Embarking on a journey through the entangled paths of obesity and reproductive health, we pulled back the curtain on a topic that affects millions yet often remains whispered about. From fertility woes to the intricate dance of sexual wellness, our conversation illuminated the stark realities faced by individuals with a BMI over 30. Dr. Maria Iliakova and Tammie LaKose approach the delicate subjects of conception challenges and pregnancy complexities with compassion and a quest for deeper understanding. The statistics are more than just numbers; they represent real people yearning for a chance at parenthood and a fulfilling intimate life.
As laughter about our children's latest antics faded, the focus shifted onto how conditions like PCOS, entwined with insulin resistance and high androgen levels, can derail a woman's reproductive plans. The potential complications during pregnancy, such as preeclampsia and gestational diabetes, came to the fore, alongside vivid personal stories. Yet, within these narratives emerged a glimmer of hope, as we discussed the transformative impact of weight loss and bariatric surgery on fertility and sexual function. It was a reminder that beyond the statistics and medical jargon, lie individual stories of struggle, hope, and the pursuit of joy.
In the nuanced world post-bariatric surgery, we navigated the altered landscape of conception and nutrition, stressing the pivotal role of tailored contraception and vigilant prenatal care. The candid sharing of personal experiences unveiled the often-unexpected odyssey of sex life transformations post-surgery, acknowledging the deeply personal nature of this journey. Our dialogue was more than just an exchange of facts; it was a collective call for support, research, and a safe space for individuals to share their intimate challenges. Join us as we champion a future where joyful lives and fulfilling relationships are accessible to all, regardless of the numbers on a scale.
Embarking on a journey through the entangled paths of obesity and reproductive health, we pulled back the curtain on a topic that affects millions yet often remains whispered about. From fertility woes to the intricate dance of sexual wellness, our conversation illuminated the stark realities faced by individuals with a BMI over 30. Dr. Maria Iliakova and Tammie LaKose approach the delicate subjects of conception challenges and pregnancy complexities with compassion and a quest for deeper understanding. The statistics are more than just numbers; they represent real people yearning for a chance at parenthood and a fulfilling intimate life.
As laughter about our children's latest antics faded, the focus shifted onto how conditions like PCOS, entwined with insulin resistance and high androgen levels, can derail a woman's reproductive plans. The potential complications during pregnancy, such as preeclampsia and gestational diabetes, came to the fore, alongside vivid personal stories. Yet, within these narratives emerged a glimmer of hope, as we discussed the transformative impact of weight loss and bariatric surgery on fertility and sexual function. It was a reminder that beyond the statistics and medical jargon, lie individual stories of struggle, hope, and the pursuit of joy.
In the nuanced world post-bariatric surgery, we navigated the altered landscape of conception and nutrition, stressing the pivotal role of tailored contraception and vigilant prenatal care. The candid sharing of personal experiences unveiled the often-unexpected odyssey of sex life transformations post-surgery, acknowledging the deeply personal nature of this journey. Our dialogue was more than just an exchange of facts; it was a collective call for support, research, and a safe space for individuals to share their intimate challenges. Join us as we champion a future where joyful lives and fulfilling relationships are accessible to all, regardless of the numbers on a scale.
Welcome to Core Bariatrics Podcast hosted by Bariatric Surgeon Dr Maria Iliakova and TMA LaCose, bariatric Coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatric Podcast does not offer medical advice, diagnosis or treatment. On this podcast, we aim to share stories, support and insight into the world beyond the clinic. Let's get into it. Alright, maria, take three. I think everybody needs to hear these stories. So has Sasha ever gotten into any food that she shouldn't have? Oh yeah.
Speaker 2:
Oh, honestly, she's really good about this stuff. Sasha's my dog, by the way Everybody.
Speaker 1:
I don't have any babies that are human at least.
Speaker 2:
And no, she did get into some chocolates over the holidays. Over Christmas I had some friends over. We were doing a chocolate and wine night and for the first time in her life she actually got into some food and it was a doggy level. So I run over there. She's got a little chocolate, little white chocolate stash going in. And I shove my hand, like you do, down her throat to make her get that back out. And turns out she ate max one piece of chocolate Kidney failure averted.
Speaker 1:
Hello, cusser dog mom, she's what I got.
Speaker 2:
Okay, but yeah, unlike you who have three yes. And so what about you? What about your babies? I just got to tell you about Kowyn that he is my youngest, two and a half years old.
Speaker 1:
I was a single pairing thing at well. My husband was out plowing snow for the DOT, so I was giving my middle son a bath, and so my youngest was I left him downstairs with his phone like watching some Blippi, and so I come downstairs. He's like come here come here. What is going on? This boy took it upon himself to take the lid off the popcorn popper, put the kernels in, put the lid back on the popcorn popper and he's like grab a bowl and make himself some popcorn. So so done with kids, no more kids.
Speaker 2:
He's two. He literally knows how to feed himself, but I did. I think as a young adult, most men are. That's myself too.
Speaker 1:
I'm not a man, as far as I know.
Speaker 2:
However, I would be in that bucket as well. So we are talking about babies of the human and non-human kind, because we're going to talk about fertility today, jamie, yes, yeah, and this is one of my favorite topics personally. It really is Fertility and sexual health. I'm not sure if you're right there, but one of the reasons why is because I am astounded by how many people are actually affected by infertility in the US. Yeah, Do you want to guess how many women let's just start with women first are affected by infertility?
Speaker 1:
Okay, we're going to be real open and honest, because we've ran this three times. My first guess, though, was one of three. One of three, so it is actually a little lower than that.
Speaker 2:
It's more like one in four to one in five. So that's still of women between the ages of 15 and 49, that amounts to almost 20 million women. That's so much, so many.
Speaker 1:
And it's probably under reported because a lot of women like myself.
Speaker 2:
For instance, I've never had babies.
Speaker 1:
I don't know if.
Speaker 2:
I have fertility issues or not, and we're talking about women as young as 15 and as old as 49. I don't think there's a lot of women that are trying to get pregnant, at those extremes of ages, for instance, but still 20 million women and so many, yeah, and that's straight up infertility. We are not talking about sexual health yet. And men, I'm curious what you think? How many men do you think are affected?
Speaker 1:
I don't remember the answer to this.
Speaker 2:
Oh, there you go, hey, there you go.
Speaker 1:
I know it was a little less. Yeah, what one in six?
Speaker 2:
Yeah, it's like one, one in eight. Yeah, about six million men, and again, this is what's reported, because we don't know if there's a lot more guys out there, guys and women. And then erectile dysfunction what about those numbers? Erectile dysfunction, you're weighing, not working, like getting it up or not blasting, or I feel like the reported number is probably a lot lower than what's actually out there, because I don't feel like men are openly going to the doctor.
Speaker 1:
Yeah, let's be honest, men are the worst to go to the doctor, but at least my husband, I should say. But especially in fact matter.
Speaker 2:
Yes.
Speaker 1:
It is embarrassing Not that there's anything wrong with you.
Speaker 2:
And the last thing is you know these. We don't really talk about sex. We're a puritanical society we don't like to talk about sex? We don't really want to deal with this, but over 10 million men reported probably more deal with erectile dysfunction. That is almost 20 million men. They're dealing with infertility and erectile dysfunction, so altogether about 40 million people. As a conservative estimate that is a lot of people. So, many people. Maybe we should talk about this a little more. Okay, okay, okay, so we're gonna. So why are we talking about fertility and sexual health? If what we normally talk about is weight and obesity and bariatric surgery and things like that, it's because obesity actually has a lot to do with sexual health and fertility and, especially when people have a BMI of over 30, their chances of getting pregnant, having a healthy pregnancy or having a really healthy sexual, sexually active life, getting what they want out of it. It's harder and there's a lot of reasons for that. So we're gonna talk about it, please do so the first thing is when your BMI is over 30. And this isn't for everyone. I want to be super clear right Absolutely. Because people can have healthy pregnancies at all ages, at all sizes, at all of that. But when your BMI is over 30, on average, the time that it takes you, both as men and women, to conceive actually how their pregnancy is higher. So it takes longer time, it takes more efforts, yeah, and even when it happens, your rates of having miscarriage are higher. That's so sad In a while, and actually miscarriage is pretty common anyway in the US, but we don't really know all the reasons for that. But when obesity is added into the equation, both either for the male or the female partner, your time to get pregnant is longer and your risk of even things like miscarriage is higher.
Speaker 1:
Okay, tell me all the ways, because I know you will be going to.
Speaker 2:
That's right, we're gonna totally talk about it, and for women specifically. So you have to ovulate, you have to release an egg in order to be able to have an egg to fertilize. So if you have insulin resistance, where your body's not appropriately putting blood sugar into the cells and using it, or if you have high endogen levels we'll talk about that in just a second. It's really hard for you to release an egg on time every time. So what are endogens?
Speaker 1:
Yeah, I usually know most of the terms. I've been through anatomy and physio. I've been through the medical field. Yeah, I don't know what that is. Okay, so androgens are actually, it's super simple Endro think men, oh when they're hot, oh okay, we've reported this three times and I'm just now saying that, so that would be why.
Speaker 2:
But no, androgens are things like testosterone. They're sex hormones or endocrine hormones basically, that help men have the features that we typically think of as masculine so hair in certain places, deeper voices, different fat distributions on their body than women do all those things. If women have high androgen levels, it is way harder for them to actually release an egg appropriately, and actually in states like PCOS polycystic ovarian syndrome this is exactly what's going on. As you have higher androgen levels, you have insulin resistance and you have lower regular hormones that allow you to actually release an implant in the egg. That makes sense.
Speaker 1:
Does that make sense?
Speaker 2:
Yeah, so, anyway. So that is a much likelier state when people have a BMI of over 30. So that's not for everyone again, but for those folks. And then, even if you get pregnant this is also interesting your risk of certain conditions like preeclampsia, eclampsia, gestational diabetes, all of that, is higher, so your risk of having blood pressure problems or diabetes even if you were healthy before your pregnancy, even if you didn't have any history family history of diabetes, family history of blood pressure problems you didn't have those problems. Your risk of getting those during your pregnancy are higher. Back so, you're going to have a baby that's a little bit more than a child and that puts you and baby at risk. So not just you, but even your baby now has a higher risk of having a preterm delivery, so delivering earlier than you otherwise would. A C-section, which comes with its own set of complications and problems and things like that, the baby being too small or too big for regular, so what's called small for gestational age or large for gestational age, stillbirth even rates are higher, definitely miscarriage rates are higher. And then even C-section or you tear your perineum, for instance, delivering a baby, especially a bigger than usual one you sometimes have to get that sewn back, your complications with those ones can be higher. So it's really the entire gamut which is nuts, because it's not just woman, it's now baby too.
Speaker 1:
But the but all the more increased issues. Complications make sense because my kids were all backwards. The first baby, I had no issues. His birth was the shortest, all the things. The second was a little more of an issue. The third was just he. He's the one popping popcorn.
Speaker 2:
So that's just sad at all, but his labor was he was worth it clearly, but yes.
Speaker 1:
His labor was 92 hours, and that's not how your body-.
Speaker 2:
Usually women's births get much quicker, like their first ones for sure, like seven hours, and then you talk about how these moms are literally popping up babies before they even-, yeah, before they even get to the hospital, and that's not always the case, obviously. That's somewhat a wise tale, but somewhat true.
Speaker 1:
But no, you're absolutely right.
Speaker 2:
So maybe weight has something to do with that. I don't know, age, maybe other factors, but you're absolutely right. When people have obesity, when they already have some extra weight on board, they're risk for these problems. So it's not, again, everyone that's having them. And, to be honest, here's something interesting. So a lot of smaller hospitals, like rural hospitals, those that are in smaller communities, ambulatory surgical centers they even have BMI cutoffs. They won't even do surgery, a scheduled surgery on you if your BMI is over 40 or over 50. It makes sense, but also I know, yeah Well, there are some increased risks and things like that. We don't want to kill people with anesthesia. We don't want to kill people during the surgeries, especially if it's a chosen surgery. So women are going into C-sections as an emergency, sometimes during already chaotic or bold, stressful situation, and then they're having higher rates of complication with the C-sections. And their BMI is especially over 30, over 40, over 50. So that's a kicker to me. I think, that's where the rubber hits the road for me at least to have more people, just people in general, and definitely more healthcare providers need to be talking about this issue out loud, because we're not just putting pregnancies at risk and things like that. We're putting moms at risk as they go through these pregnancy ways that could be avoided, could be even better, absolutely. Be healthier moms, healthier babies, healthier pregnancies it's easier to-. Exactly, exactly. And before I did bariatric surgery, before I was a surgeon, all this stuff I really didn't know anything about this as a woman who was entering her childbearing years. This never came up as a thing. We know about it anecdotally, like you said, like you've experienced it in neuropregnancy, but nobody ever really talked about it or said it out loud. I have a big question, or had a big question, about why would weight loss or bariatric surgery make an impact here? What on earth does bariatric surgery have to do with fertility and sexual health?
Speaker 1:
I'm guarantee 90% of listeners still have that question.
Speaker 2:
Yeah, so let's get into it. Yes, please do so. The things that bariatric surgery does and we've talked about it before is it's a reset. It's a reset of your metabolism in a way that just eating less or diet and exercise for weight loss they don't accomplish the same kind of reset. And you mentioned a really interesting way to think of that reset in this one. We're recording this earlier. Yeah, I said that we have a new cardiologist.
Speaker 1:
I don't even know if this hospital I work at has ever had a cardiologist and he's just out there cardioverting all the first, the right people, all the right people.
Speaker 2:
He's not cardioverting anybody with a pulse.
Speaker 1:
But yeah, I asked Maria if it was like the same thing of when a patient is in atrial fib. You've tried using medications, you've tried bearing down isn't that even a thing?
Speaker 2:
Yeah, about cells in the universe. Yeah, but your resort.
Speaker 1:
You do need to. You need to cardiovert them, you need to shock them Exactly.
Speaker 2:
And I think of at the hesitation of making bariatric surgery sound like a bad thing or like a last resort. In fact, this should be used a lot sooner, but later for people. It is the only tool that we know of that resets in metabolism. The way that I think of it is a metabolic conversion. Like a cardioversion. Think of it like a metabolic conversion. Yeah, so, especially people who have things like PCOS, a polycystic ovarian syndrome, that is something that has those higher androgen levels. They've got the insulin resistance, all of that. It's essentially impossible for somebody with that metabolism to lose weight in a healthy way. It's essentially impossible for them to do that, and that in and of itself can prevent them from ever having a healthy pregnancy. What if we could use this tool of surgery? of bariatric surgery to help that person who can't lose weight in an otherwise healthy way to actually be able to get pregnant and treat and cure their problem Absolutely and if they are going through all the hoops to have babies in vitro or whatever they're working on they're in the mindset to have bariatric surgery, but actually, you know, because they're really looking at You're already going through all of these different workups and all these different things, and surgery is a great tool to have at your disposal and to consider, and so let's talk about now why bariatric surgery? works. Why does this reset? How does this reset happen? So when you have bariatric surgery, it's pretty interesting. You are able to have higher levels of things like follicular stimulating hormone and sex hormone binding globulin, which sounds like, I know, like lettuce salad, like alphabet salad Like my crotch globulin.
Speaker 1:
Sorry, that's so weird. Am I babies? Am I crotch goblins?
Speaker 2:
No, but the thing is basically what you're doing is you have higher levels of the things that allow eggs to be produced and released appropriately in women, so for ovulation and lower androgen levels. So again, those things preventing ovulation or preventing implantation, and you also have decreased insulin resistance. So all the things that are essentially preventing ovulation are taken off the table, or at least they're reduced, and the things that are enabling ovulation are improved. So you're just lowering the barriers and you're letting things happen easier, which is super great. You also have way lower risks of problems during pregnancy, so things like preeclampsia, gestational diabetes, eclampsia in fact, those risks go down by 80% 80. 80%.
Speaker 1:
And what I learned today is that when you have bariatric surgery and are in remission of diabetes or high blood pressure even if you do gain some weight back, less likely to get it back. All my research, I just learned that today, exactly exactly, I came straight from another bariatric surgeon today.
Speaker 2:
That's right, dr Jessica Smith, that's right. No, but what we're talking about here is actually kind of interesting because even if you don't have family history of these problems or you don't have problems with diabetes or high blood pressure I need those things before you have a pregnancy. If you have excess weight, your risk of those problems is higher. After surgery it's lower, and it's lower for forever, even if you regain weight. I was saying, and that's a problem that's not just gonna affect mom, that's gonna affect baby, because gestational diabetes means and preeclampsia things like that can mean for a child that they actually get metabolic disorders as a result. They come out big, they can come out big.
Speaker 1:
That's right. I came to find out the doctor that came on call when I was in labor they induced me. She was about to send me home. She's okay, let's just do a 24 hour urine, because I'm not gonna send you home without knowing for sure, because I did get admitted for my blood pressure and sure enough. I did have preeclampsia.
Speaker 2:
And she came out.
Speaker 1:
My other two were seven pounds, this one was nine three, my lord Pop pop, poppin' baby. Oh my lord.
Speaker 2:
He knew he'd be poppin' that popcorn. He needed reserves. No, but you're absolutely right. I think those things are not anomaly, that's not something that happened by coincidence, when people have higher weight on board to begin with and then go into a pregnancy and you're gaining weight in that process too, and again having endocrine and metabolic changes, your risk of having those problems affect your baby and their birth are higher. So, even the risk of things like bone problems, so skeleton birth injuries, is higher. Even problems like seizures, for instance, can happen at a higher rate. So, yeah, it's completely not just a one person problem anymore. You're now creating a potential issue for baby two in that state Other things that can happen. Kind of interesting on the men's side. So we've talked a lot about women and getting women things like that. But what about men too? Men Need two to tango Men matter too.
Speaker 1:
I get it.
Speaker 2:
So, interestingly enough, there's a lot of research out there that shows that erectile dysfunction can be very effectively treated with bariatric surgery for people who have extra weight. We don't know all the mechanisms for that, but we think at least some of the same mechanisms that allow guys to have an erection, maintain an erection ejaculate, which is like the C-A-M-P pathways, p-i-3-k pathways, all the kinase pathways, basically all the things that allow the proper mechanism, different enzymes and things together. Those are the things again that we're lowering the barriers and we're greasing the skins.
Speaker 1:
basically, Okay, so this just a random question. So do we think that because you someone is very obese, that their body is more focused on other things, that it wouldn't be at a normal? Yeah, it's possible, focusing on getting the right things to your vital order. You are, yeah, probably having babies. Probably Keeping you alive is more important than your spermies.
Speaker 2:
That's right or whatever. That's right Because even though having sex and having children, things like that, that's an instinct, that's a prerogative of a species to continue and all of that yeah, that's. It's also a fun activity. It's also an activity that takes a lot of energy. Yeah, it's also something that isn't totally just object. There's a lot of libido and desire and how you feel about yourself and attraction, all those things involved. So that is pretty interesting to me. I don't know, the research on that Sounds possible, and that's the thing is. It's heartbreaking for me to think that there's a lot of people out there that are attractive to each other, want to have sex with each other want to have babies with each other, want to not have babies with each other, just want to have a good sex life, and don't even realize that the problem may actually be something that can be treated and something that doesn't deserve the stigma it gets, because who on earth would necessarily be like oh, I'm having difficulty getting pregnant, or I'm having difficulty in the bedroom and I have some extra pounds?
Speaker 1:
on board, Maybe surgery I would like to do? You never think about the two right? No, not at all.
Speaker 2:
But I'm so I want to shout this one from the rooftops is your sexual desire, your libido, your performance, your satisfaction, your function can be made better? Yeah, in these situations, through surgery. And so to really consider that, because oftentimes we're thinking of bariatric surgery, is extreme or the last resort, and I argue we are not considering it early enough.
Speaker 1:
And even Jessica Smith that we interviewed today, that we need to do it sooner. Correct. Because, you can actually be more successful. So what is the healthy BMI?
Speaker 2:
So between really like under 30, under 25, you know some data on that that in some age is actually 25 to 30 is perfectly healthy too. So I and disclaimer.
Speaker 1:
I don't love BMI. No, absolutely.
Speaker 2:
BMI is a way to be a population statistic. It's not the best way for us to measure health or anything like that. But we know statistically that BMI is 30 and over, we start to get some of these risks for people as a population, yeah yeah. So there's that, and then just some things to think about too, though. So we definitely had some patients that got pregnant through our program.
Speaker 1:
Yes, really, even on birth control.
Speaker 2:
Even on birth control. So that's the thing we got to talk about, because even though we get really excited about babies and really excited about people have great, having great sex lives and things like that, we want to make sure that people stay safe and stay healthy too, and that means not having pregnancies within 12 to 18 months after surgery.
Speaker 1:
Yes, and there's a couple of reasons for that, and I think you actually.
Speaker 2:
we've talked about those reasons before, so tell me about one of those reasons.
Speaker 1:
Okay, yeah. Obviously, when your tank is smaller, you can't get all the things in, especially you can't get all the things in at one time. So even when you're having a child, they don't suck the life out of you for the rest of your life.
Speaker 2:
No, it's okay, At least for 18 to 25 years, that's true.
Speaker 1:
But obviously they need nutrients and stuff too. And in those very early stages or months of bariatric surgery, you're sometimes struggling to get your own nutrition Exactly, and so really making sure that you are stabilized in, making sure you're getting, you're able to get all your water, your protein, all that good stuff, making sure you're healthy and, yeah, just stabilized out before putting another kicker in there yeah, so bariatric surgery isn't in itself as a stressor right and it's something that changes how your body absorbs nutrients, absorbs vitamins and minerals.
Speaker 2:
We put everyone on daily vitamins. And actually pregnancy when people get pregnant, we put people on daily vitamins too. Prenatal vitamins even before you start getting thinking about being pregnant, so that you have enough vitamin B and EK and calcium and iron all those good things, all the same things that we put people on vitamins for for bariatric surgery and so it's really important to make sure that you are tanked up and healthy enough before you undergo the second huge body change of pregnancy after bariatric surgery. So there I always recommend having a true contraceptive plan with a patient before going through bariatric surgery. So they know they really it's not safe to go through a pregnancy that close to bariatric surgery.
Speaker 1:
Yeah, do you ask your so? My primary care doctor who delivers my babies at my six week follow-up? Yes, he's. What is our plan, do you want?
Speaker 2:
more.
Speaker 1:
Do you ever bring that up to women now, especially because you're apparently? Making everybody on the baby machine really are like, yes, like at your tummy personally, but for other things, but at your whatever follow up because you are to keep on your birth control. There used to be a thing to stop taking it.
Speaker 2:
Right, long ago that's like years ago, right, women were recommended to stop birth control around the time of birth. Bariatric surgery Absolutely no. No, at this point would not recommend that. If you have a pregnancy around the time of bariatric surgery, that is going to really be a problem. Right, for the reasons that we mentioned, but also because why have a bariatric surgery, why go through this whole process If you are not actually going to maximize how much you get out of it?
Speaker 1:
But I feel like you should put it in your, or like your, template yeah, every single appointment.
Speaker 2:
Yeah, making sure they have for that first year. Yeah, it's a good point, because we talk about it before, yeah, and we talk about it at their first visit. After, we don't necessarily keep talking about it yeah. And there's some research now too that not all birth control methods are the same.
Speaker 1:
Oh, absolutely Not the same in terms of how effective they are.
Speaker 2:
We know that. Sorry, that's not rocket science to anyone, but it's very, very, very, very, very, very, very, very, very, very, very, very specifically for this, for our people, for people who've had bariatric surgery, especially bypasses. They do not absorb medications the same way in birth control, yeah, so it may be a good idea to switch to an Xplanon or an IUD or some other form För wa winding.
Speaker 1:
We're accidents because you're going to be explosives. How are you a witness? That is a way, though I don't know how much, how common that is.
Speaker 2:
I don't necessarily recommend that route, but yeah, so that's an important conversation to have Because we want people be safe. We are super excited when, when people get pregnant afterwards and can have safe, healthy pregnancies. But we wanna make sure that there's a good plan going forward with that. We also really wanna encourage people to come in and see their bariatric surgery team and their OB guide on a very regular basis. If you've had bariatric surgery before, now you're pregnant, you are gonna need a little bit more kid gloves, a little bit more TLC to get through their pregnancy safely, potentially. So we really wanna make sure that you're doing well, even though your risk actually of complications is really great. Some other things to think about we really wanna make sure that people are supported when they go through these things.
Speaker 1:
Tammy has a really Absolutely you had a really beautiful story that you told.
Speaker 2:
That was really tough, I think, and really real about some of the not so great changes to your sex life after surgery you weren't expecting.
Speaker 1:
Yes, so we won't get too big into that, because there is a whole episode, so don't look at sex after bariatric surgery.
Speaker 2:
There's a lot of good things, but there is also a lot of bad things and it's important also to think about there's other factors, just outside of surgery.
Speaker 1:
There's your mental health how?
Speaker 2:
you're moving your body. There's what other medications you're taking. There's whether you're feeding yourself properly whether you're getting enough sleep. All those things, all the same things that impact how well you do period and how healthy you are, also impact your bedroom activities and your fertility too. So, anyway, this topic, one of my favorites. I think we need to be doing a lot more research on this, a lot more discussion on this.
Speaker 1:
You will continue to make you can. I think people can tell the energy of the passion that you have for sexual health and you're helping me with that and just fertility and stuff like yeah, you don't only want to help people's feel good, whatever be, healthier. You want them to be able to do all the things everybody else can do.
Speaker 2:
Yes, grab life by the horns and live it as much as you want to and really enjoy it, because everyone deserves to enjoy their life as much as possible. So, anyway, if you want to hear more about this or have any comments for us, we'd love to hear from you, and if you want to tell us your stories, even if they're really personal, we'd love to hear them. Yeah, so please go ahead and follow our podcast.
Speaker 1:
We go over to Instagram, look up Corb variatrix and feel free to send us a private message with any comments, questions. Hey, I want to be on this because we will, absolutely. We want to know all the stories because we want everybody to know you're not alone. Everybody's situation is different and we want everybody to feel as supported as possible.
Speaker 2:
Especially with these tough subjects, absolutely so. One thing I just want to end with is let's help people have more babies and better sex During the right time. That's right. If they want to, yes, yes. And with that we'll leave you guys. Thank you so much. Thank you, bye.