April 19, 2024 • 34 mins
Dr. Jessica Shepherd has seen her fair share of misinformation about birth control. The OB-GYN joins The Bright Side to do some myth busting around reproductive health, and discuss questions around IUD pain, infertility, and weight gain. Plus, Danielle and Simone talk about Taylor Swift’s new album, react to the news that Nelly and Ashanti are expecting their first child, and discuss Emma Roberts’ "doll wall." Do you have any questions about reproductive health for our next conversation with an OB-GYN? Send us a voice memo at hello@thebrightsidepodcast.com
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Hello Sunshine, Hey fam Today on the bright Side, we're
talking women's health with guynecologists and CEO of Sanctum med
and Wellness. It's doctor Jessica Shephard. Doctor Shepherd weighs in
on the growing debate online about birth control and its
side effects, her holistic approach to medicine, and she also
shares how we can all be better advocates for our
health and well being.
Speaker 2 (00:23):
It's Friday, April nineteenth, and Danielle Robe and.
Speaker 1 (00:26):
I'm Simone Voice and this is the bright Side from
Hello Sunshine.
Speaker 2 (00:32):
Okay, first things first, Taylor Swift's new album is officially
here the Tortured Poets Department. Here's a primer to get
you all hyped up if you haven't listened yet. It's
her eleventh album, Borrow. I can't believe that I've lived
through eleven Taylor Swift albums.
Speaker 1 (00:49):
Can you know that number is staggering?
Speaker 2 (00:51):
I just remember listening to Taylor Swift in high school
because teardrops on my guitar would come on and I
would like cry along with hers about right. So I
can't believe we're on number eleven. But people online are excited.
There's some really Dope features Florence and the Machine post Malone,
and Taylor is always really creative with her marketing. One
(01:12):
of the fun things that I saw her do is
she offered a limited run of autographed LPs for fifty dollars.
LP's meaning like the vinyl version of her album, and
some fans on social obviously got them and they vanished
in twenty minutes. I'm surprised they lasted. That long swifties
are for real. I kind of compare it to like Beatlemania.
(01:34):
I know that's a crazy comparison, but that's the hysteria
that goes on.
Speaker 1 (01:40):
I don't think it's that crazy. I mean, there's no
fandom like the Taylor Swift fandom.
Speaker 2 (01:43):
I feel like Justin Bieber at one moment had like
a huge fandom like that. Obviously Michael Jackson did, but
I can't think of many other artists who get people
this hype.
Speaker 1 (01:55):
But I think Taylor Swift is almost in a league
of her own because of the lore and the methodology
that she generates in the easter eggs that she buries
in any of her public appearances or her wardrobe, and
then she follows back up on that in the album
so she really does create a narrative quite unlike most
artists out there.
Speaker 2 (02:14):
Yeah, I think Taylor and Beyonce are really meticulous about
how they launch albums or collections or anything they do.
So it's fun to see people that are that dedicated
to their work.
Speaker 1 (02:27):
Okay, we have some news that is making my millennial
heart flutter. Nelly and Ashanti are expecting their first baby together. Danielle,
can we name it?
Speaker 3 (02:37):
Is it the shan Is it the Chantelly Baby?
Speaker 1 (02:41):
I'm really hoping they come up with something better than that.
So just a little recap on their dating history. I mean,
they were such a fixture in my childhood in the
early two thousands, but they dated for nearly a decade
back then, and then they also broke up for about
ten years, but reunited in twenty twenty three and they've
(03:02):
been together ever since. When I saw that they were
back together, I was just like so overjoyed for them.
This is Ashanti's first baby at forty three, which I
love that for her. I love that she's creating a
family later in life. Such an inspiration. Nelly, who's almost fifty,
has four kids. He has two from a previous relationship
along with his late sister's children, whom he adopted in
(03:23):
two thousand and five after she died of cancer. I
just learned that these two coming back together starting a
family together. I mean, this is up there with like
Jada and Will for me, Freddie Pince Junior and Sia.
Michelle Geller, what do you mean?
Speaker 2 (03:36):
No, the Jada and Will love Ashanti and Nelly are
not in that category.
Speaker 3 (03:42):
No, that's crazy, top.
Speaker 1 (03:44):
I completely disagree.
Speaker 2 (03:46):
Maybe Ben and Jed I feel like they're making people
want to contemplate getting back together with an X.
Speaker 1 (03:51):
Yeah, I could see that. I love their music from
back in the day, so agree to disagree.
Speaker 2 (03:56):
I keep thinking, like, does the baby come out and
they put like a little band aid under the eye
for Nelly.
Speaker 1 (04:03):
If it's a boy, there might be some band aid insignia,
like sewn into a onesie or something. We'll have to
wait and see.
Speaker 2 (04:09):
They're definitely gonna have a fresh pair of Air Force
ones Okay, I'm gonna stop making Nelly puns, but anyways,
this is.
Speaker 1 (04:16):
Gonna be the freshest little baby out there.
Speaker 2 (04:17):
Okay, this next story is something I'm having a hard
time talking about it.
Speaker 3 (04:23):
It's straight out of my nightmares. Quite honestly.
Speaker 2 (04:25):
Emma Roberts recently took to Architectural Digest for a home tour.
I love those videos that they do. I can't believe
celebrities let us into their houses like that.
Speaker 3 (04:35):
Do you watch these?
Speaker 1 (04:36):
I love this series. I'm obsessed with interiors, So this
scratches that itch for me.
Speaker 2 (04:41):
Okay, So Emma Roberts did hers and there's an entire
wall of dolls. I'm talking Barbies, Babies, action figures.
Speaker 3 (04:51):
She says that she.
Speaker 2 (04:52):
Hopes that every night they're gonna come awake and it
would be so thrilling, truly out of my mine. Do
you have any dolls in your house? I know you
have two boys, like, do they like any of those?
Speaker 1 (05:06):
I don't have any dolls.
Speaker 2 (05:07):
No.
Speaker 1 (05:08):
I collect antiques though, I collect vintage furniture.
Speaker 3 (05:12):
Okay, but that's cool, Thank you.
Speaker 1 (05:15):
I appreciate it. You know. I've seen the response online
to this, and I have to go off for a
second on a little rant because it bothers me that
people are making fun of Emma for collecting dolls. Especially
I've seen some female empowerment accounts who are making fun
of her for this, and I don't think that that's
necessarily fair because men collect a ton of stuff too,
(05:37):
like pocket knives, fighter jet models, cars, action figures, aka
man dolls.
Speaker 3 (05:43):
I mean it's the same thing so Christmas ornaments.
Speaker 1 (05:46):
Yeah, Like I if she enjoys this and this brings
her joy, like, let her have her little doll collection.
Speaker 2 (05:53):
So it's hard for me to even imagine collections. I
grew up in a family that said collections are for museums.
Everything was like about essentialism. My parents were like anti
stuff because my dad always said, if you collect stuff,
then you have to spend money to store it and
take care of it. And I think my grandfather was
a depression baby, so it was just like no stuff.
(06:15):
So I can't personally imagine, like I collect books. Maybe
that's like the only thing that I have that even
rivals her doll collection. But I'm with you in terms
of happiness. I mean, if that's what gives her joy,
then all power to her.
Speaker 1 (06:29):
There's this meme that's been going around for a little while,
and it says that your thirties are all about reconnecting
with the things that you loved in your teenage years.
And I've been looking for ways to do that intentionally
in my own life over the past year or so,
and it has been so fulfilling. It's been so much
fun to just tap into that childlike mentality and do
(06:51):
the things that my teenage self loved, Like what like
going to theme parks with my friends.
Speaker 3 (06:58):
Also a thing of my nightmares, but keep going.
Speaker 1 (07:00):
Like getting ready with my friends again, that's something that
I feel like you lose in your thirties when you
grow up, Like that time when you're getting ready in
the bathroom with your girlfriends. That's such a sacred time
and it's such a coming of age institution. So I've
been trying to do that more. That's really fun.
Speaker 3 (07:17):
That's so fun.
Speaker 2 (07:19):
We used to sit on the floor in front of
like those mirrors that you get at Target for twenty
bucks and do our makeup and listen to music and
talk about who we were going to see that.
Speaker 1 (07:29):
Night exactly, talk about your crushes. It's fun.
Speaker 3 (07:33):
Yeah, I agree with you.
Speaker 2 (07:35):
Up next, we're talking women's health and wellness with doctor
Jessica Shephard.
Speaker 1 (07:39):
We'll be right back, y'all.
Speaker 2 (07:49):
Welcome back, Simone and I are so grateful that our
next guest is here with us today because you and
I both have a lot of questions. For weeks, we've
been seeing people post on Instagram and TikTok that document
them getting off the pill because of the negative side
effects that they say that they experience. And this is
a big part of both of our algorithms now and
(08:11):
we've been talking about doing this segment like for months.
Speaker 1 (08:15):
It's really hard to watch this discourse take place online,
not just because you know, of course, we don't like
to see people in pain, but it's also clear that
a lot of women don't have the information they need
before they decide on contraception. And also it feels like
they're getting gas lit whenever they do complain about their
issues with contraception. But fortunately we have called in an expert, Danielle,
We've got Obgin and CEO of sanctum Med. It's doctor
(08:39):
Jessica Shephard. Welcome to the bright Side. Hi everybody.
Speaker 4 (08:44):
I'm so excited to be here on the bright Side,
especially with you two amazing women.
Speaker 2 (08:48):
Doctor Shepherd, it is so great to have you here.
We've been talking about the growing number of social media
posts on birth control and women are really questioning if
they want to be on it or not. Where do
you think this is all coming from and are you
seeing it in your practice?
Speaker 4 (09:05):
Yeah, you know, I think that there has been a
lot that we've seen in the last maybe six months
to a year when it comes to birth control, and
I think that's because we're just more aware, we're more informed.
I think the ability for us to have this information
allows us to say, hey, I actually have a choice.
Speaker 2 (09:23):
Now.
Speaker 4 (09:23):
The backlash of that is that there usually is going
to be a bad versus good right. That's usually where
we see everything go with, Well, if you're on it,
it's bad, and if you're off it, it's good. I
don't think there's ever perfectly right answer, and so I
think that's where that comes with the information which we'll
get in our discussion, for people to actually have a
(09:44):
choice and be okay with where they fall into if
they're on or off.
Speaker 1 (09:48):
As a physician an obgyn, I mean, you really are
the ideal line of defense between information and misinformation. And
I'm sure a lot of patients are bringing those questions
into your office. So how do you help patients select
their birth control in the first place. Yeah, that's a
great question.
Speaker 4 (10:04):
So going back to just a quick history of like
when birth control came on the scene in the nineteen forties.
It was the birth control pill, right, and so it
wasn't perfect, but it was a great way for women
to have the choice to prevent pregnancy. So fast forward
to where we are here in twenty twenty four. Think
about where we are right now through productive justice and
how important birth control now is for some people in
(10:25):
certain states where they live. We're kind of back into
place almost to like where we were in the nineteen
forties as far as access and the ability for women
to make decisions for themselves. The fact is that we
have so many different varieties types ways that women can
use birth control, and that's the beauty of it. So
I usually counsel them on all forms of birth control,
(10:46):
like literally everything that's out there. People will usually say, oh,
I'm not taking that, and I dig deeper. I'm like,
oh well why, and what do you think about it?
And a lot of times they'll be like, oh, well,
I didn't really realize that that the information. Now I
can kind of clear that off the slate and make
a better decision for myself.
Speaker 1 (11:05):
I can tell you why I haven't been on birth
control for probably ten years. I mean, when I was
first taking the pill, I struggled with depression. I did
not feel like myself. I had suicidal thoughts. It got
very severe for me. I also tried the neeuver ring
on my freakin' honeymoon. I got migrains, which I think
(11:28):
were connected to the neeuverring, And I think this is
what women are struggling with. It's like, Okay, wait a minute,
I've had adverse experiences with birth control. I can point
to three to six other girlfriends of mine who've had
adverse experiences. How do I sort through the anecdotal evidence
versus what we really know definitively about birth control.
Speaker 4 (11:50):
I think that's a great place to for many women
who were listening to being like that was me, Like
I had something that happened, or I didn't feel like myself.
Because everyone's feel physiology is so different, so it's very
hard for me to predict how someone's going to respond
to a certain form of birth control. So now let's
go back to the fundamental of are you trying to
(12:10):
prevent pregnancy or not? And if someone is, I'm like, okay,
let's go through all the different varieties and let's figure
out let's tweak something for the birth control pill, say,
we have so many different varieties in whether it has
a different amount of estrogen in it, whether it's a monophasic,
a triphasic, whether it's only progesterone. You know, maybe you're
responsive to estrogen in a way that is not good
(12:32):
for you. And I'm like, well, let's try a progesterone
only pill. And then I would say, even though it's
a limited list, there are some birth controls that don't
have hormones. But I do have a lot of patients
who are like, I hear you, doctor Shepherd. I know
you have other options. I'm not open to them. I
just want to be off. And I'm like, great, yeah,
that's patient autonomy, that's your choice.
Speaker 1 (12:52):
Yeah.
Speaker 2 (12:52):
What I'm hearing is that it's not a one size
fits all approach or solution. I think what's so great
about the Internet is that men are getting to share
their stories. But what I'm recognizing is not everybody's body
is the same.
Speaker 1 (13:06):
One of the reservations that I have about birth control
is how it manipulates the cycle. And I just feel
like the cycle is an indicator of overall health for
the female body, and so can you explain how does
the pill change the cycle.
Speaker 4 (13:24):
Yeah, so when you look at the phases of your
menstrual cycle, you have the actual bleed, which is your menstruation, right,
So that's kind of how we dictate what is day
one of your cycle is your first day of a bleed,
and that can last anywhere from five to seven days,
and then you go to the follicular phase, right, so
you don't get pregnant. It's like Groundhog's Day. Every month,
your body is in default to get pregnant, so it's like,
(13:46):
let's get pregnant, and then it doesn't, and it's like, oh,
and then every month it's like, let's get pregnant. So
in birth control, what it's trying to do is prevent
that actual follicle from releasing during the ovulatory portion, which
is that just that short timeframe and when you release
an egg. And so in order for it to do that,
(14:07):
the way that it does is it the lock up
a better term, overrides the system, right, and so it's
overriding what your body is continuing to do where it's
saying I'm going to decrease, whether it's the lhed surge
which comes right before ovulation, so that it's not a surge,
and then the body will be like, oh, well, if
(14:28):
the LH is not going up, then I'm not going
to ovulate, And just putting in these subtle points throughout
the menstrual cycle in order for it to suppress either
ovulation or not have the endometrial lining which is getting
ready for that deposited fertilized egg to have the development
that it usually does.
Speaker 2 (14:46):
In terms of specific side effects for birth control, can
we go through a few of them and bust some myths?
Speaker 1 (14:52):
Yeah? Do it? Okay?
Speaker 2 (14:55):
Does the pill increase risk of cancer?
Speaker 4 (14:57):
That is a good question. So when we look at cancers, right,
because it's never just one cancer. It decreases your risk
of ovarian cancer, it reduces your risk of endometrial cancer.
Does it increase your risk of breast cancer? Yes, with
that caveat answer, I always say from a scientist's respective,
(15:18):
when that answer is yes, you always have to add
to that. But with what risk, right, because it can
never just be a yes, it increases your risk or
breast cancer, which I believe is what we see going
through kind of like social media. It's like a very
simple kind of statement, birth control increases breast cancer? When
we actually look at like the relative risk or the
(15:38):
absolute risk of what it's going to increase it by,
it actually is a very small risk of what it's
going to increase it by. So let me even break
that down further for you. If you were to take
all the reproductive organs, including breast, including that into the
reproductive organs, the most deadly form of reproductive cancers is
ovarian right. And so when you look at it from
(16:00):
more of a broad perspective of everything that I do
in my life, whether it's from a medication perspective, whether
it's a lifestyle, whether it's walking down the street, is
a risk. How do I want to kind of prioritize
that risk in what I'm looking for as an outcome.
What's important for my health, what's important for my lifestyle.
That's what I believe is more of the important question.
Speaker 2 (16:20):
And like your family, I'm not good at science, but
I can imagine family history comes into play. You really
kind of have to be the CEO of your own.
Speaker 4 (16:28):
Health, absolutely, and family history is an important part.
Speaker 2 (16:32):
Okay, I have two more for you, birth control and infertility.
Is there a link there?
Speaker 4 (16:37):
We have a lot of studies looking at infertility and
actual birth control, and it does not increase your risk
of infertility. And the reason I'll even expound on that
more is that infertility is caused by multiple factors and
a lot of times it can be due to the tubes,
it can be due to the ovary, can be due
(16:57):
to the uterus, it can be due to the sperm
right and so there can be a male factor of infertility.
So when you lump those all together, there has been
no direct link between birth control causing one of those
causes of infertility significantly. And the other thing that I
would say is when we look at actual reasons for
(17:18):
infertility nowadays, most of that will be two things such
as pcos endometriosis. And then also we do have a
higher age at which most women will have children now
and that significantly increase your risk of infertility.
Speaker 1 (17:35):
Can I ask one follow up question about the infertility?
Does birth control cause temporary infertility? Not long term, but
temporary as the cycle is getting back to normal. Is
there any risk of temporary infertility?
Speaker 4 (17:47):
Depends what kind of birth control you are on, because
so if it say the IUD, the IUD is what
we would consider a local form of birth control. So
once you remove it, it's not there, and so fertility
is resumed. Birth control pills the one that is in
you arm, the implanted one. Those ones because they're systemic
and depending on how long they were used, once you
come off, it does take some time for it to
(18:10):
somewhat come out of your system completely, for your system
to start doing the natural course of the ovulation and
the menstrual and ludial and follicular phase, for it to
now say, okay, we're doing full frontal of a cycle
and I'm ready to get pregnant. So that timeframe is
different for everyone, So I don't know if I would
term it like an infertile time. I would say it's
(18:32):
more of like a resolution time that maybe some people
are not getting pregnant. But I've had plenty of patients
who come off and then the next month they get pregnant.
But I do always make a disclaimer. I'll say, hey,
coming off birth control, depending on how long they've been on,
can take up to a year where you might become
pregnant because of it coming out of your system, which
I can never dictate how long it would be for someone.
Speaker 2 (18:53):
Okay, the last one that I hear that's very common
online is weight gain.
Speaker 4 (18:58):
This is where I will personally say I have seen
people have slight weight gains depending on which one. I
will say that for people who are on the injectable,
I do see a significant increase in weight for those patients.
I would say with birth control pills, it's like a
five to seven pound difference that I would see in patients.
(19:19):
That's been validated in studies. But I also think a
lot of that weight gain too, has to be this
difference in water retention. I will say that even I
go through that now, you know, being on the IUD,
at certain parts of my cycle, I'm like, oh, I'm
definitely in that phase because I just look different me
my hand's a bit different.
Speaker 3 (19:39):
In my face also.
Speaker 4 (19:42):
But then it's like the next week you're like, oh
I am cut this week, and you're like, oh, well,
I just didn't retain all that water. So the weight
gain is I think is a very valid point. When
patients bring that up to me, I do take that
seriously because they know their body.
Speaker 3 (19:58):
Doctor Shepherd.
Speaker 2 (19:59):
We're going to take a quick break, but when we
come back, we're talking more specifically about IUDs and the
videos on social media. Of people recording their IUD procedures.
Speaker 1 (20:15):
We're back, doctor Shepherd. I'd love to have you a
in on the discussion around IUDs and the pain involved
with these procedures, because this conversation is popping off on
Instagram and TikTok right now. Patients are filming themselves getting
an IUD inserted and removed. But from your perspective, is
there any reason to believe that the IUD is any
more problematic or risky than other forms of birth control.
Speaker 4 (20:38):
I will say as a procedure, right, it's a procedure
that's needed to take it in and also remove it. Granted,
putting it in is much harder than taking it out.
Is that it is. I like to put it in
the category of uncomfortable. There are some people. I mean,
I've put in thousands because I love IUDs, and so
I would say, over the course of my fifteen plus
years of putting it in, I do deposit with this
(21:01):
is an uncomfortable procedure. If at any moment it goes
to exquisite or severe pain, I need you to let
me know. And I think that's where as providers we fault.
I have heard too many stories from patients where they
get some type of procedure, whether it's an endometrial biopsy
an IUD insertion, where there is no conversation about it,
(21:24):
like we're going to do this, and your legs are
up and then all of a sudden, there's instruments going
into your vagina and there is no word about what's happening.
And so I've heard that, and I think that's where
it becomes very painful, because there's no conversation about it.
Speaker 1 (21:39):
Well, that's one of the questions that people are raising
right now online. Should there be more anesthesia around this procedure?
What do you think?
Speaker 4 (21:48):
I think that if patients pain tolerance, okay, is very subjective,
and that's why I'm talking about pain in this category
of where between the two of you, you guys could
have the same experience of an uncomfortable or painful situation
and report it completely different. Right.
Speaker 1 (22:03):
And so there are.
Speaker 4 (22:04):
People who know I don't have a good pain tolerance,
and I'm like, great, thank you for letting me know.
I may give you an injection of lytocine into your
cervix to help with the insertion.
Speaker 1 (22:15):
Okay.
Speaker 4 (22:15):
There are some people who are like, you know what
I'm okay, let's try to let's go. I walk them
through it. I tell them when the most uncomfortable portion
is coming up. I also let them know at any
time during this procedure, if you feel it's getting to
a level where this is now really intolerable pain, you
have to let me know.
Speaker 1 (22:35):
I think that we.
Speaker 4 (22:36):
Do need to take a step back as healthcare providers
to give a voice to patients, to allow them to
express what they may be feeling, what they're going through,
to be heard, especially women. One thing that we have
not brought up in that conversation is again going to
the intimacy of that actual kind of interaction, and for
(22:57):
women who have maybe had some issues or maybe some
exchanges or even assaults or trauma in their previous life
and now something going on down there where there's not
a lot of conversation that can trigger a lot of anxiety,
which can heighten pain. It can trigger a lot of
tense moments in the body that can trigger much more
(23:18):
pain that's felt. So I think again bringing it back
from the patient perspective, am I okay? And then for
providers to be a little bit more astute to saying
are you okay? Is this something that is outside of
this experience that maybe needs to be attended to before
we actually go through with this procedure.
Speaker 2 (23:37):
I took a college course about women's health that revolutionized
my life, and one of the things that I learned
that I realized a lot of women don't know is
that during any procedure that you're having, your obgin should
be talking you through it and saying, I'm inserting this,
this is going to be cold.
Speaker 3 (23:58):
And that actually cold ever warning about HL, but talking
you through it really helps.
Speaker 2 (24:03):
And I think that's something that people should know to
expect and if you're not getting it, you should ask
for it.
Speaker 1 (24:09):
Yeah.
Speaker 4 (24:10):
I think that patients can stop us.
Speaker 1 (24:12):
What are you doing?
Speaker 4 (24:13):
What's going on?
Speaker 3 (24:14):
Yeah?
Speaker 1 (24:15):
And sometimes we're not heard because we don't know what
questions we should be asking. So, doctor Shepherd, what questions
should patients be asking their doctor when they're considering changing
to a new type of birth control or experimenting with
one in the first place.
Speaker 4 (24:31):
I think they should know what does it do? I
think the questions that you asked previously on like how
does it actually work? Because think about it's such an
umbrella term birth control, right yet there's like what seven
to ten different types of birth control? What are the
different types, how do they work? And do you think
this is a good fit for me?
Speaker 2 (24:51):
Right?
Speaker 4 (24:51):
I think those are valid questions to ask. I always
say to patients, you know, if you feel that you
get to the end of your appointment, which again is
all short, and you know, cut off, that you didn't
get all your questions answered, then don't make a decision
in that time. Were the CEO of our health? Being
the CEO requires doing research and saying for me as
(25:12):
a person in the journey that I am in the
time and space where I am and why I'm wanting
to get this certain thing at the doctor's office, I
have to do the work as well. I have to
do the work.
Speaker 1 (25:23):
Well, that's where I'm really enjoying learning more about functional medicine.
For anyone who doesn't know, functional medicine is a form
of alternative medicine that focuses on identifying the root causes
of disease and pain and doctor Shepherd, you studied at
the Institute for Functional Medicine. So what is it that
appeals to you about functional medicine and where do you
see it offering an alternative to traditional Western approaches.
Speaker 4 (25:47):
Yeah, that is, you know, a great way to segue
into how I practice Now. You know, I started a
very evidence based academic medicine and just over the years,
I've really allowed myself to step back and say, how
can I serve my page in another way where they're
more a part of the actual diagnosis and management of
their body. And that's where functional medicine comes in, because
(26:10):
it's behavioral change. Yep, it's lifestyle changes, which to me
has been the hardest part of practicing medicine is because
I will say, I know why this is happening from
a functional standpoint, and here's how we can do this together.
But you're going to have to do some of this
work because it requires a lot of different changes.
Speaker 1 (26:29):
Can you give us an example of some of those
lifestyle changes? If a patient came to you seeking out
a functional medicine approach, what kind of lifestyle changes would
you prescribe in order to minimize painful periods or regulate hormones?
Speaker 4 (26:44):
Absolutely, so, when we look at that actual cycle that
we went through earlier in the different phases, is being
very in tune with your body. So knowing when you're
going through those different phases, and then in that is
adjusting whether it's sleep, whether it's the type of exercise
that you do, whether it's the type of food that
you eat. So I do believe that nutrition is one
of the most important pillars of health, but in a
(27:05):
conjunction with now how your body regulates and how your
body changes the intake that you get through food according
to your cycle. That's like a revolutionary science that really
requires you to listen to your body, to understand your body,
and to pushing through those hard times initially when you
start to make those behavioral changes, because your body is
(27:26):
always going to want to revert back to what it
does naturally or what it's been doing forever, and so
that push through really is where you're going to get
the benefit. I've noticed for patients who have endometriosis, when
we're actually able to restrict some things from their diet,
they do see some changes in how they have pain
or The best thing also is what we're able to
(27:46):
do with our mind. I'm very big on mindfulness and
the ability to mitigate and get through pain through our minds.
But again that's a lot of work and a lot
of what we see in Eastern medicine. But the ability
to do that is there, and I firmly believe that.
Speaker 2 (28:01):
I have one last question before you leave. I want
you to talk about your philosophy as a physician.
Speaker 4 (28:09):
Yeah. My philosophy really is I want people to be
their best advocate and really tune into what do I
want as the best outcome for myself in health because
I do believe that health is your best currency. You
are the one who gets to decide what you want
to show up with in twenty thirty years from now,
and so having a team on your side from a
(28:32):
medical perspective, from health advocacy perspective, and from who you
surround yourself with and how they believe in health truly
is going to form and weave this lifestyle for you
in health and wellness and to give you the best
outcome and to help build a legacy in health because
we have nothing butter health in the end, and you
have to be willing to do the work in order
(28:53):
to get that amazing outcome of impeccable quality of life.
Speaker 2 (28:58):
Yes, well said, thank you for your time and for
your great work.
Speaker 1 (29:04):
Also, doctor Shepherd, I have to mention obgu I N's
are heroes in my eyes, but specifically black obg I n's.
I chose a black O BG in to deliver both
of my babies because I felt scared and unsafe about
the conditions that exist for black women in the medical system,
especially as they're giving birth. Makes me emotional to talk
(29:25):
about it. But thank you for pursuing this work and
answering the call.
Speaker 4 (29:32):
Thank you, I really appreciate that because it's rough out
here in these streets. You know, it's not many of us,
and the calling is like so intense because we see
it and then we look at the force that we
have and we're like, there's only so many of us.
How do we actually like accommodate this great need?
Speaker 1 (29:51):
Yea?
Speaker 4 (29:51):
And it sometimes it's heartbreaking because you're like, I can't
get to everybody and I want to, and how do
we do this? So thank you for those words, because
you know, we have little groups of like obgyn's and
we talk and you know, we go through some of
the times that we hear of tragedies and we're just like,
I don't understand why it keeps happening, you know. So
it's very heartbreaking and from a standpoint of people who
(30:11):
do it as their work, but we can't fix it. Yeah,
sometimes it's hard, but.
Speaker 1 (30:16):
You are fixing it just by existing. Like just knowing
that I can seek out a black obgyn and I
can feel safe with her, feel safe with someone like you.
That is part of the solution.
Speaker 4 (30:30):
I appreciate that.
Speaker 1 (30:32):
Doctor Shepherd. Thank you so much for coming here and
bringing honesty. I actually love that you were like, listen,
there's not always going to be a clear answer to
this question. There is nuance here, and that's so important.
I'm someone who exists in the nuance. I seek it out.
I appreciate it, and I'm so happy that you brought
(30:52):
that to our show. So thank you for having me.
Speaker 4 (30:54):
I love this conversation.
Speaker 1 (31:00):
Jessica Shepherd is an obgin and the founder and CEO
of Sanctum med and Wellness.
Speaker 2 (31:08):
Okay, before we wrap today's show, I just want to
say that doctor jess is a.
Speaker 3 (31:12):
Unicorn to me.
Speaker 1 (31:14):
What do you mean by that?
Speaker 2 (31:16):
I find her to be one of the most smart,
thoughtful doctors that I've ever interviewed, and I've interviewed it
done and she just I love her holistic approach to
medicine and to science and to our bodies. The functional
medicine approach is something I think we both love.
Speaker 1 (31:34):
I really appreciate a doctor who refuses to stay stale
in the past. She is constantly growing and evolving and learning.
I mean, she studied at the Institute for Functional Medicine,
so she is constantly seeking out new approaches to her
field and what she does and looking for ways to
better serve our patients. For me, the biggest takeaway from
(31:58):
that conversation is to be your own best advocate, and
that is the cornerstone of her philosophy as a physician.
And I just think that that's so important whatever kind
of medical treatment you are seeking, you know, whether you're
looking for birth control, whether you are you know, recovering
(32:21):
from some sort of trauma, whether you're giving birth.
Speaker 2 (32:26):
Yeah, And I also think that our lives are so cluttered,
we're consuming so much. There's so much information that it's
really hard to take the time to be the CEO
of your own health, Like our health is like number one.
So I like that reframe. I like taking responsibility for
your own health. And I love what you said at
(32:47):
the end of that interview in terms of seeking out
a black OBGYN. Doctor Shepherd has been so committed to
creating safe spaces for patients and for women. She even
started her own practice, Sanctum Met and Wellness. I'm just
grateful for people like her.
Speaker 1 (33:05):
Anyone who is her patient. So lucky, yests Danielle. I
am so stoked to report that we are going to
be making this a regular thing. We're going to have
on a women's health expert about once a month to
answer our health questions and take care of some very
(33:26):
crucial myth busting for us. So send us an email
or a voice note with your questions to Hello at
the bright sidepodcast dot com.
Speaker 3 (33:34):
On Monday.
Speaker 2 (33:35):
We are manifesting big love. I'm not just talking about me,
I said, we on purpose. We have the privilege of
speaking to Catherine Woodward Thomas, author of the New York
Times bestselling book Calling in the One seven Weeks to Attract.
Speaker 3 (33:49):
The love of your life. It is a must listen.
The bright Side is a production of Hello.
Speaker 2 (33:56):
Sunshine, and iHeart Podcasts and as executive produced by Recons Witherspoon.
Speaker 1 (34:00):
Production by Arcana Audio. Courtney Gilbert is our associate producer.
Our producers are Stephanie Brown and Jessica Wank. Our engineer
is PJ. Shahamat and our senior producer is itsy Qinthenia Our.
Speaker 2 (34:13):
Conna's executive producers are Francis Harlowe and Abby Ruzka.
Speaker 3 (34:17):
Arcana's head of production is Matt Schultz.
Speaker 1 (34:20):
Natalie Tulluck and Maureen Polo are the executive producers for
Hello Sunshine.
Speaker 2 (34:25):
Julia Weaver is the supervising producer, and Ali Perry is
the executive producer for iHeart Podcasts. This week's episodes were
recorded by Graham Gibson.
Speaker 1 (34:34):
Our theme song is by Anna Stump and Hamilton lighthauser.
Speaker 2 (34:37):
Special thanks to Connell Byrne and Will Pearson.
Speaker 1 (34:40):
That's it for today's show. I'm Simone Boyce. You can
find me at Simone Voice on Instagram and TikTok.
Speaker 2 (34:45):
I'm Danielle Robe on Instagram and TikTok. That's ro b
a y See you Monday, fam, See you later.
Hello Sunshine, Hey fam Today on the bright Side, we're
talking women's health with guynecologists and CEO of Sanctum med
and Wellness. It's doctor Jessica Shephard. Doctor Shepherd weighs in
on the growing debate online about birth control and its
side effects, her holistic approach to medicine, and she also
shares how we can all be better advocates for our
health and well being.
Speaker 2 (00:23):
It's Friday, April nineteenth, and Danielle Robe and.
Speaker 1 (00:26):
I'm Simone Voice and this is the bright Side from
Hello Sunshine.
Speaker 2 (00:32):
Okay, first things first, Taylor Swift's new album is officially
here the Tortured Poets Department. Here's a primer to get
you all hyped up if you haven't listened yet. It's
her eleventh album, Borrow. I can't believe that I've lived
through eleven Taylor Swift albums.
Speaker 1 (00:49):
Can you know that number is staggering?
Speaker 2 (00:51):
I just remember listening to Taylor Swift in high school
because teardrops on my guitar would come on and I
would like cry along with hers about right. So I
can't believe we're on number eleven. But people online are excited.
There's some really Dope features Florence and the Machine post Malone,
and Taylor is always really creative with her marketing. One
(01:12):
of the fun things that I saw her do is
she offered a limited run of autographed LPs for fifty dollars.
LP's meaning like the vinyl version of her album, and
some fans on social obviously got them and they vanished
in twenty minutes. I'm surprised they lasted. That long swifties
are for real. I kind of compare it to like Beatlemania.
(01:34):
I know that's a crazy comparison, but that's the hysteria
that goes on.
Speaker 1 (01:40):
I don't think it's that crazy. I mean, there's no
fandom like the Taylor Swift fandom.
Speaker 2 (01:43):
I feel like Justin Bieber at one moment had like
a huge fandom like that. Obviously Michael Jackson did, but
I can't think of many other artists who get people
this hype.
Speaker 1 (01:55):
But I think Taylor Swift is almost in a league
of her own because of the lore and the methodology
that she generates in the easter eggs that she buries
in any of her public appearances or her wardrobe, and
then she follows back up on that in the album
so she really does create a narrative quite unlike most
artists out there.
Speaker 2 (02:14):
Yeah, I think Taylor and Beyonce are really meticulous about
how they launch albums or collections or anything they do.
So it's fun to see people that are that dedicated
to their work.
Speaker 1 (02:27):
Okay, we have some news that is making my millennial
heart flutter. Nelly and Ashanti are expecting their first baby together. Danielle,
can we name it?
Speaker 3 (02:37):
Is it the shan Is it the Chantelly Baby?
Speaker 1 (02:41):
I'm really hoping they come up with something better than that.
So just a little recap on their dating history. I mean,
they were such a fixture in my childhood in the
early two thousands, but they dated for nearly a decade
back then, and then they also broke up for about
ten years, but reunited in twenty twenty three and they've
(03:02):
been together ever since. When I saw that they were
back together, I was just like so overjoyed for them.
This is Ashanti's first baby at forty three, which I
love that for her. I love that she's creating a
family later in life. Such an inspiration. Nelly, who's almost fifty,
has four kids. He has two from a previous relationship
along with his late sister's children, whom he adopted in
(03:23):
two thousand and five after she died of cancer. I
just learned that these two coming back together starting a
family together. I mean, this is up there with like
Jada and Will for me, Freddie Pince Junior and Sia.
Michelle Geller, what do you mean?
Speaker 2 (03:36):
No, the Jada and Will love Ashanti and Nelly are
not in that category.
Speaker 3 (03:42):
No, that's crazy, top.
Speaker 1 (03:44):
I completely disagree.
Speaker 2 (03:46):
Maybe Ben and Jed I feel like they're making people
want to contemplate getting back together with an X.
Speaker 1 (03:51):
Yeah, I could see that. I love their music from
back in the day, so agree to disagree.
Speaker 2 (03:56):
I keep thinking, like, does the baby come out and
they put like a little band aid under the eye
for Nelly.
Speaker 1 (04:03):
If it's a boy, there might be some band aid insignia,
like sewn into a onesie or something. We'll have to
wait and see.
Speaker 2 (04:09):
They're definitely gonna have a fresh pair of Air Force
ones Okay, I'm gonna stop making Nelly puns, but anyways,
this is.
Speaker 1 (04:16):
Gonna be the freshest little baby out there.
Speaker 2 (04:17):
Okay, this next story is something I'm having a hard
time talking about it.
Speaker 3 (04:23):
It's straight out of my nightmares. Quite honestly.
Speaker 2 (04:25):
Emma Roberts recently took to Architectural Digest for a home tour.
I love those videos that they do. I can't believe
celebrities let us into their houses like that.
Speaker 3 (04:35):
Do you watch these?
Speaker 1 (04:36):
I love this series. I'm obsessed with interiors, So this
scratches that itch for me.
Speaker 2 (04:41):
Okay, So Emma Roberts did hers and there's an entire
wall of dolls. I'm talking Barbies, Babies, action figures.
Speaker 3 (04:51):
She says that she.
Speaker 2 (04:52):
Hopes that every night they're gonna come awake and it
would be so thrilling, truly out of my mine. Do
you have any dolls in your house? I know you
have two boys, like, do they like any of those?
Speaker 1 (05:06):
I don't have any dolls.
Speaker 2 (05:07):
No.
Speaker 1 (05:08):
I collect antiques though, I collect vintage furniture.
Speaker 3 (05:12):
Okay, but that's cool, Thank you.
Speaker 1 (05:15):
I appreciate it. You know. I've seen the response online
to this, and I have to go off for a
second on a little rant because it bothers me that
people are making fun of Emma for collecting dolls. Especially
I've seen some female empowerment accounts who are making fun
of her for this, and I don't think that that's
necessarily fair because men collect a ton of stuff too,
(05:37):
like pocket knives, fighter jet models, cars, action figures, aka
man dolls.
Speaker 3 (05:43):
I mean it's the same thing so Christmas ornaments.
Speaker 1 (05:46):
Yeah, Like I if she enjoys this and this brings
her joy, like, let her have her little doll collection.
Speaker 2 (05:53):
So it's hard for me to even imagine collections. I
grew up in a family that said collections are for museums.
Everything was like about essentialism. My parents were like anti
stuff because my dad always said, if you collect stuff,
then you have to spend money to store it and
take care of it. And I think my grandfather was
a depression baby, so it was just like no stuff.
(06:15):
So I can't personally imagine, like I collect books. Maybe
that's like the only thing that I have that even
rivals her doll collection. But I'm with you in terms
of happiness. I mean, if that's what gives her joy,
then all power to her.
Speaker 1 (06:29):
There's this meme that's been going around for a little while,
and it says that your thirties are all about reconnecting
with the things that you loved in your teenage years.
And I've been looking for ways to do that intentionally
in my own life over the past year or so,
and it has been so fulfilling. It's been so much
fun to just tap into that childlike mentality and do
(06:51):
the things that my teenage self loved, Like what like
going to theme parks with my friends.
Speaker 3 (06:58):
Also a thing of my nightmares, but keep going.
Speaker 1 (07:00):
Like getting ready with my friends again, that's something that
I feel like you lose in your thirties when you
grow up, Like that time when you're getting ready in
the bathroom with your girlfriends. That's such a sacred time
and it's such a coming of age institution. So I've
been trying to do that more. That's really fun.
Speaker 3 (07:17):
That's so fun.
Speaker 2 (07:19):
We used to sit on the floor in front of
like those mirrors that you get at Target for twenty
bucks and do our makeup and listen to music and
talk about who we were going to see that.
Speaker 1 (07:29):
Night exactly, talk about your crushes. It's fun.
Speaker 3 (07:33):
Yeah, I agree with you.
Speaker 2 (07:35):
Up next, we're talking women's health and wellness with doctor
Jessica Shephard.
Speaker 1 (07:39):
We'll be right back, y'all.
Speaker 2 (07:49):
Welcome back, Simone and I are so grateful that our
next guest is here with us today because you and
I both have a lot of questions. For weeks, we've
been seeing people post on Instagram and TikTok that document
them getting off the pill because of the negative side
effects that they say that they experience. And this is
a big part of both of our algorithms now and
(08:11):
we've been talking about doing this segment like for months.
Speaker 1 (08:15):
It's really hard to watch this discourse take place online,
not just because you know, of course, we don't like
to see people in pain, but it's also clear that
a lot of women don't have the information they need
before they decide on contraception. And also it feels like
they're getting gas lit whenever they do complain about their
issues with contraception. But fortunately we have called in an expert, Danielle,
We've got Obgin and CEO of sanctum Med. It's doctor
(08:39):
Jessica Shephard. Welcome to the bright Side. Hi everybody.
Speaker 4 (08:44):
I'm so excited to be here on the bright Side,
especially with you two amazing women.
Speaker 2 (08:48):
Doctor Shepherd, it is so great to have you here.
We've been talking about the growing number of social media
posts on birth control and women are really questioning if
they want to be on it or not. Where do
you think this is all coming from and are you
seeing it in your practice?
Speaker 4 (09:05):
Yeah, you know, I think that there has been a
lot that we've seen in the last maybe six months
to a year when it comes to birth control, and
I think that's because we're just more aware, we're more informed.
I think the ability for us to have this information
allows us to say, hey, I actually have a choice.
Speaker 2 (09:23):
Now.
Speaker 4 (09:23):
The backlash of that is that there usually is going
to be a bad versus good right. That's usually where
we see everything go with, Well, if you're on it,
it's bad, and if you're off it, it's good. I
don't think there's ever perfectly right answer, and so I
think that's where that comes with the information which we'll
get in our discussion, for people to actually have a
(09:44):
choice and be okay with where they fall into if
they're on or off.
Speaker 1 (09:48):
As a physician an obgyn, I mean, you really are
the ideal line of defense between information and misinformation. And
I'm sure a lot of patients are bringing those questions
into your office. So how do you help patients select
their birth control in the first place. Yeah, that's a
great question.
Speaker 4 (10:04):
So going back to just a quick history of like
when birth control came on the scene in the nineteen forties.
It was the birth control pill, right, and so it
wasn't perfect, but it was a great way for women
to have the choice to prevent pregnancy. So fast forward
to where we are here in twenty twenty four. Think
about where we are right now through productive justice and
how important birth control now is for some people in
(10:25):
certain states where they live. We're kind of back into
place almost to like where we were in the nineteen
forties as far as access and the ability for women
to make decisions for themselves. The fact is that we
have so many different varieties types ways that women can
use birth control, and that's the beauty of it. So
I usually counsel them on all forms of birth control,
(10:46):
like literally everything that's out there. People will usually say, oh,
I'm not taking that, and I dig deeper. I'm like,
oh well why, and what do you think about it?
And a lot of times they'll be like, oh, well,
I didn't really realize that that the information. Now I
can kind of clear that off the slate and make
a better decision for myself.
Speaker 1 (11:05):
I can tell you why I haven't been on birth
control for probably ten years. I mean, when I was
first taking the pill, I struggled with depression. I did
not feel like myself. I had suicidal thoughts. It got
very severe for me. I also tried the neeuver ring
on my freakin' honeymoon. I got migrains, which I think
(11:28):
were connected to the neeuverring, And I think this is
what women are struggling with. It's like, Okay, wait a minute,
I've had adverse experiences with birth control. I can point
to three to six other girlfriends of mine who've had
adverse experiences. How do I sort through the anecdotal evidence
versus what we really know definitively about birth control.
Speaker 4 (11:50):
I think that's a great place to for many women
who were listening to being like that was me, Like
I had something that happened, or I didn't feel like myself.
Because everyone's feel physiology is so different, so it's very
hard for me to predict how someone's going to respond
to a certain form of birth control. So now let's
go back to the fundamental of are you trying to
(12:10):
prevent pregnancy or not? And if someone is, I'm like, okay,
let's go through all the different varieties and let's figure
out let's tweak something for the birth control pill, say,
we have so many different varieties in whether it has
a different amount of estrogen in it, whether it's a monophasic,
a triphasic, whether it's only progesterone. You know, maybe you're
responsive to estrogen in a way that is not good
(12:32):
for you. And I'm like, well, let's try a progesterone
only pill. And then I would say, even though it's
a limited list, there are some birth controls that don't
have hormones. But I do have a lot of patients
who are like, I hear you, doctor Shepherd. I know
you have other options. I'm not open to them. I
just want to be off. And I'm like, great, yeah,
that's patient autonomy, that's your choice.
Speaker 1 (12:52):
Yeah.
Speaker 2 (12:52):
What I'm hearing is that it's not a one size
fits all approach or solution. I think what's so great
about the Internet is that men are getting to share
their stories. But what I'm recognizing is not everybody's body
is the same.
Speaker 1 (13:06):
One of the reservations that I have about birth control
is how it manipulates the cycle. And I just feel
like the cycle is an indicator of overall health for
the female body, and so can you explain how does
the pill change the cycle.
Speaker 4 (13:24):
Yeah, so when you look at the phases of your
menstrual cycle, you have the actual bleed, which is your menstruation, right,
So that's kind of how we dictate what is day
one of your cycle is your first day of a bleed,
and that can last anywhere from five to seven days,
and then you go to the follicular phase, right, so
you don't get pregnant. It's like Groundhog's Day. Every month,
your body is in default to get pregnant, so it's like,
(13:46):
let's get pregnant, and then it doesn't, and it's like, oh,
and then every month it's like, let's get pregnant. So
in birth control, what it's trying to do is prevent
that actual follicle from releasing during the ovulatory portion, which
is that just that short timeframe and when you release
an egg. And so in order for it to do that,
(14:07):
the way that it does is it the lock up
a better term, overrides the system, right, and so it's
overriding what your body is continuing to do where it's
saying I'm going to decrease, whether it's the lhed surge
which comes right before ovulation, so that it's not a surge,
and then the body will be like, oh, well, if
(14:28):
the LH is not going up, then I'm not going
to ovulate, And just putting in these subtle points throughout
the menstrual cycle in order for it to suppress either
ovulation or not have the endometrial lining which is getting
ready for that deposited fertilized egg to have the development
that it usually does.
Speaker 2 (14:46):
In terms of specific side effects for birth control, can
we go through a few of them and bust some myths?
Speaker 1 (14:52):
Yeah? Do it? Okay?
Speaker 2 (14:55):
Does the pill increase risk of cancer?
Speaker 4 (14:57):
That is a good question. So when we look at cancers, right,
because it's never just one cancer. It decreases your risk
of ovarian cancer, it reduces your risk of endometrial cancer.
Does it increase your risk of breast cancer? Yes, with
that caveat answer, I always say from a scientist's respective,
(15:18):
when that answer is yes, you always have to add
to that. But with what risk, right, because it can
never just be a yes, it increases your risk or
breast cancer, which I believe is what we see going
through kind of like social media. It's like a very
simple kind of statement, birth control increases breast cancer? When
we actually look at like the relative risk or the
(15:38):
absolute risk of what it's going to increase it by,
it actually is a very small risk of what it's
going to increase it by. So let me even break
that down further for you. If you were to take
all the reproductive organs, including breast, including that into the
reproductive organs, the most deadly form of reproductive cancers is
ovarian right. And so when you look at it from
(16:00):
more of a broad perspective of everything that I do
in my life, whether it's from a medication perspective, whether
it's a lifestyle, whether it's walking down the street, is
a risk. How do I want to kind of prioritize
that risk in what I'm looking for as an outcome.
What's important for my health, what's important for my lifestyle.
That's what I believe is more of the important question.
Speaker 2 (16:20):
And like your family, I'm not good at science, but
I can imagine family history comes into play. You really
kind of have to be the CEO of your own.
Speaker 4 (16:28):
Health, absolutely, and family history is an important part.
Speaker 2 (16:32):
Okay, I have two more for you, birth control and infertility.
Is there a link there?
Speaker 4 (16:37):
We have a lot of studies looking at infertility and
actual birth control, and it does not increase your risk
of infertility. And the reason I'll even expound on that
more is that infertility is caused by multiple factors and
a lot of times it can be due to the tubes,
it can be due to the ovary, can be due
(16:57):
to the uterus, it can be due to the sperm
right and so there can be a male factor of infertility.
So when you lump those all together, there has been
no direct link between birth control causing one of those
causes of infertility significantly. And the other thing that I
would say is when we look at actual reasons for
(17:18):
infertility nowadays, most of that will be two things such
as pcos endometriosis. And then also we do have a
higher age at which most women will have children now
and that significantly increase your risk of infertility.
Speaker 1 (17:35):
Can I ask one follow up question about the infertility?
Does birth control cause temporary infertility? Not long term, but
temporary as the cycle is getting back to normal. Is
there any risk of temporary infertility?
Speaker 4 (17:47):
Depends what kind of birth control you are on, because
so if it say the IUD, the IUD is what
we would consider a local form of birth control. So
once you remove it, it's not there, and so fertility
is resumed. Birth control pills the one that is in
you arm, the implanted one. Those ones because they're systemic
and depending on how long they were used, once you
come off, it does take some time for it to
(18:10):
somewhat come out of your system completely, for your system
to start doing the natural course of the ovulation and
the menstrual and ludial and follicular phase, for it to
now say, okay, we're doing full frontal of a cycle
and I'm ready to get pregnant. So that timeframe is
different for everyone, So I don't know if I would
term it like an infertile time. I would say it's
(18:32):
more of like a resolution time that maybe some people
are not getting pregnant. But I've had plenty of patients
who come off and then the next month they get pregnant.
But I do always make a disclaimer. I'll say, hey,
coming off birth control, depending on how long they've been on,
can take up to a year where you might become
pregnant because of it coming out of your system, which
I can never dictate how long it would be for someone.
Speaker 2 (18:53):
Okay, the last one that I hear that's very common
online is weight gain.
Speaker 4 (18:58):
This is where I will personally say I have seen
people have slight weight gains depending on which one. I
will say that for people who are on the injectable,
I do see a significant increase in weight for those patients.
I would say with birth control pills, it's like a
five to seven pound difference that I would see in patients.
(19:19):
That's been validated in studies. But I also think a
lot of that weight gain too, has to be this
difference in water retention. I will say that even I
go through that now, you know, being on the IUD,
at certain parts of my cycle, I'm like, oh, I'm
definitely in that phase because I just look different me
my hand's a bit different.
Speaker 3 (19:39):
In my face also.
Speaker 4 (19:42):
But then it's like the next week you're like, oh
I am cut this week, and you're like, oh, well,
I just didn't retain all that water. So the weight
gain is I think is a very valid point. When
patients bring that up to me, I do take that
seriously because they know their body.
Speaker 3 (19:58):
Doctor Shepherd.
Speaker 2 (19:59):
We're going to take a quick break, but when we
come back, we're talking more specifically about IUDs and the
videos on social media. Of people recording their IUD procedures.
Speaker 1 (20:15):
We're back, doctor Shepherd. I'd love to have you a
in on the discussion around IUDs and the pain involved
with these procedures, because this conversation is popping off on
Instagram and TikTok right now. Patients are filming themselves getting
an IUD inserted and removed. But from your perspective, is
there any reason to believe that the IUD is any
more problematic or risky than other forms of birth control.
Speaker 4 (20:38):
I will say as a procedure, right, it's a procedure
that's needed to take it in and also remove it. Granted,
putting it in is much harder than taking it out.
Is that it is. I like to put it in
the category of uncomfortable. There are some people. I mean,
I've put in thousands because I love IUDs, and so
I would say, over the course of my fifteen plus
years of putting it in, I do deposit with this
(21:01):
is an uncomfortable procedure. If at any moment it goes
to exquisite or severe pain, I need you to let
me know. And I think that's where as providers we fault.
I have heard too many stories from patients where they
get some type of procedure, whether it's an endometrial biopsy
an IUD insertion, where there is no conversation about it,
(21:24):
like we're going to do this, and your legs are
up and then all of a sudden, there's instruments going
into your vagina and there is no word about what's happening.
And so I've heard that, and I think that's where
it becomes very painful, because there's no conversation about it.
Speaker 1 (21:39):
Well, that's one of the questions that people are raising
right now online. Should there be more anesthesia around this procedure?
What do you think?
Speaker 4 (21:48):
I think that if patients pain tolerance, okay, is very subjective,
and that's why I'm talking about pain in this category
of where between the two of you, you guys could
have the same experience of an uncomfortable or painful situation
and report it completely different. Right.
Speaker 1 (22:03):
And so there are.
Speaker 4 (22:04):
People who know I don't have a good pain tolerance,
and I'm like, great, thank you for letting me know.
I may give you an injection of lytocine into your
cervix to help with the insertion.
Speaker 1 (22:15):
Okay.
Speaker 4 (22:15):
There are some people who are like, you know what
I'm okay, let's try to let's go. I walk them
through it. I tell them when the most uncomfortable portion
is coming up. I also let them know at any
time during this procedure, if you feel it's getting to
a level where this is now really intolerable pain, you
have to let me know.
Speaker 1 (22:35):
I think that we.
Speaker 4 (22:36):
Do need to take a step back as healthcare providers
to give a voice to patients, to allow them to
express what they may be feeling, what they're going through,
to be heard, especially women. One thing that we have
not brought up in that conversation is again going to
the intimacy of that actual kind of interaction, and for
(22:57):
women who have maybe had some issues or maybe some
exchanges or even assaults or trauma in their previous life
and now something going on down there where there's not
a lot of conversation that can trigger a lot of anxiety,
which can heighten pain. It can trigger a lot of
tense moments in the body that can trigger much more
(23:18):
pain that's felt. So I think again bringing it back
from the patient perspective, am I okay? And then for
providers to be a little bit more astute to saying
are you okay? Is this something that is outside of
this experience that maybe needs to be attended to before
we actually go through with this procedure.
Speaker 2 (23:37):
I took a college course about women's health that revolutionized
my life, and one of the things that I learned
that I realized a lot of women don't know is
that during any procedure that you're having, your obgin should
be talking you through it and saying, I'm inserting this,
this is going to be cold.
Speaker 3 (23:58):
And that actually cold ever warning about HL, but talking
you through it really helps.
Speaker 2 (24:03):
And I think that's something that people should know to
expect and if you're not getting it, you should ask
for it.
Speaker 1 (24:09):
Yeah.
Speaker 4 (24:10):
I think that patients can stop us.
Speaker 1 (24:12):
What are you doing?
Speaker 4 (24:13):
What's going on?
Speaker 3 (24:14):
Yeah?
Speaker 1 (24:15):
And sometimes we're not heard because we don't know what
questions we should be asking. So, doctor Shepherd, what questions
should patients be asking their doctor when they're considering changing
to a new type of birth control or experimenting with
one in the first place.
Speaker 4 (24:31):
I think they should know what does it do? I
think the questions that you asked previously on like how
does it actually work? Because think about it's such an
umbrella term birth control, right yet there's like what seven
to ten different types of birth control? What are the
different types, how do they work? And do you think
this is a good fit for me?
Speaker 2 (24:51):
Right?
Speaker 4 (24:51):
I think those are valid questions to ask. I always
say to patients, you know, if you feel that you
get to the end of your appointment, which again is
all short, and you know, cut off, that you didn't
get all your questions answered, then don't make a decision
in that time. Were the CEO of our health? Being
the CEO requires doing research and saying for me as
(25:12):
a person in the journey that I am in the
time and space where I am and why I'm wanting
to get this certain thing at the doctor's office, I
have to do the work as well. I have to
do the work.
Speaker 1 (25:23):
Well, that's where I'm really enjoying learning more about functional medicine.
For anyone who doesn't know, functional medicine is a form
of alternative medicine that focuses on identifying the root causes
of disease and pain and doctor Shepherd, you studied at
the Institute for Functional Medicine. So what is it that
appeals to you about functional medicine and where do you
see it offering an alternative to traditional Western approaches.
Speaker 4 (25:47):
Yeah, that is, you know, a great way to segue
into how I practice Now. You know, I started a
very evidence based academic medicine and just over the years,
I've really allowed myself to step back and say, how
can I serve my page in another way where they're
more a part of the actual diagnosis and management of
their body. And that's where functional medicine comes in, because
(26:10):
it's behavioral change. Yep, it's lifestyle changes, which to me
has been the hardest part of practicing medicine is because
I will say, I know why this is happening from
a functional standpoint, and here's how we can do this together.
But you're going to have to do some of this
work because it requires a lot of different changes.
Speaker 1 (26:29):
Can you give us an example of some of those
lifestyle changes? If a patient came to you seeking out
a functional medicine approach, what kind of lifestyle changes would
you prescribe in order to minimize painful periods or regulate hormones?
Speaker 4 (26:44):
Absolutely, so, when we look at that actual cycle that
we went through earlier in the different phases, is being
very in tune with your body. So knowing when you're
going through those different phases, and then in that is
adjusting whether it's sleep, whether it's the type of exercise
that you do, whether it's the type of food that
you eat. So I do believe that nutrition is one
of the most important pillars of health, but in a
(27:05):
conjunction with now how your body regulates and how your
body changes the intake that you get through food according
to your cycle. That's like a revolutionary science that really
requires you to listen to your body, to understand your body,
and to pushing through those hard times initially when you
start to make those behavioral changes, because your body is
(27:26):
always going to want to revert back to what it
does naturally or what it's been doing forever, and so
that push through really is where you're going to get
the benefit. I've noticed for patients who have endometriosis, when
we're actually able to restrict some things from their diet,
they do see some changes in how they have pain
or The best thing also is what we're able to
(27:46):
do with our mind. I'm very big on mindfulness and
the ability to mitigate and get through pain through our minds.
But again that's a lot of work and a lot
of what we see in Eastern medicine. But the ability
to do that is there, and I firmly believe that.
Speaker 2 (28:01):
I have one last question before you leave. I want
you to talk about your philosophy as a physician.
Speaker 4 (28:09):
Yeah. My philosophy really is I want people to be
their best advocate and really tune into what do I
want as the best outcome for myself in health because
I do believe that health is your best currency. You
are the one who gets to decide what you want
to show up with in twenty thirty years from now,
and so having a team on your side from a
(28:32):
medical perspective, from health advocacy perspective, and from who you
surround yourself with and how they believe in health truly
is going to form and weave this lifestyle for you
in health and wellness and to give you the best
outcome and to help build a legacy in health because
we have nothing butter health in the end, and you
have to be willing to do the work in order
(28:53):
to get that amazing outcome of impeccable quality of life.
Speaker 2 (28:58):
Yes, well said, thank you for your time and for
your great work.
Speaker 1 (29:04):
Also, doctor Shepherd, I have to mention obgu I N's
are heroes in my eyes, but specifically black obg I n's.
I chose a black O BG in to deliver both
of my babies because I felt scared and unsafe about
the conditions that exist for black women in the medical system,
especially as they're giving birth. Makes me emotional to talk
(29:25):
about it. But thank you for pursuing this work and
answering the call.
Speaker 4 (29:32):
Thank you, I really appreciate that because it's rough out
here in these streets. You know, it's not many of us,
and the calling is like so intense because we see
it and then we look at the force that we
have and we're like, there's only so many of us.
How do we actually like accommodate this great need?
Speaker 1 (29:51):
Yea?
Speaker 4 (29:51):
And it sometimes it's heartbreaking because you're like, I can't
get to everybody and I want to, and how do
we do this? So thank you for those words, because
you know, we have little groups of like obgyn's and
we talk and you know, we go through some of
the times that we hear of tragedies and we're just like,
I don't understand why it keeps happening, you know. So
it's very heartbreaking and from a standpoint of people who
(30:11):
do it as their work, but we can't fix it. Yeah,
sometimes it's hard, but.
Speaker 1 (30:16):
You are fixing it just by existing. Like just knowing
that I can seek out a black obgyn and I
can feel safe with her, feel safe with someone like you.
That is part of the solution.
Speaker 4 (30:30):
I appreciate that.
Speaker 1 (30:32):
Doctor Shepherd. Thank you so much for coming here and
bringing honesty. I actually love that you were like, listen,
there's not always going to be a clear answer to
this question. There is nuance here, and that's so important.
I'm someone who exists in the nuance. I seek it out.
I appreciate it, and I'm so happy that you brought
(30:52):
that to our show. So thank you for having me.
Speaker 4 (30:54):
I love this conversation.
Speaker 1 (31:00):
Jessica Shepherd is an obgin and the founder and CEO
of Sanctum med and Wellness.
Speaker 2 (31:08):
Okay, before we wrap today's show, I just want to
say that doctor jess is a.
Speaker 3 (31:12):
Unicorn to me.
Speaker 1 (31:14):
What do you mean by that?
Speaker 2 (31:16):
I find her to be one of the most smart,
thoughtful doctors that I've ever interviewed, and I've interviewed it
done and she just I love her holistic approach to
medicine and to science and to our bodies. The functional
medicine approach is something I think we both love.
Speaker 1 (31:34):
I really appreciate a doctor who refuses to stay stale
in the past. She is constantly growing and evolving and learning.
I mean, she studied at the Institute for Functional Medicine,
so she is constantly seeking out new approaches to her
field and what she does and looking for ways to
better serve our patients. For me, the biggest takeaway from
(31:58):
that conversation is to be your own best advocate, and
that is the cornerstone of her philosophy as a physician.
And I just think that that's so important whatever kind
of medical treatment you are seeking, you know, whether you're
looking for birth control, whether you are you know, recovering
(32:21):
from some sort of trauma, whether you're giving birth.
Speaker 2 (32:26):
Yeah, And I also think that our lives are so cluttered,
we're consuming so much. There's so much information that it's
really hard to take the time to be the CEO
of your own health, Like our health is like number one.
So I like that reframe. I like taking responsibility for
your own health. And I love what you said at
(32:47):
the end of that interview in terms of seeking out
a black OBGYN. Doctor Shepherd has been so committed to
creating safe spaces for patients and for women. She even
started her own practice, Sanctum Met and Wellness. I'm just
grateful for people like her.
Speaker 1 (33:05):
Anyone who is her patient. So lucky, yests Danielle. I
am so stoked to report that we are going to
be making this a regular thing. We're going to have
on a women's health expert about once a month to
answer our health questions and take care of some very
(33:26):
crucial myth busting for us. So send us an email
or a voice note with your questions to Hello at
the bright sidepodcast dot com.
Speaker 3 (33:34):
On Monday.
Speaker 2 (33:35):
We are manifesting big love. I'm not just talking about me,
I said, we on purpose. We have the privilege of
speaking to Catherine Woodward Thomas, author of the New York
Times bestselling book Calling in the One seven Weeks to Attract.
Speaker 3 (33:49):
The love of your life. It is a must listen.
The bright Side is a production of Hello.
Speaker 2 (33:56):
Sunshine, and iHeart Podcasts and as executive produced by Recons Witherspoon.
Speaker 1 (34:00):
Production by Arcana Audio. Courtney Gilbert is our associate producer.
Our producers are Stephanie Brown and Jessica Wank. Our engineer
is PJ. Shahamat and our senior producer is itsy Qinthenia Our.
Speaker 2 (34:13):
Conna's executive producers are Francis Harlowe and Abby Ruzka.
Speaker 3 (34:17):
Arcana's head of production is Matt Schultz.
Speaker 1 (34:20):
Natalie Tulluck and Maureen Polo are the executive producers for
Hello Sunshine.
Speaker 2 (34:25):
Julia Weaver is the supervising producer, and Ali Perry is
the executive producer for iHeart Podcasts. This week's episodes were
recorded by Graham Gibson.
Speaker 1 (34:34):
Our theme song is by Anna Stump and Hamilton lighthauser.
Speaker 2 (34:37):
Special thanks to Connell Byrne and Will Pearson.
Speaker 1 (34:40):
That's it for today's show. I'm Simone Boyce. You can
find me at Simone Voice on Instagram and TikTok.
Speaker 2 (34:45):
I'm Danielle Robe on Instagram and TikTok. That's ro b
a y See you Monday, fam, See you later.
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