Ep. 115 - Thyroid Imbalances? Bad PMS? Poor Sleep? Holistic Strategies to Improve Hormone Health Throughout Motherhood (Especially in Your 30s, 40s and Postpartum) with Dr. Aviva Romm

 
 

I have been following Dr. Aviva Romm's work and consuming everything she puts out into the world for the last couple years including participating twice in her 28-Day Women’s Gut Reset as she is the go-to top expert in women’s health and especially hormonal health.

Dr. Aviva is a world renown midwife and herbalist who is also a Yale trained MD and Board Certified Family Physician with specialties in Integrative Gynecology, Obstetrics and Pediatrics.

Her New York Times bestselling Hormone Intelligence explores the impact of the world we live in on women’s hormones and health, invites women into a whole new conversation about our hormones, bodies and health, and brings us a new medicine for women that is at once holistic and natural, while being grounded in the best science and medicine have to offer. 

She’s also the mother of 4, and grandma of 2.

Follow Dr. Aviva at


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Ep. 115 - Aviva Romm Transcript

[00:00:00] Stephanie: Welcome to mommy's on a call your sacred space to laugh, learn, and feel like a real grownup human for a hot minute. I'm Stephanie Chima Carney, a mom of three under six serial entrepreneur business strategists and donut connoisseur. Just trying to get through the day one cold cup of coffee at a time. I believe that with more intention, a positive mindset and self care, it is possible to thrive in motherhood, business, and life.

My mission is to uncover the daily rituals, life lessons, real life tactics, and favorite tools to inspire and empower you mommy, to get the most out of life every single unpredictable day. So grab your headphones, tell your kids you're on the potty and tune in weekly for some laughs knowledge bombs, and plenty of real talk with real moms and maybe a dad or two.

Welcome to the mommy pod.

Welcome back to mommy's on a call. I can't tell you how excited I am for today's guest. Dr. Aviva Romm. I've been following her work and consuming pretty much everything. She puts out into the world for at least the last couple of years, including participating twice in her 28 day.

Women's got reset as she's the go-to expert in women's health and especially hormonal health. Dr. Aviva is a world. Midwife and herbalist. Who's also a Yale trained MD and board certified family physician with specialties in integrative, gynecology, obstetrics, and pediatrics, her New York times bestselling hormone intelligence book explores the impact of the world.

We live in on women's hormones and health invites women into a whole new conversation about our hormones, bodies, and health, and brings us a new medicine for women that is at once holistic and natural. Well being grounded in the best science and medicine has to offer. She's also the mom of four and a grandma of two.

Welcome.

[00:01:51] Dr. Aviva: Oh my gosh. Thank you for having me on the show. When people read my bio though, I'm like, oh my gosh, that woman needs to take a break.

[00:01:56] Stephanie: She's I was going to say that's a pretty extensive resume and I do have some questions about that. But before we get started, I wanted to ask what's your biggest mom win or grandma win, whatever you want to say of the week.

[00:02:08] Dr. Aviva: Oh, of the week. Oh gosh, that's a big one. Okay. So my. Oldest daughter. Who's my second child that recently, mom, your powers of transformation are so incredible. And she was talking about just changes in my value system, not my values, but like how I approach the world and how I communicate. And like just shifts from.

Whenever to now. And it was really beautiful the way she said it was a real acknowledgement of like mom. You're a person and you're really cool. Wow.

[00:02:41] Stephanie: Oh, and give the audience a little bit of context. How old, or you don't have to say the age or your children, but like what range are your children and grandchildren?

[00:02:50] Dr. Aviva: 36 down to 28 for my kids. I have a boy and three girls and then 10 and seven, my grandkids to God babies too. I have three God babies actually.

[00:03:02] Stephanie: And by the way, you don't look a day over forties. When I heard that, I was like,

[00:03:09] Dr. Aviva: I love hearing your secrets in my late thirties. I got carded. When I was with my kid.

Once in my twenties, I went to a liquor store. Alcohol for making tinctures. And I got carded. I'm like, this is my child. And they're like, well, you could be babysitting. And it was like two braids. And then in med medical training, cause I already had kids when I was in medical school, I get asked out by residents and stuff and I was like, oh look, I have a kid who's 20.

And they're like, you mean 20 months? Right? No 20. And they'd be like, shut. Uh, no, I like hearing you look yet.

[00:03:46] Stephanie: So you had four kids in med school and then I read it or heard somewhere that you actually started college when you were 15.

[00:03:53] Dr. Aviva: I did. I grew up in a housing project in New York city and I was a really science and word precocious kid, and my ticket out of being in a housing project and also a two hours.

Each way, almost commute from home, the high school in the city, I applied to college and long story short, I applied to Johns Hopkins and asked them if they would just take me right into the medical school. I was 14 at the time when I applied Doogie Howser right before Doogie existed. And I actually got an, I got a letter back.

I mean, this was like when you had to put a letter in an envelope, lick the envelope, put a stamp on it and send it. Actually from Hopkins wrote me back and said, well, we can't do that. You're too young. And you have to go to college first, but there's this school called Simon's rock, which is part of Bard college that takes young.

They called it gifted, but you know, academically capable or artistically capable kids. And I got a scholarship and I went, so yeah, I went to college and I was 15. And then, um, when I was 16, I actually left because I found this whole. Going to do premeds. And then I found this whole thing that I loved, which was midwifery and herbal medicine and this natural lifestyle.

And this was back in 1981. So my family wasn't a thing. My family, actually, my grandmother, my mother thought I had joined a cult cause I went vegetarian. I'm like, no, I didn't join a call. I'm like, this is what I want to do. And then circling back around when I was 30. 30, uh, 39 when I went to medical school.

Why? And so I had to go back cause I had gone to high school only till I was 15. Then I did that year of college and then left and then had to go back and do a G D X everything.

[00:05:38] Stephanie: And you go back to med school. I mean, you've, you went down this route, you had, you know, actually gone down into midwifery and all of that.

What made you go back to. School. And at the time you said you had four children. I mean, the women out there in like, you know, 20, 22, who might even have one kid that thought of med school seems like the craziest idea.

[00:05:59] Dr. Aviva: This is a conversation where we can into definitely have a sentence and I wouldn't recommend it for everyone.

[00:06:05] Stephanie: And. And yell my, it was like, you didn't just pick like, you know,

[00:06:11] Dr. Aviva: explanation to that too. But yeah. So why I went back, why I went is at the time I was living in Atlanta, I had spent a lot, but not all of my midwifery career in Atlanta and midwifery home birth midwifery was still illegal. Midwives could get arrested and go to jail, home birth families.

There was a home birth family that actually did family bed, which now it's like just, you know, the hip Brooklyn or whatever thing, you know, LA whatever California's named India. I did it in Atlanta, but there was a family that was actually reported by their neighbors for child abuse, because they did a family bad, which was considered inappropriate.

So we're talking about a day also when. Antibiotics were being prescribed for every symptom that your child had. And literally you could go to the pediatrician and your kid can have a low, cold, and an ear infection. The pediatrician would recommend prescribing an antibiotic and you would question it.

And the pediatrician said, well, do you want your child to go deaf or die? And this was really common. And this was before the term antibiotic resistance became a. And until COVID antibiotic resistance was actually the single largest global public health issue. We were all facing. So for me, the other thing was if you were in a state where midwifery wasn't legal, uh, and even if you were in a state where home birth midwives were legal, if you had to transfer to the hospital, the Homebrew.

And sort of more air quotes here. Natural birth movement was so polarized by the medical model that if you went into the hospital, you were treated even worse. Often if you were coming with a transport, cause you were just treated as irresponsible, negligent. People had social services called on them for that.

So I wanted to be a bridge to those people who were looking for something. But may need to enter the medical model and have a safe landing there. And I also realized I couldn't fully change the medical model to the extent that I wanted to systemically and culturally, without speaking that language, but also being recognized as.

Part of the tribe, if you will. And part of the brotherhood, what was it? One of the, one of my women, friends who was a physician, when I went to medical school, she said she gave me a big hug and she said, welcome to the fraternity. And it really, even with more women in medicine now, half and primary care specialties, it's still very much like that.

And so many places. So for me, it was just about making change. Yeah. Another factor is that I am the first woman in my family to go to college, to have a profession like that. But I want us to give that legacy to my kids.

[00:09:03] Stephanie: Now, I was going to say, how was your oldest and youngest when you went to medical school and how was the process getting in even like making that mental shift?

Like what, yeah. Family structure looked like at the time. Cause I would assume you would need a lot of support.

[00:09:18] Dr. Aviva: Yeah. So one, I was homeschooling my kids and my oldest, my son was 17 and funny side story is that he was in college. He had been homeschooled until 17 and then went to college and I was in my prereq.

Post-bac for medical school. So we decided to do a year of physics together in the same class. I bumped over to his school for that one class and it was hilarious and amazing. We had so much fun and it was just a joy to share. But by the time I went to medical school, my oldest was in college and my youngest was around nine and it was really, really hard.

We moved to another state where we didn't have family or. And my, my husband, my prime we've been together for 38 years now. He was the support person. So he had segwayed his career to work with me from home. And he became the primary home parents. Like I remember coming from medical classes one day and one of the girls.

Didn't know, I had walked in the door and had called out dad, when you go shopping, can you get some tampons? And I was like, oh my God. But you know, it was hard on so many levels. One the process of getting ready to go for me on an individual personal level. As a woman, human with an intellect and goals and dreams was phenomenal.

I mean, I was learning everything that I wanted that was putting all the pieces together for me about midwifery and herbal medicine and health and medical school was the most incredible four year experience of my life. I mean, in terms of any education. As a mom, I had constant guilt. First of all, my mom was a single mom and she worked two jobs.

So I already like had to unpack issues around going from being a homeschooling mom and like over-parenting to now making this huge shift, but I kept not justifying it, but like reassuring myself that there was value in it that I was also doing something really important for my family, which was creating this new sense of possibility of what you could do. Uh,

[00:11:32] Stephanie: showing your daughters that exactly like it doesn't matter what age, it doesn't matter where you are in your life. If you're passionate about something, you should go for it.

[00:11:39] Dr. Aviva: Exactly. And it's interesting because when my husband was in graduate school, he went to a school called Atlanta university, which is a historically black college.

And there were several women who actually were living in Atlanta. In school, getting their graduate education from a few different countries in Africa. And there was this one woman Josephine Malott Schwab who, if she hears this, she's probably going to be, I cannot believe she remembers my name, but she was from Swazi land and she had three or four or five kids.

And she actually moved to the U S for two years to do her doctorate in education and left her kids back in school. With her sister to raise them. And then I heard another story of a first nations woman. I think she was Lakota, but she had four kids and she had to there's no medical school in South Dakota.

She had to travel to states. So she was living all week at medical school, then coming home on the weekends. And then when she was in residency, she was.

[00:12:40] Stephanie: Right. How do you do what residency with that?

[00:12:43] Dr. Aviva: Yeah. And the thing is what I have come to understand is that how we communicate this to our children is very culturally unique.

And so for me, particularly as a white hippie attachment parent home birth mom, I had a huge amount of guilt. And a huge amount of also judgment from people who were in my close community, who were from that background compared to one of my best friends who happens to be an African-American mom and a midwife whose mom was a primary income provider.

And she at the time was a primary income provider who was like Aviva mom, you know, black women around the world. And I'm not like trying to romanticize. She said, it's just like, you're coming from a cultural perspective where you have an idea of how it should be. But in my community, it's a lot of the moms that are working and we teach our kids to respect that.

And so it was just really interesting. Like I hope I'm not crossing any lines of what is appropriate. This is just what, the stories that I was shared with that. Was my frame of reference comparing like what my own inner guilt was about attachment parenting to the cultural insights I was getting from women from different cultures that were very different.

So it was hard. And then I would say also because my kids were S had been sort of trained by me to expect mom to be there full time. The, that gap was really hard. So they did. They've had a lot. We've had a lot of work in the subsequent 15, 18 years to unpack some of the resentments and the experience that they had.

So we know when women say write me and they all go to medical school, I'm like, we should talk, you know, just so you know what you're really getting into. You may have a rotation that puts you on call on your child's birthday and you just can't go to your child's birthday. And so, and you know, healthcare workers know that, you know, nurses okay.

After

[00:14:44] Stephanie: the last two years, I think families have definitely felt that any advice you would give to those women, looking back to go back to school for anything, whether it's med school or, you know, with children, you know, any advice you would give.

[00:14:57] Dr. Aviva: I think it's really important to follow your dream and follow your passion.

And there's never a better time. I think that as moms, when we are truly tending to our own personal intellectual, spiritual, emotional growth, and doing the thing. Make us sing and fly and happy. That is a powerful gift to give our kids and to do it without guilt, to create great support networks, be mindful of, you know, the support that you do have.

Think about how you're going to create seamless transitions, to the extent that you can for your kids. Like we went from homeschooling to still homeschooling to kids, going to school. In retrospect, I would have foreseen that transitional. Better and matriculated my kids in school a couple of years, even before.

So they were accustomed to that, or maybe even moved before to where I was going to go to medical school. So we already had a support network, but I really think there's no one right time. You know, when my kids were little, little, I waited because I wanted to be there when they were little, little, but when they were tweens and teens.

Especially with the girls. That's when they were mad that I wasn't there. And if you, anyone who's listening who has teens and tweens, they know that they don't want you there most of the time, but when they do want you there, they do. And if you're not, then you're going to really hear about it. So looking at.

What you can create as a network, how you can communicate what you're doing to your kids, to them, explain to them why you're doing it and invite them in whenever you can,

[00:16:36] Stephanie: to hindsight, do you think it made you a better.

[00:16:39] Dr. Aviva: Um, in hindsight, I don't think it made me a better mom. No, I think I was already a good mom.

And now I'm just a good mom with a different perspective and a lot more skills and experience. I think it just made me a more fulfilled person. I loved, I love. I I'm one of those people. I just loved when my kids were little, I loved all their stages, but there was something inside me that felt like there was more than I needed to do.

And so I hope in the long run, you know, my son, for example, he ended up going on to create a healthcare system, an actual healthcare system that now. Over a hundred thousand people in underserved communities in multiple states. And when he looks back, he says he was inspired by the early things he saw with me as a home birth midwife and lack of access, especially in certain communities, but then also the power of someone making major choices that can make major change.

So I hope that they're able to. See it that way, but you just, you never know. Yeah.

[00:17:48] Stephanie: Well, that's incredible. And then you moved on, so you, you did your residency, you became like an MD. What made you then kind of like go back or like when you saw all the world of the MD where you like, okay. I stick to this or were you like, wow, like this world is not messed up, but like a lot needs to change.

Like, no,

[00:18:08] Dr. Aviva: my views, my views on going into medicine, my views going into medicine and my views on the other side, haven't shifted really about the healthcare system at all. I would say that I have more compassion for. The forces that shape physicians to become the kind of practitioners that are, that most people go into medical school, really altruistic and wanting to help people and the system.

It beats the heck out of people. It really does. And my best friend whose kids are my godkids, she's been my best friend for like, you know, week one of medical school. So it's, I was 18 years now. I mean, we still talk about some of the things that we realize were traumatized by that, like the everyday life, someone writes you a note and says, we need to talk and you're assuming something horrible happened.

And you're about to be reprimanded even though neither one of us was reprimanded in medical school for things. The culture of it.

[00:19:06] Stephanie: So I have a lot of Grey's anatomy watching the interns. They're

[00:19:09] Dr. Aviva: like, really? There's some it's just, yeah. And then some of the things that I've actually seen happen in terms of like the endemic racism, sexism to patients, is more shocking than I could have ever, ever imagined.

On the other hand, I'm really grateful for what I know and. There's been one major shift since I went to medical. Well, two major shifts, one major shift is I think a lot of physicians themselves have gotten so burned out on the system, but on also their own experiences where they had a medical problem and ended up changing their diet or starting meditation.

So there is a slow trickle, I wouldn't say a sea change, but there's definitely. A change happening in medicine that is, has allowed it to be more expansive. And then the other thing is that when I went to medical school, the wellness movement didn't exist. When I went to medical school, the things I was doing were very fringe and very weird.

And so now you've got this whole wellness model that is sometimes offering phenomenal information, but sometimes it's really off base. Dangerous, even things that I, as an herbalist midwife thought back then weren't really appropriate therapies. Now, anyone with an Instagram feed and a large enough reach can seem like an expert.

And so I sometimes strangely find myself not quite in either world, like in the medical world, I'm a bit of an oddity, but in the wellness world, I can also be a bit of an oddity and that I'm a little more. I'm a little more of a critical thinker. So I don't just assume that everything that you hear is really true or works.

And I think we saw that with COVID right. And when we saw it with COVID how dangerous it was that some people were promoting therapies, including people in office at times that were promoting therapies that were actually. Really dangerous and not helpful.

[00:21:16] Stephanie: And interesting. I was reading kind of an article about that in which they were saying like all of the, you would call it the more holistic stuff.

They ended up classifying them as a certain, almost even political view, which is interesting just because they didn't believe in say like vaccines or they believe they're an alternative like treatments, but in a sense, then there's some holistic people saying like, no, we believe in vaccines. But there's other things we can do.

It's not black and white. And it's so interesting to see that. And I feel like everything you're saying is resonating. I come from a background of RMS and doctors who all based and some of my best friends are, ER, doctors, you know, pediatricians who are all literally burnt out right now. Like they're so burnt out and it's by the system.

They just want to help people. And the system is burning them out. But it's interesting because I'm 39 turning 40 this year and I just signed up. Do nutritious school or, you know, integrative nutrition, even though nothing to do with my background came from a male dominated finance world. And I just see it and it's like, it's ingrained in me.

And so I'm asking you these things as like personal advice, I'm like, okay. So I want to know how was going back to school with kids.

[00:22:28] Dr. Aviva: Can't go to a birthday. I, you know, I just loved it. I felt for me, it just fed my curiosity. It was incredibly wonderful. And I do think I bring that, but I had that before. I mean, I wrote books before I went to medical school.

I was always reading. And so it's kind of just who I am and it was just sort of the next continuity, but I think being fulfilled as a mom is really important. You know, one of the things that I've really been exploring lately, As a mom of grown children is. And I think this is partly from my own background.

In so many ways, I had a close knit family. My mom's parents were very involved in my life. We had a lot of extended cousins on my mom's side, so I was very, very supported. But then I also had, you know, the economic instability and the social instability of living in housing project, having a single mom in the late sixties, early seventies, which was.

Weird back then and a mom who worked two jobs. So I was a latchkey kid from the time I was eight. And so I really wanted to do something very different with my kids. And I think that for me right now, I think that as a mom who especially leaned into like extended breastfeeding and home birth and family, And all the things I took so much responsibility on myself for my kids' outcomes.

So if one of my kids got sick in my mind, oh, maybe I w like not feeding them the right healthy diet or, you know, like all those kinds of very, and upon

[00:24:02] Stephanie: yourself, like it was your job to fix it. And or it was your. Or your responsibility if they hello,

[00:24:08] Dr. Aviva: Dr. Freud, how did you get into my head? Because I'm a feminist on every other level, but as a mom, I wasn't a helicopter mom, but I was a very much like an over-parenting mom.

And so now that my kids are grown and they all have their like wonderful lives and their own creative selves and the things they do, they have, they're very, you know, beautiful and loving views of me. And they have their critical views of me. And I still find, but I take too personally, like I've over, I've put too much weight in my identity as a mom compared to the right.

I have to put weight on my identity. A doctor or a writer. So like last year my book came out, hormone intelligence and we were on seven bestseller lists, like number three on the New York times bestseller list. And I created the entire campaign. We didn't pay. Do you know, at high ad spend, we didn't do affiliates.

It was all. In my community and extended community of people who bought like online community, but then one of my kids was going through a really hard time. It was really resentful about to me about it. And it was like the New York times bestseller was on a zero of scale of importance. And my kid's issue with me was on a scale of one to 10 on like on a 10 of how I took it personally.

And so I think for me, one piece of advice that I really love to share with mamas at any stage. And for you, as you go back, there may be moments where your kid says you're never playing with me. Or, you know, like you're, you're reading all the time or, you know, we're having the same thing for dinner three nights, whatever it is not to, I'm sure your kids don't sound like that either.

But to know that you have the right to do that and that our kids are their own. Individuals as well. Like not everything we do is going to shape their outcome. You can't, there's no recipe for the perfect kid outcome and we just do our best. And in that also your kids are eventually going to grow up and leave home and they want you to have your own adult life, right?

They want to look at you as a fulfilled adult woman. And if your entire fulfillment is based on. Their happiness, their outcomes, how much they're in touch with you? How much they visit you, whatever. It puts it too much demand and it's an unhealthy way to go about that parent child relationship.

[00:26:38] Stephanie: Also, once they're gone, you only have yourself.

So it's like, you know, you can't place your happiness in other people. You said something interesting. You kept saying identity my identity in this. I like to call it as a role, not an identity because your identity, you are an author, you are a mom, you're all of those things, but it's the role that you're playing in that moment.

And I think for me, that has helped me separate in the guilt part. Like my identity. I am a mom, but I'm not always a mom. I'm not a mom.

And so I love like, I love though how you said identity day. Cause I was like, wait, no, it's actually just a role you're playing, like in the bigger thing.

But so on that note, I wanted to switch gears and talk a little bit about, you know, your hormone stuff, because how did you get like, so you went down this path, you know, I know like hormones are involved in, in birth and all of that, but like, how did you specifically transition after your MD and really going into everything about women's health and, you know, you were describing, going to med school in the time were antibiotics and all that.

And I look at my history I'm I'm literally that child and the child born in 1982. I had any time I had a sniffle, I had an ear infection. I had something I had so much amoxicillin in my lifetime. I'm literally immuned. I cannot take it. I had to go cold Turkey. I have to tough it out. Anytime I have a sinus infection.

Which then led to when I was 16, not getting my period yet. What did they do? They prescribed me birth control. Got birth control in order to get a period had that. Cause I was a dancer. I was a cheerleader. You know, your body just naturally doesn't get it flash forward to when I'm going to get pregnant. I was misdiagnosed with PCOS because I had irregular periods because once you get off birth control, Your body has no idea what to do.

And so I feel like I'm the poster child for like everything done wrong in the eighties and nineties for like horrible.

[00:28:36] Dr. Aviva: You have answered your own questions to me. Why did I go down that road? You are exactly why and the zillion other women who have shared similar stories.

So I was before med school, obviously as a midwife, I took care of women and then also often I would do some just kind of general. Light pediatric support as an herbalist. So, you know, the mom who didn't want to just do the ear infection, route conventionally, you know, I'd worked with a pediatrician and we would do some natural approaches, the garlic Mullen, eardrops, and recognition on all of that.

And when I went to medical school, of course, I learned all the body parts, male and female. In fact, it was hilarious. We had the way you do a lot of your physical exam training. In the simulated patient settings. And so we all had to learn how to do a prostate exam. And so there were five of us and one patient, and this is how it works.

Somebody signs up, they get paid to do it, and we all have our gloves on and it was like a comedy routine. Cause I was sitting at the end of the row of five. Oh, the, the preceptor the doctor said, so who's gonna, who's going first. And all four heads turned to me. It was like synchronized swimming or something.

And I was like, dudes, I do like this, but they had me go first anyway, but it was just so funny when I got out of medical training. And worked in a practice for two years. I did do women's health and men's health. And I just felt like for me, I like the women's stuff better. I didn't find that there were like the psychosexual power dynamics that sometimes come in with maybe.

And women, even when you're a doctor, but more than anything, quite honestly, it felt like such a natural extension of my midwifery work. It's what my passion was. And I wanted to be able to know more about less and not feel like I had to keep up with. Prostates or know about them anymore. It was like, I don't need to do that.

Someone else can do that. And so I really just honed in my work around everything from fertility and conception, but continued the pregnancy postpartum. I wasn't attending birth anymore, except, you know, occasionally friends and, um, my grandkids, but so many women were coming in. Misdiagnosed or undiagnosed or overdiagnosed thyroid problems exhausted.

And being told they had something called adrenal fatigue, which isn't. I was told that by

[00:31:06] Stephanie: the way, I just, last year I was told I had adrenal fatigue and I'm like, what does that mean? Yeah. And it's

[00:31:12] Dr. Aviva: not a real condition, but the thing is. You've got the wellness people saying you've got adrenal fatigue, which isn't a real condition.

And then you've got the medical people saying, oh, it's just stress deal with it or meditate. And there's,

[00:31:23] Stephanie: and like you have a thyroid imbalance, but they can't really just take some medicine for it.

[00:31:28] Dr. Aviva: Yeah. There's a truth that's in between. And that's the place that I live is in that place, in between that bridge.

And then just the incredible numbers of. That I was seeing in practice, but then also as my online platform grew and grew and grew now we're amplifying it. You know, the tens twenties, hundreds of women, I'm seeing in my practice to the tens twenties, hundreds of thousands of women who are in touch with me, who are struggling with very similar stories to yours.

In fact, almost identical at times, to any number of different stories from the woman who. I spent years thinking that periods from hell were normal because her mother had periods from hell until she was in her twenties and got diagnosed with endometriosis and had been just, you know, dismissed and put on the pill and ibuprofen and more pain medication by her doctors to the 50 something year old woman who had perimenopausal or menopausal symptoms who went to an integrative doctor who got put on, put her on bioidentical hormones.

And she ended up with uterine bleeding and a question of uterine cancer. And it was. The inappropriate use of hormones. So all of that, all of it just was like, all right, I'm going to focus in on this. So I started with a focus in on. Adrenal and thyroid partly to help set the adrenal story straight. And partly because I'm seeing so many women in my practice who were struggling with thyroid problems.

And then that was a natural segue into a book on endometriosis, POS fertility, all the challenges, but not just looking at them from the name of the condition. To what are the common factors that are affecting all of us as women or people in female bodies that can lead to these conditions? Becoming part of who we are.

[00:33:13] Stephanie: So I want to jump into that bridge. You sit down and speak specifically to a lot of the women who listen to this are moms of say like younger children to teens, but like most of the women here are moms. I mean, it's a mom podcast and a lot of us have dealt with postpartum issues, things that have happened.

Since we've had babies. Like, for example, after my third C-section one year later, I randomly had ovarian cysts that were actually Musinex assisted adenomas and they were tumors and now they just discovered another one. That's seven centimeters in me. And it's like, these things that didn't happen before kids, or even after my first kid are happening.

Now, a lot of my friends are having the worst periods of their life right now and had never had that before. So I wanted to like ask you about that because. As an, like, you know, mom of younger kids, I'm seeing this more and more my friends group, which means we're in our late thirties, early forties, this sort of age range built from the eighties, you know, my story to them.

What are you like any advice or any tips that like we should be looking for things that we should adjust in order to just generically speaking, maybe help with some of these. I mean, a lot of us were on birth control for years. So we don't actually even know what a real period is. Like, what are we missing?

[00:34:31] Dr. Aviva: Well, I think also. As much as we like to think of ourselves as ageless and every young and late thirties and early forties is really young. Our bodies at that stage do start to go into some shifts toward high menopause. So menopause on average happens at age 52 internationally, but the perimenopause can start eight years before that.

So for women who were in their early forties, it may be that you have several things going on at once. You're breastfeeding, you're running around like a maniac with little kids. And your

[00:35:08] Stephanie: body also,

[00:35:11] Dr. Aviva: and then at the same, at all the, you know, too much caffeine in the day and then the two glasses of wine at night because you deserve it.

Right. And then you're having trouble sleeping and maybe eating chicken nuggets, even if they're organic kind for lunch or dinner, it's like all the, all the ways we are when we have young children with very little time, for attention to ourselves. And if for some women concurrently, their bodies are starting to make that shift into that next phase. That's a lot going on hormonally.

So I think a few different things that we can do one is I know it sounds so much easier than it is to do, but truly slowing down a little more. And I can say in retrospect again, just repeating it. There's no one recipe for the perfect kid. There's no such thing as a perfect kid. There's no such thing as a perfect adult. And we do such a disservice to our kids, by even thinking that way, it's just setting them up for constant emotional failure.

But all the things that we think, you know, the piano and the soccer and the swim line, like all at once, I don't think it actually benefits most of them. So figuring out like what. Can you scale back a little bit on and S and still meet your kids' passions and get them exposed to different things.

And if you have three different kids, I mean, I know, I mean, we had the horseback riding and the piano lessons and the singing lessons and the violin it's a lot.

And I think those things can be really important, but we can overdo it. And so are there things that we can pair back? How can we make sure that. We're not just eating the chicken nuggets and the adios, you know, for breakfast and lunch that we're actually making meals and eating, but also sitting down and chewing, are we getting sleep?

And if we're not getting sleep, how can we sleep trade with our partners? If you have a partner, if you don't have a partner, can you do spend the nights with another mama and sleep trade? You know, what, what can you do really creative?

And then the other, you know, sort of simple things, make sure you're getting enough green vegetables. Are you still taking a multivitamin? We take prenatal vitamins and we take post-partum vitamins while we're breastfeeding, or usually the same prenatal into the postpartum. But are you still taking a multi because if you are eating that kids snack food all the time, are you actually getting nourished?

And then are you taking the time to do things that are just for yourself?

Now let's add on to that. The fact that the whole reason I wrote hormone intelligence for example, is the fact that even when we do a lot of those things, we're also being exposed to an incredible amount of pollution, environmental pollution, whole all kinds of levels of stress. So looking at what you can really do to unpack what's going on for you, that's adding burden, you know, what's what, what, where are you carrying too much luggage emotionally or from the environment that you can start to say, all right, I'm going to carry a little bit lighter load.

I am going to sleep a little more. I am going to stress a little less. I am going to take that prenatal vitamin. I'm going to learn about what household products I'm using that may actually be affecting my hormones, but pace it out. You don't have to do it all at once because sometimes wellness can be another major thing on our to-do list.

[00:38:28] Stephanie: It's like almost drinking from a fire hose too, because again, like you mentioned, social media has overcome everything and you see everybody is a wellness expert and they're all preaching different than. It's like, you know, everything from the stuff that is good, like nontoxic makeup or things that you put on your body lotions and stuff to like every household products, but it can get overwhelming where it's like, oh my goodness, I can't leave like a bubble or else I'm gonna, you know, everything I can't put on normal clothes.

I can't shop here. Like it gets overwhelming when you also then have little humans you're taking care of.

[00:39:02] Dr. Aviva: Totally. And the other thing too, I had one of my patients, she had just had her fourth baby, like six months prior and we were having. Uh, teleconference appointment and she got on the phone and she was in tears and, you know, like, like it took her a minute what's going on.

And she said, I was just on social media this morning. And there's a mom with four kids and all of her kids. Look perfect. And you know, they're all in their little white shirts and they're little cute shorts and their all in matchy-matchy and her house is all like black, white, and wood Scandi, and it's perfect.

And she has like the most beautiful this, and then I was like, okay, first of all, let's go look at who you're talking about because. I want to give you a perspective on this. And so I, I, I showed her, first of all, like how curated it all is, and also explained to her that her kids were actually involved in child labor and the child label, labor laws for clickbait, social media had not been established, but that she, I later found out with someone who got seven, each of her kids would get several thousand dollars a post because every post was an ad.

Right. Right. It's all sponsored. This is all sponsored. She's got somebody who has just curated her house, curated her clothes, curated her kids. And it doesn't mean that she's not that together. And it's her job. It's actually her job. And it's probably not like that behind the scenes. And, you know, there are all kinds of people that we can look at.

On the surface have this perfect life only a year later for their entire empire to be falling apart and then getting divorced publicly. This happens. Right. It's going to say,

[00:40:43] Stephanie: I know exactly who you're talking about on that one. There's one I have in mind. Yeah. So not to believe the Instagram,

[00:40:51] Dr. Aviva: but you can't judge our insides by other people's outside stress.

Yeah. And you know, you just never know you. The funny thing about me being in a doctor in this space is sometimes some of those kinds of people are my patients and they're like, they're on antidepressants and antianxiety medications, and it's like, I often wish that those people would just say that because I think it would make everybody else just exhale.

Yes. I went to the park one day. My kids, I had just the two kids at the time and I was pregnant with the third. So the kids were six and wait. They were six and three and I was. And we were getting ready to go out for a play date with the homeschool families at the park. And it was, you know, like the proverbial, trying to get the kids to get their shoes on.

That was really hormonal. And I had a Tupperware in my hand back in the days when I still would actually use a plastic Tupperware because that is one thing I really do not use plastic containers for food storage, but I just had the Tupperware in my hand and it was empty. And I just remember throwing it really hard at the ground and it bounced up and almost went to the ceiling and the kids, I was like, get your stuff together, or we're not going to the park.

And I just lost it. And I threw it at the ground and it bounced up and the kids' faces were just like their jaws dropped, you know? And they'd never seen me lose it like that. And it was really funny cause I got to the park and there, I was like the homebirth hippie midwife mama, and one of the Mo we were sitting in a circle, the kids were playing and one of the moms said, hazard, how was your morning?

You know? And she looked at me and I said, well, after I screamed at my kids and through the Tupperware and we finally got it here, it was great. And it was. All the truth talking started happening. And one mom said, well, that's not so bad. I actually threw the laundry down the stairs the other day. And that was after I threw the divorce at my husband.

I still remember that. And I think we have to just get real about it. All

[00:42:54] Stephanie: of that. Wow. Well, before we wrap it up, I do want to touch on a couple of things. Just again, along the lines of, you know, postpartum and things, we talked kind of like generically about, we should be eating hard, leafy greens or things like that.

Are there any, like, say if I was to go home and pick three things I can do today, what should they be? To maybe start besides like, you know, maybe detoxing from social media or like the stress, but like any tangible things that you like helped your patients with or prescribe, or, you know, not prescribed, but like send to the store to get or things in their house to remove.

Like, what are some like maybe three things that we can do today to get us through. I'm buying your book too.

[00:43:36] Dr. Aviva: You don't have to do that stuff on my social, on my socialist, on my website, but yeah. Get the book too. It's great. Thank you.

I would say one is probably going to make me really unpopular, but I think it's so under emphasized and that is 86 in the alcohol.

Once you get to be about 38, I would say maybe even a little before, a lot of women start to notice. The alcohol tolerance they had in their twenties may feel good while you're drinking it, but then you just never sleep that as well that night you may fall asleep. Fine. You wake up, you're irritable, you're emotional.

And so really leaning into other beverages, whether it is. An apple cider switchel or T you know, if you really want to drink, keep it to like vodka or tequila, like the white, the white alcohols, and once a week and one drink because it sets our hormones off. We know that it's an estrogen disrupter. We know that alcohol increases our breast cancer risk.

It's one of the only substances that we can actually say is proven to increase breast cancer risk. It's just like a bottom line and it makes us feel bad, ultimately past a certain age.

Another thing that is along those lines. So I would say number two is, and I'm always having to remind myself this. T and my hand is to stay hydrated.

So dehydration or just what's called hypo hydration. So you're not technically dehydrated, but you're just not drinking enough fluids can lead to irritability, fatigue, headache increased menstrual and endometriosis pain and brain fog. So you know that mommy brain, sometimes we just need to actually hydrate more.

So making sure you stay hydrated, whether that is having your own personal glass bottle of water, that you make sure you finished by the end of the day or a pitcher that you finished fill up again and finished, but however you do it.

And then the third thing I would say is find that balance between that second wind that we often get after the kids go to bed and staying up away to like, oh, I love that. I know. And I think that we, we need it. So how can we set either healthier bedtime boundaries with our kids, where at a certain age, they know. That it's time. They, if they're, even if they're not going to sleep, like they're in their room or they're in their bed and it's mommy time.

So that instead of waiting till nine 30 or 10 o'clock to start getting mommy time. And now you're up to one. How can you pull that back a little bit? And again, you know, partner swapping is one way. Do you

[00:46:20] Stephanie: have a nighttime routine or a morning routine

[00:46:22] Dr. Aviva: than that? I do. And even when my kids were a little, I mean, obviously when they're breastfeeding and they're waking up, I have one, my youngest who's now just about to turn 28 next week.

She knew that if she would stay in the room with me at night, Washington was quiet, reading a book. Mind if I was reading or doing something. So one time when she was, she was like two years old, she was in my bed while I was sitting on a chair in my room. And she was like, Hey me, I reading a book, but she had the book upside down and backwards.

It's like, she's wanting to hang out with me, but yeah. Um, Um, and we don't, sometimes we get into the Netflix series too, and ended up staying, like watching it till the last minute, but we try to hit pause about 10 and read and I don't use a Kindle or anything like that. I use, I read real books. So for me, I like to have a good 30 minutes before bed where I'm reading.

You know, after all the teeth brushing and all that stuff. Um, and then I like to do a little meditation, just a little breathing, deep breathing meditation to help me fall asleep. All of a sudden I'm just reading, I'll fall asleep in the morning. And I really try to stay off of screens in that hour off of bed.

Like before bed, social media, all of that. And then ditto in the morning, I try it. Slower waking time. And even when the kids were little, I would try to wake up a little bit before them just to have that slow start to the day, just a few minutes of breathing, getting a tea, and then they wake up. But then of course, sometimes they would wake up before me and wake me up.

And then again, no screens early in the morning, I really try to stay off of what I call other people's agenda. You know, whether that's social media or my email, first thing in the morning where I'm already getting stressed before my day has started on the to-do list or the FOMO or whatever. I didn't used to drink coffee.

I started drinking coffee and residency, and now my morning is usually some kind of movement or journaling and then coffee, a little chat with my partner because we both work from home and then getting our Workday stuff.

[00:48:19] Stephanie: Well, it's good to know you drink coffee makes me feel a little better. Every like wellness person's like, oh, no, only drink tea. Like coffee's bad.

[00:48:27] Dr. Aviva: I don't think coffee's bad. I mean, I think it's important to get good quality coffee. So you're not getting all kinds of solvents and stuff, but, and I, I need to drink decaf. Caffeine is really very stimulating for me. So sometimes I'll have just decaf or I'll have decaf and like a third of caff.

My husband drinks the calf. So I'm not opposed to coffee and. The only time that I say coffee would be bad for someone so to speak is if they have a lot of cyclical, breast tenderness premenstrually, or a lot of PMs. And interestingly, the data is not there from a scientific perspective, but enough women report it.

So if you're having menstrual cycle or hormonal problems, take a break off of coffee for a couple of months and see how it is. And if you're having sleep problems, then coffee is not your best friend. So if you're having sleep problems and you really love the coffee, keep it to a decaf, keep it to one and keep it to before 11 in the morning.

[00:49:16] Stephanie: Awesome.

[00:49:16] Dr. Aviva: and have it with food.

[00:49:19] Stephanie: Well, to wrap things up, I wanted to ask my final question, which is, what do you think is your mom's superpower or your superpower that you gained once you became a mom that makes you better in either business or life.

[00:49:31] Dr. Aviva: Oh, I'm fierce. I am like a fierce protector of the people around me.

So you definitely want me to do things like birth advocate or negotiate. I'm really fierce about speaking my truth, protecting the people I love. And I think that's probably. Probably a big one.

[00:49:52] Stephanie: Beautiful. And where can we find you online?

[00:49:55] Dr. Aviva: You can go to Dr. Aviva Romm on Instagram. You can go to Aviva Romm on Facebook or just Aviva Romm.com for my website.

[00:50:04] Stephanie: Yeah. And your blog has amazing things. I've sent your PCOS diet and your PCOS articles to so many friends and add your Hashimoto's stuff. I have a couple of friends with it. Yeah. Thank you so much for joining today. I really appreciate it. Thank you.

Thank you so much for listening to this episode of mommy's on a call.

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