Dr. Lara Briden, author of Period Repair Manual, is a naturopathic doctor and the period revolutionary—leading the change to better periods. She has helped thousands of women find relief for period problems such as PCOS, PMS, endometriosis, and perimenopause. She shares her expertise in honor of National Period Day.
What we Discuss
Why the menstrual cycle's main event is ovulation and not the period
What a normal menstrual cycle should be
How birth control impacts the rhythm of your menstrual cycle - and it's not what you would think
Lara Briden 01:58
I'm a naturopathic doctor, and the author of the book Period Repair Manual. I'm Canadian, as you can probably hear from my accent, but I live in New Zealand. And I spent nearly 20 years practicing in Sydney, Australia. So I have three I call three countries home. And I've spent the last nearly 25 years of clinical practice on the ground, pretty much nine to five, Monday to Friday, helping women have better periods with diet supplements, herbal medicines.
So I've had an opportunity, which I'm very grateful for, to learn what works and what doesn't work with thousands of women every day to the point about five or six years ago where I thought I really need to share this information with not just my own patients, but women out there. So that's how the book came into being the first edition. So it's in its second edition now and came out early 2015.
Okay, so I don't remember 2015. But I have to mention it because that was the year of the period. That was the first time there was a lot of kind of mainstream media, where they were actually using the word period. For the first time, women were talking about it openly in sports. And that's only five years ago, it's been a lot. The world is changing very quickly. But even five years ago, even back then, when I in 2014, when I was getting ready to release my book, I had a number a few people tell me say to me, “I don't know if you should put the word period in the title of the book, because it's kind of off putting. So we've come a long way. Now, in 2020, that seems pretty normal to have to say that word period. That's not a not taboo anymore.
The problem is if you are on hormonal birth control on the pill. We're in this weird situation where there's no ovulation so no hormone production, and the contraceptive drugs are not as good as our own hormones.
Georgie Kovacs 03:43
Did you write the book before that happened? So it's just amazing timing.
Lara Briden 03:50
Yeah, my book came out in February 2015, and by the end of that year, it was declared the year of the period, not because of my book, I don't think, but just because of what was happening in the world.
Georgie Kovacs 03:59
Let's talk about periods now that we're so comfortable using that word. What myths do women have about periods?
Lara Briden 04:13
I want to start with one of my key messages about periods - ovulation is the main event of the menstrual cycle, and the bleed itself is just a secondary downstream effect. The reason I start with that is because I think we put so much focus on the bleeding. From a health perspective, it's not about that.
We want the bleeding to be as easy and symptom free as possible, but the value of a menstrual cycle for women is ovulation, not just to be able to make a baby. Of course, that's part of it, but also because ovulation is how women make hormones. Men make hormones every day, they have quite a flat pattern with their hormone production, we have this monthly pattern of hormone production. But that has been treated as sort of a liability in some ways.
I like to flip the script and reclaim that it's an asset. We make hormones in this monthly pattern, but we need those hormones. Both estrogen and progesterone have many benefits. Beyond just making a baby, for example, there was just in the research mid-September, there was some new bit of research about how having more years of ovulatory cycles in reproductive years is beneficial for reducing the risk of cardiovascular disease after menopause.
Ovulation every menstrual cycle is like a deposit into the bank account of long term health. It's building what's called a metabolic reserve. And most people would know that estrogen makes bones stronger. Progesterone makes bones stronger. Both hormones are good for the heart, both hormones are good for the brain, they affect the microbiome, or the gut. They're beneficial for us, just as testosterone is beneficial for men.
So this is, this is what it all hinges on. And the thing about this is you can see it's not about the bleed. The problem is if you are on hormonal birth control on the pill. We're in this weird situation where there's no ovulation so no hormone production, and the contraceptive drugs are not as good as our own hormones. Then we have this monthly induced bleed, which doesn't mean anything. So there's no reason to have a monthly drug induced bleed, which is why we get these headlines, these crazy headlines saying things like women don't need periods. They are, what that's referring to, is women don't need a monthly drug induced bleed from the pill, which we totally don't like there's no there's no reason to bleed per se, if you're not, if it's not part of a cycle with ovulation and making hormones.
Georgie Kovacs 07:14
I love that you flip the switch. What I've been observing in women's health is when it comes to ovulation, people tie it so much to getting pregnant and even the apps they're referred to as fertility tracking apps. I wish that the whole conversation would change to just reproductive health or even women's health because when you say reproductive health, people automatically think baby, and it all runs together. I created this podcast because I want women to understand these things like it is women's health is not period, ovulation, as you mentioned, get pregnant, you have menopause. it's a whole system that is magical.
Lara Briden 08:10
Absolutely, so one way of talking about it might be to speak about ovarian hormones because they are beneficial for general health. Just as testosterone, or testicular, hormones are important for general health for men. Testosterone is not just for making a baby. It seems so obvious when you say it about men, but unfortunately, when it comes to women's health, there is kind of this idea of “If you're not going to make a baby, do you even really need any of that?” Well, that's, that's definitely what's going on with hormonal birth control because it shuts them down.
Georgie Kovacs 08:49
I recently spoke with the Ovarian Cancer Research Alliance, one of the questions that I had asked them is this very tough position that women seem to be in with birth control, because apparently, with ovarian cancer, having children is helpful in preventing it, but also being on birth control.
Lara Briden 09:15
Anything that puts the ovaries into dormancy is going to reduce the number of cell divisions happening in that tissue. So I thought about this a lot. So yes, hormonal birth control decreases the risk of ovarian cancer, just as chemical castration of men would probably reduce the risk of testicular cancer. But the thing is, in terms of that question, depending on your history could be a very strong history of ovarian cancer. That's obviously a different conversation, a conversation to have with your doctor.
Let's say your average woman has no risk factors, specifically for ovarian cancer. It's quite a rare cancer compared to other health events for which the risk is reduced by having ovulation so having active ovaries having regular ovulatory cycles, menstrual cycles, reduces the risk of a number of diseases. I'm going to quote my colleague, Professor Jerilynn Prior, who is a reproductive endocrinologist. She is in Vancouver and helped me with my book. There's a quote from her that I've used several times. She says quite boldly, that 35 to 40 years of ovulatory menstrual cycles, regular natural menstruation helps to prevent osteoporosis, dementia, heart disease, and breast cancer. And she puts breast cancer in there. Because progesterone, the real progesterone we make after ovulation, has an anti-breast cancer effect. This is a perfect example because the progestin drugs in hormonal birth control are called progesterone, but unfortunately, they're not. Progestins increase the risk of breast cancer. So progesterone lowers the risk of breast cancer and increases of breast cancer. So if we're talking about it, the cost benefit analysis of having regular ovulatory cycles throughout your life? The beneficial side is reduced risk of all those things, including breast cancer, which is obviously a lot more common than ovarian cancer. So that's kind of my short answer to, “Does the pill reduce the risk of ovarian cancer?” Yes, but big picture, this lot there.
Georgie Kovacs 11:56
Help our listeners to understand more about the impact of birth control, because I know that even in your book, you reference certain types, whether you really need them, and for certain cases they are better than for others.
Lara Briden 12:14