Ep. 202 – Healing Your Hormones and Becoming Empowered with The Girlfriend Doctor

Your trusted source for nutrition, wellness, and mindset for thriving health.

I feel honored and privileged to re-interview Dr. Anna Cabeca today! She was with me once before in Episode 94. Dr. Anna is triple-board certified. She is also a fellow of gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine. She has special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy. Over the past 20 years, she has served more than 10,000 women in her private practice and millions more through her books, online videos, and articles.

Dr. Anna has a new book out, called MenuPause. When reviewing her book, I was surprised to discover that only 20% of those going into obstetrics and gynecology trained in menopause medicine. It almost seems that once women move beyond their child-bearing years, they become irrelevant and invisible. Fortunately, Dr. Anna is helping to change that narrative!

In this episode, Dr. Anna and I dive into her new book. In addition, we talk about the need for female empowerment, the stigma of middle age, perimenopause, and menopause. We discuss intimacy as the key to connection and the importance of understanding the changes in a woman’s body as she moves through that phase of life. (Dr. Anna refers to that as pausing.) We talk about understanding the role of the connection hormone oxytocin and the importance of women being solution-based when approaching that key phase of their lives. We get into statistics and the microbiome of the gut and the vagina, talk about Dr. Anna’s various six-day eating plans, and explain how those changes can improve our physiology and stabilize symptoms. We also look into stubborn weight-gain issues, the health needs of middle-aged women, and how different cultures view middle age.

I am thrilled to be bringing you today’s exciting conversation! I hope you gain a lot from listening to it!


  • There is time in menopause for women to re-evaluate their priorities.
  • Dr. Anna challenges you, the listener, to start having girlfriend conversations. Talk to your best girlfriends about what’s going on with you intimately.
  • How to empower yourself by increasing the healing hormone oxytocin in your life.
  • There are many different ways to support your body and improve your quality of life while going through menopause.
  • Following a keto diet and fasting will give you energy, make you feel better, and improve your sex life.
  • What inspired Dr. Anna to write her new book?
  • How to improve your health, and live a long and high-quality life by cooking healthy food in healthy ways.
  • How will you benefit from fasting for six days?
  • Who will benefit from doing a pause and following Dr. Anna’s Keto Green Plans?
  • The predominant proteins that Dr. Anna focuses on in her plant-based plans.
  • Changes Dr. Anna has seen in her patients’ gut and vaginal microbiomes as they change their diets and transition from perimenopause into menopause.
  • Some common causes of weight-loss resistance.
  • Dr. Anna talks about some of the delicious hormone-balancing recipes in her book.
  • Getting enough protein is vital- particularly as we get older.

About Dr. Anna Cabeca

Dr. Anna Cabeca, DO, OBGYN, FACOG, is triple-board certified and a fellow of gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine. She has special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy.

For the past 20 years, she has served 10,000+ women in her private practice— and millions more through her books, online videos, and articles.

When her own health took a troubling turn during menopause, she sought out the wisdom of healers around the world. She learned that modern medicine and time-tested natural remedies are not at odds. Working together, they create indisputable results and true well-being. Using delicious, healing foods and simple lifestyle changes, Dr. Anna reclaimed her health and life.

Fueled by her belief that every woman deserves to be empowered and in control of their health and life, she developed the Keto-Green lifestyle, which has helped thousands of women opt out of menopause misery and experience a joyful transition to the next stage of their lives. With her methods, you, too, can breeze through menopause into your “second spring”, feeling the best you ever have.

Connect with Dr. Anna Cabeca

Connect with Cynthia Thurlow

“There’s magic in the pause.”

Dr. Anna Cabeca


Cynthia: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent are to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.


Today, I had the honor and privilege of re-interviewing Dr. Anna Cabeca. She joined me originally in Episode 94. Today, we dove deep into her new book, MenuPause. But first, we talk of great deal about the need for female empowerment, the stigma of middle age, as well as perimenopause and menopause, how intimacy is actually the key to connection, and how important it is to really understand the physiologic changes that occur in a woman’s body as she enters this new time in her life as Dr. Anna refers to it pausing, and understanding the key role of oxytocin, this really important connection hormone, and how important it is to be very solution base for how to approach this timeframe in our lives. So, we dove deep into statistics and the microbiome, not only of our gut, but our vagina. We talked about her six-day plans, Keto-Green, plant-based option, a carnivore option, a cleanse and carb moderate plan, how these changes can actually improve our physiology and stabilize symptoms. We even dove into stubborn weight gain issues, the health needs of women at middle age, and lastly, spoke briefly about how different cultures view middle age, and it’s a really exciting conversation. I’m thrilled to be able to bring this to you. 


Well, Dr. Anna, I’m so excited to have you back and even more so to talk about your new book.


Dr. Anna: [laughs] I’m thrilled too, Cynthia. Thank you. Our books, man, I tell you, it is the time. The time is right for this information. 


Cynthia: It’s so true.


Dr. Anna: It couldn’t be better timing.


Cynthia: Absolutely. It is interesting when I was reviewing your book one of the things that really stood out to me was a statistic that you mentioned that of the individuals that are going into obstetrics and gynecology that only 20% of them are trained in menopause medicine. I just found that astounding. In so many ways, we’re so focused on contraception, and pregnancy, and the postpartum period, and then, it’s almost as if when women are done having their childbearing years, they suddenly become irrelevant and invisible. I love that you’re helping to change that narrative or we’re both helping to change that narrative.


Dr. Anna: Yeah, no, it’s so powerful. I think about as because we go through our health care with our OB-GYN as our priority doc. Really, that’s taking care of our feminine needs, our gynecologic problems, any vaginal health issues. As a resident, certainly, we’re trained– and I was trained at Emory, one of the best, if not the best in the nation, plug Emory. 


Cynthia: [giggles] 


Dr. Anna: But we’ve recently developed a menopause clinic. Even with the menopause clinic, you have to rotate through, and it’s a very brief exposure to really menopausal medicine, and we know that what we have, what’s being offered certainly isn’t ideal with synthetic hormone replacement therapy. What I have found through my education and my career now 30 years in medicine, so and in my own personal journey, it’s not less than 1% is what we do from a prescription pad and a surgical procedure. Really, it is the empowerment and that’s why I love what you’re doing, Cynthia, because you are empowering women to take control of their health and to see the results, like see for yourself, just see for yourself. That’s what I really want to empower women for this transformation. Because menopause should be magical and I will say there’s magic in the pause.


Cynthia: Yeah, well, and I think on so many levels, we’re such an ageist focused society. I think many women fear and have a tremendous amount of shame about this time period in their lives. In fact, right before I jumped onto record with you, I have an eight-week program and most of the women are in perimenopause, the five to 10 years preceding menopause, and so many of them are like, “What is it going to be, am I going to have hot flashes, will I need hormone replacement therapy, what if my sleep gets terrible, what if my vagina dries up?” I’m so uncomfortable having these conversations. I can’t have them with my significant other. I feel uncomfortable having them with my healthcare provider. On so many levels, I think that we have to de-stigmatize this transitional period in our lives and really embrace all the wonderful things that come out of it.


I think it’s the most creative time for a lot of women, because they feel they have the ability to focus on something other than perhaps their children or young children, maybe they are farther along in their careers, maybe they’re more established in their relationships, and so. On so many levels, it gives us incredible opportunities to really grow as individuals and reestablish our own identities. Because for so many years, we’re put in one bucket. We’re like the mom bucket, the doctor bucket, the Nurse Practitioner bucket. And now, you could be so much more than just those things. It’s not that they’re minimize. They’re still incredibly important, but we view ourselves very differently. I feel much more confident and much more self-assured at this stage of life than I did even 10 or 15 years ago.


Dr. Anna: Absolutely. I couldn’t agree more. I think there is time in menopause to reevaluate our priorities and prioritizing ourselves, because it’s true. It’s through our energy that we are helping others. You can’t give from an empty bucket. It has to come from an overflowing cup. That’s a really important thing that I want women to now. The other thing you mentioned is seeing the difficulty in talking with your doctors. I’m pretty friendly. Anna is the girlfriend doctor for a reason. I love my patients. They all would say I’m their friend. I needed to listen to what my patients were saying. Even with that, it’s the last piece of the conversation, when my hands on the door unless I’ve asked, my hands on the doors, I’m ready to leave. “Dr. Anna, I really am feeling a very low libido or I’m struggling with painful sex.” That’s a three-hour conversation. 


One of the reasons that and I’ve been in this space. I really have a heart for intimacy and relationships for lasting long-term healthy relationships, marriages for the rest of our life. Over my many years of practice and working in this area, the intimacy, it’s stigmatized. A woman doesn’t want to say, I’m just experiencing vaginal dryness or I’m not feeling turned on. And that can say, I’m not feeling turned on by my husband. That’s not what she’s saying at all and that’s not how it should be interpreted. The answer is not in watching sexy films or giving you more testosterone. The answer’s not there. In my conversation, because I wanted to create something for women that helps them, empowers them with in healing vaginal dryness, healing from incontinence. My product Julva like vulva with a J, Julva, I created that. Still with that, I’ve heard more conversations and more opening up about it, but yet there’s still the stigma. It just keeps me what’s the one next right step that I can do for myself and for my patient. Funny way, you’ll have to let me know what you think and I’d love to know what your audience thinks. A funny way I’ve designed to overcome this is because my Julva, you can put it on your upper lips to help with those lip lines and lipstick leak as well as your lower lips. 


Cynthia: [laughs] 


Dr. Anna: Someone were like, “Dr. Anna, I know this is for my vulva. I don’t feel comfortable using it on my lips.” I’m like, “Okay, easy enough.” I created another formula for the upper lips and I’m packaging them together as the Lip Duo, upper lips and lower lips. We have to take care of them both, but it’s clitoris to anus. I had call from a good friend today, who’s amazing, amazing influencer woman, nine-figure business. She said, “I’m having dryness, which I haven’t experienced before recently 50. I’m having dryness and it’s not my partner. I’m so turned on by him.” I’m like, “Oh, see, there’s that connection again. You’re not dry, because you’re not turned on.” You’re not and that’s not it. There’s more to it. There’s physiology. No matter how much we smile, we’re going to get laugh lines. So, it’s good. But we don’t want lines down there. Then, the other piece was you know Itching around the anus and discomfort. You apply it clitoris to anus. There’s nothing worse than surgically having to separate atrophied clitoris. There’s just that should never get there. It should never get there. There’re so many things that we can do. Creating like eliminating the stigma around that, taking care of clitoris to anus, I know we’re going to talk about keto, and all that good stuff, and fasting, Cynthia, but I’m just so passionate about this, and even behind closed doors. But start having girlfriend conversations. I want to challenge the audience. 


Talk to your guests, best girlfriend and say, “What’s going on? How is the intimacy with your spouse? What’s going on?” Because often, the disconnect in the bedroom leads to disconnect in other areas of your life. And the same thing. Disconnect in other areas of your life leads to disconnect in the bedroom. But that’s where we get oxytocin. I think between the kitchen and the bedroom, those are high oxytocin rooms in your house. You want to acknowledge that healing hormone of oxytocin through pleasure, self-pleasure, intimacy, orgasm, laughter, fun, joy, and that’s healing medicine. Like I say, if you take nothing out of this conversation, it’s to increase more oxytocin in your life. There are times when you’re so down and isolated and depressed, you don’t even want to. You have to play some funny movies, talk to your friend, who always makes you laugh, listen to great, positive, wholesome comedy, and go really positive. That’s an anecdote in and of itself. And talk with your girlfriend about this. “Are you having dryness? Is there loss of sensation? Or, this is what I’m experiencing? What have you noticed?” 


Incontinence. Incontinence has become a joke. I heard this the other day in my infrared yoga class. The women were like, “Oh, yeah, of course, I’ve had three kids. I’m using a pad during this class.” I hate that. It’s so soaked at the end of infrared hot yoga, because we’re sweating like– I’m like, “Oh, my God, I haven’t worn that in forever.” Then, 40, I had trouble with that. I don’t now at 55. We don’t have to suffer or power through anymore. We have to be empowered by the changes our bodies are making, do the right next step, take action, and have healthy community around it, because we need each other to understand, to answer questions, to deal with issues, to find solutions, to just share to have community, and that’s good medicine. So, we got off, I got off on a tangent, Cynthia. We aren’t talking about fasting. [laughs] 


Cynthia: No, look, but I think it’s an important conversation to be had, because there are far too many individuals, probably people who listen to my podcast, who may have questions and this will spurn them to maybe have a conversation with their medical professional, or maybe have a conversation with their husband, or their significant other. But I love that you brought up oxytocin, because I have learned so much through you. When I think about oxytocin, I think of you, because you made such an imprint on me as a clinician to really make sure I am endeavoring to get little oxytocin boosts throughout the day. It’s the mother of all hormones, but even as simple as like hugging your significant other or your dog, like, I have two dogs, and one I call my lovey, and so, he gets lots of hugs during the day, because usually no one else is home. But I think it’s important for people to understand the value of connection to have those open conversations. Certainly, the genitourinary symptoms that you’re describing, the ones that people are really embarrassed to have a conversation about, because they seem so personal and so private, that can be just a byproduct of the hormonal fluctuations that are happening in our bodies. 


To your point, I remember my grandmother who had five vaginal deliveries, and she and her sister who were hilarious used to talk about the pad thing. Everywhere they went, they had to make sure they had a pad and it just makes me sad that we didn’t know as much then as we do now in terms of how women can navigate these changes in their genitourinary systems in a way that allows them to live out the rest of their lives with dignity. Because I think that’s really what it comes down to. If you are concerned that you’re going to have urinary leakage or you’re concerned about painful sex, that’s not going to encourage intimacy. You’re just going to feel uncomfortable, and possibly ashamed, and you may not start the difficult conversation that you need to have, so that you can better support your bodies.


Dr. Anna: Yeah, no, absolutely. Yeah, a few things to add to that. It’s that sense that we don’t have to live with it. We can use certainly Julva, we can use bioidentical hormones vaginally. I mean, game changing. I’m from a surgical background. I remember one day, I did six pelvic slings for bladder slings. In one day, it’s how common. But as I got better and I started using products like my Julva and/or bioidentical hormones, vaginal suppositories, this combination, my patients would come back in for their pre-op visit, because I wanted to prep them to have the best tissue to operate on and they are like, Dr. Anna, I’m not having any more symptoms. I’m not having any more symptoms.” I have done this in 80-year-olds. To non-surgically treat their urinary incontinence symptoms, always with pelvic floor exercises, and treating it hormonally, and that is just liberating. The other thing with that, it’s certainly a quality-of-life issue. Because if you are wanting to jog, exercise, take aerobic class, or a fun class, a boxing class, I don’t know anything and you leak each time you do, you’re not going to want– 


I have a friend, who’s a physician and she sent me recently a testimonial of a 67-year-old-patient. The patient said, “I stopped jogging 10 years ago. I started Dr. Anna’s Julva last year. I’m jogging again. I just couldn’t stand wearing the panty liners or never knew when I’d have to run and find a bathroom.” At 67, she’s jogging. At first, I was like, “Why are you doing that to your body?” Then, I was like, “That’s really cool.” I was very grateful and grateful to Dr. Angela [unintelligible [00:15:22], who turned her on to the product and sent me the testimonial. I love that feedback from physicians, because they feel empowered, too. As a physician, I can do something that improves your quality of life. That’s empowering. I’ve seen too many patients come through my door that have been on medication, say for blood pressure, cholesterol, and I’m like, “Do you feel better?” They’re like, “Ah, actually, I don’t feel better.” “Hopefully, we’ll be able to get you off that stuff, but let’s do things that actually give you energy, make you feel better.” This whole concept with fasting with women and it’s essential, it’s why it’s also part of my Keto-Green philosophy is because then you shift from using carbs for fuel to using ketones for fuel, which is higher energy and its higher sexuality. It’s the way to go to have a healthy sex life.


Cynthia: Oh, I have to agree wholeheartedly and that’s a perfect segue into talking about your new book, which I love the title. So, MenuPause and the colors are beautiful, the photography is beautiful, I love that you touch on the changes that go on in the body, as well as touching on how different cultures view menopause, which I thought was such a beautiful way to weave this theme throughout the book that how differently other cultures look at this transitional period in our lives, whereas I feel in many ways, in some Asian cultures in particular, women are really emulated at that stage of life. They’re seen as being wise, and smart, and they’re a standout in their community, and where many women, I feel in our culture feel a sense of embarrassment. I love knowing that we’re helping to change that narrative for so many people, so they don’t feel marginalized, or that their needs aren’t being met, or they’re not being articulated. So, let’s start with, what was the impetus for creating this amazing book that has such delicious recipes. I can’t wait to try them.


Dr. Anna: Oh, you’ll love them. You’ll love them. One thing was because I started my book writing for helping patients through menopause and hormone imbalance issues with The Hormone Fix. It introduces this by the mind blown Keto-Green concept, adding alkalizers to your high-quality ketogenic foods and that’s to get your body into ketosis. As women, we do things differently than men. That’s all in The Hormone Fix, which is I definitely have to say mandatory reading. There’s a vaginal health chapter in there, too. I couldn’t not talk about sexual health. All of that to introduce, and then I went to my Keto-Green 16. 16 hours intermittent fasting and a 16-day Keto-Green plan, and listening to my audience, as a doctor listening to my patients, and 16 key foods to make shopping easier, and food prep easier, so that was important. Then, as we’ve gone through this and a year or so, two years, almost two years have passed, “Okay, well, sometimes still hitting a plateau. What are you doing?” Back and forth, listening, what are you doing now? What was working? What’s changed? Sometimes, you’re eating the same things all the time. I don’t care how good they are, we got to change things up or there’s an autoimmune issue. We’ve got to change that up. Or, you actually need more carbs, or we need to reset the microbiome, the list goes on. It was really fun. With MenuPause, Marni Cochrane is my editor. She’s like, “Love the name.” It was really her inspiration for MenuPause. She’s like, “What can you do with that?” I’m like, “Oh, my gosh, I can do so much with that.” It’s so good, plus, it makes me laugh. So, there’s an oxytocin boost every time someone sees MenuPause or says it.


So it was to create five key plans that are just six days to pause something, because there’s magic in the pause. Let’s figure out what it is that could be affecting you. There’s always the can start anywhere with any of the plans, but I did put them in an order that I think works most for everyone. But I did create a MenuPause quiz to say, “Okay, what might be the best plan for you right now and then, where can we go from there?” I have that in the background. Then because I’m first generation American, and I love international foods, and I didn’t realize until I started sharing my recipes, how foreign so much of what is normal to me is to so many other people. But yet, how it was created herbs, and spices, and different foods as medicinal foods. Just a quick example. This is something that is very common to so many people. Something like beets. We like beets. Beets are good for nitric oxide, but they’re too much sugar. But most people will buy beets and throw away the greens. The beet greens are one of the certainly top alkalinizing foods there are. It’s incredibly good for the microbiome, for the gut. It’s just powerful. But we’ve been throwing beet greens away forever. My cousin was over, who’s from Israel and I was telling her, this is way back in 2014, 2015 when I was creating my Keto-Green plans and menus. She goes, “This, you just have to sauté it up, but they’re bitter.” Sauteed the beet greens with onions and butter, and then squeeze lemon juice on it, and add salt. Of course, olive oil, because we put olive oil and everything in the Middle East. It was delicious and it turned my urine from acidic to alkaline. It was that thing was just powerful. 


Then, looking at the combination, when you’re cooking healthy fat, a good salt, a mineral salt, and acid, the combination of fat, acid, and salt brings flavor into– It’s part of many traditional cooking styles. Then, some very spicy foods, the reason for the spice, the Cayenne is to kill parasites, is to help the food stay longer to kill parasites. I wanted to introduce some of the international ways. I had hoped for this book that I would be traveling around the world and meeting. I really wanted to put a documentary around this that is still on my mind, menopause around the world. Because of the pandemic, I wasn’t able to travel. I disconnected the best I can and brought some fun philosophy and empowerment through knowing. We can look around us sometimes and not see an amazing example of vibrant health in our 80s, 90s or 100s. I want people to know that it is sustainable. Optimal health, high-quality life is sustainable and maybe to 150. It just starts with little baby steps that we take now, but we don’t want to live long if we’re not living with quality, we’re not having intimacy, and healthy relationships, and feeling loved, and happy. We want to create our home as a blue zone. Every one of our homes, I want to be a blue zone, high-quality longevity, connected, loving center. That was the inspiration to bringing MenuPause to the world and definitely more of a cookbook.


More of a cookbook recipe, beautiful color photography, and then, there’s just inherent brilliance into the plans to really just change things up. From more of an autoimmune plan, very low on, like no nightshades or peppers, and then there’s a carb up plan like a higher carbohydrate, with sweet potatoes, like Shakshuka from the Middle East, good really sustainable breakfast. Different foods to help bring in some international fun. Then, there’s a cleanse plan, six days of cleanse and we did that live in our, My Girlfriend Doctor Club, we had many women get a quick peek at that plan, because we can’t give too much of the book before it’s out. They’d amazing results. One woman on the six-day plan released 11 pounds of toxic waste and her waistline improved. She lost two inches of toxicity around her waist as well. That’s inflammation releasing imbalances and thirds– Often, women are so or retaining so much fluid too, don’t even realize it. Eliminating that is hugely important. She’s kept those 10 pounds off. It’s just amazing to me. I was like, “Wow, that’s so good.” Just that shift in that mindset and healing, just a gut healing. It’s a very gut healing protocol. That’s why I put that in there, because sometimes, three days of fasting or three-day cleanse isn’t enough and I’m a big advocate of that 72 hours. But I doubled that and that’s the reason the plans are six days, two 72-hour cycles. Let’s see how you do. 72 hours to re-epithelialize the mucosa essentially to regenerate a new cell intestinal mucosa 72 hours. So, that’s why the six days.


Cynthia: it’s so interesting, because I love the variety. That was one of the things that I think makes it very sustainable is that, whether you do it sequentially, each one of the plans one after the other, what I do find is the novelty of doing different focuses can be really interesting and I love that you’re already seeing such incredible results. Let’s talk a little bit, obviously, Keto-Green we’re familiar with. Talk a little bit about, you mentioned the CarbPause. I would imagine that’s probably someone that’s going lower carb probably, ketogenic, what would be like who would be an appropriate person for that? Is that someone who’s really looking to lose weight, is that their biggest focus trying to reduce inflammation? I’m trying to think about how each one could really be applicable. Because I think that there are so many benefits from really changing things up in our diets. For more than, I would say, monogamy is good, but food monogamy is not good. We want to make sure we’re getting lots of variety in our diets. Even changing things up, maybe doing plant-based for a week and then doing the Carbohydrate Pause. Talk to us a little bit about who ideally you were thinking of for each one of these different plans.


Dr. Anna: Yeah, so, the Keto-Green extreme, the carbohydrate pause plan, that’s very low zero carbs, very low carbs. It’s more of a carnivore-ish plan. Sometimes, people are just so sensitive. Their gut, their intestinal lining, their digestive tract is so eroded essentially, so weak. It is so much eroded. Like the intestinal lining, we talk about leaky gut. It’s really damaged. Giving it anything, sometimes, greens are just are toxic to it. They can’t digest it, they bloat, they flare, rosacea flares for instance. Again, psoriasis can flare, eczema. You definitely see skin conditions and also for severely weight loss resistant or just haven’t ever– And also intellectually curious. Just haven’t ever tried to go completely nose to tail for six days and how that would be. Short-term for carnivore is a nice bump. Long-term because of metabolically, that’s increasing uric acid. David Perlmutter really made that connection for me with his book Drop Acid. That connection between uric acid on a very high-protein, high-purine diet, you need to balance that out. That’s why the alkaline are important. That’s why I still preach. Check urine pH, because higher urine pH, lower uric acid, you want to clear that uric acid. That’s a really big part of the science behind it, too. A little bump is good, enough time to heal, that two cycles of 72 hours for the gut can be very powerful. So, people with a lot of joint pain, inflammatory pain, they have been doing Keto-Green for a while, you want a really healthy plan that’s balancing for women as well as men. That’s the decision for that carbohydrate pause.


Cynthia: I love that, because many of the listeners know that three years ago, I was hospitalized for 13 days and I was full carnivore for nine months, because I could not handle the fiber. I’ll be the first person to say that, when your gut’s really inflamed, if you’re dealing with leaky gut, I’ve been on antibiotics for six weeks and antifungals, my gut was a disaster. That was the easiest thing for my body to digest. Even doing it for six days, you’ll see profound benefits. I love seeing this included in your book. And then, also, if someone has been doing a ketogenic diet for a long period of time, even doing plant based, and I love that the inclusion of plant-based diet can be very helpful for people just to shake things up. This whole concept of weight loss resistance, oftentimes, we have to get outside where we’re comfortable in order to start seeing results. Again, if we plateaued or frustrated, the first thing I always say is, eat more green things. Because oftentimes, it might just be your body just needs to have a complete digestive hiccup. It’s like, “Let’s do a pause,” as you mentioned or have a hiccup and then, we can start losing weight again. In terms of your plant based, what are the predominant proteins that you’re focusing on there?


Dr. Anna: With a plant based, we’ve done a few different things. Black soybeans for instant, chickpeas, those are probably two of my favorites. Those are two of my favorites for sure. We want to do that, but also and I was a vegetarian for over a decade as a young woman. There’s probably some of the unhealthiest time of my life. The reason I know the pros and cons of it was we have to get enough fats, we have to get enough high-quality protein, and we also have to not get so many carbs, not get so many carbs. I think that’s often an issue that many plant-based eaters have. I wanted to bring a really balanced plant-based option to try it out to see how you do lower on the carbs. But yeah, good protein, good fat, very alkalinizing in the plant-based week is because we are so stressed as well, that the alkalizers are key, the vegetables. We know that the more diversity you have in your diet, especially with plant-based foods, the more diversity within the gut microbiome, which is critical for our overall health, and our immune system, and certainly, for healthy menopause, and hormone balance, and vaginal health, too. That time to spend and to incorporate to change things up and do this is to support your gut, to support alkalinity, to support hormonal detoxification in a very clean easy to digest way. So, yeah.


Cynthia: What are some of the changes that you see in your female patients with the gut or vaginal microbiome as they’re making this transition, maybe perimenopause, into menopause and how it ties into these dietary changes? Because I always say, it all starts with food and certainly, eating the right types of foods will help support our health on so many different ways.


Dr. Anna: Yeah, actually, there was a recent study that was published looking at oral probiotic use and the vaginal microbial balance, and found a relationship. I always say the vagina is an extension of the gut. It really is that mucosal lining, we need bacteria in the vagina and we need a nice low acidic pH. That’s first line defense. That cervix opens up into our womb. That is a first line defense. I think that it’s important to understand that, number one. Number two, is the wave implemented the Keto-Green plan. I’ve heard back from so many women, so definitely higher desire, which is always a very good thing, lower inflammation, if not eliminated completely, vaginal infections and that’s really powerful, as well as bladder symptoms, the accidental cough or sneeze, so that and regular bowel movements. All of us will have relaxation of our muscles as we get older. Pelvic floor exercise, everyone just squeeze the pelvic floor, so it’s a reminder right now. It’s really important that we do those till we die. So, keep up with that. Pelvic floor exercises are critical to have good blood flow to the pelvic floor and good muscle. 


Incorporating these plans, we see that overall improvement in vaginal health. I used to have yeast infections all the time, be constipated all the time. Decades of my life was like that. I don’t even remember my last yeast infection or the last time I was constipated, except when I had dairy. Dairy is a big constipator, especially if you’re food sensitive, I mean, dairy sensitive. That’s always like. “I have something with dairy in it and sure enough.” Something got snuck into my eating plan or I consciously made that decision and had some amazing dairy, typically in a sweet or a cheese. Your body tells you. Your body tells you, but sometimes, it’s so numbed down. It’s just numb and so we don’t even know. [crosstalk]


Cynthia: Well, that’s interesting. I mean to speak over you, but it’s interesting how many women think it’s normal not to have a bowel movement every day. The ironic thing and I can’t take credit for this, but a functional medicine provider said to me jokingly, “You know that a woman’s hormones are properly balanced if she’s happy, hungry, and horny.”


Dr. Anna: Yeah.


Cynthia: I said, “Wow, that’s an oversimplification, but that’s sobering.” How many women walk around being none of the above? Their hunger starts getting blunted, probably, north of 40, whether or not it’s related to muscle mass loss with sarcopenia or loss of estradiol. I haven’t fully delayed gastric emptying. I’m not sure what really mitigates that, but certainly, if your libido is waning, you’re not happy, there’s clearly something going on that needs to be addressed. It’s not normal to feel that way. What we’re really saying to women is, through nutrition you can help better balance not only your hormones, but your health on so many levels. You don’t have to live with the limiting beliefs that you have to be unhappy with the way that your body is or the way that you’re feeling in your body. I think that’s hugely important. Some of the other things that can be problematic. You’ve touched on weight loss resistance, which I know is something that we both deal with our own patient population. What are some of the more common reasons you see in your practice this is mitigated over?


Dr. Anna: Yeah, for sure. Just back on that happy, hungry, and horny, I like that too and I just think that the power of three most important hormones. There’s cortisol, insulin, and oxytocin. Always hone in on those. When we get those in balance, life is good. Life is good. Really looking at those three things, it’s a nice thing. Then, back to the constipation comment on my questionnaire as an OB-GYN I had, “Are you constipated?” Many women would say, no. I got clever and I started asking, because on pelvic exam, you can tell someone’s constipated. She said, “She wasn’t constipated.” “How many bowel movements a day do you have?” She said, “A day, I have one or two a week.” That it’s constipated. 


Cynthia: Wow. 


Dr. Anna: One or two a day is not constipated. She’s like, “Well, that’s been my normal for 30, 40 years.” I’m like, “It’s so number one reason you’re not feeling good.” It is so the number one reason you’re not feeling good. It’s just heartbreaking, but it’s so liberating when you can help women through that. Dietary lifestyle and getting rid of food sensitivities, adding probiotics, and replenishing a healthy gut motility, and you’ll never have that ever again, I don’t care if you’ve dealt with it for 40 years. It is a very common thing and you don’t need laxatives, you don’t have to go that route and don’t go that route. It’s devastating. Address the underlying reason, why you’re constipated, because you’re not born constipated. Now, we know that when we’re moms and we have babies, they’re constipated, they’re miserable. Oh, my God, they are just so miserable. Then, what caused that– Oh, we have to maybe change what you’re eating if you’re breastfeeding or change what the formula you’re giving them. It’s so true for us, too. It doesn’t change. So, I wanted to emphasize that. 


Then, with the concept of weight loss resistance, sometimes it’s just because we’re doing the same thing every day even if it’s good for us. In other aspects its stress and that can deplete us in many different ways. A third is certainly, the lack of changing things up or getting with physical exercise or activity. But then, a really big fourth is hormone disruption. Hormone disruptors in our skincare, in our food sources, and that’s often so far from our perceived consciousness, because if I’m drinking out of a plastic bottle, how is that really going to hurt me? Are you kidding me? It’s devastating, not just to you, but to your unborn fetus, to generation. It’s devastating. The pesticides, herbicides, the flame retardants, and you have to be so aware of these things. A friend of mine told me, another colleague, a physician, Dr. Ellie Campbell out of Atlanta, she said to me, she goes, “You can’t get healthy in the same environment you got sick in” and boom, right?


Cynthia: I think it’s so important, oftentimes, we have to make some significant changes and it could be as simple as we remove one inflammatory food, maybe we go to bed a little bit earlier, maybe we make a commitment to walking 5,000 steps a day, which if someone’s been a couch potato, that may seem woefully overwhelming, or try a new food. That’s one of the things that my family and I are working on. We are talking about bitter vegetables, radicchio, which is so beautiful. We roast it and it’s bitter. I remind them, I like to say that our palates are so sensitized to sugar that when we have bitter, we almost reject it. I can’t eat that. But I remind them of the benefits of eating bitter foods, and how they help with detoxification, and making sure that our gallbladder, the bile in our gallbladder is viscous or it’s not as viscous. It’s able to help break down and emulsify fats. So, getting outside your comfort zone is really what we’re encouraging women to do is to don’t stay eating chicken with broccoli every day. Try different things, try to push yourself, try a new food. Do you have any favorite recipes in this book that you helped created.


Dr. Anna: Oh, yeah, definitely my modification of my tabbouleh is from the Middle Eastern tabbouleh, use bulgur or cracked wheat in it. Instead, I used cauliflower rice, but sometimes, I don’t have cauliflower rice. Even then, it’s never riced enough. I have to chop it really fine. I didn’t have anything else in my fridge and I had some beansprout or some broccoli sprouts in there. I chopped up broccoli sprouts, added it to my tabbouleh and it is phenomenal. It is a phenomenal recipe, because you would never think– Just because with the classic tabbouleh, you have that crunch. And those sprouts added in at the end nicely chopped up gives you that crunch and then you’ve got your chop, your tomatoes, your onion, your parsley, your olive oil, and lemon juice, and salt, and it’s really simple. Parsley is a natural diuretic and it’s a potent methylator. It is a weight loss extreme food is so good for you in so many ways. That’s one that I really loved and I modified.


Ooh, Cynthia, another one. When you come visit me in Dallas, I’m taking you to this little restaurant that’s walking distance from my condo here but I am moving. I’m actually getting a house here. Anyway, so, it’s called Up On Knox, little restaurant on the corner and they have a cauliflower soup. I was like, “Oh, my God, I love this cauliflower soup.” It was so creamy, and hot, and delicious, and I was like, “What can I do?” I can add some bacon to it. I was vegetarian. It’s in my vegetarian section. There’s no bacon in at this time. I invited some of my daughters– one of my daughter’s rodeo girlfriends over and her mom to come over, and last minute, she goes, “Well, my husband’s coming, too.” I was like, “Oh, shit. I just made cauliflower soup,” but there’s definitely not enough. I had leeks. I don’t know why but I had leeks in the fridge. Those are really big beautiful leeks and I chopped it up to just not all the way into the green, because then you have green soup. I sauteed them into my cauliflower, I sauteed them and then added into the cauliflower, and then pureed everything together, and it was gorgeous cauliflower leek soup. You can sprinkle some black pepper on if you want to add some burst to that, too. But if you’re autoimmune, you don’t want to add the black pepper and very careful on that. 


That’s how some of these recipes are created is just through accident ingenuity and just because leeks are great for sulfation, number one, really important for hormonal detoxification, especially estrogen detoxification. It’s important to make glutathione and it boosts our immune system. Cauliflower, of course, excellent for estrogen detoxification to improve the pathways that we detoxify estrogen. The combination of the food is very hormone balancing. It’s even better than any of them by themselves. Having the right combinations and it just tastes amazing. I’m hungry for it now, but I’m fasting. I’m fasting today as we’re talking because I’m talking to you, I’m like, “I got to fast today.” Yeah, okay, we are fasting with my [crosstalk] Keto-Green group, too.


Cynthia: Yeah, no, literally, my mouth is watering imagining these delectable recipes and obviously, the photos. The food photography is unbelievable. The last question I wanted to ask you about and I’m sure you see this mistake made by a lot of women, well-meaning women. We’ve been conditioned to believe that we should be very carbohydrate focused and yet, I find that the value of protein really gets lost in the mix. Have you found that to be the case as well with your patients that they focus on carbs, they think about some vegetables, and then, they’re minuscule amounts of protein? I always remind women that protein is so satiating. We should not skimp on the protein.


Dr. Anna: Yeah, I say, do you want muscle? Eat protein. [laughs] Really, an amino acid blend, especially carnitine. We can get that from our animal meat sources. One of the supplements I insisted on throughout pregnancy was carnitine. It’s just really good for brain health, for cognition. There’re so much issues with that attention deficit etc. Carnitine is really beneficial that way. I think that we sometimes forget, especially when I was a plant-based eater, that was a really big challenge for me. Making sure you’re getting good proteins and non-GMO, fermented miso or tempe, those are good sources. You’re not going to get breast cancer from eating tofu. You’re just not. I can tell you, because we know soy isoflavones improve estrogen detoxification down the healthy pathways. But it’s such a common misunderstanding and it’s a shame. But yeah, and then, I think that’s where high-quality protein becomes– 


The other thing to being a conscientious shopper and being aware of hormones and antibiotics that are in many of the foods we eat, especially when we’re going out, that’s why guys, we have to make decisions with our money for our lifestyles. You’re eating out and if you’re eating chicken, it’s been given antibiotics, you just gave your gut a dose of antibiotics, killing off all the good work you’ve done eating your kimchi, and sauerkraut, and kombucha, whatever. You have to replenish. But also, I think there’s that piece, too. It’s more expensive to buy grass-fed and finished free range food. Unless you’re a hunter and let me know, because I will definitely get some good stuff from you. Fish, too, worry about heavy metals. Pollution in our water, it makes it hard to be a consumer when we’re thinking, “Oh, my gosh, these protein sources are so damaged.” We have to make decision. We really don’t need a lot of good high-quality food. We become very, very satisfied very quickly if we don’t have a lot of– You bypass the bread when you’re eating out, and you have the great protein, healthy fats, and then finish it off if you’re in the evening or celebrating with your carb in that order, so, we don’t get those blood sugar highs and lows that wake you up at 3 AM or make you hungry in the middle of the day. To understanding, that is powerful. Our mutual friend, I think Gabrielle Lyon really pushes that protein piece and for muscle and that’s so important as we get older. 


Also, the other piece that people don’t talk about with eating meats, for instance, and again, I like to cycle into plant based. Don’t get me wrong. But with eating meat is sometimes dental. You’re getting older, you have dental issues, it’s harder to chew. Just start getting some carrot sharpen up those teeth. Definitely don’t let that. The whole dental thing is a whole another discussion, but it’s something to understand what’s the barrier to getting so much meat. Is it hard to chew? What can we do around that and that’s our high-quality protein? The balance of that, because I find it’s easier too, to get more animal proteins, but the balance is eating vegan proteins, and I use vegan proteins in my keto-green shake, because sometimes we need that easy absorbed plant-based protein for digestion. And also, I know many times there’re issues or barriers to getting all that good grass-fed, grass-finished buffalo meat and whatever else. [crosstalk] 


Cynthia: Yeah, exactly. Well, and I think meeting people where they are. It’s interesting. I’ve been prepping for a podcast with James Nestor. I don’t know if you’ve read the book Breath, but I’ve now read it twice. He talks about how modernized farming practices and processed foods, people aren’t chewing as much and that has a net impact on the maturation of bone in the mouth and impacts the anatomy of our mouths. It’s fascinating. The chewing piece, it’s ironic that you bring that up, that could certainly be an impediment for some people if they have dental caries, or they’ve had teeth removed, or they just have pain when they chew. But I think it’s such a good point about meeting our patients where they are and helping to find out what is the, as you mentioned, impediment to them making different protein choices. 


Well, I’m so thrilled that we were able to have this conversation today and I do agree that our books are so aligned. For listeners that are wanting to find a book that is specific to the needs of women in middle age, MenuPause is definitely it. You definitely want to check it out. Dr. Anna and I are super aligned on fasting and low carb, but I love that you have different types of methodologies throughout the book. There’s a carnivore piece, there’s a plant-based piece, there’s a cleanse piece, there’s higher carbs, and then, obviously, the classic Keto-Green. Let listeners know how they can connect with you. Where can they buy the book? Where can they find out more about you, as well as the rest of your books? We’ll include all those links as well as your podcast.


Dr. Anna: Thank you. Yes, I can’t wait to have you on my podcast as well. One of the places, just the best place to find me is that my website dranna.com. D-R-A-N-N-A dotcom. When you buy the book, there is the MenuPause book page and you’re able to get amazing free bonuses. So, it created, build out some easy shopping plans, and menus at a glance, and so great additional in the daily activity checklist, all these good things that I find to be very helpful. That’s for you as the book bonuses and I look forward to giving you those. Anywhere, books are sold. Support your local booksellers and you can of course, get it on Amazon and Barnes & Nobles, and I appreciate that. Thank you, Cynthia. It’s great to be here with you today.


Cynthia: Absolutely. I know my listeners will really embrace and enjoy this conversation that we’ve had today. We’ll have to have you back again soon.


Dr. Anna: I look forward to it. Thanks.


Cynthia: If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.