Unlocking the Power of the Menstrual Cycle: Hormone Health, PMDD & Period Care | Ashley Greene

Ashley Greene Khoury: [00:00:00] Your menstrual blood tells you such a, a vast amount about our overall health, that it's really a blessing. You have phases of your menstrual cycle and that they affect everything about your productivity and how social you are and, and that there can be imbalances, your estrogen and progesterone. Like if we actually lean into it, like there is so much power in your menstrual cycle.

Olivia Khoury: I've never been on birth control growing up where I thought being crazy and mental and fighting with my mom was normal, but I didn't know that it was cyclical and then it was only until. We've been taught that our

Dr. Brighten: period is a weakness, and if you pause for your period, you're weaker, you're lesser than men, and you have less value.

What do you say to that

Narrator: actress and entrepreneur? Ashley Green. Cory

Dr. Brighten: best known for her role in the Twilight franchise,

Narrator: joins us alongside her sister-in-law. Olivia Cory,

Ashley Greene Khoury: a creative entrepreneur with a background in functional medicine.

Narrator: Together they co-founded Hum Hemingway, a women's health brand redefining period care with

Olivia Khoury: non-toxic science-backed solutions from personal journeys with hormonal [00:01:00] imbalances and PMDD to launching products like the Cycle Soothe.

Narrator 2: Ashley and Olivia are here to share how they're reshaping reproductive health one cycle at a time.

Olivia Khoury: Our main hero product, the cycle soother patch. A lot of the ingredients in the patch have naturally occurring terpenes that work with the CBD to help it either enhance the effects. DBD does a very similar thing that NSAIDs do where it stops or inhibits.

Dr. Brighten: Have you guys been faced with criticism because they feel like every time. And innovation comes out in the women's health space to help them. Especially there's doctors who are like, but you have the pill, you have ibuprofen, there's mital. Why fix it? It's not broken.

Ashley Greene Khoury: Our answer to that always is, is that

Dr. Brighten: we are creating something that is.

Welcome back to the Dr. Brighten Show. I'm your host, Dr. Jolene Brighten. I'm board certified in Naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most up-to-date [00:02:00] information to help you take charge of your health and take back your hormones.

If you enjoy this kind of information, I invite you to visit my website, dr Brighten.com, where I have a ton of free resources for you, including a newsletter that brings you some of the best information, including updates on this podcast. Now, as always, this information is brought to you cost free, and because of that, I have to say thank you to my.

For making this possible. It's my aim to make sure that you can have all the tools and resources in your hands and that we end the gatekeeping. And in order to do that, I do have to get support for this podcast. Thank you so much for being here. I know your time is so valuable and so important, and it's not lost on me that you're sharing it with me right now.

Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast get out to everyone who needs it. Alright, let's dive in. All right, Ashley, the big question people have is what is a actress [00:03:00] slash model doing, stepping into the period space?

Ashley Greene Khoury: Uh, well, I am a female who has a period, so Oh, imagine that.

And, uh, I, um, you know, I actually was not concerned about my period or menstrual health in the slightest until I was in my thirties. Mm. And then I got off hormonal birth control and realized, um, that I didn't know anything about my reproductive health whatsoever. And so that's kind of what put me into this space.

I, um, had the best periods ever and, uh, and then realized that, oh, this is not really great for you, and got off hormonal birth control. And it was, um, incredibly difficult because I then realized that, oh, I have all of these symptoms that are being massed by birth control. Mm-hmm. And now I have to figure out a way to fix them.

And when I go to my, my primary care doctor. No fault of their own, but like they don't know what to do with me and, and how to look at my body holistically. And so I got go on Accutane for your acne, go on SSRIs if you have mood swings or, or feeling depressed one day. Um, a lot of additional band-aids versus going, what is [00:04:00] actually happening inside of my body and how do I fix it without putting something else in my body that's going to have some kind of adverse effect?

Mm-hmm. Um, and so that is what I am doing in this space is, is I said, you know, I'm, I'm so lost, but I'm so frustrated with what I am being fed. Mm-hmm. Which is kind of, I think a lot of, um, bullet points that people have been telling us for eons about like, oh, just go on birth control and it will fix everything or go on this and it will fix everything.

And when you ask the question of, well, what about this symptom and where's the root of it and where it's, where's it coming from? Doctors don't really have any training in nutrition and they don't understand a lot of these things. And so anyways, I went to Olivia, um, because her mom raised them very holistically and, and it was a homeopath and said, you know, this is what's happening.

Can we try and figure this out together because I'm frustrated and lost. And so that was kind of what started this journey of humming way. And, and, um, and I first said, my biggest pain point is that my cramps are [00:05:00] now starting to feel debilitating. Yeah. So let's maybe figure out a way to treat those naturally, or let's figure out a way to, to find out what is causing these things to happen.

And so, mm-hmm. Olivia and I did a ton of research for two years during COVID and said, you know, let's. S figure out everything we can figure out about ourselves. And when we did that and started polling other people, they kind of had the same exact, not exact story, but a lot of them have the same ailments and symptoms that I did, um, and said, oh my God, if you create something, please send it our way.

Mm-hmm. And so then we recognized that, oh, this is, this is something that so 50% of the population is experiencing. Yeah. Um, and so we decided to create a product and try and, and heal, uh, ourselves first, and then realized that this was much bigger than. Than just my journey. Mm-hmm.

Dr. Brighten: Your story is similar to a lot of women.

I mean, it's my story. It might be your story as well. You go to the doctor, you have period problems. You have, you know, just fill in the blank. If it's hormonally related and they just [00:06:00] say, take the pill. Yeah. Do you want a baby? No. Take the pill. Oh. And if you're not trying to get pregnant, none of it matters.

None of it matters, but that's the magic word, right? Mm-hmm. If you say, I think I want a baby. Oh. Stop everything. Didn't you say? We'll do lab tests. Yeah. I

Olivia Khoury: lied. She

Ashley Greene Khoury: lied. So she could get tested.

Olivia Khoury: Yeah. You know, and did it

Ashley Greene Khoury: work?

Olivia Khoury: I said that I was trying to get pregnant for a year and that I'm 33, so like I looked it up.

It's like I have to say that I've been trying for a year for them to get testing. Mm-hmm. And then I was able to be referred to a reproductive specialist. Yeah.

Dr. Brighten: Mm-hmm. But, and then what came out of that?

Olivia Khoury: I just figured out that I'm still fertile. I just got like tested and that, but not much. Like even then I had to fight for it because my insurance was like, well, if you're not fertile, then we don't cover IVF.

Mm. So then that would've been a whole different thing. But thankfully, like I haven't been trying, I, yeah, I just don't have sex when I'm ovulating.

Dr. Brighten: Yeah. Well, and that's actually something really common as well, that women will say, I just lie to my doctor because I can't trust my doctor to have my best interest unless it's the interest [00:07:00] of procreating.

And I think. It's such a disservice to constantly reduce us to our reproductive capacity and nothing else like and as if wanting to have a baby is the only you know thing that needs to happen for you. Be take serious life. Seriously. Your life matter and you're looking Yeah.

Ashley Greene Khoury: Quality of life to matter is that you're trying to get pregnant.

Yeah.

Dr. Brighten: Yeah. So I'm curious for you, did you start the pill because of symptoms or was it a like, oh, you're of age, you should just do this?

Ashley Greene Khoury: Yeah. No, I started, um, birth control without my parents knowing when I was, I think I was 16 or 17. It was basically the first time that I had sex and mm-hmm. And, uh, knew that I didn't wanna have an unplanned pregnancy.

And so went in and, and, um, you know, it was kind of no questions asked and, and they said, oh, here is what you should have. And then, um, you know, I think because of that, my period also never had a chance to regulate Yeah. Itself, because I started so young. So I think I got my period when I was close to 15.

Mm-hmm. Um, so not much time at all from my period to, to kind of figure out what it, what it's [00:08:00] supposed to be doing. Yeah. Um, and, uh, and yeah. And then I just, I got off it because I, um, hit a point in my life where I realized that, oh, all of these, I started asking questions basically, and I said, how dare you, what does this drug do?

And how does, what does this drug do? And, and is there a way for me not? 'cause I was on. I was on Adderall, I was on birth control and I was on, um, Klonopin, which I was like, well, if you have anxiety, you don't really know that Adderall is good for you. Um mm-hmm. But I just started going, you know, is there a way that I could maybe manage these because I don't, I started realizing all of the side effects of these things.

Yeah. And um, and that's kind of what started the whole thing was, was asking questions about what are these things doing to the, the inside of me.

Dr. Brighten: Yeah. I think it's very interesting because you see that a lot when women are getting healthy and they're starting to know their body and then they're, and it, it's something that I feel like we don't start questioning these things into, we enter our late twenties of like, because we were told these messages of like.

Periods are painful. That's normal. Mm-hmm. [00:09:00] Being a woman's inherently awful, your hormones make you crazy and you don't know until you're older that like, wait, I can challenge these narratives. I can start to ask these questions. Mm-hmm. And it's usually when women are like, I'm, I'm starting to focus on these other parts of my life that then they start to question birth control.

And they're often met with resistance of like, how dare you like question the greatest invention of women's time. Like you wouldn't even have a career if this didn't exist. And it's like, both can be true. We can be grateful for the medical advancement of course. And we can also say, this isn't working for me.

I want something different. And also, this is not the only way.

Ashley Greene Khoury: Yeah. This is not the only way. It is not. Necessarily the right way because you have a college degree.

Dr. Brighten: Yeah. Ooh, that's a hot take right there. I think that is, you know, I've had, uh, conversations with other podcast guests who are physicians, and we've talked about this, that as women who should rightly so challenge the paradigm of medicine because it has been gaslighting them, calling them hysterical.

I mean, [00:10:00] there's oodles of data that we die of, heart attacks at higher rates of than men because we're just too emotional. Like it couldn't be real. Mm-hmm. And so as women are challenging this and starting to push back, medicine's response has been, I'm the authority. You will listen to me. And trying to gain more control.

Mm-hmm. Which is only, I mean, I'm like, yeah, try that with a teenager. What's gonna happen? It's not working out. Like we have to come to a place where we respect that. Patient knows their body better than you are ever going to know it. Mm-hmm. They're coming to you for a partnership. You don't get to tell them what to do.

You get to ask questions and offer possible solutions, and you have a lot of value in that, but you have to also respect the patient. And I think there's a lot of dogma around birth control where it, I mean, if I know practitioners who are like, oh, well if you're not gonna take birth control, why are you even here?

Like, just leave my practice. And it's like. Why would you treat another human like that? I get that it's frustrating and hard to be a [00:11:00] doctor and also these are humans.

Ashley Greene Khoury: Yeah. Yeah, it is. And that's, you know, I am not saying that like I hate doctors. I think doctors are wonderful and there's a lot of great need for doctors, but I think there are certain steps that you can take before just being put on the same thing that everyone else is on.

Mm-hmm. And I think that's the frustration. Right. And a lot of it, again, like I just. Went into my, my general practitioner and, and we talked about this and she started a concierge service, which a lot of doctors are kind of having to do. Mm-hmm. To get more time with patients, to be able to ask the questions and to be able to figure out the right answers.

Because a lot of times the way that the system is set up is you come in, you have like 15 minutes and, and they have the next patient in. Yeah. And so I think it is, like, it's just the entire system is broken. Mm-hmm. It's not necessarily the doctor's fault.

Dr. Brighten: I don't think anyone goes to medical school.

There's, there's this like a narrative in the US where people just say like, doctors are just like, they just wanna be rich. They're greedy. That's why the way they are like, nobody goes to medical school being like, I just wanna make a boatload of money and I don't care about patient [00:12:00] outcomes at all. It's not like that they get, you know, pushed into a system of having to see 30 plus patients a day.

They don't have time in there. And then because they are humans, they become very dysregulated. They're completely in sympathetic overdrive. They end up with burnout and then they interact. With humans in the way that you expect if someone's like that. Yeah, so I do think. The really, I think if we wanted to point the finger, we gotta start looking at insurance models.

We need to start looking at like healthcare admin. Like there's actually an upstream issue going on. Absolutely. Yeah. Now, Olivia, you've also had like, it hasn't been smooth sailing when it comes to hormones for you as well. No, I haven't always been on birth. I've

Olivia Khoury: never been on birth control. But you're such an anomaly.

Your mom is an angel. She, she really is. It was just, yeah, never birth control. But my mom also had to deal with me growing up where I thought being crazy and mental and fighting with my mom and having suicidal ideation at a very young age was normal. [00:13:00] Mm-hmm. Like, but I didn't know that it was cyclical.

Yeah. And then it was only until I got into therapy did my therapist clock, like, I think this is cyclical. Mm-hmm. Like when I talked to you other weeks, you seem totally fine. And like, have you heard of PMDD? Have you? And I was like, what? What's. PMDD? No. Mm-hmm. And then I looked at it, and I'm sure this happens for so many women, it's a light bulb moment.

Yeah. Like you're just crying, you're like, I feel so seen. This is exactly what I'm dealing with. Like mm-hmm. Sore breast pain. Like you feel like you're itching out of, like crawling out of your skin. You don't recognize yourself. You break up with your partner once a month, like clockwork. Yeah. And it wasn't until I started.

Tracking my cycle and working with therapists and rapid transformational therapy and trauma work and listening to you and like just Yeah. Building humming way. And then once you start sharing your story with other people, which is what I loved about Humming Way, is we got to share our stories. Then so many people just like, it just comes in like, it is insane.

It's beautiful. It is beautiful. They're like, I deal with this. Like, I had no [00:14:00] idea I had PMDD or, yeah. I had no idea. This is what happens to you when you come off hormonal birth control. Like, or thank you for making your product like it cured my, or didn't cure end my endometriosis, but it's the only thing that's helped with my endometriosis.

Mm-hmm. Like, and so just we very much feel like sharing your story is the first step in reclaiming your health. Yeah. Because you realize you're not alone.

Ashley Greene Khoury: Mm-hmm. But

Olivia Khoury: yeah, it has not been, and I smooth sailing and even though I've done a lot of things, um, to help it, I still, like, I just ovulated two days ago.

And I don't know. So here

Dr. Brighten: comes the luteal phase. Oh, she's already here. Yeah. Like I took,

Olivia Khoury: and we can talk about it, but I took a Zyrtec. Yeah, yeah. 'cause it peaks at ovulation. Mm-hmm. Like I'll scratch my face and start to get really itchy. I know that a lot of my PMDD stuff is histamine related. Mm-hmm.

Because I did the whole test with the anti-histamine thing. Yeah. And it helps a lot. And now I'm on this long journey of trying to figure out like how to reduce the histamine or lower my estrogen naturally. And it's like how many more I could sell my pee for millions of dollars. 'cause I'm on so many supplements.

Like the low his. [00:15:00] It's crazy. It's crazy. And it's like the low histamine diet is so restrictive. I'm on. That is not sustainable for it. It's not sustainable. All my favorite foods are high in histamine. I quit alcohol.

Dr. Brighten: Yeah.

Olivia Khoury: And that changed my life. Yeah. Like that. I've been sober for nine months now. And a lot of the outbursts, a lot of the dark thoughts, A lot of mm-hmm.

The like wanting to just. Yeah, I don't know. Whatever. Don't need to get that deep, just like kind of went away for most of it. Yeah.

Dr. Brighten: Well, that's so powerful. And what is such a difficult part of PMDD is that alcohol feels like it can take the edge off of things, but then it pushes the estrogen and then the estrogen pushes the histamine, and that becomes this really vicious cycle.

For people who don't know what PMDD is, it is like PMS on steroids, but it hijacks at least half of your entire year. And I think that's what's important for people to understand is that it's not just like, oh, you have a few off days. It's usually 10 to 14 days out of the month. That's six months out of the entire year that [00:16:00] somebody.

Doesn't wanna be on this planet, that doesn't wanna be around their loved ones that can't enjoy their life. It's incredibly debilitating. And you mentioned, uh, before we started recording that you also have a DHD.

Olivia Khoury: Yeah.

Dr. Brighten: Yeah. So we know that A DHD women, when they were surveyed, they report, it's about roughly like 49% report.

Having PMDD autistic women is closer. It's over 90% experience. PMDD. And this is something that I actually have a whole, um, A DHD podcast that I'll link to talking about sleep. And I go a bit into the allopregnanolone and what's happening there. So. It's not the same for everyone with PMDD, that for some people when that progesterone ramps up, you get this allopregnanolone and that should make you feel chilled out and calm.

But for whatever reason in the neurodivergent brain, it allegedly can happen in other brains as well. But I'm seeing such a connection with neurodivergent brains that I'm like, I am kind of convinced that the neurodivergent brain is more [00:17:00] sensitive to this progesterone metabolite. And I wanna see the studies that the progestin in the pill that they usually will use in women with PMDD, it is the neurodivergent.

Women that I see so often have that paradoxal effect where they're like I, I mean I was so, I have a DHD and autism and I was the person put on the pill that was like very scary. Calling the suicide hotline at times. Like very, very scary. And I look back at that and I'm like, all of that could have been assigned, but so many doctors are not.

One, acknowledging that women can have a DHD and not making the connection around these things. So as you were saying, with the low histamine diet, that's like so intense. I try, I am like my, if you need to do it, try to just do it in the face where like, document yourself and be your n of one of like, when do I absolutely need to avoid leftovers?

'cause like people don't know, I mean, isn't the craziest thing, what is it

Ashley Greene Khoury: that you can't, you just basically can't have anything. It feels that way. It feels that way. Yeah. Because

Olivia Khoury: [00:18:00] lots of things that typically, like we're healthy people. We live in la Yeah. Apple cider vinegar, kombucha, sauerkraut. Yeah. All these great things for your gut.

Lemon water, citrus foods are high in histamine. Mm-hmm. All these things that I thought that I was doing good for my body. I actually, they're not super great for me. And I do notice because like I've been doing the Hello Histamine for like almost three months now and I ate avocado hummus the other day.

Yeah. And I started to like, my mouth started closing up and I felt extremely allergic to it. So it's like I do know that histamine is my thing. And that's kind of what I wanted to ask you is so many people were like, well, you have to lower your estrogen. Mm-hmm. And so then I eat all the cruciferous vegetables, which then pushes histamine.

Right. It's, it's being nuts. So, yeah, but it's like, I love it. I wouldn't have it any other way. And I'm lucky that I'm tuned into my body and that I have humming way where I can constantly learn. And you are an amazing medical advisor and I'm learning from you every single day. And so that's really grateful.

But it's definitely not like a one size fits all PMDD. Like not I've tried, I even tried [00:19:00] Lexapro that Yeah. Bad, bad idea. 'cause it made my A DHD so much worse. Yeah, that was horrible. Yeah. Um, didn't, didn't do much on when I was on Lexapro, it was just a zombie. And so Yeah. But for other people that I know, like my friend was like, I took Lexapro, changed my life.

I was like, great, I'm getting on Lexapro. Like let's go. Yeah. You know? Didn't work

Dr. Brighten: well. And I think that's important for people to hear because often whenever you are in the wellness space in any arena and you own a wellness company, people are like within your Antip pharmaceuticals. And it's like, no, no.

I'm about the tool that works. Like I just need the tool. I'm pro asking questions. Yeah. Yeah. Well. That is like, it's such a bizarre thing that that's even controversial. Like I'm pro informed consent or pro-act asking questions, and then they're like, oh, that translates to something bad. And I'm like, how are you gonna like label some women something new to keep them from?

Well, you're gatekeeping in a new way. Like, like you're just rebranding your shame and we're not having it. Yeah. Mm-hmm. Yeah. But you know, the, the other thing is you were, you were talking about the, um, the cruciferous vegetables [00:20:00] and then there's also vitamin C, which is so important for the DAO enzyme to clear the histamine, but then the citrus roots can be like pushing histamine.

So this is like, you know, you were saying you take, um, Zyrtec, so. I am, I had a frozen embryo transfer, so it's an IVF cycle transfer, and I have to be on exogenous estrogen. Well, what's gonna happen when I'm on exogenous estrogen, I have a history of PMDD, I already know I'm gonna have histamine problems.

So I'm on Claritin 10 milligrams twice a day and people are like, oh my god. But like long term that can like, have like, you know, side effects for like cognitive health. And I'm like, but if you see me when I'm rolling with high histamine, it's not so good. It's not

Olivia Khoury: cute. No. Yeah, the concept

Dr. Brighten: up there is not good.

Yeah. So I'm like, sometimes it's a bring on the medication while you then are like, you know, bring on the vitamin C, supporting the DAO enzyme, bringing in more quercetin into your diet, resolving like gut related issues, but recognizing that like when you're neurodivergent it's. Such an extra layer of, [00:21:00] the default of the nervous system is dysregulated.

The default of the immune system is dysregulated. The default of the gut is to be dysregulated. And so you have to really piece all of that together and look at, and that's, I think the problem is that we're not studying neurodivergent women. And so we already have this cookie cutter approach to women as it is.

And then we just acted like neurodivergent women never existed and we don't. And then we've got so much, um, focus on like, how do we prevent and cure and never make autism happen? And it's like, but what about the autistic woman who's aging right now? Like, what about the autistic woman going through PMDD?

Like, could we, could we get a little funding over here to like, help some women out?

Olivia Khoury: Oh, 100%. And I feel like I've been masking my whole life. Like I had no idea that I was neurodivergent. I just, I just existed in this world that just doesn't feel like designed for me, or I feel like an alien half of the month.

Yeah, it's, it's. It's frustrating for sure. Yeah.

Dr. Brighten: When I got assessed that I actually like broke down on my assessment and [00:22:00] crying the moment that like I realized and I said the words that like, I feel like. Everybody's playing the game of life and they got the rule book and I'm constantly losing because I never was told how to play the game.

And I just like started crying and I was like, oh my God. And then when I got my diagnosis, I was like, everything makes so much sense about myself. My husband was like, I don't even think you need the diagnosis. I think it's pretty obvious what's going on. And I was like, and then when I got the diagnosis he was like, yeah, it tracks like we knew that.

And I was like, I just needed to like, no, no, that it wasn't me being like lazy or not enough or like I, you know, it really was just totally weird. It's like, yeah, like you got, you got the Android operating system and everybody has the ultra intuitive apple operating system and you're trying to figure out how do you send texts and like do all that,

Olivia Khoury: all green.

I know they're all green,

Dr. Brighten: so I wanna talk about [00:23:00] how. Humming way is different because one criticism that has definitely come out out of the pandemic is that investors, the VC world got crazy on women's health 'cause they were like kaching. Mm-hmm. We have an opportunity to capitalize on women's pain.

There's an unmet need. What are you guys doing differently?

Ashley Greene Khoury: Uh, I think the education proponent to it is really important to us is that we decided early on that yes, we do wanna create products and we do want our company to be sustainable, but we also want to provide all the education possible. 'cause I think because of what you guys were talking about earlier, like even if there is not a cure for it mm-hmm.

Or even if you don't know how to manage it yet, just understanding and feeling seen Yeah. Uh, is really important. Uh, and so that to us was definitely something that was primary. And I think that makes us different than on a lot of companies.

Olivia Khoury: Yeah. 100%. Also, we aren't, we're making products that actually work.

Mm. Like, to be fair, [00:24:00] our one, our main hero product, the Cycle Soother Patch, it has C, B, D, ginger, lemongrass, menthol, vitamin E and Black Pepper. Mm-hmm. C, B, D. You can't sell it on TikTok. You can't sell it on Amazon. You can't sell it in Target. You can't, yeah. Sell it in a lot of places. And we've had investors be like, they've gotten asked a lot, take the CBD out.

It it, and we're like, it'll be fine. Yeah. We're not gonna sell you a patch with menthol for women that have endometriosis or women that are in excruciating pain because it's not going to work in the way that we, our patch works, you know? Mm-hmm. CBD does a very similar thing that NSAIDs do where it stops or inhibits like the excess production of prostaglandins.

Mm-hmm. Prostaglandins, and you probably can explain what prostaglandins are way better than I can, but, um, it helps so many people. They put it on and we chose a patch because it's one of the most bioavailable ways mm-hmm. To get ingredients into your skin. We tried making a gummy and gummies probably would've got us in all the target stores.

Mm-hmm. But gummies, you can't even put enough ingredients for it to be effective. Yeah. We don't wanna just put buzz words like ashwagandha and Don Qi, like on the front of our thing, branded, like it's [00:25:00] pink. And then be like, here, girlies take this. And like, then we're just, that's just what they need. Yeah.

Something else that doesn't work. We don't need more cane sugar, so it's really important for us. And like to make products that actually work, that take a lot of r and d that, you know, we work with different formulators mm-hmm. And manufacturers, like everyone we work with are like women that like are down for our mission.

And it's just like really important for us to stay true to, to what we're building and what our intention was. Mm-hmm. To begin with.

Dr. Brighten: Yeah. And your cycle soother patches are pretty amazing, I have to say because it was going through IVF that then I, like I, I got rid of my period pain, like my teenage years were behind me, and then going through stimulation that caused the endometriosis lesions to grow.

And I started having incredibly painful periods. And it's something that I wish reproductive endocrinologists, post egg retrieval would use these transdermal patches with women because they're like, everything in women's health take NSAIDs. Yeah. And you're like, no, but I'm telling you I can't get out of [00:26:00] bed right now.

I'm in so much pain. Like, I remember my third egg retrieval, the flare was so bad and my doctor was like. Take oral NSAIDs and then take the sublingual NSAIDs and like all, and I'm like, Hmm, you wanna know what's gonna happen? The gastritis is gonna come. Then the vomiting up my food because like I have such bad reflux, like I already know this pattern.

And I used the cycle soother patches and I was like, thank God for this. Oh, and I think that, you know, it has the utility of like helping with period pain. It does help with endometriosis, but I'm also like, there's so many other pelvic pain conditions as well where this has utility. What made you guys decide to go the transdermal patch route rather than like maybe a roll on stick or oral supplements?

Ashley Greene Khoury: It's the most effective. Mm-hmm. It's the most bioavailable and we could get the most amount of ingredients in our patch. Yeah. And so that's what we did. I mean, I think we. Because we did get a lot of advice to, to make [00:27:00] it, to make it fancy and to make it cute and to make it this. And, and we both decided like, this isn't going to be something that's groundbreaking.

Like, we're not gonna say like, we have this like, incredible ingredient that's just gonna fix everything. Like, we just wanted to put things that we knew worked. Mm-hmm. And we just wanted a delivery method that we knew worked.

Dr. Brighten: Yeah. I mean that's a big thing that you see, um, especially as you were talking about TikTok, marketing people like Chase the one trademarked ingredient so they can make like the claims about all of these things and then, you know, they get in trouble and that video like goes away immediately.

Yeah. And I appreciate the honesty about, and, and the fact that you're like, I wanna make something that works, that actually helps women. Have you guys been faced with criticism? Because I feel like every time an innovation comes out in the women's health space to help them, especially there's doctors who are like.

But you have the pill, you have ibuprofen, there's mitol. Why fix it? It's not broken.

Ashley Greene Khoury: Mm-hmm. Um, our answer to that always is, is that [00:28:00] we are creating something that is actually going to be non-toxic and that actually isn't gonna have an adverse effect. And there are a lot of people now that don't want to take this pill and they want a different option.

And so that's what we are here for. And again, we're not saying if you want to take NSAIDs and you want to take the pill, by all means go do that. We're not gonna chastise you for that in the way that I feel like people get chastised for wanting to do something that's good for their body.

Dr. Brighten: Mm-hmm. Well, and also for women with endometriosis, like we all know, we get offered the pill all the time and it barely touches the pain in most people.

And doctors are still perpetuating the myth that like, it's gonna slow the progression of your endometriosis. No, it doesn't. There's no studies to actually like back up. But like, tell me more about your evidence medicine claims. Yeah. Like you're perpetuating these myths that ultimately lead to women. You know, we talked about PMDD with women with endometriosis.

Sometimes that's two to three weeks of their life. Oh, yeah. So now we're talking nine months out of the year that they're debilitated.

Olivia Khoury: Yeah. It's, it's the messages that we [00:29:00] get from people on Instagram or on TikTok or on via email about how our product changed their life. Mm-hmm. Like there's not a lot of other companies out there where you're getting messages like that.

Yeah. Like long paragraphs where people are just like, nothing has worked for me my entire life. Like, no one has ever even paid attention to my pain. Like, your product completely changed my life. And I feel like that's why we keep doing it. And we don't really have many haters at all. Yeah.

Ashley Greene Khoury: No, I love, yeah.

We don't have, haters don't claim, like, it's really wonderful to get these messages and it is like, it does make you tear up, but we still don't go out there going, we have the fix all. Mm-hmm. And this is gonna work better than everything else. Like, we're also very transparent about the fact that.

Everyone's body reacts differently. Yeah. And so this may work wonders for you and it, it may not, right? Mm-hmm. Um, thankfully we've gotten, we've gotten overwhelmingly positive responses, but yeah, I think, again, like we're not out here trying to, to, to [00:30:00] trick anyone or to, to tell anyone that it's something that it's not.

Yeah. Um, we just know that it's, it has been shown to be really effective.

Olivia Khoury: Mm-hmm. Yeah. I also think that. With everything, with healing as women, it's not just a one, not, it's like a one pill or one patch is gonna fix it all. It's like if you're drinking constantly or you're smoking cigs and eating burgers.

Yeah. And then you like, that's where the education prevent comes into. Yeah, exactly. And you're gonna put a patch on and you think the patch is gonna make all of your period pain go away. It's like, no babe. Like your body's so inflamed from all the other things you're doing. And it's like, is your nutrition good?

Like, are you moving to your cycle? Like that's why we were like, we can't just give them a patch and be like, Hey, you're good on your own. That's why we have you. And you know, we do interviews and you write for our, the regular, like our education platform and so many things like that. 'cause yeah, you need both.

Dr. Brighten: Mm-hmm. Mm-hmm. Well, I think honest and ethical marketing is. So refreshing. However, it can hinder a company's growth. How do your investors, do your investors ever be like, we want you to get out there and like, [00:31:00] do more of this or do more of that? Or are they pretty much on board with the mission as well?

Yeah,

Ashley Greene Khoury: I think

Dr. Brighten: they're pretty,

Ashley Greene Khoury: most everyone who invested in the company was very behind the mission. Mm-hmm. And we were very honest about that from the jump. Mm-hmm. Um, I feel like your, my husband, your brother sometimes would be like, just do this, and like, you could do this. And she and I were both just like, no.

We we're, we're, we're not gonna pretend again that we're something that we're not, and this is what we wanna be. Um, and so the people who invested, uh, in, in the company are very much behind that. There certainly have been really helpful in trying to find ways to help us expand, but mm-hmm. There also is a limitation to CBD, which is really unfortunate because it is just one of those things that we're not willing to take out of the pouch because it's, it's part of what makes it so effective.

Dr. Brighten: Yeah. Do you think legislation may change in the future? Because that's one of the biggest barriers, is that, I mean, we need like, politician education. It, it is actually like wild to me that in 2025 we still have men who are woefully [00:32:00] illiterate about women's bodies. Mm-hmm. And about, you know, products like CBD, and yet they're still out there allowed to make laws and vote that affects us all.

Ashley Greene Khoury: Oh yeah. It's terrifying. Uh, I think what's happening right now is, is very scary. So I don't. Unfortunately, no. Mm-hmm. I don't see that there's gonna be like a, a really big. Change in the near future under our current president.

Dr. Brighten: Yeah. I wanna talk about how you landed on the formulation though. So you decided to include CB, D, and you've talked about that as kind of being like one of the winning ingredients, but that's not all that's in the patch.

Ashley Greene Khoury: Mm-hmm.

Olivia Khoury: Yeah. So a lot of the other ingredients in the patch have naturally occurring terpenes that work with the CBD to help it either enhance the effects or for example, like black pepper actually helps CBD get through the dermis layer of the skin faster. Mm-hmm. Because what we wanted is, again, like with holistic medicine, it takes a while for things to work.

Yeah. And women and menstruating are so used to just popping a mi mial and feeling. [00:33:00] Kind of better, even though mm-hmm. My, I'm pretty sure was like, designed for men and was like a drug for hiccups. So I don't really know how it really helps women's cramps, but, um, so we wanted to make the patch like work quite quickly.

Mm-hmm. And again, everyone's different, but like, there's so many people that are like, I put the patch on and, and feel better in my body. It's also like a nice. Act where you feel like you're placing it on your body and you're kind of being in tune with your body and you're giving it a second versus so many menstrual are just told to like, take a eye, all that.

Like we used to have caffeine and just like, move on with your day. Mm-hmm. And just like, push through your period and just go to work. And it's not really like that. Like we wanna be more in touch with our bodies and slow down a little bit and be more reflective and, and listen to like what our body's calling for.

And so I think with the patch, like that's a nice addition to it where it feels like you're doing something for yourself. Mm-hmm. We tried so many different things. We didn't wanna necessarily do CBD, like at one point we tourmaline. Yeah. We did tur Moline and it left like black marks all over your body because we were trying to make like a heat patch.

Yeah. Magnesium. [00:34:00] We tried but then the molecules were too big. Mm-hmm. It, we did a lot of work. And then we finally found this really great formulator who works in women's health and also works with CBD and she started nano emulsifying, the CBD. And they have their ingredients together. And typically when you do nano.

Fight. C, B, D. It's only in drinks. 'cause we've tried, we talked to so many people like yeah you can only emulsify CBD in like a water molecule and like put it in a drink. But she was able to do it and once she did that, I feel like that was the game changer. They really started working. They really started working.

Like

Ashley Greene Khoury: we went through

Dr. Brighten: how many iterations? I don't

Olivia Khoury: know, like 30 something. Yeah, it was wild. A lot.

Dr. Brighten: Do you guys have photos of the black like bellies? Probably. Yeah. We could look back. That definitely needs to go on your social media or we're like, how far? '

Ashley Greene Khoury: cause we're like, what? But what, but if it works. And we're like, no, this is just too far.

Yeah. And it, and to be fair, it didn't work nearly as well as the CBD does anyway. Mm-hmm. Um, but yeah, we went through a lot of different iterations.

Dr. Brighten: Sense. Have there been like any stories that you've received from social media or customers that you're like, okay, that even blew our [00:35:00] mind. Like we didn't, we didn't expect that.

Olivia Khoury: I think endometriosis end. Yeah. Yeah. We didn't think that it was gonna help so many people with endometriosis. Like I just to that

Ashley Greene Khoury: degree

Olivia Khoury: to Yeah. This girl wrote me like a paragraph and she's an influencer and she's like, I never talk about my endometriosis. Mm-hmm. And my mom struggled with it and I struggled with it, but this product changed my life.

It's the only thing that's ever helped. 'cause painkillers don't help me. Like, can you send me some product and I'm gonna start talking about it. And I think that's what's really cool is we also just did an event with Core Power for Endometriosis Awareness month yesterday. And the woman running the class had endometriosis, got the surgery, and she was like, you know what?

I just need to keep talking about this and like spreading the word. And so I think it's really great that a lot of people are just talking about it more. Yeah. And the discovery of the patch and it helping them shows them that they're not gonna. They don't have to be in this pain all the time. Mm-hmm. Um, and like to open up about it to help others and I think that's been really nice.

Dr. Brighten: Yeah. I think it's great to have a tool for the endometriosis community because while excision surgery is [00:36:00] really like the gold standard if you need it, you know, not everybody needs it. There aren't surgeons everywhere. There's not great healthcare to cover the surgery. There's a lot of barriers to getting that and that's why I love what you're doing and I'm a big proponent of like, we have to give women the tools to get out of pain.

Now I think about Canadian women, 'cause I'm always getting messages from them where they're like, it's six months to see a gynecologist. Yeah. When I see them, they blow me off. So in six months to see the next gynecologist and maybe they're like, yeah, we think it might be endometriosis, but now you have two years before you're actually gonna be able to have surgery.

And it's like. That's three years of someone's life gone. So how can we start giving them tools now to start taking back their life? Because the majority of things, even if you have excision surgery, it's still work on your part to heal from that. There's a whole recovery, like I had it three months ago.

I'm still in pelvic floor pt. I'll probably be there for another nine months. Because someone was in my pelvis, things got [00:37:00] disrupted, and I want to want not have the trigger pain that you can get from that. But also, I have to work on recovering all of this. This is a significant surgery, but I think anytime it's women's health surgery, like we think about C-sections mm-hmm.

It's very flippant of like, yeah, get up, keep going. It's insane. Yeah. Yeah. And it's almost like, you know, you, you said something earlier and it really spurred a thought in me of like, you know, pushing through your period, we've been taught that our period is a weakness, and if you pause for your period, you're weaker, you're lesser than men, and you have less value.

What do you say to that? Well,

Ashley Greene Khoury: we are responsible for procreating. Um, so it's very important. I think it's, I feel like it's something that. Men are a little bit afraid of, but I, I think that the, we're finding now that it's not a weakness at all. Actually, your menstrual blood tells you such a, a vast amount about our overall health that mm-hmm.

It's really a blessing. And I know because we're so conditioned to believe otherwise, it's hard to wrap your head around that. But [00:38:00] if we actually lean into it, like there is so much power in your menstrual cycle. Yeah. Yeah. It's a vital sign. It's the fifth vital sign,

Olivia Khoury: right? Mm-hmm.

Dr. Brighten: Yeah. Listen

Olivia Khoury: to

Dr. Brighten: it. Can we get that to be embraced by everybody because literal be real can use it instead of hearing it and, and, and shunning it, you know?

Mm-hmm. Well, I think a lot of us are taught, sometimes it's by our own mothers, but taught by society as a whole that like our period is something to be ashamed of. Mm-hmm. Not to talk about. Um, you know, I've shared that I think I was like in my mid thirties when I decided consciously I'd stop smuggling, tampons up my sleeve.

When I go to the bathroom, I'm like, what am I doing? Like, just put the tampon on the table. Like you have your period, like it's a tampon, like it's. Cleaner than a lot of stuff that was probably like the, I was just thinking of this time that I was in the cafe with like my in-laws and I was just like, I'm just gonna do it.

I'm just gonna do it. And I was like, how is this the bravest thing I'm doing? And like my life right now is just to be like, I'm gonna walk to the bathroom with a tampon in my hand and not hide it right now. [00:39:00] Yeah. And I think, um, it's, and I think, you know, someone from a younger generation might be listening to this being like, that's so silly.

I was indoctrinated. So I think we've come, it's different now. It, yeah, we've come a long way, but I still think there's a lot of period stigma. I think there's a lot that is still playing placed on women unfairly about their bodies. How do you see your roles at Hemingway's helping change that conversation and move things forward?

I think, uh,

Ashley Greene Khoury: doing things like this, being as public as possible, showing people that it's okay to talk about these things. I think, um, I. Not specifically Hemingway, but the encouragement to talk to your daughters about these things from a young age, like my daughter knows, and she's two and a half, she's like, oh, you're on your period.

Mm-hmm. That's your tampon. Like, you know, she's being educated about this stuff from the ground up so that there isn't this stigma surrounding it. I think, you know, the next generation is how we change this because we are not able to change what happened to us and how we were raised. But I think we have a lot of power to be able to speak [00:40:00] up and the more people that speak up, the less it's going to be stigmatized.

Mm-hmm. There will be a pushback. Right. But yeah. Um, but I think it's, it's community.

Olivia Khoury: Yeah. It is community, for sure.

Ashley Greene Khoury: Yeah. That's

Olivia Khoury: our number one focus is building a strong community of women who then can feel uplifted and share their stories with other people.

Dr. Brighten: Yeah, I appreciate that because I think that is the way forward is that we just normalize the conversations that are normal.

I had someone just last night that I was talking and she's like, how far along are you? And I was like, I'm five weeks pregnant. And she's like, you're telling people? And I'm like, you know, the thing I realized, it's not telling people early about pregnancy, not talking to people about my period. All of these things were never for me.

Mm-hmm. They were for other people's comfort and it was silencing me so that they could stay comfortable. And I've just decided we're not doing that anymore. Like if. You know, I, I just have very much the mindset too of like, I'm not gonna let the fear of the future rob me of the joy of this moment, and I'm just gonna have it, I'm gonna share it with people, and if things don't work out the way that I [00:41:00] wanted him to, like, why would, why should I have to go that alone?

Mm-hmm. Because, because we're told not to talk about these things.

Ashley Greene Khoury: Yeah. That's really beautiful and brave. And I think to your point, like it is, we found with, with humming way, like as soon as you open up about this, like mm-hmm. No one is saying, oh my God, I can't believe you said that. Everyone is going, oh my God, you two uhhuh.

Yeah. You know, and it's, that's what it's, it's, and Oh, I'm experiencing this. And, and then another person chimes in and it creates this beautiful movement. And it's similar with, with pregnancies and miscarriages. Mm-hmm. Uh, you find that because I had a miscarriage and um, really kept it to myself at first.

And I don't know that I've really like publicly spoken about it, but, um, but finally, you know, started. Telling people and then realize that like everyone around me had had a miscarriage. Yeah. You know, and, and I could talk to people about what I was feeling because it's sometimes hard. My husband is very supportive, but because he didn't go through it Yeah.

The same way. And because it was earlier, a little earlier on [00:42:00] to, I don't think he had formed that connection. It's mm-hmm. You know, it was just, it was tough. 'cause I was like, I don't know how to explain to you what I'm going through. Yeah. But other women who have gone through it, it would just, it was such a, a safe space.

Mm-hmm. And so, yeah, I think it's, it's great to talk about all that.

Dr. Brighten: Yeah. Well, and I appreciate you sharing that because. One of the things that's coming through with what you guys are doing in Hemingway is helping women not feel so isolated and alone. And I think with miscarriages, like when I had had my first miscarriage, no matter what I knew as a doctor, I felt like I'm the only one.

I was isolated. I was like the only one that going through that in that moment. And then, you know, as I was sharing in a conversation with someone recently, like if you think about how inefficient reproductive is, uh, reproduction is as a human, every time we try to get pregnant we have like 25% odds and then roughly 50% it won't work out even if you do get pregnant.

That's a lot of women. Mm-hmm. Who've all been thinking they're alone and the only one. Wow. So I really [00:43:00] appreciate you sharing that.

Ashley Greene Khoury: I did. And it's my fault, like what you said. In fact, he's like, oh my God, what did I do wrong? Yeah. Um, and now you're coming to find out too, like I, I, I'm curious your take on this, but you know, we're starting to see all this stuff come out now about like, oh, actually, like a lot of it has to do with the sperm Yeah.

Versus it being solely on the, on the women's head. And, and oh, if you're experiencing morning sickness or if you have miscarriage or there's some kind of anomaly, like a lot of times it is connected to the sperm versus mm-hmm. It, it being the woman's fault.

Dr. Brighten: Absolutely. I've, uh, I'll link some, uh, episodes with reproductive endocrinologists who talk about exactly that, like how problematic that fertility is always looking.

And they're like, it's not the reproductive endocrinologist, it's generally the ob gyn who's like. You're broken, something's wrong with you. We have to fix you, and you are their patient. Mm-hmm. So it's like you get that, except that there's 50% of the genetic con Yeah. Con contributor over here. That's being completely neglected.

And so we do know it can, it can affect the pregnancy, it can affect, [00:44:00] uh, miscarriage rate, it can affect the health of the pregnancy and fetal outcomes. It's super important. Mm-hmm. It's so interesting too, because the study just came out on bacterial vaginosis, which. Forever. That is something that men have made fun of women for.

You have a fish odor down there. Mm-hmm. And the study saying, you know, there's, this is possibly sexually transmitted. So it looks like it's an STI. It is 100%. Yeah. It only

Olivia Khoury: had comes when I have sex with the new party. Yeah.

Dr. Brighten: Well, I mean, to be fair, semen does disrupt your pH and your period blood can disrupt your pH.

So there's other things that contribute to bv, but to see the pushback of people who've been like, you can't call it an STI because like there's other ways that you can get it. I'm like, you can get a Hep B other ways, like you can get these infections other ways. But when it's an STI, that means that the doctor now can treat your partner.

And that's so important. Mm-hmm. And as I was trying to navigate this conversation and explain it to people, people are like. No, but stigma and dah, dah, dah, dah. I'm like, okay, [00:45:00] BV is associated with increased risk of miscarriage. So if her partner keeps passing it back to her and she's pregnant and the doctor until it's called an ST, I can't actually prescribe to that nail partner unseen.

Un you know, you have to do physical exam. Legally they're not covered. But as soon as it's classified as STI, they can protect her, him, but also baby as well. Like these have much larger implications. So it is very nuanced in, you know, what the things that can lead to miscarriage. And yet I think we always come back to like, it's me.

I'm broken. Because that those are the messages that we've been given in society. Mm-hmm. Yeah.

Olivia Khoury: Yeah. So what would it be called if men have it? It can't be called bv. Right? Right. Because that would mean they have vaginas because they've have vagina. Right.

Dr. Brighten: I mean, uh, you know, it's, they would just call it usually the organism that's overgrowing the Gardnerella, um, overgrowth.

But it's just very interesting. The other thing is that. For years, I've had patients say like, that's how I knew he was cheating. I got VV and I knew he was cheating. And I'm like, [00:46:00] women feel very vindicated in this moment. And the bad behaving men in my comments who were like, no, it's because of her hygiene.

I was like, oh, the vagina handles itself, sir. Okay. Like, stop and burying yourself. Get a book so you don't make these kinds of comments and like, read something. Yeah. Like, but to just like to, to see this discourse, like go back and forth. Um. Around this, but I'm like, yeah, I, it's not necessarily means that he's cheating.

Yeah. But there's women who are like, no, I knew this to be true about my body. And I'm like to see a study that says he could have picked it up somewhere else and brought it to you. Like after, I mean, I am like always inclined to believe a woman just say, I don't have any evidence to support this. I'm not gonna tell you're wrong.

Mm-hmm. Okay. Like if you caught him cheating. Hmm. But now see this, that's what your gut's saying. Yeah. But now I see this study. I'm like, well, there's some air of truth in that. That doesn't mean it's true for everyone in every situation. But yeah, it's interesting how science evolves and how people will.

Be so like vis [00:47:00] viscerally opposed, like getting new information and things that don't fit their narrative.

Olivia Khoury: Wow. That, that's fascinating. I'm

Dr. Brighten: curious at any point in, uh, 'cause you went to investors, because this is not, this was not an easy or cheap product to develop and you went through all of these iterations, so you needed to get investors for this.

Were there investors who were like, this is too Tableau, this is never gonna work?

Olivia Khoury: Yeah, I Not the ones, oh, not the ones that invested in us. Not the ones that invested.

Dr. Brighten: Obviously not, no. The one invested in you. They like had the vision, but I'm just wondering if there was like, you know. The growth sphere where they were like, no, this is weird.

Women don't have these problems.

Olivia Khoury: Yeah, 100%. Especially since we launched in 2021. And so when we were raising like truly there was like you and Elisa Viti talking about women's health. There was nobody else like way back in the day, right? Like and now because of TikTok and like social media, it's been like this boom.

Which is amazing. So I think obviously a lot of men have gotten way used to like hearing the word period, but there were definitely VCs, they're [00:48:00] uncomfortable, cringe at the word period, cringe at the blood. And even what was frustrating is a lot of. Older women that we pitched to who, you know, have money and they're VCs, they're like, how has this help?

Like, 'cause it didn't help them 'cause of menopause, like, yeah. Yeah. So it definitely, the pitches were interesting for, for quite a while. Mm-hmm. Um, but then we eventually found investors that like really understood, like Liz Cambridge, she's a basketball player, she was in the WNBA, this patch changed her life and so it helped her so much and so she became an investor and like, those are the type of people that we have around us.

Dr. Brighten: Mm-hmm. Okay. What's something that you wish you would've known growing up about your hormones and your body that you're now trying to share with women everywhere?

Ashley Greene Khoury: I just think that the, that you have phases of your menstrual cycle and that they affect your mood, uh, and they affect your overall, they affect everything about your productivity and how social you are and, um, and that there can be imbalances and, and, and [00:49:00] your estrogen and progesterone.

Like I, I, all of these things were so foreign to me. And so I think it would've been wonderful to have that introduced to me. Um, you know, the, the same way that, uh, we learned seven days in the week. Like, I think you should learn that you have emotional cycle with different phases. Um, I also think it would be, it would've been really helpful to know when I could get pregnant.

Oh yeah. And when I could not get pregnant instead of just any day of the month. You better watch yourself. Yeah, definitely. Or like, maybe just don't have sex these couple of days. Mm-hmm. I actually, um. Just had a conversation with someone and, and, uh, they said, do you want another baby? And I said, oh, not right now.

Um, and they were like, oh, you're on the, the pill. And I said, oh, absolutely not. Yeah. Um, and you know, this is a woman in her f like in her fifties and she's like, well, what are you doing? Like, you're gonna get pregnant. Like mm-hmm. You're not, are you, do you have a diaphragm? Do you do this? And I said, oh, no, I'm married.

Um, and we have this whole thing. And I just kind of looked at her and she goes, why are you looking at me like I'm crazy? And I said, well, it's not like I can get pregnant every day outta the [00:50:00] month, and I know when I'm ovulating and I'm pretty aware Yeah. Of these things. And she was like, what do you mean?

And it was just kind of mind blowing to me, you know, that she didn't, which I guess I don't know why I expected it, because especially my generation, especially generation above me, like we're kind of raised similarly mm-hmm. Where you just don't have information. But it was mind boggling to me where I was like, wait.

Do you know that, that there's a certain amount of days, like what is it, four days out of the week or month you can really get pregnant? Actually, if you wanna talk about that, I would love to put that clip on on my social media so that we can make other people aware. Um, but even like the, the phases of the cycle, like she just didn't know.

Yeah. Um, so yeah, I think teaching, uh, our children those things is really important. Mm-hmm.

Dr. Brighten: Yeah. We ovulate one day, we have 24 hours for egg and sperm to meet in the fallopian tube and that's it. If it doesn't happen in the 24 hours, you're not getting pregnant. So I think that's an always a heartbreaking part for women who are trying to get pregnant.

There are feeling like I'm failing. [00:51:00] Why can't I get pregnant? It's like, it has to be a certain day of the month. And then sperm, I like to call 'em loiters. There's like loitering can live for a little while, like, wait for her to come out the building. They can be around four, three to five days. Um, natural cycles has actually been really good with their data collection and doing studies and, and.

What they have found is that most sperm aren't gonna make it more than three days if you're trying to get pregnant. It's really important data to have because mm-hmm. It's three days before you ovulate and the day of are the key days to have sex to try to conceive. And if you really don't wanna get pregnant, you air on the five days before ovulation in case somebody's taking their zinc, selenium, vitamin C, and they're like got really strong swimmers.

Yeah. Plus your own uterine environment. Keeps them alive and nurtures them and is like, okay, you can hang out for a few days. They'll take it is like going, you know. Like they're loitering waiting for the like, you know, daughter to come outta the house. And grandma's like, I'll give you some cookies while you wait.

It's okay. Like [00:52:00] some cookies. So yeah, so there is that fertile window. And I remember when I learned about it and I was sitting in medical school and I was like, what the hell am I doing taking this pill every single day? And I was like, wait a minute. I'm not even sexually active. And like, what is happening in my life right now?

Like what? And who am I if I'm not on this? And like it was just this, I just remember it was like a moment where the camera like pans in, like she's having all these epi, like

Olivia Khoury: nothing. And I was like, what? And I

Dr. Brighten: was like, I'm gonna stop this. I think life will be fine. And then I was like, in hell. I was like, I have cystic acne and like, yeah and I don't have my period and what's wrong with me?

And like, oh it's like such a mess. And I was like, man, if we could just stop women from having to go through that, that would be really fantastic. Oh,

Ashley Greene Khoury: I have a question for you. Sorry. Yeah, now I'm a question mode. 'cause I recently, although like I'm kind of, I, I told you I think I might have CBO and I have all this stuff going on, so maybe that's it.

But I recently had. Like where I was like, oh, I started my period a couple days early, but it was like very light, like not like I wiped and was like, oh, there's like a little something. Mm-hmm. But then I didn't, but then I was like, like a day late on my period and I was like, wait, what is [00:53:00] that?

Dr. Brighten: Yeah.

Ashley Greene Khoury: Like what just happened?

Dr. Brighten: Well, you were just saying that um, 'cause you had surgery prior, right? Yeah. And that's what you think maybe was the impetus to developing sibo. Surgery is a stressor and any kind of stressor can throw off our cycle. And so sometimes we won't ovulate or sometimes we ovulate. And the corpus luteum, which is that little structure left behind that should produce progesterone, is like, I'm trying, but I can't.

And I'm trying, but I can't. And so sometimes that like I have spotting is like a bit of that progesterone failure. Like we sometimes think about like estrogen is laying the bricks down of the uterine lining and progesterone's the mortar that comes in there. Mm-hmm. And so if that mortar starting to go well then a brick is gonna slip.

Like Yeah. That's kind of the analogy I use. Okay. And so we can definitely see that it sometimes happens when women travel. So we're all have different. Uh, you know, barometers in terms of stress. And so sometimes just changing time zones, someone will start having spotting and they're like, why is my period coming early?

Because the stressor of that event told your reproductive system environment's not [00:54:00] safe. And your body's saying like, well, survival's the primary goal and reproductive health is secondary to that. Let's make sure we're surviving and it's dangerous to be pregnant. So we're just gonna, we're gonna stop that from happening.

Yeah. Just kind of magical. Yeah, it is really cool. Like, I think often women see this whole like, oh, I'm so sensitive to environmental stressors and everything. And like, that's so let's problematic. Yes. You're so in tune. Like that is why. Tribes that survived, had medicine, women had women who were intuitive, like feeding back.

Like it's also like you look at tribes that were like, when women were on their period, they were like, go into this tent, download the sacred information, like help support us. And then we got so far away from that. Mm-hmm. Like where they're just like, Ew, icky, go into the tent because youre dirty. And like, it's like, no, no, no, no, no.

Like, there's like great things happening during this time. It's also I think why there is so much a reclaiming of menopause right now. Mm-hmm. Because that used to be our wise women. [00:55:00] Right. And I, it is interesting to see from the evolutionary perspective how they talk about the reason why women went into menopause is so they were no longer that biological, reproductive threat to the younger women.

They didn't have to compete, they got to support them. Wow. And so they actually supported the tribe and how important that was to have the grandmothers. And I think society took that and twisted that of like, you know, making women feel like they're again, lesser in some way because they're not, you don't have reproductive capacity and like we're seeing this reclaiming of menopause, of like, no, this is like a new season and like mm-hmm.

And to realize that every season of our life and every season and phase of our menstrual cycle, like has power and utility. Yeah.

Olivia Khoury: I have a question for you. And then,

Dr. Brighten: yeah. Are we doing the question part now? Maybe. Maybe I just

Olivia Khoury: have one. You

Ashley Greene Khoury: can't come

Olivia Khoury: and

Ashley Greene Khoury: see you

Olivia Khoury: and not have Yeah. It's like free advice just with someone that has PMDD like for me.

Getting pregnant. That kind of sounds scary. Then [00:56:00] postpartum sounds scary. Mm-hmm. And menopause also sounds scary. Yeah. Yeah. Because pmm DDS already so insane. Mm-hmm. And I worry that like I'm just now at 33, kind of have it under control. Yeah. And then now I kind of wanna have kids soon, but that frightens me.

'cause they're, that's when there's a lot of progesterone and then the postpartum, like, will I even survive that? Yeah.

Dr. Brighten: So what's interesting about pregnancy is that we're not running estradiol, we're running estriol. And that's a really weak estrogen compared to estradiol. And so in cases of PMDD, a lot of times we'll see symptoms go away and moods are fine through pregnancy.

A DHD can be a little more problematic in, especially in the first trimester because as progesterone rises, estrogen starts to take a backseat. And as estrogen takes a backseat, so does dopamine, so does serotonin. And so it's something that I was actually, um, I just had someone on the podcast hasn't announced her pregnancy yet, and we were talking about [00:57:00] all of this and she was talking about, you know, the phases of your cycle and the luteal phase.

You gotta go internal. And I'm like, have you, have you framed yet that your first trimester is an extension of your luteal phase? You are going internal. You are laying down every single system of the body of a human. You're building a placenta. Like this is internal work. And so when you think like. I am failing.

I'm not enough because I'm not as productive. I don't have so much energy. I can't lift weights, I can't do all of that. You're not supposed to. It's an extension of that internal season. And then second trimester comes and you're very external. Like you're building your community, you're doing, you know, from that like ancestral perspective, but things switch at that phase.

Now when you get into postpartum, what is really important, it's very important to have someone monitoring your mood. Also monitoring thyroid health. So being neurodivergent autoimmune disease is par for the course. And thyroid disease is like the most common that we'll see postpartum. And it starts with this, like, I feel great.

I have tons of energy. I actually don't need to sleep. [00:58:00] Like I'm up, go, go, go, go, go. And now like I'm also having kind of heart palpitations and I'm feeling kind of anxious, and now I'm not starting to sleep. And then it slides into I'm depressed, I'm lethargic, I'm losing my breast milk. And that's a sign of postpartum thyroiditis that we're seeing going on.

So I, I already heard of that. That has to be kept on track. Mm-hmm. Sometimes so. What is really cool about postpartum is it's a window into your menopause experience. And so you can actually see what was this like for you? God, this is what's like, possibly coming like, no, but if you, she just nailed it in the chair.

But if you know this, then you can plan for this. So, um, it's very interesting 'cause so, um, I tried two months of Lupron for my endo. I regret that it was a bad decision, but I am glad that I went through it because the way I became absolutely depressed, dysregulated, like, had all these problems. One of the saviors for me was Saffron.

Bringing in like 30 milligrams of saffron was like a day A game. Yeah. A game changer for my mood. [00:59:00] So I was like, I need that menopause. Like, absolutely gonna be on track. So. Saffron is something that's pretty good in the research. When SSRIs fail, Saffron's a pretty good one to bring in. And so I'm looking now at postpartum where I'm like, I don't have as many mood uh, issues, but the last time I was postpartum was like writing a book with a baby on the front of me and I have this habit to like hyper focus and throw myself into work.

So even if I was having mood symptoms, I'm like, I'm not always so present for it. Like I kind of have issues with that. I work on that. But I am looking at like, well, I may wanna leverage saffron. I know I do good with oral micronized progesterone. So once your milk comes in, oral micronized, progesterone can help sometimes with the sleep, with the anxiety.

But this is the thing to know postpartum and in menopause perimenopause, if you have pmdd. So if we, um, and you're neurodivergent, if we start you in perimenopause on progesterone. We're gonna start like 25 to 50 [01:00:00] milligrams. The mistake providers make is they'll hit you with one to 200 milligrams. That can work wonderful.

It works wonderful for the neurotypical brain, but for the PMDD brain or the neurodivergent brain, it can sometimes be too much too quick. And it, oh, it floods that allopregnanolone. And that is something that I'm like very passionate talking about, because I'm like, it's great. Everybody's jumping on bioidentical hormones.

I've been prescribing these for like over 10 years. However, there's this whole entire population that has a paradoxical effect. And so, and then, um, sometimes providers are like, oh, well, let's cycle it. But sometimes with PMDD, it's actually like, keep it steady. Just keep it steady throughout the month.

Like she's in perimenopause. Um, you know, her cycles are becoming irregular and. 25 milligrams. Oral is not usually gonna like, inhibit a cycle or do anything. And you just keep those things steady. And then as we were talking about the antihistamine, so taking oral quercetin, drinking lots of nettle tea, if you can eat [01:01:00] stinging nettles, but like cook them because they'll, they'll mess you up.

Um, those kinds of things can be really helpful and adjunct. I always, when I get into my second trimester, I have a pregnancy tea I drink and it has lots of nettles in it. So I'm doing that already as a way to like, it's nutritive but it also supports that entire histamine pathway. And then it's like, but if things are starting to get off, like we know antihistamines can work and we see this, uh, it's interesting 'cause reproductive endocrinologists will talk about, with women with endometriosis.

Using the antihistamines, which I see a lot of endo in the neurodivergent community as well. But actually using, um, both like something like Zyrtec and Claritin, but also using an H two blocker, which you usually think for like stomach acid issues and partnering those together to like dampen, like a pepd

Olivia Khoury: ac.

Dr. Brighten: Yeah. Yeah. And so to dampen the, uh, the histamine response, well, you work on that because what happens [01:02:00] postpartum is that you were riding in this, let me do this. Okay. TH one, TH two, TH one viruses, bacteria, they don't belong there, kill them. TH two should be your parasites, but we don't get enough of 'em. So we do asthma, allergies, X, we switch from pregnancy to th two dominance because what's baby, it doesn't belong there.

Not you genetically distinct. And so you have that TH two dominance. When you deliver that placenta, your hormones are starting to switch. And then here comes th one. And so we can see like. Here comes the immune system, and now we're starting to have like this flare of symptoms. Wow. And that doesn't have to be forever.

That can be like a temporary thing. So, and then there's of course all of the lifestyle stuff that we can talk about, like diet, lifestyle. You have to be sleeping postpartum. We have to sleep. Like why are we not getting my, that was, that was my issue. Why is lack of sleep's, why mine is so hard? Why do we have those?

Olivia Khoury: Yeah. How do you sleep if, if you don't have help? Yeah. Well that's the thing. We should, yeah. We just,

Ashley Greene Khoury: we don't,

Olivia Khoury: but so many people don't. So [01:03:00] many people don't. Like I have a friend whose husband goes on tour. Oh. So not only does she not, should she just alone? Yeah. And no money for a nanny. So like how does that

Dr. Brighten: even, yeah.

I was, uh, I think like three weeks postpartum. And my husband had the opportunity to go to London and speak at like Google and like give a keynote and all this stuff. And I was like, of course, of course you're gonna do this. And I remember being so exhausted in the week he was done that I was walking down the stairs and I literally like collapsed on the stairs.

I was like laying on the wall, like trying to go down. I'm here. And I was like, oh my God. So like I absolutely feel that and I sympathize for that. We need, like, we need legislation to change in the United States for women. We need maternity leave. We look at the countries that have great outcomes, lower levels of postpartum depression among women.

They have nurses, doulas, people who come in afterwards who are coming to the house, checking on it's absolute bullshit. Mm-hmm. That you have a baby and then you need to take a baby to go get checked up on to a doctor's office and then you have to leave and get checked. Yeah. Why don't we [01:04:00] have a system where people can come to us?

Other countries have figured this out, so you know, it's always so easy, right? To be like you have to sleep. And then it's like, but how? And that is something that I feel like when you're pregnant plan the postpartum strategy. Yeah. So my first book, it's on postpartum health and it's, I wrote it because I was like, no one thinks about this.

Yeah. They think about getting pregnant. Mm-hmm. And they think about their pregnancy the whole time, but the hardest part is postpartum. And we have to plan our postpartum more seriously than we're planning our birth. Because you have control over postpartum and birth. You do not. And I say that as somebody who has always had like really nice ideas about what's gonna happen and then it actually happens and I'm like, oh, okay.

That's what we're doing. Yeah,

Ashley Greene Khoury: definitely. Yeah. It is really hard. And to your point, it is. It's infuriating when you see these other countries that, I mean, great for them, but yeah. You see kind of what we put our bodies through and, and what happens. Mm-hmm. And the amount of, [01:05:00] of repair that we actually need and the like two weeks that people actually get to have.

It was crazy.

Dr. Brighten: Well, it was, there was a friend of mine who, uh, was posting online about how much hate she got for being pregnant in her ob gyn residency from ob, other OB GYNs, and how she only got four weeks off and people acted like it was ridiculous that she would ever want more. And I was like, and that's the part of the healthcare system that's caring for pregnant women.

Like Yeah. And why are they acting like that? Because they're being taught that, and like, again. It comes to like, there's all these upstream issues. So like, and I think so often it's really easy to hate on politicians to be like, legislation needs to change. And it's that, but also we have this entire paradigm of medicine that's not standing up and advocating for us as well.

Yeah. Mm-hmm. Did you guys have more questions?

Olivia Khoury: I mean, always.

Ashley Greene Khoury: What do you recommend the best? Um, 'cause my, I have a, now that I'm [01:06:00] like leveled out post being on birth control, very regular period. Mm-hmm. And so it's very easy for me to say like, well just. Track your period. Yeah. Right. And, and uh, natural cycles is great and, and I know exactly when I can get pregnant, but for people who have endo and for people who have irregular periods mm-hmm.

And, and don't really have the same luxury that I do. Yeah. Um, but don't wanna be on birth control. How do they best not get pregnant?

Dr. Brighten: Yeah. Well, even with polycystic ovarian syndrome, PCOS. So that's where ovulation can be tricky. That's really at the crux of things is that we've got insulin on stimulating the cells that in the ovaries to make excess testosterone and they don't ovulate the way that they should.

And so with that, it's very interesting because I was always taught you can't do fertility awareness method in those situations. What's really interesting is Natural Cycles actually did the studies on it. They actually start, started taking the data and seeing, and they're like, you can actually [01:07:00] do it.

You still have the same temperature spikes. It's just. Not going to be as predictable. And it, um, you know, initially you're not gonna be able to be like, oh, it's gonna be somewhere in the middle. It's gonna take more time. And it makes you being aware of your body. The other thing is that we know that PCOS responds very well to nutrition and lifestyle changes.

And so that's the other thing is that as you're optimizing those aspects of your life, your ovulation can become more regular. So as we get insulin in check, as we get inflammation in check, then the ovaries start responding. And you have to keep in mind that maybe you'll never have the 28 day cycle, which I think that's like, and is this normal?

It was like 13% of women actually have a 28 day cycle. Mm-hmm. Maybe you're gonna have more like a 40 day cycle. And so you have to know what is true for you and all of that. With endometriosis, there's not ovulatory dysfunction. As part of that, we do have like a quality issues due to inflammation. So that's a whole other fertility aspect of it.

But the cycles should be [01:08:00] regular and if women don't want to, like many women with endometriosis. Don't want to be on birth control or things like Lupron, which is basically chemical castration of women. Like they don't want to be on these things and they don't get a lot of options. You can still track your period, but there's a lot.

It's like. I feel like sometimes, you know, I look at these chronic conditions and I just don't think women get enough respect that it's almost like a full-time job. It is to really manage your life. And when I talk about like how, you know, I don't eat fast food, I haven't eaten fast food in decades, and it's just as one example and people are like, Hmm, so you think you're so good?

And I'm like, no, no, no, not on purpose. My system doesn't get the same leadway that someone else might. So maybe your system can eat fast food and you're fine. And I eat fast food and I have to deal with gut symptoms for like the next like six weeks. Yeah. Which I always thought, oh, my gut symptoms like that's related to the food is directly impacting my gut.

Turns out I had endo all over my [01:09:00] bowels, so I'm like, oh, it was that affecting the endo was affecting my bowels. And so I always think it's funny when people get like, where they're like. Kind of judgmental about it. I'm like, listen, if I could just binge eat french fries all day, I would be about it. Yeah.

But I can't because meat will f up my body and I will want to die. Like it's not, it's not a great place to be. Yeah. Is Endo seen as a disability? It should be. Yeah. I actually like put that on, on threats. I was like, endometriosis should be a disability. Full stop. You should get period leave for this. And it was interesting how many people were like, you, like so many people in the US are just like so unwilling to like be empathetic and to like, I, I blame, I'm like, I really look at like what we've done in the school system, like taking out art, taking all these things that I'm like, we've lost empathy.

Yeah. But you know, it's so interesting to me how many people were like. Why should I have to pay for you to get time off? Just 'cause you have a period. I was like, I would like you to have a Chucky [01:10:00] doll living inside your body. Yeah. Going on a rampage with knives. And then you let me know and it's not just stabbing your uterus, it's all up in your anus too.

Let me know how you're doing at work and let me know. It's just

Olivia Khoury: around your period too for some people, right? Like it can be more often. Yeah,

Dr. Brighten: well it can be, um, ovulation as well can be really painful. Um, for me, when I was on the pill and I just was like, I'm just not gonna have periods, like, who needs those?

And I still had ruptured ovarian cysts, went to the ER multiple times. I had chronic pelvic pain. Um, they kept thinking like I was tearing muscles in my pelvis 'cause I was a dancer. And they're like, that must be going on. Like, you're tearing muscles or something like that. No. Turns out I had endo all over my ligaments in there.

Like, goodness. And, um, yeah. And I, you know, and the, and the myth go is like, oh, the pill was gonna slow that down. No, actually it punts the ball and the longer you go without getting a diagnosis, the more likely you are to have deep infiltrating endometriosis. So, [01:11:00] like, when they, I did this gel, MRI, when I looked at it, I was like, my bowels are literally glued to my uterus.

It was like so sad looking. It was like on there. I'm like, no amount of lupron's gonna fix it. Like nothing. Like, and if I didn't want to get pregnant, I could keep doing what I was doing and keep myself out of pain. But I was like, I wanna get pregnant. There's no real good data on the increased risk of colon cancer, but if you have a highly inflammatory tissue sitting there for the next decade, like after it's already done three decades, like just causing inflammation in that area, I worry about colon cancer.

I have bilateral endometriomas, and it's a slight increase in ovarian cancer risk. But like if I can deal, like I'm doing all the diet, I'm doing all the other stuff, why wouldn't I do everything to decrease my risk in that as well?

Olivia Khoury: Wow. Yeah. That's crazy. But you are a success story because with a

Dr. Brighten: team of people helping.

Yeah.

Olivia Khoury: Yeah. Because for a lot of people, they can't get pregnant when they have endo. Right? It's like, [01:12:00] is it the, one of the leading causes of endo of infertility. Yeah.

Dr. Brighten: So endometriosis and PCS, the two things that we've brought up, what's interesting is that the, is there some research pointing to possibly 50% of, uh, infertility cases actually endo with 25% of endo having no symptoms.

And they do have symptoms like anxiety and fatigue, but what are we told as women are crazy? That's normal. Yeah. Of course you're anxious, you're tired, uh, you're mom or you're a woman, or you're in your thirties, you're old, right? Mm-hmm. And so it's a lot of like dismissal of things that could definitely be signs.

And um, and I was saying like the gastrointestinal issues IBS is this. Garbage bucket diagnosis. Yeah. That too many endo women end up in and then they find out later, like, oh, actually pain with bowel movements and cramping and diarrhea. Like that was endo the entire time.

Olivia Khoury: Wow. That's, thank God for you.

Yeah. For my spreading the gospel and being like, yeah, you [01:13:00] need it. Like, if this

Dr. Brighten: happened to me, I'm not gonna let it happen to anyone else. Well, you're kind of

Olivia Khoury: like us, like, you know, you've, you've gone through a lot and now, and you've, you've worked, you've worked on so much on yourself and you're just like helping other people.

So we all kind of have the same mission. Absolutely.

Dr. Brighten: Well, let me ask you, so in your eyes right now, what needs to change in hormonal health and where do you think the future should be going? Yeah.

Olivia Khoury: Well, I feel like the femcare aisle needs to change. Mm. It is even still, like I see all these amazing brands come out and it's still just, they're not really there.

There's gummies now. There's gummies in the femcare aisle. Yeah. Which, again, is not really helping. And then it's still taken over by Midol and then like Vails to make your vagina smell better. Mm-hmm. And it's like when I'm in excruciating pain, I just want, give me the cycle, soother patch. Give me like a protocol when I go to the cvs.

Yeah. And I can just grab all the things that I need. And it's just not like that. Mm-hmm. And, and you all still have to walk to the way back. Yeah. There's just a, [01:14:00] I think it needs to start there, honestly. I mean, there's so much great stuff on the internet that's happening now, but again, am I only getting that because it's my algorithm?

Like is the word really getting out there about the different phases of the cycle and you know, different products that are non-toxic? Like, I don't really know. 'cause I don't know what other people see on the Yeah. On their algorithm. Um. And I think that, yeah, we need to be like, only like, I think like 1.5 or 2% of VC funding goes to women founders.

You have a better shot of being a successful women's health business if you have a male founder. Mm. And it's just like, we are the ones that should be telling this story because we're the ones that have experienced it and we're the ones that care the most. And so it's like, yeah, give us your money. Give us your money and give us a shot.

Like, you know, it just like been historically like white men that run businesses, but that's because they were the only ones given the opportunity. Mm-hmm. Like we just give women the opportunity and we're gonna just go shoot to the moon. And also more research in women's bodies. Yeah. Like that would be cool.

And I think that the fact that Natural [01:15:00] Cycles does that, and I know Clue is a period tracking app that also like creates more research. Like as long as we can do that, like I'll happily be like a test. Stemmy, like research me. Yeah. So yeah, those things.

Dr. Brighten: Anything you would add? No, that's,

Olivia Khoury: that's handled.

Yeah.

Dr. Brighten: Well, this has been a fantastic conversation. Thank you so much for sitting down with me and being so candid about your stories and for being on a mission to change women's medicine for the better You. Ditto. Thank you. Thanks for having us.

Olivia Khoury: Thank you.

Dr. Brighten: I hope you enjoyed this episode. If this is the kind of content you're into, then I highly recommend checking out this.