8:30)
  • Interference taking the pill can have on the maturation process (10:41)
  • The women’s health narrative we live under currently (12:50)
  • Treatments for PCOS (15:45)
  • Lack of research into how menstrual cycles work (16:55)
  • Alternatives to birth control (18:30)
  • The fertility awareness method (21:37)
  • Charting temperatures (24:36)
  • Coming off birth control and symptoms to look for (28:00)
  • Regular cycles are important for long-term health (34:28)

Resources Mentioned In This Episode:

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Disclaimer: The information in this podcast is intended for general audience only and is not intended to diagnose, treat or replace professional medical advice.

About the author, Farrar

Farrar Duro here, reproductive acupuncturist at Florida Complete Wellness and founder & host of The PCOS Revolution, a cutting-edge podcast where I interview PCOS experts and cysters who share their pearls of wisdom on how to kick PCOS symptoms to the curb once and for all!

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