Harmonize Your Brain-Gut-Pelvic Axis For Vibrant Libido

Introduction and Dr. Betsyu2019s Background 0:00

Hey, everybody. Dr. Diane here. One of your summit hosts. And I am so thrilled to be spending time today with your other summit host. That's Dr. Betsy Greenleaf. So we're going to have a great conversation. She and I have been having the best time putting this summit together for you all. And this is an opportunity for you guys to learn about her. So I'm going to start with a very important question, which is how did you get into the work you do and why are you so passionate about sexual health and everything that we're talking about throughout this time?

Thank you so much, Diane. This has been just pure joy. And I'm learning so much as we're going through and interviewing these different experts has been pretty amazing. You know, I went to medical school. I always wanted to help people and I certainly did not want to be a gynecology. It's like my thought was, who wants to look at that all day long? And I know people always ask me this, but I think part of it, you know, it's one of those stories that we always figure out, like why we've gone into things, have a passion.

Because looking back, I mean, I was the kid who always from the time I had my period, was getting recurrent urinary tract infections. And then like as an adult, I had my own kind of, you know, sexual stressors and dysfunction. And really it was I just kind of really like fell into it as I was going through my rotations. I was like, Oh, I really like this. And now I don't like that. And I actually started off in general surgery, but I was the person who when we were going on rounds and was, you know, I wanted to know more about the person not just about their disease.

So like somebody would have their appendix out and I'd be like, so how do you feel now that your appendix out is out, which, you know, really a waste of time in general surgery? So I found in gynecology I could have that deeper relationship with patients, which I really like that connection and then uro gynecology, I didn't even know what that was. I mean, in fact, there's only 1500 uro gynecologists in the United States. And even when I came home and told my mom I was going to do like two more years of fellowship in uro gynecology, her first reaction was like, what is that?

Is that like fancy gynecology, like European, like EuroDisney? And I'm like, No, it's a uro having todo with urology, like bladder and then gynecology combined. So that's how I ended up in there. And then once I was in that field, I found out that there was a lot of doctors that were focusing on incontinence and prolapse, and we're talking about droopy, droopy bladders and droopy uteruses and not as many people that were focusing on that vaginitis or recurrent urinary tract infections or even more so pelvic pain.

And I found myself actually having a lot of those conditions myself. And so having gone through that, I was like, you know what? I'm going to make this my my focus and my passion. And so I was like, If I can fix myself, I can at least help others on that road. You know, sometimes it's not always a fix it, say, like, let's get it to a better level. And so even now, I'm still constantly searching for natural and and effective ways to get people in my own life back. So that's how I ended up in this field.

You know, I find so interesting that there's only 1500 uro gynecologists because in my mind, those things are, like, so closely related, right? And it's just it's. Really actually kind of a cool lead in like that, that fact. What we're going to talk about today, which is the link of the brain, the vagina and the gut, because some of these, you know, things like, oh, my gosh, only 1500 people are trained that way, are trained on this connection when it's so obvious. So let's start talking about this this connection, the brain, the gut vagina, and let's kind of just take it maybe big picture first, like set the stage for us with how these three parts of the body are connected and like why that's so important for people to be aware of.

You know, it's it's interesting because this is not something in traditional medicine, in Western medicine, that we tend to make a connection between. And actually, you know, taking a little step back, I sometimes I think it's a blessing and a curse. And I was trained as an osteopathic physician so that we're an osteopathic world. We're always trained, everything's connected. But I still didn't even know that when I came out. So it wasn't a fast forward like years later. I was really kind of searching for why were, let's say specifically vaginitis It's like, why were my patients getting recurrent yeast infections?

Why were they getting recurrent vaginal infections and why when I was giving them medicine, it wasn't getting any better. So it's I actually came by this connection backwards because I, like many doctors, were focusing where the symptoms were. So I was I started doing microbiome testing of the vagina about 20 years ago and it was like, well, there's got to be an answer here. And sometimes I just found out there it is more confusing than, you know, I was finding organisms, but I didn't know what they meant.

And it wasn't until I entered into the integrative and functional medicine world that they were really started talking about this gut brain connection. And when I went a ha gut brain, then I kind of threw in like, wait a minute, let me start looking like into the vagina. And if it's connected to the gut and I still don't connect it to the brain at that point in time, and then it kind of just all of a sudden one day there was a light bulb and so you're still going, well, wait a minute, I don't understand that any of this stuff is connected.

The Gut-Brain-Vagina Connection 6:00

So I always like to start with the with the gut. And I, you know, I know this has come up a number of times in my interviews in this summit. And I know this is stuff that, you know, you look into. We know that 90 to 95% of our serotonin, our happy hormone, is made in our gut. We know that our like anywhere I've seen anywhere from 75 to 90% of our immune system is made in our gut and so happy hormones. So if we're having anxiety, if we're having depression, so many times we focus on the brain and that's where, you know, things are coming.

But really, if we don't fix the gut and fix the diet and fix the information in the gut, all the antidepressants in the world are not going to work. And I started seeing this. And actually it also comes here's an interesting story. It also comes very personally. I found myself at age 41 having had a hysterectomy, and I was blaming all my symptoms on hormones. I was blaming lack of sex drive, you know, hot flashes, of course. Lack of sex drive, hot flashes, moodiness. You know, I don't know if I would have called it anxiety and depression.

I was just really pissed off at everybody all the time and flew off the handle for no reason. And I was like, Oh, it's just must be that menopause. And so around the same time I was getting sick all the time and, you know, had my tonsils out and like 42 years old and, you know, at one point they had me see an immunologist and immunologist is like, you have a primary immune deficiency. I'm like, What the hell is that? I never learned about that in medical school. And they were like, Oh, it's hereditary.

It shows up in your forties and this is going to be your life. You're going to live your life on antibiotics. You're always getting recurrent vaginitis, recurrent urinary tract infections. You looked at me wrong. I got sick. And this was right around the time I was entering the world of functional medicine. And all of a sudden one day I was treating patients for the stuff left and right and was figuring out. And, you know, they always joke about, you know, the electrician doesn't take care of the electricity in his own house.

You know, I wasn't looking at my own health and I went, wait a minute, what is what is the common dominator here with all those things? I was blaming it on hormones and getting older, which I think a lot of us do when I'm like, Nope, it's gut health. And so I at that point in time had and like I said, getting recurrent urinary tract infections vaginal infections and yeast infections and like constantly and I was swabbing the vagina, my own vagina for microbes and I'm like, why aren't they getting any better?

And so I kind of forgot about that for a little bit. And I started looking at the gut and I did my gut testing and I noticed, you know, my gut was filled with yeast and I was like, wait a minute. As women, the vagina, the rectum, the urethra are so close together, it's very easy for us to pass bacteria no matter how clean we are. It just happens back and forth. So I found out that once I started putting myself on this gut protocol, all of a sudden the yeast infections went away all of a sudden the urinary tract infections went away.

And then I ended up going back to my immunologist and got tested and she's like, I've got good news and bad news. She's like, The good news is your labs are all normal. She's like, The bad news is, I have no idea why. And I went, I know exactly why. And so this is then this started being the approach that I was taking with patients. And so even at that time, I was able to get off and my antidepressants, which were aren't working anyway. And I start feeling the best I ever felt my life. Like, no, like no more anger, no more problems with sleeping.

And now I'm not saying that that's the response that everybody has, but I was like, Wait a minute, there's something to this. And I started doing this for the patients, and I started my patients were reporting increased in their sex drive, increasing mood. You know, their hot flashes were going away, their vaginas felt better, their bladders felt better. So then I was like, okay. And then I was like, Let me see. Like, I'm figuring this out on my own. Let me go see if there's any data on this. And that's where I went down the rabbit hole and really found out some amazing research that was out there on that.

You can go either way. It's it's like where do you start? You start the brain. You start the gut. You start at the vagina. It's you can start anywhere and make the connection. But if let's say we started at the vagina, there was research out there showing that if the vagina bacteria was off, that there was people were reporting in these studies a low sex drive. And if we think about that process, we're like, well, why? Why would that be in the body is so incredibly smart and this makes sense. And you're going, Oh my God, why don't we think about this years ago, body smart.

I mean, it wants to survive. It wants to procreate. So if the situation in the vagina is not ideal for procreation, the body's going to go, all right? Not time to have babies and you're in your body. Doesn't know your brain doesn't know the difference between you just want to have some fun or you actually want to make a child. So the body will then go, You know what? It's not time. It's not a safe situation for us to have a baby. Let's shut that process down and so we see in those individuals where now the hormones get affected, now their fertility gets infected, now their libido gets affected, and so everything shuts down.

Because that's smart. Because what happens I mean, it's not to say that people won't get pregnant during this time, but if they do, they're going to be a higher risk of that pregnancy. Having problems and miscarriages. I have actually have a really funny story. A good friend of mine, she was a nurse that was working with me and she knew that I was testing people's vaginal microbiomes. And at this time I still didn't make the connection. It wasn't until I looked back that I was like, Ha ha, look what happened.

But she out of curiosity, I was like, Hey, can you test my microbiome? And so we sent a swab off on her. Now her history where she had been with her ex-partner for six years and they were having unprotected sex, you know, male, he was male partner's female partner, unprotected sex. And she just assumed that she was infertile because she's like, you know what? For six years, we had unprotected sex. They they weren't trying not to have a baby, but they weren't trying to. They just figured if it happened, it happened, but it didn't.

So needless to say, that relationship broke up for other reasons. Around that same time, we checked her microbiome and of course, her microbiome was was completely off. So we did a bunch of things to rebalance her microbiome. And lo and behold, she started with a new boyfriend. And lo and behold, she got pregnant the first time they had sex. Now, meanwhile, I was like, Hey, you know how babies happen? You're like and like, Oh, forget about the fact that STDs. But that's a whole nother conversation.

But she jokes nowadays that like I owe her, that I should be sending her kids quotes because I got her pregnant and I was like, No, now we know your microbiome was off. So it was stopping the whole process of reproduction and sex. So, you know, it's really fascinating. It's fascinating. And then like looking further into that data because you're like, well, what about men? You know, we don't really have any. I'm sure there's a microbiome in the urethra, the male penis. And we do know that there's a microbiome, a separate microbiome of the bladder, but we don't have research showing right now that effect on sex, drive, libido or fatality.

But we do have tons of research connecting the microbiome of the gut to fertility and and reproduction and libido for men. So even for men, women, any gender, any ID, if the gut is off once again, this is an inflammatory condition that the body's sensing and it's like, you know what, any time the body is stressed because of inflammation, it goes, I need to hold on to all my reserves and we're going to put the things that are not needed to the side because, you know, it's not the right time to be having a baby because the body doesn't know if you've just been in some horrific accident and or if you're in a time of famine, it just goes like I am under stress and we're going to stop everything.

So and I know that the gut microbiome comes up all the time and time again in these in these lectures. And then the other thing is we always forget that the gut microbiome is is a place where we make a lot of our neurotransmitters. So not just our serotonin, but some of our other neurotransmitters like dopamine, I reward, you know, so if we're getting those boosts of those feel good endorphins and dopamine and serotonin, if we're not getting those effects on the brain, then we just might also not really like our partners that might affect our mood.

Like there's so many aspects. And then then it becomes a circular pattern where the brain now can affect gut and the vagina. Because if you're stressed, because you're not having sex or it's affecting your relationship with your partner, now that brain stress is going to trigger more cortisol, which is really interesting cause we do have that course that we're going to be talking about things, you know, do stay tuned. We got some things coming up on the effects of cortisol and sex and sex drive.

But if the brain is stressed and you're making too much cortisol, you can't have sex and stress can coexist. So now we got this brain, the brain involved, and it just becomes, you know, the circular pattern that we need to have, like stop the madness. Like, we let's get things on track. And it's tough because we're living in a world where there are there's a lot of stressors, there's a lot of processed foods. Forget about going on antibiotics. I mean, the one thing that drives me absolutely crazy and I see happen all the time and this is because western western trained doctors don't know any better is let's say you have a woman who has a urinary tract infection.

More often than not, their primary doctors who are not well versed in the gut brain vagina connection,

Why Vaginal Symptoms Are Often Missed 17:00

they often reach for ciprofloxacin center Cipro because it's easy. But I'm like, you know what? Why are we taking an atomic bomb when we need a sniper? We need the, you know, antibiotics are 100% bad. We need them, but we need the sniper. We need the one that's going to go after the thing that's causing the problem, not this giant atomic bomb. It's going to kill everything around you, plants, animals, other people. And so one course in most times only three D pills, but that one three day course of ciprofloxacin can throw your gut microbiome and vaginal microbiome off for years.

And I can tell you, I've noticed like I've gotten sinus infections and I'm like, oh, don't go. I don't want to go on, you know, antibiotics. And I've really tried not to. And boy, every single time I do, I know like it's going to be a recovery. And I notice my mood changes and my sex drive changes and, you know, forget about the fact everybody knows, like, you know, the woman. If you go on antibiotics, your risk of yeast infections goes up. But it's really this you know, it's affecting so many other things.

Yeah, we are our best test subjects. I think sometimes as docs like trialing the stuff on ourselves and you know, as you're talking one of the things and you're talking about like the survival and evolutionary mechanisms, one of the things I'm thinking about is the H of the vagina and how the microbiome helps the H and that helps the sperm survive is the proper H. So it brings me to something that I think would be useful to chat about, which is the type of person that I know we've both seen, which is the female that has know something is like say off, right?

It feels like she probably has some sort of vaginal infection and she goes to her classic gyno and she basically winds up getting tested for yeast and B, B and C eyes. And like all the basic things that we do in the conventional world. And she's basically told like, oh my gosh, you're totally normal and she knows that there is some sort of problem. So I'm sure we have people listening to our summit in that category. So can you talk about that a little? Yeah. And you know what the hard thing about that with for patients is there also becomes a lot of shame and guilt that gets associated with this because their doctors are telling them they're normal and it's only because traditional medicine and I'm not like I don't mean to bash traditional medicine in Western medicine because we need it.

You know, if you're in a car accident, you don't want somebody going, Oh, let's look at your gut health and where your level of inflammation don't fix my broken leg like you take me to the E.R., you know? But so, you know, it's just that they're not looking in the right place. They're not testing the right place. And so there becomes there's mental on the side of the patient of like, I'm broken, I'm defective, I'm something, I'm dirty, there's something I'm doing wrong when that's not the case. And I always say, you know, I think it's funny that we say that patients have this gut feeling because once again, there is a gut feeling.

And in fact, they're finding that these microbes not only like our affecting our health, but they could be affecting our thought processes, too. But that's a whole nother lecture we can get. And I can I can really geek out on the microbiome, but there's often pitch changes. So pitch is a level of acidity or basic of a fluid. And so the vagina is actually very acidic. And we wanted to be acidic because that's what keeps it healthy and helps to fight away those microbes. It helps to keep the tissue healthy if part of it is some of it is all these things that can throw off the city or the pitch of the vagina can be stress, can be medications, can be products that we're using.

You know, unfortunately, a lot of these washes and soaps and detergent can be really harmful towards that, the page and the health of the vagina. So there's like our diets, our processed foods, like all these things can be thrown off the page. And those things are easy to remedy when you're pre-menopausal. So when you're in your reproductive years, that's a really quick fix. But using age as a as a barometer to knowing that, hey, there's something else going on, because if the age is off and that's something, too, we have we have some information on how to do that kind of testing.

But if the page is off, that's one of your first signs that there are there's a problem. But as we get older, balancing that page becomes a little bit a little bit different because we get shifts in hormones and we need estrogen to keep the vaginal tissue really healthy because estrogen makes the vaginal tissue grow. And when we're actively growing, it's left off, you know, like our skin and our body, like we're constantly making new cells and our old cells are sloughing off. But it's the healthy bacteria in the vagina that will actually feed.

And I know sometimes that sounds gross and people are like, but it actually feeds on those sloughed off cells. So we're working in conjunction with the healthy bacteria. We make the healthy bacteria and present in the presence of estrogen. We feed our healthy bacteria, but then all of a sudden we hit menopause and we don't have as much estrogen or perimenopause or pregnancy or when you're on birth control or when you're breastfeeding, like these are all states of low estrogen. So when states have low estrogen, we're not feeding our healthy bacteria.

And what happens are healthy bacteria dies off, you basically starve to death. And that's where the gut microbiome really comes into effect, because if there's bad bacteria, you know, I hate to label it bad, but it's not the bacteria that's ideally meant to be in the vagina. But it's like one of them comes in, it's like a party and all the bad guys get together, they all come in. So this is another thing. A lot of times we're treating women that say that they have a bacterial vaginosis. We're trying to find a medical school that garden areola is the cause of bacterial vaginosis.

It's usually not one bacteria by itself. It's this is why often when women are being treated for bacterial vaginosis, they're get given a medicine and they don't always get better. And then a couple weeks later, it's back again and again in medicine again and it's back again. It's because it's just usually more than one one guy party. And then there is one bad guy. So it's really we got to try to fight. We've got to create a healthy environment for the the bacteria to want to stay

Probiotics, Fermented Foods, and Microbiome Support 24:00

and create the environment to get rid of the bad guys. So it's a combination of that. MPH is a quick and easy home test that can be done. That would tell you that there's something that could be that could be a hint or something that's off sound. So just to make sure everybody's clear on a couple of things you mention, if you guys are like, Oh, okay, Betsey said how she's going to give that. We're going to give something about testing this stuff. So just look out throughout the summit and especially after the summit, we'll give you guys information on things like how to get your adrenals tested and how we can help support what these tests mean for testing and more.

So just keep your eyes out for that. And I feel like but we should tell people next a little bit more is okay. So yes, fix the guy. Yes, fix the microbiome. But there's so many different because I know people are thinking, right, like, okay, well I'll just go down to my local CVS and pick up whatever probiotic they have. So let's talk about how to really fix theirs. What are the differences in probiotics? How to really there are other things they can do besides what you already mentioned on working the gut to really help with the population and the repopulation of the vaginal microbiome.

We talk about that. Yeah, definitely. And you know, it's a combination of not all probiotics are made equally. You know, I see time and time and I don't want to throw any brands under the bus, but I'm going to bring the one that comes up time and time again because they've gotten really good marketing. So the marketing is usually on a line, is usually one that everyone's like, I'm taking a line, I should be great. Or they're, you know, I'm trying to think, what is that there? There's the yogurt that everybody's like, you know, because Jamie Lee Curtis does the commercial for the yogurt and everyone's like, I'm eating this yogurt, you know, what are the problems I see with that is they're really discovering now that there are actually be coming up with what microbes do, what.

So they're finding there are certain microbes that are really good for weight management. There are certain microbes that are really good for pain perception, like, for example, acidophilus, which we often think about for the vagina and is one of the great lactobacillus acidophilus is one of those great bacteria that we find in fermented foods and in probiotics and is really good for vaginal health. But it's also really good for pain, pain control because it affects our our pain receptors. So they're finding out what microbes do, what.

And so I don't think we've 100% figured out the amount of microbes because that's where it gets really confusing, because you'll go to the, you know, the pharmacy or wherever you're buying your probiotics and you buy one. It says it's got like one, you know, billion, million, you know, colony forming units or you got the one that's got 250 or there's prescription ones that go all the way up to 900 colony forming units. So it's sometimes I think the ones that are like the what like one are not enough.

I tend to go shoot for the ones that are like anywhere from 30 or higher. But I also I'm specifically looking for ones that are female oriented. You know, that's actually something that I'm in the process of developing for the pelvic floor store is we're looking in an end to find that it's not just taking one microbe, but used to be like, oh, just take acidophilus. That is like microbes are like life. The more diversity we have, the more we thrive. Because I always think, how boring would it be if we were all like, Well, same thing.

They found that the more microbiome diversity you have in your gut and in your vagina, the better. And also now is not going to do you any good if you're taking probiotics all the time and we're not, you know, or eating fermented foods. And I always try to get people to eat at least one serving of fermented food a day. And that's things like some people get on me about dairy, but I'm like, you don't have a problem with dairy. I don't. I have less of a problem with like the yogurts or the fears because of the fact that those bacteria will break down some of the milk sugars.

So but there's a lot of nondairy options. We have kombucha, we have sauerkraut, we have kimchi. Just we evolve, not have a refrigeration. No, I'm not saying get rid of your refrigerator. But, you know, we've evolved with bacteria, so we need to get more bacteria into our diet or, you know, be taking taking probiotic sticks. But like I said, get one. I look for now, there's so many choices of ones that have made ones specifically made for women's health. So I would say at a minimum, get one that's made for women's health.

And like I said, we're in the process of developing one right now for the pelvic floor storm. Let you know when that comes out. Okay. So exciting. And I know I know. Another question everybody is having is so you talked about one thing they can do to help tasks and be aware of a problem. It's like use strips for the vagina area, but what. Like. Tests that they should be doing? Like how are people besides like, oh, I have some symptoms and I have low sex drive, right? So besides the basic symptoms of things you've already talked about, how are they going to know that this is a root cause.

That, you know, there are so many, which is this is a really exciting time and microbiome science is really about to explode. You know, I think it's like seeped into the integrative and functional world, but from a general standpoint, it's going to explode pretty soon. And I think it's I would highly recommend people to get this testing on their own. There are so many different companies that are out there that do gut microbiome testing. So this is looking at stool testing and we can see what's present in the stool.

Testing, Interpretation, and Finding the Root Cause 30:00

And it's not just looking at the microbes, it's going to look at inflammatory levels. And then we have options to do vaginal microbiome testing. I have a I have a preference towards some of the practitioner focused testing because I think it's really it's really expansive and it gives much more information. Asian there are some companies that do over the counter testing where you as a as a patient who order the test yourself. The only complaint I've seen from some of the home based testing is sometimes too much, too or too much information.

It can be overwhelming. So I've had clients where they've gotten that, they've ordered the test themselves but didn't know how to interpret it. And it can be pretty scary when you get this test and it's like you got all these things with these crazy names. And I know a lot of us like to use Dr. Google. You know, I get it. You know, Dr. Google is excessive, but when you have one of these tests, you've done it and ran yourself and Dr. Google, a couple things happen. It can be terrifying because a lot of women want show and men will show positive for something called mycoplasma and urea plasm and mycoplasma and urea plasm.

If you go Google that now, it will say it's a sexually transmitted disease. I'm here to tell you it is yes and no. Yes in that it can be passed between partners. It's like if you had a cold and you kissed your partner to give him your cold. But we don't say it like the common cold is a sexually transmitted disease. No. In that you don't have to have sex to have mycoplasma in your rear plasm in your system. You know, it is just a microbe that is out there. We don't know where sometimes we pick these things up.

And so there are people who never had sex or, you know, I've had widows who, you know, years and years and years been, you know, maybe they got from the part, maybe not. But we don't want to treat that as like an STD, you know, in people and even STDs. We shouldn't really have the stigma because something like I mean, like herpes, one in three people have it. Not everybody really expresses it. So so I assume you got to take those those results. And really, if you go and get your own result and do your own testing, you're going to take that with and take it to somebody who knows how to interpret it because there are some microbes that will show up also that will like there's no research out there.

I mean, we're finding microbes with this advanced testing. Nobody even knows. Like they don't even have names for them. There's too there's bacterial vaginosis, bacterial vaginosis associated bacteria, number one. And two I've been out even give names to these things yet so it can be pretty daunting to do this testing on your own and not have the experience of how to interpret it. So I kind of caution people that like, yeah, those tests are a little bit cheaper, but it really is probably better if you're going to get one of those tests to work with somebody who can help you interpret it and how to fix it.

Then you know where I like some of the more advanced practitioner test that will give us not only like what is there, but they will also give us like what those bacteria are sensitive to because if it is something we have to treat with an antibiotic, I'd rather do the sniper antibiotic then give somebody the, you know, atomic bomb. So that's why I like I like some of the advanced testing better. And we're getting better and better with this test, these tests every day. But there's so many out there, too.

I love those metaphors. And you're making me think of being in medical school. You know, when we are learning different things and like, you're fatigued and all these symptoms are happening because medical school is hard and medical school is like Dr. Google is like, Oh, I have that or I have that. So there's really, really good advice and we've talked about a lot. I want to make sure that anybody just remembers that that Betsy and I are going to be doing a master class for you all. So if you're if these things are coming up and you're like, oh, my gosh, I want to know more and how is this related to my sexual health and ask those questions.

And we're going to be make ourselves available for you. So make sure you look throughout the summit for that master class to register for that so that you can actually ask those questions that I know you want to ask and anything else you want to make sure we wrap up with today and leave everybody with? You know, I just think that's, first of all, great thing. Like, I would really take advantage of those master classes. I've done them before and I'm looking forward to doing it. They're really good and it's you're going to get your answers like it's you have an opportunity to ask questions.

So I think that that's a great opportunity.

Wrap-Up, Resources, and How to Connect 35:00

You know, really, I think that when it comes to health and wellness, there are so many different factors that we can't always blame things on on one thing. So and we need to look elsewhere. So, you know, I mentioned really quickly about, you know, sexual health and microbiome, but this is also something to take into consideration for hormones. You know, a lot of times people as we get older, we're like hormones are the answer and if you go on hormones and they're not working, one of the possible root causes may be the microbiome.

So it's not that the hormones aren't working. And it doesn't always mean like, well, then I just need more hormones, so we need to take all these things into consideration. So that may also be a factor. And you know, and ultimately you're not broken, you know, you're not defective. There are solutions and there are natural and easy solutions. You just need the right guides. And I think that's something that, you know, we're here for that. Yeah. Yeah. Such good wrap up advice then. I'm sure you guys have heard us both say a lot of times that information on everybody that speaking is in their speaker bio.

So you'll see that for Dr. Betsy and her speaker bio. But can you remind everybody how people get a hold of you and you know, kind of what they do if they want to work with you as well? Sure. We get I got tons of places that you can go. So first of all, follow me on social media just can find me by putting in Dr. Betsy Greenleaf (@drbetsygreenleaf). It's under one form or the other. As long as you get kicked up. I'm again. So that's why I can't give you specific because it varies from time to time.

There's also the pelvic floor store. We have a bunch of different pelvic health products femversity.com where I have my courses and you always look for me DrBetsyGreenleaf.com oh and I always forget to put the podcasts. We got some of your parts and right now we have the Health Explained show, which is an internet show that you can find on wytv7.org. So thanks so much for your time. Thanks for doing this summit with me. It's really been such a pleasure and what a great talk today. So thank you so much, Betsy. Oh, my goodness.

It's been awesome. Thank you.