Why Your Birth Control Story Isn’t Over: The Lasting Effects of Synthetic Hormones with Elizabeth Katzman

In this Season 3 kick-off, Mary sits down with Elizabeth Katzman, Functional Diagnostic Nutrition Practitioner (FDN) and founder of Strong Choices, to unpack the long-term impact of birth control on women’s health, the concept of “the pill hangover,” and holistic strategies for thriving through perimenopause and menopause.

Elizabeth shares her personal journey from attorney to FDN, and how her own family’s health challenges led her to question conventional wisdom around women’s health, antibiotics, and hormonal interventions. Together, Mary and Elizabeth discuss:

• What is “the pill hangover” and how can it affect women decades after stopping birth control?
• The critical connection between gut health, hormone balance, and bone strength
• Why supporting your liver and gut is essential for hormone detox and overall well-being
• Practical hacks for managing menopause symptoms, including vaginal estrogen in the ear 
• The importance of advocating for yourself with healthcare providers and building a supportive care team
• How to educate and empower the next generation to make informed choices about hormonal health
• Insights from Elizabeth’s upcoming book, “Sexy Bones,” and her approach to strength training for bone density

Elizabeth also shares actionable advice for mothers of teens, women considering or coming off birth control, and anyone navigating the midlife transition. Plus, learn why variety in probiotics and fermented foods matters, and how small daily choices can make a big difference.

Connect with Elizabeth Katzman

• Website: strongchoices.com
• Instagram: @strongchoices1

I would love it if you could support the show. Go into the show notes and click on the button where you read "support the show." You have the option to donate monthly, $3, 5, 8, 10. Be a loyal supporter for as long as you want with recurring fee as little of three as $3 a month, and opt out at any time. Each investment goes directly back into producing episodes with even better content, improved audio quality, and we'll go a long way in bringing great guests onto the show.

Transcript

If you're being put on the pill in perimenopause, you have no idea if you're fully menopausal. So I advise women to stop taking it and find a different form of contraception if that's their main goal of taking it.

Some women have been told that it's actually HRT, and it's definitely not HRT, I tried to help them get off of it so that they know are they even in menopause?

And I help them support their gut. So a good probiotic, lactobacillus and bifido, those are the strains that the pill really wipes out, which leads to leaky gut. a lot of women that are on the pill have gut issues, 

and a lot of women have thyroid issues because it disrupts thyroid function by depleting selenium B vitamins, which makes methylation difficult.

It also affects the enzyme that you need to make T three from T four. So, a woman in perimenopause already is really susceptible to having thyroid issues, and when you throw the pill on top of that, it makes matters even worse. So you want to support your thyroid function with progesterone.

Selenium often iodine if you're being put on the pill in perimenopause, you have no idea if you're fully menopausal. So I advise women to stop taking it and find a different form of contraception if that's their main goal of taking it.

Some women have been told that it's actually HRT, and it's definitely not HRT, I tried to help them get off of it so that they know are they even in menopause?

And I help them support their gut. So a good probiotic, lactobacillus and bifido, those are the strains that the pill really wipes out, which leads to leaky gut. a lot of women that are on the pill have gut issues, 

and a lot of women have thyroid issues because it disrupts thyroid function by depleting selenium B vitamins, which makes methylation difficult.

It also affects the enzyme that you need to make T three from T four. So, a woman in perimenopause already is really susceptible to having thyroid issues, and when you throw the pill on top of that, it makes matters even worse. So you want to support your thyroid function with progesterone.

Selenium often iodine

with methylated B vitamins. So there's a whole bunch of things that we can do a month or two before we decide to stop taking it. So that it's less of a reaction when they stop.

We are kicking off season three with an episode that will be eye-opening. Shocking. Lots of aha moments and holy shit, I didn't know that. I wish I knew that when I was younger. We're talking with Elizabeth Katzman. She is a functional diagnostic nutrition practitioner. FDN for short, who transitioned from a legal career to holistic health.

After her personal experiences with her children's health er to question conventional approaches and seek deeper nutritional knowledge. She'll share her story from law to her expertise in women's health, particularly focusing on perimenopause, menopause, and the long-term effects of birth control pills.

We will explore various health topics, namely gut health, microbial function, and the importance of understanding the body's natural communication networks. And she also shares practical tips and hacks for improving health outcomes. she's coined the term.

Hangover to describe the long-term effects many women experience after using birth control including hormonal imbalances that can persist well into perimenopause and menopause. And so she advocates for empowering women and mothers with knowledge about alternatives to hormonal contraceptions and how to support the gut and the liver, and making dietary changes like increasing phytonutrient rich foods to optimize hormonal balance and overall wellbeing.

And one other area that she is very passionate about is bone health and will have an upcoming book She'll tell us all about entitled Sexy Bones, aimed at shifting the conversation about bone care in the younger audiences and to highlight the connection between bone health, appearance and longevity.

Things that we should be thinking about early in life and not in the perimenopause years, Elizabeth, like me encourages women to advocate for themselves in healthcare settings, seek practitioners who align with the evolving needs and approaches to women's health, and to take a proactive, empowered approach when having conversations with your doctor.

Does doctor know best? Nope, not really. And you're gonna find out why. So stick around. Thank you again for joining me on the Menopause Disruptor Podcast.

Welcome 

to the Menopause Disruptor Podcast. Delighted to have you here. We are gonna unpack so much functional diagnose, nutrition practitioner coined the term, the pill hangover. Wow. Welcome to the show.

Hi, nice to see you. Thank you for having me.

So just before we got started, I did one of Elizabeth's hacks I placed a little bit of vaginal estrogen cream on the tip of a Q-tip and placed it in my ear. And that is just one of several hacks that Elizabeth is gonna share with us today in the show. Stick around, you're gonna wanna learn about that one. But before we get into all of that, please tell us, tell the listeners your personal journey. What led you to become a functional diagnostic nutrition practitioner?

I know it's such a mouthful. I just say FDN.

Yeah. I was an attorney, but I was always very interested in health. Then when I was pregnant with my first child, I just assumed, I would have a baby and head right back to work, but like I fell madly in love and didn't wanna leave the house and had ended up having four children.

But with my first two early on when they were, around. Two and four, and they were being put on a lot of antibiotics for ear infections. So I researched and it looks like there was a link between dairy and ear infections. So I stopped giving them dairy and they never got another ear infection.

Never needed another antibiotic. And I realized I had really given up a lot of control over our health to people that I don't really know and who obviously aren't trained in nutrition. And at that time, was about 18 years ago, it was more difficult to find a holistic practitioner. So I went back to school for nutrition, for health coaching, and then eventually the FDN program because at the time you couldn't order labs for your family.

There was always a middleman. Now there's more direct to consumer labs and supplements and all of that available. At the time there wasn't. So that's why I went through that program. I really wasn't. Intending on it being a profession, it was just to take care of my family. But then just through word of mouth and talking to other moms, it just grew.

And now all of my clients are sort of in the perimenopause, menopause age. We all sort of came upon it together. And so my practice now, although it's holistic, so it's still liver, gut and all the things, that you need to have proper hormone function, but I do really. I honed in on the perimenopause space, not just because it's popular, but because that's the age of my clients at this time.

Interesting though, that in your journey had this aha moment when you realized that of course, many women struggling with the midlife transition balancing hormones, you linked it back to long-term use of birth control, hence coining, the term, the pill hangover. So

about that.

yeah, a lot of women, have been on birth control. Many women, were on it not for contraception, but actually for other issues. So acne, painful periods, irregular periods, when I was put on oral contraception. I was young, I was still in high school. I wasn't sexually active, but it was sort of just the standard practice.

Oh, you have a menstrual cycle. Okay, here's the pill.

I don't think there was ill intention. I think that there was a lack of understanding of what the pill does and how it actually shuts down our hormones. And so do I think my doctor intentionally tried to deprive me of anything? No, I think he was trying to be helpful.

A lot of women, I think were in that situation and when you try to get off of it, some women are absolutely fine. So it doesn't apply to everyone. But the concept of the pill hangover, it's not just the day after or the month after. I find side effects even now in the perimenopause menopause group. and in the older group.

20 years down the road. The reason is that the pill really overrides our own natural hormones, they're synthetic hormones. Our body receives them differently,

Of

and they have a really strong affinity to our receptors. So for a woman, let's say, who stopped taking the pill at 30? Now, she's 48 years old and she wants to add in progesterone.

A lot of those women will have a progesterone intolerance because their receptors have been altered by synthetic progestin from the birth control pill. So you'll often hear that bioidentical progesterone is very calming. It works with, our GABA receptors and creates allopregnanolone, which 

Makes us calm and can sleep and lowers anxiety. But for a subset of women, it actually does the opposite. It has an excitatory effect and they have a hard time sleeping, and a lot of those women have a history of being on the birth control pill. And so, we really have to work on receptor cleanup and there's products.

Biotics has some great receptor detox products. Um, I like to take saunas. You can take some niacin, which causes blushing and get circulation going. but sweating is a great way to, to clean things up,

Of

so.

course.

The hangover can be over a wide period of time. There's also the women who will feel it right away, they'll automatically have a lot of acne because the pill will suppress your oil glands.

And so that's why teenagers are often put on the pill if they have acne to suppress those oil glands. But you know, guess what? They come back the second you stop the problems that you were trying to avoid. We'll come back. So for some women, if they were having painful periods beforehand, perhaps it was endometriosis that wasn't diagnosed, that will, will or can not, none of this is a hundred percent, we're all individuals, but that can come back when you're off the pill and it can be worse.

So when you see some of the women coming to see you about this, are they already voluntarily off the pill? Do you help coach them to get off the pill or is this something that they come to see you because they've been off the pill now and they said, I don't know what to do now because the hangovers can be so severe.

yeah, and anxiety and depression with a lot of women. But what I'm seeing a lot now is women who are on the pill in perimenopause. And I say that sort of in quotes 'cause we don't know if they're in perimenopause or full menopause 'cause they're on the birth control pill. if you're being put on the pill in perimenopause, you have no idea if you're fully menopausal. So I advise women to stop taking it and find a different form of contraception if that's their main goal of taking it.

Some women have been told that it's actually HRT, and it's definitely not HRT, I tried to help them get off of it so that they know are they even in menopause?

And I help them support their gut. So a good probiotic, lactobacillus and bifido, those are the strains that the pill really wipes out, which leads to leaky gut. a lot of women that are on the pill have gut issues, 

and a lot of women have thyroid issues because it disrupts thyroid function by depleting selenium B vitamins, which makes methylation difficult.

It also affects the enzyme that you need to make T three from T four. So, a woman in perimenopause already is really susceptible to having thyroid issues, and when you throw the pill on top of that, it makes matters even worse. So you want to support your thyroid function with progesterone.

Selenium often iodine

with methylated B vitamins. So there's a whole bunch of things that we can do a month or two before we decide to stop taking it. So that it's less of a reaction when they stop.

So they're just not going cold Turkey. It's a bit of a, a detox process to get off of the addiction, 'cause I guess in a way, the body does become somewhat. Addicted in that it's learned, the hormones have learned to adjust or switch off because, a, synthetic is now doing the job, as you said, and the receptors aren't as strong when you're on.

the, the, yeah, you've switched off your own hormones and when you're talking about at any phase in life, it's an issue. So if you're a teenager, this is when you're building your bones. before the age of 30 is when you're building all your bones. If you're on the pill, you've taken away your natural progesterone and estrogen, which are the building blocks for our bones. Also, the pill increases sex hormone binding globulins. So, it will bind to testosterone so you don't have as much free testosterone. We also need that for bones, so teenagers then are set up for not having a strong of bones. In perimenopause, we lose a tremendous amount of bone density, so both stages are really crucial for having optimal bioidentical hormones and the pill is robbing us of that.

It's so, disheartening to now understand this, when a young girl is going in to make that choice, a young adult is going in to make that choice. And as you said, right from the get go, it might not necessarily be for a contraceptive for. Prevent pregnancy. It's simply to address critical things like acne and painful periods.

And it just seems that, a lot of medical practitioners just, it's, it's the cookie cutter, one size fits all. Oh, bad, acne, painful periods. We've got a solution for that. Here, go on this birth control And then these young women are convinced that this, this is the only way to go. And they're not getting those guidelines from someone like yourself who clearly understands the ramifications long-term 

So what advice would you give to mothers who might be listening to this episode right now do have young daughters who are on the pill

or. 

I do, I work with a lot of teenagers because a lot of my clients have teenagers. So it comes up all the time and, depending on what they can afford testing wise, 'cause the functional test could be expensive. I love to do a gut test to get more specifics to see. If it's a girl dealing with acne or painful periods, I like digging into the gut to see, well, is it more of a toxic exposure issue?

Is it more of a methylation issue? Is it. low glutathione levels. Is it low sulfation? Like there's so many different things that it could be if someone can't afford those tests 'cause they can be $400. then we just go back to the basics. And

if I am able, if to talk to the girl one-on-one, I can make better inroads than it coming from mom.

'cause there's just an automatic push pull that it's nice to take away and have an objective outsider come in and sort of give 'em the motivation. I have found that girls are largely motivated by aesthetics. So I say, listen, if you want your skin and your hair and your nails and everything to look radiant.

'cause a girl will suffer through painful periods way more than they'll deal with having a breakout. I talk to them about the importance of not eating ultra processed foods and sugars and how that disrupts their gut and their hormones and the greasy foods and the seed oils. And we don't even need to get into the gut testing if we're just cleaning up the diet.

And the younger someone is, the faster we can clean them up. So it's much easier to work with a teenage girl and clean up their diet because they'll see results right away. Whereas someone in their mid thirties, it's gonna take a little longer to see results. So that girls are tend to be pretty motivated.

I wanna circle back on this because I did a solo episode about the midlife belly fat. Our gut health and how stress is processed through the gut first before the brain even registers, and then just the cascading effect it has on our gut health. to be able to be educated at an early age about the gut microbiome. And its role in skin, even the role of the liver in our appearance as well. So, I like, before we touch on the gut, I just wanna be able to talk a little bit more about, the connection How can you educate, women about taking steps to address their gut health? Lab tests are not just understanding what the role of the gut is in an overall health and wellbeing.

One of the simplest things that I like to explain to all women is that our estrogen, although we want it, we don't want it to be circulating. as soon as it comes out of our liver, we wanna grab it, metabolize it, and excrete it. So I explain the importance of going to the bathroom every single day.

Especially if someone wants to take HRT, they have to be making a bowel movement every day. and a lot of teenage girls, because they eat so much processed foods, they're not having daily bowel movements. A lot of midlife women aren't because they have sluggish thyroids, which makes that difficult. But if we don't have proper gut health, if we're not eating enough fiber to bind up the circulating estrogen and excrete it.

Then it recirculates. And that's when you get into what can be called estrogen dominant, because you're gonna have the negative effects of estrogen. So we want it to come in and we want it to go out. And in order for that to happen, we need the proper microbes, which we need to feed with. I always say, when you eat, think of feeding your microbes more than you're feeding yourself.

And each one likes a different color. I usually recommend starting the day with a berry smoothie because you can get so many phytonutrients just from that smoothie. It's generally tastes great. It's easy to have, even if you have high cortisol in the morning and don't have much of an appetite.

It's not that hard to do a smoothie for a kid who's racing out the door. They can drink it in the car on the way to school and that kind of thing. but just from berries alone, you get a ton of nutrients that are feeding different microbes every, greens feed different ones, reds blues, so you just wanna get a handful of colors throughout the day.

Greens typically don't come in until later in the day, unless you're doing like a green smoothie or green juice or something like that. Um. I want them, especially at the younger ages, to make a connection between, you know, the idea that yes, you're feeding yourself and you should enjoy what you eat, but you're really gardening the microbes in your gut.

Tell us the listeners, in case they're not familiar with the term

Phytonutrients are basically what every. Color will offer different nutrients and different microbes will be geared towards, like you hear a lot about akkermansia. this is where gut testing can really come in handy and I'd love to have it if I can, because sometimes people will ask, well, how do I know, you know, what probiotic I need in general?

Lactone, bifido or like two that are generally depleted, especially with the pill. But Akkermansia has become really popular because it also acts as a natural GLP one. It helps with glucose control. But it can also eat your mucosal lining. it can, and it does. That's its job is to eat your mucosal lining.

so Akkermansia loves, certain phytonutrients that are in reds. they like dragon fruit. I often recommend people put a little dragon fruit, powder into their smoothie. And if they're going to take Akkermansia, they can take a mucosal support.

I love mega mucosa, so that there's something for it to eat while it is going down the digestive tract. and it helps our mitochondrial function. at the end of the day, our health really comes down to our gut microbes and our mitochondrial function

in order for those things to work properly.

Colors. We need colors.

And why green towards the latter part of the day.

just as people tend to, their taste buds tend to not want greens at the beginning. I mean, if it's, if it's an apple or a cucumber or something like that, it's a little bit more palatable. I make a green juice that I really like and I'll often have that for breakfast, with collagen in it. but I put pineapple in it.

So it's sweeter, but it's mostly the core because there's a lot of brolin in it, so it gets your digestion going right away. It's also has a lot of ginger in it. And then I just put three good fist bowls of mixed greens in there. a whole cucumber, and I blend it and it, it's about two days worth, but it's like two huge salads

Oh wow.

and.

So it gets your digestion going. So if anyone has an issue with that, it helps. I mean, obviously coffee can kind of do that as well. but we wanna make sure that if you can, first thing in the morning to have a bowel movement for proper hormones.

Aha. Fantastic. Tell us a little bit about stress and the nervous dysregulation interact. When we go back to what we were talking about earlier, with being the on the pill and the. Imbalances as related to her hormones because of the pill.

Well, our vagus nerve is the communication highway between our gut and brain.

Mm-hmm.

You know, usually if you have someone dealing with depression and anxiety, there's going to be a gut connection. There's gonna be, lower diversity and that communication with the vagus nerve. Is often very disrupted. And when we talk about having the pill in there.

So what the pill essentially does is cuts off the communication between our brain and our ovaries. So we're no longer signaling FS, H and LH to stimulate ovulation because we cut off ovulation. So the pill overrides all of that. So our brain and our gut and our ovaries, and you know, the HPA access with our adrenals, everything is really being disrupted.

So that's why, one of the reasons why, in addition to the fact that it depletes our B vitamins, a lot of women will notice that they went from taking oral contraception to getting on an antidepressant. it's not only the lack of B vitamins and selenium and magnesium and zinc. it depletes us of a tremendous amount of minerals, but it also lowers the diversity, makes us less resilient.

and I don't know if there's any research on it, but I, I believe that it affects the communication with the vagus nerve.

Hundred percent. I have to, I can't argue with that because of the fact that I had just done the A podcast. And I even said that super high way, that communication network is the nerve called the vagus nerve and never heard it in the context of the, well, the pill is supposed to suppress ovulation. Of course it's gonna cut off that communication 

Just that concept alone of cutting off that natural innate communication highway from brain to gut, gut to brain. Because we are giving the body a synthetic merely to, alter the experience of a period, which I say is a woman's rite of passage to go through good periods and bad periods.

'cause this is how we start to understand and learn our bodies.

Exactly. It's a sign. I mean, it's a sign that we get each month. It's a report card of how

Yeah.

your body is functioning. Is it on time? And no big deal every month. Well then, yay, you got an a. And did it all of a sudden change? I mean, that's the quickest indicator that we have that, okay, what do we need to address?

What shifted, especially when we're talking about perimenopause. Let's say you had your period was always 28 days. Now it's 25. That's a good indicator that you're stepping into perimenopause. maybe the earlier phase. but how would you know that if you were on the pill, you, you wouldn't, 

So it's a great indicator that I think we're very blessed to have, and I feel like it would be a good idea for moms to try to frame that with their little girls. I know I've heard a lot of moms be like, oh no, oh, well one day you'll get your period. there's a lot of negative connotation around it, and I feel it would be very helpful for moms to change the energy around that and be like, oh, that's so cool.

My youngest daughter is nine and I have three boys and a girl. She's my youngest, and a lot of her friends eat a lot of processed foods. A lot of they do like Slurpees and donuts, and she's not allowed to do that. But I don't just say, no, you can't do that. I have conversations with her, so she doesn't wanna do that.

I want her to understand, and I say, you know, listen, when you're friends, when you guys all get your periods. There's a good chance that they're gonna be missing some school, they're gonna have cramping, they're gonna have painful period. I said, but if you wanna be like, mom, I just know it's on this day and I feel fine and I'm not bloated.

The only way I know is like I'm hungrier the night before. And that's it. And it's no big deal. And that's how it's gonna be for you. it's more than just, oh no, you shouldn't eat that. It's bad for you. 'cause no one's gonna listen to that. It's why, how, where's the payoff?

There has to be some sort of reward for not doing what everyone else is doing. Like the payoff is that you're gonna feel really great and have a ton of energy. And at nine she understands that.

Yeah. It's so convenient to turn off the things that are on play. To avoid them, but what a beautiful gift that is. That we have that ability to have a monthly check-in, like the report card, as you said, to gauge if, how our system is working. That's something that the male gender does not get that same luxury.

So if we can just reframe it with this perception that this is a luxury that,

And they don't get that. there's not a lot of talk about men and I, I think women, there's a lot of talk around, oh, we're not educated on this and this horrible thing happens in midlife, but guess what, it's happening to our men too. And they are, going through a male menopause where they're losing testosterone.

And they're gaining more estrogen than they should have, and they're getting the belly and they're losing their energy. they have a huge midlife shift as well. But we're fortunate enough that we have a cycle that we can determine at what stage we're at and what we should do.

So for any women who are listening and who have been on the pill and have transitioned off of it to move into their perimenopause and the menopausal phase, procreation phase is over. We're birthing a second spring. and they're starting to, women probably are starting to connect the dots probably very for the very first time having heard some of the sage wisdom and advice that you've given. what are some of the things that they can start to do? To heal from that pill hangover.

The first thing really is getting the gut and the liver functioning the way that it wants to because it really, it does have to pass through the liver. which is why it elevates inflammatory markers, which is another reason why I really dislike it for women in perimenopause because our inflammatory markers are already going up by virtue of losing hormones.

And if you add in an oral birth control on top of that, it's going to continue to increase inflammatory markers. That's not a good idea. So we wanna clean out our liver. There's lots of great liver support supplements, NAC and milk thistle, and I love castor oil packs. they don't have to be complicated.

I actually, for midlife, I encourage women to not just put the castor ill on their liver, but also on their thyroid because our thyroids are so vulnerable and it increases to, or even on your breasts. You can, put an old t-shirt. 

You can get a cotton T-shirt, put castor oil with some frankincense, put an old t-shirt, and then put a heating pad on and, just read a book or watch a show or whatever. It's a nice way to relax before bed. it's very calming and it helps with circulation and cleaning out your liver.

It helps with, if you've got cysts or fibroids, on your breasts or ovaries, it helps with those. So that's a great thing for any age and super easy castor oil, along with supplements. and then most women need mucosal support, so. The pill, as I said, does create leaky gut, but also so does losing estrogen.

So in perimenopause and menopause, as we lose estrogen, we're losing our diversity. Um, and we're more susceptible to leaky gut. So anything that, marshmallow, aloe, licorice, um, not the marshmallows or licorice candy, but you know, the herbs. and a lot of those are in combined supplements or, 

Like, and the immunoglobulins that are in the mega mucosa, I don't have affiliations with these companies, but, the immunoglobulins that are in mega mucosa are great. So anything that's supporting, liver and gut is gonna be just super important. And really, we have so many exposures to viruses and toxins that, it's good to just, every once in a while do a nice.

30 to 60 day mucosal support protocol preventatively. it's always easy to prevent them to fix.

and you can just do that protocol, without doing any. You're fasting, you can just start supplementing.

Yeah.

it's all benign, it's not like probiotics where you really can go overboard if you're. Taking too much of the same strain. You know, a lot of women will start a probiotic and five years later they're still taking the same one. my general rule of thumb is just when the bottle's out, pick a new few other strains, maybe even from a different company, and then take that bottle when that bottle's out switch again.

So then you don't get stuck in a rut, you know, with the same probiotic.

I am so glad you said that because I have been doing that un unknowingly. I just have been doing that because I feel in my body, like I feel like I'm still getting the same results and so I'll pick up something else or order. I've tried, other leading brands that I've ordered. other, green drinks that are fortified with a probiotic to just even switching up probiotic rich foods to, things like keifer and sauerkraut and, and yogurt to going back to an entirely different brand that I hadn't seen a couple years. So I'm so glad you said that, that that is actually not only normal, but it's a wise thing to do.

It's just like, you know, you don't wanna eat the same food every day 'cause you're feeding different microbes. You just, you want some variety and yeah, any kind of fermented food, yogurt, ke or sauerkraut is great because every batch is gonna be different. So even if you eat sauerkraut all the time, every batch of sauerkrauts a little different.

So it's not, you're not gonna be feeding those same exact microbes.

Such great hacks and castor oil too. I mean super cheap. You don't need to. Buy all these expensive supplements simple, something like an old wives tale almost. Or

Right. That's been around forever. Yeah.

Yeah, like good old folklore right there.

Yeah.

who would've thought, I talked about the hacks.

You've shared lots. Tell us about the the vaginal estrogen cream into the ear.

Um, yeah, so itchy ears was, although I didn't know it at the time, was one of my first signs of perimenopause. It started when I was about 45. I was still getting a 28 day cycle ovulating regularly, really no other symptoms. And at 45, Perry wasn't even really on my radar, but I did have itchy ears, and it lasted for.

A long time, and I don't even remember where I heard it the first time, but I do know that when we lose estrogen, we get dry vagina, dry eyes, dry skin. It just, it dries us out. We lose moisture without estrogen. so I heard that this was a couple years ago to try just a little low dose vaginal estrogen on a Q-tip.

And of course, be careful and don't clunk it in there. We don't wanna claws clog our ears, we don't wanna puncture at ear drums just a little bit. And it was miraculous. so I've been using it a couple times a week ever since in my ears. No longer itch. If I go for maybe two weeks, if I forget, they'll start itching again.

I'll use it. but a lot of women are getting prescribed eczema medications and steroids and all kinds of things. Honestly, it's just we're getting, we dry out without estrogen. And even if you're taking, which I take systemic estrogen, even if you're taking systemic estrogen, you, will often need a low dose on in your vagina.

of course.

And so if you have that, just use a little in your ears too. the feedback I've gotten from thousands of women, I've never heard one woman say, it did not work for her. Everyone's like, holy cow. This is the answer to my prayers.

And so you had asked me when, before we started, what was my first sensation, and I had said, well, almost felt soothing. okay, I've just put some something soothing on a very. Area of dry, itchy skin

Yeah.

and so I'm gonna continue that. What a great hack. Let's see where that goes. You have so many other things on the go though.

We've talked about the pill hangover. We've talked about, stabilizing, the gut and liver cleansing that up after coming off the pill. Tell us a little bit more about what you've got in the works. I was poking around on your website. You're doing a lot in the strength training area as well. you're gonna be coming out with some information or I believe a book on bone health because of your story.

And also you have a number of, supplements on your website as well. So you have the floor, Elizabeth, tell us about all those irons in the fire.

my book, sexy Bones, is not out yet, I'm hoping next summer. I named it Sexy Bones just because I wanted it to grab some attention and honestly, every book about bone health I feel like has either an old lady or an old couple who are. look like they're in their nineties and the message sort of is, well, you should start thinking about your bone health when you're in your twilight years.

Right. so I wanna shift that conversation and I have noticed it has been shifting, the past couple years. For me, I was, I got a DEXA scan and. It showed I was in the range of osteopenia, which is not osteoporosis, and it's not technically a diagnosis. It's just telling you your bone density, um, is not optimized.

And usually what you'll be told is there's not much you can do about it. A lot of people are given bisphosphonates. You can only take those for a couple years and they make your bones more dense, but more fragile. Because they're not, flexible anymore.

Of course.

So as opposed to dexa, but not covered under insurance. And harder to find. I like an echo light REMS scan. It's an ultrasound and it tells you your bone quality and your actual fracture risk. So on my rems my bones actually look pretty good. My fracture risk is very low. I have healthy bones.

They're just not as dense as I would like them to be. Although in the past couple years, I've improved them tremendously by prioritizing protein and strength training. which can be tough, but we have to do it. It goes back to the pill for teenagers, you know, if we're cutting off their hormones when they're building their bones, it's a, it's a real disservice.

That's setting them up for later year issues, hip fractures and that type of thing. And I don't, I constantly hear, oh, teenagers or girls in their twenties, they don't wanna hear that. I have yet to run into one young lady who's not interested. they all listen. They're like, what? Really? Oh my gosh. Or kids, kids, I mean, whatever you define a kid as, but 16 to 20, let's say.

they really care about their health and they do actually have a vision of. Longevity and what they want their life to be like. And they are way more exposed to, information that we didn't have and more receptive to it and eager to hear it. So I really don't think there is a issue with them being in interested.

I think it's maybe more how it's being articulated.

To them in a way that is maybe more interesting or mutual, a mutual conversation rather than just trying to tell them

Yeah.

to do without an understanding of why.

Right. So in your book, upcoming book intended to come out for summer 2026, we'll have to get you back to promote that, by the way. sexy bones, do you keep that in mind? Is that part of telling the story? obviously choosing the word sexy 'cause it will garner the attention more likely. Uh, and certainly for the younger ones who we want to educate early enough.

Yeah. And, and part of it too is the idea that if your bones are good, like everything of your, your hair, your skin, your nails, your. it's all a full picture. Anything you do that benefits your bones is gonna affect your appearance and, and everything else, and your vitality.

right. Of course. two things that came to my mind. We spent a lot of time when we talked about the, the pill hangover and referencing oral contraceptives, and then you made, a mention of try to find another alternative. So would an IUD, would it render the same results or is that a safer option for the body?

It's just. It has its own set of issues because it is, well if it's a copper IUD, it's gonna deplete you of zinc. And it also

okay.

a localized inflammation. So if you're having overall inflammation, it can be tied to that. also the, then the progestin only it's progestin, so it's then blocking your own natural progesterone.

Which is going to affect not only your bones, but your mood, because progestin is more tied to anxiety, whereas progesterone is, you know, tied to more calm. so it's not without it's downsides. there's some great devices now. I like UVA a lot. You know, you pee on the stick. It tells you if you've had an LH surge, so.

Sometimes if you use some of the devices that will tell you if you're ovulating, but you might be a day too late. So you, you really wanna know when that LH surge is happening because that's when you wanna start being careful. If you've already ovulated, you might already be in trouble. and talking to women about

how their cycles work. Most women in their forties and fifties really still don't understand how their cycles work. the understanding of you're only fertile for those days right before ovulation, during ovulation. So it's a short window to take a drug every single day of the month when you can just figure out when those days are and be extra cautious

Yeah.

the day.

So condoms and.

Yeah. Yeah, and it's, I, I feel it's a shared responsibility in a, in a mutual relationship whereby they're both consenting adults,

Yes.

late teens, engaging in sexual activity. It's a shared responsibility and it just seems that the healthcare system, society wants to place all the burden, all the responsibility on the female and the male. Just as responsible, to contributing to an unwanted pregnancy. So why doesn't he pick up the slack for those few days of

yeah. And I get that it's a symbol of female sort of freedom and liberation but to me it's kind of outdated. it's an option for those who want it, but it seems archaic at this time, at this point when we have tools that can

No.

us that this is our fertile time.

True.

don't know. I just feel like it's, it's outlived it's purpose. I think it's gonna take a little while to, to catch on, but. It does just seem outdated to me.

Just give us a.

It's just depriving us of so many benefits and happiness and especially at a time when anxiety is just so off the charts. It's just one more thing adding to that.

true. We have so many tools to do many great things in this digital era that we live in. Why not a tool that's gonna give us the information so that we're empowered

Yeah.

critical times where we can make, uh, wise decisions good. Great point. Give us just a quick summary though, when you speak of lh, FSH and lh.

for so listeners who don't understand how those, two hormones work in the, whole cycle of a woman, 

So FSH, if you wanted to test it would be the first three days of your cycle. and as estradiol declines, FSH goes up. So it's one of the more consistent markers. If someone wants to know what stage of perimenopause they're in, the higher FSH is. The, and consistently, 'cause our hormones do change month to month.

And so you'll often hear, oh, it's the zone of chaos. Don't even bother testing. But it's really about patterns. So if you've tested FSH, let's say, every six months for two years, and every single time it's climbed well, you know that. You're further into peri and it's an indication of if you are looking to do HRT, it might be time.

your LH is your luteinizing hormone. So our luteal phase is the second phase of our cycle. It's, when we ovulate. So lh, is what is going to stimulate your ovaries to release that, follicle and which is going to cause you to ovulate. And have progesterone for the second part of the month.

So if you're trying not to get pregnant and you see that your LH has risen, then that's when you wanna be more careful because you know the ovulation is right around the corner.

Ah, yes. Very, very good information just to put that out there. And I do wanna touch on the DEXA scan, how that information can help set women up to understand their fracture risk. Of course, with osteopenia and osteoporosis, I will say, one of the women that I've been coaching, uh, remain Unidentified 'cause I don't have her consent to say her name, she is in her mid sixties and did a DEXA scan after several weeks of doing strength training and incorporating more heavy lifting with me, and the results came back that it showed that she had improved her bone mineral density. The doctor said, what are you doing because this is fantastic information here. And she said, strength training. And I've upped my protein to support my increased bone mass as I build muscle. You spoke about that too. I wanted to touch on that, how important that is, but also for women to advocate if she wants to have a DEXA scan to have. request those because it's, some women are outright told you don't need one until you're into your late sixties or seventies. But that risk, as we know can happen at any phase in your life. Your story, case in point,

Yeah, of course everything comes back to insurance. So they say you don't need it until then, 'cause that's when insurance covers it.

ah.

but if you want insurance to cover it when you're, let's say 39 years old, which I think would be a great time to get it, you wanna be measuring your bone density during perimenopause, so maybe every two years.

And when it changes, you'll know that you are really losing. Hormones. so it's a good indicator for if it's time, if you choose to take HRT or not if it's time. but if you're, let's say you're 39, you know it's not gonna be covered under insurance till you're 65. You can pay out of pocket little less than $200.

Or you can say, you know, I'm concerned about my bone density because I'm entering in. Perimenopause and my mom has osteoporosis, or my mom had a hip fracture when she was young. I'm a little achy and things just seem off, there, there's ways you can word it, say whatever to, to let them know there's a family history.

Then usually it doesn't take much and they can take a look at it. There's a lot of places popping up though. body composition places where you can go for usually less than 200. You can get a dexa, you can get your body composition, your fat and muscle, and they can also measure your VO two max.

So, you wear a mask and you go on a treadmill and it says how well you're utilizing oxygen. Um, so it gives you a sense of your metabolic health and you can measure that, and watch it increase as you're increasing your, you know, weight training and all of that. So you can go and get markers for all of this stuff without insurance, but it's obviously helpful to have it paid for and there are things you can say to get it paid for.

I'm glad you mentioned that. Family history. And that is one of the things that I help when I coach women as a menopause doula, is that when you go in to have that difficult conversation or maybe helpful it's, the purpose is the goal is shared decision making with your healthcare team.

But go in there armed, like a lawyer, goes in, uh, to the courtroom with all of their evidence, your medical history, your family medical history, and then a list of questions. things that you would like to have answers to or perhaps request tests on. I think that's a really important piece of that, of that puzzle to go forth and advocate, take agency.

And you know, you're entering a different phase of your life, and so the doctor that you've had since giving birth to your kids may not still fit, or maybe they still fit for certain things, but you need to add to your team. So there's no. Saying that you have to stick with any one particular physician, or you can't have multiple physicians.

So if something's feeling off and you're not being listened to, I'm always shocked with how long a woman is willing to stay with the same practitioner even though they're not getting what they want. Because at this point there are so many great practitioners out there who are willing to work with you and to have a more functional mindset and to have different training than perhaps yours did.

And maybe you never realized that. 'cause you didn't. Have those needs at the time, and now that your needs have changed, maybe it's time to make a change. There's nothing wrong with that. There's no hurt feelings. It's a professional relationship and we hire them, and I think a lot of women come to the physician relationship as if we work for them, and I'm not sure why.

It's like they come in wanting to apologize and not wanting to be too difficult and not having too many demands or issues, and no, actually we hired them. They work for us, not the other way around. So of course you still be polite and be a nice person, but if you're not getting what you want, hire someone else.

absolutely. I loved how you framed that. somebody a girl would want in her corner

Oh, thank you.

educated and advocating and you offer so much, your website is incredible, strong choices. Just tell the listeners where they can find you, what your offerings are currently, and a little bit, about what's up next for you.

find me@strongchoices.com or on Instagram at Strong Choices one. and on my website, I do have some supplements that I just constantly. Recommending So came up with them for myself, it was just easier. I love my collagen because it has for to bone and for to gel and variel. All of those are have clinical research for your bones, hair, and your skin and joints.

and I do one-on-one coaching and liver cleanses. So anything that a woman might need.

Elizabeth, I'll get all those links in the show notes. I am so delighted to have you on the show and share so much wisdom that you've accumulated in your years since switching over to become a, I'll keep it short and sweet. What do you call it? The terminology is FDN. We lucky for it. so listeners go check out that website.

It's in the show notes. Thank you, Elizabeth, joining me here today. Let's get you back when that book hits the shelves and pump it up to a New York Times bestseller. 

Listeners, my hope is that you will walk away from this episode with some truly surprising insights, many of which the medical community often overlooks or isn't well versed in. Namely, the effects on a woman's body from long-term use of birth control, including hormone dysregulation.

Gut health, skin complications and bone mineral density loss issues that are rarely discussed when prescribing contraceptives. This one size fits all approach to hormonal contraception for youth and young women is setting females up for challenges. Decades down the road. But the good news is you can turn it around if by first you properly support the gut and the liver before coming off birth control altogether.

And that could be the case when you are beginning HRT or MHT as we see here in Canada. Elizabeth shared with us the importance of having diversity In our gut microbes, which is accomplished by eating a full spectrum of colorful foods, and even the timing of our daily intake of certain phytonutrients can influence hormone balance and long-term health in ways most doctors never discuss.

Here's why a diverse diet low in processed and sugary foods can help properly balance the guts Mucosal lining and reduce risk of leaky guts. Interesting fact, a 2019 study on the GI tract revealed that women's gut microbiome diversity plateaus by age 40.

Certain gut microbes, including the one we discussed. Akkermansia, which has garnered a lot of hype in recent years, can act as a natural GLP one stimulator. That's Glucagon like peptide one, a peptide released from the small intestines, which acts like a chemical messenger to tell the brain you are full.

And this helps with glucose control and metabolic health. So again, eat a diet that nourishes these microbes, prebiotics, probiotics, and fiber. But an over proliferation can result in too much mucus consumption. So balance is key. And working with an FDN like Elizabeth can help. Did you know that a daily bowel movement is one of the simplest and most effective ways to help flush out excess estrogen from your body?

And Elizabeth shared with us that once estrogen is processed by the liver, it needs to be excreted efficiently, otherwise it can recirculate and contribute to estrogen dominance. So ensuring that you have a daily bowel movement, especially by eating enough fiber and feeding your gut microbes helps bind and eliminate estrogen supporting hormone balance, and overall wellbeing.

Another key takeaway. Worth paying attention to bone health and isn't just a concern for our later years. It should be prioritized much earlier. Smart choices in our younger years nutrition exercise. And yes, use of contraceptives can shape not just our bones, but your skin, hair, and overall vitality for years to come.

So moms out there, share this with your daughters. Huge takeaway in this conversation. Estrogen dominance and progesterone intolerance, they are complex and often misunderstood issues that can arise after long-term use of hormonal birth control. Estrogen dominance occurs when the body has too much circulating estrogen relative to progesterone.

Which can lead to symptoms like mood swings, weight gain, and menstrual irregularities. Progesterone intolerance, on the other hand, can develop because synthetic hormones from birth control may alter hormone receptors over time, making it difficult for some women to tolerate bioidentical progesterone later in life.

Elizabeth emphasizes that these conditions are not always recognized or properly addressed in conventional medicine, and that supporting gut and liver health as well as carefully managing hormone transitions can help women restore balance and reduce symptoms. These are just a few of the unconventional eye-opening takeaways I got from this episode that you're not likely gonna take away from a doctor's visit.

Insights that go beyond medical wisdom and can empower women to take agency of their health. And this brings me to my last point, advocate for your health. This means bringing evidence to the forefront. Begin your research by tracking your symptoms and cycles. This is a must, and I coach my clients to do this.

Even if they've stopped cycling, remember as Elizabeth states, having a Menzies is in a sense a monthly report card, but even without one in your postmenopausal years, your body still follows ebbs and flows and patterns. Get familiar with those patterns.

Second arm yourself with your family medical history. They can also serve as little clues, more so I find it teaches us what to do and what not to do to set ourselves up for success health-wise, based on what our lineage gained or did not gain from their lifestyle choices. You could find Elizabeth at her website, strong choices.com, 

And she can also be found on Instagram at Strong Choices one. Her book, sexy Bones is scheduled for release in summer 2026, so keep an eye out for that. Okay, that's a wrap for me. If you found this episode valuable, share it with a friend, a family member or a colleague, and I'll also add that if the conversation on GLP one, albeit brief sparks interest and strikes a chord, you are not alone or shouldn't be ashamed.

There is so much confusion and controversy around medications that act as GLP ones or GIP receptors, so much so that the Girls Gone Strong Coaching Program. From which I received my coaching certification, created a course GLP one and Menopause to debunk misunderstandings and bring more positive conversation to this topic so that coaches like myself can be compassionate and curious listeners while also using critical thinking to help our clients 

Who may be interested in on or trying to get off these medications.

And for me, this is just another area where I can bring common sense and evidence backed information to the forefront. As a menopause doula educator and woman strength coach, let's keep disrupting the status quo, challenging, outdated narratives, and shining the light on the truth about women's hormonal health.