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Hormones, PCOS, Menopause & Fertility

Link to the Episode

Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness so that you can then go and empower others. Thank you for being with us today, Dr. Fegerl.

Dr Fegerl: Thank you very much for the invitation maám.

AB: So we start with: how do you know if your hormones are in balance?

Dr F: That is a very big question and not easy to answer. But if you allow me to take a step backwards, the hormones are produced by your body and your body is trying, with the performance of the hormones, to stimulate either this organ or this function, to improve and to accelerate another function too, for example, to rest. A very simple example is the cortisol that is produced in the morning allows us to wake up after 8 hours of sleep and I can start my day energetically, and the melatonin that is produced at the end of the day is allowing me to rest and to sleep, to find recovery during the night-time. If I do experience that one of my performance’s normal metabolic acts or the rhythms in my life, no matter now if it is the menstrual rhythm or if it is the daily Circadian rhythm, is somehow disturbed or is not working properly. This is then the moment when you should consider testing, a laboratory testing maybe, and a physician’s consultation to check [whether] your hormones are in a normal and physiological range or not.

AB: Okay, so what do you mean when you say test that one of the rhythms of the body is not working?

DF: If you find it, for example, difficult to awaken in the morning, and for example, two years ago that was absolutely not a problem, that is something. If you do suffer from sleeping issues and those sleeping issues are not based on a higher number of concerns, for example, or restlessness of defeat, you are experiencing that you are not able to rest anymore successfully. Or with women or young women, but also with the more experienced women, changes in the menstrual cycle cannot explain changes in lifestyle, for example, or the years they are alive.

AB: Okay, and what is the earliest stage you would say because a bunch of people here have young daughters and things. What is the earliest age that these symptoms can show up? Hormone imbalance?

DF: Hormone imbalance in early childhood is normally first visible as a delay in the growth of height or a delay in the development of age-adequate muscles. For example, if children stay very childish, although they are eleven or twelve or 13 years of age, that is something that shows that could be a sign of a delayed start of sexual hormone production. For example, if children in kindergarten or in the nursery are significantly smaller than the other children the same age, please consult a pediatrician, and the pediatric will compare the size and the weight and strength of your children to the mean statistic and is then measuring them as to be either fitting in a certain passivity or not. And accordingly, you are changing the recommendation of what hormones should be tested and what hormones [should] not.

AB: Okay, so you were saying that if you feel your hormones are out of balance then get your hormones tested. If they are out of balance, what is the best way then of getting them back in balance?

DF: That very much depends on the hormone and the reason why the hormones are out of balance. For example, the most common reason for hormone imbalance is stress and starvation.

AB: Starvation? Oh, God!

DF:  This is what we very often find with teenagers. If they are unhappy with the way how their body is looking like because they are feeling themselves to be overweight, for example, they stop eating very often and if they at the same time also do intensive physical activity and exercise, they are producing at the same time— high amount of stress. And that is, in the case of girls, for example, immediately stopping their ability to be fertile, or in other words, the menstrual psyche will stop immediately.

AB: Right.

DF: Another thing is for example, if boys or girls are unhappy or stressed because of the divorce of their parents or because of the pandemic situation, for example, they stop physical activity and try to compensate for this unhappiness and uncertainty by eating a lot of food or comfort food. And with that, they are making their body experience a lot of inflammation because of the indigestion, like we talked about and discussed the last time we met. But because of this stress and inflammation inside of the body, the hormonal change, hormone balance is changing and they become very often estrogen dominant. With the estrogen dominance, the boys for example are not developing enough muscles. They stay small and become a little bit obese. And girls for example also experience a change in the menstrual cycle with very painful and very strenuous menstrual bleeding and especially PMS, a premenstrual syndrome, aggressive pain and fatigue and spasms. Ah, yeah, those are all signs of a hormonal imbalance. So in other words, if you allow me, if the hormones are out of balance, you experience your body not being balanced.

AB: Okay, so you’re saying just be very observant and vigilant.

DF: Don’t be so anxious. If changes in the routine are changing your reactivity, your metabolic state, that is just physiological. But if without any experience of all the triggers affecting you, you are still in an extraordinary metabolic or emotional state, this is then the moment when you please should contact your GP [General Practitioners] to do proper hormonal testing.

AB: Okay, and you know, while we’re talking about teenagers, I’m hearing about more and more people getting polycystic ovary syndrome or P-COS as it’s called, what is your view on that? What symptoms should typically someone be looking out for if they have a daughter? And do you think we should be proactive with young girls and check before we see symptoms?

DF: That’s very important for me because polycystic ovaries are very common, they are not limiting and reducing your lifespan, not from the point of scientific knowledge right now, so please don’t panic. And if someone is suffering from polycystic ovaries it doesn’t mean that this woman will not be able to conceive, for example, or give birth to children and become a grandmother for example, or that this woman is infertile and will always suffer from pain. That is not the case. So very often, I meet clients that are carrying the diagnosed PCOD in front of them.

AB: (interjects) And they’re panicking…

DF: Yes, that’s not important. That’s not right. Polycystic ovaries syndrome or polycystic ovaries means there are cysts on the ovaries on examination, visible when you examine the ovaries with an ultrasonic test and you can make them visible.

AB: Right.

DF: Secondly, if you measure in the blood the sexual hormones at the special state of the hormonal cycle you will find the androgens, and you will find the estrogens to be on the higher side. That is not a symptom but that is a criterion. And the third thing is pain before the menstruation in a higher amount and quality. That is also normally assigned for polycystic ovaries together with no ovulation at all.

AB: Okay. Together with no ovulation. Okay.

DF: No ovulation.

AB: Yeah.

DF: The ovulation is normally taking place on day 15 of the menstrual cycle. Day 15 of the menstrual cycle means you count or you start counting with the first day of menstruation or bleeding and at around day 15 you have a higher state of estrogen inside of the female body and this means an overlap for liquids riping and then popping and bursting.

AB: Right.

DF: And this can then cause irritation and pain, normally typically on either one or the other side, left or right. And this is shown the moment when the body starts to produce more and more progesterone and is reducing its production of estrogen or androgens.

AB: Okay, so… Sorry, sorry, I stopped you. You were saying something, go ahead.

DF: The classic risk factor for polycystic ovary syndrome or polycystic ovaries is obesity and the consumption of fructose or fruit sugar. There are other triggers that can accelerate the development of cysts and the androgen dominance inside the female body. Like for example, a dysbiosis in the intestine. That means fungal overgrowth, for example, after the usage of antibiotics, something very often seen with Indian and Asian but also US American clients that are taking antibiotics once they suffer from bronchitis, congestion and coughing. With an antibiotic treatment, you affect the microbiome inside of the gut. You’re stimulating a fungal overgrowth. And the fungal overgrowth is physiologically leading to estrogen dominance and to androgen dominance.

AB: And that causes polycystic ovaries?

DF: That is aggravating polycystic ovaries.

AB: So, would you suggest that the young girls get checked beforehand? Or should one wait for symptoms?

DF: I think the most important way of how you can support your daughter or your granddaughter, the best possible ways that you yourself and the girl are physically active, yeah— take her for a walk every day, not standing, but take her for a walk every day for one hour and it’s very unlikely that she will develop polycystic ovaries.

AB: Oh, that’s interesting. So, you are saying that if you are not active, the people who are not active, develop it when they are young.

DF: And the other thing is fruits are a highly valuable source of antioxidants and vitamins. They are fantastic, but they’re containing a form of sugar that requires all our digestive possibilities and tools to transform into something that is beneficial for us and protects us from turning fructose into something harmful for the liver. It is important to know because if our liver is struggling, it is very often that our body is then storing some special sugars, macro sugars, inside of the ovaries which is leading them to a buildup of cystic formations inside. So please, if you are concerned for the health of your daughter, but it’s also true for the health of your son, don’t offer them dried fruits. Try to reduce the consumption of fruit juices, especially watermelon juice, pomegranate juice, and also honey. And the third is fruits, yes, but in smart quantities that means maybe one portion a day. That would be fine.

AB: Okay, that’s very interesting. So, it’s not hereditary? Something like…

DF: There are of course also rare polycystic ovary diseases existing that are related to a hereditary factor. If your mother, for example, suffered from it, it is of course increasing a little bit of the chance that you are developing. But look, the genes you have can affect the performance of your genes through epigenetics. Epigenetics means with your lifestyle, like for example, an active physical lifestyle and reduction of food sugar consumption, you are reducing the risk that you yourself, and also because you affect the genes of your future daughters as well, and children as well, will develop polycystic ovaries.

AB: And if someone does have it, what do you recommend they do for it?

DF: Like I told you, physical activity, may be practising intermittent fasting. That means you are fasting for 16 to 18 hours a day would be nice. And in those 6 to 8 hours when you are eating, please don’t compensate for the meals that you passed, all the foods that you missed, but really enjoy a good variety of foods, not too many fruits and stay away from juices. That would be great. In this combination, you can protect yourself very well and you can support yourself very well. You can, of course then also use herbs. You can of course also use them as a very intensive antifungal treatment to get free yourself from possible other triggers like for example, fungal overgrowth. Or you can help yourself with the intake of bitter herbs like bitter gourd or karela, to make the body experience an increase of the progesterone or the gastric, that is of course also possible, to make you experience fewer symptoms and allow your body to get back into a rhythm

AB: Okay. And then the other thing is that for some reason a lot of people are trying to have kids and seems to be becoming more and more difficult. Now, very often people just say it’s a lifestyle. It would be interesting to hear what you have to say about fertility.

DF: The defect that a woman or a couple is conceiving first and then receiving a child, that is a blessing. Although it is a woman and it’s America so none of us is having the right to that, but there are a few factors we can influence very positively to increase the chance that it is happening. For conceiving it is important that the body of the woman is a good potential nest and the nest is built not on the windy place of a tree but on the safe and cosy side of the tree. So if the woman is experiencing a lot of stress, emotional stress, or also stress through an increase of environmental pollution, the stress of suffering from a lot of indigestion and maldigestion, for example, the stress of inflammation caused by an injury, by hormonal imbalance, or also, again, the stress of not sleeping enough, of being immobile not physically active, that is making it more difficult for a woman to conceive.

AB: Right.

DF: Hence we do know in Austria, for example, that infertility is more than 50% caused by male infertility. Also, men have the duty and the possibility to increase fertility; the fertility and the activity of the sperm by being physically active, reducing inflammation in their body. That is very important because men are continuously building sperms. So, the sperms that I used to impregnate my wife and my partner, for example, were built today or maybe in the last few days, the way I live, is dramatically affecting the quality of the sperms. So these men, we are on duty and [have a] responsibility to increase our fertility and not only blame our women and wives.

AB: No, that’s a very good point. So, do you think a simple diagnostic blood test is useful to start with or not?

DF: What’s important is really a proper examination with a woman, women, sorry, with women, especially an ultrasonic examination of the pelvic organs, the ovaries, the tubes, the uterus. Also, analysis through a talk, an examination and an assessment through asking questions.

AB: Right.

DF: It is possible that someone is not ready to conceive because of a private situation like it is too stressful or the pandemic situation is causing too much stress and insecurity. It’s not right?

AB: Okay. And now we come to again a huge topic of menopause and we had lots of questions about menopause. So what is your view on menopause and on HRT [Hormone Replacement Therapy], which is what every woman asks at some stage in her life.

DF: It is a hormonal change. Menopause is a hormonal change and the hormonal change is not an illness and it is not a sign of a character weakness. Some women are suffering from more problems and symptoms than other women. It’s not a sign of vitality if you experience no symptoms, it’s just life and luck.

AB: Absolutely.

DF: So, the hormonal change is affecting your metabolism, it is affecting your hormones, of course, it’s affecting your libido, your stress resistance, it is affecting your ability to perform and your ability to also rest. In this situation, you notice changes in your body and changes also in your mind. If a change is causing immediately a stress reaction inside of you, please start to read a little bit to inform yourself about the hormonal change, to relax a little bit. Yeah? Because again, a hormonal change is not a disease. Secondly, if the symptoms are pushing you that far and that much out of your state of well-being that you say your life is holding no quality anymore and you’re experiencing yourself being pushed out of health, then please contact your physician, do a proper examination, do also testing of your hormones. In my experience, the best possible would be if you test your hormones at around day 23-24 of your menstrual cycle. Because this is the moment where most likely the estrogen and the progesterone are the highest and the slow decrease of the progesterone is becoming visible the earliest, and understandable in this situation. After this examination, you can discuss either herbal or also you can discuss bioidentical hormone replacement therapy. The classic hormone replacement therapy with synthetic hormones. I would be very normally not supporting because a hormone is something that is an effect on the body, not only stimulating but also calming effect. You need a hormone to have negative feedback on the body at the same time, not only stimulation. Because with just simulation, you’ll suddenly experience negative side effects of hormonal treatment. Whereas bioidentical hormones, for example, are also hormones or hormonal-like fetal therapeutics. That means herbal remedies. They are not only stimulating but also calming at the same time. So the chance that you experience the negative side effect of hormonal therapy is going almost down to zero. It is of course possible that you are not liking the way how it is affecting you. This is why I would really recommend the consultation and the guidance to find you the right remedy.

AB: So you’re saying don’t self-medicate here? Make sure you go with an experienced therapist.

DF: It’s a little bit like it is with fruits. What is well experienced by your neighbour or your sister can cause harm inside of your body. Or if it is not causing harm, it isn’t making you experience the success you are expecting. So, please consult with someone who is knowing and is experienced in treating clients either with herbal or also with acupuncture, for example, acupressure or also bioidentical hormones. But stay as step number one, if you experience hormonal change, don’t panic and take over control up to a certain point. Don’t punish yourself with physical activity and exercise, but be a little bit more physically active. Reduce inflammation as much as possible inside your body by avoiding maldigestion. Avoid poisonous food as much as possible, like alcohol, nicotine, and caffeine. And also reduce a little bit overall amount of calorie intake. That is easiest by reducing the consumption of juices. No matter how well meant the smoothie is that you are consuming, reduce depending on the situation.

AB: Okay. So, someone has said, should there be a general diet to be followed during perimenopause.

DF: Maybe to explain it like that. The hormonal change is leading to changes inside of your body and inside of your body’s performance and organs’ performances. That means it is changing the way of how well you digest something and how well you metabolize or how well you react in a stressful situation. So, if you already know what is putting stress on you because you are not digesting it well or not feeling well by consuming it or after consuming it, please avoid this at least in your daily routine. It’s not necessary to ban it completely out of your life, but create a routine for yourself at home that is as friendly as possible, containing fruits you find easy to digest. Introducing maybe a little bit of intermittent fasting. Avoid the few spices that are making you hot and dry. Drink a good amount of water. Hydrate yourself in between meals. Because water is very important. It is allowing us and our organs to exchange and get rid of metabolic waste. To also avoid water retention inside the body, it is important to have a good amount of water. The more hydrated you are, the less likely is it that you develop water retention and in the diet, please avoid poison like caffeine as much as possible.

AB: Okay. You also said calorie counting…like cutting down on calories. You said that in conversation at some point, right?

DF: The easiest would be that you just, for example, perform intermittent fasting. Skip one meal and at the end of the month, you will have consumed fewer calories than you consumed before. That is the easiest. And I’m not a big fan of diet in a way to count on calories. Please really have good meals, but chew them and consume them with awareness. Have small bites of them, smell them if they attract you nicely, enjoy them. Stop eating the moment you feel warm and relaxed inside your stomach. Don’t wait for this feeling of a bursting and bloated stomach, that’s just too much. A meal should make you feel more alive afterwards than before.

AB: Lovely. Now the next question is lifestyle or food recommendations for breast cancer diagnosis. Now this person is in their late 30s. It seems like one in every few women is being diagnosed with breast cancer. So firstly, why is that happening and secondly, what should one do?

DF: Well, this is still a topic of scientific research over why the number of breast cancers is going high. It for sure has something to do with inflammation inside of the body. And in inflammation, again, stress is another word for inflammation— metabolic stress. That means the inability to nourish myself or also to perform according to my evolutionary plan. For example to be physically active; the stress of living in a more and more polluted environmental condition; the stress of being not nourished enough. That is not satisfying my need for nutrients and trace elements especially. The stress of being more alert and awake longer than the time that I allow myself to rest throughout the night. Melatonin is the sleeping hormone. Melatonin is a very strong antioxidant and is affecting women struggling with breast cancer, normally in a very positive way, because it is allowing them to experience longer hours of repair and also of regeneration and defence, of course. If someone is already suffering from cancer, please don’t starve yourself, but make your body experience as often as possible, really hours, where you are not consuming fruits or consuming juices. Allow yourself to do intermittent fasting because your immune system is your protection against cancer. And your immune system has to protect you against the food that you consume and the outer world that you consume through the act of eating a meal.

AB: Right.

DF: It is strongly defending you against cancer at the same time. Either to the one or the other. And if you nourish yourself with awareness and a relaxed state and allow your body enough time to digest and to rebalance and stabilize what you consume, what you have consumed, you strengthen yourself and prepare yourself in the best possible way to protect and to fight cancer as well as possible. When it comes to special foods and cancer I would recommend, especially with breast cancer, to avoid everything that is whitish, creamy, cold and slimy, that is…

AB: White, creamy, cold and slimy.

DF: In other words, no yoghurt, no curds, no sour cream for example, no paneer please, no milk and also not to substitute those substances in food directly, with for example, coconut yoghurt or almond milk. Reduce the consumption of those white and slimy things and have a little bit more clear liquids.

AB: Clear liquid? And why is that? Why are you saying that?

DF: Because from the energetic understanding, there are different types of breast cancer. But breast cancer is taking place in an organ that is a gland and if you confront the gland with something that is sticky and creamy, you block the gland. And what is blocked?

AB: What did you say? What did you call it?

DF: If you consume something sticky, you make the gland be blocked.

AB: The gland?

DF: Yeah, the gland.

AB: Okay.

DF: And when the gland is blocked, you stop the exchange. And if the exchange is stopped, you have an environmental condition that is supporting cancer and is not helping cancer. That is not a very medical explanation. That is more of an energetic explanation. You will find this explanation also, for example, in traditional Chinese medicine. In China, you say breast cancer is a rich woman’s disease because the rich woman is living the western lifestyle, consuming milk.

AB: Okay. And the same lady is asking about breast cancer along with the Lupus diagnosis.

DF: (laughs) Lupus. Lupus is a big capital. We still don’t 100% understand lupus. If you allow me to cut a long story short, lupus is inflammation. To reduce inflammation inside of your body and the big inflammation, lupus will also be affected through this reduction in a positive way. And when I mention inflammation, please consider the triggers that I mentioned before, like pollution, stress, not resting enough, consumption of food that you don’t digest, and dehydration, for example, to just be stopped.

AB: Okay, thank you for that. Now, someone’s asking the practice for help with hormone balance.

DF: Of course, with yoga, you reduce stress. And like I told you, stress is the most common reason for hormonal imbalances. It is beautifully supportive. It is not always the solution, because it can be that you are either hereditary or because of an accident or another condition, not able to keep the hormonal balanced. This is why I would kindly ask you if you suspect yourself to suffer from a hormonal imbalance without detecting or without feeling active to one of the triggers that might have caused it, right? If you are uncertain what is causing it, then please contact a physician and let’s start a proper examination on this.

AB: Okay, So now, Dr. Fegerl, someone is asking about, you know how you said don’t substitute it with plant milk, Take away white milk, white, sticky [milk]. So, they wanted to know more about if you can substitute or not at all.

DF: Look, of course, you can. And don’t get me wrong, dairy products are beautiful sources of energy, and especially the little children, and most likely the very old ones, need a little bit of milk or milk products because they can transform it very easily into a lot of energy. That is good. But if we are talking about imbalances, for example, or changes that are going beyond the physiological intensity, then please consider milk products not to be the best possible source of energy, calories or calcium. The concern very often is of my clients, especially female clients, that the reduction of calcium is leading to osteoporosis. In European treatment of osteoporosis, calcium supplementation is almost completely put out of and we only treat nowadays with vitamin D.

AB: Right. Oh, that’s very interesting.

DF: Physical activity. Physical activity or vitamin D, but no calcium anymore. Because we know that calcium supplementation can, if you’re not suffering from a calcium deficiency, calcium supplementation can increase the risk to develop a cardiovascular event. And this is the number one killer.

AB: Oh, wow! Okay, that’s very interesting. And that’s something I didn’t know at all, that we don’t use any calcium supplementation

DF: Until or unless you are suffering from calcium deficiency that can be easily tested.

AB: Okay, Dr. Fegerl, I’m going to quickly, we’ve got about three minutes left, so I’m going to rush through one or two questions. Someone’s asking, does beetroot have a high hormonal effect? And someone else wanted to know about lime and lemon for cancer treatments because they’re saying they have a lot of it.

DF: BeetrootI’m not very much aware of [it having] a huge hormonal effect. It’s maybe that the beetroot is containing a higher level of fructose inside— fruit sugar, and that, again, affects the androgens and the estrogen-like hormones to be increased. That is the one thing. Secondly, with lime and lemon juice, if you consume small quantities of that prior to a meal, you increase your digestive strength. With that, you make it more likely that you digest foods rich in proteins easier and more completely. So with that, you can support your digestion of protein bombs. But to cure cancer with lime and lemon, not that I know of. Sometimes high dosage of vitamin C therapy is recommended by me or through me and my colleagues. But this is a decision or a recommendation that is based on a proper examination and individually given. And to do high-dosage vitamin C therapy with the consumption of lemon is impossible. You would need to consume more than 200 a day and no one would feel comfortable with it.

AB: Yes. Dr. Fegerl, someone else is asking about what you were talking about just now about you saying cardiovascular disease. They’re asking did you mean calcification of arteries?

DF: The cardiovascular event is, for example, a stroke; it is a myocardial infarction [MI] that can be caused by atherosclerosis. Atherosclerosis is an inflammatory change inside of the vessels, making or producing stenosis more and more. But a cardiovascular event can also be caused by angina pectoris, for example, which means the spastic reaction of the coronary arteries blocking the blood circulation for a certain period of time. And both causes of cardiovascular events can be caused by us, becoming more likely if someone is experiencing a high calcification.

AB: Okay, thank you. And the last question I’m going to ask you is actually a very relevant one because it’s come up a few times in the past as well. Someone said a lot of elderly people take glucosamine sulfate tablets supplementation for bone wear and tear. What’s your opinion on this?

DF: You can take chondroitin sulfate and glucosamine, for example, to support the nourishment of your cartilage in the joints.

AB: What was the first one you said?

DF: Chondroitin sulfate. Chondroitin.

AB: Chondroitin, okay.

DF: Sulfate and glucosamine acid— they are nourishing the cartilage and they are not nourishing the bone. For bone nourishment, you need physical traction. That means the physical activity, supports the usage of mechanical stress on the bone. That is important. And of course, vitamin D. If you want to be very sophisticated, you can add vitamin K, two at the same time, for example. Also vitamin A. But once you get diagnosed to suffer from osteopenia, please consult one of your physicians to receive a proper recommendation. And if you don’t get a proper recommendation, move your four letters, be physically active and tidy up your vitamin D intake.

AB: Okay. Thank you. Thank you, Dr. Fegerl. Now, my last question for you is something people have been also asked. Most of you know Dr. Fegerl is based in Austria at the Viva Mayr Clinic. But he does come to London. When are you in London next?

DF: It is because of the actual situation and because of a personal situation here in Altaussee, where I’m normally working, it’s not completely clear. I’m super happy that I have a fantastic and wonderful colleague in London that is keeping the Viva Mayr flags high. Her name is Katrine Brower. She is a general practitioner, an expert on internal physician, and internal medicine, and practices a very holistic approach. And she owns a golden heart.

AB: I think I will put the contact details. Thank you so much. As always, you give us such a wealth of information. Thank you.

DF: Thank you for your patience with my English. And I hope I didn’t cause too much of a confusion. I would be happy. If there are questions, please contact Viva Mayr. Contact one of us physicians. Or if you have a very personal question or concern, please use one of our telemedicine channels to book our meeting for a consultation. I wish you health. Stay safe and confident. Bye, bye. Best regards.

AB: Thank you so much. Thank you. Thank you again. Take care. Bye bye.

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