Dr Helen O’Neill: We Know Less About Miscarriage Than We Do About Mars

0:00We could just give men contraception and alter their hormones and they were like, oh you couldn't, that might fuck them up. The female body has never ever been studied. Every single cell in our body, down to every single medication we've ever taken, has been built, tested and tried on men, male bodies, male cells. What's the impact of this? Women are more likely to die, more likely to have adverse reactions to drugs, more likely to have their pain dismissed. Every bit of our bodies is wired differently, created differently to create life. Can you give me and everyone listening, like what do we, what do I need to know?

0:42Welcome to this episode of Motherkind. It is me, your host Zoe, and we are proudly sponsored by Wild Nutrition's Women's Supplements. I think so many of us have spent years feeling frustrated by our bodies. We judge them, push them, ignore them and often wish that they were somehow different. But what if our bodies are actually trying to tell us something? In this episode, I am joined by Helen O 'Neill, reproductive scientist and founder of Hertility, who is on a mission to help women better understand their hormones, cycles and health. What I just absolutely loved about this conversation is that it's not really about fertility it's actually about something bigger it's about understanding ourselves so we talk about the incredible intelligence of the female body how our hormones can shape our energy emotions and mental well-being and why learning to tune into what's happening throughout our cycle can be such a powerful act of self-awareness this conversation just really reminded me how extraordinary our bodies are So if you've ever felt disconnected from your body, confused by it or simply curious to understand yourself on a deeper level, you are going to love this episode.

2:00Don't forget to share and subscribe. Here it is. Helen, I'm so excited to be chatting to you and I have done so much research and what you are doing is just phenomenal. but I want to start with asking you what is one thing that you wish every woman knew about her body? That it is the most powerful weapon that can protect both you and your children just through adaption, immunology, all of these things. Our bodies are so understudied but they are so powerful. When you say understudied what do you mean? Oh how long have we got? The female body has never, ever been studied down to every single cell in our body, down to our genetics, down to every single medication we've ever taken has been built, tested and tried on men, male bodies, male cells.

3:01So when we even look at some of the scientific repositories that scientists use to benchmark, almost like if you if you want like a dictionary that you would use to compare words or look up words, we use certain types of dictionaries, but they're for proteins that are in our bodies or genes that are in our bodies. And the current global database for all of the proteins, fewer than 4 % of them are female derived tissues. so we use the male form as the gold standard yeah i know there are no words there are no words there are no words and it was only in 1993 that women got included in clinical trials right and even then it was a one or two here and there what's the impact of this what do you know you're speaking to women day in day out what is the lived impact the lived impact is that women are more likely to die women are more likely to have adverse reactions to drugs women are more likely to have their pain dismissed and not get a diagnosis not get a prescription there there is no prescription for them it's it's almost hard to put to words the impact of our complete negligence and neglect of women as entirely separate biological entities.

4:27It's amazing that we're not all revolting on the street, isn't it? I'm trying to rally. It's like this blind spot. Yeah. And nobody sees it. And once you start to see it and start to unravel this tapestry of wrong, you think, oh my God, why is everyone not talking about this? Like I spoke with the chief scientific officer of one of the largest pharmaceutical companies in the world. And I said, you know, this is this is a big problem. And it's an even bigger problem when we take into account that AI is now building systems that are going to lock in those errors and compound them forever. And he's like, oh, it's a bit embarrassing.

5:14Embarrassing isn't the word. Like shocking is is the word. But yeah, when we think about what our bodies can do, we are the creators. Yes. Our bodies create life. We feed, we nurture, we carry. Every bit of our bodies is wired differently, created differently to create life. And we don't understand the majority of that power. actually just given me given me chills because imagine if some of these huge challenges endometriosis infertility imagine if they were actually well imagine if they're a male issue right well the difference in in funding it would be solved it would be solved i went to a massive conference recently um and they had free prostate screening exams on the fifth floor for every male participant and they were giving away bookmarks from Prostate Screening Association or whatever it is.

6:16And they were boasting that they'd raised a billion dollars for prostate cancer. And I just thought like... Which is great, but... No, that's fine. But that's less than the budget that was given for... I mean, meanwhile, the Women's Health Strategy had raised$500 ,000 and spent a year trying to do it. So the disparity is sickening. when we think about it. And you'll find the good fight because you are leading this reproductive revolution, really. That's what we call it. Tell us... We call it the mother of all movements. I love that. I love that. Tell me what was the seed that sparked that idea?

7:02I'd say many seeds over my scientific career that sparked it. I often say like scientists are supposed to have eureka moments. I think I had a what the fuck moment where I did my master's in prenatal genetics and fetal medicine. So everything to do with how we're formed isn't the earliest of embryos. And I was so consumed with like how, how incredible this was that every one of us had derived from like a single cell that it's split and divided. And I thought, why wouldn't everyone be obsessed with knowing this information? We all started there. We all began as embryos that implanted in our mother's wombs.

7:40And then when I did my PhD, I studied the differences between ovary formation versus testis formation. So that sexual dimorphism, in other words, the binary, male or female, when it came to our chromosomes, our genes, our ovarian formation, our hormones, our genitalia, all of that was so divided depending on the signals that we were given. And so that, again, further compounded this differentiator differentiator between how our cells can act so differently, but perform different tasks based on their environment. And then it just surprised me so much that when it came to preclinical studies, huge, huge human trials, that we just chose the male because the female was a little bit too hormonally noisy to study.

8:30So we'll just leave her out. And I remember asking somebody in a seminar, did you check whether the brains of these animals were male or female? Because I know they are very different. And they said no. And I just thought, I can imagine this study is entirely redundant because you're just missing out on key signals. But I think really what drove it home was when I was lecturing, master's students and medical students, all about female reproductive anatomy, physiology, all of these things, and felt completely in the dark about my own body. Like when you educate people about something you feel so passionately about and then you all of a sudden start to ask questions about your own body and are completely in the dark and yet have the liberty of having world class experts at your doorstep that you could ask these questions of.

9:19I thought if I'm confused about my own fertility, my own hormones, I have no clear direction as to where to go. I know I can't go to the GP and simply just inquire without a reason for being there. and no I don't want to go to a fertility clinic because I am not infertile or am I am I the one in six all of these questions really started to consume me because I thought you know if I'm so educated around this and so in the dark how does anybody else navigate this journey and that's really why I created fertility yeah and I think that you know I feel the same way and I think the fact that we are in the dark means that you outsource your power a little bit like everyone When I was how old, sort of 15, 16, 17, everyone was going on the pill.

10:03And I was like, OK, everyone just went on the pill in my generation. What's amazing is you never questioned it. Never questioned it. Never questioned it. They were like, it's good for your skin and some other stuff. And everyone took it. And the weird thing about this is when you play a thought experiment about switching it over and you say, well, we have a very complex calculus of hormones that are changing every single month. and when we take hormonal contraception we're really trying to mess around with or you know modulate a whole slew of hormones in order to prevent a pregnancy and then you think well actually we could just give men contraception and alter their hormones and I remember saying to somebody well men only have one hormone testosterone why wouldn't we just kind of suppress that to a certain extent and they were like oh you couldn't that might fuck them up and I was like and here we are perfectly fine to mess around with a young teenage girl yeah developing body developing hormones but definitely don't do it to a boy what can you give me and everyone listening like a hormone sort of 101 like what do we what do i need to know my little girl is 10 we're having lots of conversations about you know hormones and body changes what also do i need to be talking to her about?

11:24I think it's unfortunate that we decide that hormones are just to do with reproduction and that they're just for girls. I think having a broad conversation about girls and boys being driven by hormones, at the end of the day, testosterone is one hell of a hormone that is responsible for a lot of damage, both sexual and physical violence. So I think talking about hormones as if, you know, men are very hormonal, but we only ever say it to women. True. So true. We weaponize. We never see an angry man and say, oh, he's hormonal. Exactly. And we should. So I think I think evening out the idea that hormones, because when you think about our hormones, they dictate mood, weight, skin, appetite, energy, metabolism, all of these different things.

12:11Adrenaline is a hormone. Right. And so I think when we talk about them, it's better to talk about them across the board and the power of their function in all of our body. Even our wake sleep cycles are governed by hormones. You know, you have your melatonin that rises in the evening and falls then in the morning. So that is a good way of kind of talking about it. So it's not just talking about reproduction and reproductive function and periods. Nonetheless, when we do talk about those things, when we talk about the menstrual cycle that is this month where we have like a roller coaster of hormones and the reason you're telling me yeah yeah we do we're all we're all belt and braces here but i think if you are belt and braces at least you can prepare and i think that is a huge thing is preparation for what your body is doing and acknowledging the differences so i always say we acknowledge the difference between night and day and what our ability is during the day when you're raring to go versus in the middle of the night where you would take, you know, you need sleep.

13:18Our body needs different things from one end of the menstrual cycle to the next. So at the earliest, the first few days of your menstrual cycle, your menstrual cycle starts the day you bleed. So day one is when you're bleeding. And it's everything is kind of at a baseline then. It's why women sometimes say, oh, finally, my period is here. I start to feel normal. Yeah, it's quite a relief, that first bleed. There you go. And then that whole phase is called your follicular phase. And that follicular phase is essentially when all of the follicles or immature eggs are getting ready to mature. And so you get a rise in follicle stimulating hormone or FSH.

13:56And actually, estrogen is rising as well. Is that when you feel good? That is when your body is getting ready for ovulation. and so ovulation is that midpoint when the egg is released but from day one of your period all the way up to that your body's like i'm getting ready she's she's gonna be fertile and so it it is linked with so much of your energy your mood your metabolism your skin um the way you your brain function yeah your cognitive ability you're sharper um and it's because when we talk about oestrogen we typically talk about it to do with our ovaries and all feminine things as opposed to oestrogen being this incredibly potent and powerful hormone that is in every part of our body we have oestrogen receptors all over our bodies from our eyes to our brain to our ovaries to our skin which is why the menopause symptoms affect our whole body right exactly exactly so we move our associations with hormones away from simply being reproductive and we think of them as being chemical messengers in every part of our body, we start to pay a little bit more homage to them.

15:10Okay, so we've got the, carry on with the cycle because I'm locked in. Peak. And then your body releases an egg, typically, and the egg will wait to be fertilized and when it doesn't get fertilized, our body again sends signals and then you start to see this crash of estrogen. And that's really when you start to feel like angrier and then sadder. And the process starts all over again. And it's incredible that our bodies every single month will do this process, assuming, waiting for us just to procreate. procreate. But our bodies never in throughout history and evolution would never experience so many periods like women of today have far more periods than women of hundreds of years ago, because they would get pregnant.

16:08They would breastfeed for much longer amounts of time and then get pregnant all over again. So they would spend much of their much more of their life in pregnancy and lactation and therefore not cycling than we do now god that's amazing i never i never thought of that and you say that one third of women will face well you don't say this it's it's one third of women will face reproductive health issues yeah why is that well when you think about that complex cycling of hormones that go up and down and also the i guess the physiological things that are happening your uterus is building up a lining every single month it's like the cushion waiting for the implantation for this baby and then that doesn't happen in the lining sheds um of course we're going to see you know interruptions to that process we're going to see um health consequences so when we think about the most basic of um interruptions that we that that our menstrual cycle will face is like stress it's highly attuned to stress it's highly attuned to our diet to our exposures to our sleep and so when those things start to compound that impacts that that rhythm so is a change in your period almost like an early warning yes signal it's the it's the most unspoken yeah because i just tend to ignore it i'm like oh that was weird a bit heavier or that was weird a bit shorter or yeah and I think if more women were attuned to a normal menstrual cycle and say okay I'm I feel great because I'm ovulating or I feel shit because I'm you know premenstrual and say okay this will pass a couple of days I'll be fine as opposed to going into it blind and being like why am I feeling like this like why am I so angry and then feeling like why am I so pathetic?

18:01I feel so tired. I started tracking my cycle for that reason and I've stopped doing it for just, you know, you do something. You need the Hurtility app. We put a lot of work into this. Yeah, okay, I need to get your app. And just last night I said to the kids and my husband, I was like, I've had a really good day but I feel like crying. And Guy went, what day is it? I was like, oh yeah. Yeah, there you go. It's amazing. But that, because we're so busy. It's like the internal voice in your head whispering like, it's okay. There's a reason for this. And that can be very powerful, but also then acknowledging that that is changing over time.

18:36And that's why I say being familiar with a regular menstrual cycle is important, because then when things become irregular, you can start to pick apart the reasons why. And it's your body telling you. And when your body does tell you those things, it's doing it for a reason. It's nature's way of saying, you are not in a position right now to procreate and I'm going to protect you from that by stopping your ovulation, by stopping your periods. And that sounds like a very nice thing, but actually it's a real warning sign that most women ignore. And what we see is that women who've had their periods stop for actually consistent amount of time because they're overexercising, under eating or both, or they're completely stressed.

19:18they just ignore it and they're like actually somewhat grateful that their period hasn't come instead of saying there's a reason for this and and i should acknowledge that yeah it's actually wild when you think about it that way that it's your body trying to protect you because it needs to preserve all energy for you it is not willing to divest any of that energy to procreation

19:43gosh it's phenomenal isn't it what are the what are the big you know i think there's a lot of conversation at the moment about women having children later egg reserves sperm health i think is becoming more and more a conversation which is amazing but from your perspective what are you seeing as like the big things that you really want people to think about know and consider around fertility? I wish every girl, teenage girl who gets her first period was aware of their menstrual cycle, ovulation, and that actually fertility isn't forever, that we have a set ovarian reserve and that it does deplete over time.

20:24Because if you have that message from a younger age, then it doesn't come as a shock to you when you're older and you've been expecting things to work forever. And I think that is where so many people say, you know, why did no one tell me? Like, here I was just, you know, still taking contraception as if I was going to get pregnant any single month, and then they come off it to try to get pregnant, and it's much harder. I think if we knew at an earlier age that our fertility does decline, and it does so at a predictable time, then both the symptoms that we should then anticipate for perimenopause won't come as a shock to us emotionally or physiologically.

21:04But equally, we'll make preparation for that. And society still has not caught up with that. That's the strange thing is that our societal expectations of women have changed so significantly. Yes. Faster than in any other time throughout history. I always say her story. That we are now expected to do far more than just get pregnant in our teenage years and get married in our early 20s and have babies for our life and be housewives. That seems so foreign. And yet it's not so long ago that that is all we were allowed or expected to do. And so now it's almost switched the opposite way where you have to have not just a job, but a career, an education, a social life, look after your children.

21:53You have to meditate, do yoga, freeze your eggs, call your mother. Like all of these things our lives have become so crowded with the things that we should be doing in order to be perceived as, you know, ticking every single box in life. But it's really put a stress and a strain on becoming a mother. And it's delayed the time that we're expected to do that so significantly to where we've normalized. And of course it is normal now, but we've normalized the idea of having babies in our late 30s and 40s. But that was historically never really the case unless you were having them your fifth or sixth or seventh child then.

22:33And that's crazy because obviously our bodies don't pick up on that. And don't get me wrong, I had my second child at 40 and my body did that and I was very grateful. But when we look at statistics generally, our bodies struggle a lot more. And so the consequences to maternal health and infant health can be much more profound when we expect our bodies to do that. And I always say it's like running a marathon. You know, if you were running a marathon in your 20s, you'd expect your body to recover much more quickly. You could probably do it hungover. You could do it hungover. Whereas you can't even face a hangover in your 40s.

23:15Stop drinking years ago. Exactly, because it's not worth it. But we're expecting our body to do this nine month incredible process then followed by you deliver and you're at the goal line. Of course, it's going to prepare and react differently. It must have been so fascinating for you to go through two pregnancies and two births with all of that knowledge. Like, what was that like? What was your experience of matricence? And was it what you thought it was going to be? With my daughter, when I first got pregnant, I remember like day by day, I would be like, the neural tube is forming what do I need to be eating?

23:55Or I'd be like You knew too much. I knew too much. It was a bit much. But I loved it in a lot of ways and I did so much reading about the things that our bodies need at those individual times and to this day it surprises me so much that we don't just simply prepare women we tell them to take prenatals but we don't prepare them for like the individual nutrients that protect you and baby and can have lifelong consequences as a result for your health and theirs by simply just taking certain nutrients and the devastating consequences of lacking them. So actually, in my second pregnancy, I was B12 deficient.

24:34And I couldn't, but when I started to read about what that meant for me and my baby, babies can have lifelong neurological deficits as a result of a simple B12 deficiency. And I remember feeling so angry, like, how did I let this happen? And thinking, like, why was I not screened on day one for every deficiency? But we don't. And that, to me, is where we can really move the dial on changing different maternal outcomes is simply better education and access to testing. Well, it's the testing, isn't it? Because education is one thing. Like, oh, I need B12. But how are you supposed to know who's your deficient?

25:12How do you know whether you're going to be overtaking it or not? Exactly. Yeah. So that's a big move for us is now all the nutritional deficiency testing. That's exciting. And what was it like becoming a mother for you? You started the business. I incorporated. When you were seven months pregnant. No, when I was three months pregnant. Three months pregnant. And, you know, you look back on that and you think, how would I even consider doing that? But in a weird way, and I'm reading more and more about mums who start businesses when they're pregnant or postpartum. Because there's a strength that kicks in.

25:45That was my experience. And this is, again, this unquantified strength and change of mentality that you have, this ruthless prioritization. Like I used to call my due date my deadline. And everyone's like, you've got to stop calling it your deadline. And I was like, oh, this is the mother of all deadlines. But I got shit done as a result of knowing that that was a deadline I could not move. And everything thereafter, you have this ability to prioritize. like nothing else. Like I've always said, I'm like a, I will work, I'm a last minute person. I will work through the night to get something done.

26:24But with this, time is not on your side. And so you just get things done. I think you befriend good as opposed to just longing for perfection. And that is a really healing thing to a certain extent when you're somebody who always wants perfection. So true. I also think, you know, the brain changes in matricence where we sort of essentially go from thinking more about me to thinking more about we, right? I think that's why so many businesses like yours, like mine, do get started. Yeah. Because you look around and you're like, why is no one doing this? I did the same with MotherCard. I was like, why is no one doing this?

26:59Why is no one doing this? And you kind of go, okay. But your eyes open to the world in a different way because you're no longer looking for just yourself. You're no longer a selfish person. And that's not a bad thing. I was selfish before. I wouldn't say it. It's just a term for who else did you have to look after, really? Like you were driven by your own needs. That's a natural human thing. But when you have a child, you are driven by their needs and their needs come first. And so it's against everything in our bodies when it says like fix your own oxygen mask first. But actually, it's because now all of a sudden you need to let something else survive.

27:38And that opens your eyes up to a whole other world. and as a result of that vision, you're not just seeing the world through a child's lens, you're seeing the world through that future child and how you will never let them go through what you went through. And so that makes you fiercely determined to change the world for them and to change the world for all of the other people that you now see too who are mothers. What do you want for our daughters? What do you want them to never go through that our generations have? I never want them to go through the idea that they have to prove themselves 10 times as hard as their male counterparts just to be taken seriously.

28:20I never want them to have to prove that they need or are worthy of medical attention. And I never want them to be in the dark about the most profound weapon. Weapon is probably the wrong word. It's like a magic power that their bodies are, whether it's feeding, whether it's nurturing, whether it's birthing. I want them to know the power of their bodies. Some of the things that I learned about feeding, I was like, how on earth is this real? Yeah. that my nipple based on my baby saliva will change the consistency or formula of my milk to for what they need i was like that's some some sort of woo woo voodoo well this is it magic this is it it's weird like everyone says like are you are you religious or spiritual and i'm like i believe in physics um and biology i think that makes you spiritual by the way a hundred percent because there are so many things that you cannot explain.

29:28You just have to trust. And like, even when I look down the microscope, I'm like, just bigger than us. When you see something so incredibly complex inside one single cell and you're like, human, I can't see this. And yet here we are, right? As mothers going, oh, I feel so guilty. I'm not good enough. I can't do it. And yet your body is adapting. And yet we're incredible. Without doing anything. It's the one thing, And I will say this about becoming a mother. Every other part of my life I worked for, studied for, like endlessly devoted myself to learning a craft, learning a theory, a process, you know, whether it was in the lab or in the library and becoming a mother.

30:13every skill I had was innate to me. And I think so many mothers drown out the fine tuning of what their body is telling them to do, whether it's menstruation before they come pregnant or whether it's during pregnancy, like the smells that all of a sudden we know we're in danger or that we shouldn't be eating or we shouldn't be around, like that hypersensitivity that you smell things. It's your body's way of saying, do not eat that. Do not use that product. Get out of here. Is that? Yeah. Is that why you eat weird perfumes? Yes, exactly. Because they were like, what's the word? Endocrine disruptors.

30:48Is that real? Yes. What? Of course. It's why you eat random things your body is needing. And going, don't go near that person because it might disrupt your hormonal. Yes. Imagine tuning into this incredible signal and then postpartum where you have like a letdown, where you have, you know, this need for nurture. it's just the most innate knowledge that you have and yet we're never taught it what are cravings cravings are your body's desire for nutrients that you don't have so what's why some vegetarians end up eating meat during pregnancy because they're like need that iron i tell you i had that so i sadly miscarried and we were on holiday and we got back to the airport and i was actually in a wheelchair because i was so weak and faint and i hadn't eaten meat in quite a while and i said to my husband I was like you need to go and get me a red barely cooked hamburger and he was like but you haven't had I was like don't don't just go and I devoured it it was like something bigger something bigger than me yeah yeah so how do we start then to tune in better to what our body's telling us because I think the other side of that that I hear particularly if people are trying to get pregnant is like the anxiety and like oh there's a twinge oh how do we do it where we're like listening to our body but we're not becoming sort of anxious with every twinge especially if you had like me where I had my first amazing kind of dream pregnancy dream birth then had two miscarriages then got pregnant and it's it was very difficult for me to to I couldn't actually have that same ease that I had with the first because every twinge I was like yeah I would hold my breath.

32:37Yeah and I think that's the the hardest thing and where I actually get angry that we know less about miscarriage than we do about Mars. One in four that we know of will have a miscarriage and yet you're just told well another one might happen and another one might happen and after that we might investigate and I think that there are so many things especially when we look at the studies that are coming out about the role of sperm health in placental formation and therefore miscarriage and that sperm with higher dna damage just poorer quality sperm um is linked with higher rates of miscarriage that makes me want to start a revolution where i'm like you know we we say about women who are doing everything um to just be the my body is a temple and their partner is not doing anything and they only have to show up once you have to carry for nine whole months and everything after um and so i think that is something we need to learn more about is the role that sperm is playing um but so much more research is needed on this but we we also need collectively to speak to each other about when it happens this idea that we don't tell anyone about a pregnancy till you're 12 weeks actually just means that do we know where that came from It comes from the fact that there is such a high incidence of pregnancy loss in that first 12 weeks, because I think it's why you don't get your first scan until 12 weeks.

34:12There is such a high rate of pregnancy loss for many different biological and genetic and chromosomal reasons. But as a result of that secrecy, it means that you don't get the support that you need. Well, you go through one of the hardest things that, you know, is very difficult often without the support of your, or it's such an awkward conversation. It's like, I didn't tell you I was pregnant, but I've actually lost a pregnancy. Exactly. It's so awkward. Yeah. It's just, we need to do more. So with sperm health. Sperm health. It's a big one. So all of our eggs we're born with, right? What do the men need to be doing?