Empowering Intimacy: Sex Life After Breast Cancer

Anna Cabeca, DO, OBGYN, FACOG

My goodness. It is great to be here with you. It is such an important topic. Part of how I got started down the integrative and regenerative medicine pathway was because of one of my first patients in medical practice when I graduated from Emory, I was a National Health Service Corps scholar. I ended my repayment in rural Georgia, and a patient came to me. She was this 63-year-old silver-haired, five-foot-11, 153-pound female biotech Exec. She said, Dr. Anna, it hurts to have sex. Dry. I had a DCIS diagnosis, ductal carcinoma.

Jennifer Simmons, MD

Ductal carcinoma in situ

Anna Cabeca, DO, OBGYN, FACOG

Ductal carcinoma in situ. That is what the abbreviation is.

Jennifer Simmons, MD

Well, we could have a whole conversation about how that diagnosis should not even exist, but we will save that for another day.

Anna Cabeca, DO, OBGYN, FACOG

The fear that is associated with the diagnosis, and her physicians at Emory, this is back in the 1990s, when her physicians at Emory said you cannot have any estrogen. This progressed to cancer, and we are treating you as a cancer patient. She is like, Dr. Anna, I would rather die than live this way. I am a woman in my 60s. I love my husband. I cannot have sex with him. I would rather die. 

I am like, Okay, shoot. I am fresh out of Emory, thinking I got trained at the Ivory Tower of Medicine, and here, What is in my doctor’s bag? Jenn, you know how is it? I looked at my doctor’s bag, and there was nothing in there. I went to the research because I was a researcher before I went to Medicine as a biomedical researcher. I dug into the research, and I learned about testosterone and DHEA, vaginal estrogen and topical versus oral, and the safety profiles in women who have had breast cancer or the studies that were done in models of breast cancer, and I could say very safely with consenting to her that this is what we want. This is an option for her. She said I am opposed to signing anything you want me to sign for consent. That is how I got into using DHEA and testosterone and topical versus oral and bioidentical hormones versus synthetic hormones. That is our body, identical to what our board wants us to call it now. 

Jennifer Simmons, MD

Yes. Let me ask you something because this was at the beginning of your career. First of all, I am a firm believer that there are no accidents. That person was put in front of you to shape your career. But how has it shaped your career? Because most physicians would see a person in front of them with a history of breast cancer and listen to the rhetoric, which is that that is an absolute contraindication to any hormone support.

Anna Cabeca, DO, OBGYN, FACOG

Yes, that is a good question. I think it came from my upbringing and the ability to question everything, but after my mom went through the standard medical model and was very sick and dying prematurely, it was my commitment at her bedside as she passed away to not let this happen to any other woman, to understand why, what the underlying reason was, and to question everything, everything about how we were doing things. 

Because my mom was an immigrant to this country and two of her brothers were also immigrants, they all died prematurely. From what we say, diseases of the modern world include colon cancer, heart disease, and diabetes. Compared to her siblings, who outlived her in a war-torn area of the world. I started questioning everything that I was being taught or started looking at: what are the underlying reasons, what is the mechanism of action, and what is the basic physiology behind this drug and this intervention? I made a few wrong turns along the way and got corrected a few times in my health journey, where I was in crisis and had to reevaluate everything that I had learned. I think that.

Jennifer Simmons, MD

I also think it is very hard to be your physician. You usually put yourself as the very last priority, and you are not looking at it with the same clarity as someone else’s.

Anna Cabeca, DO, OBGYN, FACOG

We could talk about that now. I am ready to go on a trip to Mexico and do some research to practice what I preach. You need to take the time, put your feet up, and walk in the ocean. Yes, but that is a big part of me.

Jennifer Simmons, MD

Not too far from the ocean. You can walk in the ocean, but not too far.

Anna Cabeca, DO, OBGYN, FACOG

Not too far. Yes. Everything is in perspective, but so true. It is so true. What leads us down this path, and what is the next right step? I was thinking, What is the next great step? Or, I think that is it for one of the things to Jenn, as I have seen because I listen to my mom as she goes through her health journey and things that are against her culture and against her practice that she is being told to do versus traditional medicine. I started understanding as I treated thousands of patients, thousands of women, that women have intuition. Tremendous. 

We as physicians, when we go to be physicians, have a tremendous amount of intuition and a sixth sense that guides us in this journey, that guides us to order the task, that guides us with the time and space to do so, to make the best intervention collaboratively with our patient. Our intuition, listening to a woman’s intuition, a woman knows. If she listens to her heart, to her spirit, she knows something is going on there. We are doing something that is not benefiting us. I think there is, a piece of that has to be in collaboration because our fears can mislead us. But I think that is one of the things I have learned along the way. 

My patient who had come into my practice said that I would rather die than live this way. Her intuition was, There is an answer here. You cannot just tell me I am going to shrivel up and die, and that is it. I have to accept and have no sex for the rest of my life. You cannot just tell me that that is going to be okay. There has got to be a better way. Plus, when you have this diagnosis of breast cancer and I have treated many, I became a referral center because, again, it is southeast Georgia, not many subspecialties, but I became a referral. I saw women from all over the world with that diagnosis because no one was asking, What caused your cancer? No one was looking at how we create bodies that are resilient to cancer. When I see patients come in for the first consult and I do blood work, for example, their vitamin D level would be 11 or 13. For me, that feels like malpractice that is just obscene. I still see it today. Women who have had breast cancer are allowed to have you are not even checked, or evaluated, nor are their vitamin D levels or DHEA levels.

Jennifer Simmons, MD

They are not, and they are not checking them. 

Anna Cabeca, DO, OBGYN, FACOG

They are not, and you are not checking them or doing surgery at a time when progesterone is the highest in our reproductive age, breast cancer. This is research that has been around for a long time now. You have to question.

Jennifer Simmons, MD

Well, there is no timing for surgery around the reproductive cycle. None.

Anna Cabeca, DO, OBGYN, FACOG

Where there should be. 

Jennifer Simmons, MD

It does not happen. I am guilty of it as anyone in that in the 17 years that I practiced and I was the first fellowship-trained breast surgeon in Philadelphia, this was never discussed. Never, ever.

Anna Cabeca, DO, OBGYN, FACOG

Wait, Jenn. I did not know you were in Philadelphia. I grew up in Doylestown.

Jennifer Simmons, MD

You are kidding me. That is so funny. Yes, I have lived here all my life.

Anna Cabeca, DO, OBGYN, FACOG

Yes. I went to college in their finest college, D.C., and at Temple. 

Jennifer Simmons, MD

Yes. Wow. 

Anna Cabeca, DO, OBGYN, FACOG

Then down in Dallas, Texas. 

Jennifer Simmons, MD

There you go. I love Dallas. Such a great place. Okay, so you have this experience very early on in your career, and you review the research because the research is out there. I have no idea why no one taps into it. But quite frankly, we were trained with this dogma that estrogen causes breast cancer. I would recommend you as a triple-board certified physician of women’s health expert, and advocate. Can you please respond to that statement?

Anna Cabeca, DO, OBGYN, FACOG

I think this is where I say that that statement itself is misogynistic. Anti-woman. That statement is, Estrogen, evil. It is demonizing femininity, in my opinion. I call it misogynistic. The reason is that it is not estrogen-causing breast cancer; it is hormone disruptors. It is the disruption of the estrogen detoxification pathways. It is the inflammation and elevated glucose, or gluconeogenesis, in our systems that result in breast cancer. It is the toxicity; it is the hormone disruption. It is the, means there are so many things. because as I started thinking about this again, I wasn’t trained this way, but as I started thinking through this patient after patient after patient.

I had a patient, her name was Cindy. She is, but she is not sure where she is. She is doing amazing now. But in her early 40s, 41 or 42, she was diagnosed with stage 2 breast cancer. She underwent surgery, chemotherapy, and a run. I saw her for several years; she was 47 when I saw her. Several years after her diagnosis, she had been finished with her chemotherapy, etc. She is just waiting for the next shoe to drop. When’s the next diagnosis? I said, Well, let us see what caused me. What did your doctor say? I was so naive. What did your doctor say caused your breast cancer and did that say anything caused my breast cancer? Well, let us look into it. You go back into it for what? 

As I have learned, as I have trained, and as I trust the world medicine training that I have had, let us go way back. How was your mom’s pregnancy with you? Where did you grow up? It turns out she grew up in rural Georgia, on a farm, and worked in a paper mill. Paper mills were rich in formaldehyde and toxic chemicals. for the entire year, she worked there. She had gastroenteritis, diarrhea, and irritable bowel syndrome. it started. She had also had 20 years of birth control pills. Now, birth control pills are not bioidentical by any means. They are hormone disruptors. 20 years of birth control. and she also had an abortion that she never came to terms with. 

If you look at world medicine, you think, Okay, what are the hormone disruptors? I learned from healers around the world that the breast holds the energy of relationships. When I am working with someone with breast cancer, I do inquire into relationships, history, or anything around that. Many things worked together that I wanted to work with her to address. in all of these levels and to understand and then vitamin D insufficiency, pure, pale white, blue-eyed, blond hair, used a lot of sunscreen and sun protectant because, fear of wrinkles, skin cancer, and sun damage, all of those things. We just started looking at all of these factors. I also did genetics. I looked at her genetics to see what pathways contributed. But in addition to that, look at organic acids, look at estrogen detoxification pathways, etc. 

You are looking at all these pieces of the puzzle to say, Okay, we can address these things, deal with each one, and recognize, that this may have been the perfect storm. Now here is what we do to create a body resilient to breast cancer: I wrote the pathway in my first book, The Hormone Fix & Keto-Green 16. There is a nutrition and lifestyle piece that starts with detoxification and improves the gut. I always say it takes more than hormones to balance our hormones. That is a big piece of this combination. You have my book, right there. The Hormone Fix. Seriously, it is my magnum opus. I am super proud of that book.

Jennifer Simmons, MD

My green screen is going to come into focus.

Anna Cabeca, DO, OBGYN, FACOG

I love it. I think that looking at her now, gosh, she is beautiful. She is now in her mid-60s and just doing amazing. The intervention, the book, the food plan, the nutrition, the supplement plan, and the hormone plan that are all part of her regimen are there to sustain her and create resistance in her body. 

Jennifer Simmons, MD

It is so important to ask the why. The why is there when you take the time to go back and look, you can find the drivers. Unfortunately, in the traditional medical system, not only are they not taking the time, but they are not even acknowledging that there could be etiologies; they call breast cancer multifactorial, and they leave it that ambiguous goo that no one knows what to do.

Anna Cabeca, DO, OBGYN, FACOG

I just started thinking about that, and with this, it is never back to your original question. I went on a huge tangent, but it is never your body’s natural estrogen that is the cause. I have never found it. Well, you are just your estrogen, which caused death. That is why we need to suppress all your estrogen. We need to decrease tumor growth. But there are many ways to make a body resilient, and so on. It is not by poisoning our system or there is no estrogen. 

Jennifer Simmons, MD

When you started to talk about that, you started to talk about hormone disruptors. I know that you spend a lot of your time and focus on educating people about hormone disruptors. For the benefit of people here who do not know or understand what that is, could you dive deeper into hormone disruptors and help people understand where they are, where they are encountering them, and what is happening inside of their bodies as a result of encountering hormone disruptors?

Anna Cabeca, DO, OBGYN, FACOG

Yes, that is a good question. It is loaded. I do dedicate a whole chapter to it in my book, The Hormone Fix, but that is not nearly enough. I think you can have books and books, so hormone disruptors are those that disrupt your body’s natural hormone production or the receptors of your body, the receptor sites for your hormone, so your body’s ability to receive or function properly with those hormones. They work in both ways, from production to reception of your hormones, and they can damage receptor sites or inner lock into those receptor sites so that you do not even recognize your body’s natural hormone production. 

Things plastics, pesticides, herbicides, glyphosate metals, and lead mercury molds. Specifically, I studied this, thinking I was going back in time. I want to be a biblical scholar, but I always go back in time. Where in history has this type of hormone disruption happened before? I think that through time, there have been periods of culture where there is tremendous hormone disruption. What could have caused that? Like petroleum, chemicals, and molds.

Jennifer Simmons, MD

I am Jewish. We have a prayer that we say every Friday night about who we are and why we are not allowed to light the Shabbat candles with the Shabbat candles. It goes to a variety of things, and it comes down to those things being toxic when they burn the hormone disruptors. I am. Our ancestors were so brilliant that they recognized that these things when you burn them, make you sick. Do not burn them. This is what you need to burn. They called it things that were not clean, but that is what they noticed: that they burn dirty, and it is doing the same thing in our bodies. Parabens and things that they make scented candles with, the scent, the fragrance, perfumes, all of those dryer sheets. That is a combination of all of those things. You are elevating plastic, fragrance, different volatile chemicals, and all of these things. 

You talked about it affecting the receptor because it looks like estrogen, It sits on that estrogen receptor. But unlike estrogen, which sits on the receptor and then can dissociate and be metabolized, they are shaped a little differently. They get locked onto that receptor, and they get stopped there. They are causing ill effects. Also, I was under the impression that when we detoxify our estrogen, we have three different pathways. We have a safe protective pathway, the two pathways; we have an intermediary pathway, the 16 pathway. Then you have a pathway that is quite dangerous. It was my impression that these xenoestrogens, as we call them, go down that dangerous pathway, that spore pathway. Is that correct?

Anna Cabeca, DO, OBGYN, FACOG

The estrogen pathway. Yes. It is along the Quinones pathway, and it is an incredibly toxic free radical formation that is incredibly toxic to our systems.

Jennifer Simmons, MD

Yes.

Anna Cabeca, DO, OBGYN, FACOG

We can measure that in women in urine and blood. We can look at the two 16-hydroxy m hypoxia estrogen pathways, and that should be done in every man and every woman. But especially if there is a risk or diagnosis of cancer.

Jennifer Simmons, MD

Yes, but that is never happening. When I signed my patients back to the medical oncologists and said, Please show this to them. To know that you do not need to be on an aromatase inhibitor because you hardly have any endogenous hormones and hormones do not cause breast cancer. But on top of that, look at what your preferential pathways are, and you are not methylated. I do not think we should be putting more into your system. They come back to me because they want me to put them on Tamoxifen or something. I say that Tamoxifen is not a good drug for you, here is why. I make recordings for medical oncologists, and they come back, and they are. If this were true, I would know about it. I do not.

Anna Cabeca, DO, OBGYN, FACOG

Which blows my mind? Because the literature is there. That is one of the reasons why I created my product line, because, certainly, My Mighty Maca, which was my first formulation, is adaptogenic and was for my health journey. Then Julva, which is topical, and Vulva Cream were for my breast cancer patients. I started doing this way back in 1999 for my breast, DCIS is not breast cancer, but it is for this patient. From there it just continued. I continue to learn. But to create something available over the counter that you can take into your own hands because physicians are not trained in this. Physicians are not trained in this. We know topical estrogen is safe; topical DHEA and topical testosterone can be very safe. Again, we want to understand what is going on and make sure we are doing everything else. It takes more than hormones to fix our hormones.

Jennifer Simmons, MD

It does it.

Anna Cabeca, DO, OBGYN, FACOG

A body that is inhospitable to cancer has a low inflammatory effect.

Jennifer Simmons, MD

While we are on that topic, can you start to address it because it does take more than hormones to fix your hormones? The gut response. The gut reaction is to just prescribe synthetic hormones to someone who is having a hormonal problem. Many kids get put on birth control for difficult periods, acne, or this or that. They do not realize that not only is that not solving the problem, but it is also creating problems down the road that I know you are seeing in the middle of that story and I am seeing at the end of that story because the end of that story is they are in my office because they have breast cancer. Because the hormone issue that started when they were nine, 10, 11, 12, and 13 only got worse over that time, not better tackling.

Anna Cabeca, DO, OBGYN, FACOG

Exactly. I would say that suppressing a woman’s puberty makes no sense. There is nothing good that can come out of that nor should we suppress a woman’s menopause. There is optimization. I say hormone replenishment, and again, it is multi-factorial because either way, it does not lead to a good outcome. You want to optimize our body’s natural number one detoxification and heal the hormones. That is pretty well established and has a similar clinical base. 

I love talking to you about this, Jenn. Because as a surgeon in gynecology, I used to do 2 to 3 surgeries a week when I learned this stuff. When I worked with diet and nutrition supplements, I needed to do 2 to 3 major surgeries a year. That is the difference. By empowering the body to heal itself, we can reduce, if not eliminate, most surgical interventions because the body is innately intelligent. However, not universally. There is always an exception. But I prefer to be the exception rather than the norm. When hysterectomy is the norm, when removing ovaries is the norm, and when breast cancer is becoming the norm, this is not good.

Jennifer Simmons, MD

Yes, but people, you are very unpopular with the hospitals.

Anna Cabeca, DO, OBGYN, FACOG

We are very unpopular. Yes. I do not want to go to a hospital board and say I am going to keep patients out of the hospital. Can I have privileges?

Jennifer Simmons, MD

Yes. I do not do that. They did not do that. Can you talk a little bit about why healing the gut heals the hormones? Because I think that is a difficult concept for most people to understand because they do not connect the two at all.

Anna Cabeca, DO, OBGYN, FACOG

This is where I want people to do their little experiment because, since one of the first programs that I did, I have since retired since I elevated into the hormone fix, but I called it women’s restoration. I would say, a healthy mind for a healthy body. Nutrition is key and good digestion for a healthy complexion. This is the experiment of doing the 10-day Peter Green Detox in my book The Hormone Fix or any of my plans that, after healing the gut in just 10 days or following a clean detox, you will see your skin improve. It will feel better. It will feel cleaner. You can just feel inflammation is lower. When it comes down to it, inflammation, adrenal dysfunction, and hormone imbalance are the three causes of all diseases. 

That is the devil’s pitchfork that will dig our grave faster than anything. Addressing those issues—healthy digestion for a glowing complexion—is one thing. It is nice to see. You can see the change; you can feel the change, and that is important for everyone to understand. When I work with patients, I tell them, I want you to do my detox. At that point, it was a 21-day detox. I am okay. Do my 21-day detox. I have had resistance. One of my young patients was in her 30s, and she had had PMS and anxiety issues. Finally, after two years of coming to see me, she is in. Okay, I am in. Do it. I feel terrible. She goes, my God. I did not realize how bad I was feeling till I started feeling good again. I will never forget her comment and just her energy and her aura that were around her at that follow-up visit, because she was lit up and energized. She was loving life again, loving her family. That is the power of healing the gut to balance our hormones. 

As we have learned through our evolution, where we had put so much on the genetic code and broke the genetic code, we realized, gosh, it is not the whole thing. It is the microbiome. It is the bacteria throughout our body that are part of this hormone-balancing physiology. It is a synergy. The symbiotic relationship that we have with our bacteria keeps us healthy. That is a tremendous part of what is happening in our gut. We know that we have the estrobolome and the metabolon. We have bacteria that help us with estrogen detoxification. We have bacteria that help us with our metabolism. Keeping that gut healthy is key. We know that way back to Hippocrates, that healing begins in the gut.

Jennifer Simmons, MD

Yes, that is exactly it. Often we forget. We forget to go back there. We forget the basics. I think there is so much being relied upon in modern medicine that we have completely strayed from what we truly know to be true, which is that we are brilliant machines. The body knows how to heal itself. We just have to give it what it needs and take away what it does not need. 

We have made it so complicated when, oftentimes, it is simple. It is getting back to the basics. That is, a lot of what your book talks about are fixing your gut by eating real food and eating in a way that is evolutionarily correct and physiologically correct. 

I would to talk a little bit about that because, again, I think it is hard for people to imagine that just by changing their diet, they can make such profound improvements in their health and their hormonal health.

Anna Cabeca, DO, OBGYN, FACOG

Yes, and I think we should say that should be our first step. It is often the last step for people, after the diagnosis. They start making changes or feel motivated to make changes. I want people to recognize that whether, anywhere you are on your journey, it is the time. I would say that what I call Keto Green or the Keto Green Way, is a nutrition and lifestyle plan that is not just a good idea in perimenopause and menopause, it is mandatory because as our bodies are shifting and our hormone levels are shifting, the protective hormones, progesterone, testosterone, and DHEA, are protecting us, and those hormones start to decline. with that.

Jennifer Simmons, MD

I want you to say that again because those hormones are protective.

Anna Cabeca, DO, OBGYN, FACOG

Those hormones are protective and progesterone and I always call it the lid of our pressure cooker. If you remember those old pressure cookers, and I remember my mom used to have their rubber banded on or whatever, however, we clamp those pressure cookers on, it is always terrifying when they are out. The pressure cooker was on to cook food, but you never want to take the lid off until all the pressure’s out. 

But I consider progesterone the lid to our pressure cooker because our body and our lives are, a journey. in perimenopause, a menopause, it can feel we are, we are living in a pressure cooker while the progesterone that starts to dip boom off goes your pressure cooker, off goes your lid. there are mental issues, anxiety, mood swings, and the monster in me came out. I cannot believe I reacted that way. I love my family. I do not feel love for them. Why do I get so angry? I am becoming a terrible person. I cannot I cannot go on living this. All of those things. Yes, it is real thoughts, either from myself or from patients. 

Jennifer Simmons, MD

I often say that, if estrogen is the on switch, progesterone is the off switch. if you cannot turn it off, you are a hot mess.

Anna Cabeca, DO, OBGYN, FACOG

Yes, that is great. Yes, I love that. Progesterone, we say, relates to our neurotransmitter GABA, which is that calm, that peace, that calm. for people to remember, think of the rock group Abba and the musical Mamma Mia. it is, that is a good feeling. It makes you feel good. That progesterone starts to decline in our 30s. But add stress at any age and you are losing that progesterone, you are creating infertility, and you are reducing the amount of natural reproductive hormones you have. That progesterone is neuroprotective. 

Jenn, I just had a client write to me. She had been hurt. She had been following our program and was on bioidentical progesterone. and then her general physician, her GYN, said, you do not have a you do not have a uterus, you do not need progesterone. She stopped her progesterone. She goes, Dr. Anna, I am feeling terrible again. But my doctor says I do not need it. That is such an old story. The fact that we are still saying that in 2023, just blows my mind. The reason that came about was because of the whole premarin provera. Premarin in the 1950s started to be a miracle pill for women to make them nicer during menopause and more sexually receptive to their husbands and all that stuff. 

Then women started having endometrial cancer because unopposed estrogen, real endogenous or exogenous, or hormone disruptors cause endometrial cancer. They said, Okay, we will bioidentical progesterone. We cannot patent that. This is why they are so pharmaceutical, with a whole patent of drugs. We cannot patent a bioidentical but we can create something similar close enough that is going to work against the endometrial lining. Unfortunately, progestin increases your risk of breast cancer, it decreases your risk of endometrial cancer. Then they said, well, if you do not have a uterus, you do not need this progestin, you just need the estrogen alone. That is how that myth started. But with the ignorance that progesterone receptors in our brain in our bones, in our breast, in our vagina, in our fascia. We get StiPP. As we get older, aches and pains, maybe a frozen shoulder or something that. You think progesterone, that is.

Jennifer Simmons, MD

Progesterone drop off. I hate to make it about sex, but the truth is that most of this dogma is born out of men not understanding the female experience, therefore making it unimportant and unnecessary. That whole progesterone story is about, well, if you do not have a uterus, then you do not need it. In terms of the opposition of estrogen stimulation in the uterus. No thought is given to it. Well, I do not care about the fact that you cannot sleep. I do not care about the fact that you are snapping at everyone. It is just that it is so narrow-minded because I think most of this dogma comes from men who simply do not understand the female experience. I am not a feminist. No, I am not.

Anna Cabeca, DO, OBGYN, FACOG

There are certainly exceptions. I always think I am thankful for the work of John Lee, M.D., who did his work on gender. What your doctor will not tell you about progesterone. I am thankful for the work of Dr. Christiane Northrup, a pioneer and trailblazer in the field of body wisdom, and women’s wisdom—so many good people. But I would also say that as an obstetrician and delivering maybe 500, maybe a few hundred babies before I gave birth to my own, as good as I am as a male physician can be, he will never understand what it is to go through childbirth. Does it matter how many babies you deliver? You will never understand what it goes through. 

I am thankful for the women now who are going into positions that are going through menopause and are saying, I would have been teaching; I would have been saying, Is it working? There has got to be a better way. Because I went through early menopause at 39, that is part of my whole story, and reversing it. I recognized, that God forced me to recognize that, there was a better way a lot earlier. I think we should start to see a change. But I still hear it because you have social media and you have physicians, women physicians, saying, that is ridiculous. You do not need progesterone if you do not have a uterus. I am going through menopause. 

Jennifer Simmons, MD

Yes. Listen, there are also people like Susan Love who, God bless her. She has done a lot of wonderful things for a lot of people. But her attitude is that menopause is a blessing, and menopause is not a blessing. It may not have been a horrible experience for her, but the symptoms and what is physiologically happening in the body are two separate things. 

Even if you are not symptomatic, you are still accelerating heart disease, you are still accelerating bone loss, and you are still increasing the risk of Alzheimer’s disease. We do not think that as many people die as a result of a fracture a year, then as many women die as a result of a fracture a year, as do breast cancer. Where is the conversation about that? 

Anna Cabeca, DO, OBGYN, FACOG

So true.

Jennifer Simmons, MD

No one is walking around with them. I know what color ribbon it would be, but no one is walking around with the bone fracture ribbon, saying we have to put an end to this.

Anna Cabeca, DO, OBGYN, FACOG

Can we talk about incontinence, vaginal dryness and discomfort, and sex now too? Because.

Jennifer Simmons, MD

Also.

Anna Cabeca, DO, OBGYN, FACOG

Menopause is natural, and mandatory suffering is optional. I want to look at menopause at 56 years old now. I want to look at menopause as the second spring of my life. I know that the Japanese say it is the second spring, so enhancing our second spring of life so that we can thrive. Enjoy the love. Love is that we have created the family, the legacy that we created, and continue to have passions and purposes. 

It is not over, but how do we optimize it and step into it? I just think, I see, I always say, I am open to learning. I will continually question what I say and what I teach. I am also an observer. I can see that I have been in medicine for 30 years. I can see people who have aged healthily and who have not aged healthily. You are just you with wisdom and time. God grant me wisdom with time and, to know, to be able to make the right choices now.

Jennifer Simmons, MD

Yes. But that is a lot based on humility. It is based on the assumption that you do not know everything and that you are a student of life. An ever student of life. I think of that as a great time to transition to one of the things that you talk about all the time, which is mastering your most important hormone. As we enter this spring of life, what is that hormone, and what should we be thinking about?

Anna Cabeca, DO, OBGYN, FACOG

I want everyone to write down the word OxyPlay. O-X-Y-P-L-A-Y. That is the process of increasing the most important hormone in our lives. That is the hormone oxytocin. Oxytocin is the hormone of longevity, connection, and love. It is an anti-aging hormone and it alkalizes the hormone. It is a resilience hormone, a first line of defense hormone. Oxytocin is not to be confused with Oxycodone, which is a pain reliever; sometimes that gets confused. 

Oxytocin is the hormone that we naturally secrete when we have orgasms, when we feel loved and loving someone when we are in childbirth, and when we are having contractions. Oxytocin causes those contractions, and that creates that bond with the baby that you deliver, as well as a pain-relieving effect, analgesic effect, and amnestic effect. You forget the pain of childbirth, so otherwise there would only be one child ever for any woman. The pain of childbirth. That is the benefit of oxytocin throughout our age. It is, and I know this from my own experience with trauma and PTSD, and losing our child at a young age, traumatically going through grief, and beyond explanation, that stress, PTSD, chronic everyday stress, and traumatic stress create that physiologic imbalance between the stress hormone cortisol and the most important hormone of our body, oxytocin. 

When we go through an experience like that. That is why there are increases in divorce rates, you can say, Well, it is because of the trauma, but it is also the physiology of trauma that you are disconnected from that person that you love the most, and your depression and those isolation feelings are what I call the battle between oxytocin and cortisol. Empowering oxytocin regularly is not only lifesaving, but it is also amazing because it creates amazing physiology. It is so important. Regardless of what we have been through, it is important to have oxyplay daily. There are many ways we can increase oxytocin beyond orgasm and having a baby, and it should be part of our daily practice.

Jennifer Simmons, MD

I love those words. I think that we often dismiss that. We get lost in daily life, and we dismiss the importance of hormonal health and that connection. We only get that stimulus, from the connection. If not, we are wandering around pointlessly and aimlessly, and we were all put on this earth for a purpose. It does not happen. You do not have to save the world. You do not have to be a leader. You do not you do not have to be anything. You just have to live your purpose. By living your purpose, you get all of that.

Anna Cabeca, DO, OBGYN, FACOG

I think it is the sense of experiencing pleasure, being happy, and feeling happy to tap into that regardless of our circumstances and our external environment. That is the ability that we have. That is a powerful thing that is universal in our human existence: the ability to be happy without understanding the peace that surpasses all understanding. That is an internal environment that can create every one of us. 

I say this from a place where I have been to hell. I have been on the verge of suicide. I have been going back to hell, back to hell, and back so many times in so many ways. But I say that with a heart to understand that, with this ability that we have to focus on all that is good, beautiful, worthy, and lovely, To shift our physiology, it is life’s saving grace, and it creates a better environment, not just for us but for all those around us. and I love seeing that. I look at midlife transition as the ability to tap into that exponentially.

Jennifer Simmons, MD

Yes. That is a choice.

Anna Cabeca, DO, OBGYN, FACOG

Daily choice.

Jennifer Simmons, MD

That is a choice you make every single day. I think that we should end by circling back around to that because the question of whether or not you can regain a life of intimacy, love, of purpose after breast cancer is a choice for people. I want them to know that that is a choice and that intimacy can exist after a breast cancer diagnosis. It probably comes from working with someone you or me who recognizes what is happening in the body. Can you just address that a little bit for people?

Anna Cabeca, DO, OBGYN, FACOG

Yes, absolutely. There is always the next right step. You can just think, Okay, well, I feel overwhelmed. Dr. Anna and Dr. Simmons have spoken about so many things here today, and I just feel overwhelmed. Think about what is your next right step. That is one thing that just got me through so much: what is my one next right step? I always say in the audience of one, for me, it is the audience, just with God as my audience, no one else, not the girls, not the work, not the employees, not the expectations of other people, and the audience of one. What is my next step for me today? 

I think that is where it starts. Then being able to realize, Okay, thinking outside the box, because number one, we have been there. Number two, we have seen it go wrong and we have seen it go. Having the ability to work with someone powerful and I think two, is putting it in your own hands. Jenn, I will also give you free trial links to our Julva and our Mighty Maca to give people that as an extra tool, just naturally what is available, that they can choose to use or not use, but can give that to your audience, too.

Jennifer Simmons, MD

That is so great. Thank you. I am grateful. Okay. Just to summarize today. We talked about the importance of vitamin D, and I think it is curious that we talk about the increase in cancer, it also happens to follow the timeline of the increase and the ubiquitous use of sunscreen. As a result, we have become a vitamin D-deficient nation, and that is causing a whole host of problems, cancer included.

Anna Cabeca, DO, OBGYN, FACOG

Because it is not deadly, we do not get deadly types of cancer from the sun. We get deadly cancer from not having the sun.

Jennifer Simmons, MD

Yes. In villainizing the sun, we have created a lot of chronic illnesses in our society. It is very important to know your vitamin D level and to optimize your vitamin D level. I keep people between 60 and 100 nanograms per deciliter. What is your optimum range?

Anna Cabeca, DO, OBGYN, FACOG

Yes. 50 to 100. I think that is the same range. 

Jennifer Simmons, MD

Yes. I asked why you got breast cancer, and I am getting a satisfying answer, which means that someone has to take the time to look at you from a historical perspective. You said, you ask, were there any problems with your mother’s pregnancy with you? It starts from the moment of creation and goes from there. Someone does need to take the time to look at you and to look at what you have been through and what you have been exposed to because that helps to answer the question and put the pieces together. But just acknowledging that you have a tumor is not going to help you in the long run.

Anna Cabeca, DO, OBGYN, FACOG

Empowering to know the why, is the answer.

Jennifer Simmons, MD

It is. Then we looked around for hormone disruptors in your environment because it is so important, and we learned what those hormone disruptors are doing to you, how they are disrupting your health, and how they are contributing to cancer diagnoses. When you heal the gut, you heal your hormones. 

We did talk about your book and started to see diet as an avenue to healing the gut and your hormones. I love what you said. Most people do not realize how bad they are or how bad they are feeling until they feel good again. We have normalized feeling bad, You are supposed to be tired. You are supposed to be achy; you are supposed to be slower. We have normalized all these things because, in general, medical doctors do not know how to promote health. They just assume that aging should be a negative process. It does not have to be that way. If you are not feeling well, there is usually a reason why. You should go seek to feel the way that you deserve to feel. The root of all illnesses, the inflammation, adrenal dysfunction, and hormone imbalance. 

Everyone should pick up. Dr. Anna’s book, The Keto Green Way, The Hormone Fix. It is an absolute required reading. It is a how-to guide to optimal function. At the end of the day, that should be what we are all looking for. Health is not the absence of disease; health is optimum function. That is when you feel good again When you are functioning optimally. The importance of oxytocin and getting oxyplay in every day, and do not be overwhelmed by all of this because all you need to do is take one right step. 

Dr. Anna, thank you so much for being here today, for sharing your experience, and for being so vulnerable and raw. I learned a lot of things about you today that I did not know. I know that you are going to help thousands and thousands of people who are struggling with the trauma in their lives. Thank you so much for being vulnerable, for being here, and for bravely doing the work that you do. It is so important.

Anna Cabeca, DO, OBGYN, FACOG

Well, thank you for having me. Thank you for this opportunity to share this information and what you are doing. I know summits are hard, so everyone listening should share and pay attention. Take notes, and just. Thank you. Thank you so much.

Jennifer Simmons, MD

Thanks. It is Dr. Jenn. Bye for now.