Show Notes
Charna Cassell: [00:00:00] Hi, welcome back to Late Open Podcast. I'm your host, Charna Cassell. And today's guest is Dr. Keesha Ewers. And she's been on before season four, , the season finale. I encourage you to listen to that and check out her book. And, , we're going to have a dialogue about something that is frustrating. It doesn't get talked about enough, or at least it's starting to get talked about.
50 percent of our population is dealing with menopause, and only 1 percent of funding actually goes towards women's health and menopause specifically. I just, I want to encourage men, because you also go through not only your own process of hormonal changes at later stages in life, but if you have coworkers, sisters, mothers, You know, daughters, partners in your life, and you're committed to those relationships, you really need to know about the whole life cycle of your relationship and [00:01:00] their experience.
And so please don't, don't turn it off and think it's not for you.
Anytime we're dealing with physical symptoms, I really see that there's important information behind the symptoms and they're pointing towards something for us to put our attention on.
I don't think it's a coincidence that menopause happens in a certain stage of life where women, if you have children, are dealing with empty nests and there's been an exorbitant amount of energy output for most of our lifetimes. That's what we're conditioned to do. And This is a turning inward opportunity.
So even though the symptoms can feel absolutely crazy making, , why are they there? Some people don't have them at all. So some of this is genetic, some of this is environmental, but also it's our habits and, and how we. have habitually lived our lives, and this is an opportunity [00:02:00] to interrupt some of those things.
And yes, for some people, simply taking hormone replacement therapy might be the solution, but there might also be a constellation of changes that we need to make. And one of them might be looking at how we can replete , the ways that we live our lives and the ways that we attend to ourselves. So I look forward to any thoughts and feelings you may have about this episode.
You can always reach out to me and enjoy. Welcome back Keesha. So Glad to have you.
[00:03:00] Imagine yourself brand new. Imagine yourself brand new.
Dr. Keesha Ewers: Yeah, so glad to be here.
Charna Cassell: I'm really looking forward to this conversation, and it's a conversation that has been brewing more and more, at least in my social media feed. , but I feel like It's, you know, generations back, women going through menopause just have not had resources, and you offer a special vantage point being a functional medicine doctor, doctor of sexology, , and having worked as a nurse and working with autoimmune conditions.
So I'm really looking forward to hearing what you have to say on the topic of perimetopause and hormones and [00:04:00] yeah.
Dr. Keesha Ewers: Well, uh, this is such a wonderful topic to be covering because you're right. , this is something everybody goes through, whether it's naturally through age, chemically induced, surgically induced, right.
That we're going to go through transitions if we live long enough with our stages of life. . So maiden, matron, if we're there. And matriarch, right? Yeah. And with each of those comes a different. Um,, there's a lot of things that we can set up in our bodies to match the stage of life that we're in. And there are all kinds of ways that that can get dysregulated and we wind up having a terrible time with transitions rather than a smooth time.
I'm going to be turning 60 and, , just a few dates.
Charna Cassell: Oh,
happy almost birthday.
Dr. Keesha Ewers: Thank you. Thank you. And I went through menopause at the age of [00:05:00] 55 and not one symptom. Um, so I, I didn't, I don't have insomnia, I don't have memory problems, I didn't ever have a hot flash, I don't have vaginal dryness, you know, so some of the things that are associated with menopause.
So if you go in and see a sort of like standard Western medical doctor or nurse practitioner that doesn't have that holistic view, we'll just say, Oh, well, you're in perimenopause or you're in menopause. So therefore your kids, that's, that's your symptom, right? And that actually should not be what we hear.
And so I really appreciate this conversation And like anything else, um, when I was 30, I was diagnosed with an autoimmune disease called rheumatoid arthritis. And it felt like all of a sudden I woke up one morning and I had inflammation in my joints. I'd gained 10 extra pounds [00:06:00] of fluid and it was like someone had taken the batteries out of the energizer bunny.
It felt all of a sudden, right? And all my patients say that, like all of a sudden I'm sick. That is never accurate. And so when you go through menopause, you know, and, or andropause for the male bodies, , this is not different for the male body. Yeah. So there's also a transition for that body. So when you go through that and, and you don't have enough fuel in your tank, you know, I used to be a marathon runner.
When you cross through that tape. It feels awful. And like you trip and you fall and you injure yourself at the, at the, at the finish line. But if you have actually set yourself up for success a long time ago, this will not be that way. So we can talk about that. Like, and if you've already gone through menopause and you're having all those symptoms that we just talked about, then also that's reversible.
So these are feedback mechanisms from the body, right? Vaginal dryness. [00:07:00] Low libido, memory stuff, insomnia, fatigue, mood that doesn't, you know, that, that, that your mood is supposed to fluctuate like this. It's never supposed to go like this, right? And so if any of those things are happening, then that's a feedback from the body saying, I would really love to have some attention from you, right?
And so oftentimes instead we're Quite tyrannical with our bodies and like a toddler, pulling on a pant leg and saying, Hey, Hey, I need your attention. Like, Hopefully you don't just go smack. I don't want to hear from you. And so you wouldn't want to do that with your body either. Like how come you're just not behaving the way I want you to behave like, Oh, I see you need something for me.
Let me compassionately tune in with curiosity. With an aim toward collaboration with you. So that's, that's what I just want to kind [00:08:00] of set up as the ground for this conversation.
Charna Cassell: Absolutely. Yeah. I, I've actually been thinking a lot about, So a lot of the people in my life, as well as clients, are going through perimenopause.
And I've had, you know, I have clients that come to me that, uh, because of cancer, go into menopause or work with teenagers, which is always fascinating to work with both poles of kind of this huge flux of hormones and having so much compassion for. young people and going like, wow, can you imagine, you know, you look back and go, I had to go through that without all these resources that I've gained to regulate myself and bodily awareness and embodiment for the last, over the last 40 years.
So just so much compassion for young people out there.
Dr. Keesha Ewers: Think about the apps that track your period that like, You know, I never had. Right. Just awareness of the body is easier to track than it's ever been, I think, [00:09:00] so.
Charna Cassell: Yeah, definitely easier to track and the, the powerlessness that you're going through as a teenager, living under someone else's rule and whatever is going on in your family system and, and navigating all of that versus like.
You know, a lot of, you know, some women feel empowered and don't have that going on in their 40s and 50s. And yet at the same time, I've been thinking about menopause, , as it relates. Potentially to climate change, like thinking about it as women's women who are very depleted in resources, like the people around them and even them taking their bodies for granted, thinking like I can just keep giving, giving, giving and not replenishing and then the body goes, Hey, you have to stop this behavior.
It is time for you to focus on yourself and prioritize yourself. So I've been thinking about symptoms in those [00:10:00] terms, um, as, as a wake up call.
Dr. Keesha Ewers: That's the depletion I'm talking about. So there are, I always say there are four Ps with autoimmune disease, right? And, and they apply to this. So the four Ps are people pleasing, right?
So you're like not keeping good boundaries with self care and your own thoughts in an effort to manipulate and control out here. So that you receive back what you want, right? There's a lot of energy expenditure doing that. So people pleasing, perfectionism. Oh my gosh. You know, I'm like a recovering people pleaser and perfectionist.
And then, , the poison of past pain. The impact that trauma has. And we can talk a bit about that because trauma, right, everybody has trauma and trauma is just an event you go through that you do not yet have the skill set to navigate. So then it's depleting because it's stressful. And then the fourth one is the peta dosha in Ayurvedic [00:11:00] medicine, which has more fire.
So you literally have learned in order to have self worth in the world to burn the candle at both ends and you burn out by the time you get to menopause, which. Then you're on fire. And so, you know, in your climate change metaphor, right? It's it's that's happened when climate changes like that. There have been a lot of root causes, causes and conditions that have made it so that this is now the reality.
And that is the same in the body. A lot of causes and conditions that have led to this point of hot flashing. And so people like I have a TEDx talk called, Have you heard from your libido lately? And I, I did that talk because, you know, what I was saying was I had so many patients that were coming to me and saying, I want to be on bioidentical hormone replacement therapy, which is a huge conversation when we talk about andropause and menopause and [00:12:00] perimenopause is like, well, what about hormones?
Right? And one of the things I said in that talk was, you know, I would have like people coming to me and saying, I want to be on bioidentical hormone replacement. You gave hormones to my sister, my brother, my dad, my mom, my friend, and my kid. And I, I like really want some of that. They're doing amazing. And then asking the question, well, you know, like, why do you think you need to be on hormones?
And there are a variety of reasons. Person that says. Well, I feel like I have cut glass in my vagina when I have intercourse. I'm like, yes, let's do some testing and get you set up. But when I ask a question that says, you know, well, you say that you have low sexual desire, do you like your partner? And then I get tears, right?
Then I'm like, well, so what's happening here? Well, they had an affair five years ago [00:13:00] and I forgiven them, but I don't really feel like having sex with them anymore. It's like, well, hormones aren't going to fix that, right? This is what took me back to get a doctorate. My doctoral work was, a study called the healing unresolved trauma study.
And out of that came the HURT model. And what, what I saw was I started teasing apart, Oh, half of the people. And I'm just going to say sexual desire, we can actually make into a broader definition of just desire. So libido comes from the Latin word desire, desiree, which means from the stars, which is actually your life force vitality, like the energy for creativity, you don't have to have sex with it.
So if you're depleted and dried out, overheated, and you can't find passion in your life anymore, then you know that what thought about and what I found is that 50 percent of people roughly [00:14:00] have had that ever since. They can remember it's called resistance to life. And so the hormones don't fit, you know?
And there are things to do with that. But then the other 50 percent where it's acquired, like I used to have passion and vitality for life. I've lost interest. It feels like I've cut glass in my vagina. I'm like, yes, let's, let's work you up and, and see what your body does with hormones.
There are so many options in there. And if you don't get rid of the byproducts, those are the things that cause cancer, not the hormone. So like you have to be worked up properly and then followed and tracked. So a lot of the discussion around hormones is not complete enough because, , you know, it'll just be.
Well, what about the women's health initiative study that said that, you know, hormones cause cancer more heart than women. Like, we can, we can tease that apart because that, that's a misreading of a study and [00:15:00] it is not following people, men and women. Because you can be the Lance Armstrong and take a whole bunch of testosterone and only follow blood work, but not look at how you're metabolizing your testosterone and have it convert to a whole bunch of estrogen, which then gives you prostate or testicular cancer. And you say the testosterone did it. Well, no, it's what your body did with the testosterone and the person that ordered it for you didn't track you. So that's like my public surface announcement for today.
Charna Cassell: Yeah. The other, the other thing that, you know, that there seems to be conversation around is like even the value. So some people are getting. Tests, and then other people are like, well, depending on the day, your hormones are constantly changing. Like how accurate are these tests? And so how valuable are they to inform what you need?
And you could be totally level with estradiol or estrogen and progesterone [00:16:00] and testosterone and everything, but you still have all these symptoms.
Dr. Keesha Ewers: Yeah. So it's how well you're breaking down the hormones and using it. And we have these things called hormone pathways. And there are, like I said, many choices.
And so sometimes I have to give, like, a nutrient, like, let's say inositol, if somebody is making estrogen out of testosterone instead of, or estrogen out of DHEA, when I really want them to make testosterone out of DHEA. So I always say, I have to give you a sheepdog to actually get it to go down the right chute, right?
And so that's, that's, like, in depth testing that is not done with blood work. And So that's really important. Your body, what it does. And then I always run genetics when I, um, am administering hormones for people, because I need to know if you have, , like a phase one or a phase two liver detox pathway, single nucleotide polymorphism that [00:17:00] inhibits your ability to then dump what the metabolites are of those hormones.
And like I said, The, the harmful one is for hydroxy estrogen. That one is the one that fits everyone at risk for cancer. So if you're genetically not wired to be able to effectively dump that through your kidneys, your liver, and out into the toilet, then we have to, again, give some assistance with a few, like a couple of supplements with that to encourage, right.
It to go. I'm one of those people. I build up for hydroxy estrogen like it's no big business. We have all these estrogen mimicking chemicals. I have these big windows right here. That's what I'm pointing to outside. And that, you know, they're being dumped into the environment, into the air, water, and soil daily by the ton.
And so I don't have to be on estrogen [00:18:00] to have a buildup before hydroxy estrogen metabolites, and that will cause hot flashes. Right. So you could have a toxic burden overload of what looks like estrogen to your body and not genetically be wired to be able to dump it. And now it's just from breathing the air that you're having this trouble, not because you're even on estrogen.
Now you add exogenous estrogen like into the patch or a pellet or orally or as a cream or inter vaginally. And then. It compounds the problem you already have, and lo and behold, you are in an autoimmune or cancer risk.
Charna Cassell: Mm.
Dr. Keesha Ewers: Yeah.
Charna Cassell: And, and so for someone who like you, like, what did you do if you're already so susceptible and you're taking that in, how do you prevent that?
Dr. Keesha Ewers: Every six months I do the testing that I, I use on my patients. [00:19:00] And then I take a supplement for the rest of my life. , the first time I ran the test that I do for testing, , I was not on estrogen. I had not gone, I hadn't even entered perimenopause. And, I, , went into the lab, the lab, the head, the medical director of the lab called me and said, Dr.
Ewers, , are you on anything hormonally? And I said, you didn't put it in your paperwork. I said, no, I'm not. And she said, , I have never seen somebody with a higher level of four hydroxyestrogen metabolite. This is a huge cancer risk. And I said, I've always been an overachiever. And she started laughing and she said, you know, this is actually saying something.
We're an international lab and I have never seen someone hit this bar. And so I said, Oh my gosh, I'm so glad to know this. And you know, breast cancer is all through my family autoimmunity. I'd already had it in my family. [00:20:00] I was able to reverse it. So. Knowing this then, I put the sheepdog supplements inside me every day and have now for 15 years and I've been on, I am on currently on bioidentical hormone replacement.
The second I went through menopause. I was like all. Right? Because I do this testing. I provide my body with what it needs to support my genetics and the environment I live in. It's just ubiquitous now. It doesn't matter if you eat organic and you use all clean skin care and hair care things. I do.
Charna Cassell: Yeah,
Dr. Keesha Ewers: But just breathing on our planet now.
We have it, it's in our water table, right? I have water filters. I mean, you know, I do everything, air filters. That I tell my patients to do, and it's just so ubiquitous now.
Charna Cassell: Mm. Mm. So many thoughts. I'm like, I can see all the threads, and I'm trying to decide which [00:21:00] to follow. , Because one of the things that you brought up is how there's cancer and autoimmune in your family.
And I also know, , from your book and from meeting you previously, the conversation around trauma and sexual trauma. And so I'm very interested in epigenetics and, , and, and our ability to shift things for ourselves, , but also what we used to conceive of as like, oh, this is genetic, right? But it's like, oh, what's actually in our environment?
How are our belief systems impacting us? And also how trauma, because of, its also its connection to cortisol and, and all the things, and you'll be able to explain it better than I can, but how trauma I impacts our hormones
Dr. Keesha Ewers: yeah, it's really huge and it's a great question. So, , the way that if you. So if you just like put the image in your mind of a zebra being chased by a lion and you think you're about to get eaten for [00:22:00] dinner, the way that the zebra and the human and the lion are actually designed is that if you believe that your survival is threatened, that zebra's digestive system is going to shut down completely because there's a lion on its tail, it's not safe to stop and poop or pee, right?
So you can't like stop and empty your detoxification organs right now. You have to like clamp everything up, move towards survival as fast as you can. So when your digestion shuts down, also the way that you utilize your hormones changes. So You have perception, right? This is not brain. This is actually mind, mind and brain are not the same thing.
So you have perception. Oh, there's a lion on my tail. I may not survive the next five minutes. So [00:23:00] that perception activates the part of the brain that says, you know, the limbic system, we're in trouble. That then sends the message to the adrenal glands that says cortisol out there so that we have. The ability to fight, flee, or freeze, right?
Our sympathetic nervous system arousal. And with that, everything that would ordinarily, pregnenolone, DHEA, , choline, all of the nutrients that would ordinarily make your sex and reproductive hormones get hijacked and taken over to make cortisol only. Because right now, it's not safe to reproduce.
Anymore that it's safe to go to the bathroom. And so it's like, I can't keep you alive. I'm not gonna let you put another being I have to keep alive, right? Mm-hmm . So then all sex reproductive hormones get transferred over to emergency [00:24:00] only hormones. which is cortisol. And so, problem with this is, the zebra, once it's saved, within 10 minutes, will come back into a homeostatic balance and graze peacefully, while the lion pride is within vision, eating the weakest of that herd.
And they're like, biologically they know, physiologically, This little pride over here that's chewing on their herd member is going to be good for at least a week and they can actually graze now completely calmly Insight of their predator totally fine humans. Don't do that This is called heart rate variability your willingness and ability to resume a homeo allostatic , and then you can go about your [00:25:00] job, your life, right?
In a way that says I'm safe. If you have a perception up here, Constantly looking to see if you are safe. Right. Oh, I'm a highly sensitive person. And I've been hurt before by those toxic narcissists out there. So I'm always on alert for that. Am I okay? Am I going to be held okay? Are people keeping me safe?
Then that means that, and this is shown in fMRI scans, that your prefrontal cortex will shrink. This is your adult executive function of your brain. And the right side of your amygdala, which is the like child limbic system, reptilian brain is going to grow in volume. And when you keep doing that, and here's another in my doctoral work.
I found this study that was so compelling. Like, Oh my gosh, it was a study that was done on people that [00:26:00] have filled out a perceived stress inventory. And that's the one that everyone's seen that says in the last year, have you gotten married? Have you lost your job? Have you gotten a job? Have you gotten divorced?
Have you had a baby? Have you moved right? Those things, those life things. One of the questions on there is, do you consistently see yourself as overwhelmed? This is a perceived stress scale, right? It showed that people, it didn't matter how many of those life in stressful inventory items that they said yes to, overwhelm was the biggest one that actually shrink the prefrontal cortex.
It acts just like somebody that's been in a war, PTSD, sexual trauma, domestic violence. It actually behaves the same way in changing your brain architecture and your hormones to be overwhelmed. Yeah. I was like, Oh my gosh, I do not [00:27:00] ever have one patient that comes to see me that does not report themselves as chronically overwhelmed.
Charna Cassell: And I just have to just, I want to continue on this thread, but I'm just thinking, Oh my God, what kind of hormonal mess is all of the United States going to be in?
Dr. Keesha Ewers: I know,
Charna Cassell: given the amount of overwhelm that people are already feeling.
Dr. Keesha Ewers: I know. First, it's what I try and point out, I'm in grad school right now, I'm getting my master's in Divinity, and I'm like, here's a place where you would think yeah, that you could go through an election and the people have the tools.
My professors are coming unglued. Yeah. You know, they can't even start out a lecture without some commentary about the election. And I'm just like, wow. Nowhere are there people that I'm seeing like in the, in the halls of a place that I would think there would be more resilient. No. So I feel like I'm sort of like Isaiah on the wall in the Bible.
And [00:28:00] it's saying, look, everybody, election cycles come and go. It is really important that you pay attention to your own thoughts. Quit worrying about what's going on out here and come back in here and have good boundaries with your thoughts.
Charna Cassell: The one thing I wanted to mention about the heart rate variability, I was part of a study that it's like during these meditations for 24 hours, I wore a, ,
a, monitor,
right?
And so this remarkable thing of being able to be in multi hours of meditation and maintain heart rate variability. Yet what the monitor showed was. I couldn't go to sleep. Like my, my sleep, my tendency, I'm such a light vigilant sleeper because of childhood trauma that it was like slow, slow, slow, slow, slow descent.
And I was actually asleep for maybe 15 minutes before it was time to wake up. but the, it's a plug for meditation [00:29:00] because that was something that put even a vigilant nerve, you know, habitually vigilant nervous system into a state of heart brain coherence.
Dr. Keesha Ewers: Resilient.
Charna Cassell: Yeah, it was like really replenishing my system. And so I love that you're adding, uh, a master's in divinity to the mix because it feels like such an essential piece to me. Yeah. To be able to have that spiritual perspective, , especially when you're dealing with it's like the physical body and what we go through And the stories we can if we can get stuck in in those loops Versus being the capacity to see things from a different vantage point Yeah so
Dr. Keesha Ewers: much So you can feel it in your system if you If you feel inside that you're contracted and it'll be tight tight Gut tight shoulders tight jaw tight guarding over your heart, you know, just like tight you'll be that's always [00:30:00] Fear and child space.
Yeah, and so it's like it's not bad You can just have it be a feedback like oh, I'm how old do I feel right now? Definitely in a child's face of vigilance and my child parts are not supposed to be the ones running the show I need to make sure they're safe inside the cavern of my heart, bring them in, right?
And then bring my older, wiser self, either the age I'm at right now or one that I can visualize, but even got more wisdom than me forward to lead into the world. And so that's going to be felt as expansive openness, which can contain the complexities of life, not the black and white. This is right. Or this is wrong.
But like complexity, right? Children can't do complexity. So that expansive, open, holding, creating a container for that is unconditional [00:31:00] love. That's compassion. That's wisdom. And you'll be able to feel the difference of how they, how they show up inside of your system. And one of them. will create a risk for epigenetic diseases and the other one doesn't.
One of them will keep your hormones depleted and constantly being hijacked and your digestive system whacked out. The other one won't.
Charna Cassell: What you just described is really core for being able to give consent. No, making choices in your life, knowing what you want, knowing what you don't want.
And it's like being able to track your embodied sensations is something that is just like daily, what I'm sitting with my clients, helping them start to just pay attention to, because with trauma, as you know, you often leave your body or you numb out. It's like you could have [00:32:00] all the sensations if you're home, but if you're not in your body, you can't.
You can't feel what's going on and know, um, what your body's saying yes to and what your body's saying no to.
Dr. Keesha Ewers: It's such a smart thing. Like, the wise mind of the child that learned to leave their body, well done. My ten year old self that was sexually abused in a vice principal's office in elementary school, well done.
Like, don't stay in that body. Right? Very good. And then, now I can leave it if I want to. And I can come back when I want to be. Right. So I love astral traveling at night. You know, it's like, these aren't bad things.
Charna Cassell: Totally.
Dr. Keesha Ewers: But you
want to be in charge. '
Charna Cassell: Yes. I'm a total fan of teaching people how to, what I call choicefully dissociate.
It's like a client who come in, they're like, okay, I need to go away for a minute before we're present. And then I go and they're like, okay, I can come back. Yeah.
Dr. Keesha Ewers: And there are different energy systems and patterns. And the more air you have in you, the more that that's actually [00:33:00] a really beautiful thing to do.
Totally. Because you get to go into the realms and bring back all this beautiful, magical wisdom that comes from other dimensions of time and space, right? I was at 10 talking to angels. So you know, it's like, that's because I have a lot of air in me, an earth person is going to like hunker into the earth and endure.
And then that grounding stability will be the positive side of that the negative will be. Disassociating into the ground, like cool stuckness, right? And you can, you can actually bring in those different energy shifts for yourself with choice. Oh, I think I need more earth here. I need to get more grounded.
Ooh, I'd like a little bit more air. I want to play with the fairies right now.
Charna Cassell: I love that. Can you also speak to water and fire?
Dr. Keesha Ewers: So water is codependence in the shadow. It's like, I'm not okay if you're not [00:34:00] okay, people pleasing, love me, I'll take care of you. I have a lot of water in me and I had to heal the shadow aspect of that big time.
And so then the positive part is I, I have four children and I am very maternal. And so it's that maternal, loving, nurturing, nourishing energy that, you know, it's like, Oh, I want to be super present with you. How do you need to be supported right now? Right. And that's that ability to attune to be there with that emotional depth and stability, empathy without having to fix it.
Right. Yeah. Yeah. And fire. And then fire is the transformation energy. And so fire people that are mainly fire say that vulnerability is weak. Can't have tears. It's weak. Can't be vulnerable. It's weak. I have to always [00:35:00] be seen as strong. And so the, the shadow aspect of that will be, you know, anger, lots and lots of it.
And it'll be a pushing away of anything that feels dangerous, like. And so the, you know, the, like, it's called, um, Christ consciousness, like the white Christos is male and the red Christos is feminine. It's the Dakini energy. And it's that fire transforming trauma into wisdom and it's passion.
Charna Cassell: Yeah, I'm all water, fire, and air over here.
I'd like, I'd like a little more
Dr. Keesha Ewers: earth.
Charna Cassell: Like a little more.
Dr. Keesha Ewers: We tend to be attracted to people that have earth in them. Oh yeah. Like that, it's like, ooh, I love you, ground me. I know,
Charna Cassell: I call it like tree trunk men. Yeah. Like hunker down, except for the tricky thing is the part of you that likes to transformation and change and movement gets very frustrated.
Dr. Keesha Ewers: And they're very slow to digest
things. Slow to [00:36:00] process. Yeah.
Charna Cassell: Totally. That's, it's such a common dynamic I see in the couples that I work with. It's like the, the, You know, action as a survival strategy versus the hunkering down. I call it like armadillo energy,
Dr. Keesha Ewers: right?
Charna Cassell: I would like to do a 180 completely change what we're talking about and come back to something that I think is important information for, for folks listening around the difference between, Sorry, so there's patches, there's pellets, there's shots, there's creams, there's external creams, there's internal creams, and
Dr. Keesha Ewers: there's synthetic, and there's bioidentical.
Charna Cassell: Exactly. And, and so, you know, and depending on your symptoms. Like, I tend towards migraines, and I recently found out, um, uh, that you, you know, getting, doing the cream is not good, what I heard, because it's like a, it's releasing all at once versus like a slow release, so that changes [00:37:00] in hormone, fluctuations in hormones can also contribute to, to migraines.
So I would love to hear some of your thoughts about these different things, and of course it's hard because, you know. We're all different and we have different needs and, but in, when people are considering one over the other, what are some things to think about?
Dr. Keesha Ewers: I first want to drop in on the migraine thing.
There's a gene. I, have you had your genetics done? I have not. You might want to do that with me. Yeah. Yeah. I would love, I definitely, I'm a migraine gene and it's called the MAO monoamine oxidase, um, SNP, single nucleotide polymorphism. And when people carry that, Then they are more susceptible to the hormone fluctuations.
And it isn't about the hormones. It's about the snap of not being able to actually break down this particular neurotransmitter, which is activated and [00:38:00] made compounded. You know, so much worse if you have this SNP by something called tyramine in food. So tyramine, you can't break down if you have this tyramine is present in all foods that are aged and fermented.
Alcohol, yogurt, kimchi, kombucha. All migraine activators with that SNP. So there's, there's a lot more to this picture when you throw in the word migraine. Right. I want to just tell our audience that there's so much more than hormones. Okay.
Charna Cassell: Yeah.
Yeah.
Dr. Keesha Ewers: Because migraines have a whole bunch of different other root causes.
So, and hormones play into it for sure, because people that are migraineus notice in their cycle that there are times when it's worse. Right. So then different applications of hormones to your point can make things worse. So coming back to your question around just hormones, how [00:39:00] do we differentiate and make our choices?
It does very much depend because, I like to do testing first and see what's going on with somebody and I include genetics with that because what I want to know is if you have a hard time like we mentioned earlier with genetically having potentially a problem to get rid of excess hormone metabolites, it's going to matter what I offer for delivery.
Okay. And then it's going to matter how I track you to make sure that is actually working because all we're working on at first is theory. Like, because you have this, then this is the potential that we always test don't guess. So I'm going to give you this. And then this little compound that we've created that matches your testing and your genetics and your symptomology and your lifestyle and your request [00:40:00] for how you want it to work into your life.
And then we're going to come back and we're going to test to make sure your body is doing good things with it. Okay, and then we might make adjustments, you may be like, Oh, you know what pellets probably not a great idea for you. I, I actually happen to like intravaginal use if somebody has intravaginal symptoms.
Like why give somebody, and I never give oral, never. The liver hates hormone replacement therapy. And so I will avoid oral use at all costs because it creates two passes through your liver to take it orally. And so liver is already something that it's a very forgiving. Um, organ of detoxification, but when I look at genetics, I often see that if people have little mystery issues that they've got a liver problem.
And so I want to [00:41:00] support the liver. And I also want to make sure that I'm, I'm not aggravating it. Right. Yeah. So the way that you make that decision is based on, I always say we're each of us is a unique puzzle. So it's going to be based on your symptoms, your lifestyle, um, where the things are occurring.
So do we need to give you estrogen just because of bone density? That's going to be different than if we're doing it because you also have vaginal dryness.
Charna Cassell: And, and so one of the things also, I know a lot of, a lot of people who are on patches, for instance, it's like, that's what their doctors offer. It would be amazing.
What a different world it would be if we had doctors like you across the board. Right. That we're looking at the whole picture,
Dr. Keesha Ewers: Oftentime
but the provider will learn a system and then that, you know, they always say, like, if you have a, a hammer, you're looking for a nail, right?
Charna Cassell: Exactly.
Dr. Keesha Ewers: Yeah.
Charna Cassell: But then also it's, [00:42:00] it's estradiol or estrogen and progesterone and testosterone is left out.
And, and so that's the thing is I haven't come across any, I don't think insurance covers testosterone from what I could see. It's basically not, like in turn, I haven't met any, I haven't talked to anyone whose insurance actually covers it. And so there are all these. Separate companies that are now, it's like out of pocket.
If you want to get an
Dr. Keesha Ewers: I actually do not take
insurance because the kind of testing and individualization that I utilize is not paid for by insurance. You have to think about the insurance paradigm. I'm not calling it bad. I will never diss Western medicine. If I have a heart attack, if I have symptoms of the stroke, you can bet I am in the first western medical emergency room, right?
That's why my background is there. It is fantastic medicine for acute care. But not for [00:43:00] actually diving under symptoms. Why is the symptom here not match the drug with the symptom? Insurance pays for that. So if you're having hot flashes and you go to somebody that takes insurance, they're going to look for something that gets rid of your hot flash, not at how well you're using the estrogen and how well you're getting rid of the metabolites.
Insurance doesn't pay for that. It doesn't pay for the genetics component. I, I tried for a really long time to do the paired, you know, like My model of medicine and fit it into the Western model and I took insurance and then one year I got charged back by the insurance company 20 grand. It almost put me under and what they said in their letter.
It was just like this letter out of the blue that here are these six patients. They had audited and in those patients. I had not prescribed one medication, but [00:44:00] In each of the six patients they chose, I had reversed cerebral ataxia, I had reversed type 2 diabetes, I had reversed two autoimmune diseases, I had helped somebody's Hashimoto's go into like their autoimmune markers to zero, and that didn't matter.
The way that their little algorithm is set up. Is, doesn't matter about that. So it was so frustrating and I said, I can't try to like have this model and fit it into this one. Those two don't go together. It's maddening. And insurance companies, the way, I mean, you can't be mad about it because it's like, it's a, it's a gambling paradigm.
So they gamble on you paying a premium and them not having to pay out. So if you really get it, then you're not going to be mad about it. Like, okay, that's actually the model. They've never ever been anything but transparent about that. [00:45:00] Right. Insurance companies have never said. Our objective is for health.
Right. They want to make money.
Charna Cassell: But so if you come back to the, so, like, pellets, patches, testosterone,
it feels like there's much less information because people are just going to their doctor and getting a patch and being like, okay, I'm all better. There's so much less information about testosterone and, and, and how women can get that if, if they're having certain symptoms that show a decrease in testosterone.
Dr. Keesha Ewers: Yeah. So testosterone, you know, is not a panacea for everything. No, no hormones are, but it's necessary. And so I use, , topical testosterone on my clitoris. So I have intravaginal biased that I use and I have topical testosterone [00:46:00] in a separate tube that I use clitorally because it helps to enhance sensation.
And so I absorb testosterone through my clitoris. And I absorb my estrogen through my vaginal wall, , just to prevent any dryness. It's how I, I prefer taking it and I use progesterone on my wrist at night and that's what I do. And that works for me, but I, I actually, , order like pellets for some people and I do patches for other people and you know, it's just really depends on the person.
Charna Cassell: And is taking, doing pellets the only way to get bioidentical hormones, or is, so the cream can be bioidentical, right?
Dr. Keesha Ewers: Oh
sure, yeah, compounding pharmacy can put it in anything. You can take it as, , you can get biased with hyaluronic acid if you have bad pH that keeps having yeast [00:47:00] infections after you go through menopause.
Obviously you have to change your diet. , you know, and, and I do GI testing to make sure that you don't have an overgrowth of fungus in your gut and you have to like, stop drinking alcohol and eating sugar and drinking coffee. Right. When you go through menopause, that's just like, please do those things.
Hormones don't cure any of the things, the harm caused by those don't drink, please. Alcohol and caffeine and don't eat sugar. You will have, that's why I don't have any hot flashes, right? You will have such a better life. And so then you can use hormones and it will actually, depending on what's going on, right?
Yeah. So you can get bioidentical hormones, like all the minor bioidentical that I give to my patients. Yeah, I can do it in an oil base right here. Yeah. The wrist, um, administration or behind the knees. I [00:48:00] can do a cream. I can do kind of an, I have a, I call it the magic face cream, but I also use my, , I get my estrogen that way with a retinol, , a prescription retinol, , based.
And that's what I, I use that on my face and in my vagina.
Charna Cassell: Mm hmm. Mm hmm. It's so, you know, um. What I hear from a lot of people and I could get as if I was a listener listening and being like, oh my god Where do I start? Because it is it it's a mystery.
Dr. Keesha Ewers: It really isn't It's only a mystery if you haven't asked your body would hit one Then it's a mystery because it's like I always tell people you can you can have an apple Yeah, and you can study the Apple You can play with the apple, juggle the apple, become an expert at apple, a scholar on apple.
You can be an artist and paint apple, but until you actually bite the apple, you don't get any of the nourishment from the apple. You actually have to do it, right? [00:49:00] And so the testing is asking the body what it needs right now. So I've changed the way that I do my personal hormone replacement over time, depending on what's going on and how my body's responding.
There's not one thing that you stick to. You constantly come back and ask your body. So how's this? How can I support you? Yeah.
Charna Cassell: Yeah, absolutely. Being able to whole, whole separate conversation, but using your body as a pendulum, being able to actually tune in on a daily basis and see what is going to nourish you and in terms of supplements, in terms of food, in terms of all the things.
And so for people who don't have the, I mean, I know I reversed. I was having momentary period of intense hot flashes during, , as a trauma response after, , something that happened last year, , and completely reversed them through exercise [00:50:00] and diet and taking a few, like, you know, magnesium and certain supplements, that it was like full on and then completely gone.
Dr. Keesha Ewers: And hasn't returned. Right. So what are some ways if people don't have an abundant, you know, abundant financial resources to do all the testing that they can begin to address and tune into what their body might need related to these hormone changes.
When it comes. to tuning in, like I had said before, if you will, you know what foods cause inflammation and alcohol is not a food and caffeine is a drug.
Dr. Keesha Ewers: And so if you can really get that, like, Oh, those are not food. That's not nourishing me. It's going to cloud everything if you're ingesting those things. So anything that can cause inflammation like sugar [00:51:00] and caffeine and alcohol, then it will be hard. You can't actually use your body as a pendulum. It's going to be toxic.
So it'll be tough to be able to say, like, if you're drinking alcohol and then you're having hot flashes and take magnesium, that's kind of like being a bad diabetic. I'm on insulin so I can have the Snickers bar. Over time, that catches up to you. So the way to really tune in is to watch your tongue. If you stick it out and you look at the back of it, if it has a coating on there, then your liver is backed up.
You might have fatty liver. And when that's happening, like first order of business is the liver detox. Okay. That affects your hormones. Like, it's one of the things that affects your hormones the very most is how well your liver is operating. If you look at your lines on your face, so like when I go like this, you can see these lines here.
and This is important not to [00:52:00] put fillers and Botox in your face because that also will affect your hormones. Um, taking um, appetite suppressant drugs will also affect your thyroid and your hormones. So first and foremost is what are you putting in and on your body? That, that would be first rather than here's how to control the symptom of a hot flash, right?
A, a number one thing. Um, listen to the signs, like, is your urine clear, like light straw colored? Does it have an odor? Do you have a vaginal, um, odor? Do you have a vaginal? Any kind of vaginal, um, drainage? What do your stools look like? Do they look like a brown banana every day and they're easy to pass?
You don't have to wipe very much and you're not on the toilet for more than two minutes. Two of those [00:53:00] a day, okay? So, is your body weight within your, you know, your BMI, is it healthy? , these are all things that will affect your hormone balance. And they're all things that have to do with the choices you're making in your lifestyle before we ever even reach the discussion of what to take.
And that doesn't cost you anything. And in fact, it saves you money, right? Yeah. Yeah. Walking. I walk 15, 000 to 20, 000 steps a day. A day. Rain or shine. . It is one of the very best things for my hormones because like lymphatic system, I, my lymphatic drainage happens without a problem. Mm-hmm . I mean, I'm 60. I have no joint pain.
I'm on nom meds, you know, like it's walking in the forest [00:54:00] every single day of my life it has been. The biggest long term health choice that I have made, you know, in addition to healing my sugar addiction and, you know, like, like I said, like the things that I'm talking about are free. I get very interested when in curious when people say, well, out of pocket testing is too much.
I can't afford it. I'm like. Okay, let's talk about, like, do you buy coffee every day? You know, like, are you sedentary? Like, what's the cost of this on you, you know? And so this is really important. Mm hmm.
Charna Cassell: Yeah. Yeah, I want to, I want to wrap us up. Thank you so much.
And, um, is there, is there anything else that you want to leave our listeners with? And I also want to make sure that people can find you.
Dr. Keesha Ewers: Yeah, I think, um, you know, one of the other things that when you're talking about hormones, I would [00:55:00] say read Solving the Autoimmune Puzzle because it really helps you understand the feedback mechanisms of your body, like how to read your tongue, how to read your fingernails, how to read your sweat, and what it smells like, how to read the lines on your face, how to read your eyes, um, all of these things are actually like communication to you from body letters that maybe you have.
Left unopened return to sender for your whole life and in the book solving the autoimmune puzzle It really gets you into that like, oh, how do I get really curious about what my body's been trying to tell me ever? Um that actually, you know, that's miles ahead of taking a hormone, you know, and again Not not expensive at all to learn how to do that, right?
Yeah, right. I would leave that because It's really learning you and you are not even your sister or your mother or your, you know, like you're your friend, you [00:56:00] are not anyone but you, you're unique. And um, solving the autoimmune puzzle really points you to that. Like you are a puzzle and learning how to put that health puzzle together based on you.
It's really important.
Charna Cassell: Yes. Thank you. And, and what's your, your social media, your website?
Dr. Keesha Ewers: Drkeesha.
com, d r k e e s h a a dot com. And then TikTok and Instagram, it's also, uh, drkeesha yours.
Charna Cassell: E w e r s. Right. And it'll all be on the show notes. So thank you so much. I so appreciate your time.
Dr. Keesha Ewers: Thank you. Thank you so much.
Bye everybody.
Charna Cassell: Bye.
Thanks for joining us. If you appreciate this episode, please like rate and review and share with your friends. I'd really appreciate that. If you'd like to stay connected, you can find me on Facebook or Instagram at late open podcast, if you go to charnacacel.
com, you can sign up for my [00:57:00] newsletter, um, you'll get discounts and learn about different resources in each newsletter. And at passionatelife. org, you can read more about the work that I offer and my particular approach to healing. This has been Laid Open Podcast with your host, Charna Cacel. We all have different capacities, but I believe in our capacity to grow and change together.
Until next time.
