In this episode, we are joined by dream doctor, Dr. Shruthi Mahalingaiah and discuss hormones and the environmental impacts on the female at birth body.
When your self care is slowly posioning you, you know companies are pushing profits over our bodies. In this week’s uterus in the news, straightening hair treatments for women of color are being flagged under our radar along with the amount of chemicals found in nail salons. Self care and beauty is something we shouldn’t have to sacrifice because of greedy companies. That’s why here at Hello Uterus we are still giving away beauty boxes from Beauty Heroes! All the beauty products you need but guaranteed clean and free from hormone-disrupting chemicals! To learn how to enter, visit our instagram!
This week’s guest is a dream doctor who understands how these chemicals affect our bodies. A physician researcher with an extensive learning background and key research areas ranging from ovulation and menstruation health to the environmental impacts on the female at birth body. Dr. Shruthi Mahalingaiah joins us for an eye-opening conversation over the link between chemical exposure and our bodies, hormones, and how to stay in tune with your body for your mind and health.
Lastly, we end on a high note! There’s less than a 2% chance of getting struck by lightning and an even smaller chance of having this miracle!
Thanks for listening, learning, and being you. And join us back here every Tuesday for all things uterus, in service to you, uterinekind.
Carol: You are not broken. The female human body is an exquisite system, but a whole lot of other systems are totally broken. We're here to help when it comes to uterine health. I'm Carol Johnson, and this is Hello Uterus.
On today's show, we have a very special guest, literally hope personified for those with a uterus dealing with conditions like infertility and P C O S. But also hope personified for just human beings in general because Dr. Shruthi Mahalingaiah, a physician researcher, is focused on, among other things, the environmental impact on the female system, and honestly, all gender alert. The environmental impact on all of our systems is hellacious. We are. Operating at Optimal Wellness, and I'm just gonna tell you my, judgey opinion. I blame chemicals. Chemicals in the air, chemicals in the food, chemicals in the products we put on our bodies. Chemicals, chemicals, chemicals. That's who I blame. Dr. Shruthi Mahalingaiah is someone who will get to the bottom of this. Trust me, she's gonna get to the bottom of this. When you hear her bio, your eyes are gonna pop outta your head, so I am so excited that she made time to be with us on the show. This past week we spent some time together in between appointments, these people with their multitasking capabilities. Ah, I feel so inferior, but that's okay. It's like good news cuz if I was the best of the bunch then man, we wouldn't be in a good state. So we'll give you a little bit more background when we introduce S Truthy, but first uterus in the.
So a new study out of the National Institute of Health shows something that I think we've already all known, that hair straightening chemicals, often used by people of color increase the risk of uterine cancer. NIH scientists looked at 33,947 racially diverse women, ages 35 to 74 across the US for more than a decade. During that time, 378 women developed uterine cancer. They found that the rate of uterine cancer was 4.05% in women who used straightening products four or more times a. Compared to 1.64% in those who did not, The theory is the chemicals are absorbed into the scalp and travel to the uterus. I'm gonna go out on a limb non-clinician here and assume that they travel everywhere. but there's that brain uterus connection again. So if they go through the scalp, do they, are they like on the outside of the skull and they think, Oh, hey guys.
Like let's not mess with the brain. Let's just go directly to the uterus. Cause it, If they're doing that, then, they're against us. . They're not doing that. We know they're not doing that. We know. What is absorbed through our skin travels throughout our body and chemicals. They're gonna go and do that And we know from prior episodes, and you probably know this from the research that you do, that these chemicals are hormone disruptors. So they throw our perfect system out of balance and then the system goes a little bit haywire. So I thought it was interesting that this study kicked off 10 years ago because before I read this study, I was thinking to myself, Wow, it's been about 10 years since I interviewed several women. Who told their physicians, they were concerned that the products they used were causing problems. These women were, women of color, and we were specifically talking about not just hair straightening products, but just in general the products that they generally use and the, frequency with which they use. and then also the problems that, that they were experiencing and they wondered could this possibly be connected to the products that I'm using on my body? and this was specifically about fibroids, right? Which I think is interesting cuz this particular study is talking about cancer and from what I can tell, all the cash goes to cancer research and I get that cancer is a killer. So are they just, are they not researching the potential connection to fibro. Hopefully they will at some point in time. But you know, the chemicals going into your head that they're probably impacting the basic systems of our body, which are kicking off these other problems. For instance, another piece of information that dropped this was a, a law that was Implemented in New York City, I believe at the beginning of the year where nail salons are finally required to install air purification systems. After studies showed that those working in the salons had significantly more occurrences of infertility, miscarriages, and one person had I think over 10 miscarriages, And a whole slew of other symptoms that suggest their hormones were wholly out of whack.
and they didn't talk amongst each other about this. A lot of the people that were experiencing these problems for a while, because why, cuz we've been sort of conditioned to believe that we can't talk about these things. and they would wear gloves while they were working with these chemicals and doing their client's nails. But it's the absorption. We're like little sponges with legs and we run around and we absorb everything. Some of us don't run around. I don't think I've broken into a run and probably a whole year. But anyway, it's getting into our systems in a wide variety of ways. We could just be, living close to a freeway or a highway. Who knows? Cuz nobody really studies this stuff. But the fact that we're. Seeing this information now that Thank you NIH for studying this. It's crucial we have to get ahead of, products and what they're doing to our systems. So super excited about that. Great. Move. New York City, taking care of the people who are working in nail salon. Who are in there all day, 8, 10, 12 hours a day. I cannot even imagine the level of exposure there. So we fold these data points, you know, about endocrine disrupting chemicals and their impact on our systems, and we fold. It in fold all that into what we know about female systems, which is barely anything because studying them has not been a priority and in fact wasn't even allowed until 1993. And then consider the millions, millions of people living with chronic uterine or female specific conditions. And it doesn't take a scientist to see the red flags cuz I'm seeing red flags and I'm, very far away from scientists. So is it the chemicals? When I think about, and you gotta do this in small bites because otherwise it's just too depressing. When I think about our society's love affair with the dollar and all things capitalism, to think our health is sacrificed for profits and we know. We know that that's happened throughout time. It's not a leap to nod. Yes. that the industries that populate our world are, you know, I'm I'm gonna go right to the nth degree here. They're poisoning us and we don't even really know. Badly. They're poisoning us because the female body is deprioritized in our male-centric health system, World, universe, even . Hopefully not the whole universe. And you gotta wonder what else is making us sick. But industries tell us it can't possibly be they tell us. No, it can't be that. I'm pissed at companies that churn out products and hoard profits profits that are made from chemically laden crap. And they tell us that in amounts this low, there's no evidence of toxicity. Okay, you know, I'm not two. I understand when someone says there's no evidence of toxicity, you didn't study.
And that if you've got, an ingredients list on your website and you indicate that, all of these ingredients are in this product, and the FDA has indicated that, you know, at these low levels, it's not at all toxic. I don't buy it. I call total BS on that unless their impact. On the female system has been studied in my view. They haven't been studied, That's my take. That's my position. If you haven't studied it on a female body, and if you're not looking at, years of data, then you don't have the data. Not that there's no evidence of toxicity. Say it a different way. We don't know if it's toxic. How about that? How about that? So, here's the takeaway. Don't use them, don't use any of them. Don't let your children use. Find other solutions. They don't have to be expensive. I have a jar of organic coconut oil that costs $10 and it's my full body go-to. I use it on my skin, my hair, I use it as lip balm. I use it for everything and that's me. May not work for you, but you'll find options. I'm convinced. I know that you will because we're so resourceful. And please do, because the alternative is to reward industries that use toxic chemicals, and we don't wanna do that anymore. Our health and wellbeing is way more important than their profits. Remember that you are far more important. Corporations and their need to churn out new products that they market to us and so that they can return shareholder value and have a strong stock price on Wall Street. Like none of that matters. None of it matters. All of it can go away. As far as I'm concerned, we'll figure out we don't need Wall Street to stay alive. In fact, Wall Street is probably killing us slowly. So just to remember, you, your health and wellbeing is more important than their profits and they are not prioritizing your health and wellbeing unless you are finding products designed by people who are taking on the powerful chemicals and petroleum.Unless you're doing that, you really gotta watch out. And if you are doing that, I wanna thank you for that because you're taking care of you and you're taking care of the planet and that is so important. As you know, just a little, little, I think you'll probably hear one of our ads for beauty heroes.
But seriously, if you wanna spend some cash on some products that are completely clean, there's one place to go. Beauty heroes go there.
After this quick break, we'll be back with Dr. Shruthi Mahalingaiah.
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Carol: We've been looking forward to this interview for weeks at Hello Uterus, Dr. Shruthi Mahalingaiah, a physician researcher. Those two words next to each other are like, I don't know, catnip the greatest meal you've ever had. It's like the best thing in the world to see physician, researcher. so here's a little bit of her bio I'm actually gonna go into some detail here because there's some, aspects of her background that are exciting and fascinating and again, we're just thrilled to have her on the show today.
So Shruthi is an assistant professor of environmental, reproductive, and women's health in the Department of Environmental Health at the Harvard th Chan School of Public Health. She serves clinically as a physician specializing in ovulation disorders, reproductive endocrinology, and infertility at the Massachusetts General Hospital in the Department of Obstetrics and Gynecology. Get this supported by Thomas J. Watson, the third fellowship. She lived with indigenous shamans in the Ecuadorian Amazon Basin, Andy's mountains and Bali studying the role of ritual in the healing process before matriculating to medical school. That is so cool. And she attended Harvard Medical School and completed a residency in the ob gyn combined program at Brigham and Women's Massachusetts General Hospital.
We know how important fellowships Here at Hello Uterus. she completed a fellowship in reproductive endocrinology at Brigham and Women's Hospital. Thank you. Seriously, Thank you Shruthi, for taking time to be with us.
Shruthi: Thank you so much, Carol. It's really lovely to be here and talk with you. I'm so.
Carol: Excellent. So we're, we're gonna dive right in and I'm gonna ask you to please share with us an overview of your research, the area that you are either most focused on right now, or, or if there's something that you're really excitedly looking toward, taking on, if you can share with us a little bit about that.
Shruthi: Absolutely. I think right now my research kind of has three buckets. One is understanding individual risk and kind of precision medicine, for ovulation and menstruation health particularly for women with polycystic ovary syndrome or ovulation disorders that kind of run the spectrum, between P C O S and hypothalamic a.
So what does that mean? we are looking deeply at the lived experience through surveys, and we're also looking at large data through the electronic health record to understand if we can predict risk of P C O S or among those who have the diagnosis, really make Interventions in a timely way to reduce long term health outcomes, that we know are associated with P C O S, such as infertility, cardiovascular disease, and metabolic disorders.
we have a little bit of innovation in that area too to try and help, innovate around at home ovulation prediction for women with ovulation disorders, which is really hard. A lot. Women complain that their, the LH strips or the ovulation predictor kits aren't working. So we're kind of thinking about that.
Another area of course, that I'm, critically interested in is the impact of our environment. So, The environment to me is broadly defined. from my time living with the, Amazonian Shaman, villages as well as in the Andes Mountains. Some of the philosophies of health incorporated the environment.
So, sometimes deconstructing environment to elements Earth, air, water, fire. the Boies had different concepts of community health and. The earth in their kind of incorporation, into their rituals around community dance and community movement rituals to reinvoke the balance. I've kind of taken that background as well as my experience growing up visiting India and the air pollution and other kind of pollutants I experience to really hone in on that as.
An area that I wanna understand more in terms of understanding the exposure, how does that exposure get to the uterus? And you know, how can we make decisions either as individuals, as communities, as governments, or globally to kind of make the healthiest choices so that we can live, healthy lives for as long as possible.
As minimal risk. I think it's really hard because right now our lives not only in the US but globally, are just bathed in chemicals. And some of them are really helping us and others may be detrimental. And one of the guiding philosophies for me is that everything is interconnected. And if we think that we're separated, we just haven't figured out how we connect to that chemical thing, process, people. you know, that's something that guides me when I think about new exposures or, innovations in medicine that may help for short term, but maybe actually adding to. Disease burden in the future and then something new. The third arm of what I'm up to right now is health communications and communicating around women's health.
I'm really impressed by your story and I think. Despite the number of fellowships I may have, and I might know a physiology or a pathology fibroids, infertility, ovulation disorders, you name it, or just, reproductive transitions. What's normal? What is a menstrual cycle? How does that affect you?
What. Normal bleeding. I did not realize how much we need to work together to fill the gap. and that might be starting in schools and really honing in on. educating high school students or younger on understanding your body and having the vocabulary to describe what might be affecting you, in the hopes of getting to, understand health, being your best, as well as knowing when something's wrong.
Carol: Yeah, absolutely. That first of all, I don't know how you do it all, It's like, I try to figure out, can I, fit in some lunch here and I've got like two or three things I have to do during a day, and then you're also treating patients at the same time. So I don't, I that's a different podcast and probably a different host cuz I wouldn't even know the right questions to ask. , much of what you said stands out to me, but something that you said really connected, which was that to you, everything is connected and so Your guiding thought is, Well, how is this connected? And that stands out because how many times have we experienced expressing a symptom? Or some sort of, experience that we had, whether it's it's menstrual or it's just a physical symptom and it's been told point blank that can't possibly be connected, that can't possibly be connected to your birth control pills now.
No. The, Esha of, you know that no, the coil could never cause that. Like that sort of, I guess it's conditioned, shutting down if a female expresses something that maybe challenges that person's perspective or idea and they just don't feel like dealing with a challenge that day.
I don't know. But that really, that stands out. That's how you look at it.
Shruthi: I think your reflections are, spot on. I. Don't think it's enough to, say to a patient, you know, your symptoms don't fit the textbook or what you're saying. really listening at the symptoms and finding patterns and understanding what might be at the root cause is really important.
I do try to do that in a variety of ways and sometimes we don't find an answer or sometimes the symptoms do go away. But I think it's really important to listen in the, patient doctor context. Sometimes I do ask my patients to track their symptoms whether it's on a paper log or in their calendar somehow, because, sometimes things don't make sense from a top down perspective, but if we can start looking at patterns and seeing like, Oh, this is happening at this point in time, or this happens every time you have a yeast infection or something like this it helps us kind of maybe potentially get at a root cause.
Carol: And just having that, curious mind, to be open to that is so refreshing. Rather than it's like, well no, we don't see that. I just loved that you said that. The other thing that I wanna talk about today kind of really dive into is the myriad of.
subjects that come up over and over when we're out there as patients acting like a pinball in a pinball machine online trying to find information, right? And it's like, this is what it's all about. This is what it's all about, and there's all this conflicting information and we're bouncing around trying to figure out what's going on in our bodies.
But, three things come up over and over again, hormone. Hormone disrupting chemicals and chronic inflammation, and I've been at this for a long time. I still don't understand hormones and I don't think we know all the hormones that are out there. You know, they're described as messengers, they carry information.
I get all that, but it still doesn't like really connect yet. I know. In gut where there's hormones, I know that, this has to be one of the big keys. and are these the big threes in our health today, given what our environment is like? Hormones, hormone, discrepant, chemicals, and chronic inflammation.
Can you share your thoughts with us on that?
Shruthi: Absolutely. I do think you've hit on the big three in terms of big areas of concern. Around how. , our bodies communicate with the outside environment and bring in information from the outside to the inside and that how that can impact health. And one of the ways is definitely proven to be chronic inflammation.
I think there might be other ways as well. But let's start with the first topic. Um, Hormones. Hormones are part of a system. in our body called the endocrine system. And the endocrine system I think is one of, the most beautiful and intricate systems we have. The system in general is responsible for our energy balance sleep wake cycles growth development, puberty, reproduction and just everyday functionality.
One of the things in the endocrine system you mentioned is hormones. And of course, simply put hormones are molecules or the own body's chemicals that one organ sends to another to give a message. And these, messages are controlled or sensitive, not even controlled. Able to be modulated at many levels in the body.
And because of that sensitivity and you know, need for modulation, which impacts our, in the end it's our survival. How much energy do we have? How much can we do today? Can we reproduce, can we, do we need to hibernate? Things like this, do we have energy to shunt into growing and entering puberty or is there not enough energy or is there too much energy then that's its own kind of form of disruption as well.
So to say it's simply the organs communicate through these chemical messengers and that's not the only way. The endocrine system communicates the, cells in the organs can communicate through almost like synaptic transmission. So in the brain there's an area that communicates with the pituitary gland that transfers kind of chemical, synapse kind of things that happen in your neurons right into the pituitary gland, which is responsible for, regulating and maintaining a lot of.
Endocrine function in the body. and in that area we are able to incorporate inputs from our environment, including light and dark signals, um, sensations of safety, perceived safety and actual safety. And there is a very unique, blood supply that samples how much nutrients are in the blood and, you know, what can we do with that level of nutrition, in our everyday, day-to-day.
from there, the cells can communicate by we talked about synaptic transmission, but there's also cell to cell communication. So, this can happen in the uterus where the muscles touch each other and during the menstrual cycle there can be contractions and that's more of a kind of like the heart.
There's. An electrical impulse as well as a muscular movement. And those cells are communicating with each other in concert to do something together. And in this situation it's having a period. And so that's one.
Carol: whi which we've reduced to such a simple thing. Right? A period almost like it just sort of happens. But like when you've listened to that and you think about the amount, This is freaking me out. You think about the amount of communication that's going on in your body, and you said the endocrine system that it, it's, kind of thrilling to you.
Same here with us. Like it again, you understand it. We don't, but, we can tell that it's doing some pretty insanely remarkable things and also that it needs to be in perfect balance, that's like juggling, you have one hand and you're juggling 50 balls.
It sounds like, you've got so many things that we understand, so many that we don't understand. There's environmental impact. We're needing to impact it with medications. We kind of don't really know exactly what all is going on. it's just remarkable to me how. it's like a city.
It's like a city communicating.
Shruthi: Absolutely. It's interesting you say that. We used that very analogy, of an apartment building in our kind of, Description of the menstrual cycle. I had a amazing group of students as well as collaborators. and we developed a five minute animation that aired at the Museum of Science Boston on the menstrual cycle that was de gendered.
And you know,
Carol: Oh, cool.
Shruthi: language for the general public. Um, so we, it's interesting you say that cuz we, we definitely use that analogy in, how the organs communicate and how a menstrual cycle happens.
Carol: Yeah. So then that would suggest, and, and I'd wanna dive into hysterectomy, although I hope you come back and talk more about this. But that would suggest, you know, that in contrast to what we're often told by a certain segment of the population, that the uterus is not. disposable, dormant, baby bag that serves no purpose to the female body other than to incubate a fetus that that's inaccurate.
Right.
Shruthi: I think it's all perspective. I don't think of the uterus in that way, but I do think, if you. deconstruct it as a, what is its purpose? What is the only point of it? I can see why people say that, but I think, there's a lot of complexity to what we can learn from the uterus in general, and, um, specifically regarding the interconnectedness of our environment and our.
Carol: Yeah. So, so let's, segue over to the environment hormone disrupting chemicals. and I guess just in general, you said that we sort of walk through the world. And were bathed in, numerous chemicals that our bodies couldn't have had the opportunity to evolve to metabolize in any healthy way given the recent invention of these chemicals, relatively speaking, and our exposure to them.
can you talk to us a little bit about HDCs and, we I think we don't, we try to ignore it and, or maybe we like buy a clean beauty product, you know, as a representation of our, mission to get clean. But, I just walk outta my house and I think, Goodness, , can I
Shruthi: there's so many chemicals and, I think historically, There has been a tendency to look at individual chemicals or an individual class of compounds, but unfortunately the truth is we are, We are bathed in mixtures and the field has moved towards mixtures, but there's just so many. Molecules out in the world, it's almost impossible to isolate and then remove, critical exposures or understand the kind of component effects of each one.
I think if I were to think of big picture exposures, of course pollutants in the air, so air pollution, which is a mixture of a variety. Of things from vehicular traffic to industrial processes and burned, waste products. And, and there's differ differing, air pollutant production depending on where you are in the country and the world.
then there's the food supply the water supply. and understanding like what is actually cleaned when the water goes to the water treatment facility and how does that, there are some places that have excellent water quality and others that don't. How do our pharmaceuticals that we metabolize and then excrete into our.
Sewer systems then get detoxified outside our bodies. And then how, you know, how do we get that water back and is it really clean? And how much can not only our bodies and the earth tolerate of this kind of cycle and potentially, accumulation of our chemical waste, in the body. Sometimes there are chemicals that are called lipophilic or that are attracted to.
these molecules can actually, get gobbled up or differentially get absorbed into our fatty tissue. And so in some ways we are repositories of our exposome or what we're exposed to. And, um, that fat can be under your skin or in your abdomen. So if you do unfortunately have to undergo a gynecologic surgery, you know the distance between your skin and.
fascial layer and we have to get through the fascia and the peritoneum to see your abdomen and the organs inside. Is, is one. Metric and then the fat inside, the mental fat or the, visceral fat is another area. that's been interesting in a concept that I've been wanting to, learn more about and understand, like, how is that protective, You know, we think of fat potentially as protective, animals before they undergo hibernation will.
On their fat stores. sometimes people say, you know, they, they're stress eating and that's like a form of protection. we're building our body stores. So how much is this of this is, to facilitate our body protecting. The organs by sequestering those chemicals in the fat. Um, it's something I'm interested in learning more as well.
Um, and of course there's those downstream concerns when these chemicals either leash from the fat or have site specific effects. But then there are those shorter term. Short term chemicals or water soluble chemicals, hydrophilic chemicals that kind of come into contact with the body and we excrete more readily and there's a potential for kind of bioaccumulation, but those are things like the bisphenols and ths preservatives, things like that, like.
Fragrances. there's a huge body of literature that shows that, many of these chemicals, and again, there's thousands and thousands, have hormone effects. And one of the challenges that I see is that when a chemical goes and is manufactured, the post use concept, where do these chemicals go?
How do they get, degraded isn't really within our. At least that I'm aware of in our approach to creating something, a new product, a new item to use, after it's been purchased, kind of like, it's not really considered within like the one box of where you know what to do with it. I think there are efforts to understand, but it is really complex and interconnected.
So, sometimes I feel like if we had better. Assays. So understanding representative tissues in the body. So having uterine tissues or ovarian tissue derived tests for endocrine activity can be potentially very helpful. when trying to get at environmental exposures from chemical mixtures and, our organs.
Carol: there were, um, two studies That come to mind when, bringing together the idea of chemical exposure and disrupting our hormonal balance and. Medicating, diseases with what we have to medicate them, right? So I'm talking about birth control here. so one of the, one of the studies was in Denmark and it, it was over a million people where they followed people before they were put on, hormonal birth control.
And then throughout the course of time, through their public, And it was really, frightening actually. I'm just gonna just quickly, detail it. So, anxiety and suicide ideation and depression, those were the three things that they really focused on there. And as I said, they evaluated over a million people over 10 years.
And according to the study among 15 to 19 year old females, those taking. Oral combination birth control pills were diagnosed with depression at a 70% higher rate than non-users. And progestin only birth control created even higher rates of depression and antidepressant use. Oral forms of the drug doubled the use of antidepressants among young women.
And IUDs nearly tripled the number of both depression diagnoses and antidepressant use among the studies younger participants. So that's one study, but Briefly, I wanna mention the other, it's just a snippet of a study around P C O S and just mentioning the increased likelihood of stroke and that these risks are exacerbated by oral contraceptive use. stating that like, we don't know everything, right? We haven't fig figured it all out. as a person and putting myself into a patient's shoes, well, there's actually two patients. There's the patient that, believes that, this has to be safe. And they just go, Yeah, sure. And then there's the other patient who's like, Whoa, I don't know.
This seems a little sketchy because we're putting hormones on top of an imbalanced hormonal situation. And in a lot of cases, from the people that I've interviewed, there isn't, at least from their perspective, a really in depth diagnostic process going on to, to get at what's going on. It's more like, let's try these pills.
So when you hear, data like that, how do we deal with this ? Cause first of all, we're not antibi birth control pill at all. We are so pro access to birth control. We are just pro research and we're also pro proactive, you know?
Shruthi: Yeah, no, I hear all of those concerns and I, counsel patients every day with, that fit into those two buckets, either it's like, Yeah, I'll try anything you say, or, Here's what I've been reading online from either the literature to what's on. And why they will or won't do what I say. uh, or what I recommend, and it's a conversation and it's an exploration of what makes sense for the individual.
But when, if I can anchor us in. Counseling patients on what it is that they might need. and I'll give you the P C O S example. one of the key components for my approach to managing women who have a new diagnosis of P C O S or who have an established diagnosis and they kind of want to make sure they're they're on their right pathway, is, the concept of protecting the uterus In some individuals. and we see if we've studied a population of women with ovulation disorder, P C O S, who have certain risk factors like a higher body mass index, maybe pre-diabetes, poor physical activity, and certain dietary factors like high fat, high sugar diet, or, simple sugar.
That are mostly kind of refined carbs, and fast foods. The risk of endometrial hyperplasia or overgrowth and cancer is increased. That increased risk is gradual. It accumulates over time and is proportional to these, Risk factors I mentioned, as well as the number of times a woman has an ovulation or a mens trait has ovulated that year.
So for a true ovulation to happen, the body, selects an egg. It ovulates, there's progesterone that's made by the corpus lidia and that progesterone. Matures the lining. and then that lining sheds due to a withdrawal from the, decline in progesterone. That has to happen at least four times a year for the uterus to remain at that kind of less risk of endometrial hyperplasia and cancer.
Carol: Okay. First, first time I ever heard that and I think for a lot of people that is Wow. So it to go, it needs to go through that cycle four times a year to good to know.
Shruthi: especially with the risk factors, because what's happening is with the estrogen that's in your body, the estrogen that's also made by our fatty tissue, it's giving signals to the uterine lining to grow when you get the signal to grow. chronically, it can lead to overgrowth in cancer.
And that's some of the physiology and the pathways that underlie in abnormal growth response and can lead to cancer. And that's why we need to have that happen. So when I talk to patients who are really concerned about what they read from a variety of different sources, I talk about like, what is it for them that I'm trying to do with the hormone?
And there's a lot of. Strategies to use, there's, you mentioned the I u D or, or other, you know, implantable contraceptions. There's also very short courses of progesterone. Like if our goal is just to protect the uterus, can you please do a 10 day course? And we have our protocols and make sure they're safe.
Every couple of months, every two months, some people, if they go for more than three months, they end up hemo. And I'm like, We can't have you go to the ER every three months because you're afraid of, like there's a balance. So we negotiate around what they can do and how they can do it and what makes sense.
How set your time or put a calendar reminder like, we have to work with your physiology. Some people might be on a different kind of ovulation disorder spectrum where they might have hypothalamic ahea. , they're not ovulating because maybe there is perceived stress or physical stress or over exercising and under nutrition.
And, you know, we also have to assess their risk, which might not be the same in terms of the requirement to have a similar kind of ovulatory response for uterine health. But then there's also lower estrogens and we need estrogen for bone health. and for, um, multiple other, Health in, just in the body at every level, which is why I'm having, finding one word, you know,
estrogen on so many levels.
and so it's in a balance and we have to think about that balance when I counseled the patients on, what it is they need and why. And you mentioned kind of risks of different things and I, I really think it's important to underst. medication risks in relation to the risk if you don't get on a treatment form.
we talked a little bit about that, but I do agree fully with, the need to understand who develops. These strokes or who develops the depression and how generalizable is that? is it a genetic component? Is it because these people aren't having the minimum physical activity? Is it because, in the Nordic countries there's less sunlight for certain periods of the year and there's a higher risk overall.
I mean, I think I'd have to look at the study also to see its methodology and it's probably. Uh, nicely done and has a large sample size. But these are the details I would be interested in, and I do think that with combined aspects of kind of genomic medicine, we can really counsel on risk more. I, I completely agree.
When we initiate a birth control pill, there's a lot of like this one or that, and I've only used this kind of one and this group of people. . but when I've seen people from different parts of the country or world come through, they're on a different cocktail, that might work well for them. And, I do think that.
there's so many hormonal formulations specifically for the progesterone component, which as you mentioned, can drive a lot of mood and other things. I think it will help to be able to identify who might benefit from like, , the innovative, even lower dose IUDs and will that help what their goal is?
Because as you heard from me, my goal of using hormones is very different than maybe a pure birth control standpoint. It's really to reduce the overall chronic risk and, of, health conditions that might happen from ovulation.
Carol: Yeah, we see it's funny with birth control. I kind of like tapping into maybe a frustration that, that maybe we haven't, we being sort of the large group of people currently taking or have formally taken birth control, a frustration that we haven't. Maybe been part of the process or, looked to, I guess, you know, having our experiences validated.
And then, also this frustration like is, is this what we get? Like we got this, you know, back in the seventies and the, the cocktails have changed and the delivery mechanisms have improved. to some degree with other complicating factors and we're learning right. In process.
but I think when I look at other drugs, we know that they have side effects and we go through that very same decision making process, right? There's something a little bit different about birth control. so for whatever reason we won't crack that today, but. I do feel strongly that if people understand more about what's happening in that apartment building that you described, and like I've often said it on this program for the longest time, and by longest time, I mean, up until like 10 years ago, I lived from my, my neck up, I really didn't live fully in my body, so it was very hard to connect the dots. Things, you know, that were happening because I, I wasn't really engaged in my system and I didn't, give myself the, luxury or sort of the permission to become intimate with my physiology, if that's the right word, but just how my system's working, right.
And we are all very different. it's just a complicated. I think of people going in know, and some doctors will not say this because their, theory is, Well, if I tell her that this could happen, then she's gonna make it happen. , it's like, okay, I don't know if we can do that.
But, you know, just going in and saying like, Hey, pay attention to the real subtle feelings that you're having as. utilize this therapy and that helps us, that evidence helps us get ahead of these things. Cuz uh, when I listen to people's stories, it's, they've been on a birth control pill for you know, let's say eight years.
And it's only when they go off it that they recognize, Oh wow, I'm a different kind of person than I was. So, you obviously walk them through this, but when we're talking about patients who, don't have the luxury of having, essentially a unicorn like you because honestly, like, I've talked to doctors who haven't picked up research in a while. It's just, they're like, Yeah, it's good. I got it down. I've been doing this forever. Like you are actually out there on the forefront doing it. So can you give us some guidance, like how do we best, direct our own care experience. What can we do that's really healthy for us? And I'm curious if something stands out from your experience in the Andes, or in the Amazon. were there things that they did naturally that you saw, that you feel if we incorporated, We might have better overall experience with our health.
Shruthi: Carol, you have just asked a question. I think we could spend multiple podcasts
Carol: and we have like, we have like four minutes,
Shruthi: but these are all critical, critical questions. I think. Being in the space that I sit in is uncomfortable, you know, trying to. Provide sound, solid evidence based care while including, maybe some research that's pushing the boundary or even including the, individual patient's experience, I think is going to be critical, but it's uncomfortable.
it's important. So another thing you mentioned is, Living from your head, you know, you're living your life from your head up and not being in touch with the body. I think that is one of the major issues our culture and our society is facing. And I do think, I have found exercises from meditation to Tai chi, to experiential anatomy have helped.
And I've had amazing professors throughout my college and. Undergraduate, graduate life. kind of incorporate these into the process of, not only being aware of your own body, but then being able to teach that for a patient or a, group of people. I think, during my surgical training, we try to incorporate, our own awareness of our body.
Are we tachycardic or, you know, is the patient tachycardic? What is going on and how, how do we. Remain embodied and present, not only to provide the best care, but to be able to do this job for a very, very long time. I think that getting in touch with your body as a patient, Or just an individual on the planet is really critical.
Oftentimes it's not until there's something out of whack or something abnormal that calls you to your body that you start to pay attention. And that is unfortunate. A lot of times we go through our day, everything is working and isn't that great. And if it's not, if it's a subtle enough decline that it doesn't impact our day to day life or our, immediate survival, we're not gonna do anything about it.
It has to kind of really jar us. Bring that attention down there. And I think, understanding our bodies, our physiology, which is amazing, in our education curriculums, I think can help. And then incorporating movement practices that get us in touch a little more with, with our bodies, I think can be critical.
Um, it's not anything I could prescribe to a patient before they get to me because it'll have required years and years of. Engagement potentially. But you know, I do think that, um, specific advice for patients, um, when they're coming in, I think it can be very frustrating and it often takes like more than one visit to even establish what is the symptom complex, especially if it's kind of not traditionally.
there, or there's not language for those specific symptoms, or if those words haven't been categorized as a symptom category that's in a textbook. So I do think having, Sat with yourself, kind of describe what's going on and have that even mapped out. If it's something hard to understand, the pattern of like, do a, chronology of events can be helpful because sometimes if you have that, it might not be.
That first doctor that's gonna figure out what's going on, but it might be the second or third through a, a group system. I think having your own log of what's going on will help reduce the time to sharing your story when you get there. that you don't have to go over the same motions, like, isn't this in your medical record?
I told the other doctor the same story. kind of thing. the only other aspect I'll say is like, I don't, right now we're building bridges between environmental exposures and how we can make a difference through individual exposure reduction or, state level or governmental level policies that limit, exposure.
concerning chemicals, like for example, potentially chemicals and personal care products that might infa impact the, gestational length or, you know, influence an earlier gestation or delivery also, part of that is understanding that what we put on our faces and into our bodies is at the level of the endometrium, and we've just started publishing in addition to a couple of other groups that we can really see everything in that.
Menstrual blood from your pharmaceuticals to your personal care products and supplements to some cleaning products and fragrances. It's all there. So is that gonna cause cancer immediately or is there something bad that's gonna happen in a, you know, short time window? It's gonna be hard for me to.
show that discreetly, but you know, what is the time window that we're concerned about? And oftentimes research studies that have funding timelines that are on the order of a couple of years, may or may not have the perspective that we need to actually determine that risk. And you know, a question that guides me is how much information do we need before we say like, let's change our process.
Carol: Yeah. That is absolutely, that is a giant question that that's like when they found out that mushrooms could eat plastic and they're like, Well, let's, you know, study this. And I'm like, No, let's get a bunch of mushrooms and let's throw 'em on all the plastic that we have I gotta, we don't need to study this.
Micro plastics in breast milk for the first time.
so we have to let you go because you have patience and, and a life. And I have 50 more questions for you. I hope that you will be able to come back and join us. Um,
Shruthi: you so much. I, Yes. I look forward to.
Carol: Excellent. This has been just, really insightful. thank you so much, Shruthi, for being here today.
Shruthi: Thank you so much for having me.
Dr. Shruthi Mahalingaiah is like that right there. Dream doctor. Dream doctor. Right? A practicing physician who prioritizes research and then applies that research in her practice. I don't know how she gets any of it done. It's just gotta be, I some brains are magical.
And with an MD, bachelor's and MD and a master's in public health, I mean that, that's a magical, magical brain, but also a human being who care. Could have gone into any medicine, went into the medicine, the area of medicine where one has to fight the hardest for funding for support fighting disinformation.
And then today because of the repeal of Roe v. Wade, fighting to care for your patients without having to go to jail so much. For Dr. Shruthi Mahalingaiah and really every single physician out there today who takes their role seriously, stays on top of research, does not gaslight, does not dismiss their patients to all of you.
Pure love man, just so much love. you know, what would be cool? This is, it would be a dream wish. To have a Council of Physician researcher gynecologists, essentially comprised of those we've interviewed here on Hello Uterus and they magically become like the overlords of gynecology and they run everything.
Wouldn't that be amazing? If the amount of focus and energy on things like, the Hubble telescope and traveling to Mars and all that, if all of that intellect and money was instead directed to our new Council of Physician researcher gynecologists,
we would learn. And discover and solve so much. Learn so much, discover so much, and solve so many problems, However you wanna say it, it would be amazing. It would be amazing. And so I think, one of the things that it might be considered a little woo woo or whatever, but we always hear about like, reflecting, right?
Like, as above, so below and, we reflect other people back to them and that, that kind of an idea, it would be so amazing. If we, as people born female, if we thought of ourselves as these amazing, exquisite creatures that were so deserving of respect and attention and focus, and that we are a priority if we fully, fully believed.
Would we then have an effect on the care system that takes care of our bodies? I think we would, but even if we didn't, we'd all feel so much better. So we should just go ahead and do that . All right. We're gonna take a quick break and then we're gonna end on a high note.
Carol: So a couple weeks ago, , I swear I do not do this on purpose. I don't know how this happens, but okay. Ending on a high note. Starting off. in the depths of despair. So a few weeks ago, a 12 year old girl was struck by lightning in the Phoenix area. Could you imagine? Oh, well, we don't have to imagine it because in about the same place in 2018, A teenager was also struck by Lightning, a boy, and they interviewed him after this young girl was struck, and he told her some things that I thought were just incredible.
One, he was so kind and he, gave her words of comfort and support, and then He told her about what his recovery was like and that it was hard and that he had to work at it, but that he was able to able to not just get back to his old self before being struck by lightning, but, and this is the reason why it's ending on high note, This is so wild parts of his brain that he never accessed before he was able to.
He described being able to do things like write poetry, play music, learn instruments, write songs, write music, talk about emotions like this whole other side of his brain was lit up as a result of this terrifying experience of being struck by. Now I'm of course not at all, suggesting that like, if you wanna learn how to play guitar, you should go out and get struck by lightning.
But it is wild to think, was it associated with that? I have no idea. But I mean, he would know. He's the one who experienced it and described this literal, complete, you know, sort of opening of these gifts. Not just that he could, strum out happy birthday or smoke on the water or something.
I mean, he can compose music and poems and lyrics and wants to also, That's the other thing that he, he was inspired to go into this artistic direction, so, I'm sure it has to do with sides of the brain. And I, have no idea that he got struck on his leg. at least the wound is on his leg. I don't know if that's where the lightning went in or the electricity came out.
I have no idea. But just an amazing, amazing experience. You know, one for. Girl who is just at the beginning of this long journey of healing, to be able to know , to know that there is this boy out there who experienced this same thing and that he is there to help her. And then to also have on top of that this like, really inspiring and certainly curious situation unfold.
Where, not only did he not lose any capabilities, he actually gain. A lot of talents and skills, or at least he they were unlocked in him somehow, and I just thought that was just the coolest thing ever. So there you go. That's the ending on a high note. Started out a little dark right, but it got, bright and shiny really fast, which is my goal.
So thank you, Angel. You are amazing and Maryelle back at headquarters booking guests to help Angel and I out and keeping us all organized. And also Maryelle is out there running our social media. So please follow us on Instagram at Uterine Kind and also definitely enter our, gift away for our Beauty Heroes Box.
I bought myself the box this month and. Insane full size products. My, I am tell you this, my hair has never looked better, ever. My mom would be so proud of me. She was always like, You should brush your hair. You should brush your hair. I don't have to brush my hair now because whatever was in that October beauty box, the shampoo and the hair mask and the, cool minty scrub for my scalp, amazing.
And this, stuff I can use. I could eat this stuff. There's nothing bad in. So, so, so good. Definitely, definitely enter the gift away. You will be stoked to win. Thank you team at Uterine Kind. We are almost ready to give you a few sneak peeks of our app here on the podcast before we launch, so come back next week for that.
And for our interview with Laura Parker, the author of Vagina Problems Endometriosis, Painful Sex, and Other Taboo Topic. I'm gonna add onto that, that we hope are no longer taboo, but we know that they are. But we're gonna change that. Laura and I are gonna have an amazing conversation next week, so definitely tune in for that.
I've got a rare political interlude, but I think you'll understand why. Please vote. Please, please vote. Good God. I'll drive you. I'll do whatever you need. I'll cook for you. Not the greatest cook, but I'm fun. Dinner party guest. I'll do whatever I have to to make sure that you vote because reproductive and female system, healthcare will be sliced and diced and gutted, filled with gray areas.
Research, funding, cut. Doctors are afraid they're gonna go to jail. We cannot live like. It's not even been a year, and it's been a complete disaster. Deadly disaster. So we really must vote, make this a single issue election, whether you have a uterus or not. If we don't codify Roe and publish the equal Rights Amendment to the Constitution, those who identify as women will be truly second class citizens of a country whose citizens are supposed to be free and equal. Free. And, So please vote and thank you for being here with us, for taking the time to keep yourself informed, even in light of the fact that Midnight's dropped this week and there were seven extra songs. So I totally understand that you had to make time to be here, and I want you to know that we're really, really grateful.
Until next week, be cool. Be well, be kind.
Angel: The Hello Uterus podcast is for informational use only. The content shared here is to not be used to diagnose or treat any medical condition. Please speak with a physician about your health condition and call 911 if it's an emergency. And thank you, Uterine kind for listening.