Hormones & Mental Health in Women | Dr. Michael Azzi

About the Guest:

Dr. Michael Azzi, founder of Napro Life Centre and trained in the US in naprotechnology, joins Debbie and Eddie for a deep conversation about women's health, hormones, mental health and fertility. Michael opens up about the loss of his daughter Lily, the cultural weight of suffering in silence, and why your symptoms aren't a sign you're broken. They're your body asking to be heard. Part One of a two part series. You'll learn how to read your cycle, when to seek help, and how holistic care restores hope.

Key Takeaways:

• Holistic Healthcare: Emphasising the importance of a holistic approach to women's health, Dr. Azzi integrates medical treatment with lifestyle changes and spiritual considerations.
• Fertility Awareness and Naprotechnology: Dr. Azzi outlines how fertility awareness methods like the Creighton Model can provide insights into health issues, advocating for understanding the body's signals.
• Impact of Personal Experiences: Dr. Azzi's work is deeply informed by personal experiences, particularly his journey with pregnancy loss, which enhances his empathy and connection with patients.
• Cycle Awareness and Mental Health: There's a distinct interplay between a woman's menstrual cycle and her mental well-being, deserving attention and care rather than dismissal as "normal."
• Stigmas in Women's Health: Addressing the societal stigmas around menstruation and fertility, the episode encourages openness and understanding as part of breaking down these barriers.

Notable Quotes:

1. "Symptoms are a meaningful way to listen to your body calling for help." – Dr. Michael Azzi
2. "It's that kind of approach that, through my training, has always led me to kind of just ask further questions about what's going on." – Dr. Michael Azzi
3. "Sometimes our experiences kind of dictate our behavior, and sometimes we just do things without even knowing what we're doing." – Eddie Reaiche
4. "Your value is not defined by your fertility." – Dr. Michael Azzi
5. "It's all about just having that balance between the two and treating both streams at the same time." – Dr. Michael Azzi

Resources:

• Napro Life Center: Focused on holistic care and naprotechnology in Sydney. 

You and your mental health is important to us. If this episode brought up any heavy emotions, please know you do not need to carry them alone. Reach out to Lifeline, Beyond Blue, or the counselling service at Hills Sanctuary house at hshl.org.au 

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Transcript

0:00:00 - (Debbie Draybi): And welcome back, everyone, to another episode of Finding Sanctuary. And I've got Eddie with me today. Hey, welcome back, Eddie.

0:00:07 - (Eddie Reaiche): Hey, Deb, how you going?

0:00:08 - (Debbie Draybi): Yeah, it's always nice to reconnect. We've got a wonderful guest today. We're very excited to introduce Dr. Michael Azi, who's the founder of Napro Life Centre. Welcome, Michael. We're really excited for you to join us.

0:00:20 - (Dr. Michael Azzi): Thank you so much for having me. It's great to be here.

0:00:23 - (Debbie Draybi): You founded Napro Life center and I just wondered if you'd give us a bit of a context of what that centre's about and what's your main focus in the work that you're doing there.

0:00:32 - (Dr. Michael Azzi): I specialised as a GP in women's health. But at Napro Life Centre we focus on what's called naprotechnology, which is a further specialised training. It's not available here in Australia, so I've actually had to train in the US for that. But it's a women's health field that's essentially focused on identifying and treating underlying causes. It's for fertility challenges, but also just women's health in general, men's health.

0:00:58 - (Dr. Michael Azzi): Again, I guess I'd explain it more as a root cause type of approach and a holistic approach, you know, looking at integrative care.

0:01:06 - (Debbie Draybi): Yeah, that sounds fascinating. So you've had to do some training overseas to really introduce this for the first time in Australia. That's amazing.

0:01:14 - (Dr. Michael Azzi): Yeah. I wouldn't say it's first time in Australia. There's been other Napro doctors.

0:01:18 - (Debbie Draybi): Okay. Yep.

0:01:19 - (Dr. Michael Azzi): But I guess in terms of, you know, trying to open a medical center that's dedicated to that.

0:01:25 - (Debbie Draybi): Yeah.

0:01:25 - (Dr. Michael Azzi): You know, first in Sydney, definitely. We work very closely in a kind of collaborative environment with practitioners that teach NFP methods. So that's a big part of what we do is based on an NFP method called the Kratom model, which is, you know, very accurate method that can. It's accurate enough to look into medical causes and medical issues, you know, when women are tracking their cycles and charting.

0:01:51 - (Eddie Reaiche): So NFP being natural family planning.

0:01:53 - (Debbie Draybi): Correct.

0:01:54 - (Dr. Michael Azzi): I think these days they're trying to shift away from that terminology as well, more into fertility awareness. But I say NFP because most people would.

0:02:01 - (Debbie Draybi): Yeah. Understand what that is. Yeah. I just wonder whether you want to tell us a bit about your journey and how you've come to do this work. So you started off your medical training in general practice. What led you to women's health and men's health as well? What are some of the things that led you there.

0:02:20 - (Dr. Michael Azzi): I've always been the type of doctor that kind of likes to look a bit deeper and a bit further under the surface, and I like to think I'm pretty thorough. It's that kind of approach that, through my training has always led me to kind of just ask further questions about what's going on. I think with working in general, GP work and working in the medical environment these days, you can get a lot of fragmented care. So I always kind of look to go past that. And, you know, Napa was always kind of on my radar a little bit, ever since I learned about it probably 15 years ago in medical school.

0:02:55 - (Dr. Michael Azzi): But I never really had the opportunity to train in it until after I finished my GP training. Personally. We went through a little bit of a journey with our second child, our baby, Lily. She was a stillborn during delivery, and so, you know, running into some pregnancy loss and dealing with my wife and I, it kind of also gave me a little bit of push to go a little bit into, you know, that environment regarding fertility, but not just fertility, but women's health in general.

0:03:26 - (Debbie Draybi): Wow. Thank you for sharing that. That would have been very difficult time for you and, yeah, you and your

0:03:33 - (Dr. Michael Azzi): wife, and it wasn't easy, but our faith got us through and I had the opportunity, you know, thanks be to God, to baptize her as well. So that was, you know, a big blessing and a hope for us.

0:03:43 - (Debbie Draybi): Yeah, that sounds very beautiful. Very spiritual experience and. And, you know, it's. It's helped you shape your career as well and move into an area based on, you know, your own grief and experience.

0:03:57 - (Dr. Michael Azzi): Yeah, I think it helps me also connect with my patients because I see a lot of people who might have been through recurrent pregnancy loss and similar situations. Having dealt with that on a personal level as well, I find it brings a lot to, you know, my practice.

0:04:12 - (Debbie Draybi): Yeah, yeah. I'm hearing that a lot from you, Michael, around the importance of building that connection with patients and getting a good understanding of what's happening for them. Because often it is just on the surface, isn't it? But you explore a lot deeper.

0:04:28 - (Dr. Michael Azzi): Yeah, I like to. I think it's just part of my outlook on life is I've always looked for ways to live my faith out. And so that kind of started with doing charity work with maronites on mission and helping start that up. And then when Napro came along, it was an opportunity for me to live out my skills and my training and to further those skills in that training as well. Just a way to put my faith into action.

0:04:51 - (Eddie Reaiche): You must be one of the most empathic doctors around.

0:04:56 - (Dr. Michael Azzi): I don't know. I don't see myself as empathetic, to be completely honest.

0:04:59 - (Eddie Reaiche): Really?

0:05:00 - (Dr. Michael Azzi): Yeah, I think it's. I don't try and be empathetic in that. It's not.

0:05:03 - (Eddie Reaiche): I think it'd be natural, but.

0:05:05 - (Dr. Michael Azzi): Yeah, exactly. Sometimes I just like to build a connection, really, is what I would say about it.

0:05:10 - (Eddie Reaiche): I think sometimes our experiences kind of dictate our behavior and sometimes we just do things without even knowing what we're doing. And having the experience that you've had, and even the tragedy and loss, it almost puts a seed in us and it allows us to understand people at a different level. So it's more like, oh, that must be pretty tough. You know, it's tough. I can imagine a patient who tells you their story or their journey and you listening, would be able to empathise with them a lot greater than most other people.

0:05:46 - (Dr. Michael Azzi): Yeah, of course. Yeah. And I think that's what I love about naprotechnology and practicing it is, you know, when I'm sitting down with my couples or, you know, women or men, if they're on their own, I'm really just trying to sit there and listen to their background, listen to their story, build a connection with them and, you know, learn more about them, integrate their spiritual aspects, the physical, not just the medicine, but, you know, lifestyle.

0:06:12 - (Dr. Michael Azzi): We try to cover everything and that's where our assessments go into so much depth and can be quite thorough. You know, our couples assessments can take, you know, 90 minutes as an initial assessment.

0:06:22 - (Eddie Reaiche): Sounds like a truly holistic approach.

0:06:24 - (Dr. Michael Azzi): Yeah, that's what we try and do.

0:06:26 - (Eddie Reaiche): A lot of people say it, but I don't know if they achieve it. But I think from what I hear from you, it sounds like it's something you can deliver.

0:06:33 - (Dr. Michael Azzi): Certainly trying to.

0:06:35 - (Debbie Draybi): Michael, one of the things that A key theme for our podcast has been that connection of physical health and mental health and spirituality and being able to, you know, that mind, body, spirit. One of the things I'm wondering if we can explore together, your experience as a clinician around that, particularly where there are, you know, during development, very rapid hormonal changes that then impact on the physical health. But then thinking about it in terms of psychologically and the mental health, I'm wondering if we can talk a bit about that and what you're seeing in your practice, but also your experiences in this space.

0:07:13 - (Dr. Michael Azzi): Yeah, I think the main thing I see in my practice that deals with this is the issues surrounding mental health and women's cycles. And essentially we try and deal with how a woman's cycle can impact her mental health and our hormones can have an effect and play into that a lot as part of the whole holistic or integrative approach. We don't just say that that's the only cause. We try and work with everything else that's going on, but we try and definitely pay some attention to it as a factor that can be contributing.

0:07:44 - (Dr. Michael Azzi): And I think that's something that can be missed a lot of times.

0:07:48 - (Debbie Draybi): Yeah, yeah, absolutely. Why do you think that is, that it can be missed? Like understanding the cycle and the impact that that can have someone's mental well being?

0:07:58 - (Dr. Michael Azzi): Yeah, a lot of times it can just be brushed off as part of your cycle. You know, this is normal to experience these types of symptoms. Your cycle can present some patterns and we think that essentially that's your body talking to you, the symptoms that you can be having. So sometimes it can also be mislabeled, you know, as whether it be anxiety or depression or other things like that. But there can be a really a big link there. And so, you know, what I would say to some of my women is that if you feel like a different person at certain times of your cycle, that's not random, that's something worth listening to that your body's saying.

0:08:37 - (Eddie Reaiche): Because I know there's a lot of women where it's actually debilitating and they take off two or three days every month because they literally can't function.

0:08:46 - (Dr. Michael Azzi): Yeah, those types of symptoms, pain or whether it be mental health symptoms or PMS symptoms, especially if they go through that type of cycle and they disrupt your life, they shouldn't be ignored, they definitely should be listened to. That's not to kind of understand the mental health aspect with it. So I still think, you know, a lot of my patients that I see still need that type of care and that approach. And, you know, they just link in with counsellors and psychologists.

0:09:15 - (Dr. Michael Azzi): Some of them, you know, need to be on antidepressants, but it's just adding that extra level of care. When you identify that there could be a hormonal component going on, whether it be, you know, a hormone deficiency or fluctuations and what's causing that in the background. So a lot of times we see certain things like PCOS driving that or endometriosis driving that, or, you know, other women's health issues, but they're the two main things.

0:09:39 - (Debbie Draybi): Yeah, I think that's been a really big theme in women's health. Certainly as a woman growing up in a traditional culture where you do feel like sometimes you're silenced and almost socialised to ignore the signals that you're saying. I think it's really powerful message and, you know, thank you for saying that. Being able to validate, recognize and to really amplify those signals rather than just shove them down and just perceive them as, oh, it's just the time of the month, it's normal. All women put up with it. You know, it's just what you do as a woman.

0:10:13 - (Dr. Michael Azzi): Yeah, correct.

0:10:14 - (Eddie Reaiche): I wonder if there is a cultural aspect to this as well. I mean, how much do women. Are they available to disclose how they feel talking to you as a man, for instance, even though you're a doctor, do they feel. Do you find sometimes they feel that it's very difficult for them to disclose what they're actually going through?

0:10:36 - (Dr. Michael Azzi): I would say yes and no in certain circumstances. I think in my experience working as a gp, when there's a lot of kind of competing agendas and, you know, you have certain issues that you need to speak to someone about and they need to come in and, you know, disclose certain issues, it's not so easy. But moving into more of an this type of napro approach, which is a little bit more holistic and what we spoke about, about building that connection, I think it really helps people open up.

0:11:02 - (Dr. Michael Azzi): So, you know, early on they might not be so open, but over time and as we go through a bit of an assessment and learn about each other and connect with each other, that does start to come out. And I find most of my women have, you know, no problem sharing.

0:11:16 - (Debbie Draybi): That's interesting, the importance of building that connection.

0:11:20 - (Dr. Michael Azzi): Yeah.

0:11:20 - (Debbie Draybi): You know, coming at it from a different lens in a general practice, you don't really have that space to do it.

0:11:26 - (Eddie Reaiche): Yeah, that's easy for a therapist to build up a therapeutic relationship because we're spending an hour with them. But you're very time limited, though, and you've got to do a lot in a very short space of time. So that could be challenging in itself, couldn't it?

0:11:40 - (Dr. Michael Azzi): I think part of that and some of those challenges and why I found it so fulfilling working in the napro field was what led to me to kind of switch over and open up Napro Life center, which is more dedicated to this type of care and providing the time and the comfort and the space that's. That's needed for that.

0:11:58 - (Debbie Draybi): Yeah, it really does. Like, just, you know, hearing you sounds like it's a good fit. Just how you approach things and your level of compassion and openness. I think you should have been a therapist, to be honest.

0:12:13 - (Dr. Michael Azzi): Yeah. Sometimes it feels like being a therapist to be honest and, you know, you have to work through a lot of things and talk through a lot of issues with people and try and, you know, get them where they want to be.

0:12:23 - (Debbie Draybi): You know, this psychiatry. Right. You were making an awesome psychiatrist. I'm just saying we need more. Yeah, that's wonderful. Like, I think about experiences that people have of doctors who do listen and who have that openness to hearing their full story and getting to know them as a person. You know, this model that you've created, I think that's, that's really powerful because there's a bit of a gap in medicine around that, isn't there?

0:12:50 - (Dr. Michael Azzi): Yeah. With medical care it can be these days, you know, very goal oriented or very guidelines driven. And there's not that focus on just building connections and getting to know the whole person. Not only kind of their history, their medical background, but, you know, things about their life and, you know, what they do and their relationships and how that's playing into everything and how that affects everything.

0:13:13 - (Debbie Draybi): Yeah, yeah. I think that's a very important message for our listeners around finding a doctor that listens to you and all of you, not just your symptoms.

0:13:24 - (Dr. Michael Azzi): So I guess, like, as part of that approach, we try to, you know, include in our assessment a lot of lifestyle things. You know, I ask people about, you know, what we mentioned, their faith, their relationships, ask them about their mental health and what their stress levels are like, how are you sleeping? We look into, of course, all the organic and the medical issues, but we also look into, you know, what's your exercise like and are you sedentary and what's your diet like and what are the factors in your diet that can be affecting things.

0:13:53 - (Dr. Michael Azzi): And I find that can have, you know, real improvements. I see a lot of women with irregular cycles who are having a lot of issues for that. And one of the most effective ways that, you know, I can recommend to them to control their cycle is really controlling their diet, you know, more so than medications or anything. And part of NAPRO stands for natural procreative. So the natural is a big part of that. And we're always trying to do something naturally. And I'm trying to get my patients to help themselves with a lot of those lifestyle approaches before I turn to medicine, which, you know, that can be part of what we do.

0:14:26 - (Dr. Michael Azzi): But it's not the first step.

0:14:28 - (Debbie Draybi): What is the first step?

0:14:31 - (Dr. Michael Azzi): The first Step, I would say, is understanding your body and your cycle. And that's why the fertility awareness or the charting method is very, very use for us because it gives us a lot of insight into what's going on. It helps women track their cycle. Not only kind of their bleeding, their ovulation, their cervical discharge, you can track what symptoms you're having and when you're having it and how it links to your cycle. So it can be a really important part of building that picture.

0:14:56 - (Debbie Draybi): Yeah, I think it's a really good starting point for our listeners who might be grappling with mental health, seeing that link of understanding your body first and what might be happening there.

0:15:10 - (Eddie Reaiche): I can imagine a lot of listeners sitting, listening to this now and thinking, going to ChatGPT, saying what diet should I be on for my menstrual cycle? And try and go as natural as they can. Because it's hard to believe something so simple could be a cure or curative. And I think that's beyond a lot of people because everyone expects it's got to be something technical, it's got to be a tablet, it's gotta be surgical, it's gotta be something else, not simple like just changing my diet might actually help.

0:15:43 - (Eddie Reaiche): But that sort of message is amazing. I think it's really important for people to hear.

0:15:49 - (Dr. Michael Azzi): Yeah, there's a really big link with diet. Especially our modern day diets might not be so nutrient rich. They might be, you know, very hard to digest because they're so processed. So they lead to inflammation over the long term. You know, that has flow on effects all over the body. It can lead to problems with regulating and producing hormones. And again, that would have a flow on effect on mental health if there's, you know, significant fluctuations.

0:16:14 - (Dr. Michael Azzi): And we take that sort of approach not just with diet, you know, very similar thing with sleep. So, you know, if there's sleep can be part of a cycle, it can be disrupted from mental health, but it can also feed into that. And if you're not sleeping properly, you can have issues with regulating your melatonin, your circadian rhythm and then you're not regulating your hormone production overnight and things like that. So the body as a whole, it's all linked. It is, it truly is. Mind, body and soul. So, you know, everything can be connected.

0:16:41 - (Dr. Michael Azzi): That's why we try and cover all our bases.

0:16:43 - (Eddie Reaiche): It's interesting because in therapy we always promote the three big things that people need to do, like sleep, proper diet and exercise. And a lot of that helps people, particularly in depression and anxiety. It's interesting how that goes across to the medical domain as well.

0:17:01 - (Dr. Michael Azzi): Definitely. There's very real biochemical links there.

0:17:07 - (Debbie Draybi): So, thinking about that, I'm wondering, for our listeners who are struggling and they're just not used to listening to their bodies or paying attention to those early signals, what's your advice around that? What are ways that people can start to really have that disconnect from their body and not really having that awareness? What are some of the things they can start to do to reconnect and understand their body more?

0:17:35 - (Dr. Michael Azzi): I think it might just be getting a little bit selfish, you know, just reflecting a little bit more about yourself and your body and how it's reacting to your environment and what your body is telling you at different times in your cycle. Especially for women. I think that's a big part of it. Yeah, a lot of it is self care. Just taking the time really, to look in on yourself and notice what your body's trying to say.

0:18:01 - (Debbie Draybi): Really, I think that's a really strong message, Michael, in our cultures, for women who are really socialised, to pay attention to everyone else and care for them, being able to turn that inwardly is really hard.

0:18:17 - (Dr. Michael Azzi): I think a big part of that in our culture is a bit about this idea of just suffering in silence as well.

0:18:24 - (Debbie Draybi): Yeah.

0:18:24 - (Dr. Michael Azzi): You know, what I would say to that is that God's given us the tools to deal with our sufferings. And yes, you offer up your suffering while you're going through it, but it doesn't mean you don't work towards correcting that, because you have to be able to live and function in accordance to your state in life. So, you know, if you're a wife, you know, you have to be able to live with your husband. If you're a young mother, you have to be able to look after your kids. And if your suffering is stopping you or debilitating you from doing that, it might not be trying to choose the right words, but it might not be such a noble thing to just suffer through that if it's going to impact how you are living out your state in life.

0:19:02 - (Dr. Michael Azzi): Sometimes, you know, suffering with Christ is great and like I said, you offer it up while you're going through it, but staying in your suffering. That might be more for, like, someone who's religious or a hermit, where that's what they want to do. But I'm a big advocate of just leaving out your state in life and being able to function in that.

0:19:22 - (Debbie Draybi): We are drawn to suffering in our. In our faith, but also being able to embrace wellness and Healing and being proactive about that and making it a priority, that's a big thing.

0:19:34 - (Dr. Michael Azzi): Yeah, it is.

0:19:35 - (Eddie Reaiche): It doesn't have to be a cross you have to carry.

0:19:38 - (Debbie Draybi): Yeah, correct.

0:19:39 - (Dr. Michael Azzi): Yeah.

0:19:39 - (Eddie Reaiche): A lot of women tend to think it's my cross and I have to carry it, and they think it's spiritually, it's what they're meant to do.

0:19:47 - (Debbie Draybi): But.

0:19:47 - (Eddie Reaiche): But I think it's true that God gives us tools and gives us a way out. Similarly, when with mental health, we don't have to suffer in silence, there are people who are just as spiritual as they are, who are actually helping people with mental health. There are people spiritual as they are helping with medical help. And we're all under the same roof for the same God, so I don't see anything wrong with that.

0:20:15 - (Dr. Michael Azzi): Yeah, definitely.

0:20:17 - (Debbie Draybi): A big thing that we've been exploring as well has been around understanding stigma and how it can really be a huge barrier when it comes to mental health. But thinking about it also does apply to women's health, too. We're thinking about that stigma related to being open about your cycle. And it's always been hidden. I mean, even if you look at, you know, mainstream media, when they have commercials of sanitary pads, there's no blood to be seen. It's.

0:20:48 - (Debbie Draybi): It's hidden and almost. It really is still stigmatized. I'm wondering, from your perspective, you know, what are some of the things that we can do collectively as a community to break down that stigma so people can feel safe to talk about and to seek help when they need it?

0:21:06 - (Dr. Michael Azzi): I think it's just becoming comfortable discussing it openly, like we're doing today, really just putting it out there, letting people know that, you know, this is normal thing that women go through, but it's something that can be treated and can be managed effectively. And, you know, it always gets me thinking about the story of the haemorrhaging women in the Bible. She was kind of shamed and looked down upon, but she had to reach out and grab the hem of Jesus cloak. So it also kind of requires that action of reaching out and asking for help as well.

0:21:38 - (Debbie Draybi): What a beautiful example. Being able to, you know, have that courage to reach out. Despite the fear, the shame, the guilt and whatever else she was carrying, she did reach out.

0:21:50 - (Dr. Michael Azzi): And that's not trying to put all the onus on, you know, someone reaching out. There is still that stigma, like we said.

0:21:55 - (Debbie Draybi): Yeah.

0:21:56 - (Dr. Michael Azzi): And we can, you know, work to reduce that by, you know, exactly what we've talked about and just putting it out there, really. This is very similar with mental health. You know, it's really just putting it out there and letting people that, you know, you're not alone in your suffering. And a lot of people are going through this, and there are options. Really?

0:22:12 - (Debbie Draybi): Yeah. Yeah.

0:22:14 - (Eddie Reaiche): Michael, I was thinking a lot about some of the clients that I get as well, particularly couples. Sometimes women are referred to as hormonal, and that's why they get the mood swings. Now, I know this is probably more of an ignorant perspective of just how they look at it or the way they see as women just being emotional because of their hormones, but there's a greater link between hormones and mental health.

0:22:43 - (Eddie Reaiche): And sometimes they're separate and sometimes they're very close together. Can you just explain the relationship?

0:22:48 - (Dr. Michael Azzi): Yeah. Hormones don't explain everything, but they matter. And I think the key difference is the timing, and that helps us differentiate. So if there is truly a link with that premenstrual phase, where you can definitely get more moody, more irritable, There can be a lot of other symptoms in premenstrual syndrome. Bloating, breast tenderness, a lot of exhaustion and mental fatigue, headaches, and all that can play into someone's mood as well.

0:23:15 - (Dr. Michael Azzi): And so if there is that definite link in that phase of the cycle, after ovulation, or luteal phase, we call it, that can be hormonal. But a lot of the times it's not the whole picture. You know, there can be underlying issues with anxiety, with disorders, with whatever else might be going on, and that will extend out into all aspects of life, and not only in that phase of the cycle, but all throughout the cycle. So timing is a big thing that helps us differentiate that, and it's a balance of the two. So it's not just focusing only on hormones. Hormones can help improve that, but also dealing with the mental health aspect as well.

0:23:53 - (Dr. Michael Azzi): And I think misdiagnosis can kind of happen both ways. Like, you know, hormone issues can sometimes be labeled as mental health problems, Whereas what you're saying, you know, the other way around, the mental health can sometimes be ignored and is focused just as a hormonal issue. So it's all about just having that balance between the two and treating both streams at the same time.

0:24:14 - (Debbie Draybi): So it would be really important for any listeners. You know, you might be confused about what it is and where it's coming from. Is it hormonal? Is it mental health? What's a good starting point for them to get a better understanding of what's happening?

0:24:29 - (Dr. Michael Azzi): Speak to someone, Speak to a doctor like me, I guess. It plays into what I said earlier about just listening more to your body and starting to track your cycle and things like that.

0:24:40 - (Eddie Reaiche): I'm really curious about. Wonderful. Can talk about infertility.

0:24:44 - (Debbie Draybi): Yeah. It's another one that you'd see in your practice as well.

0:24:47 - (Eddie Reaiche): And one of the most tragic things that I hear is women who feel they're infertile feel like they fail as a woman. And I think it's one of the saddest things that I've seen because they dictate them or they look at themselves purely as procreator or someone who bears children. And when they fail in that they fail to see themselves as a woman. I wonder how that, how you deal with that.

0:25:19 - (Dr. Michael Azzi): It's not easy, and it's very hard when there is that stigma in our society where, you know, every married couple is expected to have kids and have many kids as quickly as possible. And, you know, what's, what's happening. Why haven't you guys, you know, why don't you go see someone? All these types of inquiries and questions from friends, from family, from everyone around you. And that type of stigma can play into, you know, this image that people get where they tie their worth to their fertility.

0:25:48 - (Dr. Michael Azzi): And, you know, we have to kind of acknowledge that gently and say to people that your value is not defined by your fertility, but your fertility is certainly something that needs to be understood and that's indicating something deeper going on in the background. So, you know, our view on fertility is that it's a sign of your overall health. Thinking about it a little bit philosophically, you know, when your body isn't in a good state, it's unhealthy, it's battling issues, it's diverting resources.

0:26:17 - (Dr. Michael Azzi): What's the first function that's going to shut down? I think your body's going to turn a little bit selfish. It's going to say, I'm not going to worry about my fertility, my outward function, and I'm just going to focus on other aspects of what the body does. So our approach is really part of that whole holistic care is identifying all the issues that can be at play in correcting that. And I say to people that your fertility improves as a side effect of that, just by you know, treating, you know, your underlying issues that are going on.

0:26:49 - (Eddie Reaiche): That's fascinating. Never really thought about it. And I think you've explained it really well. You really articulated that well.

0:26:56 - (Dr. Michael Azzi): Thank you.

0:26:57 - (Eddie Reaiche): I think it's going to help a lot of people, particularly people who are struggling to fall pregnant and how they look at themselves and there's always hope.

0:27:06 - (Dr. Michael Azzi): Yeah, definitely.

0:27:08 - (Eddie Reaiche): No priority provides.

0:27:10 - (Dr. Michael Azzi): Yeah, that's what we say. It's fertility care that restores hope.

0:27:14 - (Debbie Draybi): Yeah, yeah, absolutely. The importance of understanding your whole self, not just parts of who you want to be or what society expects you to be. And I think it's a really powerful message and there's so much there, there's so much that we can explore around fertility and women's health. I know that we've talked about that. This is the first of a two part series, so we're really excited for you to come back and continue this conversation with us.

0:27:42 - (Debbie Draybi): But just as we're wrapping up, I wondered whether there's any final messages for this first part that you think would be really useful for our listeners.

0:27:50 - (Dr. Michael Azzi): I think just to summarise in terms of, you know, when to seek help or, you know, to turn to a doctor like me who takes this type of approach, it would be when you notice that there's a repeating pattern going on, you know, with your symptoms, especially if it might be tied to your cycle, if it starts to be debilitating or affecting your daily life or your functioning in any way as well. And certainly if it's something that's, you know, not improving over time.

0:28:17 - (Dr. Michael Azzi): So, you know, it's always worth looking into if something feels off like that and then just to let people know that these things can be fixed, there's, you know, real solutions. You're not broken. Symptoms are a meaningful way to listen to your body can be calling for help sometimes.

0:28:35 - (Debbie Draybi): That's beautiful. Seeing symptoms as signal, not brokenness and being able to understand this, help you help them unpack what those signals might mean. Such a beautiful perspective.

0:28:47 - (Eddie Reaiche): That is great.

0:28:47 - (Dr. Michael Azzi): Yeah.

0:28:48 - (Debbie Draybi): Can you be my doctor? I'm just saying women's health.

0:28:53 - (Dr. Michael Azzi): Yeah.

0:28:54 - (Debbie Draybi): Menopause, I mean.

0:28:55 - (Dr. Michael Azzi): Well, we'll talk about that.

0:28:56 - (Debbie Draybi): 16 years old.

0:28:58 - (Eddie Reaiche): I think Deb will talk about menopause in the last session.

0:29:00 - (Dr. Michael Azzi): Yeah, we will.

0:29:01 - (Debbie Draybi): That's the most.

0:29:02 - (Eddie Reaiche): I may have to. I may have to host that one.

0:29:06 - (Debbie Draybi): Michael, this has been amazing. Thank you so much for your time. We're really excited to invite you back for another conversation. We're going to explore together, exploring further around pregnancy loss, perimenopause, postnatal depression. They're the key topics. So really excited for you to come back for part two. And I think that you're also going to have another colleague with you, Is that right? Yeah, yeah.

0:29:30 - (Dr. Michael Azzi): Thank you very much for having me on. I've really, you know, enjoyed talking about and making people aware of these issues and looking forward to, you know, unpacking a little bit more in the second part. And yes, my colleague, Dr. Mary Rose Moad, she's napro trained as well. She's got a background in obstetrics and gynecology, so she'll be joining me for that one.

0:29:47 - (Debbie Draybi): Oh, that's fantastic.

0:29:48 - (Eddie Reaiche): Fantastic.

0:29:49 - (Debbie Draybi): Very excited. Looking forward to the session.

0:29:51 - (Dr. Michael Azzi): Thank you.

0:29:52 - (Eddie Reaiche): Thanks, Michael.