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Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Dr. Keesha Ewers is an integrative medicine expert, Doctor of Sexology, Family Practice ARNP, Psychotherapist, herbalist, is board certified in functional medicine and Ayurvedic medicine, and is the founder and medical director of the Academy for Integrative Medicine Health Coach Certification Program. Dr. Keesha has been in the medical field... Read More
Betsy Greenleaf, DO, FACOOG (Distinguished)
Betsy Greenleaf, DO, FACOOG (Distinguished). Premier women’s health expert, entrepreneur, inventor, and business leader, who specializes in female pelvic medicine and reconstructive surgery for over 20 years, Dr. Greenleaf, is a trailblazer as the first female in the United States to become board certified in Urogynecology. She possesses a professional... Read More
- Understand the link between your vaginal microbiome and your gut microbiome
- Combat autoimmunity by addressing the root of the problem in your gut
- Develop a diet that improves your vaginal microbiome balance to avoid issues with hormones, sex drive, and fertility
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Welcome back to the Reverse Autoimmune Disease Summit 5.0. This is “Healing the Energy Body”. I’m Dr. Keesha Ewers and I’m delighted to bring you Dr. Greenleaf, Betsy Greenleaf, who takes a holistic body mind spirit approach to healing and wellness. She believes many of the answers to a healthy life are found within. She views her role in life as your wellness guide. She’s a premier women’s health expert, a bestselling author, entrepreneur, inventor and business leader, specializing in female pelvic medicine and reconstructive surgery and that she’s done for over 20 years. She’s a trailblazer as the first female in the United States to become board certified in urogynecology. Congratulations. She’s the owner of Greenleaf Health and Wellness, CEO of the Pelvic Floor Store. She manages a blog at drbetsygreenleaf.com and is the host of Some of Your Parts Podcast and the Body Mind Spirit Podcast. She’s also the best selling co-author of “You Were Made to Be Unstoppable”. Welcome to the series, Dr. Greenleaf.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Oh, thank you so much, Dr. Keesha for having me. I’m so excited to talk with you.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
So of course, as a sexologist, this is near and dear to my heart to be able to talk about these connections. The vagina’s actually connected to the intestine, ♪ The intestines connected to the brain ♪ Right? So we tend to think about these things as separate entities because we have specialists in all these areas, but there is a connection between the brain, the gut and the vagina. How does that work?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
You know it’s something that I wasn’t taught in traditional medicine, but now that I know about it and researchers are really starting to look into it, it makes so much sense. The biggest thing, which has just come out in the last couple years has been that how the microbiome, the bacterial balances in these different areas of our body, how they interact. And it’s so funny ’cause it’s like, all right, where do you start with the connections? Because everything is connected, it’s always like, all right, well which one do we start with? Do we start with the vagina or do we start with the gut? And sometimes, I tend to start with the gut ’cause in some ways it’s almost a little bit easier to understand, especially how it connects with the brain. And one of the things I find that’s incredibly interesting is that 90 to 95% of your serotonin, your happy hormones, are made in your gut. And look at most of the standard American diet, which spells out the word sad, and how that’s affecting our gut health. And no wonder we have a nation that is plagued with issues with anxiety and depression. If we’re eating poorly, we’re not supporting that chemical production in our intestines to feel good. And more so they’re even connecting that if the microbiome of the vagina is off, that there’s this feedback loop actually to the brain because the brain doesn’t know the difference between you’re trying to make babies or you’re trying to have fun.
It just knows that, okay, if things are off in the vagina, that this is not an ideal time to reproduce. So the brain affects the rest of the body and it says, okay, well let’s start dampening the hormones of reproduction. So now we start seeing patients having issues with infertility and even low sex drive, which is absolutely amazing because I mean how many times does somebody walk into their doctor’s office and they’re asking for hormones for their sex drive when it may actually be a microbiome imbalance? And not just even in the vagina, now they’re actually even finding out microbiome imbalances in the gut will also have a similar feedback in that just anytime the body senses inflammation or things out of balance, it’s gonna be dampening the processes of reproduction and of wellness because we’re putting the body kind of in this stress state when we’re experiencing that inflammation.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
So what is, I mean in my book, “Solving the Autoimmune Puzzle”, I talk about food equals mood. So if you’re not in the mood to have sex with your partner, could it be what you just ate for breakfast, lunch or dinner or what you’ve been eating as a habit over a long period of time?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, definitely, and then even connecting that with autoimmune diseases. I mean a good portion of people suffering from autoimmune issues have a gut source. So if we’re eating inflammatory foods and now we develop leaky gut where the bowel, the actual cells in the bowel become swollen and kind of separate, and now we have toxins from our food, whether it’s insecticides, pesticides, the foods themselves, medications that we’re taking leaking into our body and now everybody responds to that differently. Some people, it may worsen their heart disease. Some people, it may worsen their diabetes. And other people, it actually causes and worsens their autoimmune conditions. And so again, not only is that causing inflammation elsewhere in the body, but yeah, anytime the body is inflamed, the body goes, okay, you know what? This is not a good time to be reproducing and so we’re gonna dampen sex drive, we’re gonna dampen the hormones of reproduction. Women that are menstruating, it may affect their menstrual cycles. So it all kind of balances out. I’m sure you’ve talked about it elsewhere in this summit and I always love to make this connection is we basically have those two nervous systems, the sympathetic system and the parasympathetic, and they’re great, we need them, they keep us alive.
When we were people and we traveled across the savannah and a lion jumps out, we don’t want to sit there and take the time to go, oh, hey kitty, kitty, aren’t you so cute? We want that sympathetic nervous system to kick in before we have time to think that’s gonna make us either run away, freeze or fight that lion. And so what happens is the body knows, put all your energy into stress hormones to get away and to survive and it’s gonna suck away all the hormones from digestion and reproduction. So there you go with the reproduction and sex drive. And then it further, sucking away from the digestion is gonna further feed into issues with leaky gut and gut issues. And so the biggest problem I think in modern days is our lions are now coming in the form of work stress, economic stress, illness, mental stress, family stress, other areas of stress. And so we’re getting stuck in those stress levels really much longer than if a lion jumped out and we like ran away and now we’re safe and now we can go back to living a nice life and reproducing and eating and digesting and growing and healing. So the modern life has really kind of affected why we end up having more of these issues. And unfortunately, our foods in general are not as healthy as they were hundreds of years ago.
Advances in food production, yeah, we have insecticides and pesticides to be able to make more food, but those foods contain a lot of toxins, our soil has been drained of a lot of nutrients. So even if those foods are grown without those chemicals, they’re not as nutritious as they have been in the past. And so this is all affecting mental health, gut health, inflammatory health, sex drive, fertility, increasing your risk of urinary tract infections, increasing your risk of vaginal infections. And it’s just amazing how all of this can be connected.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Right, there’s another thing that food affects too when you start talking about vaginal health, and I don’t hear this talked about, I wrote a blog about it several years ago, but it’s that what you eat actually informs what you taste like, what your vaginal secretions smell like, that all of that plays a part in it. If you eat pineapple, you’re going to have a different vaginal odor than you do if you have a steak and it’s pretty dramatic. And so this is another interesting piece of food affects vaginal health, wellness, the biome, but also, we have this other piece of it, and that is I know a lot of women are very sensitive about that, like what are their secretions? And they don’t realize it’s not a marketing consumer product that they need, a douche, to change all of that. Actually, just like everything else, it’s what you’re putting in your mouth.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Oh exactly, completely. And the other thing with that, I was thinking, I just saw some study, it was interesting about how the foods we eat and the part of digestion, we make these different organic acids and those organic acids are also even excreted in our sweat so it’s also vaginal secretions, it’s coming from sweat. And that as we age, we also are processing those organic acids a little bit differently, which I guess we could even term pheromones. But yeah, unfortunately I see too many times, it drives me crazy every time I see these feminine health products that are like here, smell like a creamsicle or let’s smell like some roses. Like the vagina isn’t meant to smell like creamsicles and roses. I mean it has its own special odor and there’s a purpose to that odor. And if things are off, a lot of women will be-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Fragrance rather than odor.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yes, yes, I like that, I like that, it has its own fragrance. And women are always trying to cover that up. And even if there is something that’s a little off, I mean if there’s like a fishy smell, which can be a sign of a bacterial imbalance, or if there’s more of a bread smell, that’s a more of a sign of a yeast imbalance, I mean that’s your body kind of screaming out like, hello, help down here, something’s going on.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
A pleasant aroma and taste on your secretions to an odor that isn’t pleasant, then that is actually feedback from your body that it’s been giving you in a variety of other ways too, it’s not just your vaginal secretion’s aroma. It’s going to be the way that your breath tastes and smells. It’s going to be what your skin looks like and feels like. It’s going to be what the quality of your bowel movements are. All of this stuff is, are you keeping hair in your head or are you losing hair? These are all pieces of information the body’s always trying to give us. And so masking with feminine hygiene products is just, I just go, stop the madness, you know? Yeah.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And some of the problem with some of those products is they’re really stripping away a lot of the protective oils. So when you’re having harsh detergents, harsh soaps, you’re stripping away the protective oils that are keeping that vulvar skin, that vaginal opening, even if you’re putting something in the vagina, it’s gonna throw off the balance and actually make things worse and potentially have more issues with it.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, I mean heaven forbid we actually turn toward the body and say, ooh, I see you’re giving me some information, thank you so much for that information. What is it you want me to know? Because I want to support you in the very best way I can. You’ve been so amazing supporting me all this time. So yeah.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
I look at that as, sometimes I say, it’s the vagina screaming for help to tell you that there’s something bigger going on in the body. For example, I had this woman who came to me and really we didn’t get into the fact that she had some autoimmune diseases, she really came to me because of recurrent yeast infections. And so-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Those are very, very separate, not connected at all.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And so we were focusing on the yeast and she was going to the doctors, like her primary care doctors or her gynecologist and was getting creams and was getting pills and she would get better for a short period of time and then it would come back and then she was running to the store and trying to get whatever over the counter cream and this was going on for two years. And so we got to the point where we’re like, let’s check your gut first and her gut was filled with yeast. And so really I was focusing on yeast and so we ended up doing a three month treatment of different herbals and some medications and some probiotics rebalanced out her gut, but being so super focused on the pelvic area, I forgot to mention to her that she may see other improvement. And so for her, she was having nail bed issues, her nail beds had looked and her nails were growing in a spoon shaped fashion that they had, she’d been working on the dermatologist for years and they never really cleared up and so her nails started growing in normal. She had psoriasis and the psoriasis got better. She was also having issues with fibromyalgia and was noticing that her joint aches and pains were not as painful. And we were all able to be like, okay, well once we cleared up that inflammatory yeast in the gut, it could have been worsening all these other conditions.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
And all the herbals and the medications that cleared up the yeast in her gut weren’t the end of the story because she would’ve also needed to stop drinking the glass of wine every night before be and she would’ve had to stop having the coffee in the morning with sugar in it, she would’ve had to stop having gluten because that’s what started the yeast in the first place.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And it’s funny, the thing about yeast is I always point out that yeast is kind of almost like an alien that hijacks your brain because when you have yeast, it tends to cause sweet cravings. So those are the people that are having problems losing weight because as soon as they go on a diet, all of a sudden they get these intense sugar cravings because it’s the yeast hijacking the brain saying, feed me, feed me, feed me. So I always have to tell people that have yeast like all right, you’re gonna be fighting it and it’s gonna be trying to take over and stop feeding the yeast. Don’t give it the sugars. Don’t give it the simple carbohydrates to keep it going because you’re right, none of the other treatments are gonna work if you’re still feeding it so.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
You’ll just get it back all over again. And treating the leaky gut that they’re hanging out in, all of that stuff. So it’s so interesting ’cause people want to land on, oh, I’m sure I have candida overgrowth, here, I hit all the symptoms, I took the quiz online, and it’s like, well, yes and. You wound up with that overgrowth for a lot of different reasons and your body’s been trying to tell you about it for a very long time and we need to also take care of that so it doesn’t keep coming back so yeah.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And you know what, the funny thing is anytime there’s an itch or a discharge, I mean thank God we have over the counter products now, because I remember when I first was having these same problems myself as a young woman, you didn’t have any of these products over the counter. So now we can go, if it’s a weekend and you can’t get to the doctor’s office, but one of the things is the majority of those itching, burning discharge, only 12% of the time is it actual yeast. 82% of the time-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Wait, stop. Say that again. 12% everybody, 12%. Yeah this is so important to really highlight this part. Everyone always thinks they yeast and then they have, when they start getting discharge. So what’s the rest of it?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
The majority of the time, 80% of the time, it’s actually a bacterial imbalance. So when you run to the 24 hour pharmacy, you’re buying that yeast medication- yeah, yeah and it doesn’t work, it’s because it’s probably not yeast, it’s probably a bacterial imbalance. And I’m probably gonna get in trouble for telling this secret, but I’m gonna tell it anyway. A couple years ago, the yeast medication industry was actually trying to get boric acid shut down as being able to sell boric acid over the counter because what I love is boric acid is something that can be used vaginally that would take care of either case, whether it’s bacteria or yeast. And so from a business standpoint, that was a threat to the yeast medication industry because so many women are, they go and they grab the yeast medicine when I like people grabbing boric acid because you don’t really have to know what it is, it’ll take care of it either way so.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, so much simpler and then also stop drinking the wine.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yes, yes, yeah.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Everything else, right?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah and I actually, I saw also some recent literature that was really surprised at how wine actually affects our estrogen metabolism. And this is why they even say like only one or two glasses of wine like a week or something like that for women, otherwise it increases your risk of breast cancer and other hormone related cancers. Men can drink more wine than women, but even men, it can lead to gynecomastia, breast development, men can get breast cancer and they can also develop estrogen related cancers that can be worsened by alcohol and alcohol throws off your gut
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I mean I don’t want to pick on wine because it’s all of it and beer is also one that turns to sugar instantly. And so the thing that I’m pointing to and I rain on everyone’s parade on that is when, I see people with autoimmune disease, and when I do genetics, I do genetic testing on all of them, there are certain patterns I see in genetics of people that have autoimmunity. And one of them is they can’t, they don’t metabolize alcohol very well. And so it’s one of those things that throws their microbiome off. So then the one or two or three or four glasses a week that comes out in a statistical analysis does not pertain to people with autoimmunity, they really need to be alcohol free so yeah.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And unfortunately, I think the health community or maybe the media did a disservice because I remember, I mean it’s got to be almost 20 years ago that they came out wine was good for you. And so I have so many patients that come in, they’re like, oh, I did my glass of wine every night because it’s got resveratrol in it and it’s-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
40 years ago, Betsy. We are getting older. So it was the 1980s, I remember it was on the front of “Time” Magazine having a glass of wine every night is good for your heart. And then several years later it came out, oh no, it’s not. And then these conflicting, I don’t know how you were, but when I took my babies home, one baby, they would say, make sure you, avoid SIDS so make sure you have ’em sleeping on their back. The next baby, avoid SIDS so make sure they’re sleeping on their tummy. The next baby, avoid SIDS, make sure they’re on their right side. And I’m curious, this actually happened, I have four kids, the next one was left, and I finally went, wow, we really don’t know what we’re talking about when we take statistical information from a study that has a cohort of a certain number of people in it who all have their variables that are individual and try to apply it to a population, it doesn’t make any sense.
So yeah, the thing around wine is very fascinating because that we’ve had conflicting research and you can just choose which one, same with coffee. No, coffee’s good for you, here’s a study, right and then there’s another, you can find equal number of them that say, no, coffee causes inflammation in people with autoimmune disease, please don’t drink it. But that’s why I like genetic testing, ’cause then I can go through and I can see where are you with coffee metabolism? Where are you with the APOE4 gene or an MAO snip to see if can tolerate alcohol? So I think this is an important discussion we’re having right now. We’re at the point that we can individualize now.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And the way things kind of stick when it comes to things that come out in the media, I mean was the late 1990s or 2000’s where everybody came off their hormone because the Women’s Health Initiative Study was like hormones are bad and so everybody come off your hormones. Yeah now it’s like, you know what, that was done on synthetic hormones, like a study that was based on synthetic hormones which we now are metabolized in a way that can now damage your DNA and can increase your risk of cancer, but bioidentical, but I like to call ’em bioequivalent, I like that name better bioequivalent. Those hormones themselves don’t cause cancer, and in fact, sometimes some of them can actually help prevent them, and they definitely prevent colon cancer and they definitely prevent osteoporosis. But I always do mention to people when it comes to hormone replacement, hormone therapy is that we’re making cancer cells all the time in our body and majority of the time our immune system takes care of it, but if you happen to have one that takes hold, there are hormones can sometimes feed it, but it’s not gonna cause it if it’s a natural hormone.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
What we can also do nowadays that we weren’t doing during the WISHES Study is we actually can track what’s going on in an individual body in response to a specific bioequivalent hormone. So you can see what is the metabolic pathway your body is taking? How is it using it in your body? So that we can see if it’s leaving behind some of the garbagey carcinogenic byproducts that can get stored in your system and create some problems. So it’s really cool now. We don’t have to just take something made from mare’s urine and then ignore it for the rest of our lives and then have it go sideways in there. We can actually be very, very thoughtful, very precise according to what your body’s asking for and then track it. Right, that’s the safe way, that’s what Lance Armstrong did not have, right?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, no I agree, I agree. And that’s something that comes up too is that a lot of women walk into my office and they think, well, from a vaginal health standpoint, they’re like, oh, I’m good because I’m postmenopausal and I’m on hormone therapy, but what we don’t mention unfortunately to people unless they’re in my office is that as we age the blood flow to the vaginal tissue is not as robust, actually you get kind of retraction of those blood vessels. We also see that in some of the autoimmune issues where, so you could be taking all the hormones you want systemically, but if the blood can’t bring it to the vaginal tissue, the vaginal tissue is not gonna be healthy. So therefore, this is why sometimes we need to incorporate other therapies, whether it’s topical hormones or I’m a big fan of laser. I’ve seen just so many people, especially from an autoimmune standpoint, we see a lot of conditions like lichen sclerosus, which can be very uncomfortable and it’s an autoimmune inflammatory condition that the vulva and vagina, first, it doesn’t respond as well to hormones or even steroids, but using laser and some of the regenerative therapies, like RevLite or even PRP, platelet rich plasma injections, they tend to, they can almost return the tissue back to normal.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I mean I’m a fan of compounding pharmacists, taking what it is you need based on, tests don’t guess, right, based on what your body’s asking for and smearing it on your face and in your vaginal tissue. I mean, that works for me.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, definitely.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I put estriol on my face a couple times a week and same with my genitalia. It’s like, oh, that works really great. So there are so many different options we have now that we never used to have so yeah. I love that we’re having this discussion. This is the stuff that a lot of people don’t get to know about, right?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, no, it’s really, and you know what, I think that’s the problem is I looked recently, there was a study based out of England that 65% of women are uncomfortable saying the word vagina, yet 80% of us will have a pelvic health condition at some point in our lives. And so my mission in life is let’s normalize the conversation. I mean if you had a problem with your elbow, you’d be like, hey, I’m having an issue with my elbow, my big toe’s bothering me.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Down there, down there.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah exactly. So it’s just another body part. I’m constantly battling-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
One of my missions is to help people understand that when they’re referring to their vagina, they’re usually talking about their vulva.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yes, yes, but I have to say-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
The all encompassing term that actually we’re leaving out the vulva so yeah.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Exactly, you’re right, the vagina’s just the tube on the inside and the vulva is everything on the outside. I’m just happy if anyone says any of those words.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I know.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Any of ’em. But I have to say, unfortunately, I’ve kind of, trying to fight the battle, I’ve found unfortunately the hard way that the word vagina is not accepted very much in social media so I’ve had my social media shut down a couple of times, though it drives me crazy using the word down there, that’s the language that a lot of women use is down there. So now I’m going off as well, I’m the down there doctor, because at least maybe that’ll kind of get me in the door and not get me kicked off social media.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I know.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
For saying vagina.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Which means you could be a podiatrist, down there.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
I know, right?
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
That’s what happened to me too. I am the mother of functional sexology. I’m first one that started saying functional medicine sexology, these need to go together, right? And so I would do these things around functional sexology and I had the Functional Sexology Institute. I couldn’t email anything. Every server would shut it down. So if it has the word sex in it, then it’s not okay either, which we haven’t really come very far from the 1800s I’m afraid.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
It is ridiculous, it’s a natural, normal part of life. I mean this is something that I’m doing with my kids right now. We talk about it like it’s just a regular subject because if you talk about it enough, you desensitize yourself and it’s not taboo or shameful or embarrassing, it’s just a fact of life.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
It’s information that you want them to have that comes from you or somebody that is an expert, not from the internet where they may get drawn into some sort of chat room or some weird place that they can get information that they’re seeking. Yeah, I used to have sex parties when my kids were teenagers where I basically was like the Doctor Ruth of the neighborhood. They would come over and I would let them write down any question they had and they would put it into a bowl and then I would just draw them out and read them and answer them.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
That’s a great idea.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
So thirsty for this information, they would just rapt attention. Sometimes I’d be there for hours just answering questions ’cause after I get through the papers, then they’d start feeling comfortable and start just asking questions. I thought, wow, this is a real hole in the education for these kids. So yeah, it was a really great way for my kids and their friends to explore information that was coming from a place that was sex positive, non-shaming, non-erotic, just information, right?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, no I love that, I love that. And talk about misinformation. I just saw somebody post recently on this website and they were talking about with vaginal secretions, this misconception that as a woman, the wetter you are that that’s a sign of how excited you are. And this is definitely something that we need to get rid of that idea that’s kind of pervaded general society because that can be very damaging to women because there’s so many things that can play into vaginal secretions and the amount of it. Some people make a lot, some people make a little, some people are more hydrated than others, some people are dehydrated. If you have an autoimmune disease, if you have something like scleroderma, you’re not gonna be making, your tissue’s gonna be a little bit drier, you’re not gonna have those secretions. And it has nothing to do with how excited or not excited you are, it’s just basically.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Or how sexy, attractive, desirable you are. Because I find when somebody feels like they can’t desire or they can’t respond physically the way they want to, that their head gets in it, your head, I always say whatever’s in your head, goes to your bed. So their head’s get in the way and now you’ve got all this mental chatter going on, and mental chatter definitely shuts down desire and physical response to arousal cues. So if you’re thinking about all of the things going wrong, then it’s very likely things won’t be going right.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Oh God, completely, completely. And unfortunately too, the different lubricants that are on the market, I’m gonna throw them under the bus, but KY happens to be probably one of the worst things you could possibly ever use because it was actually designed to purposely dry your tissue so you have to keep using more and more and more. And so the science of lubrications in the last, oh my God, 10 plus years has exploded. And now we have products that are more balanced for vaginal health, that support the microbiome. Some of my favorite companies are like, I guess Good Clean Love or UberLube and there’s new and better ones coming out all the time.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Sesame oil is amazing, sesame oil. They’ve been using that for thousands of years in ayurvedic medicine and it works really well. Yeah, the KY Jelly-
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
My question for you, it always comes up to me and I want to ask you this one, I want to turn things on you. What is your opinion about coconut oil? Because I get that one a lot and I have mixed emotions about it.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Coconut oil in the ayurvedic paradigm is cooling. And so you actually want something warming, right, you don’t want to cool. So you use coconut products, whether it’s oil or coconut milk or coconut water, it grows in a place where it’s tropical, it’s mother nature’s way of cooling you down, here, here’s a coconut. So if you are using it as a vaginal lubricant, I mean it could be neutral, it’s not gonna be beneficial though. Especially if you have dryness, you don’t want to cool that, you want to warm your tissues, plump your tissues. And sesame oil has a really nice, and it’s the same with oil pulling, people say to use coconut oil, but no, I mean fine, but sesame oil is much, much more robust for that and it has antiviral and antibacterial properties. So you’re also getting that when you’re doing oral oil pulling or using it as a lube so.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Oh, that’s fascinating, thank you.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mmhmm. Well I was gonna say, you can actually, you don’t have to believe what we’re saying here. If you take a drop of water and you drop it onto any surface and then you rub it really, really, really hard and you get friction and heat underneath your finger, you’re gonna have that squeaking and pain, searing pain from that heat friction. That’s what’s going on with KY Jelly. It’s that base, you don’t want to be doing that, like putting it on something and then creating friction. So it’s the worst choice possible. You get vaginal tearing, yeah, yeah, not good.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
And for years, I mean that’s, all we had in the clinics at the hospital was Surgilube, which is very similar. And so a couple years ago, we replaced all our lubricants in the office with more, like a Good Clean Love or something that’s more balanced for vaginal health.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Beautiful, well done.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Or I tell patients, obviously, if you’re not coming to see me, bring your own lubrication with you to the doctor’s office and just say, excuse me, I’m sensitive or whatever. Do you mind using this product? And most doctors are fine.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah. Well, is there something that we haven’t talked about that you feel we need to say before ending this amazing conversation that I would love to continue forever?
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Yeah, I know. I think the biggest thing is looking into eating a clean diet, doing things that are good for your body, getting enough sleep, hydrating. 75% of Americans are chronically dehydrated, make sure you’re getting enough fluids, enough sleep, get off those tablets. All these little things are adding to inflammation in the body and let’s talk more about vulvar and vaginal health. Even if you gotta get in front of a mirror and say the word vagina or vulva like 20 times just until you get to the point where you’re like, oh, you know what, that’s just another word, I don’t even notice it. You can’t ask for help if you can’t say the words where you’re having the problem so.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Exactly, exactly. Thank you, Dr. Greenleaf, I appreciate your time and wisdom so very, very much.
Betsy Greenleaf, DO, FACOOG (Distinguished), FACOG, FPMRS, FAAOPM, MBA
Oh, thank you so much for having me, I always love talking to you.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Alright, until next time everyone, be well.
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