Have you ever wondered why you are prone to hormone problems? In this episode of the Hormone Prescription Podcast, we talk with Dr. Aviva Romm about why women are more likely to experience hormone imbalances and what we can do to prevent them. Dr. Aviva Romm is a leading authority on natural health and holistic medicine, and her insights will help you understand your own body better. She is a midwife, Yale-trained MD and Board Certified Family Physician who specializes in Integrative Gynecology, Obstetrics, and Pediatrics, with a focus on women's endocrinology. She's also a world-renown herbalist, and author of the textbook, Botanical Medicines for Women's Health, as well as 7 other books, including The Adrenal Thyroid Revolution and her new book, Hormone Intelligence, an instant New York Time Bestseller, which explores the impact of the world we live in on women's hormones and health, and brings us a new medicine for women that is holistic and natural, while being grounded in the best science and medicine, have to offer. A practitioner, teacher, activist, and advocate of both environmental health and women's reproductive rights and health, she has been bridging traditional medicine, total health ecology, and good science for over three decades. In this episode, we discuss the importance of listening to your "hormone intelligence" and how it can guide you to making better choices for your health. You will learn: -Why women are more prone to hormone problems -What you can do to prevent hormone imbalances -How to listen to your "hormone intelligence" -The importance of making choices for your health And much more! [01:01] Welcome back to another episode of the hormone prescription podcast with Dr. Kirin. Thank you so much for joining me today. We are going to jump into some hormone deliciousness today with Dr. Aviva Ram. Some of you probably already know her because she is one of the queen bees of hormones. She's a medical doctor. She's also a nurse midwife. Her background is in nurse midwifery. We actually found out that we went to the same high school in New York City, Bronx science. [01:56] So maybe you will learn some tips on how to tune back into what she's telling you and transform your hormones and your health. I think that that quote really exemplifies what Dr. Aviva Ram is all about. She shared this quote with me before we met for her interview. And it's really what she wants for you. It's what I want you. I think that you will get lots of information that can help you to thrive and not just survive in this life. Cause if you're just surviving, you're not doing it right. [02:55] So Dr. Aviva Ram is a medical doctor and a midwife. She's Yale trained for her medical degree and she's a board certified family physician who specializes in integrative gynecology, obstetrics and pediatrics with a focus on women's endocrinology. She's also a world renowned herbalist and author of the textbook botanical medicines for women's health as well as seven other books, including the adrenal thyroid revolution and her new book, hormone intelligence and instant, New York times bestseller, which explores the impact of the world. We live in on women's hormones and health and bring us a new medicine for women that is holistic and natural while being grounded in the best science and medicine have to offer a practitioner, teacher, activist and advocate of both environmental health and women's reproductive rights and health. [04:16] I am super excited to talk to you about hormones in, oh my gosh. I freaking love your book and agree with really everything that you say. And I love how honest you are and you're honest. I mean, it's unfortunate, but we've gotta face some hard truths right now about the care that we are giving women or should I say not giving women. And I love that you are honest and that you really stop the medical gas lighting that's going on. And you say women, you are right. You are not being taken care of. You're not being nurtured. So talk about how you became so passionate about women's health. [04:56] Well, it started out really early for me. I, as we were chatting about before, um, Karen and I, you all, we, we both went to the same geeky science high school in New York. We both went to Bronx high school of science and I knew I wanted to be a physician even as early as ninth grade, but I wanted to get out of New York and I was living in a housing project. [05:53] And we're talking back to 1981. So this was a long time ago. And when I started to look at the history of women's health, the fact that at that time in 81, the C-section rate was already becoming a concerning issue, how high it was getting. And at that point, it hadn't even hit 19% yet. Now we're at like 34% nationally in 1981, it was still legal for black and brown women to be sterilized at childbirth without their consent in California, for example. [06:57] So it kind of goes pretty far back deep in my roots of the things that I was just very blessed and ballsy enough to like that combination of like stepping out there to dare, to take some chances. And then those people were in my path to help me understand. So that really kind of just pushed me to a whole new commit, to deeply understanding healthcare. And I became a home birth midwife. [07:49] And at that time too, you know, we're talking like 81 all the way into the mid two thousands. Believe it or not things like herbal medicine, nutrition, midwifery, these were really fringe. I mean, really, really fringe. The medical model was not giving any of these things, even lip service at that time. It was like you were either in the system or you were out of the system. [08:52] So I also wanted to be a voice and an advocate for people needing it, but like increasingly my mission is now to also just be a voice and an advocate for changing healthcare because healthcare providers are getting burned out on how healthcare is too. So that's kind of, you know, in a nutshell, the journey and where I've come through and come to. And then, you know, I was part of that. I went to medical school. I mean, I went to Yale, I got my MD and did my internship in internal medicine, women's health. And I did my residency in family medicine, cuz I wanted to add in the OB and the pediatrics, which most internal medicine docs don't do. I couldn't do the OB. I started the interview, no like I to interview in OB programs. And I actually withdraw my applications because I was like, I am gonna be so unhappy as a midwife doing OB in that system. So I really give you credit for doing that. For me, family medicine was a softer way to be able to stay aligned with what I, who I was and where I was going. [09:56] You know, it's interesting that, you know, you point out that a lot of herbal medicine was on the fringe home. Midwifery was fringe. When I came out of residency in 96, a couple years later, I actually started being the backup for the midwives locally. And they had applied for privileges at the hospital to do liver decades before and been blocked repetitively. [10:37] And that's for the nurse midwives. Right. So that was for CMS. It wasn't even like the traditional direct entry midwives. And they had the CMS had an obstacle and they're trained in the medical model. [10:50] Right. And even after the commission and the suit, they say the hospital has to entertain their application. When they reapply, they would always lose their application and bottom line, they weren't gonna let them in. And then I came and the tides had turned politically and it was then in Vogue to have birthing suites yeah. And allow the family in and have midwives. [11:22] Yeah. That's amazing. You know, in Georgia, there are over 90 countries that have no OBGYN at all, no hospital access at all. So we were really trying to advocate. In fact, I just spoke this past year to the, um, Georgia state legislature. And we did a lunchtime hour for them still trying to get a home birth midwives licensed. It's very difficult for nurse midwives to attend home births because they're under the auspices of the OB GYN. So if the OB GYN don't approve it, they can't do it or they'll lose their licenses and privileges. So they can't do it. [12:18] It is insanity. And I may be a little liberal on this, but I really think that it doesn't take all the training that we OB GYNs have to deliver a baby. And this medicalization of the process, really, I think the majority of births would be handled by midwives. [12:35] That's my, yeah. I mean, we've seen that in every, I mean, we're not talking, you know, in the middle of the Outback somewhere and you know, Australia, we're talking about the middle of like the Congo. We're talking about Western nations that have demonstrated that year after year after decade, after decade, Canada, Germany, UK, Sweden, et cetera, et cetera, that home birth is optimal for otherwise healthy women. [13:31] And I think like, you know, along with the medicalization that you mentioned an overmedicalization, we see this incredible and infantilization as if adult women should have to be told what we're allowed to as opposed to like, may I, or is it okay if I do this procedure or check you? And it's not just in birth, it's pelvic exams, breast exams, how we're talked to in the doctor's office. [14:24] It is, you are so right. It is so true. And I really think it's time for a complete revamping of women's healthcare, really a revolution. And I think your book is a great place to start because you cover a lot of these kinds of sociopolitical issues in there. So can you tell everyone what hormonal intelligence means? [14:46] Yeah. So to me it means a couple of things. So one this idea that we have actually an innate biological blueprint that really hasn't changed over eons of time when women menstruate, the same way we get pregnant, the same way we give birth the same way internationally. We go into menopause basically at the same age that may have changed a little bit historically over time, the age that we did, what these processes repeat over and over and over same hormones, the hormones haven't changed, you know, since we first started walking on two feet and actually even before. [15:39] We can't just say, oh, well, that's because you're a woman or that's because you have estrogens because you have a uterus. We haven't always had all of these problems. And certainly not at the scope and magnitude and amount of women that and people with a womb that experience them now. So hormone intelligence on the one hand is understanding that we have this innate biological blueprint, hormone intelligence is also having the intelligence or wisdom to understand that blueprint. [17:05] It's so true. In my medical training, I really was taught and got the impression that we were little men and, and that we had this little extra accessory pack, like a little black bag you might wear to a black tie event. That was our female hormone pack that conferred oh, interesting. The ability to reproduce. And that was like a separate department and it really didn't affect who we are foundationally. And you know, in my journey I've learned that nothing could be further from the truth we are. [17:46] Totally. And I think sometimes too, because as women, you know, we all know the statements. What are you on your period? I mean, we had a president that said to a reporter, is that you're, you know, is that blood coming out of your hoots or whatever right now, you know, it's like the, to admit that our hormones have an impact on our life and our actions and thoughts and behaviors. [18:32] Yeah. And you know, I love how you talk about just the words that we use to describe our anatomy. Can you talk a little bit about that and kind of moving towards a less violent nomenclature that is more nurturing and supportive of us. [18:49] Yeah. We tend to have a very male centered and militaristic approach to health in general. I mean, we all hear, you know, in this moment of the pandemic, right? Like your immune system fighting and battling, and we're very keyed into this war mentality and with, with women's bodies, I mean, all the parts are named after men, even pelvic floor exercises were for women were originally named after Dr. Keel. You know, we have our Bartels glands, we have all these pouches of Douglas. [19:45] So I really like to reclaim body parts whenever we can use an Ana correct name. That's great. But I do think we need to rethink some of those names and maybe rename things. But you know, when we can just call things what they are pelvic floor instead, you know, pelvic floor exercises, instead of Kas, you can say birth canal, if you want to, instead of vagina and not everyone who has one wants to get birth. So how do we rethink it? It's so funny, but because my oldest daughter is here visiting me right now and she's 33 and she was saying how funny it was. [20:30] And my daughter was like, it's so funny, mom. Whenever I hear it, she's like I cringe cuz it was so embarrassing when I was a kid. But she's like, it's so popular now. And it's not necessarily the perfect word, but it is at least a respectful term for women's really means the VVA. That's another thing too. [21:25] It's so true. Ava and I used to, when I practiced basic OB GYN, which I don't do anymore, I used to keep a mirror in my exam rooms and I would show everyone when we would have the speculum exam, this is what your cervix is and show them their anatomy. And I was surprised how many women had never looked yes. At their anatomy. [21:47] And when do they're like, oh, that's amazing. Or that's really cool or wow, that's not what I thought. Yeah. [21:54] I am for anatomy and biology education, age appropriate all the way through our training. Just so I think we'd have a lot fewer health problems. I love how you explain cuz this is so I harp on and I love how you describe this. Hormones are messengers, symptoms are messages. So I don't think a lot of people understand what is the role of hormones? What are they doing? Can you talk a little bit about that as messengers and then symptoms? [22:38] Yeah. For sure. Well, as you and I both know, I mean even in basic medical school, basic endocrinology, we learn that hormones are chemical messengers and that's what they literally are. They are produced in one part of the body, in a gland. So that could be your hypothalamus, your pituitary, your thyroid, your adrenals, your ovaries, and then those c