447. The psychology of PMOS/PCOS ft. Dr Hazel Wallace

I was recently diagnosed with PMOS, and with that came a lot of questions: why is my body like this, what caused it, will I be able to have kids, how can I fix it? There's a lot of information (and misinformation) online, so today I decided to sit down with an expert to ask all my burning questions on this condition. Watch on Netflix: HERE https://netflix.com/thepsychologyofyour20s Dr Hazel Wallace is a medical doctor, registered associate nutritionist, women's health expert, author and founder of the platform, The Food Medic. In this episode, we discuss: The origins of PMOS/PCOS Why we had to change the PCOS name What causes PMOS and whether it's genetic How PMOS intersects with psychology and mental health The 5 things you should and shouldn't do if you have PMOS What actually helps How to deal with medical dismissal and misinformation Happy listening! Dr Hazel's book HERE https://www.panmacmillan.com/authors/hazel-wallace/47438 Follow Dr Hazel HERE https://www.instagram.com/drhazelwallace/?hl=en Follow Jemma on Instagram: @jemmasbeg https://www.instagram.com/jemmasbeg/?hl=en# Follow the podcast on Instagram: @thatpsychologypodcast https://www.instagram.com/thatpsychologypodcast/?hl=en# Subscribe on Substack: @thepsychologyofyour20s https://substack.com/@thepsychologyofyour20s For business: [email protected] mailto:[email protected] The Psychology of your 20s is not a substitute for professional mental health help. If you are struggling, distressed or require personalised advice, please reach out to your doctor or a licensed psychologist. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  This is an iHeart Podcast. Guaranteed Human.

• 0:04Jemma Sbeg?

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• 0:49Jemma Sbeg?

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• 1:26Jemma Sbeg?

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• 2:10Jemma Sbeg?

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• 2:55Jemma Sbeg?

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• 3:21Jemma Sbeg?

  Hello, everybody. I'm Jemma Sbeg and welcome back to the Psychology of Your Twenties, the podcast where we talk through the biggest changes, moments and transitions of our twenties and what they mean for our psychology.

• 3:40Jemma Sbeg?

  Hello, everybody. Welcome back to the show. Welcome back to the podcast. It is so great to have you here back for another episode as we, of course, break down the psychology of our twenties. Today, we are doing an episode that selfishly, I think I need more than anything right now. And on a topic which I have searched, I have looked, there aren't really, or there are very few in-depth podcast episodes about it. We are talking about the psychology of PCOS, PMOS, as it's now called. Kind of to begin the episode with a little bit of a story time. I was diagnosed with PMOS last year.

• 4:21Jemma Sbeg?

  And I think just since then, I've found that the information and the advice and the help I've been looking for has been very, very lacking. And I know I'm not alone in this. It can take years for our symptoms to be recognized, to finally get a diagnosis. And even afterwards, the advice we usually get is come back when you want to get pregnant, go on the pill, do some exercise. What is often not examined is the impact of this dismissal on our psychology and the impact that PMOS has on our mental health, our emotional health, as well as the physical symptoms. Something I know would have helped me would have just been sitting down with an expert and just getting to ask a lot of why questions. Why was this happening? Why did this start? Why does my body behave this way?

• 5:05Jemma Sbeg?

  Why are certain treatment options often and others are not? So today, we're just going to create that opportunity for others. I have in the studio, Dr. Hazel Wallace. She is a female health specialist, a doctor, a nutritionist, the author of Not Just a Period. She has spent thousands of hours, probably more, thinking about studying, examining women's hormones, women's health, women's nutrition, PMOS symptoms. She also has PMOS herself, so she really knows the ups and downs. We are so excited to have her. Dr. Hazel Wallace, welcome to the Psychology of Your Twenties.

• 5:40Speaker 02

  Thank you for having me.

• 5:41Jemma Sbeg?

  Do you find the intros a little bit awkward, as I was saying?

• 5:43Speaker 02

  Yeah, I always do, I always do. It's hard to know how to respond, but I think you captured everything, so thank you very much.

• 5:50Jemma Sbeg?

  I'm so glad.

• 5:55Jemma Sbeg?

  Well, I've done the in-production, but I'm going to let you do your own as well. Who are you? What are you? What's the work that kind of lights your fire? What do people know you as? Or who do people know you as?

• 6:06Speaker 02

  So in terms of who I am and how I got into this work, it is quite a long and winding story. But I'll try to summarize it quite short for you. So my backstory is when I was 14, I lost my father to a stroke. And being a 14 year old girl, that was really significant in my life. And I think that moment made me first want to be a doctor. And second of all, it helped me realize that our lifestyle, including nutrition, plays a really big impact on our health. So those two things started to shape what came next.

• 6:46Speaker 02

  So I went into medicine and I was really excited to learn everything there is about nutrition. Doctors don't learn really anything about nutrition and I was a bit disappointed by that. And also quite shocked because from my own reading, I was understanding that nutrition was hugely impactful on our health and preventing disease. So I started a blog and Instagram page 14 years ago now, which is crazy because I'm like a dinosaur in the industry, called The Food Medic, really trying to like connect medicine and nutrition. And that was what I did for a really long time and the Food Medic page still exists today. And I've written books on nutrition.

• 7:27Speaker 02

  But along my journey as a doctor, I was working through the pandemic as a COVID doctor, which was a really challenging time and I was living alone. So outside of my hospital hours, I spent a lot of time reading. And I was reading a lot about how women were neglected in health and healthcare, how most of the medical research we have is based on men or male cells, male mice. And that a lot of what we know about women is just kind of left up to guesswork, which means women's health is hugely neglected. I found that insane and really enraging as a woman and also as a doctor with many female patients. So I wrote a book on it called The Female Factor. And since then, which was around 2020,

• 8:12Speaker 02

  I completely pivoted my work into women's health because there is so much work to be done. And I think also, as you mentioned, I also was going through my own diagnosis or diagnosis journey with PMOS. Despite being a doctor, it took me two years from first going to my doctor to actually getting the diagnosis because I was told that I just didn't fit the picture. There was no need to kind of progress with further testing. And I think being a junior doctor at the time, I didn't want to, I don't know, step on anyone's toes who was more senior than I was in that space.

• 8:51Speaker 02

  So fast forward to 2025, last year, I released my second women's health book, Not Just a Period. And that is basically your encyclopedia to the menstrual cycle in terms of not just the hormones and everything that happens across the phases, but how that impacts your skin, your mood, your nutrition, your exercise, even your libido. And for me, that was really, a really empowering book to write because I learned so much about myself. But also, I feel like it's something that every woman should know.

• 9:27Jemma Sbeg?

  I'm just like listening to you being, just nodding my head. Yeah, yeah, exactly. What I find so interesting about that story, and there's so many things, like you speaking about your dad and how you've had this like powerful, motivated to change people's lives and completely pivoting. Part of what I found really interesting as well was you talking about how you were a doctor got looking for a diagnosis. And it took you two years.

• 9:52Speaker 02

  Yeah.

• 9:52Jemma Sbeg?

  And i- if that is not the most insane, but also perfect metaphor example for like what it's like to get help. As a woman, um, I really don't know what is.

• 10:07Speaker 02

  Yeah.

• 10:08Jemma Sbeg?

  So today we're gonna talk about P M O S and you went after your own diagnosis, you got one and so many other women that I know are currently like at some s- stage. In that process, can you give us a quick overview of what P M O S is, formerly P C O S? Maybe also like touching on the significance of that name change because that happened.

• 10:30Speaker 02

  Very recently.

• 10:31Jemma Sbeg?

  Like three months ago.

• 10:32Speaker 02

  Three weeks ago.

• 10:32Jemma Sbeg?

  Three weeks ago, wow, my gosh, so, so that is happened very recently, okay, um, talk us through it.

• 10:39Speaker 02

  So there are a lot of letters and a lot of words, but I'll, I will break it down. Um, so formerly called P C O S, polycystic ovary syndrome. Has been renamed to P M O S, which stands for polyendocrine metabolic ovarian syndrome. Like breaking down that name in itself, I think is really important. Polyendocrine, poly means many, endocrine means hormones, many hormones are involved. We often talk about testosterone when it comes to P C O S or P M O S, but there's many hormone systems involved. Metabolic signifies that it's not just your ovaries, it's your metabolic health. So what I mean by that is like your blood sugar balance, insulin resistance, cardiovascular risk.

• 11:23Speaker 02

  Ovarian highlights that your ovaries and your reproductive system are still involved, they're still a very important part of the diagnosis. And then syndrome means that there's many different symptoms and signs, there's not one cause, so it's kind of like many things together. And the reason why the name change is really important, first of all, it's so rare to change a name in medicine, like that in itself is huge. But it came about because so many patients and practitioners were like, P C O S is so misleading and it's confusing. Because polycystic ovary syndrome kind of focuses just on the ovaries and it makes us assume that. You have to have polycystic ovaries to have the condition, which you don't.

• 12:07Speaker 02

  And also that it's just an ovary problem, but now we know it's a full body condition. So this new name change, I think pivots away from this is just a problem at your ovaries. And actually, this is a full body condition. You don't have to have polycystic ovaries to have the condition, some women do, but it's not essential for the diagnosis. So I think that in itself is really important because a lot of people were only getting the diagnosis. If they had kind of that picture on their ultrasound. So by changing it, we're opening up the definition and it means a lot more women are fitting that criteria.

• 12:47Speaker 02

  And I think thinking back to my own diagnosis, I was told you don't fit the picture of P C O S, so you can't have it. Because I wasn't fitting that very tight definition that they had in their textbook. Whereas now we know it's much more than that.

• 13:04Jemma Sbeg?

  So that is something I did not know, which was that previously, as you were kind of telling us, only if you had cysts on your ovaries. Would they say, yes, you can kind of enter the gate, is that what you're saying? And if you didn't, they were like, well, something else is wrong with you and I'm gonna assume they weren't gonna look any further. Is that what I'm, am I right in assuming?

• 13:24Speaker 02

  Yeah, you're right in saying that, I mean, to be diagnosed with P M O S or P C O S, there are three criteria and you need to have two of three.

• 13:32Jemma Sbeg?

  Oh, okay.

• 13:33Speaker 02

  One of them is polycystic morphology, so these cysts on your ovaries. They're different to the cysts that we talk about when we say you've got a cyst on your ovary and it's ruptured. These are immature follicles that have not kind of developed fully and they look what we call like a string of pearls on your ovary. So having one of those is, uh, can be diagnostic, the other two features are having raised testosterone and this can be on a blood test. Or it can be clinical features of it, so clinical features of raised testosterone would be excess hair around your jawline, your face, your neck, your chest. Typical male pattern or acne or hair loss from kind of male patterns on the forehead or on the scalp.

• 14:17Speaker 02

  And the third feature is absent or regular periods. So you have to have two of, three of those. So technically, you don't need to have the polycystic ovaries. But I think for a lot of people, that was an area that was causing confusion. But also, even if you got the diagnosis, so you've been fighting for your diagnosis, you got it. A lot of women were then told, well, just come back when you wanna get pregnant, because it's just an ovary problem. So, or, or take the pill and that will sort you out. And I'm not saying the pill is a bad solution, I know we're gonna talk about that later.

• 14:54Speaker 02

  But I think the problem is we were completely neglecting that women were really struggling with the fatigue, the difficulty losing weight. The metabolic features, the cravings, the blood sugar crashes, the excess hair growth, the cystic acne. But, and just telling her to go away and come back when she wants to get pregnant.

• 15:15Jemma Sbeg?

  Yeah.

• 15:15Speaker 02

  Seeing, and it's so wild to me because I was given that exact quote. Whenever I say it online or I, I hear it repeated back to be my, by thousands of women.

• 15:26Jemma Sbeg?

  Yeah, I'm not gonna lie, somebody said that to me last week. I had a, I'm not even joking, I had a gynecology appointment last week. I had to go private because I like, I'm, I, I'm in the U, in the U K, but like the waitlist was too long, I was having really terrible problems. I couldn't get to go and see a public, you know.

• 15:46Speaker 02

  G P.

• 15:47Jemma Sbeg?

  A G P, well, I have a G P, but they, what, she basically was like, the, the referral process was so difficult. She was like, well, if you have the means, go private.

• 15:56Speaker 02

  Okay.

• 15:57Jemma Sbeg?

  And I went and I was like, I have never gone to a private doctor before in Australia, it's very rare.

• 16:03Speaker 02

  Hmm.

• 16:03Jemma Sbeg?

  And I was like expecting her, I was like, oh my gosh, I'm so, I was excited, I was, I'm so excited, feel like she's gonna have something for me. And she told me to exercise, which I was like, well, I already do that. And then was like, oh, but your, your blood pressure, like your heart rate's really low, you have like brachial cardio and I was like, oh, well, cause I, I exercise, so we can rule that. Thank you for the advice, we can rule that one out. And then she was like, do you have a, a partner? And I was like, yeah, I do. And she goes, are you guys trying to have kids? And I was like, no, no, no. And she kind of looked at me like, why are you here? Like, and then she was like, oh, well, and then at the end was like, you know, I would, we'd be really worried if you like trying to get pregnant, but you're not, so we kind of have some time. And I left and I actually was like very teary and very upset about it.

• 16:49Jemma Sbeg?

  And something that my boyfriend actually said was like, that advice is inappropriate, A, like just because you should still get treatment. But what if you just didn't want kids?

• 16:59Speaker 02

  Yes.

• 16:59Jemma Sbeg?

  And I'm sure that's something you see all the time where it's like, wait, so if I don't want children, this isn't going to be. Dealt with is a bad way of saying, but managed. And yet you're saying, and I know from experience, I'm sure many women listening to this know from experience, there is like a laundry list of other stuff. That is going on, you've mentioned three.

• 17:22Speaker 02

  Hmm.

• 17:22Jemma Sbeg?

  Um, well, actually you've mentioned quite a few, but can you give us some others that might have nothing to do with. Your period or nothing to do with, you know, reproductive health?

• 17:34Speaker 02

  Yeah, I think the most kind of visible ones and for a lot of people can be. Almost the most distressing is the visible features and that is cystic acne. And also hair sitism, which is hair growth in unwanted places. And it's typically around like the jawline and the cheeks and the neck and the chest. And it can be quite stubborn, um, and even on fair skinned women who typically wouldn't have dark hair. It can be very dark and difficult to get on top of. The other symptoms will be things like gaining weight or difficulty losing weight. Um, anxiety and depression is very common, there's a higher risk in women who have P M O S. So that's something that's often not spoken about.

• 18:20Speaker 02

  Um, the fertility issues, of course. And then insulin resistance is a huge trigger for the condition, but also that can cause symptoms in itself with. Blood sugar crashes, fatigue, um, and you know, is, is a really core thing that we need to be focusing on. So I find it really difficult when you tell me that you've gone to see someone.

• 18:41Jemma Sbeg?

  Hmm.

• 18:42Speaker 02

  And just that conversation didn't happen because that carries its own risk factors of future type two diabetes, cardiovascular disease. Which women with P M O S unfortunately have much higher risk of. So it's so important that every woman who comes through the door with a new diagnosis of P M O S is being screened, it's in our guidelines. We need to be checking blood sugar, we need to be checking cholesterol, blood pressure, that needs to be done. I would say like majority of the time that's not happening from what I'm seeing.

• 19:12Jemma Sbeg?

  Well, yeah, I didn't, um, I didn't get any of that, but that's interesting, maybe I'll ask for a follow up appointment.

• 19:17Speaker 02

  Please do.

• 19:23Jemma Sbeg?

  I've been approaching my health really differently this year. I used to be really focused on maximizing and doing more. And now I'm just realizing that if I listen to what my body needs, I perform way better. And that's why I am obsessed with my Whoop. Truly, you guys, you know, I'm such a data and information driven person. And I love opening my Whoop app and seeing how my sleep, my stress, my strain is correlating with my mood, with my running performance, with how I'm just feeling day to day. I'm not an elite athlete by any means, but I do really benefit. And I also just really enjoy knowing more about my body. And Whoop also gives me these actionable personalized insights that have made me more intentional

• 20:09Jemma Sbeg?

  and meant that I make smarter decisions day to day about what I need, rather than just putting my foot on the gas and just going, going, going, going. New members can try Whoop with a 30 day free trial before committing to a membership. That's join.whoop.com/psychology for your free month of Whoop. This episode is sponsored by Gymshark. Gymshark has spent over 14 years obsessing over gym clothing and the people who wear it. And let me just say, I think we all know they are very, very good at what they do. No, seriously, their stuff is so good. Their everyday seamless collection is light, it's soft, it's stretchy. All of their stuff just looks good on and it's made for people who love to exercise, whatever exercise that is.

• 20:53Jemma Sbeg?

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• 21:05Jemma Sbeg?

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• 22:12Jemma Sbeg?

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• 22:51Jemma Sbeg?

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• 23:11Jemma Sbeg?

  Growth isn't linear. There's no magic timeline or secret template. And no one understands that quite like Southern New Hampshire University. Because SNHU has online degree programs built for whatever path you are on. Tried college before? Transfer up to 90 credits. And if you're new to this, no worries. Every student gets a dedicated academic advisor. And here's the best part, there's no set class times, so school actually fits your life. Ready to get started? Visit SNHU.edu/psych. That's SNHU.edu/psych. So what I've always wanted to know, and something that I feel like nobody's explained to me,

• 23:56Jemma Sbeg?

  is what is actually happening in my body hormonally, on a cellular level, scientifically, that is creating this? So you spoke about this kind of, for some women, it's like this string of pearl. I'm not sure if you said underdeveloped or overdeveloped follicles, like in the ovary.

• 24:16Speaker 02

  Yeah.

• 24:17Jemma Sbeg?

  Is that what it is? Or like, how does this, how does this start? Where does it come from?

• 24:22Speaker 02

  It's a great question. And in terms of what causes PMOS, the short answer is we don't know. But it's likely to be a combination of genetics, environmental, and lifestyle factors. So a combination of things. But what's happening in your body, first of all, can kind of vary from person to person. And the other thing to mention is PMOS and how it presents in a different woman can be so different to the woman next to her. It can kind of appear very differently. But the main thing to say is it's not one single hormone that's causing this, and it's not one single organ. Think of it as like a network problem, where the ovaries, the brain, and your metabolism are just not really communicating in the way that they, they should.

• 25:08Speaker 02

  So all our hormone systems in our bodies do not work in isolation. They all communicate with one another. And when one of them is out of, we'll say balance for lack of a better word, but if it's out of sync, it impacts everything downstream. And so in the case of PMOS, there's a few things that can be going on. First of all, the brain can be sending signals to the ovaries, which is normal. But it can be sending too many, which can stimulate the production of androgens, which are male hormones. The one that we often talk about is testosterone. Now, it's normal for women to produce a little bit of testosterone. That's good. Lots of testosterone can be problematic because it can interfere with ovulation,

• 25:53Speaker 02

  which means the follicles, which are going to be eggs, don't fully mature. And that's why women with PMOS don't ovulate every month and have long cycles. So that's the first thing. Now, the other big component is insulin resistance. Eighty percent of women have insulin resistance regardless of their BMI or body weight. Insulin resistance means that our body isn't responding as well to insulin when we have carbohydrates. And so it has to produce more insulin. High levels of insulin and dysregulated blood sugar have a knock on effect by also increasing things like androgens, testosterone. They can also directly impact the ovaries.

• 26:35Speaker 02

  All of this is like a huge cascade of things that cause us to have longer cycle length, higher testosterone, which impacts things like ovulation, but also those symptoms we mentioned, acne, hair growth. And the insulin resistance is impacting, first of all, our risk of those future illnesses that I mentioned, conditions, but also our blood sugar balance, our cravings, our ability to lose weight. So it's multiple things happening at once, which is really confusing and hard to disentangle. And some women will be more impacted by one part of that pathway than others.

• 27:14Speaker 02

  So you might find that you actually don't really get terrible androgenic, those kind of acne hair related symptoms, but you're impacted by other things. And so we treat all women with PMOS the same. But I think what we're starting to see in the research is that there's probably different types of PMOS going on. We can't neatly categorize them yet, but I suspect that in the future that we'll have very personalized treatments for different types of PMOS because it behaves so differently in different women.

• 27:50Jemma Sbeg?

  That is so interesting because, and again, I keep relating this back to my personal experience. But again, at the top of the episode, I'll let them know. I told them. I'm like, I'm here just to ask you questions for my own sake in a way, but I would go online and be like, okay, PMOS, back then, when I was really looking, it was PCOS, like PMOS, like really heavy period. PMOS, like I've had my period for like four months, TMI to, to the gang, listen. But like, you know, PMOS, like this, this, this, and it would be, PMOS is, is the lack of a period. PMOS is this and this. And I was like, but I don't have those things. And a big thing that really confused me was I was like, but I don't have acne. And I don't really grow hair in other places. And I don't, I get, I have the opposite problem.

• 28:34Jemma Sbeg?

  Like I, like my period doesn't cease. And what you're saying is, as the research is progressing, you think that we're going to start categorizing it, maybe the same way that we like categorize diabetes in some ways, or maybe the same way that we even categorize certain like neurological disorders. Is that kind of what you're seeing?

• 28:55Speaker 02

  Yeah.

• 28:55Jemma Sbeg?

  Happening?

• 28:56Speaker 02

  Yeah, I think like we can, if you think of it like a Venn diagram, this is how I see it in my head, with like four circles and in the, in the middle, there's like where they all overlap. And someone might have all of these features. And that's one type. And then someone might have two of those features. They may have, you know, the irregular cycles and the acne, or they may have normal cycles and really bad hair sitism and acne. Or they might just have fertility struggles and they've only realized that they've got PMOS because they've been on that journey. So it seems that there is different phenotypes or types of PMOS. The, the reason I'm really cautious with this is I've seen that idea kind of been captured

• 29:37Speaker 02

  and spat out on social media in various different forms, and it's not always accurate. So I think like, at this point, if someone's telling you, you need this specific type of treatment for this specific type of PMOS, we don't, we clinically don't use that terminology yet. But I think it will be, I think it's really useful for women who have PMOS to understand what are, what is their problematic features, what is really concerning for them. So they can articulate that when they're speaking to their doctor and ask for support in those areas. Because I think that's where maybe we are really letting down women.

• 30:22Speaker 02

  I really want to touch on.

• 30:24Jemma Sbeg?

  Something you just said, which is you see this idea online a lot.

• 30:27Speaker 02

  Yes.

• 30:28Jemma Sbeg?

  This idea of the four different phenotypes, categories, strains, whatever you wanna call it. And I've seen that. And I was gonna ask you, I was like, what are the four different types? And it's so interesting, cause I think this is a pattern with a lot of uh health conditions that primarily, if not exclusively, uh impact women. You're not getting the information from probably your G P, you're not getting the information even from the specialist that you need. And so you turn online, turn to like online resources. And this is a whole different conversation, but the amount of misinformation you're saying is kind of spreading through those channels because like there is no consensus on this.

• 31:09Speaker 02

  Yeah, that's it. And I think it, that's so reflective of every area of women's health. If you feel like you aren't getting the help from your normal healthcare provider, women turn to social media.

• 31:20Jemma Sbeg?

  Yeah.

• 31:21Speaker 02

  And if you see someone who has something similar to you, then you're gonna see what are you doing that's helping you? Or you see someone who's got a stethoscope around their neck and they're on social media and they've got a page, you're going to listen to them. And, I mean, I am a health professional who also creates content and has done for years. But I really, I think you have to approach anyone who's giving healthcare advice on a specific condition with a lot of um skepticism, because just because someone has a doctor title or a healthcare title doesn't mean that they're a specialist in that area. And I guess that's the wild, wild west of social media, because it can be amazing to connect communities.

• 32:05Speaker 02

  It can be amazing to sometimes get support. And I think that's great. But also, it's just so unfortunate that there is, it's a very muddy place to get health information. And it's never gonna be personalized to you. And I guess what I'm trying to say is that when it comes to P M O S and I have a, I work in a clinic and I see a lot of P M O S women. And I would say, no two women are getting the same pieces of advice. You know, everyone's getting such specific advice based on their goals, based on their symptoms, based on their diets, based on, you know, so many different things.

• 32:43Jemma Sbeg?

  Yeah. I relate to this. I've spent many a night on a Reddit thread. And I've also spent a lot of time on social media being like, well, this person looks like they, you know, what they're talking about. And as somebody who also operates in that space, I think a big red flag is if somebody does not at some stage say, this is general advice, or doesn't at some stage say, I am not your doctor, I am not your therapist, go and this is where you can go and find it. And that's like a big thing that I always try and do is, we have it in every single episode description.

• 33:16Jemma Sbeg?

  We say, at, at the top of every single episode, you know, like I cannot provide you with individual kind of feedback or help.

• 33:26Speaker 02

  Yes.

• 33:26Jemma Sbeg?

  And I think that's a big red flag if you have somebody who's like, I'm gonna give you the cure all.

• 33:30Speaker 02

  Yes.

• 33:31Jemma Sbeg?

  I'm gonna tell you the final secret on this, it's gonna fix your life. It's like, no.

• 33:36Speaker 02

  No, that's so true. I think you're looking for disclaimers and caveats and no one's selling you this magic bullet, because they just don't exist. Like unfortunately, they don't.

• 33:47Jemma Sbeg?

  And you're looking for research.

• 33:48Speaker 02

  Yes.

• 33:49Jemma Sbeg?

  If somebody cites, make sure they're citing sources.

• 33:51Speaker 02

  Yeah.

• 33:52Jemma Sbeg?

  And check the sources.

• 33:53Speaker 02

  Absolutely.

• 33:54Jemma Sbeg?

  Sometimes somebody, we, I actually had this happening the other day where I was like, this source is amazing. And it was like a blog post written by the person who was doing the video. And I was like, I just got tubes. I was like, I was like, that is such great advice. And I was like, oh, that's an opinion. That's like not even real anyways. I kinda wanna circle back to something, cause I, I, I flew over it too quickly, which is you mentioned the increased chances or likelihood or prevalence, I guess, of anxiety and depression and a myriad of other mental health concerns in women and people with P M O S.

• 34:31Jemma Sbeg?

  Why is that? Is it purely because they are experiencing a medical issue that is being dismissed? So is it contextual, is it environmental? Or, or is it biological or social? What, why do you think it is?

• 34:46Speaker 02

  I think with anxiety and depression, it's usually multifactorial. And that's the case in P M O S. Anyone with a chronic health condition typically has a higher risk of, of anxiety and depression. We also know that women with P M O S have more issues with body image and a higher rates of eating disorders. And a lot of that is, from what we know, is at least in part related to the fact that there is a nutritional component. And if you're told that the only way that you're gonna get better is if you lose weight, if you cut carbs

• 35:28Speaker 02

  and all of the pressures put on you, that can create very troubled relationships with food. So I think it's a component of this, likely the kind of hormonal systems are probably at play here and impacting women. We know that the hormones of your menstrual cycle that are impacted here are not just sex hormones, they impact everything. You know, you've got estrogen receptors on your brain. So it's likely hormones are at play, but the kind of experience of being a woman with P M O S is just hugely stressful in itself and living with that. And it's not just, you know, it's not something that's curable from what we know. You may get to a point where you are living mostly asymptomatic and that would be amazing.

• 36:12Speaker 02

  But for a lot of women, they really struggle to get there. And there's just such little support. And from what we spoke about earlier, you know, physical manifestations can be really hard for women, fertility problems. There's, I guess, there's, what I'm trying to say, there's so many things that could be contributing.

• 36:28Jemma Sbeg?

  Yeah. And I like that you have, have said that rather than just being, that's just a hormonal thing.

• 36:32Speaker 02

  Yeah.

• 36:32Jemma Sbeg?

  Because I do think a, a large part of it as well is dismissal. And the fact that you are staring down at like the barrel of a diagnosis that, as you said, doesn't have a cure. But then also, you can't find a way to manage it. And then there's probably somebody being like, I don't know if you have that or not. And you're like, wait, but I, what am I meant to do? I, I, do I, I feel it so deeply that this is impacting me, but there, maybe I don't have it. A doctor took, took a while to diagnose me. Now they're saying, come back when, when you get pregnant. What is the impact of that on our psyche? Like in your patients or the people that you see?

• 37:12Jemma Sbeg?

  You know, how much of the mental distress is, nobody believes me or nobody can help me?

• 37:16Speaker 02

  Yeah. I think, I mean, it's, it's massive and it goes for so many women's health conditions beyond P M O S, you know, endometriosis takes eight years to be diagnosed.

• 37:29Jemma Sbeg?

  Wait, eight years?

• 37:30Speaker 02

  Yeah, eight years on average, like globally.

• 37:33Jemma Sbeg?

  Oh, I didn't even know. That is insane.

• 37:35Speaker 02

  It's insane. And the UK, there was a report in the UK not too long ago, which there was this fact from it, which was so shocking that on average, women had gone to their doctor more than ten times, their G P more than ten times before a referral for investigations. Which is, is just wild. So I think P M O S, slightly shorter uh time to diagnosis, largely because different ways that we diagnose, it's less invasive.

• 38:06Speaker 02

  But I think having P M O S myself, I'm probably more empathetic to it than someone else. And it's just having consultations with women who have maybe been waiting for a really long time or they have the diagnosis, but they've been sent away because there's not really anything that they've been offered. Just being able to speak to someone who understands the condition, they will be hugely emotional. And I think they find that hugely therapeutic because no one explained to them what it is or what that means for their fertility or their future health, or what they can do outside of pills or having babies.

• 38:46Speaker 02

  And I think, you know, even from a, a public health perspective, there's not much knowledge out there. There's not more kind of, there's maybe one charity in the UK that supports P M O S, but there's not much being done in the way of like public health messaging, supporting women

• 39:08Speaker 02

  who have that beyond go see a private doctor. And you know, from your experience or from other people's experience, that's not even always a great experience.

• 39:17Jemma Sbeg?

  No, it wasn't, it wasn't a great experience. Um, but I think that, I like that you've pointed to this, something you said, this amazing point, which is the benefit of like catharsis. Of somebody coming to you and being like, oh my God, thank you for listening to me. Thank you for just like letting me say that. And I'm sure like the stress levels plummet immediately probably. And like just this, this tension that you're like you're holding is finally released. And what's interesting to me is the role of, of stress in P M O S, which I wanna ask you about. And, and how significant it is and the process of getting diagnosed, the process of getting help, the process of maybe pursuing like your fertility journey

• 39:57Jemma Sbeg?

  is so stressful. It's kind of like, wait, don't be stressed, but like this condition is, is so uniquely stressful that it's like almost impossible.

• 40:06Jemma Sbeg?

  Maybe I should have asked you this earlier, but can you talk about the role of, yeah, stress and, and all those things on, on the systems of somebody with P M O S?

• 40:14Speaker 02

  Yes. Stress is hugely impacted. Stress is hugely impactful on our hormones in general and our sex hormones. And that goes for all women. So there are multiple different types of stress hormones, but the main one is cortisol that we often talk about. And that can impact our ovarian axis. So the hormones that are released from our brain that tell our ovaries to produce hormones. Cortisol can basically down-regulate that. So it can switch off those signals in when you're going through chronic stress. And a really good example of this is when we were going through the pandemic. So many women found that their cycles had skipped a month or their cycles were really long, like globally.

• 40:58Speaker 02

  Because we were all going through this insanely stressful event. Now, that can happen in P M O S and it can also happen when women are going through kind of physical stress, be that their extreme dieting, doing a lot of exercise, going through anything that's physically demanding. Your body basically is switching off signals because right now is not a safe time to have a baby. In P M O S, that can happen, but also cortisol may increase the production of things like androgens, testosterone.

• 41:29Speaker 02

  And there's an association with P M O S where women may have higher levels of cortisol of P M O S. So baseline levels are slightly higher. And then if you're kind of more stressed, you're kind of increasing that even further. So it's not great. So stress management is a huge part of the picture when it comes to helping improve P M O S symptoms. Now, I think when it comes to stress management, often the advice is just, just stress less. Like, just don't, don't be a stress.

• 42:02Jemma Sbeg?

  Yeah, and goodbye.

• 42:03Speaker 02

  Yeah. Have you tried meditation?

• 42:05Jemma Sbeg?

  Yeah.

• 42:05Speaker 02

  Um, and I think also for a lot of people, it naturally falls to the bottom of the pile of the things that we're gonna prioritize. Like, you know, supplements is far more tangible. I can take a pill, I can get on with my day. How do I manage my stress when I'm working like ten hour days? I'm, you know, moving house, moving country, whatever it might be. So I think how I speak to my clients about it is integrating kind of stress management buckets in your day where you can like dial down the amount of stress you experience. And that might be that for the first thirty minutes of your day, you're not going straight on your phone because cortisol's highest in the morning. If you get up and you're looking at your phone, looking at your emails, you're just increasing that further. If you're getting

• 42:47Speaker 02

  up doing fasted exercise, that's also quite a big stress with P M O S. With women in general, I'm not a huge fan of fasted exercise because we're increasing cortisol when we don't need to do that. So it's those little things. It doesn't need to be like huge hours of journaling or hours of meditation. It could be downloading a meditation app and doing five minutes, ten minutes a day. But stress management for every single woman with P M O S is, is very important.

• 43:17Jemma Sbeg?

  And I found this when I, when I, when I moved countries at the start of the year, was like when my symptoms were the worst. And I remember saying to my mom, actually, I was like, I don't understand. Like, I'm doing, I'm actually doing everything right. You know, I'm, I've, according to like this information I was given, you know, I'm, I'm like doing so good with like not eating processed carbs and like I'm eating my three meals a day and I'm hitting my protein goal. And I think that is the invisible factor of like stress feels like a necessity for so many things that it's sometimes like the last thing we wanna cut out.

• 43:51Speaker 02

  Yes.

• 43:52Jemma Sbeg?

  Do you know what I mean? It's almost like, it's like the alcohol or like the cigarette of like the emotional states.

• 43:58Speaker 02

  Yeah.

• 43:58Jemma Sbeg?

  Where it's like, oh, but I need my stress. I need my stress to like get stuff done and I need my stress to like be successful. And then it's, you eventually get to a point where you're like, but also I, I need to be healthy. And we don't really consider it until you exit a period of that or like you accidentally have a period where you're not as stressed and you're like, wow, my body functions so much better, so much better. Um, I'm gonna ask you some questions now about what actually works with P M O S. Actually, before I do that, I don't wanna skip over this, which is getting diagnosed. And if you've been had, what does that actually look like? If you go to a G P's office, if you go to a doctor's office, what should you, I don't know if you're allowed to do

• 44:42Jemma Sbeg?

  this in the UK, but what should you ask for? What should you mention that you, you know, that will, that will get people paying attention? How do you advocate for yourself? Just very quickly before we go into.

• 44:54Speaker 02

  Yeah, great question. I think first of all, your cycle length is an important factor. Now, if you have regular cycles, that doesn't mean that you don't have P M O S, but it can be a really big feature. So first of all, if you're not tracking your cycle, I would really do that. So you can have at least three cycles worth of like, this is what's happening. I would also list the symptoms that you're experiencing because first of all, you have them to hand. It's easy to forget things when you're in a ten minute appointment and you're feeling pressure with like a doctor staring down at you and asking you to kind of hurry up. Um, and it just helps you to kind of know what are the patterns with my symptoms as well. The main things, as we mentioned earlier, for getting the

• 45:37Speaker 02

  diagnosis are those, that criteria. So two of three. And that's the same, even though we've changed the name, the criteria for diagnosis is the same. So irregular cycles, evidence of raised testosterone, or, um, polycystic ovaries on a scan. So to get diagnosed, we want to know your symptoms. So that's what you're gonna bring. We'll do a blood test to see if you've got raised testosterone. And sometimes you don't have to go further than that. You could be diagnosed with just that, uh, cause you're meeting two of three criteria. In some cases, if you don't, then you'll be referred for an ultrasound scan and that is a transvaginal scan. So they kind of basically put the, the probe inside

• 46:18Speaker 02

  your vagina and look at your ovaries. Um, beyond that, we should also be just doing our due diligence, checking things like your blood sugar balance or what we do, we use a different test in the UK, um, called H B A one C, and checking risk factors. So making sure your blood pressure's okay and cholesterol levels and asking you a little bit about your family history. That's the main things for P M O S.

• 46:42Jemma Sbeg?

  Okay. That's good to know. Cause I wasn't, um, I didn't do a testosterone test until like this year recently.

• 46:49Speaker 02

  Hmm.

• 46:50Jemma Sbeg?

  Which is like so interesting that that would have been nice to avoid the third option that you gave.

• 46:55Speaker 02

  Yes.

• 47:01Jemma Sbeg?

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• 47:44Jemma Sbeg?

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• 48:42Jemma Sbeg?

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• 50:03Jemma Sbeg?

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• 51:33Jemma Sbeg?

  I would say that's a cause for celebration. Some people might feel very daunted by it, but I think it's a good thing to just know. Um, what are some things? Well, I was gonna ask you, what are some things that actually help? But I'm gonna give you a list of some things that I've heard about. And I want you to kind of rate them out of 10. And then maybe go into some things that aren't on the list.

• 51:55Speaker 02

  Okay.

• 51:55Jemma Sbeg?

  So I spent, as I said, I spent a lot of time online.

• 52:00Speaker 02

  On Reddit.

• 52:00Jemma Sbeg?

  Reading, um, not just on, on Instagram as well. And sometimes on TikTok if I really want my sources, no, but just like looking things up online, going to forums and websites and all this stuff. I've got eight things here.

• 52:13Speaker 02

  Okay.

• 52:14Jemma Sbeg?

  That are factors in PMOS might help, might not help. You ready?

• 52:18Speaker 02

  Yes.

• 52:19Jemma Sbeg?

  Okay, the pill.

• 52:21Speaker 02

  Oh, this is such a big one to start with.

• 52:25Speaker 02

  So I won't give you a quick fire answer, but I'm gonna give you maybe a six out of 10.

• 52:31Jemma Sbeg?

  Okay.

• 52:31Speaker 02

  Maybe a seven. So the answer really is, it depends. Now, there's so much pill fear mongering going on right now in general. I don't think the pill is suitable for everyone. And it also is not a cure for PMOS. So sometimes people will say, oh, the pill regulates your cycles. Not necessarily. It gives you a regular bleed because it gives you a false bleed. So for some women with PMOS who have really irregular cycles, that's quite reassuring because every 28 days they're having a bleed. If you have very irregular cycles, and I mean like three to six a year, so not very many.

• 53:14Speaker 02

  It's really important that we're protecting your womb lining. Because if you don't bleed regularly, that builds up and it increases the risk of something called endometrial hyperplasia, which can increase the risk of endometrial cancer. So in some women with very irregular cycles, the pill is actually protective. Cause it means that we're kind of losing that extra endometrial lining every month. So it's helpful. For some women, they take the pill with PMOS because the combined pill is anti-androgenic. So it blocks the acne symptoms, the hercetism, the hair loss, and it's really beneficial. So for those women, fantastic.

• 53:59Speaker 02

  If they're not issues for you, or for some reason you can't take the pill because there are contraindications, then it's not an option for you. And also I think, you know, some, some women experience side effects from the pill that they really don't like. And that can vary, whether that's mood, libido, whatever it is. So I'm gonna give it a six out of 10. Because for some women, it can be like a nine out of 10. For some women, it's a one out of 10. So it really depends.

• 54:24Jemma Sbeg?

  And this is the combined pill. What about a progesterone? How do you pronounce that?

• 54:28Speaker 02

  Progesterone.

• 54:29Jemma Sbeg?

  Progesterone. I always like, I always struggle with it.

• 54:33Jemma Sbeg?

  Is that different? Would your rating for that be different?

• 54:34Speaker 02

  Yeah, well, the progesterone pill can be used as well. And sometimes women are given a progesterone type pill to just have a withdrawal bleed every few months. So you don't take it all month. You just take it to help you have a bleed. And some women prefer that. The thing with progesterone is that it can actually, the progesterone only methods of contraception can sometimes worsen acne symptoms. And that's not always spoken about. So if your doctor knows that you have PMOS and suffer it with acne, they shouldn't really be kind of looking at those progesterone only methods.

• 55:12Speaker 02

  I feel like that's not something that's like commonly spoken about.

• 55:15Jemma Sbeg?

  Yeah, I've never heard of that. There we go.

• 55:17Speaker 02

  But again, for some women, they can't have the combined pills. So progesterone might be the only option. It's, it is a minefield.

• 55:22Jemma Sbeg?

  I was just thinking that's the right word for it.

• 55:23Speaker 02

  It's such a minefield. Um, I do kind of really go into great detail about this in my book. But there's also a great platform. It's called the Lowdown. And it's kind of like a trip advisor for contraceptives. And it's run by doctors and I, I really rate it. So before you go into the doctor, have a read of that because you can like compare different options, see the side effects. It's really helpful.

• 55:49Jemma Sbeg?

  That's great.

• 55:50Speaker 02

  I know it's really great.

• 55:50Jemma Sbeg?

  I'm gonna leave a link to that below.

• 55:54Jemma Sbeg?

  Anositol.

• 55:54Speaker 02

  Anositol. Um, I really rate this, so I'm gonna give it an eight out of 10.

• 56:00Jemma Sbeg?

  Oh my God, that's a high, that's a high score. That's an A.

• 56:03Speaker 02

  Anositol is like a type of sugar compound in the body. We can get some from food. But it's really, it really needs to be taken in supplements to get the high dose where we see benefits. And the most kind of evidence backed form is myoanositol or a combination of myoanositol and D-chiroanositol. And this kind of works by improving your insulin sensitivity. So it helps with blood sugar, but it also improves ovulation. And I think probably the biggest win that women experience is that if you've got irregular cycles, you tend to find your cycle length starts to shorten.

• 56:41Speaker 02

  And it, you know, it's, it's a fantastic supplement. It's well evidence backed, very low side effects. I don't really hear much from, from people who take it. But it's also not a magic bullet. And for some women, it's fantastic. And they get results amazing and they just think, oh my God, I could never be off this. And other women try it and they're like, it actually doesn't do very much for me. And that might be because we're seeing different types of PMOS and we don't fully understand that.

• 57:08Jemma Sbeg?

  There we go. See, I responded really well to it because I read a couple of studies about it last year. And shout out to Grace Beverly Shreddy, PMOS.

• 57:18Speaker 02

  You find it beneficial?

• 57:19Jemma Sbeg?

  I, life changing. And I, but I also have just taken myoanositol on its own. Anyways, but that's just my experience. Um, but yeah, I like that you gave that an eight. Kind of confirmed something for me. I'm like, oh, it's working. Okay, great. Um, low carb diet.

• 57:36Speaker 02

  Um, I'm gonna give it like a three out of 10. So that's not because there's no evidence for low carb diets. There is. But there's nothing to say that it's better than like a moderate carb intake. So like 45% of your diet. Also, a lot of the low carb studies are actually pretty high carb. Like they're not like, well, not high carb, but they actually have quite a lot of carbs. They're not like ketogenic in, in that they're like 10% of your calories. So in these studies where women are on low carb diets, they're still eating quite a lot of carbohydrates. I generally like to keep carbohydrates in the diet because they're a really great source of fiber, B vitamins and other nutrients. Carbs are also important for thyroid hormone production. If they become low, that can impact your cycle.

• 58:20Speaker 02

  And also it's just more enjoyable. Like why cut out carbs if you don't need to?

• 58:24Jemma Sbeg?

  Yeah.

• 58:25Speaker 02

  Um, so in my practice, I always include carbohydrates in the diet. And we just focus on the quality of carbohydrates. So low glycemic index. So carbohydrates that aren't giving you big spikes in glucose. And that means, you know, we're choosing those that are full of fiber, your whole grains, your brown rices, that kind of thing. So yeah, I really don't rate a low carb diet.

• 58:48Jemma Sbeg?

  Okay. Um, what about high protein diet?

• 58:51Speaker 02

  Yes, big fan of that. I think protein in the diet can be hugely satiating. And also really important for kind of body composition, but also high protein diets have good evidence in PMOS.

• 59:03Jemma Sbeg?

  Seven hours of sleep.

• 59:05Speaker 02

  Uh, I'm gonna give it a seven out of 10. I would love seven to nine, like if you can go even more. Kosh is saying that because some women are like, I'm struggling to get seven. I have kids. I have demanding work life, all of that. So I think on the days you can get more, go for more.

• 59:21Jemma Sbeg?

  Yeah.

• 59:22Speaker 02

  But seven as a minimum.

• 59:23Jemma Sbeg?

  As a minimum?

• 59:23Speaker 02

  Sleep is so important for PMOS.

• 59:26Jemma Sbeg?

  What would you give nine hypothetically, if I had said nine? Knowing that it's not always accessible, but if it's a perfect world.

• 59:33Speaker 02

  I would think nine out of 10.

• 59:34Jemma Sbeg?

  Okay. Red light therapy.

• 59:38Speaker 02

  Like two out of ten because there's not really any research on red light therapy. From the top of my head, I think I've seen one study and it was an in vitro or mouse study on that and P M O S. Um, I'm seeing more of it in the fertility space, so I don't wanna eat my words. But right now, I'm gonna say two out of ten, like, don't waste your time.

• 59:59Jemma Sbeg?

  Okay.

• 59:59Speaker 02

  Focus on the other things.

• 1:00:00Jemma Sbeg?

  It's not a big thing right now, drinking alcohol.

• 1:00:03Speaker 02

  Zero out of ten.

• 1:00:04Jemma Sbeg?

  Okay.

• 1:00:04Speaker 02

  Well, like, do you know what, it's fine to drink, uh, uh, there's nothing to say that moderate consumption is going to ruin your symptoms or in worsen your symptoms. But it's not going to be helpful. Alcohol is very pro-inflammatory. P M O S is a pro-inflammatory condition, so we wanna reduce inflammation. Drinking a lot isn't gonna help. It's also gonna have knock-on effects on your sleep, on your stress, everything else, so it's not great. Um, but if you have the odd glass of wine here and there, I don't think it's gonna cause much harm.

• 1:00:37Jemma Sbeg?

  Yeah, you don't need to get too stressed about it.

• 1:00:38Speaker 02

  No.

• 1:00:39Jemma Sbeg?

  Yeah. Uh, lifting weights.

• 1:00:41Speaker 02

  Um, probably like one of my favorites. I'm gonna say nine out of ten because I don't really see many drawbacks. Um, obviously it requires effort.

• 1:00:51Jemma Sbeg?

  Yeah.

• 1:00:51Speaker 02

  Yeah, requires effort, so that's the only drawback, but we want to build muscle. And as P M O S, it's really important that we've got muscle mass because muscle is like a sugar sponge. So I seen someone use this analogy of like, do you know Weetabix, the cereal?

• 1:01:10Jemma Sbeg?

  I, I, yeah, I think Weetabix is Australian. Or is that just something that everybody claims, probably?

• 1:01:15Speaker 02

  Yeah.

• 1:01:15Jemma Sbeg?

  It sounds British, not gonna lie. Yeah, we have Weetabix.

• 1:01:18Speaker 02

  So if that's your muscle and then you pour milk on it and then it soaks up all that milk, that's kind of what your muscles are doing with blood sugar.

• 1:01:26Jemma Sbeg?

  Okay.

• 1:01:26Speaker 02

  So the more muscle you have, the more insulin sensitive you are. So it's really beneficial to be building muscle. And that doesn't mean that you have to like be so hench and like have loads of muscle. But it's good to lift weights and do resistance training. So that doesn't include like small weights on your ankles when you go for a walk. I mean, like actually lifting weights, some form of Pilates do count, cause I always get asked that, like people say, like, does Pilates count? Some forms do, but the reformer Pilates would be like more resistance, cause you're actually using a lot of resistance there. Whereas if you're doing mat Pilates and you're not doing a huge amount, you may not be using as much stimulus. It's not to say it's redundant, I love Pilates, but I'm just saying I love when women use

• 1:02:10Speaker 02

  weights because then they're adding more of a stimulus to building muscle.

• 1:02:15Jemma Sbeg?

  So this is something I'm sure a lot of women have heard, which is like, you need to be lifting heavy.

• 1:02:18Speaker 02

  Hmm.

• 1:02:20Jemma Sbeg?

  What does that mean? When somebody says, oh, you need to be lifting heavy, I'm a big fan, but I remember hearing that and being like, I don't, what, like, uh, something over my head, or like when I first started, I was like, do I push something or what, what does that mean?

• 1:02:33Speaker 02

  Uh, it is a very vague phrase and I think it's all relative, but moving any form of resistance, I think is beneficial. So if that's weights, if that's bands, if that's reformer, that's going to be muscle strengthening. So if we want to build more muscle and build strength, we need to have progressive overload. So we need to increase the amount that we're doing. So if you're, you know, you've go to the, if you go to the gym and for the first four weeks you're lifting, let's just say, two kilogram dumbbells. In the next couple of weeks, I want you to increase that, cause you need to increase the stimulus to build strength.

• 1:03:12Jemma Sbeg?

  Hmm.

• 1:03:12Speaker 02

  And that's just what we mean, because I think typically, and this is very much like generalizing, you know, women use these tiny one kilogram weights. And sometimes those one kilogram weights can be really heavy if you're doing lots of reps. Um, but if you're using the big muscles of your body, so that's like your quads, your glutes, your hamstrings, your back, we can lift a lot more. And so we want to be kind of pushing ourselves. If you're able to do twenty reps and you're not breaking a sweat, you're not lifting heavy enough.

• 1:03:45Jemma Sbeg?

  Hmm, I like that, I like that as a rule. Okay, I've got one more.

• 1:03:48Speaker 02

  Mm-hmm.

• 1:03:49Jemma Sbeg?

  And I just threw this one on, cause it was a, a nice fun one, which is peppermint tea.

• 1:03:54Speaker 02

  So I see a peppermint tea and I raise you spearmint tea because spearmint tea.

• 1:03:59Jemma Sbeg?

  Is that what's in gum? The spearmint flavor? Is that what I'm thinking of? Okay, okay, yeah.

• 1:04:04Speaker 02

  Uh, it's actually hard, it's quite hard to get your hands on, like pure spearmint tea, but there's evidence that spearmint tea can reduce androgen, so testosterone, two cups a day. Try it for three months, there is some research for it. Peppermint tea less so, but it's good for the I B S girlies.

• 1:04:21Jemma Sbeg?

  Oh, okay. There we go, girls. Um, knowing your ratings there, oh, you didn't give it, what, what would you give spearmint tea, sorry?

• 1:04:30Speaker 02

  I'm gonna give it a five out of ten.

• 1:04:32Jemma Sbeg?

  Okay, peppermint tea would be less?

• 1:04:34Speaker 02

  Yeah, not for P, P M O S, we'll give it two out of ten.

• 1:04:36Jemma Sbeg?

  Okay.

• 1:04:37Speaker 02

  Cause if you get bloated, it might be helpful.

• 1:04:38Jemma Sbeg?

  Okay, great. I've been really trying to prioritize my health in a realistic way this year and something that has kept me really motivated is my Whoop. I am such a data person, which is why I love Whoop, because I can genuinely see why my body feels differently depending on the day, why I'm running differently, why I'm maybe less focused. Whoop effortlessly tracks my sleep, it tracks my strain, my recovery, my stress, and most importantly, my overall health. And it just gives me all that data and all those patterns, so I can make better decisions, which includes knowing when to go easy and knowing when to go hard. New members can try Whoop with a thirty day free trial before committing to a membership.

• 1:05:19Jemma Sbeg?

  That's join dot whoop dot com slash psychology for your free month of Whoop. This episode is sponsored by Gymshark. Gymshark has spent over fourteen years obsessing over gym clothing and the people who wear it. And let me just say, I think we all know, they are very, very good at what they do. No, seriously, their stuff is so good. Their everyday seamless collection is light, it's soft, it's stretchy. All of their stuff just looks good on and it's made for people who love to exercise, whatever exercise that is, lifting, cardio, Pilates, running around campus, maybe just doing errands. Discover Gymshark and find your new favorite gym clothing at gymshark dot com.

• 1:06:01Jemma Sbeg?

  Know two journeys look alike. That's why Sky Miles is designed to move with you wherever life takes you. Fly, it flies with you on new adventures, family getaways, business trips and the moments that matter most. Earn, it earns alongside your everyday life. It dines with you on special nights out, it streams alongside your favorite entertainment, rides through your daily routines and helps turn everyday moments into something more. Redeem, it helps you redeem for what's next. From spontaneous weekend escapes to the trip that you have been dreaming about, to upgrading your next trip to a premium cabin experience, the miles you've earned along the way can help take you further. Access, and it unlocks access to exclusive, one-of-a-kind experiences and opportunities

• 1:06:46Jemma Sbeg?

  that make membership feel rewarding long before takeoff and long after landing. Because Sky Miles is more than a travel program, it is a membership that moves with you. Fly farther, earn every day, redeem your way and access more. Because when your membership is as unique as you are, there's no telling where your next journey will take you. These days, there are more people than ever telling you how to manage your health. And we've all gone down an internet rabbit hole exploring the latest health trends. Your social media feed is packed with wellness advice, telling you to cold plunge, protein max, detox, track your sleep. But what's actually real? What's exaggerated? What's just wrong?

• 1:07:29Jemma Sbeg?

  That's exactly what Health vs. Hype from the American Medical Association and iHeart Media's Ruby Studio is here to find out. Each episode, Emmy nominated science communicator Trace Dominguez, who's racked up billions of views across PBS, Discovery Channel and YouTube, talks to health influencers, real people, and most importantly, doctors, to separate fact from fiction. Because when it comes to your health, who you listen to matters. Listen to Health vs. Hype on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

• 1:08:08Jemma Sbeg?

  Growth isn't linear, there's no magic timeline or secret template, and no one understands that quite like Southern New Hampshire University, because S N H U has online degree programs built for whatever path you are on. Tried college before? Transfer up to ninety credits. And if you're new to this, no worries. Every student gets a dedicated academic advisor. And here's the best part, there's no set class times, so school actually fits your life. Ready to get started? Visit s n h u dot E D U slash psych. That's s n h u dot E D U slash psych. I walk into your office, I go, Dr. Hazel, help me.

• 1:08:53Jemma Sbeg?

  And I give you my symptoms. If you had to give like a top four, what would you say to a woman who's experiencing P M O S to, to start doing or to start trying or to stop doing?

• 1:09:05Speaker 02

  So I'm gonna leave any medication chat to your

• 1:09:12Jemma Sbeg?

  to your doctor.

• 1:09:13Speaker 02

  Yeah, to your doctor, because there are some options beyond the pill that you can discuss. And also will depend on whether you are actually trying to conceive or have any risk factors. What you can start doing today, nutrition is gonna be a huge part of it first and foremost. Now, there's no specific diet, there's no single diet that will kind of cure P M O S. But nutrition is so powerful, like I can't tell you enough, I feel like it transformed my symptoms and it's what I do every day in my practice. The best way to kind of like summarize what you need to do from a food perspective for P M O S is following a Mediterranean style dietary pattern. I know that we bang on about this diet for everything and that's because it does a lot of things.

• 1:09:59Speaker 02

  But because it's a dietary pattern, so it's not a specific foods that you need to consume. It's not have two almonds a day or anything, it's a pattern, which is good news because it means that it's flexible to you.

• 1:10:11Jemma Sbeg?

  Hmm.

• 1:10:11Speaker 02

  And and what I mean by that is we want to have lots of colorful fruits and veg, whole grains, fish, um, nuts and seeds, moderate intake of dairy, less red meat, processed food and alcohol and sugar. Within that, when it comes to the macronutrients, the key macros are, the three are protein, carbs and fats. We already talk talked about carbohydrates, but we want to have them in the diet to make up around forty percent of your overall calorie intake, so present at every meal. But the high fiber, low glycemic carbohydrates. Glycemic, we, when we say that word, we mean blood sugar.

• 1:10:53Jemma Sbeg?

  Mm hmm.

• 1:10:54Speaker 02

  And adding fiber to your meal reduces that glycemic impact. But also pairing carbs with fat and protein further reduces it.

• 1:11:04Jemma Sbeg?

  Hmm.

• 1:11:04Speaker 02

  So if you're having a slice of toast and you add some smashed avocado and maybe a poached egg on top, you're getting carbohydrates, fats and protein. So that blood sugar response will be less than if you had a slice of sourdough with some strawberry jam on top.

• 1:11:21Jemma Sbeg?

  Hmm.

• 1:11:21Speaker 02

  Or banana. And that's not to say that you can never have a single carb on its own because they have their place. Like around exercise, we want those fast acting carbs. I run a lot, I'm having bananas before I run, I'm having toast with honey on it. That is absolutely fine if you've got P M O S. But if you're sitting at your desk or you're about to go to work, we want steady energy levels. And it's gonna be those balanced meals that give us those steady energy.

• 1:11:48Jemma Sbeg?

  Mm hmm.

• 1:11:48Speaker 02

  Now, I mentioned inflammation earlier and the only, the things that help reduce inflammation in the diet are all that colorful fruits and veg. And so we want as much of that in there, we want nuts and seeds, we want our oily fish. Um, oily fish specifically is a really great source of omega threes. And we can get omega threes from other sources like chia seeds and walnuts and plant based foods. But our body has to convert it and that conversion is not, we're just not great at it. So if you don't have oily fish, and I'm not saying you have to, but if you don't, I would think about adding an omega three supplement and still prioritizing those sources.

• 1:12:30Speaker 02

  Because omega three is hugely beneficial in P M O S, you've got lots of good evidence behind that. That's really diet in a nutshell, we kind of said, we mentioned alcohol. Ideally, limit it as much as you can, limit as much processed food as you can. But if you're traveling for work and you're in an airport and the only thing that you can get is a processed snack, one, one day of kind of processed foods is not gonna derail you.

• 1:12:56Jemma Sbeg?

  Yeah.

• 1:12:56Speaker 02

  It's what you do eighty percent of the time that will impact you the most, not what you do twenty percent of the time.

• 1:13:02Jemma Sbeg?

  Hmm.

• 1:13:02Speaker 02

  So that's nutrition. And then supplementation, annoying answer, but it does depend. I think Nostal is a great one for most women with P M O S. Um, give it a go for three months anyway. In the UK, vitamin D is a big one because we don't get much sunlight. Low levels of vitamin D are quite common in P M O S. And if you've got low levels, that may worsen symptoms. So I tend to look at supplementation, but always look at people's blood tests first. And then on top of that, it's really variable. So like I mentioned omega three.

• 1:13:36Jemma Sbeg?

  Mm hmm.

• 1:13:37Speaker 02

  If you're getting two portions of oily fish in your diet, there's no point in me adding omega three into your diet. Uh, supplementation. There are other supplementations, supplements that people try and that could be magnesium, berberine, chromium, copper, loads of different ones, they're varying amounts of um, evidence. You'd probably be surprised at how little I prescribe supplements because.

• 1:14:01Jemma Sbeg?

  Yeah.

• 1:14:02Speaker 02

  I think if you can get it from your diet, I really don't wanna be giving you loads of supplements. The supplement industry is so poorly regulated as well.

• 1:14:09Jemma Sbeg?

  Hmm.

• 1:14:10Speaker 02

  And I think nothing's better than a food first approach.

• 1:14:14Jemma Sbeg?

  Yeah.

• 1:14:14Speaker 02

  And outside of food, exercise, sleep and stress management are the other things. So exercise, there's no single best form of exercise when it comes to P M O S. A lot of people say only do low intensity, that's not true.

• 1:14:31Jemma Sbeg?

  That was gonna be one of my questions, I always see people being like, don't do HIIT workouts.

• 1:14:34Speaker 02

  Yes.

• 1:14:35Jemma Sbeg?

  But I love, I have this one class I talk about on this podcast all the time called Sculpt. That is just like a HIIT workout in like, in like a sauna, basically. And I've always like, oh, should I be doing that? What's your take on um, yeah, on HIIT workouts?

• 1:14:50Speaker 02

  So I, um, I've really wanted to talk about this because I find it really surprising that this is a big thing. Like it's a big myth. Um, because the research shows the opposite, there's like good research to say high intensity exercise improves P M O, P M O S symptoms. And when we pool together all the different exercise studies in P M O S, there's no superior type that's like best for women with P M O S, it's kind of a combination of both.

• 1:15:18Jemma Sbeg?

  Yeah.

• 1:15:19Speaker 02

  Um, the caveat to that is, and this is where I think, because some people I speak to say, well, actually, I know high intensity exercise or running made my symptoms worse.

• 1:15:32Jemma Sbeg?

  Mm hmm.

• 1:15:33Speaker 02

  And then when we kind of get into the grains of salt or whatever the phrase is for that.

• 1:15:38Jemma Sbeg?

  The grains of rice?

• 1:15:39Speaker 02

  The grains of rice.

• 1:15:40Jemma Sbeg?

  We get into the.

• 1:15:41Speaker 02

  We get into the.

• 1:15:42Jemma Sbeg?

  The nitty gritty.

• 1:15:44Speaker 02

  What I realize is, it's actually, it's not the high intensity exercise, that's the problem. It's the fact that you're doing loads of exercise fasted and you're doing a ton of exercise and you're not making time for recovery and your sleep is off. So we're under fueling and we're under recovering and we're doing too much exercise. And actually, if we bring down the intensity of how much you're doing, so instead of doing seven back to back Barry's classes every week, we're doing three HIIT workouts and two strength sessions per week. We're fueling before we go to the gym or for our HIIT sessions. We're making sure we're optimizing our recovery afterwards, we're resting.

• 1:16:27Speaker 02

  No longer do we see those issues, so, and that goes for every woman with, with or without P M O S. HIIT is not bad for you, it doesn't harm your hormones, but if it's all you do, you're not recovering and you're under fueling, you're gonna have issues.

• 1:16:43Jemma Sbeg?

  Hmm, I like the caveat.

• 1:16:50Jemma Sbeg?

  I've been approaching my health really differently this year. I used to be really focused on maximizing and doing more. And now I'm just realizing that if I listen to what my body needs, I perform way better. And that's why I am obsessed with my Whoop. Truly, you guys, you know I'm such a data and information driven person. And I love opening my Whoop app and seeing how my sleep, my stress, my strain is correlating with my mood, with my running performance, with how I'm just feeling day to day. I'm not an elite athlete by any means, but I do really benefit. And I also just really enjoy knowing more about my body. And Whoop also gives me these actionable personalized insights that have made me more intentional

• 1:17:35Jemma Sbeg?

  and meant that I make smarter decisions day to day about what I need, rather than just putting my foot on the gas and just going, going, going, going. New members can try Whoop with a thirty day free trial before committing to a membership. That's join dot whoop dot com slash psychology for your free month of Whoop. This episode is sponsored by Gymshark. Gymshark has spent over fourteen years obsessing over gym clothing and the people who wear it. And let me just say, I think we all know they are very, very good at what they do. No, seriously, their stuff is so good. Their everyday seamless collection is light, it's soft, it's stretchy. All of their stuff just looks good on and it's made for people who love to exercise, whatever exercise that is.

• 1:18:19Jemma Sbeg?

  Lifting, cardio, Pilates, running around campus, maybe just doing errands. Discover Gymshark and find your new favorite gym clothing at gymshark dot com.

• 1:18:31Jemma Sbeg?

  No two journeys look alike. That's why Sky Miles is designed to move with you wherever life takes you. Fly, it flies with you on new adventures, family getaways, business trips and the moments that matter most. Earn, it earns alongside your everyday life. It dines with you on special nights out, it streams alongside your favorite entertainment, rides through your daily routines and helps turn everyday moments into something more. Redeem, it helps you redeem for what's next. From spontaneous weekend escapes to the trip that you have been dreaming about, to upgrading your next trip to a premium cabin experience, the miles you've earned along the way can help take you further. Access, and it unlocks access to exclusive, one of a kind experiences and opportunities

• 1:19:16Jemma Sbeg?

  that make membership feel rewarding long before takeoff and long after landing. Because Sky Miles is more than a travel program, it is a membership that moves with you. Fly farther, earn every day, redeem your way and access more. Because when your membership is as unique as you are, there's no telling where your next journey will take you.

• 1:19:38Jemma Sbeg?

  These days, there are more people than ever telling you how to manage your health. And we've all gone down an internet rabbit hole exploring the latest health trends. Your social media feed is packed with wellness advice telling you to cold plunge, protein max, detox, track your sleep. But what's actually real? What's exaggerated? What's just wrong? That's exactly what health. Versus hype from the American Medical Association and iHeart Media's Ruby Studio is here to find out. Each episode, Emmy nominated science communicator Trace Dominguez, who's racked up billions of views across PBS, Discovery Channel and YouTube, talks to health influencers, real people, and most importantly,

• 1:20:21Jemma Sbeg?

  doctors, to separate fact from fiction. Because when it comes to your health, who you listen to matters. Listen to Health vs. Hype on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Growth isn't linear. There's no magic timeline or secret template. And no one understands that quite like Southern New Hampshire University. Because SNHU has online degree programs built for whatever path you are on. Tried college before? Transfer up to 90 credits. And if you're new to this, no worries. Every student gets a dedicated academic advisor. And here's the best part, there's no set class times.

• 1:21:03Jemma Sbeg?

  So school actually fits your life. Ready to get started? Visit SNHU.edu/psych. That's SNHU.edu/psych. Let's finish on an optimistic pathway. What are some of the promising things that you are seeing in the research right now that you're excited about?

• 1:21:28Speaker 02

  I think, well, I guess, first of all, the fact that PMOS has had a name change, I think, is going to open up more opportunity for researchers because it means that we're shifting our focus, which is so important because it means more research means better guidelines, more treatment options for women.

• 1:21:49Speaker 02

  But across the board, we are seeing a lot of advances in diagnostics for women's health, especially when it comes to conditions like endometriosis, where typically our diagnostic techniques are quite invasive, where you have to look inside your tummy through surgery. And there's a lot of research looking at kind of on the spot diagnostic for endometriosis, which would be amazing. So I think that's fantastic. I think when it comes to PMOS specifically, there's no specific thing that's on my radar that's going to transform things.

• 1:22:28Speaker 02

  But if we can fully establish these different types of PMOS, I think that will change how we treat women. I'm really hoping that this new name change means that when women go to their doctors, they will start to feel like they're actually hurt, that the symptoms that they're feeling outside of their reproductive system matters. Because I think for a long time, that was kind of dismissed as it's just not relevant to the conversation.

• 1:22:58Jemma Sbeg?

  Yeah, no, for sure.

• 1:23:02Jemma Sbeg?

  I know I said we're going to end on a positive note, and we are, because I'm going to ask you this question that I think is kind of strange. But it was inspired by this article I saw that was like, this is so strange, but it's like people with endometriosis are like, read it as more attractive. And I know this has been debunked, but I remember reading it and being like, that, that's so funny that they're like, here's a consolation prize.

• 1:23:26Speaker 02

  Yeah, they, they actually retracted that article because there were so many issues with it. But I'm also like, to publish a paper, first of all, there's, there was like multiple authors on that. So they all sat around and agreed that this was a great idea. And then they went and got, you know, ethical approval for it. So other people had to approve it, that it went through a whole publishing peer review. And no one was like, this is absurd.

• 1:23:53Speaker 02

  It's completely irrelevant. And also, like, this is April Fools, like, wild.

• 1:24:00Jemma Sbeg?

  Also, so funny that you couldn't have the emotional intelligence to realize women's health funding is so limited. They got money to do that study that could have been spent on like a million other things.

• 1:24:15Speaker 02

  Yeah.

• 1:24:15Jemma Sbeg?

  And they were like, are these women hotter or not?

• 1:24:18Speaker 02

  Yes, that was basically.

• 1:24:19Jemma Sbeg?

  Hot or not, they were like, can you pay us to play hot or not with a bunch of people who are like experiencing like a life changing illness?

• 1:24:25Speaker 02

  Yeah.

• 1:24:26Jemma Sbeg?

  Please.

• 1:24:26Speaker 02

  No, it's.

• 1:24:27Jemma Sbeg?

  How crazy is that?

• 1:24:28Speaker 02

  It's so crazy. And there's, there's been other studies at like within endometriosis. And it's like the impact of endometriosis on patients, on, on the male partners of patients.

• 1:24:41Speaker 02

  The, the impact of their sex life.

• 1:24:43Jemma Sbeg?

  On their sex, that's what I was thinking it was.

• 1:24:45Speaker 02

  No one cares.

• 1:24:47Jemma Sbeg?

  Also, yeah, go away. Leave her alone. Like, she's going through something cra- like, that's just insane that it's like, that we have all this, this limited money and we're going to be like, here is the patient. And then it's like, they shift. I can almost imagine like they're looking at her and then they're like, their gaze like kind of goes out of focus and they like look behind her and they're like, you. They're like, point to like, how do you feel? And it's like, what, hello? Like, um, and this is going to sound so ironic because I'm going to ask you like, obviously, I'm not, yeah, are women with PMOS more attractive? Dr. Hazel, what's your opinion? No, but you mentioned things of like, oh, women with PMOS may have more testosterone, androgens, X, Y, Z. Is there anything beneficial or not beneficial, but just like

• 1:25:32Jemma Sbeg?

  any silver linings for PMOS? Anything that you're like, great, at least I'm maybe better at that. At least I have a lower risk factor for this. Anything that's like, again, a consolation prize?

• 1:25:44Speaker 02

  So potentially may be able to build more muscle, um, which is beneficial for many things.

• 1:25:54Speaker 02

  Because you might go through the menopause slightly later. I think it's like two years on average later, which is a beneficial thing. And I think something I've been personally thinking about in my own journey is, and I don't think I've been, I've never articulated it publicly because it could go one or two ways. But I think for me personally, it was while I didn't cause my PMOS, the lifestyle I was living wasn't helping. And I think going through the diagnosis made me, for the first time in my life, actually start putting me first and caring about my sleep, my boundaries, my nutrition, exercise, like a lot of things that I really enjoy,

• 1:26:39Speaker 02

  but I always put other things first. So I think it's helped me to, yeah, put, put myself first and actually prioritize my health. And while I'm not grateful to have PMOS, I'm grateful for that. Because I, I believe that I'm actually a much healthier person than the person I was when I first got my diagnosis.

• 1:27:03Jemma Sbeg?

  Yeah.

• 1:27:03Speaker 02

  Um, and I don't really experience the day to day symptoms of PMOS after, you know, I was diagnosed in 2018. After eight years of, of going through this.

• 1:27:15Jemma Sbeg?

  Yeah.

• 1:27:15Speaker 02

  I have regular cycles, I ovulate and I see that. I can help women achieve that. And I think that's a really positive thing. It's not, you know, we talk about all of these risk factors. It's not a sentence. This doesn't mean it has to happen.

• 1:27:30Jemma Sbeg?

  Yeah. And I think that's really how I wanted to end the episode of like, this is, you said before, like it can kind of go into, it can be asymptomatic. Asymptomatic. And I think I read a paper that it can go into remission.

• 1:27:41Speaker 02

  Yes.

• 1:27:41Jemma Sbeg?

  Almost. And I think we've spoken a lot today about how the difficulties in so many areas of life.

• 1:27:49Speaker 02

  Yeah.

• 1:27:49Jemma Sbeg?

  For someone with PMOS, from an anecdotal point of view, from clinician point of view, from a research point of view. And so I think ending on this note of like, yes, terrible experience. Yes, hard to have your symptoms recognized. However, like there is hope and there are things that maybe you aren't being offered that will assist you. And maybe there's not a silver lining, but having any kind of conversation about women's health is helpful. And having any conversation about your own health, even if it's maybe not the conversation you want to, you're like, maybe you don't want to be having, um, just brings an awareness that I think has benefits to it.

• 1:28:30Speaker 02

  Yeah, I completely agree. And I think I was on Grace Beverly's podcast also, we talked about PCS at the time. And there's a really, there's a soundbite that went really viral. And it was me saying, we say that PCS can't be cured. It was PCS at the time. Say PMOS can't be cured, but I'm not so sure anymore. And that clip went really viral because we, we say it's incurable. But actually, I have seen it in myself and other women be completely dormant, where even your ultrasound features improve. And I think, I think it's helpful to use that terminology because women need to know that.

• 1:29:07Speaker 02

  The kind of, the state of their PMOS today doesn't mean that it's gonna be like that forever.

• 1:29:11Jemma Sbeg?

  Um.

• 1:29:11Speaker 02

  And they need to know that there is a chance for improvement. And there is in absolutely everyone. But the way to get there might be different for another person who has the condition.

• 1:29:22Jemma Sbeg?

  Um.

• 1:29:22Speaker 02

  Um, and you know, one of the things you mentioned, which we, we didn't really cover in great detail is the fertility aspect, and it is more difficult to get pregnant if you've got PMOS, that is a fact. But that's largely because you're not ovulating every month. There are medications we can use to help. There are fertility uh techniques. Beyond that, before you get pregnant, we can work to restore ovulation through supplementation, through nutrition, through all those things we spoke about. And I think PMOS compared to a lot of the other women's health conditions, I'm thinking about endometriosis, is probably the most influenced by our lifestyles. It's so influenced by our lifestyles, which is a good thing and a bad thing, but it's a good thing too.

• 1:30:05Jemma Sbeg?

  Yeah, and I really liked that we've also ended on that because I didn't even talk about this. But again, I didn't, I didn't wanna um make the conversation too like fertility dominant. Cause I know for some women, that's just not something they're thinking about, you know, in their early twenties, mid twenties, or just not something they want. But um I like that you've mentioned that, you know, when I was told I had back at the time, PCOS, I was like, oh, a third of women can't get pregnant, like dun dun dun. And I remember really freaking out about it and then just reading and being like, wait, that's, where did they even get that number from?

• 1:30:38Speaker 02

  Yeah.

• 1:30:39Jemma Sbeg?

  Right? Like, that's just this random number. And another thing to say that's completely separate, anytime you see a statistic that's like one third, and it's a neat number, like twenty five percent or like fifty percent, or it's just such a clean number, you should always be skeptical.

• 1:30:53Speaker 02

  Oh, my gosh.

• 1:30:53Jemma Sbeg?

  Always be skeptical because that's, when does that happen? Um, and learning more about like, actually, no, like, there are so many stories of women who have this condition, who never have trouble, do have trouble, find, you know, these amazing treatments and clinicians who believe them, like, there is just so much, um, the fact that we're having this conversation, like, the momentum towards better days for people with this condition is on the up, like, the velocity at which we're moving towards a better future for people with PMOS is, is increasing. Um, so thank you for, yeah, confirming that.

• 1:31:30Speaker 02

  You're so welcome.

• 1:31:31Jemma Sbeg?

  Yeah, one more question. I'm sorry, and it has nothing to do with what we talked about. I'm almost, I'm so like enraptured by how you're, how you're explaining this in a way that is just like so remarkable that I almost forgot to just do the thing that we do on every episode, which is um about your twenties. Are you still in your twenties?

• 1:31:50Speaker 02

  No, I'm thirty five.

• 1:31:51Jemma Sbeg?

  You're thirty five, okay. Um, I actually think that's a great age to ask this question because you still remember what it's like, but like, you're, you're like halfway through your thirties now. Um, what is one piece of advice that you wish you had, had received in your twenties or you wished you knew in your twenties that our audience should know? Caveat, because we love a caveat, as we've spoken about, has nothing to do with what we talked about today.

• 1:32:16Speaker 02

  Okay, um.

• 1:32:19Speaker 02

  Can I give two?

• 1:32:20Jemma Sbeg?

  Oh, yes, you can give like four, you, you are full of information, you can, you could just do a whole other episode, we would welcome that.

• 1:32:26Speaker 02

  I, my first one that I've been thinking about lately is

• 1:32:32Speaker 02

  I regret not having more fun in my twenties, because I think I took my life very seriously to get to the place I wanted to with my career. And I think I still could have done that and still taken myself less seriously. So I think embrace your twenties, because you can still have so much fun in your thirties as well. But if there are things that you wanna do in your life, be that like buying a house, having, starting a family, things can, your responsibilities can rack up, so enjoy kind of the, the fewer responsibilities of your twenties if you can. The second thing is it's okay to change your mind and to pivot. For a really long time, I was kind of stuck on one pathway and I thought everyone would judge me if I changed.

• 1:33:17Jemma Sbeg?

  Mm hmm.

• 1:33:17Speaker 02

  I left the NHS, which is the National Healthcare System in the UK, um, a couple of years ago, and I was so terrified of judgment and I'm so much happier for it. And I've, you know, dedicated my life now to women's health, which was very different to what I was doing before, I was doing nutrition in the hospital. Um, and I think for so long, we, we kind of picture ourselves as this one identity. But it's okay if that changes and that might change again. So it's okay to not have it all figured out and it's okay to change your mind.

• 1:33:51Jemma Sbeg?

  I love that advice. What a beautiful way to end the episode. Your book is coming out in paperback very, very soon.

• 1:33:57Speaker 02

  Yes, in two day, three days.

• 1:33:59Jemma Sbeg?

  Three days, that will be, would have already happened when people listen to this. Um, it's called Not Just A Period.

• 1:34:05Speaker 02

  Yeah.

• 1:34:05Jemma Sbeg?

  I just feel like from the conversation we've had today, I'm gonna be picking up a copy and I'm gonna leave a link in the description for you guys too as well, because I know you, you might be somebody who feels awkward when people give you compliments, but the way you've explained that

• 1:34:21Speaker 02

  Thank you.

• 1:34:21Jemma Sbeg?

  is one of the most remarkable kind of conversations that I've been able to have on the podcast. So thank you so much. Um, anywhere else that people can find you or where they should go looking for you?

• 1:34:32Speaker 02

  Yes, um, I, on, on social media, on Instagram's my main thing, I also do TikTok, but Instagram and TikTok under my name, Dr. Hazel Wallace. I talk mostly about women's health, I do a lot of nutrition on there related to women's health as well.

• 1:34:47Jemma Sbeg?

  Mm hmm.

• 1:34:48Speaker 02

  Um, and I'm very happy for you to send UDM, so.

• 1:34:51Jemma Sbeg?

  Yeah, and um, yeah, book, Instagram, I will also leave like a link to your, I guess, your website or like your clinician page as well, so people can, can check you out. But again, thank you for coming on the podcast. I hope you, the listener, has enjoyed, I hope you've learned, if you are, whatever way through your PMS, PMOS journey, you are, um, sending you a whole lot of love and support and hopefully just the value and the knowledge that other people are going through it as well, and that there is a lot to be optimistic about. So until next time, be safe, be kind, be gentle with yourself, we will talk very, very soon.

• 1:35:34Jemma Sbeg?

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• 1:36:19Jemma Sbeg?

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• 1:38:32Jemma Sbeg?

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