The Incredible Pelvic Microbiome & Your Fertility & Sexual Health

Introduction to Dr. Betsy Greenleaf 0:00

Welcome to the bio optimized summit where we are exploring the next level of physical and mental health you can achieve through targeted and intentional optimization. I am your host Dr AMY and today I have with me someone who's become a good friend dr Betsy Greenleaf and she is one of the coolest people I know and she is actually board certified in three different things. So triple board certified and is actually the first female in the United States to become board certified in neuro gynecology.

And so she is a true Trailblazer when it comes to women's health in terms of the pelvis and all things related to those parts of us. And that is actually the name of her podcast as well, the different parts of us. So she has triple board certifications in obstetrics in gynecology from the american board of Osteopathic abstract tricks in gynecology, female pelvic medicine and reconstructive surgery. Again from the american board of osteopathic O B G Y N. And then the procedural medicine and aesthetics from the American Association of Procedural Medicine, Not only that then, but then she has these business degrees, she has both the masters and an M.

B. A. And so she has really developed for herself a reputation a professional reputation that has led to being sought after by medical societies associations and corporations to be providing lecturers, educational content teaching and advanced trainings. She has been honored with the title of distinguished fellow of the american College of Osteopathic abstract tricks and gynecology. So she also has the online pelvic floor store that she will manage as well as the blogs and then the host of some of your parts podcast.

Her mission of course is empowering women to find health and wellness through self discovery and education, focusing on the mind, body, spirit connection and really teaching this aspect of you are greater than the sum of your parts. Which is why I very much aligned with what her value system is, what her work is. And I'm so excited that dr Betsy you are with us today. Thank you so much. Oh thank you so much Dr amy for having me here. I'm I'm so honored to be here and I'm so excited to be talking about this. Absolutely. And this is such an important topic right?

Like this affects all of us And we're gonna talk a little bit about men um but especially women, this can be something that is very shaming and we don't want to talk about it. We have questions in, we tend to hide if we do and so this is really affecting our health, physical health, mental health. And so I appreciate you being on. And let's start by talking about microbiome because a lot of this really does come back to this idea of microbiome. So walk us through what is a microbiome and why would we be talking about that as it relates to the parts of us.

Understanding the Microbiome 3:00

You know it's so interesting. So the idea of microbiome is the bacteria and yeast and organisms that are normally on our body in our body and the microbiome has kind of gotten a lot of press lately because it's gotten a lot more attention you know, I think in some ways you know, I think back like my poor kids to like everything they touched, we were telling them like hand sanitizer, hand wash wash wash and now we realized that no that these microbiome, these organisms that live on our body in honor in there, there to work with us that all those years of us using crazy different hand sanitizers or antibacterial soaps that we may have been taking antibiotics or eating inflammatory foods. We can throw off our microbiome and it can affect so many different areas of our life.

You know, most people hear about the gut microbiome. So there's these nice healthy bacteria that live in our intestines and they if they're doing their job then they actually help support our immune system and also help support there's this big connection, the gut brain access so they support the production of serotonin which is one of the the chemicals that makes us feel happy. And so if our gut is thrown off, we can have issues with recurrent infections and we can have issues with depression and anxiety and there's so many different things that can throw off the microbiome and this has been like you say, this has been a relatively new thing that has you know hit the news and the publications, even though it's something that may many physicians especially osteopaths, right?

Like this has been a foundation of their training for a long time. It's nothing new, but it is new in terms of hitting more of the mainstream awareness and this idea of hey, like we, we know that we've got this gut bacteria, but we actually live in this symbiotic relationship with them ideally if we have the right gut bacteria, if they're in the right balance and In terms of the types of bacteria and all the different things that they do for us in terms of digestion and toxins, eliminating toxins and like you mentioned the serotonin and how 90% of our serotonin is actually in the gut made in the gut that these bacteria with the microbiome are helping us with and so so much of what is going on in the brain is really a shadow of what's happening in the gut and the microbiome.

You know, it's amazing too. I mean even they're talking about skin microbiome and that there's a lot of healthy bacteria that's like in the dirt that we don't expose ourselves to. And I don't know you as a mother. I mean, I remember when my kids were out, I mean like I remember as a kid, I would get out and play in the dirt, nobody thought of anything. And then I know that like we got went through this phase where everybody got so scared of germs and now we're now we're back, you know. And unfortunately my kids grew up during that time where I was like you know everything they did, I was like wash your hands like antibacterial sanitizer.

And now we're really seeing with our Children that they may have affected our immune, their immunity. And now it's like no no get out, go play in the dirt, roll around in the dirt so that there are really healthy that we really want those as part of our skin too. So every little part of our body has its own little environment and that supports a different type of bacteria that helps to keep us healthy. And there is also this vaginal microbiome and that can get off of balance and that can have these effects on our physical health, mental health relationships.

Right? So tell us about the vaginal microbiome. There's so much about this. I'm getting so excited because the further I become involved in like looking at the research of this, the more I'm finding out and it's still a pretty new field. Um but there's there's so much new like information and studies that are coming out. I'll talk about some of the exciting studies later but we know that the ph of the Vagina should be between 3.5 and 4.5 and the reasons. So let's say like a woman who is menstruating.

So because that's probably the easiest one to talk about and then we can talk about some of the other um ranges but a woman whose men's trading typically for her to have a healthy vagina. It needs to be between 3.5 to 4.5. And the reason why it's that acidic is there's these happy little bacteria called lactobacillus and there's a whole bunch of different types of lactobacillus. Most people have heard of acidophilus um It's one of the ones that's commonly found in yogurt. But acidophilus likes to live and um in the vagina and it it actually feeds off of the dead slough off cells that you know as the body's making new cells.

We slept them off our skin, sloughing off all of our tissue, your intestinal cells. So they did you know, they die off, they slept off. We make new ones but the lactobacillus likes to eat something called glycogen in that slough off those left off cells. And in return the lactobacillus will actually produce hydrogen peroxide. And so it's that hydro peroxide that actually makes the vagina very acidic and in return it protects our mucosa protects us from vaginal infections. It protects us from urinary track infection. And so it's very incredibly protective um And there's a whole bunch of other lactobacillus that we're now finding out because I've had patients be like all right well let me just take some you know probiotic

Vaginal pH, Lactobacillus, and Infections 9:00

but not all probiotics are made equal. Like now we know there's something called lactobacillus ram gnosis, lactobacillus gas airy room terry. How do you know which one to take? Exactly? And you know it's really nice nowadays. Is that there are there are probiotics are made just for women. So there's ones that you can find. But um but yeah so this is what keeps it everything kind of imbalance and there's so many things that can throw us off because there's some women are like well then why you know why do I get recurrent urinary tract infections? Why do I get recurrent vaginal infections?

Well it could be two fold. It could be if your gut microbiome is thrown off that's gonna affect your underlying immune system to begin with. And then things like stress. We definitely stress with the elevated cortisol. That's gonna throw off not only just our hormones but it's gonna throw off the ph in our body and and the whole it'll make it so that um that the lactobacillus doesn't really want to be in the vagina. Um And then we have things like inflammatory diets. So if we're eating things that are like our sugar sugar gluten in dairy being the three largest cause inflammation in our bodies that can throw off our gut microbiome and our vaginal microbiome and then of course if you get a cold and you get put on antibiotics then and it could take it can take a long time. Especially for your gut.

Your gut can be thrown off for almost a year after one course of antibiotics. I saw that study. Yeah. And so it's like you gotta be really actively trying to get things back to where it used to be. But there have been other studies that show that taking you know, save the vaginal microbiome is thrown off that taking a month of probiotics can actually start to reset. It accelerate. Yeah, that reset. That's interesting because one of the things that I did for a while when I was first starting, you know, whatever you want to call it bio hacking was measuring the ph of my urine every day throughout the day. And there was definite differences that I noticed when I was stressed or when I was eating different things.

And so I can only imagine because in the vagina this is like the most acidic place in our body. And so that balance is even more delicate because of that more acidic range that it has to stay in. And so I imagine, yeah, like the effects of diet, the effects of stress and cortisol are really going to be affecting that microbiome because of the narrow range and the higher acidity that it has to maintain itself for optimal health. Yeah, definitely. And then there's some natural things that happen that throw off our ph and so some people can go through these things and not have a problem. Some people are more susceptible to infections.

So when, when women are menstruating when they get their period the some women will and are more susceptible to getting yeast infections during that time of the month because the ph as the blood is passing through the vagina the ph of blood is much higher and it's gonna make the vagina more basic. So there's some people that are more susceptible and there are tips and little tips and tricks to try to solidify the vagina during that time. Or there's some women that are having sex with men that and I don't like this one. I've never been able to figure out.

But the women's vaginas are very acidic. Men semen has a ph of 7 to 8. So it's a very basic very basic. So I've never figured out why nature wants us to be that way. I don't have a great answer. But some people you know what they're exposed to steam and have no problems at all. Some people it throws off their throws off the ph, throws off their microbiome and now their deal with vaginal or your urinary tract infections. I was gonna say one of the common things that I see and those who have trouble with that are the U. T. I. S. That they get after intercourse.

Yeah this would be why it disrupt that microbiome interesting. You need to do things to try to get acidified back so they can get back. So um yeah and one so one of the great one of the ways to acidified during that time is use boric acid depositories quick and easy way to do it. So there's a number of different products that are out on the market and there's new ones coming out all the time. And so I have people you know sometimes we have people traditional medicine, they'll have people take antibiotics after intercourse if there's somebody who's prone to urinary tract infections once again I'm not a giant fan if we can do it different ways. Um But if we can try to number one maybe try to acidified the vagina by using a vaginal boric acid suppository that means suppository goes in the vagina you do not want to eat or swallow boric acid brightness.

You can put it in the vagina just please don't eat it. Um But you know one like for a day or two after intercourse. So and how would a person know how much to use? Do they just use it for one day? Do they like how would they even know how to start experimenting with that? You know I would say start off with just doing it for one day afterwards and just see how you do and unfortunately if the one day doesn't work and the only way you're going to know is that all of a sudden now you're going to have an infection but when it comes to vaginal infections sometimes boric acid is actually a way to treat those infections without using antibiotics.

And and the nice thing about boric acid is it doesn't matter if it's a yeast infection or it's a bacterial infection that boric acid suppository will take care of both. Also, it's just a matter of actually uh Acidifying the vagina. There's another product on the market that's pretty good called Levina. Levina is a prebiotic for the vagina. So it contains glycogen. And so what it does is if for some reason the vagina has been thrown off. So you've been on antibiotics or you're really stressed and now you're prone to infections and you just want to try to rebalance that actually using this Levina gel, it goes into the vagina and it's gonna feed your lactobacillus.

So, you know, you may have like a couple of lactobacillus or just hanging on for dear life and we want to kind of get them going, you want to feed them by using a product like that. Some people do complain about because that product is um it goes in as a gel, but from body heat, it tends to melt, you tend to get a discharge that people to complain about the the yeah, not comfortable feeling with it, but you know, it's something that you can use, some people use it like once a week just to help balance and keep things healthy. Some people use it just, you know, after they've taken it or during and after they are taking a course of antibiotics and just try to keep the lactobacillus as healthy as possible.

Yeah, this is very similar, very comparable to what we do to feed our gut microbiome right? Like we use both probiotics and probiotics to paint on the situation. But it's very parallel, like we're doing the same thing in order to feed that healthy by violence of the microbiome and the vagina and be able to allow that acidity to the level that we need it. Yeah. And then, you know, there's tons of, like I said before, there's tons of these probiotics and I always tell people look for women's probiotics because that's the easiest way, because they're finding out that with probiotics, these bacteria, there some of them have such different uses.

There are ones that are just good for the gut. They're even finding ones that are present. Um this was interesting and we're going to get off the subject of vaginas. But they found that people who are obese have a different microbiome than people who are not obese and they're using that information to actually give people who are obese this, these certain types of specialized lactobacillus to actual actually change their gut microbiome and they're finding they're actually losing weight. So, you know, I think because of this and they're finding certain ones are associated with mood, you can find different probiotic products for whatever your problem is.

So used to be like, oh just take probiotics and everybody would go and pick whatever off the shelf, but now you want to look at specifically what is your problem. And and so I always tell people look for the women's women's brands because those usually

Pelvic Floor, Trauma, and the Vaginal-Brain Connection 18:00

have not only the lactobacillus, but they usually almost always have ram no sis or terry which are also really, really good. And then some people just don't want to do probiotics at all. You know, some people are not pill takers, I get it. Um you can do it with diet and you know just you know, I start to think about our like ancient ancestors and how they were probably so much healthier than we are today that between nowadays between processed food and refrigeration, many of us don't have fermented foods in our diet.

And fermented foods were a necessity for our ancestors because they didn't have things that stayed on the shelf and didn't go bad for like, like God, what do they say? Like a Twinkie can like last something like 30 years or like indefinitely without going, can you kind of wonder if things don't ever go bad, right? You know or or refrigeration? So and fermented foods actually during quarantine my kids and I we started having fun as science projects, making some of these things ourselves yogurt and I know yogurt has like because it's dairy, there's like this iffy attitude towards yogurt, some people are like no because it's dairy, you shouldn't have it is inflammatory.

And then there's other people are like no because the process by which the bacteria are growing in it, it makes it not inflammatory. So I say with yogurt you just have to try it out and see if it bothers you. But we make yogurt now at home, we make our own kombucha this summer. This summer. I actually got involved in there's tons of recipes online and making my own sauerkraut and kimchi. So it's fun you know where you're getting it and um you know the other thing is that you can find the stuff in the supermarkets now where you used to not be able to find any of it. So um yeah definitely.

There's so many different options. You know kombucha is fermented tea and kimchi is like a little spicy sauerkraut. You know I've had this with my patients like I'm eating sauerkraut and sauerkraut and I forgot to tell them no don't get the canned stuff because this process you got to get the stuff that's been refrigerated that has like kind of like a cloudy fluid or the pickles that have like a cloudy fluid, those really still have the healthy bacteria as Yeah. So then like I can only imagine like the the consequences, the effect that this has on the whole pelvis and the tissues and all of there's some really important stuff happening in the in the pelvic floor with all those muscles and that's actually a big area for many people in terms of even like their trauma work and the body trauma work, like working with those pelvic muscles and tissues because so much can be stored there.

A lot of stress can be stored there. So I would love to hear like how does this microbiome, how does all of this like influence and effect the whole rest of what's going on in the pelvis? Because that's such a vital place for a lot of the nervous system and stress and all of that. I'm so excited to ask. I just got chills. I'm so excited to talk about this because this is some information I just recently came across because I'm involved in this organization that's doing research on vaginal microbiome.

So yes, going back, I'm going to go back with the, what you were talking about the pelvic muscles. So many people who have experienced trauma or just have some kind of stress, especially women, but they can happen to men to hold their stress. Women particularly hold their stress in their pelvis and they tend to subconsciously tighten their muscles and not don't think about it. And that in turn can lead to a number of different things where they can have problems with constipation, they can have painful intercourse or not even be able to have intercourse if their muscles are so tight, they can get just con chronic pain.

Um so there's a lot of different things that can cause those muscles to tighten. But what they're finding out, there's this new area of research where they're finding out there may be a vaginal brain connection. And that's what I'm so excited about. Because we know that there's a gut brain connection. But now they're saying that there's a vagina brain connection. And so they're looking at different microbiome, like different bacteria in the vagina. And they're actually trying to figure out which ones were not sure which ones yet. But they're trying to figure out which ones that they're binding that if the microbiome and the vagina is thrown off, this may actually affect sex drive. This is how it's affecting the brain.

So it makes sense because if the body is the reproductive organs really their their nature, their goal is to reproduce. If things aren't ideal in that area, the body would not want to reproduce. The body wouldn't want to be reproduced and then have some kind of feedback loop that says, okay, it's not good to reproduce. So we're going to affect your sex drive. So, you know, for years, especially women, you know, there's so much when you're in a in a relationship or even if you're not and you're just going like, wait, why am I just not feeling like everyone else is having sex and I'm not and I'm not interested. And that's the last thing on my mind.

You know, it's always in the past has always been blamed on, well, it must be something with your brain. Like, psychologically, you know, and now we're saying, you know what? It's not your brain. It's something going on actually fit basically in the vagina. And that maybe the bacteria are telling you that it's not time to have sex because we don't want you to produce because fertility is not optimal right now. So I'm going to throw something out there and see what, see what you think. Because as you're talking about this, it's making me really excited because what we are discovering in terms of the somatic um the somatic work in terms of trauma and a lot of this is coming out of our new understanding of the vagus nerve and the vagus nerve, especially the dorsal branch of the vagus nerve that has that freeze response wired into us and the fibers of the vagus nerve that go below our stomach and digestive system. For a lot of people, that's where they have thought that the ends of those vagus nerve branches lie.

But what we're realizing now is no, like the ends of the vagus nerve go all the way down into the pelvis and these pelvic floor, muscles and tissues. So that when we're talking about a person's actual, I want to call it life force. It's in their pelvis. It's that deep in almost like their sex organs because that is the source of creation of creativity, of existence of reproduction. And so it makes total sense to me that there would be this vaginal brain connection because the vagus nerve does have that line of communication from the ends of the dorsal vagal branches, that their purpose is to bring all that information up from the nerve endings all the way to the brain. And it's this messaging system telling the brain what's going on in the body.

And so it's it's giving that brain the information of. Are we safe? Are we not safe? Are we safe enough to explore and create and connect and thrive?

Men, Bladder Microbiome, and UTI Guidance 26:00

Or do we need to be in some type of survival mode? Because even just internally things are off, the vagus nerve is gonna be that connection between the vagina and the brain. That yeah, that makes complete sense. You know? And I honestly I really didn't even think about it. And then when you said it I was like, oh yeah, you're right. That does make completely which would make the vagus nerve very sensitive to the changes in the ph and so the bacteria, the microbiome that are responsible for creating that ph like, that could be like the mechanism by which the microbiome are feeding that information to the brain is through the ph changes which then get communicated through the vagus nerve.

Yeah, I definitely think that is and I'm gonna give that information back to the group that I'm working with, that we need to look at that too because that's definitely makes a lot of sense now that you say that. So this is just great by the collaborations are wonderful. Well, yeah, with the vagus nerve, especially that dorsal vagal like being all about, is it safe to be, is it safe or is it not safe? And if it's not safe, it's going to be shutting down any type of impulse to reproduce. Hmm. You know, women are always asking for they want the little blue pill for them.

They want the pink pill. But you know, I try to tell them, even for men, the blue pill doesn't make people in the mood, right? The blue pill, all it does is increase blood flow. It's changing blood flow. That's it. That's all it's doing. So, um, you know, whatever is the root cause, it's not addressing the root cause. Yeah. So, which brings me to my next question that I'd love to talk to you about is any of this parallel to issues in the pelvic floor and muscles and men, you know, so, men have obviously have things are a little bit different.

Their sex organs are mostly on the outside. But yeah, they can have a microbiome on their skin and we don't know as much about their microbiome when it comes to their health. But, you know, an interesting aside is that they found that women who, well, it actually came out of research with women who have women partners that they found that if there was one woman who was getting a lot of recurrent infections that even though her female partner may have a microbiome that was off that. But her partner may not be be affected by it.

But then they extrapolated. So they found out that there was definitely a connection um with that and whether, you know obviously women using sharing toys or that would be a way that things were being exchanged. So then they started looking at men and they found the same thing with men that if a woman the female partner was getting recurrent infections, there may be something that's off on the male microbiome. But it's interesting because traditional medicine doesn't say treat the mail too. And there's been tons of studies on this. But they're just like, yeah, there may be something with the male partner.

Um, but you know, on another note that men do, men can get urinary tract infections, men can get prostatitis inflammation of the prostate. So, and here's something that we know for both men and women. That's been fascinating. You and I were trained in medical school that urine was sterile urine is not sterile. They're finding out that we have a microbiome in our bladder and that there are normal bacteria that lives in the bladder. They're still trying to figure out what that means. Um, but that we know with our testing the testing has become more advanced than our clinical connect. But we now know that hey you know what the urine isn't sterile that there are normal bacteria and that here's the biggest thing I think for patients to take away from that is that when you go if any of us go to the doctor and we get tested because there's always like oh let's do our routine urine screening and you come back and there's bacteria.

Well that would get thrown antibiotics and you'd be like oh I have an infection. I didn't know it guidelines have changed. So the new definition for a urinary tract infection is you have to have symptoms. So I don't want to give you antibiotics if you've if it comes back on culture but you don't have symptoms they're saying don't treat that now. Yeah. Yeah. So and then on the other hand if you have symptoms and the urine comes back negative then the other thought is maybe the bacteria isn't floating in the urine, it's actually in the tissue of the bladder and we just can't pick it up. So in those cases and maybe there are other treatments that you need to do. So it's so fascinating.

And then to support the micro this explains too why supporting the microbiome of the bladder. Why it's something like de Manos works. So de Manos is a type of sugar which is a prebiotic. So now in some people it does great at preventing them from getting urinary track infections because we're probably supporting the healthy bacteria in the bladder that's fighting the bad guys. Some people the demon oh, so affects their gut microbiome and causes some intestinal upset. So it's like you got to see how that works with your own microbiome. So this is especially for anybody who has like the small intestinal bacterial overgrowth, giving the de manos would be would be very uncomfortable that it's almost like a way to confirm that they have SIBO Right?

Yeah, definitely, definitely. So it's just I think this whole area of microbiome and like all these different environments on our body that we're almost like a whole universe and ourselves and like that we have all these different areas that are working together. And it's just fascinating to see that this work is starting to come out. Yes, it is exciting. So if a person at this point does not have any problems, but they want to optimize and ensure that they continue to have a healthy balanced microbiome.

What are things that they should be doing? You know, it's funny because it seems complete unrelated, but the most, the biggest things are get enough sleep because I'm sure you're having people on here that talk about sleep because sleep affects your cortisol that affects your healing. So you want to make sure you're turning off those, those blue light Things that are keeping us awake and and setting a bedtime drinking enough fluids that 75% of Americans are chronically dehydrated. So finding a reliable, healthy source of water, not in a plastic bottle.

So um and then really eating low inflammatory foods, stay away from the

Optimizing Microbiome Health Through Lifestyle 33:00

inflammatory foods and getting tons of fermented foods into your diet. You know find ones that you like. There's so many different versions of fermented foods out there. Unfortunately beer and wine are fermented but they no longer have the healthy bacteria in it. So you can't call those fermented, so you need to have fermented foods that still contain live bacteria in them. So and just stress, you know, whatever that means for you whether it's meditation or doing a hobby or yoga, I think those are probably the four, you know the four main things with diet, sleep hydration and stress reduction that will keep you healthy and all sorts of different ways right? Because it really is like the whole system that keeps the microbiome in balance in check. And so I love that you first went to sleep right? You went to the diet and water and stress because all of those things, the nervous system is really gonna impact that balance that we have with the microbiome and that was where I had to start, you know with my health journey when I had um kind of my health crisis and collapse, like I call it sleep with where I had to start. And I was at the place from like there, I don't even know why I'm not able to see sleep, something else must be wrong.

But still, I was able to find some things that allowed me to get a better rest, things that I hadn't even thought of before. So that's when I started doing blackout curtains and got a weighted blanket and cooled the temperature down in my room and unplugged my wifi and you know about the blue light blocking glasses, all of these things that really did end up making a difference, even though at first I was skeptical and be like, no, I've tried everything. I, I'm notorious for wanting to get one more thing done done. And so I have had to learn that I cannot be on my computer after eight o'clock at night because I'm on my computer after eight o'clock at night, even with, I have all the blocking glasses will help a lot.

But even then I cut off all screens after 8:00 at night because otherwise I get the second wind and then I can't get right, it activates the brain and you can't turn the thoughts off, they're still going. You know, it's funny because I find that when I realized when I was on vacation that like eight o'clock at night would come around and because I'm not on screens, everything, I'm like, wow, it feels like it's 10 o'clock, I'm so tired and I realized because on vacation I'm more in tune with my body because I'm not screens I'm out doing things in nature most of the time when I go on vacation and it really is like, wow, you know what, that really has something to say, like really supposed to be more in tune with our circadian rhythms and we affected with our artificial light. Yes. And I think it's a bit ridiculous to expect our body to have a healthy microbiome if we're just trying to take a prebiotic or probiotic or you know, whatever it is, but we're neglecting these different things like the stress, the screen time, the sleep because there's no pill that will outdo the negative effects of those. Yeah, that's why I like, I think everything is connected and I agree. Like I tell people you can't make a pill in all of a sudden be healthy. You know, it's you got to work on all these aspects because one's missing. You know, then, you know, somebody said it once as a table, you know, you've got your four legs of the table and you're doing like three of the healthy things, but you're not doing four, the fourth one, the table still going to fall over, right?

You can optimize those legs, but you better get that fourth leg on. Yeah. Good. Where can people find you dr Betsy sure they can find me at dr Betsy and that's B E T S Y. Green leaf dot com. Also I have a podcast called sum of your parts, you can find me on any place you listen to podcasts. I also posted on Youtube. So if you just look up dr Betsy on Youtube um and um yeah you can find out everything that I'm doing. And and also we have I have the pelvic floor store which is a place where you can find reliable pelvic health products awesome.

And I just wanna thank you for the work that you do. This is really important work and I love that you are so proficient at being able to articulate and get this information out there to help people great thank you so much and I'm so excited for your son and I think you're doing amazing with this. Thank you Dr Betsy. Thank you. Yeah, thank you for taking the time today, appreciate it. And thank you for joining us today. I am your host DR Amy for this bio optimized summit and make sure you get the discount price available for all the recordings and the content and the gifts.

Because once that discount price is gone it is gone forever. And I would just love to see you inside be able to connect with you more and get to know you more and together let's find that next level of health and aliveness