Hysterectomy, Hormones, and How Cannabis Can Help Manage It All

In this episode, you will meet Melissa Groves Azzaro, The Hormone Dietitian, who shares her personal journey of exploring the healing properties of cannabis after recovering from her own hysterectomy experience. We discuss the role of cannabis in managing the challenges of post-surgical pain and how CBD can act as a natural hormone balancer for women and enhance overall well-being.

Features

• Release Date: Wednesday, August 16, 2023
• Episode Number: Season 1, Episode 41
• Special Guest: Melissa Groves Azzaro, The Hormone Dietitian

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Full Transcript

Melissa: I think of it as just another herb and always recommend herbs and adaptogens. I’m recommending Reishi, Ashwagandha, Tulsi, and all of those things, and it’s just another herb. They all do different things, which is what this one can help with.

Announcer: Welcome to the Well With Cannabis Podcast, a show dedicated to telling the life-changing stories of those who live well with cannabis all while teaching you how to do the same. Meet your host, Emily Kyle, a registered dietitian nutritionist turned certified holistic cannabis practitioner. Emily changed her life for the better with the help of the cannabis plant, and now she’s committed to helping others do the same.

Tune in each week to hear heartwarming stories and gain the knowledge you need to feel connected, inspired, and supported on your own cannabis journey. Whether you’re a new cannabis consumer or a lifetime lover, you’ll benefit from these uplifting tales of real-life journeys that will show you how you, too, can live your best life well with cannabis.

Disclaimer: Hi there. Before we jump into today’s episode, I wanted to share a note on potentially sensitive content. The episodes on the Well With Cannabis Podcast are created for adult audiences only. We will, at times, cover sensitive topics, including but not limited to suicide, abuse, mental illness, sex, drugs, alcohol, psychedelics, and the obvious use of plant medicine. Explicit language may be used occasionally. Please refrain from watching or listening to the show if you’re likely to be offended or adversely impacted by any of these topics.

The information on this show is for informational and educational purposes only. It does not constitute medical advice. If any of the content on this podcast has brought up anything for you, please reach out or speak to a professional or someone you trust.

Emily: Hello, and welcome back to another episode of the Well With Cannabis Podcast! I’m so excited for this episode. After over 30 interviews, this is the first time I’m interviewing someone I actually know and who is not a complete stranger. I’m so excited to welcome Melissa Groves Azzaro. She’s a fellow registered dietitian nutritionist, and we bonded in that part of our career. It’s been a couple of years. I’ve been so lucky to be a guest on her podcast, Hormonally Yours with the Hormone Dietitian. I am really excited to let her talk about her personal and professional experiences with cannabis with you today. Melissa, welcome. Thank you so much for joining me today. 

Melissa: Thank you so much for having me. I’m excited to chat. 

Emily: I am sorry you recently underwent a big health change. You were always working originally as a registered dietitian nutritionist, focused on women’s health and hormones. Is that correct?

Melissa: Yeah, I’m a second-career RD. For the last five years, I’ve had my practice, The Hormone Dietitian, where I specialize exclusively in women’s health and hormones. I work primarily with people with PCOS (polycystic ovary syndrome). I do not have PCOS. I have had other hormone imbalance issues throughout my life, and that’s what we’ll be talking about today. 

Emily: As dietitians, of course, we have to talk about our health and profession, but I’m going to put that on the back burner, and I really want to talk on a personal level. Everybody is sharing how cannabis has helped them in their real life, and you have a new story to tell. So if you’re ready, tell us a little bit about your relationship with cannabis. 

Melissa: Yeah, I think, to put it in a bit more context, I’m an integrative and functional dietician. I’m looking at things like root causes; I’m considering all avenues of treatment when it comes to the person as a whole. In my professional perspective, cannabis is an herb, just like any other adaptogens or herbs I would recommend in specific circumstances. And we know the benefits of cannabis being anti-inflammatory, helping with mood and sleep.

Melissa: It’s always been something that I’ve not hesitated to recommend to my clients and I think they’re always surprised when I bring it up. If they’re struggling with something like endometriosis or really painful periods, I’ll ask them if they have tried cannabis and does it help them. Nobody’s ever asked them that before or brought it up as something they might want to try, so it takes a second to recover from the shock. 

Melissa: My personal relationship with cannabis, let’s see… Going back to college, that was the first time I had ever tried cannabis; I think that’s pretty common. Most people try it in college. I think my first impression – and I think we talked about this on my podcast – but my first impression was that my friend had a little wooden bowl, so it tasted very smoky to me. At that time, I mostly was eating plant-based, and I… smoked is not a flavor that you get a lot in the vegetarian world. And so my first comment was that it tastes like ham. 

Emily: Oh my gosh, I don’t know if it tasted like ham; I don’t know if I could go back for a second try.

Melissa: I know, it’s just that weird smoke. So, it’s always been there; it was never a large part of my life. It was always occasional usage for relaxation more than anything. I’m very high cortisol, high dopamine, high anxiety kind of person. What I have found in my own personal life with cannabis as opposed to something like anti-anxiety medications like Xanax or even alcohol, which wasn’t helping matters, is the day after something like that, you get a worse anxiety hangover. I’ve noticed that for myself, and part of what got me weaned off all anti-anxiety meds is I feel worse the next day.

Melissa: Whereas with cannabis, you can take a little bit, take the edge off, and the next day you wake up and live your normal life. You get up; you exercise, you eat breakfast. It’s not like having a hangover, or you do not have that rebound anxiety that you can have with some of the pharmaceutical medications that can help with anxiety.

Melissa: So that’s been my personal experience. What’s been happening recently, and it goes back about four years, my gynecologist found polyps in my uterus, and she was like, “Oh, we’ll just go in. We’ll nip them out. They’ll be gone. There won’t be a problem.” I went in for the little hysteroscopy surgery; it’s basically like a D&C. They go in, and you go home the same day. It’s not very painful. Two weeks later, I went in for the post-op follow-up, and the look on her face… You know it’s bad if a doctor can’t hold their bedside manner, like a straight face, and the look on her face was just like a shock.

Melissa: And she was like, “I have some really bad news. They took out the polyps, and the pathology came back questionable.” And asked her what she meant by questionable. She said it came back. It’s endometrial intra-epithelial neoplasia, which is basically endometrial hyperplasia complex atypical hyperplasia is what they used to call it, and now they call it EIN. They couldn’t rule out adenocarcinoma stage one. 

Melissa: They took my slides, and the pathologist at the hospital where I had the surgery read them and sent them to me. They sent them down to Johns Hopkins. I’m still getting bills from Johns Hopkins from the pathology department for reading these slides.

Melissa: So I asked her what all that meant, and she recommended that I immediately book an appointment with a gynecologist oncologist. I went to this female gynecologist oncologist who was Harvard educated, with the hair and the nails and the high heels, and she recommended an immediate hysterectomy. At this point, I was 41 or 42; I was still having regular periods and wasn’t really having any issues. It wasn’t like I was bleeding heavily. Now, doing what I do, my periods are better than they’ve ever been in my whole life.

Melissa: I asked her if she wanted to do further texting to make sure it was cancer before she took out a properly functioning organ. Her response was that if I wanted kids I should have IVF immediately and then have a hysterectomy when I was finished having kids.

Melissa: That was not an answer I was willing to live with at that point. Because of what I do with hormone nutrition and lifestyle support, I was able to see that my cancer-causing estrogen was at 19%, and it should have been below 11%. After about six months of changes, I got it down to 3%. I eat broccoli sprouts like it’s my job, so I really cut down the risk. It took me a really long time because of a lot of complexity with health insurance and what was covered and what was not going to be covered.

Melissa: I got a second opinion. Surprisingly for me, because he is a male doctor, he totally agreed with me and thought a hysterectomy and IVF were ridiculous. He wanted to do a D&C to scrape everything out and see what was there before we made a decision about how to move forward. I agreed.

Melissa: This was around when I was getting married, so I was transitioning onto my husband’s health insurance. He wasn’t covered, and I knew my past surgery cost about $18,000. I could afford $18,000 out of pocket for a D&C, so I had to wait. Then COVID happened. Mine was the last elective surgery that day. It was March 16th. I had a D&C at the local hospital with the second doctor, and he found nothing. He found some abnormal cells, but he didn’t find any cancer. 

Melissa: He suggested that I go in every six months for an in-office endometrial biopsy. It’s basically a spot check to see if anything is progressing. We proceeded like that for another, I think I went in three different times with him, and then we moved across the state. 

Melissa: Now we live 2 hours away, and since I wasn’t happy with my regular gynecologist there, I established care with another GYN. We’re close to Dartmouth Hitchcock, a big teaching hospital. My father-in-law was treated for cancer up there, and I feel very confident in the care there. I had to wait about six months to get in with the GYN there.

Melissa: I got COVID in March of 2022, so I couldn’t see her until May 2022. I waited to see her because I knew she was good and would trust her opinion. She was happy to continue what we were doing, which is the endometrial biopsy every six months, to see the results before we decide whether we are moving forward with the hysterectomy. She was very clear with me.

Melissa: My recommendation did not change. She recommended a hysterectomy. That is because 97% of EIN turns into uterine cancer within a year. I was determined to be that 3%. I was adamant that it was not going to happen to me, but this was always hanging over my head.

Melissa: And now, every six months, I have to drive an hour and 45 minutes up to this hospital, have this painful biopsy that they give you no anesthesia for,  and I can’t even pop a CBD on the way up there or back because I’ve got to drive myself an hour and 45 minutes. 

Melissa: It got to the point where I realized that there’s never a great time to undergo a huge surgery like this. But this isn’t a terrible time. Business is always quiet through the holidays. My husband works in education. He has the best health insurance. I was not going to end up paying $18,000. I’m going to end up paying like $50 out of pocket for this surgery, so I might as well do it. For me, it was preventative, but it was also a big relief to have it off my mind. 

Melissa: Part of the other continuum is when I was 41, I was less far into perimenopause than before the surgery. And once I had started to experience that, my periods were all over the place. They’d be missing for three months, every 14 days. What’s happening here? At that point, I was a little more willing to do it.

Melissa: Unfortunately, once that C word (cancer) is on your chart, the procedure is considered a radical hysterectomy. It’s the most radical surgery that they do. They basically take everything. Everything. They take the ovaries and tubes. She definitely recommends that with that surgery, you get the uterus, the cervix, and the fallopian tubes. She was 50/50 on taking the ovaries. She brought up all the risk factors with taking the ovaries at my age (46): bone density, heart disease risk, dementia, and, because of who I am, because I’m a dietitian, I decided that I could manage those risks.

Melissa: My biggest thing was, that I didn’t want to be back there in 5 years with breast cancer. So if you’re going in and you’re taking everything, you’re taking everything. I wanted the ovaries gone. So we did everything and she agreed with that. The most recent science supports menopause hormone replacement therapy up to the age of 50. For the next few years, I’ll be on a low dose of estrogen. I’m managing the cardiovascular risks myself. I was like, “You don’t understand how many vegetables I eat. Like it’s not a problem.” I’ve started lifting weights for the bone density risks. I don’t love it, but I know I have to do it. So I’ve started doing that. But this was a major surgery.

Emily: A major surgery. 

Melissa: There are different types of surgeries. With a radical hysterectomy, you would think that they would have to open your abdomen, but it goes based on the size of your uterus. My uterus was only about a third enlarged over what it should be, so they were able to go in vaginally with laparoscopic assistance. If you are undergoing laparoscopic surgery, they send you home the same day. And they gave me five oxycodone pills. And that’s it. 

Emily: That’s it? 

Melissa: That’s it. 

Emily: They send you home and say, “Here’s your five oxycodones. Good luck?” 

Melissa: Yeah. 

Emily: I’m shocked. If you’re just listening and not watching, I’m shocked. That is mean. What did you say? 

Melissa: I just did my “doctor’s office smile and nod.” And then, I instantly came home and started researching. So, knowing how much cannabis can help, especially with menstrual pain, and how much in the past, I’ve really liked the 1:1 CBD-THC ratio edibles for menstrual pain. That really helps. I decided to go to the dispensary and talk to them about it.

Emily: I’m so proud of you

Melissa: You know this, and I know this from talking to you and what I’ve learned from you, and also what I know from playing around with edibles is that it might not kick in for two to three hours. What I was really worried about was breakthrough pain. When you’re in pain or sick, the worst part of the day is when you wake up in the morning and feel that pain. The thought of feeling that pain and having to wait two to three hours for something to kick in was not something I was willing to do. Went to the dispensary. Actually, it was my first time in a dispensary. 

Emily: Did you enjoy it? 

Melissa: I did. The people who work there are so happy and nice!

Emily: So nice. Aren’t they the best? So happy.

Melissa: I don’t know anything about vapes. I know they’re quicker. I didn’t know how to pick out what I was looking for, and he really guided me toward a five-to-one ratio of CBD to THC. And that was really great. I had my little pen, and I played around with it the week or two before surgery to see how long it took to kick in and try to estimate how long it would keep me pain-free. It’s hard to tell when you’re not in pain, though.

Emily: It’s so smart to experiment the week before. For anybody listening, that’s absolutely the best thing you could do. 

Melissa: Yeah. I figured out that it kicked in immediately and lasted about four hours. Going into the surgery, I felt pretty good that I had a plan. We had this hour and 45-minute drive back from the hospital after my surgery, so I had my cute little vape pen packed in my little bag with my blanket and the belly binder. I really don’t remember much about the trip getting home, but I was worried about getting from the car into the house into bed. And it all went really fine.

Emily: Oh, good. Do you remember being in pain at that time? 

Melissa: Not necessarily. It was a weird feeling. I remember describing it as like the worst period cramps you’ve ever had, plus you feel like you have a UTI because they do a catheter during the surgery. That was burning. There was a little bit of a weird feeling, but not necessarily as bad pain as I thought it would be. I’m very lucky, and I’ve always been active. I was a ballet dancer. I ran marathons; my legs were really strong. Even in the hospital, they told me that I was moving much better than they thought I was going to. 

Melissa: I felt pretty good with my pain management plan, and it gave me the flexibility with those five oxycodones where I was able to spread them out and only take them at night when I had to sleep. I used cannabis to manage the pain as needed throughout the day, on top of ibuprofen and Tylenol, which were having my cycle in the beginning. That was it. They’re like, “Here’s your Advil and Tylenol. Good luck.” 

Melissa: The other thing about the type of surgery that I had is when they take your ovaries, you’re instantly in menopause. Surgical menopause is no joke. Menopause is no joke, but most of us have several years to get used to what’s happening. And so it’s just, you’re suddenly in menopause, and that brings all of the things that menopause brings, like hot flashes, night sweats, and sleep issues.

Melissa: I don’t know about you, but sleep is my number one priority. If I do not get my eight hours a night, I am a monster. So it was really important to me to continue getting quality sleep through the recovery. So that’s another place where cannabis has really helped with this. I could have a great sleep and wake up feeling rested.

Emily: Do you find that you’re still getting good sleep? Has it supported you throughout this transition?

Melissa: Yeah, I’m eight weeks out from surgery and not using cannabis throughout the day. It’s really just the one, one little poof before bed. I’m almost afraid to stop doing that at this point because I sleep so, so deeply and so well, and I wake up refreshed, and I don’t want to get to the point where I’m struggling with sleep.

Emily: Absolutely. Oh, I’m so happy to hear that you had something to support you through that. And you also are so educated. You’re such a good patient because you’re an advocate for yourself, but then to have this on top of it, you really are the best patient. That’s perfect for transitioning into your role as a healthcare provider because I’m sure this experience has given you greater empathy and compassion for the people you work with. I don’t want to gloss over what you just went through. I want to say thank you so much for sharing that because I know it’s pretty new for you to share how cannabis has helped you manage the pain. I hope it is really helpful for other people who experience a major surgery like that.

Melissa: Yeah, and I would say, going in and talking to the people at the dispensary was super helpful because helping them understand what I was about to go through. I explained it so that they understood that I was specifically looking for something to help the post-soft tissue surgical pain. That really helped them narrow down what to recommend for me. If you’re concerned about feeling high all of the time, if you’re taking one milligram of THC, you are not going to feel high. Most people are not going to feel high on one milligram of THC. Just having that has been so helpful. 

Emily: And I’m so glad you said that because a lot of people don’t want to feel high. The last thing they want to do is go into surgery and come out feeling anyway. So really hitting home that you only need a tiny bit of THC to hit the pain and that you can offset some of those other unwanted feelings of THC with the CBD.

Emily: So when she says five to one, it’s five times more CBD than THC. And that’s always an option for people to try as well because you don’t have to get high to feel better. So I’m so glad you said that.

Melissa: Yeah, I won’t say I was feeling super on top of things mentally, but to lie there and recover and re-watch Gilmore Girls from the beginning, it was, like, perfectly fine.

Emily: That is so good. And then, hopefully, this isn’t too personal when the five oxies were out. Did you feel okay? Did you feel like you could manage this pain on your own?

Melissa: Yeah, absolutely. And definitely like with the last two nights, I didn’t really need them, but I took them so I could sleep better.

Emily: I’m so glad. That makes it like a seamless transition – and that’s how it should be. Imagine if everyone was educated enough to recommend a pain med and some cannabis so we could easily transition like that. I think it could save a lot of people, a lot of problems.

Melissa: Yeah, I felt like I had a really good transition. And of course I was doing all of the other surgical support. This gets into the advocacy and the knowledge portion of things. My doctor is great. She’s fantastic. She’s great at what she does. She didn’t tell me anything about nutrition, didn’t tell me anything about working with a pelvic floor physical therapist. These were things that I had to research on my own.

Melissa: I’ve used a surgical protocol with patients before. I used it on my husband when he had his knee replacement, where we’re doing extra zinc to support the wound healing, we’re doing extra zinc, we’re doing vitamin C, we’re doing collagen and bone broth to support the tissue healing, and then we’re doing all of the anti-inflammatory stuff on top of that.

Melissa: I was making a batch of fresh ginger juice once a week, and then I would pour that into my seltzer water and have a little fresh ginger ale. I was doing turmeric. I was doing pineapple, bromelain, and super high protein wound healing. I aimed for about a gram per pound of body weight. I think all of that helped my recovery go much more quickly and much more smoothly.

Melissa: I also contacted another health care practitioner, where I found a pelvic floor physical therapist specializing in hysterectomy prep and recovery. For 4 weeks before the surgery, I was doing pelvic mobilization exercises, and then, 10 days after surgery, I was able to start exercises and cardio. I was surprised that she told me to get up and do cardio. I’m talking like 5 minutes in the beginning, 7 minutes, 8 minutes, and it builds up from there, but I’m at the point now where I can do 30 minutes again with no problems. I’m only 8 weeks out, but these are things that doctors are never going to tell you. 

Emily: That’s why I’m so glad you’re telling the people who are listening because all of these things that you’re doing contributed so much to your healing; I’m sure that is not even, like you said, not even mentioned by doctors.

Melissa: Yeah, I was actually shocked because if you read, if you read people’s stories and you read what to expect during recovery, and I saw the statistic that was like six weeks out from surgery, you can expect to walk 30 minutes, two weeks out, you can expect to walk 10 minutes.

Melissa: It’s okay; maybe that’s like a very low bar if you’re not doing anything else. You’re reading these things, and you’re thinking that it’s going to be terrible. I was worried about going to the bathroom. I didn’t know what to buy after the surgery. I’ve been a tampon person all my life. I didn’t even know what to buy, so I bought everything. I bought overnight pads. I bought Depends.

Emily: I bought Depends after I had my baby. I feel like most women actually try Depends for a few different reasons.

Melissa: Yeah. And also, when I was searching for post-surgical pads and things, it takes you down the whole c-section rabbit hole, which, when you’re having your uterus ripped out, it doesn’t really feel great to be like seeing all these pregnancy ads. So I bought everything.

Melissa: Peeing was not an issue. I got up and went to the bathroom with no trouble. Again, those strong legs, like getting down to the toilet and back up by myself, were not a problem. Some of the things that I was most scared of did not end up coming to pass. 

Emily: What was your favorite product out of all the products that you tried?

Melissa: I think the one that is the most fun is the vape because I had never done anything like that. And it’s some sort of blueberry taste where it doesn’t taste like blueberry while you’re inhaling it, but then there’s a memory of blueberry essence left behind. 

Melissa: I’ve been a really big fan of those. Mr Moxie’s mints for a long time, too. They’re usually the 2 to 1 or 1 to 1. And they had a 5 to 1 that was ginger. So they’re mints that are five to one and those are great, especially for the daytime where it’s okay, I just want to take the edge off the pain a little bit, but I don’t want to feel knocked out, or I need to go to bed immediately so those are good there’s another one they didn’t have it, my favorite one, which is another one to one, it’s their cherry flavored gummies in a little round tin. Those are always my favorite.

Melissa: Things that have not worked for me are anything that says nano on it. My brain feels scrambled for days afterward. I can’t do anything nano. I can’t remember what the blueberry haze brand is, but it’s a little disposable pen; it wasn’t like we were going to invest in a vaping system or something.

Melissa: So they’re just so convenient, discreet, and easy to use. And so cost-effective, I have to say, because one little puff, one little puff, and each little vape pen has something like 200 puffs in it. We were trying to do the math where it’s okay if I did one puff every night; how long will one pen last? Months. We definitely do enjoy the yummy chocolates with the fun things in them for recreational purposes, too. We’ve tried a variety of stuff.

Emily: I have a question. I hope it’s not too personal, but as a healthcare professional and someone who always advocates for yourself, did you tell your surgeon your plan to use cannabis?

Melissa: No, I didn’t. My surgeon knows nothing about any of the supplements or anything. And that’s always the way that I’ve operated with doctors. I think my record says I take a multivitamin and vitamin D, and you know what I was doing for surgery. I was doing Arnica and Bromelain, and I know the risks. I stopped using fish oil a week before surgery. I started it back up again a week after surgery. 

Melissa: I was able to manage that for myself, but for people who are not healthcare practitioners or who are not super educated on the risks of supplements and how to use them, you should be working with someone. You can increase protein, usually, unless you have kidney problems. My dad just went through back surgery, too, and I didn’t have him doing any of what I was doing. I just told him to increase his protein and take a multivitamin. 

Emily: Yeah, I guess the sad part is I feel like even if you did tell your doctor about your supplement routine, I don’t know if she would even be able to make a, not to be mean, but an educated opinion based on it, or would she brush it off as you are someone who takes a lot of supplements.

Melissa: Yeah, I mentioned them, and I thought she was a little… She’s definitely more open-minded than most doctors, but I mentioned the gene mutation that puts me at risk for this is the COMT gene. I have two mutations on the COMT gene, which basically means my body does not methylate estrogen, and she didn’t know what that was. And so I think it’s like you have different doctors for different purposes.

Emily: It’s like you read the audience.

Melissa: Yeah. Yeah. It’s like my PCP will handle my annual cholesterol check, but I’ll see a naturopath to manage my thyroid or anything hormonal that I need help with besides myself. And that’s actually something that I’m in the process of doing researching a new, more functionally-minded doctor who can manage the hormone replacement for me. Just to make sure it’s the right thing for me. 

Emily: Moving forward, you say you’re not using cannabis daily. What does the future look like? How does cannabis play a supportive role when needed?

Melissa: Yeah, I think it will continue to play in the way it always has on an as-needed basis in different forms that work better for different things. I always talk about the salves and the lotions if I’m going to a conference or I’m going to New York City, and I know I’m going to be walking 30,000 steps a day, I always pack that so that when I come home, I rub my feet with it and put them up and that helps a lot. I think.

Melissa: Probably the most common time I’ve used it over the last 5, 10 years is for period pain. And so I don’t, that’s not going to be a problem anymore. It’ll probably just be very sporadic as-needed support, but I do use full-spectrum CBD pretty frequently.

Melissa: I don’t drink alcohol. I don’t drink alcohol at home ever anymore. And it has that same almost ritual to me at the end of a work day. I’m going to put a couple of drops of CBD under my tongue to transition from work to relaxation. That’s how I use it. I don’t need even a milligram of THC for anti-inflammatory and anti-anxiety purposes.

Emily: I’m so glad it’s nice that you have it when you need it. If you ever come back and you need it for something else, you know how to use it; you know what you like. And that’s really a beautiful thing. I always tell people it’s a tool in the toolbox of wellness. And now you can just put it in your toolbox and wait until you need it again, which is amazing.

Melissa: Exactly. It’s additional support. Why would you not if it’s an option for you?

Emily: Absolutely. I love that. And I’d love to transition into your professional work. And you mentioned helping with period pain for yourself, but you work with women who have all sorts of female issues. Could you talk a little bit about that and how you’ve seen cannabis help them in any way?

Melissa: Yeah, I think there’s a lot of period pain out there, but more, more so than the period pain; I also see a lot of PMS or feeling, just feeling bloated, feeling like your sleep is disturbed, feeling the mood disturbances that happen.

Melissa: The biggest category of people I work with have PCOS. One of the main underlying drivers of PCOS symptoms is inflammation. CBD is so anti-inflammatory, even without the THC. I find it can be a helpful adjunct to treatment.

Melissa: It is just that little extra bit of something you need to feel good sometimes. Usually, the salve is a good gateway product because you can try rubbing it on and seeing how it feels. Sometimes I’ll try to encourage a full-spectrum CBD so that they’re trying that and maybe sleeping better, feeling better. They’re going to have more energy the next day. They’re going to be able to exercise and do things they didn’t have the energy to do before. So yeah, I definitely recommend it. It’s a tool in my toolbox that I do recommend to clients if they seem open-minded to it. 

Emily: I was going to ask if you always bring it up. Do you sometimes bring up, do you just read the room, see who might be up for it?

Melissa: Yeah, I read the room. I think I’m so open about who I am and what I believe in that I tend to attract more open-minded clients. So that usually helps there. They’re usually very excited. I love when I hear back from them that they got it and they tried it, and they slept better than they ever slept before. Or they didn’t need to take as many ibuprofens with their period because all of those things have risks, that ibuprofen can tear a hole in your stomach, and I don’t know, you don’t want to take too much because that can mess with your liver. And we don’t want to, especially when we’re talking about hormone imbalances; the liver is so crucial to metabolizing hormones that we don’t want to bog down your liver with toxins that it has to clean up because when it’s cleaning up those toxins, it’s not doing its day to day jobs of metabolizing estrogen the way that it should. Yeah, so it’s been a helpful adjunct. I’m always so happy when someone tries it, and they’re like, “This was great. This made such a big difference.”

Emily: Oh, it’s going to make you feel good. And on the flip side, they have to be like, “Wow, I have a provider who’s so open-minded and suggested something.” They have to feel so relieved, especially if they are cannabis consumers. And maybe you didn’t even know, but they could be just excited that you suggested it.

Melissa: Yeah. And I think of it as just another herb, and I always recommend herbs and adaptogens. I’m recommending Reishi and Ashwagandha and Tulsi and all of those things. And it’s just another herb, and they all do different things, and this is what this one can help with. 

Emily: Such a great perspective. I feel like if more healthcare providers could have that well-rounded perspective, we’d be in such a better place. But I can’t thank you enough for sharing your personal story and a little bit about your work and what you’re doing. I want to be respectful of your time, but I also want to ask you the same four questions I ask all my guests. Are you ready?

Melissa: I’m ready. 

Emily: All right. The first one, what are you most proud of in your life to date? 

Melissa: Yeah, I’m most proud of leaving my original career at the age of 35, I was a pharmaceutical copywriter in advertising in New York City for 15 years, and I had to leave. It was destroying my mental and physical health. I had always been interested in nutrition, and I just started chipping away at going back to school, so I left my life in New York City, I left my career, left everything that I knew, and really didn’t know what was going to happen and it was worth the risk.

Emily: I’m so happy for you. A lot of people find this to be the hardest question, but you don’t actually use cannabis daily, so I don’t know how this will impact you. What would your life look like if you didn’t have cannabis?

Melissa: Yeah, and as it relates to the surgery, I would have been much more afraid of what was going to happen afterward. I don’t think I would have recovered as well because the cannabis was managing the pain for me, allowing me to do the physical therapy exercises afterward. It allowed me to get up and feed myself and do all the things I needed to do to recover. I think it made a really huge impact on my recovery. 

Emily: Oh, I’m so happy that you brought that along with you and were able to benefit from cannabis. If you could go back 10, 20, or 30 years ago, give yourself a piece of advice; what would it be?

Melissa: Oh, that’s always the hardest question to answer.

Melissa: I think I would probably say trust your gut. When things aren’t right, when you’re in a relationship that’s not right, when you’re in a career that’s not right, when you’re living a life that’s not right for you, and your gut and your symptoms are trying to tell you, get out, they’re trying to give you these little signals that it isn’t working. You need to try something else. And I think there were so many years there where I was just so unhappy with relationships, career, and even living in New York City. Can you imagine someone with high cortisol living in New York City and what that does to your mental health? There’s nothing chill about New York City. Just trusting in my gut that what I was starting to feel was right and that I should listen to it. 

Emily: And that brought you to where you are here today. And that brings us to our last question. And it doesn’t have to be specifically for the cannabis space, but what would it be if you could be remembered for one thing in this space?

Melissa: Yeah, I think it would really be my work in advocating for women, to empower them, to be able to advocate for themselves, especially In the conventional medical space. If you’re not getting what you need, go elsewhere. You may have to cobble together different providers for different things, but your needs will be met when they’re not being met in one place; whether a doctor, a relationship, or your career, you can build the life you want. 

Emily: That is the perfect way to end this. Thank you so much for sharing your personal story and your work with us. If people want to learn more about you, where can they find you?

Melissa: I’m most active on Instagram. 

Emily: I’m sorry to interrupt you. You have a great Instagram account. If anyone’s on Instagram, please follow her. Say it.

Melissa: Thank you. It’s the.hormone.dietitian, and my website is also TheHormoneDietitian.com. 

Emily: Wonderful. I’m going to leave links so everybody can find you. If you are a woman with PCOS or any female condition and are looking for support with a cannabis-supportive provider, please reach out to Melissa. And again, thank you so much for sharing everything you did here with us today. I really appreciate it. 

Melissa: Thank you.

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