Women’s Health Questions Answered: AMA 1 Lightening Round

0:00Your ears comfort more important than my uterus comfort. Every doctor was just telling me, oh, it'll get better, it'll get better. And I finally had to have it out because I was like, there were days where I couldn't even walk. You should suck it up. Why are you being such a baby about it? I don't understand. It doesn't hurt that bad. Clearly it hurts. I'm crying. Do women need pain management? The rest of the world's been looking at the U.S. being like, you're barbaric. What are you doing to women? This is absolutely barbaric. What impact may severe unmanaged endo and adeno pain have on the autonomic nervous system?

0:33Oh, this is so important. Endometriosis and adenomyosis change the brain. They will change your brain. Now your brain and your nervous system has changed to perceive everything as pain. That's more of a problem. Hey, Chicago. Class it up with Crocs. You know back to school is coming in fast. So why wait to find your new fave footwear? Step into a local croc store and step into your new look. Try it. Style it. Make it yours. Because the right pair doesn't just show up. It shows off. First day fits, handled. Walk out ready for whatever's next. Visit your nearest croc store today. Propel Fitness Water.

1:17With Gatorade electrolytes, zero sugar, and vitamins, Propel hydrates better than water to help you get the most out of your workout and get back to your best self. What propels you? Propel with Gatorade Electrolytes. Hey everyone, I'm Dr. Jolene Brighton and you are on the Dr. Brighton Show and today we're doing something really special. We're sitting down with my assistant and friend, Angela, and she's gonna be asking me all the questions you submitted. Now, here's the thing about the Dr. Brighton Show. We've been at this for a hot minute and we're coming up on episode 200. It's like right around the corner.

1:50And this show has always been about you, not me, meeting your needs. So this is what I need from you. A little bit of a favor. Let me know. Is this AMA what you're into? Do you like the AMAs? Do you like the panels that we do, like the endometriosis panel that we had? If you do, good news, we have an ADHD panel coming up. But also, do you want guests? Do you want solos? What do you want more of? How can I meet your needs? How can I help you thrive? And what can we at the Dr. Brighton Show team be doing more of that you enjoy? Because it shouldn't just be about learning. It should also be about having a good time.

2:25Now, with that said, I'm going to let Angela throw some lightning round kind of questions at me. I haven't seen any of the questions you guys have submitted so that it was a little more fun for me, too. But Angela, I will let you take it away. Yes. So here we go. Dr. Brighton, are you still gluten free? I am not gluten free. And this is going to probably upset some people. So I have Hashimoto's thyroiditis. And something that I found is that when I would eat gluten, I would get severe joint pain. And so gluten just did not like me at all. We were not friends. And then interesting thing happened that when I was in Paris with my son, and those of you that have been with me for a while, he developed this condition called pandas, which is an autoimmune condition of the brain that's activated by strep.

3:13It was the most stressful time of my life. And And I was like, I just don't even care. I'm having a glass of wine and I'm eating a baguette. And as it turned out, I didn't have any problems. And I was like, hold up. Because everyone always says like, when you travel overseas, it's because you're relaxed and you're in a different state. And that's why you can tolerate foods. But no, I found I could eat that. I can eat gluten in Europe. I can eat gluten in Mexico. I can eat gluten if it's not, the wheat's not coming from the US. So when I actually experimented with in Mexico is I was like, okay, here I am eating their sourdough.

3:47I'm eating all their, all these, you know, carbalicious foods. And then there was a loaf of bread and it was imported from the US. And I tried that and all of my symptoms came back. So I would say my relationship with gluten is complicated because I can eat it in certain places, but the US, there's something going on there. And could it be the glyphosate that we spray things with? Possibly. Could it be the hybridization of wheat that makes it more concentrated in gluten? Possibly. but I really thought, oh, maybe I've moved past this gluten intolerance because you can, you can totally move past food intolerances.

4:22You can heal your gut. And I was like, yes, this is what's happened. And then as it turns out, I was wrong in that experiment. But that's kind of part of being a little scientist when you're near the end of one is that you're going to get it wrong sometimes. But I was so confident. I was like, I can eat bread anywhere now. And I was like, I cannot in fact. So yeah, that would be my answer. I'm not still gluten free, but it's complicated. I hear that. Next question. What's a good multivitamin for men with MTHFR? So in general, like if you have MTHFR, the first place we want to start with your food, actually.

4:58So people are always like, what's the best supplement? There is a molecule called biopterin that you need if you have an MTHFR mutation, and you can only get that by eating your fresh leafy greens. So that first, right? The second thing is, is if you're a man, you don't menstruate. The odds of you needing iron are very low. So a multivitamin for a man shouldn't have iron. And it's only if we test you, we find your iron deficient, then we would supplement with iron. Now, when it comes to MTHFR, we want to be looking at activated B vitamins. So methylfolate, we want to have and so that's the instead of folic acid we're using methylfolate methylcobalamin which is the activated b12 and it's better that we're getting a multivitamin here because we also want our minerals we want our cofactors involved in that as well but the caution i would give is that some people can feel worse if they do a full dose of like methylfolate so sometimes what i'll say to people is like just start at half the dose see how you do and then increase the dose to the full dose and then see how are you because some people are more sensitive other people not so much but well I think a multivitamin is a good insurance policy I would not I would not skip your vegetables in that and then the other thing I would say is that if you look for like a women's multivitamin so like we at the Dr.

6:21Brighton Essentials Company have the women's twice daily that is for women across the board and it has no iron on in it on purpose so that perimenopause menopausal women can take it. It's actually a multivitamin that my husband uses because it has no iron and it has the formulation. So that's like really the big difference in multivitamins between men and women is that iron content. Wow. I did not know that. Could endometriosis be a response to hypermobility, the body gluing organs together for stability? Well, that's a really interesting way to think about it. I would say no, because what we're seeing is that it's internal organs that are being glued together.

7:02And in hypermobility, like everything can be affected, right? Your skin, your joints, your cardiovascular system, every single system can be affected. And so I don't think endometriosis is a response to that. I think that's an interesting way to, and I like the, like, maybe my body's just trying to keep me safe take on it. But what's actually happening with adhesions is that there's bleeding, there's inflammation, There's a clean cleanup crew that tries to come in and then scar tissue formation because of how the immune system's reacting with everything. That's what's going on with endometriosis.

7:37And so it's quite dysfunctional. So I would say no. And I can't foresee research saying otherwise in the future. But, you know, if it does, I'm OK being wrong. Yeah. Can you discuss the copper IUD and how it causes inflammation in the uterus? Yeah. I love that you have a British accent. And then I should tell everybody that I'll probably start copying your British accent at some point. So the copper IUD, it works by creating a hostile environment. So I think this is important to know. This is going to be really controversial because some people believe life begins at conception. So in the fallopian tube, egg and sperm meet.

8:15And so you might not believe that, but I think as a doctor, this is an important part of informed consent. because if this is your belief, then you need to understand that if egg and sperm meet, then the embryo cannot implant. And so, you know, that's because it's such a hostile environment there. But the copper is also toxic to sperm. It's like a cold blood killer when it comes to the sperm. So it also lowers the odds that egg and sperm will ever actually meet because it causes that low grade localized inflammation and it's irritating. That's why so many women with endometriosis or adenomyosis are not recommended to use the copper IUD because it can be irritating.

8:55You can still have irritation. So you can still have like, my pelvis is heavy. It's crampy. I don't feel right. If you don't have endometriosis or adenomyosis. And so I'd really encourage you to listen to your body, see if it works for you. I had it, I had it fitted. It was horrible. No pain relief at all. And, um, I bled and the nurse said to me, oh, you're bleeding. I wasn't that, I wasn't that rough and I had a vasovagal reaction to it. And yeah, my body completely rejected it. It was awful. I bled nonstop for weeks until I said, I have to get this out. Yeah. Bad experience on that. But just to talk about the nurse that was so lovely, that was like, I wasn't that rough.

9:42And I'm thinking, well, actually you were. So when I had my IUD placed, when I'm in a lot of pain, I use very choice words that you don't ever hear on the podcast otherwise. So I curse a lot. And it was very interesting. There's research that shows that people who curse when having pain, they actually have a higher pain tolerance. So there's something to it that helps. But with the nurse, it was so painful. All they tell you, right, take some Tylenol, take some paracetamol. Like, it'll be fine. It was so excruciatingly painful. And of course it is. But I was being gaslit by the nurse practitioner.

10:17She's like, it's just a pinch, but you don't even have nerve endings. And I'm like, how could it be a pinch if I don't have nerve endings? As it turns out, your vagus nerve is like all up in your business down there. So like lies. I was cursing because it hurts so bad and I was crying. And she was like, if you do not like clean up your mouth, I am not going to continue. I don't have to listen to this. And I was like, why is your ears comfort more important than my uterus comfort? Like, what is that about? It was incredibly painful. I had six weeks of incredible pain. Then I just had flooding just nonstop, like just so heavy.

10:54And I became anemic and developed iron deficiency anemia. And every doctor was just telling me, oh, it'll get better. It'll get better. And I finally had to have it out because I was like, there were days where I couldn't even walk. Every doctor that I talked to and that nurse should have said, this could be endometriosis. This could be adenomyosis. we should work this up. But instead they said, you should suck it up. Why are you being such a baby about it? I don't understand. It doesn't hurt that bad. Clearly it hurts. I'm crying. Yeah. I went into shock and I was in bed for days after it. Yeah.

11:26No one warned you about that, right? No. And you know, to your point on all of this, like no one warned you about it. It wasn't until 2026 that ACOG's like, maybe we should actually do a study. Do women need, like look into the research. Do women need pain management? Oh yeah, we should recommend pain management for this. Meanwhile, the rest of the world's been looking at the US being like, you're barbaric. What are you doing to women? This is absolutely barbaric. And because everybody looks to ACOG, they're like, oh, well, ACOG says you don't need anything but Tylenol. Yet like it took millions of women on the internet telling their story for ACOG to finally listen.

12:01And I'm like, oh really? As if every gynecologist that's like all signed up and in bed with ACOG couldn't have listened to women. and spoke up sooner. Yeah. I mean, I got mine pitted in the UK actually. So pretty much the same. You know, I want to say people like romanticize the UK's healthcare system. It is just as flawed as the US is. I'm going to throw Canada in the loop there as well. I mean, women are making, waiting like six months to two years just to get evaluated for some conditions. And then once they're evaluated, they get the diagnosis. It's another two years to have a procedure on it.

12:34The UK is very good at gaslighting women. They're very good. I mean, if you go and look at the studies on gaslighting, you will find the US and the UK, they're always like fighting for like, who's going to be top of like, you know, basically putting women down and doing a disservice to them. Yeah. No, I'm not surprised. I mean, you just can't get an appointment in the UK and everything is go on the pill or take a SSRI. That's, that's essentially it. And see you never. So you never, you know, I would love women who are listening to chime in in the comments, like where are you out in the world and what's been your experience?

13:08Because, you know, I've heard from women with endometriosis in like Sweden. Literally, I could name like every country in the world. I think I've heard from women and they're like, it's no better here. It's no better. And I think, you know, that's why I always say when you see a doctor in the system doing right by women, women lift them up and praise them. There are very good doctors in the UK who are really fighting the good fight for women. And I think there's good doctors in every country. Oh, everyone. But the problem is they get so burnt out because the system is like, it's set up against women and against doctors who are really delivering the quality.

13:45And I think that's not to say other doctors are bad or evil or, you know, anything like that. It's that like they're stuck in a model. It's not designed to work for the patient. No, absolutely. How do hormones affect inflammation? is pain fluctuating with the cycle connected? Yes. So, you know, progesterone, estrogen, testosterone, they're all tightly tied to the immune system. And it's interesting because we always talk about estrogen with immune system modulation. It's very Goldilocks. You know, you have too little inflammation happens. So we get older, we don't have estrogen. Everything starts getting inflamed and we're aging more rapidly.

14:21You have too much estrogen. We got too much histamine. and now we're like feeling like our brain's on fire. We're so irritable, we're so enraged. But testosterone never gets enough airtime. And there's been interesting research showing that when women don't have enough testosterone, there can be immune system dysregulation because it's very tightly tied to T cell regulation as well. So all of your hormones, including cortisol, which I love, it's one of your most anti-inflammatory hormones, oxytocin or cuddle hormone, melatonin, people think of it as like, oh, it's just about sleep, but it's a hormone and it helps with modulating the immune system as well.

14:59And it's a lot about antioxidant protection. So coming from that area. There was a second part of the question. Oh, cycle, cycle specific. On your period, I'll say that's usually when we say like, don't necessarily have like certain procedures like before your period, around your period. But having a breast exam like early in your period, yes, because the breasts are under the influence of the hormones. So the reason why we say that is because there are changes that can happen and you can have more sensitivity. One thing I would say is that you're sometimes at the mercy of your menstrual cycle, right?

15:32Like when can you get an appointment? When can things happen? First thing in the morning is going to be best. So rather than being like, let me try to control the menstrual cycle and then get really frustrated that you can't where your appointment lands, try to control first thing in the morning. Your endorphins are higher and your pain tolerance will be higher. But when it comes to the immune system, absolutely the shifts in estrogen and progesterone are going to influence it. So around ovulation, estrogen's highest point in your cycle. If you're someone prone to histamine issues, that's when the histamine issues will be their worst.

16:04And then when you see like, you know, progesterone is rising up, progesterone actually helps with modulating histamine. but at the same time, because there's like a little bit less estrogen stimulating, there's still estrogen present, but in terms of like receptors and who's stimulating, estrogen's a little less so than what we see in the follicular phase. You might find that like, no, actually, like I do feel like I get a little more inflamed and then there's prostaglandins. And so prostaglandins, those are the primary cause of what's called primary dysmenorrhea. And primary dysmenorrhea means there's no underlying medical conditions.

16:41There's no endometriosis, no fibroids, there's nothing else. But I would challenge that you only know if you look. And endometriosis loves to throw out prostaglandins. So always check first. But prostaglandins can go up in that very late luteal phase and then on our period. And they are inflammatory. The more omega-6s you eat, the more inflammatory they are. The worse your period poops, the worse the period pain. The more omega-3s you eat, they still do their job, these prostaglandins, to help you shed the uterine lining. but they're not as aggressive. And prostaglandins are not bad, even though you might hear that in inflammation.

17:17I mean, without prostaglandins, you couldn't have a baby. They're helping stimulate uterine contraction. So they have a very important role, but they can be inflammatory and that can be influenced by our diet. And if you're someone who's like, I have food diversions, I can't eat a perfect diet. Omega-3 fatty acids is a supplement. Getting third-party tested, small batch, like we do in our company, you know I'm very, I'm so picky about omega-3s. I'm like, no, I'm only putting the omega-3s in my body that we've actually manufactured, that I've seen everything through on production. I know it's in it because they can be oxidized and then you're taking it.

17:50It's working against you and they're not cheap, right? And then the other thing is that they'll sometimes be cut with other oils. There's a huge regulatory issue. And anyone who owns a supplement company might be mad at me for this. But I do think third-party testing and label verification should be mandated. And that's, you know, something that we do completely different in our company is that I'm like, if it says it on the label, it better be in the capsule. Like it better be in the capsule. Like no lies. Like we treat our customers like they are our family. And so that I think is just a huge regulatory issue that we face with how the FDA is governing things in the United States.

18:30And it's why sometimes women try, women will be like, I went to a big box store, I bought the biggest thing, container of omega-3s I could find. I took those, it did nothing. And I'm like, yeah. Was it a clear bottle too? Yeah. Okay. So UV exposure, very, very bad for these omega-3s. So we want to make sure that if we're taking omega-3s, they're high quality. But I would also always say start with your food first. If your ADHD feels different across your cycle, postpartum, or in perimenopause, ADHD in Women explains why hormones can change your brain and what you can do about it. Pre-order now and for a limited time, get the first chapter audio read by me, Dr.

19:11Jolene Brighton, for free. plus a bunch of other bonuses like a free recipe guide and a PMDD workshop. Claim your bonuses at drbrighton.com slash ADHD and women. That's D-R-B-R-I-G-H-T-E-N dot com slash ADHD and women. Hey Chicago, class it up with Crocs. You know back to school is coming in fast. So why wait to find your new fave footwear? Step into a local croc store and step into your new look. Try it. Style it. Make it yours. Because the right pair doesn't just show up. It shows off. First day fits, handled. Walk out ready for whatever's next. Visit your nearest croc store today. So salmon, mackerel, sardines, anchovies.

20:06I laughed because we were at dinner the other night. And like everybody was like, I'm not eating these anchovies. And like my husband, they were all piling it up on my husband's plate. And I don't know if you heard me say, but I was like, dementia be damned. He's eating all his omega threes right now. Yeah. So I take your supplement. Of course. I love it. When I open it, I put it in the fridge. But if I'm traveling, what can I do? Because can you take it out of the fridge to travel and put it in my supplement organizer? Or tell me. Yeah, because travel short term, right? So why you bring up a good point, I always say, put your omegas in the fridge, they're big capsules.

20:50But also like, it will help with their shelf life. What I will say is that the problem is, is that if you have a bottle, you don't take a bottle, you open it, you have it on your shelf for like six months open. That's when it's like, it's not going to be as potent. it doesn't mean it's gonna be bad for you but yeah you you know this is something keeping in the fridge can help extend the shelf life when you travel it's only a few days now let's say like you're traveling to egypt and it's going to sit in your bag right and be out all the time i would try to stick it in like a hotel fridge like when you get there and just pop it in but the biggest thing is keep it out of direct sunlight i would keep the capsules out of direct sunlight okay yeah i just wanted to know i was like i'm not sure because it always says keep refrigerated so I'm like okay once open and it's just because we want to make sure that you're taking the most potent like nothing bad's gonna happen right but like especially if you take it on schedule but like if you're like me who's like oh yeah I've been like really good at it for seven days and then three days go by and I'm like oh I need to get back to that so keeping in the fridge just it's like an insurance policy we all know what that's like what impact may severe unmanaged endo and adeno pain have on the autonomic nervous system?

22:03Oh, this is so important. And I think emerging research in this area is so exciting. So endometriosis and endometriosis change the brain. They will change your brain. In fact, we see structural changes happening now in brain imaging. But I think the most pertinent thing to like your day to day living is that it will prime you for pain. So I like to say like, it's like a ghost living in your house. Even if you have excision surgery, even if you have your uterus removed, the endometriosis lesions, wait, let me back up and be really clear with you all. A hysterectomy does not treat endometriosis, but it does treat adenomyosis.

22:41This is a definitive treatment because that's where endometriosis is. If you no longer have the organ, adenomyosis cannot exist. But what happens is that these lesions, especially endometriosis, because we have more research there, they actually participate in increasing blood supply and new nerves. And they don't just, it's not just like the lesions chill in here being a troublemaker, it extends out. And so there's like this halo around it, where it's releasing all these chemicals and it's irritating all the nerves. It changes and shapes some people's nervous systems into what we call central sensitization.

23:19The central sensitization is now your brain and your nervous system has changed to perceive everything as pain. Everything is painful. You have a surgery, you remove all the lesions, pain persists as if there's a ghost in your house, right? Person's not living there anymore. Maybe this is a morbid way to put it, but the ghost is the spirit of them. You can still feel it, right? And I think that's an important thing to understand because, you know, in the endometriosis reset course, I go a lot through central sensitization and we set up all these ways to like increase your polyphenols, bring down your inflammation, start to work with your gut, reintroduce more foods because most people with endometriosis are not eating enough variety.

24:00That's more of a problem because everyone tells them just don't eat any of these things and you'll fix yourself. And then before you know it, they're like, all I can eat is watermelon. And you're like, And so now your immune system's like everything's a problem. So I actually take people through how to introduce those foods. But why we have to do all that first is because if we don't bring down inflammation and we don't give the body the perception that it's safe and there's no alarm going off, you can't work on the nervous system. And so the last phase of that course is really working on the nervous system because you can walk it back out of central sensitization.

24:38But it is usually a two to three year process of working on it. And I don't say that for you to be like, oh my God, like, you know, it's, it's hopeless or anything. I say that to say, you have to be patient with your nervous system. The nervous system is kind of lame and that like, it's very slow healing, very slow healing. And then the entire world is inundating you with like signals to disrupt the nervous system. Right. But you can, you can walk it back. You do usually need cognitive behavioral therapy, working with like a psychiatrist, a therapist. but I would also say the other things I talk about doing is bringing in things like omega-3 fatty acids, exercise, citicoline, things that we know are good and nourishing for the nervous system, but exercise is one that can absolutely change and transform your nervous system.

25:27And I'm talking a long time, but the last thing I wanna say is vagus nerve. So I have prescribed vagus nerve stimulation for over a decade now, And research is now saying there is a major disruption in vagal tone in those with endometriosis. What does that mean? Parasympathetic nervous system is struggling. And that vagus nerve, okay, kick it back to our nurses, right? You don't need pain management. Yeah. That vagus nerve innervates the heart, the gut, all these organs and the uterus. That is how important your uterus environment is that the brain wants to be checking in, right? It's like every day having like your assistant check in on you and give you the updates.

26:10That's what the vagus nerve is doing to the brain. And the uterus is just as important in terms of the hierarchy in the nervous system as your heart, as your gut, as all of these other organs your brain is serving. Oh, I like this question a lot. What changed in your process and approach from your first book to your latest book? My first book was on postpartum. My latest book is on ADHD. Those are kind of different things, but I do talk about the ADHD experience. So I don't think they probably mean the postpartum book because most people found me through beyond the pill. Something that I would say that I've really changed.