Reproductive Health, PCOS and Menopause with Dr. Anna Glezer

Women’s reproductive health is a multifaceted division of healthcare that actually affects more areas of the body and general health and wellness than you might think. Today I am welcoming onto the podcast Dr. Anna Glezer, a psychiatrist who practices reproductive and integrative psychiatry, and focusing heavily on perimenopause, menopause and PCOS. Dr. Glezer and I get into some important content right off the bat, covering everything from the specifics of treating patients who struggle with PCOS, to listing some practical goals that you might consider setting that can improve your overall wellness and your reproductive health.

I am honored to have had Dr. Glezer on today, and I know you’re going to enjoy and appreciate this content as much as I enjoyed this interview myself. Thanks for listening!

Connect with Dr. Glezer:

Women’s Wellness Psychiatry Podcast

Clinical Website (Licensed in CA)

Psychiatry Clinician Fellowship Program

Mind Body Pregnancy Blog

Instagram

Quotes

I really focus on the theme of acceptance of whatever decisions we make. Acceptance kind of goes along with forgiveness because oftentimes what we end up doing with past decisions is we judge them based on current information which we did not have when we made the decision. So you're like ‘Monday morning quarterbacking’ your entire life, which isn't fair to past you. - Anna Glezer MD

The size and shape of our bodies has so much to do with things that are completely outside of our control, having to do with genetics and trauma and epigenetics. - Anna Glezer MD

There are so many things that we can do for our bodies, regardless of their size, that can keep us healthy. - Anna Glezer MD

Society tells us that our size is something we should have control over, and that kind of pressure is what leads to a lot of negative self-talk, negative self esteem and challenges with body image. - Anna Glezer MD

I think that setting goals that are not based on numbers on a scale can be really healthy because they're much more achievable. - Anna Glezer MD

The data just does not support that losing weight for the purpose of losing weight has any long term success. - Anna Glezer MD

We have this really complex endocrine system and everything is interrelated. So if you make a tweak in one part of the system, it's absolutely going to have downstream effects in other parts of the system. - Anna Glezer MD

Audio Stamps

00:58 - Dr. Anna Glezer introduces herself and shares about her background, passions, and current involvements

04:37 - Dr. Glezer explains her unique approach to healthcare and how to create healthy goals that don’t revolve around a scale

17:45 - Dr. Glezer shares her approach to PCOS care and what she focuses on when helping patients that struggle with PCOS

21:57 - Dr. Glezer shares how she works specifically with women going through perimenopause and menopause

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Transcript

0:28

We are going to have a really great conversation today. And I know this because today we have the privilege of having on Dr. Anna Glaser. And we have actually, well, I should say, I have had her on a previous podcast of mine. The conversation was so great. People learned so much that I wanted to bring her back to have a little bit more conversation related to mental health. So can we start out with you just introducing yourself because everyone here is going to be new to who you are and kind of how you help patients. Thank you so much again for having me on this podcast. First and foremost, I really, I love our conversations. I love how energetic and dynamic you are. And I really love being a part of this. So thank you for, for having me on first and foremost, just to introduce myself. So, I'm, I'm Dr. Anna Glazer. I'm a psychiatrist and I specifically do a combination of reproductive and integrative psychiatry. And the reproductive piece really means working with women across the reproductive lifespan. So it could be those who are suffering from premenstrual challenges or PCOS, or they might be pregnant or postpartum. They might be going through perimenopause, really at any point during a woman's lifespan when hormones play a role. Which is, you know, from like menarche through post menopause. So really large window of time. And then the integrative piece is more of the approach. So it means, you know, taking a combination of conventional medicine tools, like psychopharmacology, like using medications and integrating them with non conventional tools. So things like. Nutraceuticals and supplements and psychotherapy and mindfulness and nutritional medicine and complimentary tools and all of that kind of stuff. So I do a combination of those two things. And I do that, in a private mental health clinic called women's wellness psychiatry. We serve patients all across California and then part, so that's the clinical side of things. And I really love the clinical work. But I also really love. And so that's why I love doing this kind of thing, which is, you know, going on different podcasts, you know, having a podcast, you know, doing an online course for clinicians, going to conferences, all that kind of stuff. Cause I really like. And enjoy the educational part of all of this. Yes. And can you say the name of your podcast? Because I know we'll say it all again at the end, but it is so good and I listen to it. So just what people want to find that as well. Yes, absolutely. This is the Women's Wellness Psychiatry podcast. So please take, take a listen to anyone who's listening to this one, pop over and take a listen to Women's Wellness Psychiatry as well. Yeah. The reason I like plugging your podcast and just you in general, because I've followed you for a long time. And I feel like a really big area that's missing is for women to understand how uniquely different we are, that we're not, you know, so men, I was just saying this beforehand, you know, they're kind of every day getting a lot of testosterone. We work more in cycles. So we're a little bit more complex sometimes to figure out. And I can't tell you how often people will say, Oh, I just never heard these things, or I didn't understand these things. I think we've We've been left out of research. We've been under, understudied. I mean, all of it. Right. So when I met you and I heard your approach, first of all, I never even knew that that was an area in psychiatry, which was appalling to me that as a primary care doctor, all those years, I didn't even know to tell people this. So like to search out that right, but anyway, hopefully everyone that's listening is going to benefit either through your clinic or if you need that, finding someone that, that has that. So the reason today I reached out, there's a lot of topics we're going to talk about, but I quite often with my patients, I do not focus on weight loss. Now, this sounds really weird because I'm an obesity medicine physician, but the reason I called my clinic, the rentia metabolic clinic is because I know that. Metabolic health rarely has that much to do with where your weight's at or the control that you have over it I like to focus with people on the things that they can change. What goals can they make? What can we look at? So what I'm wondering is, can you tell me kind of, you talked a little bit about taking a Hays approach with patients. Can you explain what that is or kind of why you take that approach? Yeah, so H. A. E. S. Stands for H. A. E. S., Health at Every Size, and it's basically an anti diet approach, a health at every size approach, because we can't look at someone and say that they're healthy or unhealthy based on their size, because there's definitely a lot of folks out there who might be in slightly larger bodies, and they are fit, and they are healthy, and they're eating well, and if you do a whole bunch of blood work, you'll see that they're, You know their blood sugar and their cholesterol and all that looks great and they are healthy and they actually don't have high risk factors for anything because they are healthy. They just maybe happen to live in a slightly larger body and then you might have someone else who happens to live in a smaller body and they have multiple markers that put them at higher metabolic risk and so health at every size means that you're looking at those underlying factors that actually. might put someone at risk, like maybe they have elevated blood sugars, or maybe they have, you know, challenges with their lipids, or, you know, maybe they don't have great aerobic capacity, or, I mean, any number of things, right, that affect our metabolic health that have nothing to do With the actual size of our bodies because we can be healthy at any size and the size and shape of our bodies has so much to do with things that are completely outside of our control, having to do with genetics and trauma and epigenetics and, you know, all that kind of stuff. And it's not something that we can control, even though, unfortunately, you know, society tells us that it's something we should control that aside, I think that there's. You know, but there are so many things that we can do for our bodies, regardless of its size, that can keep us healthy. And that's the approach that I like to take. I think it's really good for our, of course, metabolic health, but also our mental health. Yeah, can you talk more about that? Because I find that, I'm not a psychiatrist, but there's a little bit of, you know, some coaching, a little bit of behavioral stuff that we do in the clinic again, not not a heavy lift. Right? So if there's history with trauma, I'll make sure that everyone's getting the appropriate care. But I find that. Diet culture, you know, you have to eat this way, you have to look this way. It is just everywhere. And a lot of that be dieting. It's really hard for people to hear that, that no, I don't need to look a certain way or I actually get autonomy over what I'm doing. So how do you start to work with? I mean, how would people even know if this is a challenge for them? I guess that's number one. I've met a lot of folks where it's not a challenge for them because we live in this society, right? Like we're not off on some, some Island without the pressures of. Modern U. S. culture, and not just U. S., you know, U. K., Canada, like this happens in so many of, so many, countries where it's, it's the societal pressure to look a particular way and to be a particular way and, you know, that perfectionism and, and all, you know, that idea of having it all and being it all and all, all, all. And it's really hard to kind of step away from that. But I think, you know, that kind of pressure is what leads to a lot of negative self talk and negative self esteem and challenges with body image. And you don't necessarily need to have a formally diagnosed eating disorder to have. some disordered eating patterns and to turn to things like, you know, food for emotional comfort, which can be appropriate in some cases, but what's the underlying thing that's going on there that can be really important to look at. And so I think that, setting goals that are not, number on the scale based can be really healthy because they're much more achievable, the data just. Does not support that losing weight for the purpose of losing weight has any long term success, but when we look at like behaviors, what are the behaviors and patterns that we can use to work on our metabolic health and our mental health, those actually can have longer term success. Yes. Okay. I love that you bring that up. And so I'm wondering, because I sort of have like a few things when I think in my mind, okay, what are sort of non scale things that we work on? Right? Like I would love people to just like throw the scale out in general, but there's, there's too many things with insurance and things that are drawing us back. But my question is, what are some of the things that people could contemplate, making us goals that don't have anything to do with weight? I think there's so many different directions you can go in and yes, it's really unfortunate that our goals have to be often dictated by insurance companies. And anyway, we can go on a tangent. But there's, there's so many other kinds of goals, both physical and emotional health goals. So I have some patients where, for example, one of their primary concerns is energy level. And we talk about the role of nutrition in energy. You know, are they actually eating enough? Are they eating enough protein to sustain their energy levels, particularly in the afternoons? And so, so energy targets could be a goal. Sleep is another big one. You know, I have some individuals where depending on, for example, what they eat during the evening meal can impact. you know, how they, how they go to sleep and what their sleep is like. So sleep could be a potential goal. I have folks where, you know, the, the goals could actually be related, not necessarily to how they feel physically, but how they feel emotionally, because there are some folks who definitely notice the impact of certain types of foods on their anxiety or their mood. There's so much interesting data on certain types of nutritional approaches. I prefer the term nutritional approach rather than diet. So certain kinds of nutritional approaches that actually have really good data for managing symptoms of, let's say, depression. So things like Mediterranean diet and anti inflammatory diet for managing symptoms of depression has some really good data. If the target is maybe cognition and cognitive health, you know, there's some interesting data on, the, the mind diet, Which is a combination of the Mediterranean diet and the DASH diet, which is for hypertension. Putting those together has been shown to help with, managing some of the cognitive decline that can happen as we age. And so, you know, if you're focusing on cognition, you might choose that particular nutritional approach. And then there's also, you know, metabolic targets, right? If someone wants to improve their Blood sugar regulation because maybe they actually have something like a reactive hypoglycemia or they have other indications that there may be prone towards blood sugar dysregulation. Maybe they have high cholesterol and they want that as a target. So there's, there's metabolic potential targets. There's, you know. Mental health targets. There's, you know, physical energy kinds of targets. So many different other targets besides that number on the scale that we can use that might actually lead to long term success because the data suggests that these nutritional approaches can actually help this, but we really don't have any data that says, you know, this diet helps with weight loss. Right, right. I'm sitting here laughing like, yes, yes, yes, yes, it's everything you're saying because it's so true. Well, what always fascinates me, people are always like, well, what should I eat to lose weight? It's like everything equalizes the same thing within a year. So like all of it does not matter. All of it will come back up the right stuff. I mean, just all of it, right? It's just all kind of almost nonsense if that makes sense. But I love how you just, how you, there are so, it's almost, there's even a few on here that I hadn't thought of, right? Like tracking energy levels. I love this sleep, emotional health, metabolic targets. So I, hopefully people that are listening, they're seeing that. I always say that the reason you should be working on whatever you're working should never be the number, the scale, it should be all these other things that you're worried about, all the other things that are a little bit more intangible, what can you make a realistic, goal for what you want to do, right? And this is a slightly deviating, but I was thinking about vitamin D, because I know you had talked about this on a previous podcast. Can you just, because you were talking about, nutrition affecting. Can you talk a little bit about vitamin D, where that fits in with all this? Yeah, so individuals with low levels of vitamin D can actually have symptoms that are similar to depression. And so making sure that you're getting enough vitamin D, which our bodies cannot make naturally, so we need to actually either ingest it or get it from the sun, but it's really hard to get from the sun. Actually, case in point, I'm happy to share this with listeners. I actually just recently got my own vitamin D levels done. And I thought that they were going to be great because I live in a place where we get sun 260 days a year. It's nine months of sunlight. I spend several hours outdoors. But I wear, you know, I wear sunscreen. I'm concerned about, you know, skin cancer, so I wear a lot of sunscreen. And so my vitamin D levels were actually a lot lower than I expected them to be. And so I started supplementing, you know, just with, with oral vitamin D, because I was I saw that level was a lot lower than it needed to be and I really haven't met, a woman over the age of 30 that's had a good vitamin D level without oral supplementation. And so, and some people actually need, you know, even, you know, intra intravenous, or supplementation for, for really, really, really low levels, but most people can just take like a vitamin D supplement and it makes a big difference. And. Vitamin, you know, you could notice an improvement in your energy levels, in your mood and all of these things because of this one vitamin, this one fat soluble vitamin that is missing for so many of us. Yeah. Yeah. It's, it's interesting, right? Like sometimes it's the simple thing, like you can get that checked, right? And that can have a, an impact on things. So can we, can we go back to more of the nutritional stuff? Because I always think it's fascinating how much that affects our mental health. I have felt this greatly that to me, I always say kind of add, don't subtract, like if you're really struggling with a lot of processed food. That it's really hard to just suddenly get rid of something that's like that, that's potentially really affecting us so much. And so I say, let's add in the healthy stuff and I can tell that I'll be low energy. I don't have depression, but I'll feel down. I can feel it. And I think If I, on top of this, I think about some patients that I have, if on top of this you had depression or other things going on, I can't imagine how I'd be able to navigate it. So how do you, how do you even assess if that's, if that's the case for people or how they can work on it? Well, I love what you just said in terms of adding, not subtracting, because I use that same approach. And, you know, once you add enough, Some of the, the other stuff is actually going to naturally going to kind of fall off a little bit. Right. For so many of us, we don't get enough fiber in our diet. So if you're adding fiber, you're naturally going to actually probably feel more full and you're, some of the other stuff is actually going to naturally kind of fall away because you feel full and you don't necessarily want to eat more. And so definitely adding things. So. For example, if I'm talking with someone about the Mediterranean diet, we're going to think about adding it. Where can we add more olive oil? Or where can we add, more, you know, vinegar? Where can we add more fish? You know, all of these kinds of things. Let's just add, add, add. And then that means that the other stuff is going to end up kind of falling off a little bit, the stuff that is less helpful, more, pro inflammatory, less, less, helpful for, for our mood and for anxiety and things like that. I do absolutely support the, let's add, let's not take away because, nothing is. I mean, none of our food, nothing in life is black and white. It's not all good or all bad. It's not all, this food isn't healthy or not healthy. It's just, does it work for your body? And what works for one body might actually not work for another body. You know, that's why, there's some people who have more food sensitivities or more, irritable bowel or things like that where they're not able to tolerate some things that someone else is that doesn't mean that the food is good or bad. It's just whether or not it agrees with you and makes you feel good. And so choosing foods that promote your energy levels or help you feel like you're in a better mood and kind of moving away from the ones that don't. Yeah, yeah, I like that. So it sounds like actually paying attention how you're feeling on things and and kind of letting that a little bit lead the way. 1 of the things I know that a lot of the patient population that you serve that they might be paramenopausal or menopausal and also PCOS. So I'd love to talk about. Sort of I'm going to use the term profile, but I'd like to talk about kind of both of those types of women, because I get a lot of them and I find it's a little bit different. I'm curious to pick your brain on it. So maybe if we could start out with PCOS, what typically do women struggle with when they come to you or what aspects do you help with there? So there's an interesting correlation between PCOS and depression, where there are higher rates of depression in women who have PCOS, and we can think about the underlying reason why that might be. There's so many different, both biological, but then also, psychological reasons, right? Some of the symptoms of PCOS are the signs of PCOS aren't necessarily societally accepted. And so then there's, you know, stigma and things like that. So lots of reasons why that might be the case. And so, we might turn to, how are we going to manage the depression, nutritionally speaking, and in turn, that is probably PCOS symptoms. There's also a number of, I mean, we know that blood sugar regulation and insulin sensitivity are an issue with PCOS. And so that's something that, I like to approach nutritionally as well. And, you know, sometimes with certain supplements like inositol, for example, but there's definitely a nutritional approach to that as well. And again, this goes back to that point that, your body might have more difficulty with. a load of certain kinds of carbs than someone else's body, and that doesn't mean that carbs are good or bad. They just exist. And it's just, how does your body process that? And so again, making the choice of I'm going to eat this way because it is better for my body and how it's able to, to process these nutrients. Oftentimes. You know, we'll, we'll, it's one of those things where worse symptoms of PCOS can influence depression. Depression influences PCOS. It kind of goes bi directionally. So we can, we can intervene in either point. And I think that there's definitely nutritional approaches to both. Yeah. What do you find nutritionally that when people start doing those things, maybe their mood starts to lift a little or that they feel better? Yeah. So I think oftentimes we, again, we add more things that are in line with that kind of anti inflammatory approach. And we begin to kind of back off the things that are more in that ultra processed category, more in that, really high, high carb. But like. Really refined carbohydrate category. Because again, for folks who have PCOS, it often does mean that they might have some challenges with processing blood sugar, and they have some insulin resistance. And so we want to, to really be gentle with those kinds of loads and. If you're not overloading that body system, then you're going to have an improvement in the mental health component as well, because it's all I mean, it's all one endocrine system, right? You've got your insulin and blood sugar and that influences our sex hormones, right? And so our estrogen progesterone is affected. by our insulin and blood sugar. And then you have the entire hypothalamic pituitary access. It's this really complex endocrine system and they're all interrelated. So if you make a tweak in one part of the system, it's absolutely going to have downstream effects in other parts of the system. Yeah. I love that you said it's all connected because everywhere in medicine, I always see people like, and this is about the heart and this is about the lung. Wait, as if the heart is disconnected from the lung. So I love that you bring that up. And yeah, I just had a thing or a word in the middle of it right now, depending on when this releases, but, the blood sugar mastermind, and I talked about no foods, good or bad, but a lot of what you're talking about it's interesting. We weren't necessarily we haven't evolved quick enough to handle this ultra processed food. Right. And so. Some people, they get away like bandits with it. They're amazing, right? And then others, if you have PCOS or things like that, you might be more affected. And like you said, nothing right or wrong, but just learning, like I might not do great if it's, it's not even the fact that it's a carbohydrate. Like it's, it's interesting. We kind of dug into like. Apples are super low glycemic index. And there's actually a ton of carb and chickpea, but it's so low glycemic index as well. So it's like, when you look at these things, the carb necessarily is not the problem, but, but how and, and how your body's responding. So I just love that you, that you bring that up. So it sounds like you're really doing a lot of different areas with them. Is there any difference in the approach? Like, what do you see differently when a woman is either entering perimenopause or menopause? What types of challenges do you see there? So that's probably the largest growing population of women with whom I work, are those who are entering that process. And I think so many are actually surprised when I tell them that they're, that they're in perimenopause. It's something that I have been diagnosing for more and more of my patients. And a lot of them are surprised because they think, oh, it's not something I even have to think about until I'm in my fifties. But perimenopause often starts like a decade before. So, you know, women who are 39, 40, 42, 43 are kind of starting to enter that process and are, you know, a little bit surprised that, oh, you know, maybe their metabolic health isn't where it was five years ago, or their mood symptoms seem to be getting worse. And they might not necessarily yet be having any changes in their menstrual cycle. But the hormones are still changing. And it's one of those things where especially in early perimenopause, you know, you might have slight decrease in things like testosterone and progesterone. And your average estrogen is going like this. And for those who are listening, I'm kind of pointing out a rollercoaster of, of estrogen. So, you know, it's really, it can be really hard to, to be living through that. And so that's one of the main reasons that so many, patients come to see me is because they, they feel those changes and those challenges. And I mean, fortunately, these days, there's much more attention being paid to this topic of perimenopause and menopause, where I think even a decade or two ago, it was not really discussed. And it's, one of those, you're just going to go through the change, so to speak. And it just, it was, you know, talked about in kitchens and nowhere else, but now we're actually talking about it. There's a lot more, you know, research. There's more, more books published, more information out there about what this means, which is great, and yet still very underserved, area of research. We definitely need a lot more information because to your point, it is. You know, women aren't just, slightly smaller men. There's, there's a lot of other hormonal shifts that are taking place. And so it's important to think about how those hormonal shifts influence both our mental health and our metabolic health. And do you find that there's any things that help different than what we've talked about? Like, are there any things unique to this or is it again? really about anti inflammatory diet and not as much processed and sleep and things like that. Is there anything different? I talk a lot with my patients about also making the decision, when do they want to explore potentially supplementing their hormones, potentially working with, a GYN who is going to help them figure out whether, hormone replacement is going to be the right fit. Because sometimes the only thing that someone needs is their estrogen back. And that's going to make such a big difference, and not just estrogen, but also, the progesterone and testosterone. And so, you know, helping, helping my patients make that decision to figure out if it's right for them. To also think about expectations and maybe reframing expectations because your body is not going to respond at 42 the same way that it responded at 22, Cause I think people want like a rapid timeline. Like it was at 18. And I find that that's just all of my patients. I'm like, but it's a new world right now. Where you're at right now, it's, it's potentially different. Let's stop comparing to pre pubescent you, like maybe that's not the best comparison, you know? Yeah. Yeah. And even, I mean, even a decade, 45 and 35, those are very different. experiences metabolically and from an endocrine perspective. So, I think resetting expectations and that doesn't mean you lower them. It means you change them. And so I think, you know, having that conversation is important. Yeah, I like, okay, I like that you brought this up. I, I'm actually a really big fan as well of people getting appropriate labs done, seeing a functional medicine doctor if they need that, whatever it might look like, or a conventional medicine, but someone that actually understands this. I find that. If a doctor does not actually understand hormone replacement therapy or what to do, then they're told, I cannot tell you how many patients have told me this, like direct quotes. Basically the male doctor was like, this is just how it is. Get over it. I mean, I'm not, I'm serious. And it's, we've got, we've got options. We have things we can do. Like, it's not all just an emotional mental thing that's going on. It's like, wow, we can support you. So yeah, I love that, that you even have to help them to, it's almost like. You would think that someone would just seek it out, but it's almost like it's a, it is a choice that has to be made if that's the right thing. So I like that. You're even helping them navigate that. And then I think what's really sticking me with with is this resetting the expectations because I feel like we can all have a healthy dose of that. Right? So is there anything else that you see your patients really struggle with that you feel like maybe every day you're like multiple times a day telling people this that you think other people would benefit from hearing? There's probably a number of different ways I could answer that question because there's a lot of themes. I would say that one of the, the main Themes is a focus on, self compassion that kind of goes, goes back to that, the topic of expectations a little bit, but having some self compassion. And I talk with a lot of my patients about, you know, how, how do you talk to yourself? How, how do you set expectations for yourself? Do you talk to yourself? The same way that you would talk with, you know, your best friend or your sister or something like that? Or is it, is it a very different way that you talk to yourself? And, and why is that the case? And, you know, let's use that to figure out how to, you know, to, to nourish yourself and to care for yourself appropriately. Yeah, that's you just brought that up. I went to a conference and she had us write out, basically what our challenge was. I forget the exact scenario, but then she had someone as an example, come to the front of the room and she said, now you read that to me and I'm going to be your best friend. And you're telling me this as advice. And we were all like, Oh, she was saying the things, you know, so that exercise was so powerful. What you're talking about, right? It was like, yeah. Real time. And we were all like, Oh, yeah, we'd never tell someone this. But yet repeatedly all day long on repeat. We're just willing to hammer it in for ourselves. I find that because this happens for my patients to for in my lane. It's a lot of, people, internalized bias. Like I took this on. I made this happen. I'm the problem. I should have done things differently. How did I let it get to that? Those type of things, yeah. And so how how do you help people pivot out of that? I mean, obviously, I know this is like a one sentence thing. But are there ways to, start to work on that if people are noticing I have that maybe they're not working with someone at the moment yet. Yeah, I really focus on themes like acceptance, acceptance of whatever decisions we made. Acceptance kind of goes along with forgiveness because oftentimes what we end up doing with past decisions is we kind of judge them based on, current information, which we did not have when we made the decision. So you're sort of like Monday morning quarterbacking your entire life, which isn't fair to, to, to past you. And so working on kind of that acceptance and forgiveness of the, of whatever it was that you're, you know, kind of negatively ruminating on, and then kind of coming back to the present, focusing on, okay, how do I provide myself both? Physically and emotionally with what I need right now to feel nourished, to feel resilient, so that I can kind of move towards the future. Oh, that is so good. I, that will be a soundbite for sure. Because I'm, I'm thinking like I, sometimes when you talk, I think of scenarios and I think of me in medical school was really hard for me. It was like a big period of like overeating, not bending, but just overeating all the time. And I think, but I was so stressed and I didn't have appropriate outlets. And I think, But you got through it that, you know, it's like, it was just interesting. I don't know. I could have knowing, like now me knows different, but that version didn't know. So I can't bringing that back. Like it's, it's not helpful in any way. And I like this, this acceptance and forgiveness. I find forgiveness is quite a powerful word. I don't Thanks. So I have just loved our conversation today. Do you think that there's anything else that our listeners need to hear in the way of any words of wisdom, anything parting? I would just encourage folks, you know, if they feel like they're struggling in terms of their emotional well being, their psychological well being, to absolutely not hesitate to reach out. That's, you know, for working with a professional or maybe it's working with a supportive... Coach, or maybe it's working with, you know, and connecting with other like minded people like, you know, socially and in, in terms of, you know, kind of social groups and friends and just, I think oftentimes in today's society, we tend to be a little bit isolated and I think connection is so, so important for, for well being. So if you're struggling, please reach out and connect. I love that you say that. I think there's, it's hard initially to find that, but you're so grateful when you do. I know me personally, me having found different opportunities was has been really changing over the past 5 years. And I also find with patients that. Usually if they're struggling in other areas and they're just working with me, they're not getting what they're really wanting. And then if they come in and they say, you know, I have a therapist, I'm working with a psychiatrist. I just noticed that the growth mindset, the acceptance of where they're at, the ability to work on what they want. The capacity for them to have and to grow is like so much increased. So I love that you bring that up. How can people find you, your clinic, your podcast, your website? Can you just tell all the people? Yes. Yes. And I'll make sure that you have all of the links. So for folks who are in the state of California, I would like to work with me and my team directly. You can go to anaglasermd. com. That's our clinical website for women's wellness psychiatry. If you're interested in an educational podcast, it's Women's Wellness Psychiatry Podcast. If you're a clinician and you like this kind of integrative approach to women's mental health, I would encourage you to check out the fellowship that we have, which is psychiatryfellowship. com. And if you are someone who's going through pregnancy, postpartum, fertility challenges. And you want to read a little bit more about kind of the mental health aspects. The blog that I have is mindbodypregnancy. com. So many different ways to find me. I'm also on Instagram. So. Many different ways to connect. And I'll say, I think you have linked on your website, your podcast. It is so good guys. Listen, the episodes are like not overwhelming. Like they're like bite size and the topics are great. And just thank you so much for coming on. I always learn so much, I so appreciate your approach and, you're just sharing your knowledge and helping us all to understand this better. Thank you so much for having me. I've really enjoyed our conversation.