Dr. Natalie Crawford: Female Hormone Health, Fertility & Vitality

Added: Nov 13, 2023

Dr. Crawford begins by discussing the development of female hormones and fertility, starting from in utero when a female fetus has the most eggs she will ever have, to the onset of puberty, and extending to menopause. She explains that the timing of puberty in girls does not impact the length of their reproductive lifespan, as the loss of eggs from the ovaries is a continuous process that begins in fetal development.

The discussion then delves into the impact of endocrine disruptors on puberty and fertility. Dr. Crawford explains that exposure to certain chemicals and fragrances, such as evening primrose oil, lavender, and tea tree oil, can lead to precocious puberty or accelerated puberty in both males and females. She emphasizes the importance of minimizing toxin exposure, especially during critical developmental periods.

The conversation also touches on the impact of maternal health and exposure to toxins during pregnancy on the future reproductive health of the child. Dr. Crawford highlights the susceptibility of the ovaries to environmental factors during fetal development, which can predispose individuals to conditions such as low ovarian reserve, PCOS, and endometriosis later in life.

Regarding the menstrual cycle, Dr. Crawford explains that the normal duration between menstruation cycles can vary, but for an individual, the cycle should be relatively constant. She emphasizes the importance of regularity and predictability in menstrual cycles as a vital sign of hormonal health. Changes in the regularity of menstrual cycles, such as a shortening of the cycle, can be indicative of potential issues with ovarian reserve or hormonal communication.

The discussion also covers the process of egg retrieval for fertility preservation and in vitro fertilization (IVF). Dr. Crawford dispels the misconception that egg retrieval diminishes future fertility, explaining that the process simply involves accessing and preserving eggs that would have been lost naturally. She emphasizes the importance of understanding the normal process of egg loss and the role of IVF in preserving eggs for future use.

In addition, Dr. Crawford addresses the impact of nutrition on female hormone health and fertility. She highlights the correlation between hormonal fluctuations and mood, energy levels, and overall well-being. The role of estrogen in neuromodulation and its influence on mood and cognitive function is discussed, emphasizing the importance of high-quality nutrition for both physical and mental health.

One of the key takeaways from the podcast is the importance of optimal nutrition for supporting cellular functions in the body, including the gut microbiome. Dr. Crawford emphasizes the need to obtain essential vitamins, minerals, probiotics, prebiotics, and fiber from high-quality, unprocessed or minimally processed sources. She also highlights the role of estrogen and progesterone in the ovulatory cycle, explaining how estrogen primes progesterone and the impact of these hormones on energy levels and vitality.

Dr. Crawford addresses common questions about birth control and its potential impact on the ovulatory cycle. She clarifies that birth control pills do not change the release of eggs from the ovaries but may affect the levels of antimullerian hormone, which is a marker of ovarian reserve. She also discusses the effects of hormone-based contraception on fertility, emphasizing that the pill does not cause infertility but may impact ovarian reserve and fertility outcomes.

The podcast delves into the topic of fertility and the most fertile time for conception. Dr. Crawford explains that the fertile window for women is typically five days ending on the day of ovulation, with the day before and the day of ovulation being the most optimal for intercourse. She also addresses the common misconception about getting pregnant during menstruation, highlighting that the likelihood of conception during this time is low in individuals with regular menstrual cycles.

The discussion extends to the impact of lifestyle factors on egg quality and fertility. Dr. Crawford provides insights into the effects of substances like cannabis, alcohol, and nicotine on egg quality and sperm production. She explains that these substances can decrease sperm production, sperm motility, and sperm morphology, as well as impact egg quality and fertility outcomes. Additionally, she emphasizes the importance of moderation and abstinence from these substances, especially during pregnancy and when trying to conceive.

The podcast also covers the use of intrauterine devices (IUDs) as a form of birth control. Dr. Crawford explains the mechanisms of copper IUDs and progesterone-based IUDs, highlighting their effects on the uterine lining and ovulation. She discusses the potential impact of progesterone-based IUDs on menstrual patterns and fertility, emphasizing the need for a period of adjustment after IUD removal to allow for the restoration of regular menstrual cycles.

Dr. Crawford highlights the importance of understanding the potential consequences of using birth control, particularly the Depo shot. She explains that the high level of progesterone injected into the system can last for a substantial amount of time, leading to a prolonged absence of periods. She advises women to discontinue this contraceptive option a year and a half to two years before planning to get pregnant. While the birth control pill can be beneficial for some women in managing heavy periods, mental health issues, and preventing certain types of cancer, it also comes with potential risks such as increased blood clotting and changes in vaginal and vulvar health.

Dr. Crawford emphasizes the importance of understanding ovarian reserve and its impact on fertility. She explains that the number of eggs in the vault decreases as women age, leading to a decline in egg quality. This decline becomes more pronounced after the age of 37, affecting the likelihood of natural conception and increasing the risk of genetic abnormalities in embryos. She encourages women to consider getting their anti-Müllerian hormone levels checked, as it provides valuable information about ovarian reserve. Dr. Crawford also discusses the viability of egg freezing, highlighting the significant advancements in technology that have improved the survival rate of frozen eggs to 90%.

Dr. Crawford advocates for empowering women to make informed decisions about their reproductive health. She stresses the importance of education and data, allowing women to understand their bodies and make choices based on their individual circumstances. She encourages women to advocate for their own health and ask questions about potential fertility issues, genetic mutations, and other factors that may impact their reproductive choices. Dr. Crawford believes that providing women with autonomy and informed consent is crucial in navigating fertility-related decisions.

Dr. Crawford addresses the misconception that egg freezing diminishes the number of eggs in the vault. She clarifies that egg freezing does not reduce the existing number of eggs and can be a viable option for women who wish to preserve their fertility. She also emphasizes the nonlinear drop-off in egg quality after the age of 37, prompting women to consider egg freezing as a proactive measure to preserve their reproductive options. She encourages women to consider their life goals and circumstances when making decisions about egg freezing, highlighting the potential benefits of preserving viable eggs for future parenthood.

Dr. Crawford emphasizes the importance of freezing eggs at the optimal age, which is around 32-33 years old. Studies suggest that this age range offers the best intersection of egg quality and quantity for the average person. Freezing eggs at this age can provide a higher chance of success in the future.

The process of egg freezing or IVF involves injecting synthetic mimics of follicle stimulating hormone and luteinizing hormone to stimulate the growth and maturation of eggs. The eggs are monitored through blood tests and ultrasounds to determine their maturity. A trigger shot is then administered to allow the final stage of meiosis, where the chromosomes separate, making the eggs ready for retrieval.

Dr. Crawford also discusses the importance of sperm freezing, especially for younger males in their late 20s or early 30s. While sperm can regenerate throughout a man's lifespan, freezing sperm can provide a backup plan for future family planning, especially in cases where life circumstances change.

The podcast delves into the ethical considerations surrounding embryo donation and the challenges of regulating the fertility industry. Dr. Crawford highlights the dilemmas associated with egg and sperm donation, including the potential impact on future children and the need for proper consent and understanding of the long-term implications.

Dr. Crawford addresses the question of whether IVF babies have a higher incidence of developmental disorders, such as autism. She explains that the hormonal environment during fresh embryo transfers can impact fetal outcomes, but modern practices, such as frozen embryo transfers, have shown significant improvements in neonatal outcomes.

The podcast raises important ethical concerns related to fertility treatments, including the recruitment of egg donors and the use of third-party reproduction. Dr. Crawford emphasizes the need for proper consent and understanding of the potential ramifications of fertility treatments, as well as the challenges of regulating the fertility industry.

One of the key takeaways from the podcast is the importance of nutrition and supplementation in optimizing fertility. Dr. Crawford emphasizes the significance of a healthy diet, including fruits, vegetables, whole grains, and healthy fats. She also recommends taking prenatal vitamins with folic acid, vitamin D, and omega-3 fatty acids to support reproductive health. Additionally, she highlights the role of supplements such as CoQ10 and myo-inositol in improving egg and sperm quality.

Dr. Crawford emphasizes the importance of understanding the medications and procedures involved in fertility treatments. She encourages patients to ask about the specific drugs used for pain management during procedures and to be aware of the clinic's approach to sedation. This knowledge can help set realistic expectations and ensure a comfortable experience for patients undergoing fertility treatments.

Another significant aspect of the podcast is the discussion on the impact of lifestyle factors on fertility. Dr. Crawford highlights the role of sleep in hormonal function and cellular repair, emphasizing the need for adequate rest and quality sleep for optimal reproductive health. She also addresses the impact of weight and inflammation on fertility, stressing the importance of maintaining a healthy weight and reducing inflammation through dietary choices.

The podcast also touches on the use of supplements such as L-carnitine and myo-inositol in addressing specific fertility issues, such as polycystic ovary syndrome (PCOS). Dr. Crawford explains the potential benefits of these supplements in improving insulin sensitivity and reducing inflammation in individuals with PCOS.

Another important topic discussed in the podcast is the impact of menopause on women's health. Dr. Crawford highlights the risks associated with low estrogen levels during menopause, including an increased risk of dementia, osteoporosis, heart disease, and stroke. She also explains that menopause can bring about a range of symptoms, including hot flashes, vaginal atrophy, and mood changes. It's crucial for women to seek support and consider hormone replacement therapy to alleviate these symptoms and maintain their overall health and well-being.

Lastly, Dr. Crawford delves into the topic of hormone replacement therapy (HRT) and its role in managing menopausal symptoms. She emphasizes the importance of initiating HRT at the onset of menopause to provide relief from symptoms and maintain a healthy quality of life. HRT can involve various forms of estrogen replacement, such as pills, patches, or vaginal inserts, along with progestin to mitigate the risk of endometrial cancer. Dr. Crawford stresses the need for individualized treatment plans that consider each woman's unique needs and preferences.