742: Conventional Gynecology Is Not Just Failing Women, but Hurting Us With The Gutsy Gynecologist

Child: Welcome to my Mommy’s podcast.

Hello, and welcome to Wellness Mama Podcast. I’m Katie from wellnessmama.com. And this episode is all about how conventional gynecology is not just failing women, but actually hurting us as well. And I’m here with Dr. Tabatha Barber, who has devoted her life to giving women a voice and a choice when it comes to their health and well-being. She struggled with quite a few issues in her own life and survived being a teenage mom and a high school dropout. And then went on to become a doctor and now a functional medicine gynecologist. She’s triple board certified in obstetrics and gynecology, menopause, and functional medicine. And she has the unique situation of being licensed to practice medicine in over half the country. So she can work with many women in the U.S. She’s the host of the Gutsy Gynecologist Show, where she speaks specifically on this topic to help women reclaim their health. And she also does a lot of other speaking and online education work to help women in these areas as well.

And we go deep in this podcast on why we’re asking the wrong questions when it comes to women’s health. Why gynecologists are surgeons, how she became disillusioned with the mainstream approach and what she does differently, how a lot of the interventions we do commonly actually cause problems, including things like magnesium and B vitamin deficiency, questions to ask to find a good practitioner, signs and symptoms to be aware of, and so much more. So, let’s learn from Dr. Tabatha. Dr. Tabatha, welcome, and thanks so much for being here today.

Tabatha: Oh my gosh, thank you for having me. This is such an important conversation for women, so I’m excited to be here.

Katie: I absolutely agree. I’m so excited to get to go deep on some topics with you. And most of our listeners are moms. So, I feel like this will be especially relevant for the listeners. To start broad, I have read some of your work and listened to you in other interviews. And you talk about the concept of conventional gynecology, not just failing women, but also harming us in some ways. And I think this is a great diving-in point. So, can you explain and maybe give some examples of what you’re seeing sort of from the inside in this world?

Tabatha: Absolutely. So, I was a conventionally trained OBGYN. I went to medical school with the plan to help women have voice, have a voice, have a choice in their healthcare. And I quickly was told, well, then you need to be an OBGYN because that’s a women’s health expert. And so that was the path that I went down. And I went through all the training, the residency, and I came out, started practicing medicine and quickly realized that I didn’t have a lot of tools in my toolbox. Birth control pills were like the major tool for me to help with period problems. We would say, this will regulate your period. This will help your mood. This will help your skin, those types of things. And I didn’t have any other tools besides surgery.

So that’s kind of the way I practiced for a decade or so. And it wasn’t until I had my own health issues and went into physical burnout and had a back injury that I realized that how we live and function in our day-to-day lives really impacts our health, and it’s not being addressed with women. So, it was really an eye-opening experience, and I found out that I was really practicing Band-Aid medicine. So, women would come to me with a complaint, like, I have a heavy period. Okay, here’s your birth control pill. If you can’t tolerate it because it causes headaches or causes depression or it doesn’t fix the bleeding, then we try an IUD, and then we try an ablation, and then you get a hysterectomy. We go down all of these surgical paths, but we never actually figure out why you had heavy periods in the first place, right? Like, what was the root cause of that? There’s no asking why.

Honestly, I remember being in residency one time and asking my attending physician who was training me, why we had to keep a woman on this pump that she was on for her preterm labor. I said, she’s not dilating. She hasn’t had contractions in two days. Why can’t we stop this pump? And he yelled at me. He literally said, that is not the algorithm. You need to know what the algorithm is, and you will know when to stop that pump. And I said, but I’m just trying to like understand, so that when I get out into practice, I can make these decisions. And he said, we don’t ask why. We follow the protocol. And I just thought to myself, well, who the hell makes the protocol, right? Like you have to have critical thinking. That is part of being a doctor, or so I thought. But I was trained during this transition period of doctors following protocols. And so, it was like, you just check off the list of what to do. And we’re really not teaching doctors critical thinking anymore. So, we’re losing common sense. We’re not asking why. We’re just doing this cookbook, Band-Aid medicine.

And unfortunately, it’s harming women. So, if you have heavy periods for a couple of years, and I keep masking the symptoms with birth control pills, and then an ablation, and all these things, and, we don’t treat the actual problem of estrogen dominance coming from a gut issue or from liver issue, that estrogen dominance continues on, even though you no longer have the period. So, you got rid of the symptom, but you still have the dominance.

And what I started to see was this pattern of women coming back three to five years later with breast cancer. And I realized, oh my gosh, their body is trying to tell us something. Those symptoms are a message. Their body is trying to say something’s out of balance, please figure it out, but we don’t. And so, we continue to go on and have new problems and new conditions. And breast cancer is one of those. You know, the sad thing is even at that point, a lot of doctors don’t stop and say, OK, why did you get breast cancer? It’s all about let’s get rid of it. Let’s cut it out. Let’s remove it. Let’s do the breast reconstruction and pretend this never happened. Like you just get on this assembly line, and you get treated and pushed out. And it’s really sad that we do this to women.

Katie: I love so many things about what you just said because I say so often on here that we are each our own primary healthcare provider and that the best outcomes happen when we get to partner with a practitioner who really knows what they’re doing, but we still have the responsibility. And I also love how you talked about symptoms being a messenger or like I try to reframe them. They’re truly actually a gift because that’s our body talking directly to us. And I’ve had people on this podcast before talking about this same trend in medicine in different areas of medicine, whether it be gut health, whether it be cancer medicine, whatever it is, there is seemingly hopefully a shifting trend, but a trend to go after the symptoms rather than listen to them and learn from them. And so, I absolutely love that that’s your approach.

I also feel like for women, often the women’s health and gynecological world feels like an area that maybe seems a little daunting to become your own primary healthcare provider in because we just aren’t actually, I don’t think given a lot of foundational knowledge and understanding about our bodies and everything that’s happening, especially for people who got put in the like, oh, you have acne. Here’s birth control cycle very early on, we kind of don’t get some of that data we might normally get about our bodies as we’re going through the different phases of life. So, I also know you practice what you call functional gynecology, and I would love for you to speak to some of the differences because even with what you just said, I was sitting over here taking notes and fully agreeing with you on that. But I think we need more voices like yours. So, what separates functional gynecology from the conventional model you just explained?

Tabatha: Yeah, so I just want to, I want your listeners to understand that we’re asking the wrong people for help when it comes to women’s health. I thought I was a women’s health expert as an OBGYN because that’s what you’re told. But honestly, I did a four-year surgical residency. Gynecologists are surgeons. I learned how to do a hysterectomy four different ways and do stat C-sections and colposcopies and all these procedures. I didn’t sit and study the intricacies of hormone balance and the endocrine system and how it’s impacted by our gut and our adrenal glands and our thyroid and all of the things.

And so, I was always in the mindset of how do I fix it? How do I take care of it with my hands surgically or procedurally? It was never asking why and trying to get to the root cause. So as a functional gynecologist, you’re trained to take a step back and look at the bigger picture because it turns out our body doesn’t function in silos. The thyroid system and adrenals, they actually affect our sex hormones, our ovary function, our gut affects our ovaries, our brain and our mood affects our ovaries, and all of that is interconnected. But in conventional medicine, we treat them as if they don’t have anything to do with each other. You go to the gastroenterologist for your IBS, and you go to the gynecologist for your heavy periods and the psychiatrist for your mood disorders. But it turns out that’s all interconnected. And so, as a functional gynecologist, I am looking for the why is this happening. Why is there hormone imbalance? And so, to do that, you have to look at all these systems together. You have to take a comprehensive approach and turn over all the pieces of the puzzle or you don’t see the true picture. You just see one small piece of the picture, and that can be very misleading. That’s the first thing I want women to understand is gynecologists are surgeons. You’re asking the wrong person for help when it comes to actually feeling well and being healthy. They’re going to fix your disease, like if you have a huge cyst and you’re in the ER dying of pain, like you do want them to perform surgery on you. There is a time and a place. It’s an acute care approach. If you have to have a baby and there’s a complication, you want that trained obstetrician to come in, but it’s not for health and wellness. So that’s the big difference.

And we are told lies when we are being trained, and then we pass those lies on to patients. The biggest lie out there is that birth control pills regulate your hormones. It is a flat-out lie. And yet we say it all day long to women, and we believe it. I believed it. I thought I was regulating women’s hormones. So, here’s what’s happening. You take birth control pills, or you use a NuvaRing or a Depo shot or an Implanon rod or an IUD, and those are synthetic hormones that are chemically different than what your body makes. And you take them and it actually suppresses your own hormone production. So, your ovaries and brain, it’s called the hypothalamic pituitary ovarian axis, there’s this conversation going on between your brain and ovaries all day, and also, between your brain and your thyroid and your brain and your adrenals. And that conversation stops. We shut down that communication and we no longer produce our own hormones.

And the first time I realized this was I had a postpartum gal who was, I don’t know, maybe 25. She was in her early 20s. And it was her second baby. And she was crying in my office at six weeks postpartum because she didn’t want to be married anymore. She just absolutely had no interest in her husband. She never wanted to have sex again. And she wanted to figure out how to just like get him to leave her alone. And I thought, okay, well, why don’t we do some blood work? And I was really starting to study functional medicine at this point. And so, I decided to test her testosterone. And she had none. It was like zero. And she had gone on a birth control pill right after delivery. It was a mini pill, a progestin-only pill so that you could still breastfeed. But literally that pill was preventing any testosterone production. So, she was feeling blah about life because testosterone doesn’t just give you a sex drive. It gives you a drive for life. It’s like my friend calls it the get crap done hormone. And so, it was her hormones. They were out of balance.

And I talked her out of getting off this pill and using condoms for a little while. She wasn’t even having sex, so it didn’t matter. And she felt like a different person within eight weeks. Like that got out of her system. Her hormones started to come back online because she, you know, was not breastfeeding exclusively. And she couldn’t believe that she had felt so different because she went from birth control pill to pregnancy to mini-pill to pregnancy back to mini-pill. She’s like, I feel like I didn’t in high school, like I’m a different person now. And that was the first sign that I really recognized, oh my gosh, these pills change how we feel about ourselves, about our loved ones, how we show up in life, how we function. And your gynecologist believes that it has nothing to do with any of that. So, we dismiss women. We just gaslight that there’s nothing wrong with you. Oh, it’s not the pill. That weight gain is not the pill. That anxiety that’s new that you’ve never had, that couldn’t possibly be the birth control, when it is in fact, all of those synthetic hormones. And so, we need to help women really take back control and consider using birth control pill just for birth control, not for all the other stuff. And maybe even then it’s not the best option. Get back to some other options that aren’t affecting our hormone production.

Katie: That makes so much sense. And you’re right. I don’t think a lot of people realize, especially because they aren’t told by their doctors necessarily, that those are actually downregulating your own hormone production. So, when framed like that, it seems so logical that, of course, this is going to impact how you feel and your mental health and so many other aspects because hormones are so intricately connected to everything. It’s so sad to me to watch so many, especially young girls, get put on birth control for acne or for heavy periods or whatever it is and never get to experience their own data about their body. Because I’ve mentioned before on here, women were largely excluded from medical research until 1993 because of the more complexity of our hormones, which, of course, is a disservice to women in and of itself. But I think it’s also a disservice to medicine because we’re losing the data. We get more data as women because our hormones change so much. We have this amazing input that we can look at every month and kind of get a baseline for what’s going on. And I feel like we’ve just not learned that. And somewhat ignored that data. And like you just explained, birth control also comes with risk, and it does affect your body.

Are there any other things women should need to be aware of when it comes to birth control? And what do you think of some of the other options? Like I know, for instance, a lot of the wearables are now integrating with apps that let you track your fertility through the app and have actually gotten pretty reliable. Or what do you recommend to women who don’t want to go the synthetic hormone route or the birth control route?

Tabatha: Yeah, this is a very important conversation. And one of the biggest reasons I actually went into medicine. So, I was pregnant at 16. I had a very traumatic pregnancy and delivery. I was on Medicaid and food stamps. I was treated like a second-class citizen. I had things done to me, nothing explained. And, I came out of that experience, not only a mother, but like a woman on a mission to actually give women informed consent and control over their bodies. Because when I looked back at what had happened to me, it’s just appalling. And we’re not having the necessary conversations. You know, why did I get shots in my butt? Why did I have unnecessary pelvic procedures? They actually, I went into a Hashimoto’s flare after my delivery, and they took me in and radioactively iodized my thyroid and killed it off without any conversation. My parents weren’t there because I was emancipated. I had now become a mother.

And so, I let some major things happen to me and people are like, well, that’s really just crazy. And I said, you know what? It’s not. This stuff is happening in this day and age. My daughter is 30 now, but this is how doctors still practice. They believe that they know what’s best for women’s bodies, and they’re going to just tell you what to do. There’s no conversation. And so that’s what’s happening with birth control is women are not being told, this affects your gut health. This shifts your microbiome. This causes leaky gut. This causes vitamin and mineral deficiencies. It causes vitamin B and magnesium deficiencies so significantly that women start to have anxiety and depression that they never had. They can no longer metabolize those hormones that they’re taking properly. That causes an increase in 4-hydroxyestrone, which is an estrogen we don’t want too much of. And that is driving a lot of our cellular dysfunction and depression.

So, we’re just continuing to see this rise in abnormal breast cells, abnormal cells in the uterus and the cervix, and all of these things. And nobody’s questioning it. We just continue to hand out this synthetic hormone-like candy. And there’s no conversation. So, when I was a surgeon, which I absolutely loved, but I had to sit down and say all the risks and benefits, have the patient sign the paper saying that they understood and we had this conversation. But I will tell you, it’s supposed to be risks, benefits, and alternatives. And I never thought about that as a surgeon because I actually wasn’t giving them the alternatives. I was giving them what I knew how to do and what I could offer. So, there was never a discussion about, huh, maybe evaluating your hormones with some testing or evaluating your gut health or looking at your diet or telling you to stop drinking alcohol on a regular basis or using supplements to metabolize your hormones.

And so, we are having women consent to things without true informed consent. And like you said, you have to be your own health advocate because the doctor doesn’t even know. And I would say, don’t even be mad at your doctor. I didn’t know. The system is so broken that I was way more unhealthy than my patients. I was trying to just get through the day, crank up the 40 patients I had to see, deliver babies all night or do surgeries. And I barely had time to shower and eat and care for my own kids. I wasn’t watching Dr. Oz or reading The New York Times bestseller books. I didn’t know anything about health and wellness. And it’s not that I didn’t care about my patients. It’s that I was stuck in a broken system, and it broke me. So, I just want women to realize there’s no point even being upset. Just you have to go seek out someone else in the functional space, in the holistic health space, a naturopath, somebody else. Because you’re really not going to get what you’re looking for. And they’re, they only have certain tools in their toolbox.

So yeah, is back to birth control options. Surprisingly, at 17 years old, I was given a diaphragm after my delivery. And I think it’s because that’s just all they had to offer back then. And somehow, I didn’t get pregnant using the diaphragm. But it reminded me like if you teach people how to use things properly, it can actually be a really effective form of birth control pill or birth control. So, I like the diaphragm if you’re in a committed relationship, and you kind of know when you’re going to be sexually active. And it’s a nice, easy form because that way there’s no hormones involved. You don’t have to ruin the moment. You can put it in like an hour before. You leave it in for hours afterward. And it’s a nice form of birth control. So, any kind of barrier method, a sponge, a condom, where it’s just stopping the sperm from getting through is a nice way. But it is user-dependent. So, it’s only as good as the user and if you remember to use it.

Something like a non-hormonal IUD like a Paragard can be really helpful. That is the most effective birth control without having your tubes tied. So, it’s reversible. Having your tubes tied is not something that you should ever think of as reversible. That’s a permanent deal. You sign up to be done, you’re done. So, a Paragard can be nice, and it can stay in up to 10 years. So that can be really helpful. And there’s this idea that, well, sometimes it causes heavy periods. Most of the time, it’s because you’re having heavy periods from a hormone imbalance that’s not being addressed. It’s not actually causing heavy periods. There’s, I would say, a small subset of women who might have copper excess, which is a whole other issue with your minerals. But that’s really pretty uncommon.

And then, like you mentioned, the rhythm method, the tracking methods, all of those, those are awesome. And I, those are my favorite because you do want to be listening to your body. You do want to know where you are in your cycle and make sure you’re having it every month because that’s your superpower is to really get in tune and listen to your body and know when you function best. We all have a feeling the first week of the month. We’re like rock stars. We want to go out and conquer the world and do everything. And we all know how we feel the few days before our period. We just want to like curl up and watch a movie and eat some ice cream. And so, if you know what your month is going to look like, you can put your life around it and learn how to thrive. You can know what’s best for your exercise routines and for your travel and for your work schedule and all that stuff. So, it’s way more than just your fertility. Like you really can use this to harness an awesome, incredible life.

Katie: That’s such a great point. And I’ll speak to it. So much has changed 20 years ago when I first started tracking my cycle. Back then, it was paper charts and taking my temperature every morning. And now like my Oura ring integrates with the app and I get data on my temperature, I can input symptoms. So, we’ve come a long way in making that not just more effective, but much more user-friendly as well. And I know it does require a little bit more work than some of the other methods, but for me, it’s been really effective and also really great data because I get to see my temperature rise in real-time. I know when to anticipate PMS or whatever might happen. And even now, they can email your partner and tell them like, hey, just a heads up. She’s going into this phase. You might want to, you know, be a little extra kind today or whatever it is.

I also think it’s important to highlight what you said about not talking badly about doctors because I do agree with you. Many, I’ve talked to many doctors who are as frustrated as patients with the problems with the system. And every doctor I know in real life, only you only make it through medical school and residency because you actually have a heart to help people and to care. And so, I love that you brought that up. And I certainly also don’t ever want to speak poorly about doctors. I’m just a big fan of find a practitioner who is your partner and who’s in your corner and who can work with you toward what your goals are. And like you said, that might not be every single doctor. You might have to look for the one that’s going to be the right fit for you. And on that note, I know you have a ton of resources available, and I’ll link to these in the show notes, but what are some things for people to think about, maybe questions to ask in identifying a good doctor when it comes especially to this area of women’s health?

Tabatha: Oh, that’s a great question. So yeah, I have a download, How to Balance Your Hormones Naturally. And it goes through the five basic things that really cause our hormones to get out of balance and cause the problems that we’re dealing with, the period issues, the mood swings, the weight gain, the anxiety, all that stuff. So that’s a great like, I can do this on my own, I can start to look at those five different areas and really figure things out.

But I created a virtual practice where we actually help women get to the root cause of these issues. And it turns out you can test hormones, and you can get them balanced and figure it all out. But I had to go on to do functional medicine training to understand that and get certified through the North American Menopause Society and do A4M training, anti-aging medicine. And so, you want to look for a provider who has more credentials than just an OBGYN. Otherwise, most likely they’re still going to be practicing that conventional Band-Aid medicine. As much as they care about you, they just don’t know. I have a lot of conventional colleagues and friends, and they are very intrigued by the way that I treat period problems and all these issues now. But it takes a lot of studying and a lot of investigation.

So you can go on ifm.org and look up providers in your area. You can just Google functional medicine provider in my area, hormone expert in my area. There’s a few things you want to be careful about. There’s a company called BIOT. No offense to them, but they are a pellet hormone company, and that’s what they do. They claim to balance your hormones through pellet placement. And what I always say to women is be careful if someone can only do something one way. You know, if there’s only one way, then that’s probably not actually true functional medicine. You need a comprehensive approach, and you need to be able to tailor it to the individual. It needs to be individual care. And so that’s why I really love testing, not guessing. Like see what’s actually going on in your gut and affecting you. See what your adrenal glands are doing and how you’re handling your stress. And what are your hormones doing every month?

So, I would say do your homework and always word of mouth. Like, I bet you have a friend or somebody who’s going to someone, if you’re seeing some, one of your girlfriends and they’re just thriving and having an incredible life, like say, hey, what did you do? How did you do that? Who are you seeing? What’s going on? And it’s usually like, hey, I read this book. I read, you know, Whole30. I did an elimination diet. I realized I need to follow the EWG guidelines. I’m following Wellness Mama, doing all these things and then see who are those people going to as their provider. And that would be my best advice, but we are licensed in over half the country. So, we do see women all over the country. And it’s amazing to see the transformations because, honestly, I used to be a surgeon. I would do four to six surgeries a week. And it felt like so incredible to heal women, you know, with my hands, but honestly, I no longer do any surgery, and I’m actually healing women and transforming them. And that is so much more rewarding because it’s not just for women that I did surgery on. It’s like every woman I’m coming in contact with because we’re getting to the root cause. So, it’s so, so amazing.

Katie: I love that. And I’ll make sure I link to your practice so people can find you directly in the show notes. But what I love about the functional medicine approach and all the things you’re talking about is that because it does take into account our diet and our lifestyle factors and sleep and supplements and all of those things, it really points out all the things that are actually within our ability to change related to our own health. And I feel like the hormone part, I’m so glad this is finally entering the conversation and that there are resources like you because I feel like I’ve heard from so many women who that’s their biggest frustration point. And now there are tools and people to work with like you that can really help you take back your own power in that world and listen to what your symptoms are telling you and get to actual solutions, not just Band-Aids.

Are there any, in our last couple of minutes, any common themes that you find with women or things that you feel like are in general good starting points or helpful when it comes to lifestyle factors or diet or addressing the gut side or hormones? Obviously, testing is going to be important too, but have you seen anything that is a pattern of generally helpful? Or generally things to avoid?

Tabatha: Yeah, I would say for women, I don’t think they realize that the connection between the gut and their pelvic health, their hormone health. And so sometimes you can’t just change your diet and get into balance. Sometimes you actually do need to kill certain things off or you have a low immune system that you need to support or you need digestive enzyme support and different things. And so that’s where testing can come in really helpful. If you’ve done all the right things and you’re still having problems, then yeah, it’s time to find a practitioner to help you find the root cause of what the heck’s going on. Because for, I would say probably 70% of people, just cleaning up your diet and setting boundaries in your life and focusing on getting good, healthy sleep, and all of those foundational things, that should be enough to give you a regular period every month, not have crazy PMS.

So, if your period is irregular, you got to figure that out because that means you’re not ovulating. You’re not making progesterone, your calming anti-anxiety hormone. If you’re having severe PMS, that means your hormones are out of balance. If you keep being told like you got this new growth or that new growth, you know, sometimes people will be like new moles popping up or fibroid cysts in their breasts and fibroids in their uterus or endometriosis, like all those growths, your cells should not be growing abnormally. So even if it’s like a skin tag or little bumps on your skin, all those abnormal growths are a sign that you’re not balanced. So that’s a really big piece of it.

And the other piece is we have to see what’s going on with the other systems. You know, blood sugar is a big issue for people lately. If you had gestational diabetes or you barely passed the test, like you had to do the three-hour and then passed, you might have insulin resistance. You might have prediabetes that you need to deal with. So, there’s all kinds of things that we just we forget about like blood pressure issues during pregnancy or history of preeclampsia, all of those things. Those are all red flags of, hey, your health is potentially going to be affected going forward because your body didn’t respond appropriately during this pregnancy. And so, we need to do some investigation after that pregnancy is over. So just stuff like that.

Katie: I love that. I think those are such useful tips. And the great part about that is, like you said, 70% of people may resolve just from addressing those things. And even if you’re not one of those people that that entirely fixes it, those foundational habits are going to make, I would guess, anything you do in the functional medicine world more effective. When someone is sleeping well, when they’re getting morning sunlight, when they’re hydrating and nourishing their body and addressing their stress, that’s going to make anything additional you need to do more effective, I would guess, as well.

Tabatha: Oh, absolutely. It’s essential. Like you have to do the foundational stuff. You cannot bypass it. Pill for an ill just doesn’t work. So, I’ll have women every so often, they’ll come to me, they’ll do all the tests, but then they just want the quick fix because they still want to do their crazy job or they want to ignore their toxic relationship or they don’t want to move their body. And it just doesn’t work. You have to take care of everything.

Katie: So important. I feel like I’ve learned a lot in this conversation. I’ve taken a lot of notes, and I will put a lot of links for you guys listening on the go in the show notes at wellnessmama.com. But thank you so much for your time. I am so, so grateful that you are shedding light on these topics and giving women real tools to actually see improvements in their own lives, as well as direct help from you. Thank you for being here and thank you for sharing your wisdom today.

Tabatha: Oh, my pleasure. Thanks for having me.

Katie: And thanks to you for listening. And I hope that you will join me again on the next episode of The Wellness Mama podcast.

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