Maureen Benkovich (00:00.982)
Hey everybody, welcome back to Sober Fit Life. I am so honored today to have trail blazer, Dr. Betsy Greenleaf on Sober Fit Life. You guys are going to be blown away by her. She's an amazing overachiever and we get to benefit from that. Betsy is renowned as a premier expert in menopause and andropause, which we're going to talk about. Best-selling author, entrepreneur and innovative specialist in female pelvic medicine and reconstructive surgery for over two decades.
She is the first female in the United States to achieve board certification in Eurogynecology, founder of the International PAWS Institute, which has perimenopause, menopause, and andropause under that whole umbrella of support, CEO of Pelvic Floor Store, and founder of Femversity, Women's Empowerment Through Education, holistic approach focusing on body, mind, and spirit. And if that's not enough, she also has a podcast called 40s.
and we'll talk about why she picked that title for her podcast. But thank you so much, Dr. Greenlee, for coming on to Sober Fit Life. So happy to have you here.
Dr. Betsy Greenleaf (01:10.03)
Maureen, I'm so excited to be talking with you. I've been looking forward to this.
Maureen Benkovich (01:14.516)
You have so many certifications, OBGYN, functional, aesthetics, integrative is what you're working on now. I think I missed one. What else do you have? Is that a sort of relatively new field?
Dr. Betsy Greenleaf (01:23.948)
Yeah, and urogynecology, yeah.
Yeah, interesting enough, didn't become, it started in the 1970s, but did not become a board recognized specialty until about, I think it was 2012. I should actually look that up because I know people always ask me and it's kind of a blur. But, and some people are like, Eurogynecology, what in the world is that? And I remember when I first came home and told my mom, I was going to do extra training in that beyond obstetrics and gynecology. She's like, is that like?
fancy like gynecology, like European, like was like Euro Disney. like, I'm like, you know what, I never thought about it like that, but Euro has to do with the urology. So it has to deal with like the urinary system. like bladder, but really Euro gynecology is kind of more of a misnomer. It's like we deal with everything inside the pelvis at a different level than just the regular gynecologist. So we're dealing with the bladder and the...
Maureen Benkovich (02:01.151)
Hahaha
Maureen Benkovich (02:11.957)
Mm-hmm.
Dr. Betsy Greenleaf (02:23.874)
vagina and the uterus and the rectum and like everything that's in the pelvis, which is the area from your belly button down and from your thighs up. Like that's our specialty.
Maureen Benkovich (02:31.861)
Right. It makes so much sense though, because all those systems are so integrated. And as I'm in my 60s, I'm starting to see a urogynecologist. So I understand, you know, this is such an incredible field that you're in. So the pelvic floor is very much involved in this. Can you tell us about why is that important that women need to understand the pelvic floor?
Dr. Betsy Greenleaf (02:41.576)
my gosh.
Dr. Betsy Greenleaf (02:47.958)
Yes, definitely. Yeah.
Dr. Betsy Greenleaf (02:55.276)
Yeah, so you know, like all muscles in our body, their pelvic floor muscles start to weaken over time. And really, our pelvic floor is just made up of muscles, some skin, some ligaments, and that's it. Otherwise, we are an open hole to gravity because the bony structures like the hips and the pelvic girdle that make up our hips and our sacrum, that's just going around the outside. There's nothing really stopping gravity from dropping.
And so, you a lot of times what we talk about neurogynecology, it's like, you know, my vagina has fallen and it can't get up. This is like a true thing, you know, unfortunately, because of we start to lose all of us, men, women, everybody, we start to lose about 8 % of our muscle mass every decade after the age of 30. And people think about exercising their arms, their legs, nobody ever really thinks about exercising the pelvic floor until all of a sudden they're like,
aware of their pelvic floor. And no one even thinks about that area of their body until all of a sudden there's a problem. muscle weakness in that area can lead to things like incontinence, so leaking urine. may be holding and having difficulty holding in gas. I mean, you don't want to be, know, let's say you're an, you know, an executive, you don't want to be giving a presentation and standing in front of all your people. And then all of a sudden you have to fart. Like you want to be able to hold that in.
Maureen Benkovich (03:58.475)
Right.
Maureen Benkovich (04:14.325)
Yeah.
Maureen Benkovich (04:19.902)
Right.
Dr. Betsy Greenleaf (04:22.35)
And then also sexual function. I mean the stronger the pelvic floor muscles are the better that we can orgasm both for both men and women. So it's really important to think about doing things like kegel exercises or just in general just doing things to support muscle health. you know another thing we tend to do especially as Americans is we don't get enough protein in our diet. And so you need protein to support muscle and then you need
Maureen Benkovich (04:31.882)
right?
Maureen Benkovich (04:46.569)
Yes.
Dr. Betsy Greenleaf (04:50.89)
exercise and strength building to support and build the muscle. So it kind of all goes together.
Maureen Benkovich (04:56.691)
Yeah, and it's pioneers like you who are bringing this to the surface about being more preventative and taking care of those muscles that, like you said, we ignore until there's a problem. And you don't just treat women, you treat men too. So there's andropause. Can you talk about that too a little bit?
Dr. Betsy Greenleaf (05:02.243)
Yeah.
Dr. Betsy Greenleaf (05:06.36)
Yeah.
Dr. Betsy Greenleaf (05:11.724)
Yeah, it's so funny because menopause is having a moment right now. Everyone's heard of it. It's everywhere on social media, almost to the point where it's like, my God, if I hear one more thing about menopause, my brain just might explode. But when I mentioned to people the word andropause, they're like, wait, what is that? And I start talking to the guys about like, all right, you know, after the age of 40,
Maureen Benkovich (05:21.909)
You
Dr. Betsy Greenleaf (05:33.856)
Like you're working out and things just don't look the same. You kind of getting that dad bod, know, fat is starting to show up where it wasn't before. Or maybe it was there and now it's like getting worse and you're exercising and nothing's happening. And then you start having some brain fog and maybe a little bit less motivation and you're starting to have mood issues and maybe even lower sex drive.
Like all this falls under andropause. So women get menopause, men don't escape this. They still have issues too. So starting in both men and women, testosterone drastically starts to die after the age of 40. So that's when we start seeing all these things showing up. so many men have heard of low T or low testosterone. That is just kind of like another name for andropause.
Maureen Benkovich (06:02.581)
Mm-hmm.
Dr. Betsy Greenleaf (06:25.422)
this time of life when the hormones are just kind of starting to decline. And the thought is, from an evolutionary standpoint, you know what, do we need to really be reproducing after the age of 40? You know, from a basic like cave person evolutionary standpoint, no, because we know that the risk of birth defects goes up drastically over the age of 40 with both older
quote older because it's biologically older mothers and older fathers. So, you know, from a biologic standpoint, you know what, maybe we don't need to be having this sex life and reproductive life. But from a modern day standpoint, we're living into our hundreds and why not have a very, you know, there's other things other than like reproduction that sex life helps. I mean, we know that
Maureen Benkovich (06:56.509)
Right.
Maureen Benkovich (07:08.372)
Yes.
Mm-hmm.
Dr. Betsy Greenleaf (07:19.636)
It's directly correlated with improvement in sleep, improvement in mood, improvement in confidence. Even from a work standpoint, they know people who have more active sex lives, whether that's with themselves or with a partner, tend to have better work balance. So it's stress reduction. So there's a lot of better cardiovascular health. What better way to work out?
Maureen Benkovich (07:41.632)
Right? I love that you're talking about all this. Well, I coach men and women and on Sober Fit Life, I like to bring people information because everyone's interested now in longevity and preventative medicine, but we kind of ignore this elephant over here in the room of alcohol. Can you speak to how alcohol affects the pelvic floor in women and for men, you how does it affect them? Their testosterone, all the things.
Dr. Betsy Greenleaf (07:53.986)
Yes.
Dr. Betsy Greenleaf (07:59.342)
Yeah.
Dr. Betsy Greenleaf (08:08.546)
Yeah, you know, unfortunately, I don't know what happened, but like I would say like early 2000s, there was a big article that like resveratrol, which is this anti aging component found in wine that this was like the big anti aging thing. I saw, mean, alcohol has always existed. It's been around as long as people have been around because things accidentally get fermented and then people drink it and they go, look at that. So
Maureen Benkovich (08:19.273)
Yes.
Maureen Benkovich (08:29.269)
Mm-hmm.
Maureen Benkovich (08:33.587)
Mm-hmm.
Dr. Betsy Greenleaf (08:37.07)
But the problem was starting in like the 2000s this article that came out about the resveratrol people decided that drinking alcohol was healthy for me and that and that this was gonna like help me live a long life and the problem is
Maureen Benkovich (08:52.681)
Well, people were assisted by the alcohol industry that jumped on that study that said, hey, let's drink resveratrol in your wine. But the amount you'd have to drink to truly get the bioavailability of that would be incredible amounts. Right? Yeah.
Dr. Betsy Greenleaf (09:01.11)
Yes!
Dr. Betsy Greenleaf (09:07.734)
And in fact, now it's ridiculous. You would have to drink so much wine that you wouldn't even be able to get that much into your body to get the anti-aging benefits of the Versivirotrol. So it's not even, but I did see around that time, like every patient thought, I have a glass or two of wine a night. I'm being healthy. When now we're saying like no alcohol is preferable.
Maureen Benkovich (09:17.62)
Pass out.
Dr. Betsy Greenleaf (09:32.206)
because we're really stood a lot of the studies are really showing more how the alcohol is affecting every body system. so ideally, mean, I always tell people like, you know what, you got also have to live your life and know if you can do things really well 80 % of the time and 20 % of the time, if you're able, you know, to handle the alcohol that, you know, then 20 % of the time, it's not gonna make a big difference. But what we're seeing with
Maureen Benkovich (09:38.719)
Mm-hmm.
Dr. Betsy Greenleaf (09:58.686)
even just one glass of wine or one glass of alcohol is that it really affects so many aspects of health. mean, first of all, we know it affects the liver. I mean, that's not a big surprise to everybody. From a hormonal standpoint, where our hormones mainly metabolize is in our liver. So especially if we're entering midlife and we're already starting to have some issues with our hormones and now
whether you're on hormone replacement or not, now you're just not metabolizing them properly. So we don't want to affect the liver, which is going to be helping us with our metabolism. The other thing which I'm super, super passionate about is the gut microbiome. And we know that alcohol will throw off the gut microbiome. so, all right, what is the gut microbiome? Well, microbiome is just, it means the bacteria and organisms that live in different areas of our body.
Maureen Benkovich (10:39.007)
Yes.
Dr. Betsy Greenleaf (10:51.468)
and we have a microbiome in our mouth that's different than our gut and in women that's different than the vagina, that's different from the skin. And when it's in balance, we know that it's actually going to keep us healthy. But things like alcohol will throw off the gut microbiome. And in fact, I mean, you think about it, alcohol is like an antiseptic. I mean, it's going to kill bacteria. Not a good way to, know, not a great antiseptic. You don't want to be like, I'm killing off the bad bacteria doing this.
Maureen Benkovich (11:13.407)
Good and bad, right.
Dr. Betsy Greenleaf (11:21.336)
but it's also gonna kill off the good bacteria. And we know that with health and longevity, the more different types of bacteria you have in your system, the healthier you are. And so like for example, they've done a study with Tibetan monks and Tibetan monks have the most diverse type of bacteria in their gut than any other group of people on the planet.
and they tend to be the healthiest. Now they're also meditating like six hours a day. So the question is like, they don't have a lot of stress in their life. And we know stress will also affect the microbiome, but even just like just a little tiny bit of alcohol will throw that off. And what here's the thing we have to start thinking about, like, what does the microbiome now affect? If we throw it off, it affects everything. So this, would tell you that
Our microbiome is responsible for 90 % of the medical conditions that are out there. So if you throw it off, you're going to get worsening of diabetes, worsening of heart disease. We know that there's definitely, and especially we know the data for alcohol, there's an increased risk of cancers, especially the hormone related cancers. We know there's going to be worsening of arthritis. From a mental health standpoint, 90 % of our happy hormone is made in our gut.
Maureen Benkovich (12:15.487)
Really?
Maureen Benkovich (12:26.953)
Yep, seven types.
Dr. Betsy Greenleaf (12:40.694)
And who doesn't want to be more happy? So why would you want to like affect your gut bacteria that's making the happy hormone? mean, this unfortunately, there's too many and I'm not saying there isn't a role for antidepressants. There's definitely a role for that. But I would also challenge people to like look at their gut and what are they doing that may be affecting their gut health because your bacteria will naturally make that happy hormone. The gut bacteria also makes a hormone called a gas or neurotransmitter called
Maureen Benkovich (12:41.994)
Right.
Dr. Betsy Greenleaf (13:10.604)
called GABA, which is also really healthy for the brain and brain functioning and preventing a brain fog and brain health in general. So we don't want to affect that. The other thing that the gut does is it's in charge of our immune system. So 80 % of our immune system is made in our gut. If we throw something like alcohol in that, now all of a sudden we're at much higher risk of chronic illness, disease, cancer. So it's really,
Maureen Benkovich (13:11.349)
Mm-hmm.
Dr. Betsy Greenleaf (13:40.25)
I would really challenge people to say like, no alcohol is good. Yeah.
Maureen Benkovich (13:44.372)
Yeah, it's tough to get to. The people I mostly work with are gray area drinkers. and actually studies have shown that a lot of gray area drinkers are drinking to fill their GABA need. Maybe they don't make enough of their own. So they're drinking that to fill that down regulation. And yet it has this negative impact because then your body starts making less of its own to counter what alcohol is doing. So can you speak to that a little bit?
Dr. Betsy Greenleaf (14:09.964)
Yeah, you know what I was also thinking too, just the effect of stress on the body and alcohol being a stressor. so, yeah, so not only, well, so, you know, not only are we having people that are adding this alcohol, but we know that stress in the body produces cortisol and cortisol in return is going to prevent you from healing.
Maureen Benkovich (14:16.213)
Mm-hmm.
Dr. Betsy Greenleaf (14:32.616)
so that if we're adding, I mean, there's other stressors other than alcohol, but if there's something that we can affect, why not take the one thing that we can affect? There's also mental stress, emotional stress, other inflammatory foods, and I would say that alcohol is definitely an inflammatory food.
Maureen Benkovich (14:40.009)
Yes. Right.
Dr. Betsy Greenleaf (14:51.842)
but like high processed foods, high sugars, some people dairy, not everybody has a problem with dairy, in some people gluten, but not everybody has a problem with gluten, all these things can throw off the gut. And so, yeah, I would say that there are definitely connections with that. Now that I'm talking about it, I forgot to mention with sex drive, with libido, there have been a number of...
Maureen Benkovich (15:17.085)
Yes, I was going to ask you about that.
Dr. Betsy Greenleaf (15:19.008)
Yeah, number of studies that have shown in both men and women, when the gut microbiome is off, it will also throw off all processes of reproduction. And to the body, fertility and libido are the same. Like the body doesn't know the difference between you're trying to make a baby versus you want to just have some fun. Like to the brain and the body, it's all the same process. So if there's any inflammation or stress,
that's being picked up by the body, it'll go, wait, this is not the right time to reproduce and it will down regulate all those processes, libido being one of those things. so, know, with the patients I'm dealing with, the patients that I'm dealing with that are already in mid life and are already kind of running, know, their hormones are starting to like fizzle out. Now you throw something like alcohol on top of it that's now going to affect the gut. And now normally we're going to have more
Maureen Benkovich (15:57.169)
Interesting.
Maureen Benkovich (16:01.045)
Mm-hmm.
Dr. Betsy Greenleaf (16:13.802)
problems with hormone production because when you raise that's the other so sex and stress also can't coexist so the hormone pathway by which we make our hormones the hormones will pick one of two ways it'll go down and make testosterone and estrogen or in a stress state it'll make cortisol so they can't both coexist so anything that the body perceives as a stressor it's gonna go bloop let's go make some cortisol long term and then let's at the expense of the testosterone and estrogen
Maureen Benkovich (16:42.485)
That's interesting because ironically most people drink in response to stress, you know, to de-stress and yet it introduces cortisol, the stress hormone. Right. So Dr. Huberman talks about that so that even when you're not drinking like the next day or two, you're feeling an elevated level of stress because of those counter chemicals that are given off from drinking.
Dr. Betsy Greenleaf (16:43.095)
So.
Yes. Yes.
Dr. Betsy Greenleaf (16:50.71)
which is going to make the stress worse long term. It's going to actually raise cortisol.
Dr. Betsy Greenleaf (17:04.406)
And it's also interesting is that from a symptomatic standpoint, some people will report like, they wake up and they don't feel well rested. So then they're like, so then they caffeinate. And then at the end of the day, they can't shut their brains off or they can't relax. And so then they drink alcohol. When if we actually listen to what's happening is the can't getting up in the day in the morning usually equates to symptoms of low cortisol.
and the not being able to shut the brain off and not being able to relax at night correlates usually with high cortisol. So what happens with cortisol is naturally if everything's working properly it rises in the morning and it goes down as the day goes on. That's why we wake up in the morning and then we go and get tired as the day goes on. So that's the way the normal cortisol curve is supposed to happen. When people start giving these symptoms like I can't get up but then I can't shut off
they've actually flipped their cortisol curve and that is indicative of high stress, that the body is under stress. So, and now you add to that system, you add the alcohol and the caffeine, it's gonna worsen those stressors. So it's just gonna add to more of the issue.
Maureen Benkovich (18:03.347)
Right.
Maureen Benkovich (18:14.174)
Mm-hmm.
Maureen Benkovich (18:18.655)
just further aggravates that system being flipped. Yeah, that is so interesting. And I want to go back to the microbiome because you have a term that I've never heard of. So gut-brain-vagina connection. We always hear gut-brain. So now you've added that third segment. Can you tell us how that all works together and how alcohol interferes with that?
Dr. Betsy Greenleaf (18:21.706)
Yeah, yeah.
Dr. Betsy Greenleaf (18:30.71)
Yes. Yes.
Yes. Yes. we are, so we know that if the gut microbiome is off, that leads to systemic body inflammation, which then can lead to chronic disease. It can lead to low libido. It can lead to low hormones. But then more so for women, what ends up happening too is the, we're just going to go medical terms here. The anus is very close to the vagina and the vagina is very close to the urethra, which is the opening in the bladder. And it's very,
very easy for bacteria to get passed back and forth. So what happens is if the gut microbiome is off from stress, from inflammatory diets, from alcohol, any of those things, we get a buildup of these bad organisms, yeast, bacteria that are now in the anus, and it just happens to be very close to the vagina. So now the vagina becomes overpopulated with these quote, bad guys.
And then there's a number of things that can happen. Women at a higher risk of recurrent urinary tract infections, recurrent vaginal infections. Also, because the body is very smart, it goes, wait a minute, things are inflamed down there. It's not right. We need to shut down reproduction. So it will shut down fertility and libido. So this is another thing. People are always asking me about libido and they're like, you know, I'll just go to my doctor.
Maureen Benkovich (19:55.412)
I need a drink to get in the mood. Yeah.
Dr. Betsy Greenleaf (19:56.942)
Yeah, I need a drink to get in the mood and I need testosterone. Well, here's the thing. The drink is not going to, it's long term going to affect that. It'd it even, make your libido even worse. And the testosterone is not going to, like, even if you're taking testosterone supplements, it's not going to work if the body's not prepared for it. So if the gut microbiome is off, it's just, you're just going to convert it more into cortisol. And if the vaginal microbiome is off, it's going to
just cause more problems with cortisol. So it's gonna block that being able to use that testosterone for men and women. Men also kind of have this pelvic, gut brain pelvic connection. It's just a little bit different. I mean, they can get a feedback loop in the bladder and the prostate. So we're finding out that those areas which we used to think were sterile do become colonized over time with bacteria.
And more so we see if the gut is off in a male that they can have libido issues. But women have this added extra area that can now affect not only the risk of infections, but the risk of, of back libido issues. And then you throw, let's then, then you throw a woman into menopause and what happens is she has low estrogen. And because she has low estrogen, the vaginal tissue responds very well to estrogen. So when we're,
menstruating and were younger, the vaginal tissue is actively growing, it sloughs off, the dead cells, this sounds gross, but the dead cells contain glycogen, which is the food source for lactobacillus, which is the healthy bacteria that lives in the vagina. In return, that healthy bacteria keeps us healthy by producing peroxide. And so the peroxide acidifies the vagina. So a healthy vagina has a pH between 3.5 and 4.5.
when it's very acidic, the bad bacteria doesn't want to come in there and doesn't want to be there. So maybe the guts off of maybe it's not getting there because the vagina is being protected by lactobacillus bacteria. Now all of a sudden you throw somebody into menopause or let's say they're on birth control, which is even funnier and you're on birth control not to get pregnant, but then you don't have sex drive because the hormones of the birth control affect libido and now it also throws off the pH of the vagina. But
Dr. Betsy Greenleaf (22:15.862)
So now the vaginal tissue, because the lack of estrogen is not actively growing and basically lactobacillus starves to death. And so this is why women in midlife are much more prone to having issues with recurrent urinary tract infections, recurrent vaginal infections, odor, discharge, libido issues from this shift in the bacterial balance in the vagina.
Maureen Benkovich (22:38.719)
And does the fact that alcohol dehydrates you as well, does that also impact that area?
Dr. Betsy Greenleaf (22:42.798)
definitely, definitely. And especially too for bladder health, because that is something that people always forget and they think about, well, if I'm having a bladder problem, let me dehydrate myself because if I go less. But what happens is two things with alcohol in the bladder. Number one, it dehydrates. So when it dehydrates, it makes the urine more concentrated. When the urine is more concentrated, it's more irritating to the bladder. And then the other thing is
Maureen Benkovich (22:57.119)
Mm-hmm.
Maureen Benkovich (23:09.29)
Mmm.
Dr. Betsy Greenleaf (23:11.926)
some of the alcohol is actually processed through the kidneys. so alcohol is an irritant to the lining of the bladder. And so now in both men and women, we see an increased risk of not only bladder problems, bladder cancer, but also overactive bladder. They actually said that there's more people walking around in their 70s with overactive bladder at any given time than has the common cold.
And so an overactive bladder is more like, you you're sitting there, you're fine, fine, fine. And all of a sudden you're like, my God, I got to go, you know, and then hopefully you can hold it in, but sometimes you can't. So that, that is actually worsened by alcohol. So
Maureen Benkovich (23:47.338)
Yes.
Maureen Benkovich (23:56.692)
and you're doing some interesting treatments, Botox in the bladder. Can you, I love that story because then you're like, well, people are like, if there's something left over, you tell this story. That's so funny. But it's interesting that you use Botox in the bladder. Can you talk about that?
Dr. Betsy Greenleaf (24:00.368)
Yes, yes.
Dr. Betsy Greenleaf (24:07.036)
Art!
Yeah. So Botox everyone thinks is just a wrinkle reduction medication, really it is the only way to say it. There's no nice way it paralyzes muscle. So why we put it in the face is if you can't move the muscles to make the wrinkles. So we've been putting it into the bladder and to the pelvic floor since the early 2000s. because what happens with, especially with overactive bladder is over time, the
Maureen Benkovich (24:25.981)
Right. I'm like,
Dr. Betsy Greenleaf (24:38.158)
The bladder is just a giant muscle bag. And then what it does is as it fills up, it gets to a point where it realizes it's full and it sends a message to your brain that you have to go. And then hopefully the plan is you calmly walk to a bathroom and then your urethra will open first, which is a tube you pee through and the bladder as a muscle will just push everything out. So you don't have to actually do the pushing, which is another thing that yeah.
Maureen Benkovich (25:03.679)
Right, you don't want to push.
Dr. Betsy Greenleaf (25:05.803)
So what happens sometimes is over time for whatever reason and alcohol being one of the causes, not always, there's always other things that can cause the bladder to start spasming. And so we get really thick bands in the muscle of the bladder and then it doesn't expand the way we want it to. So one of the treatments for overactive bladder and that frequency and urgency is to actually go in with a little scope and inject those muscles.
with some Botox just to relax them so they're not spasming. Yeah.
Maureen Benkovich (25:38.645)
Yeah, and you think about the adult diaper market. I can't imagine how much money and how much money people spend. Instead of just saying, well, I guess this is what happens when I hit this certain age. I just start wearing diapers again. Now there's an alternative to get Botox.
Dr. Betsy Greenleaf (25:41.878)
Yes!
Dr. Betsy Greenleaf (25:45.506)
millions and billions.
Dr. Betsy Greenleaf (25:50.562)
Yeah.
there's so many alternatives. When I came out of training, there was like two medicines on the market. Now I can't keep track. There's like eight medicines. There's an acupuncture option. There's the Botox. So there's even actually a pacemaker that can, and a little electric pacemaker that can be implanted that helps with bladder control. So we have a lot, a lot of different options, but the easiest thing is drink more water and stay away from inflammatory foods like alcohol.
Maureen Benkovich (26:00.404)
Right.
Maureen Benkovich (26:22.229)
Right, and that's what I'm thinking. If you're going to go and get Botox injected in your bladder and you continue to drink alcohol, because I'll just back up for a minute so you know, a large part of my population are women who are grandmoms or they're living in these retirement communities and it's like a frat party at a lot of these places and the amount of alcohol that is being drunk is more than their adult children. They tell me this.
Dr. Betsy Greenleaf (26:29.089)
Yeah. Yeah.
Dr. Betsy Greenleaf (26:39.566)
Oh, I know. I know.
Maureen Benkovich (26:46.779)
and they're all taking medications and struggling with overactive bladder and UTIs and not making that connection. And you keep saying it, you're like, you know, it's one of the easier things to remove. We have all these other things that can cause overactive bladder and UTI, but alcohol is one of the things that you can consciously realize, wow, this is adding to these problems.
Dr. Betsy Greenleaf (27:07.212)
Yeah, definitely. Definitely.
Maureen Benkovich (27:08.809)
Yeah, yeah, that is so interesting. tell the, so I think this is how you got into aesthetics then because people were like, well, can you put some of that in my face?
Dr. Betsy Greenleaf (27:15.914)
Yeah, exactly. That's exactly how I got into aesthetics because people were like, if there's any leftover for my bladder, can you put it in my face? And I was like, I don't know how to do that. So I went and got the training in that. And then I was like, well, then I can do it to myself now.
Maureen Benkovich (27:28.748)
That's what I mean. You're so amazing. You're like, I don't have that certification. I'll just go get that. Yeah. And you say that, you know, keep learning. I was looking at one of your Facebook posts. Just keep learning. You really love to learn.
Dr. Betsy Greenleaf (27:41.206)
Again, I wish they would pay me to learn that would be so much. I would just keep going to school forever. And then also right before we came on, we were talking about like, I, you know, I kind of knew from a standpoint of like medicine and I had read the articles and I knew alcohol was, was not great, but I, it wasn't until I got the whoop band and I know like, I'm not a spokesperson for them or anything, but like, I know there's other trackers that people are using, but all of a sudden I was like, my.
Maureen Benkovich (27:43.125)
Wouldn't that be nice?
Maureen Benkovich (28:01.205)
Mm-hmm.
Dr. Betsy Greenleaf (28:10.584)
God, one glass of wine. I couldn't believe how much it affect my sleep quality on my tracker, my heart rate variability, like tanked, my like oxygenation, my, whether I was getting into a deep sleep, I think, I don't even know if I can bring it up on this video. I know some people may be watching the video or some people, but if you can see, I, the other day we had gone out with family and that red dot was the night.
Maureen Benkovich (28:22.025)
Yes.
Maureen Benkovich (28:36.074)
Yes.
Dr. Betsy Greenleaf (28:39.502)
that I had had like the morning after I'd had a glass of wine at dinner. And I was like, every time I'm like, oh no, can't bother me that much. And I do this and I'm like, see how much it tanks my health. I'm like, yeah, no, it's not even worth it anymore. Yeah.
Maureen Benkovich (28:43.157)
Mm-hmm.
Maureen Benkovich (28:55.519)
So you did exactly what I try to share with people. Get informed and you informed yourself because you're a learner and you have wearable tech and you noticed that. So intellectually, you said you've read all the articles, you know it's quote unquote bad for you, but how does that affect you now seeing it actually on your own real time what it's doing to you?
Dr. Betsy Greenleaf (29:12.712)
it just makes me go, you know, it's just not worth it. It's like, know, I mean, I was already in midlife starting not to like be able to handle alcohol like I did when I was younger. And I would argue we probably shouldn't even start that when we're younger. It's just just not a good thing that we should be doing. But he really hits you a lot more when you're older, you know, and the recovery is the next day is not worth it. But now when I just see like
Maureen Benkovich (29:15.657)
Mm-hmm.
Maureen Benkovich (29:28.885)
Right.
Maureen Benkovich (29:32.693)
Mm-hmm.
Dr. Betsy Greenleaf (29:39.04)
I used to think like, just one glass is not going to make that big of a difference. And now when I see it on the tracker, I'm like, you know what? I'm trying to be healthier. I'm trying to lose weight. I'm trying to get rid of all the body aches and pains. That one glass really makes, tanks everything. And it may be throwing my microbiome off for like a week or so. So I'm like, it's not worth it. So now, you know, if I'm out with friends and family that are
Maureen Benkovich (29:49.183)
Mm-hmm.
Maureen Benkovich (30:00.277)
Mm-hmm.
Dr. Betsy Greenleaf (30:06.136)
that are drinking, always go for, know, like there's a lot of different non-alcoholic options, especially, I actually like some of the, like the hop water or the non-alcoholic beer or, you know, or I'll even just like do like seltzer with some bitters. Bitters are really, really good and they're very healthy for your gut. We as Americans don't get enough bitter into and actually the bitter,
Maureen Benkovich (30:10.933)
There are, yeah.
Maureen Benkovich (30:18.517)
Mm-hmm.
Maureen Benkovich (30:24.137)
Yeah, I like them too. Yeah.
I didn't know that.
Dr. Betsy Greenleaf (30:33.25)
The physiology of bitter on the tongue actually helps to suppress appetite. So when you put some like bitters into like, you know, seltzer or club soda or whatever, you're actually going to be helping yourself from overeating. yeah, and it's kind of the way it's actually is almost like an herbal like GLP one.
Maureen Benkovich (30:46.953)
I think I just heard everybody go out and buy some bitters.
Dr. Betsy Greenleaf (30:56.142)
or these GLPs is the effect of bitters. And that's why actually we don't see it as much in our culture. We don't incorporate a lot of bitter foods into our, into the American diet, but they're doing a lot of research on bitter foods and it having these GLP type of herbal effects. There is a, there's a product on the market that's like an herbal GLP. It's, it's actually hot. It's made from hops.
Maureen Benkovich (31:22.89)
Mm-hmm.
Dr. Betsy Greenleaf (31:23.488)
and hops being a bitter, but you can get the hops through these non-alcoholic beers or the non-alcoholic, you know, the hop waters, which are completely non-alcoholic. So.
Maureen Benkovich (31:32.925)
I love to hear that because that helps people have an additional motivational reason why to try some of these non-alcoholic options with bitters or the hop water. Yeah. The de-alcoholized industry, the beers are probably some of the best and then any of the wines that have bubbles in them, anything that, you know, has the bubbles, the wine is furthest behind. Most people are disappointed with that. But do you...
Dr. Betsy Greenleaf (31:40.64)
Yes. Yes. Yeah.
Dr. Betsy Greenleaf (31:56.61)
Yeah, I've tried them. don't taste as good and they still have a lot of sugars in them, which I'm like, you know, but I yeah, they are definitely they are definitely working on it. So.
Maureen Benkovich (32:00.583)
Yeah, but they're working on it. They're going to get there.
And do you find when you're out with your friends and you're having a non-alcoholic option that you realize it doesn't matter what's in your glass to other people, you can still have a good time?
Dr. Betsy Greenleaf (32:15.124)
Exactly, exactly. And even though I remember like being almost self-conscious with the non-alcoholic beers, which is silly, I you know, I'm in my 50s, why should I be self-conscious about what I'm drinking? But I, but like nobody ever notices. And like, I think too, you know, because of the whole biohacking industry and the people being more healthy, I think it's definitely more socially acceptable. And people aren't like, aren't you drinking? You know, I think in the past there was more of that question. Now people are like,
Maureen Benkovich (32:19.497)
Mm-hmm.
Maureen Benkovich (32:41.109)
Mm-hmm.
Dr. Betsy Greenleaf (32:42.754)
you know, especially if you're trying to lose weight. mean, which I think there's a good number of people who are struggling with that. Why would I want to throw off my microbiome when we know that here's from an obesity standpoint, the people who are obese, it's not a willpower issue. It's not a food issue. A lot of times it's a hormonal and microbiome issue. And the studies have shown that the microbiome of people who are obese is not the same as people that are thin.
And fact, they actually did a study where they took twins, where the one twin was thin and the other twin was heavy. They took the microbiome from each one of them. They gave it and fed it to mice. The mice that got the microbiome from the twin that was heavy, that mouse became fat. And then they reversed the diet. The thin mouse stayed thin. And then they reversed the diet and the fat mouse became thin and the thin mouse became fat. And it was all just based on the microbiome.
Maureen Benkovich (33:09.109)
Wow.
Maureen Benkovich (33:35.132)
interesting.
Dr. Betsy Greenleaf (33:35.666)
So that's another thing when I look at a glass of wine or a cocktail, I'm going like, do I want added weight on me? No, I don't. So sometimes blood pressure might not be as motivating as like, I can get into those genes.
Maureen Benkovich (33:50.558)
Right.
Maureen Benkovich (33:54.24)
Well, and it's also true that when you're drinking alcohol, your liver has to prioritize, now we've got to get rid of this toxin. So the food you're eating, the nutrients are not going to get absorbed. So that's another problem with that. And people don't realize that because we've all been conditioned to think, wine pairings, this wine goes with this food, but really it interferes with that.
Dr. Betsy Greenleaf (34:00.738)
Yeah. yeah.
Dr. Betsy Greenleaf (34:14.05)
Yeah, and in fact, there's just completely empty calories. I mean, you're adding calories that have no nutritional value on the body. And it's so funny because every January, I see my friends do this all the time. Everyone does dry January. They all drop weight like crazy during that month. But then in February, they pick back up. And I'm like, guys, why you just gave it up for a month? Why don't you just keep going?
Maureen Benkovich (34:16.788)
Mm-hmm.
Maureen Benkovich (34:38.151)
Yeah, that's what I try to encourage people to do, to notice how good they're feeling and be curious about why don't you continue past dry January for a little bit and see how much better you can feel. Yeah, I mean, that is a phenomenon you bring up and I did it when I was drinking, I'd be like, I want to drink my calories and a lot of women will start off with drinks and then they don't really eat. Either they overeat later on when they get home or if they don't really eat at the bar. So that has such a negative effect.
Dr. Betsy Greenleaf (34:45.772)
Yeah, exactly.
Maureen Benkovich (35:04.133)
alcohol on an empty stomach I would imagine really affects the microbiome and the gut lining.
Dr. Betsy Greenleaf (35:09.102)
Oh, definitely, definitely. It's just gonna, you know, basically kill off everything healthy. So, and you know, you bring up an idea too, is that I know because of it reducing your inhibitions, I would notice that I'd be really good at keeping to my diet all week. And then I'd go out in the weekends with friends and have a glass of wine. And then all of a sudden, inhibitions are gone. And I'm like, give me that hamburger, give me that cheesecake, you know, what I probably wouldn't have made that decision if I didn't.
Maureen Benkovich (35:36.735)
Mm-hmm.
Dr. Betsy Greenleaf (35:38.894)
about calling me.
Maureen Benkovich (35:39.357)
Yeah, exactly. Yeah, again, back to, you know, being fit and healthy and not putting on extra weight. Alcohol definitely makes you eat the cheeseburgers. And then that whole myth about the next day, if you're hungover, go ahead and eat greasy foods. That really is not helpful.
Dr. Betsy Greenleaf (35:54.188)
You know, and I was thinking too with like for men, we know that well, just alcohol in general can raise estrogen levels, it's going to affect test, it's going to lower testosterone and raise estrogen. For women, this is not a head of one of my patients once go like, since it raises estrogen, can I do that as my hormone, my hormone therapy? And I'm like, no, it doesn't really work that way.
Maureen Benkovich (36:03.54)
Right.
Maureen Benkovich (36:11.093)
Because isn't it it raises the wrong ester estrone isn't it that yeah
Dr. Betsy Greenleaf (36:16.554)
Yeah, yeah, and it also helps with conversion of estrogen and fat. And then it's also affecting how we detoxify our estrogen because we detoxify estrogen down three different pathways. And two of those pathways are healthy and one is not. And if we're going down the not healthy pathway, now we have an increased risk of it damaging your DNA, which could potentially lead to cancer. So that's why actually
alcohol consumption is directly related to increased risk of breast cancer, prostate cancers, anything of the hormone related cancers. But you know, for men too, with lowering their testosterone, increasing their estrogen, we see, know, in heavy drinkers, men get, they get the man boobs and you know, that's not a look that people are typically going for. So, you know, think about like every time you drink, you could be adding to, you know, some breast tissue as a man and that's not, not great.
Maureen Benkovich (37:00.201)
Yeah, man boobs.
Maureen Benkovich (37:10.377)
Yeah. You hear that man?
Dr. Betsy Greenleaf (37:12.662)
Not a great way to build breast tissue for a woman.
Maureen Benkovich (37:16.917)
I'd like to get your opinion on this because, you we're talking about this not to scare people, but to inform them. If you're caring about longevity, you're trying to take care of yourself, you need to take a look at alcohol and what it truly does. But why do think it is that we can intellectually know all this stuff? We can read it and yet we choose to disregard it.
Dr. Betsy Greenleaf (37:38.467)
I think there's still a lot of societal kind of pressures, know, I see it sometimes, you know, because alcohol has been used in celebration. So you know, it's used very socially. Same thing as like, you know, how food can be used socially. I mean, we need to eat to live, but we don't need to drink to live. So, but it kind of gets stuck in that like part of all this is like the social norm and this is what happens. So, you know, I have
Maureen Benkovich (37:48.085)
Everything.
Maureen Benkovich (37:59.03)
So good.
Dr. Betsy Greenleaf (38:08.362)
I'm going to throw them under the bus. Here we go. Hopefully they won't listen to it. I have in-laws who my father-in-law has always, as long as I've known him, had a glass or two of alcohol at night. And so did his dad and his mom. so I see it sometimes run in families where it's like, okay, this is just what you did and this is what you do at the end of the day. so I think it's...
Maureen Benkovich (38:18.121)
Mm-hmm. Mm-hmm.
Maureen Benkovich (38:31.561)
That's that neural pathway though. It's that you've created that association.
Dr. Betsy Greenleaf (38:37.23)
Yeah, so I think part of it is just breaking some of those habits and those associations and replacing it with something else. you know, yeah, because otherwise, you know, if you just sometimes if you just go cold turkey, people are like, ah, what do I do? Like, what do I, you know, like if I had a glass of wine every night, you know, while I'm watching TV and now you're like, all right, well, I don't have that association or that trigger.
Maureen Benkovich (38:40.009)
Yes.
Maureen Benkovich (38:45.331)
Yes, you got it. Replace. have to replace.
Maureen Benkovich (38:54.237)
yeah.
Dr. Betsy Greenleaf (39:04.502)
to like be this is relaxation time. It's like, it's a trigger that's telling the brain, but you can replace that trigger with other things. mean, anything you want, you just have to make that association be like, okay, every time, I mean, this is gonna be extreme, but every time I sit down, I'm gonna have some warm milk and like, you know, and that's gonna be relaxed. And you probably get more from the warm milk than, because the tryptophan's that are gonna help with sleep, but.
Maureen Benkovich (39:09.375)
Yes.
Yes.
Maureen Benkovich (39:26.687)
Yeah.
Dr. Betsy Greenleaf (39:30.86)
Yeah, there's also this idea, I think because alcohol also makes people feel sleepy, they think it's going to help with sleep. in reality, it just worsens the whole sleep cycles and you don't get into a deep enough restorative sleep when alcohol is involved.
Maureen Benkovich (39:35.679)
Mm-hmm. Yes.
Maureen Benkovich (39:44.842)
Yeah. And sleep hygiene or sleep architecture has become a whole big study, especially with the wearable tech. People are seeing it, like I said, in real time and seeing, it actually negatively impacts my sleep. It's sedation. It's not sleep.
Dr. Betsy Greenleaf (39:50.637)
Yes.
Dr. Betsy Greenleaf (39:59.843)
Yeah. and that brings up, so when I'm thinking about sleep, I'm also thinking about men and men normally if things are working below and they're healthy, they should be getting erections when they're sleeping. so, and waking up with erections, that's a sign that everything's working normally. So if they start waking up, number one, they're not getting deep enough sleep, but then the alcohol itself can affect blood flow.
Maureen Benkovich (40:00.884)
Yeah.
Maureen Benkovich (40:22.549)
Mm.
Dr. Betsy Greenleaf (40:25.406)
that not only are lack of morning erections a giant red flag that there's a bigger problem going on, but they not only can be related to the alcohol and blood flow, but it could also be related to a heart condition or cardiovascular condition that's starting that just hasn't gotten bad enough that you notice it anywhere else. So I always tell men like your penis is the giant red flag. If something's going on down there,
Maureen Benkovich (40:49.065)
No pun intended. Yeah.
Dr. Betsy Greenleaf (40:51.112)
and this is what drives me insane. It drives me insane that people can go online, put their information in, never see a doctor and get prescribed Viagra or any of those medicines and or hormones. When honestly, especially for men, it happens with women, we just don't have it's not as obvious. like if something is going on down there, it's a sign that there's a larger issue going on.
Maureen Benkovich (40:58.452)
Right?
Maureen Benkovich (41:04.127)
Mm-hmm.
Dr. Betsy Greenleaf (41:17.248)
and throwing Viagra and hormones at it is not going to make it better. And in fact, from the time a man starts having erection problems, starts losing those morning erections, it's about 10 to 20 years to a major cardiovascular event. like any of my patients that come in, because we do treatments for erectile dysfunction, and when they come in, unfortunately, you just bought yourself a trip to the heart doctor because we need to make sure your heart is functioning.
Because if your heart's not functioning, your penis definitely is not going to. Like, if you're dead, who cares about the penis? Yeah.
Maureen Benkovich (41:47.342)
Interesting. So you treat people holistically. Yeah, you look at holistic. my gosh. I'm so glad you're saying that. And that's why they need to come see you at the Pause Institute. Now I understand why you call it Pause because it's for men and women.
Dr. Betsy Greenleaf (41:58.242)
Yes, yes.
Yeah. And also, mean, sometimes they're like pause and it's pause like stop, like not like pause like animal feet because sometimes when people hear they're like, what? It's because it's menopause, andropause, but also because I look at things from a whole body mind, spirit standpoint, like sometimes we just need to take a pause. Like life gets stressful, you know, and you know, even from a standpoint of relaxation, like doing breath work is far more important for stress.
Maureen Benkovich (42:08.358)
Yeah.
Maureen Benkovich (42:24.757)
Mm-hmm. Yes.
Dr. Betsy Greenleaf (42:30.506)
response than a glass of alcohol. So just taking some deep breaths, even just four deep breaths can really reset your nervous system way better than any kind of alcohol would ever do that.
Maureen Benkovich (42:32.404)
Yes.
Maureen Benkovich (42:44.053)
Yes, yes. And that's one of those things to replace alcohol with. We've given alcohol the job of relaxing us and really we have our breath with us all the time. It's portable. We can do it anywhere. It's free. And if you learn, there's so many breath techniques. So I love that you brought that up. And I want to talk a little bit about your podcast because you named it, why did you name it 40s Forward?
Dr. Betsy Greenleaf (42:49.002)
Yes.
Dr. Betsy Greenleaf (42:54.568)
It's free.
Dr. Betsy Greenleaf (43:00.512)
Yeah, yeah.
Dr. Betsy Greenleaf (43:07.618)
Yeah, I needed to get 40s forward because 40s is like the cutoff where things start to happen. So not that everything's going downhill or people are falling apart after the age of 40, but we know from a lot of medical research that on average 40 is where testosterone is starting to decline, estrogen in women is starting to decline. So this is where people are starting to potentially enter perimenopause, that pre-andropause.
And this is where people start to complain that these aches and pains and things are happening in the body. At the same time, you have a cumulation of everything coming together where people are now potentially in the middle of their careers or now very established in their careers. So now there's maybe different type of work stress.
Maureen Benkovich (43:47.765)
Mm-hmm.
Dr. Betsy Greenleaf (43:57.391)
you know, in the 40s and even to the 50s, we're starting to see things where, you know, you may be taking care of kids that are going off to college, but then you're also dealing with parents that are elderly. So like 40s is the start of a lot of different stressors. So it's really, I mean, I take care of people over 40, but it's really the 40s is where it's all starting to change.
Maureen Benkovich (44:05.983)
Yes.
Dr. Betsy Greenleaf (44:19.726)
And so I really wanted to focus on health and life for people over the age of 40 and how we can kind of normalize all the stressors and optimize our health so that we're living into our 50s, 60s, 70s, 80s, 90s and beyond. So, yeah.
Maureen Benkovich (44:35.477)
Yeah, and that's I think is important because in 40s, I was drinking a lot in my 40s. And I wasn't taking any hormone replacement because I'm part of that generation that missed out on that. It wasn't until later that I started taking hormone replacement. But I think it's so important that you're pointing out, even though you guys feel pretty invincible in your 40s, it's actually when you should really start looking at this to be preventative and longevity because we are living so long. So how do you want to live into your 60s, 70s and beyond?
Dr. Betsy Greenleaf (44:39.714)
Yeah.
Dr. Betsy Greenleaf (44:48.655)
sure.
Dr. Betsy Greenleaf (45:04.066)
Yeah, definitely.
Maureen Benkovich (45:05.299)
Yeah, so everybody go listen to that podcast. And also you said, just because you don't have enough to do, that you're working on an app.
Dr. Betsy Greenleaf (45:12.83)
Yeah, I'm so excited. And in fact, actually, if you're if you're listeners, listen, use it, I'm it's not officially out, but it's out enough for people to try it. So I need your help to help me work out the kinks and like tell me where is it not working? How could it be better? So if you go to pause labs, so P A U S E and then labs L A B S dot health.
Maureen Benkovich (45:25.557)
Okay.
Dr. Betsy Greenleaf (45:36.463)
you can actually get a hormone tracker. So it tracks not only your hormones, but your symptoms. You can track your food. You can track your stressors. Maybe I'll add some. I've got to figure it Yeah. And so it'll track all of that. And so because this is the other thing, hormone levels by themselves don't mean anything. And because menopause has become very popular, I'm seeing people, you know, and like I said, anybody can go get hormones online now without ever seeing a practitioner.
The hormones are just a tool. They're not a panacea. Even hormone levels, labs don't mean anything by themselves unless we combine it with looking at your symptoms. This is what I've learned over years of doing this with patients. If we track their symptoms and their lab values over time, we actually got the real picture of what was going on. There is an AI component for educational purposes. It interpret things for you and make suggestions.
Maureen Benkovich (46:24.233)
Mm-hmm.
Dr. Betsy Greenleaf (46:32.0)
not medical, have to say it's for educational purposes only make sure you actually see your real practitioners. But if you go to pause labs that health and sign up and then use the code sober fit, that should get you three months of the app for free. So you can try it out. Let me know what's going on. And if you love it at the end of three months when we release it, let me know and contact me and we'll get you something. We'll get you another code for a discount.
Maureen Benkovich (46:58.073)
I'm definitely signing up for that. I'm putting it in the show notes so everybody can go find that app and be a part of this. I wonder if in the future you could add something that shows how alcohol affects hormones just to throw that in there.
Dr. Betsy Greenleaf (47:03.713)
Yeah
Dr. Betsy Greenleaf (47:08.842)
You know what? I know I was just thinking about that. was like, ooh, how do I add that in there?
Maureen Benkovich (47:13.245)
Yeah, because as you can see from your own experiment, when you can see it yourself, what's happening with you, that's powerful information. I could talk to you for hours. You have so much information. Everybody go check out Dr. Betsy Greenleaf's website, listen to 40s Forward, and let's get that app. So remember, it'll be in the show notes. And I can't thank you enough for coming on to Sober Fit Life. So appreciate your time.
Dr. Betsy Greenleaf (47:17.793)
Ex-
Yeah, exactly.
Dr. Betsy Greenleaf (47:37.707)
I appreciate this was so much fun. Thank you, Maureen.
Maureen Benkovich (47:40.266)
Thank you.
