Body Dysmorphic Disorder: Symptoms, Causes, Social Media & Treatment with Dr. Juliana Hauser

(upbeat music) - Hello, welcome to the Love Me of Eat podcast, sponsored by Tham Pharma. I'm Jerry DPNO, founder and CEO. Thank you for joining us, as we discuss all aspects of women's healthcare. Please note, this podcast is for educational purposes only, always refer to your healthcare practitioner for personal advice. (upbeat music) - Hi, this is Jerry DPNO again, and I am with Dr. Juliana Hauser, who is one of our medical advisory board members. And Dr. Hauser is a psychologist, a board certified, and also a sex therapist in Dr. Juliana. Tell us more about yourself. - Yes, I am a twice licensed life professional counselor, licensed physiognomy therapist. I have a specialty in sexuality, menopause and psychedelics, and love talking all things with you, Jerry. - Of course, we always have a great time chatting. Some of our topics can get a little thorny at times, but we always want to end with hope, and we're gonna do that today, as we talk with something that's pretty serious and something that we have seen possibly an increase in due to more spending time or time on social media, where what the body ought to look like turns into something that can produce quite a bit of anxiety and distress, and that's body dysmorphic disorder. So first of all, let's have you define body dysmorphic disorder. - So this is a phrase and a diagnosis that we hear more and more used in everyday conversation, and it's often used incorrectly. So how I will hear it is someone saying, oh gosh, I just look so big now compared I used to, and then their friend says, no, you're very thin, you're very in shape, and like I don't have body dysmorphic disorder, and that is not the correct definition of it. So the difference of the diagnosable condition is that you have a perceived perseveration on, it can just be one part, it can be a whole variety of parts that to someone else's point of view, they wouldn't have noticed the difference, they wouldn't have thought it was anything other than typical, and this person is pretty obsessed with that feature checking it and asking about it, doing things to change it or to hide it. For some, it can be so interfering that kind of a range of it is like internal thoughts to like other people around them having to constantly reassure them about that part to going to multiple plastic surgeons or having multiple plastic surgery interventions to feeling a lot of depression and anxiety all the way to suicidal thoughts because of the way a body part or part of their body is perceived by them. And it is something that we are seeing prevalence of, and something that we absolutely as therapists think is related to the increase in social media and our ability to see others to compare ourselves and have people judging us. In particular, it's for all genders, it's certainly female dominant, but it's all genders have experienced this. - You know, it's interesting that you bring up genders, there is a slight difference between and the incidence in women versus men, but it is ever so slight. So it's not disproportionate as in something like an autoimmune disease or even major depressive disorder. And that was kind of striking to me, but for what you just mentioned, which is that men and women are seeing themselves in others could be celebrities, could be someone that just shows up on an Instagram feed but they have an image that they want to try to replicate and may not be possible given your genetics, given the way in which you lead your life. You know, if you're working 20 hours a day and let's face it today, people are working two jobs just to make ends meet. So trying to find that time for a good diet or exercise or what have you might be challenging, and then trying to achieve perfection. And I guess that's really, so when I think about the difference between being concerned about an imperfection versus being obsessed about what you perceive is an imperfection or two different things. And at least the way I have understood body dysmorphic disorder, it's the latter, it's more of the extreme of const focus, hyper focus on whatever you perceive is a quote unquote defect. - It's very different from an insecurity. It is an all-consuming thought that is a perception that there is something wrong. Like there are some times that you could see the will just use a nose as an example, that you could perhaps look at somebody's profile and say, oh yeah, I do see there is a bump there. And I can see like maybe why it bothers you or it's causing you to snore, you know, that kind of thing that if you were to put 10 people in front of them, that 10 people would notice it. And then there may be a variety of people, how they react to it, but with body dysmorphic disorder, it's often something that most people wouldn't notice that they don't see this difference in. And it can be even something like asymmetry, that they think that their eyes are very different or their jawline is different. It's not even necessarily a body part. And so it's a perception issue, it is a consuming issue. They often need lots of reassurance, either internally or externally. And it's something that is so obsessive for them that they begin, it's for some, they won't leave the house, they won't let themselves be photographed. They are devastated by the way they look, they are certain everyone is seeing it and looking at it. It is a level of preoccupation that most people can't identify with. That is a diagnosable component of this. There are certainly things on the continuum leaning up to that, which is where we hear people talking more often. But for those who are truly suffering from this diagnosis, it's debilitating. - Yeah, basically what I've read in the scientific literature, is something that develops over the course of time. And so it can show up, even in children, but mostly in starting in the teenage years, what are some of the factors that can lead to body dysmorphic disorder? - And there's certainly a social aspect to this. If we were to look at the nature versus nurture, we see in this environment, especially in the last 20 years, and really in the last 10 years, the increase of phones, the increase of social media, our ability to be exposed to people that we would have never seen, except for maybe movies and some TV shows, and seeing everyday people and social media platforms, especially like TikTok, where we're seeing the everyday person, who is getting a very big following off a video to or in general on their platform. We're being exposed to different beauty standards. And with that, there's comparison. My daughter is a middle school, and it's brutal. It is brutal, the way that your body becomes a target of differentness. But I think that is something that's been around for a very long time, but you put that on social media, or people are able to do group chats and talk about it. It really grows. And when we have a society that does place a lot of worth, self-worth, and also external worth, on some of these looks, and there's a social currency based on your beauty, where your beauty lands on the continuum, and who you're around. Now, there's a culture aspect of that. There's different beauty standards and different races and different regions, and some of that is really healthy. The differences are, and some of them, the differences are not healthy. And so we have all this inundation of like, what is okay? What is normal? And of course, we've had movements along the way, of body positivity and better body images. And, but we don't have a movement. This is where I learned a lot of my work is, how do we grow a different relationship with our body? When that is not really the vernacular, and we don't have classes that we're teaching kids about this, then by the time you are hitting high school college and in your adulthood, you already have such a vast history of how you look matter so much to how you get a job, to who wants to be with you, to your sexual currency, that if you already had a tendency to be fixated on something, in general, if you already had like the brain chemistry of the genetics to have a perseveration issue, for some it comes out in eating disorder, for some it comes out in obsessive-compulsive disorder, it can manifest itself and by dysmorphia, by being linked into some point, something happening, that the pain of your own perception or someone bringing out something about your body that they perceive is different, that's the hook-in, and then it's a very difficult journey. And then we add to the aging process, or you change if you have a body that can get pregnant, it gets pregnant, those changes, we see a rise in it in pregnancy, too, that it can all of a sudden turn on when they start getting weight through pregnancy or their body changes significantly. after pregnancy and then paramanopause and menopause. It's just, you know, a huge shift. - So it is, it can be co-occurring with other types of mood disorders, like obsessive-compulsive disorders, anxiety, depression. And I think as you illustrated, if they are, it can show up as part of that diagnosis. - Yes, it can. - Mm-hmm. - And it's, and not everyone has that comorbidity, which means a co-diagnosis, but a lot of people do, or at least there's a presence of it, we notice it. And it's interesting because a lot of this have very similar treatments, which is cognitive behavioral therapy, because you're getting at the thought process, if manifesting itself in the way that you're thinking about your body. And we know this in a lot of ways, because we will see people who will actually do something that changes that body part with plastic surgery, and yet when the plastic surgery is complete, and again, other people would say you're successful, and it looks good, that person does not perceive it that way, and they have a perseveration on how it has been changed and what it's been changed into. And so we know, again, it's a thought process. - So we talk about eating disorders. This could be body dysmorphic disorder as well. If you are obsessive or obsessing about your weight, you're never thin enough, but that's just one aspect of what is body dysmorphic disorder, but this could be fixation on anything. It could be fixation on your nose, your eyes, your teeth, your mouth, your breasts, your genitals. - And again, it's okay if you don't like it, and I don't have a judgment on if what it is, if you don't like it and you want to change it, that is different than somebody who has body dysmorphic disorder, and no matter really what you're doing with it, whatever surgery you're having, it's highly likely that they are going to not change their perseveration based on any cosmetic change. And that the origin of that change is different, as well as the intensity of need for that change. It's really a continuum. So, I know we don't want to position people who have plastic surgery or especially labia plastic, which is the change of your labia shape and size, that it automatically means that you have that, it doesn't, but how you talk about it, why you're having it done, what your connection is with the outcome, and then how you react to the outcome is different. And plastic surgeons are learning more and more to screen for this, but I've talked to several plastic surgeons, and if they see that somebody, most likely has body dysmorphic, and they ask them to go see a therapist, they could just go to somebody else who isn't screening, and I have that done. It's a really hard problem for plastic surgeons to overcome, but they are often a first line of bringing this to their attention, because the other part of the disorder is, a lot of times they're not aware. It's very hard to convince somebody when they have this disorder, that what their perception is isn't accurate. They are convinced that it is, and other people just aren't telling them that, whether it's your genitals or another body part, and again, it's not always body parts. It isn't, and it's hard for other people to understand, and it's truly a debilitating disorder to experience. - When someone looks in the mirror, and they see something different than what everybody else in the world sees. So, for example, let's say that you look in the mirror, and every time you look in that mirror, you see a terrible set of lips. Everybody else thinks your lips look just fine. You have cosmetic surgery. Maybe you do lip fillers or something more profound, but you still see those lips that don't look quite the way they should in your view. So it's really that misperception that you see in the mirror that no one else sees, and then the repetitiveness with which you approach the surgery or other forms of enhancement to try to get to that level of perfection, which is not able to be achieved through any means. - And for some, the interventions, like, for instance, with lip filler, there's a difference of lip filler at that to people like, wow, I mean, you didn't need it, or gosh, like we can tell you've had it, there's that conversation too, like, whoa, what is going on with your lips, and they don't even notice that the intervention is, and other people's perceptions kind of outlandish, and quite obvious, and in fact, a problem. It even could happen to that degree as well. But again, I'd go back to, I was talking to a parent once, he was having a really difficult time with somebody, their daughter, who was going through this, and she's like, I just, I mean, it doesn't matter. How much I tell her to love her body, how amazing her body is, she's not listening to me at all. And I was like, it's not going to be something that you understand, and it's about the body part, and it's not about the body part. Like, we have to look at this holistically, and not just so singled in. But I said to her, the only way that I can get, you to understand is if you were to go back, look at a picture, she was in her 50s, if you go back to look at a picture of yourself at 20, how many, and I'll just speak to women right now, how many women would go back and say, oh, I have no idea how great my body was back then, and like, had I known, like, if that was like a thinnest I was ever going to be, or that was going to be the most fit I ever was, I sure would have appreciated it more. I mean, that is such a commonly heard phrase of, I wish I'd appreciated my body back then. The, but at the time, if you remember, a lot of people would say, like, oh, I was upset about this, we're upset about that. That again, that's not by this morphing, but it is the closest that somebody who doesn't have that or propensity can understand, I'm like, what, how could you not see when you were at that age that you had this wonderful body because you couldn't see it? And, and in the perception is off again, that's not, it's not a perfect example, but it's one way to try to understand something it doesn't make sense to a lot of people. And when we have mental health disorders that are related to our looks related to, like, our, our body, like, an eating disorder, or even for some obsessive compulsive disorder, there's a different stigma attached to it. I mean, there's less stigma attached to mental health in general, but there seems to be like, if you were to look at like a diagnosis, like schizophrenia, people understand that someone hasn't made that happen. They haven't wanted it, they haven't thought themselves into this, and someone with body dysmorphic disorder, or sometimes even with eating disorder, there is a blame put on somebody that they have this. And so, thusly, if you just buckle down and did something different about it, you wouldn't have gotten this. And that blame adds to the shame that that person is experiencing, and I haven't worked with a lot of people with this disorder, but those who I have, they are miserable, and they do not want this experience at all. And when, if you can get them to the point that they kind of have a wake up up their perception, their grief stricken over, you know, what they've done already to their bodies, or how much they've lost because of this, because there's a lot of loss associated with this disorder. It is, it's really tragic, and it's misunderstood, and it's not supported. And we're in an environment that's really hard to get away from. Same with when I work with eating disorders, we have to eat, and we have a coat of the soul lunch that's wrapped around eating, and same with our bodies. It's, it's very hard to break away from all of the inundating messages that are unhealthy for, especially for somebody who already has a tendency towards listening out for that. It's really hard to quote, get clean from it. And it's harder than say, you didn't cause this. This isn't your, this isn't a blame for you, but the solution is helping getting your thought process different. It's, it sounds contradictory, but it, it isn't, and it becomes a neuropathomy issue. Yeah, yeah, we, we talked a little bit about teenage years and how they, you know, something is like a mole on the face, can all of a sudden take, take on these proportions where it dominates the entire face and it's hideous, and you need to change that and remove that, or, you know, a nose that's not quite symmetrical or eyes, or what have you. And then you, you had mentioned during pregnancy and postpartum where we know that, you know, because of hormonal shifts and so forth, the weight gain, et cetera, the issues may actually start to pile up, so as we think about, you start out as a teen who may be self-conscious. And the self-consciousness may not be BMDD at that point, but by the time you reach the point where you're having a child, let's say it is something where, you know, your features become slightly distorted, right? Face becomes puffy or maybe the nose doesn't look quite as thin, the jowls start to drop a little bit, and now that adds on to your insecurity, to the point where now it becomes an obsession. Now it's trying to get rid of that pregnancy weight plus, you're looking at this new body and this face that seems to have changed, where things may have shifted due to that weight gain. You can almost imagine, the exacerbation of symptoms as women transition from that and then to perimenopause. Perimenopause, you know, obviously, there are a constellation of issues. Yes. And sometimes with final health disorders, we will see like the, like, the light switch gets flipped on. And for some, it just seems mysterious. For others, there seems to be a quick, you know, an obvious, biologic link. And we, as we've said, a lot of times there's not a research for us to understand a lot of these things should in perimenopause and menopause and mental health. But I think anecdotally, a lot of us see that in perimenopause and then menopause, we see a rise of this. And there's a legitimate change that is happening. And so when there's even something even close to being legitimate, your body, most people's bodies are changing in perimenopause and menopause, if that is going to be the thing that triggers it also, like something real in that you can observe, then they can take it on a life of its own. If you already have the, you know, genetic predisposition or environmental predisposition towards this. And again, it's, it's fixation is the word that I would use for a diagnosable aspect of this. But there's a lot of suffering that happens before you would actually hit the diagnosable level. And the suffering, you mentioned some signs that there is extreme suffering taking place withdrawal, maybe a hyperfocus, spending a lot of time in front of a mirror, self-loathing. So there are any other signs that person's suffering, but also for the people that love that individual. Yeah. There's a lot of, well, and again, everyone's a little bit different, but you'll see things like they start talking differently about themselves, either seeking out reassurance or if you compliment them, they take it in and take it to a level that feels different than either before or other people. You know, women in general aren't great about taking compliments to their appearance, but it's more than that, and you'll just, you know, you would feel a difference of it. And then it's the withdrawing, like, from photographs is a very typical thing, or socially, there's not wanting anyone to see them. So staying inward more and not letting themselves be photographed, always being the one taking the photographs. But again, but a lot of women are like that anyway. There's always a one that are the ones taking the photos because no one else is doing it, but it's you can't, even if you try, they're not going to do it. And again, it's a level up to stress, either that's hidden or they're verbalizing or you can see it, not wanting to socialize it to go out and the reasons and excuses don't really add up, or they try to go and they're getting ready and they just can't leave the mirror. They just can't imagine anyone seeing them in this state. It's looking at those immediate, differently. It is doing lots of research about it. It depends on what it is. They're perseverating on, but you'll often see lots of searches about it, talking about other people who have the right, whatever. Probably what I see most is lots of searches on cures, things, and then for some, especially if they have the money to do it, or even if they don't have the money, they budget for interventions that can be anything that's just more topical to plastic surgery. And we've seen a rise in the promotion of products that can address everything from the neck to the eyes. We are fixated on youth and if aging in this kind of youth-focused culture is really challenging for individuals as they hit their fifties and beyond. And yes, things are going to change. You know, there are some eye circles that develop, especially if you don't sleep or you eat improperly. So we do see that things will change and you're not going to look the same as you did when you were 18 or 19. But because we are so focused on youth and youthfulness, there's abundance of products that can treat everything under the sun. So it's easy to see where someone who has body dysmorphic disorder would lean in and start to acquire and accumulate any number of potential cures for these types of problems. And when they don't work because most will help, but they're not going to undo. So the undoing is really where the plastic surgery, cosmetic surgery comes into play. Not everyone can afford plastic surgery. And nor should they. Because let's face it, there is some beauty in the wrinkles that we form these nasolabial folds from smiling all the times. My non-n use to say that. Said, you know, I earned everyone of these folds because I always smiled. And that is actually a beautiful way to think about the aging process. But to somebody who has body dysmorphia, those nasolabial folds look like craters in the face. And again, there's a lot of people who would say, yeah, I don't like it. Like that's great, but I wasn't given that message. And I don't like it. That that not liking it is not bite dysmorphic. It is the perseveration, the fixation. It's getting it fixed and not being satiated in it. Either it didn't fix right or now they're moving on to a different part. But the example you gave of a grandmother, I mean, what a precious gift that she gave you. And what if that is what we were inundated with? What if that was it? And I do think that if we had truthful examples and we were heralded, like if we could see that there was our heightened social currency in aging and the way that our body ages, I do think that would be different. I think we wouldn't see nearly as many people suffering from body dysmorphia. But I also think it's more than that too. It's not just the perseverational effect. I think there's a genetic component to this also. But I gosh, I sure wish that we were given that. And again, and I know that we have the same way. It's not that plastic surgery in them itself is a negative thing. But I had an example of my own life that I have, I'm hearing a whole lot more of people my age and my friends having the surgery of the eyelash. I forget what it's called. Bluff, bluff something. Bluff, bluff, bluff, bluff. Bluff for a plastic surgery. Yes, the upper and the lower. That's what my other word says. And I've heard enough that it's something that I was like, "Hi, I wonder." I was like, "What makes you get it?" And was it like, and I've seen people who say, "Oh, wow, you really can see a difference." And you can, you look more useful in it. It was something I would have never thought of. I'm hearing it, I'm seeing it. Somehow, my social media is now picking up and giving me more social stuff. About it. And again, I hear more of my friends. So it's like, it's no one's saying it about me. No one is criticizing myself. And it's nothing I really thought of. I've always had like, kind of like, they could just call them like slitty eyes. And again, I haven't perseverated over that. But I've thought about it. And I admire like the people who have those big eyes that you can really see their eyes. So again, it's in my mindset. And then I just had an eye exam, a very thorough eye exam. And when he downloaded my eyes, he had to pick up my eyelids. And if I had bought this morphia, it would have felt like he was just like really trying to get it up. I would have felt devastated about the fact that he knew how bad my eyelids were. I had like a little bit like, "Oh yeah, I guess they are second more." Like he clearly couldn't see in my pupils because my eyelids were down. And you know, I just got like what I obviously didn't think of thing. But if I had bought it this morphia, it would have been devastating. I probably would have ever gone back, maybe ever gone back to an eye exam because it was so humiliating. It could have taken me out for days. And that is the difference of it. But the exposure I've had to it is what gave me a thought that it was something to think about and to fix. And that's pretty profound to me too. That if I hadn't been exposed to it, it would have never occurred to me. I don't even know if I would have been noticed it. That's a really great example. And it probably goes to something that how do you self-correct? So there's something that we can do. So thinking about how to address the prism signals and warning signs that we recognize in ourselves. So you recognized it quickly. But for those of us that aren't trained professionals as you are, what are some of the signs that we see in ourselves and we're people that we love? What should we do about it? Do you mention cognitive behavioral therapies? How do we approach recovery? All right, at least are we somebody else? Because oftentimes we see it in others before we can see it in ourselves. And that is, you know, if you just notice those changes that I mentioned earlier in somebody and you ask them about it, like I feel really sad to that. I don't any photos of you in it. I would really love a sicker photo. And their reaction is no, I don't look good or I can't do this. And you can tell it's always an excuse. Then you can say to them, this is something I concerned about. Does this sound familiar? Is this some of the way that you think? And then in our, the way that our mental health system is set up right now, it is so difficult to get help. It's so difficult to make the phone calls, you know, all of it. When the kind of things you can do after recognizing it in somebody is helping them get from recognizing it. to finding somebody that they can see. And it used to be in our profession that a lot of therapists wouldn't take somebody who wasn't making the phone call themselves or reaching out themselves. In general, I think we are realizing now the scaffolding of the system of mental health is set up that shouldn't be the barrier. And the thought process was that someone isn't going to actually really participate in therapy if they haven't been able to make a step to ask for help themselves. And there's validity to that to a degree. But I think if you can help them get in the door because the system's just so hard. So make the phone calls. Find out who is an expert in this area. And you do want someone who's an expert. If I had someone come to me this, I would be able to go to a certain degree. But I would say this is not my area of expertise. I can diagnose or I can tell you this is an issue. But if you want to go to a person like this to really treat you, if you're come to, if you have an issue that is recognizable to somebody else, you need to find an expert in this. It's not easy to find. If you are somebody who is struggling with already doing a Google search for this, it's going to be such a huge hurdle. You most likely are not going to follow through with it. So do that for the person. And then ask them about it. And be an ally. Be somebody who can hear it and listen. Because oftentimes, when I have talk to people who are dealing with this, what they'll say is everyone told them not to worry about. Everyone dismissed it. Everyone said, oh, you're beautiful. Oh, you're whatever did it. What are you talking about? And then they thought they were bad for superficial. And so they really shut down in it. So be a friend or a family member that doesn't shut the person down. And here's that is something that is legitimate to them. They won't get help if the people who are talking to them are saying this is something they shouldn't be feeling. You have to meet them where they are and the perception level of where they are and say, hey, I'm concerned about this. I hear you and I'm concerned, let's go do this together. But it's a highly resistant population. Perception is a really difficult thing to treat. And it's usually long-term therapy with a skilled therapist that's going to make a difference in this. But there are people who do recover from it. And there are some people who take medicine that can really help cognitive behavioral therapy is highly effective. And if there's ever like a trauma point that can-- and there isn't always a place that's related to trauma or a specific incident. But if there is, there's work that can be done to help with that. Even like EMDR can make a difference in going much of this moment and reliving it and changing the neuroplasticity of that moment. So that is not held on. And then if it's yourself, do you have the insight to realize that this is different than other people? Do you have the self-analysis that this is hampering your life? Do you have enough loss that you no longer are going out? You've lost your friends. Your family is sad that you aren't going to do things. You feel terrible about yourself. You perhaps feel suicidal. Those are the signs that you also need to go get help. You need to tell somebody. Sometimes the first person they tell is a therapist. Some people can go on their own and get the help themselves. And others, it's asking someone to help them do it. So ask because there are things that can be done to help you feel better. And it is such a debilitating and disorder to experience. And there's so much loss associated with it that it always breaks my heart when I hear about it because I know that somebody who has suffered a long time. So body dysmorphic disorder is not about vanity. You can be helped. If you know someone, if you love someone, if you care about someone who you suspect, be their advocate and their allies, you pointed out. Encourage them to seek professional counseling without judging. And I know that this information will be helpful to individuals who do see that imperfection is much larger than it is and have unrealistic expectations. For those that want to make a correction, we want to reinforce that this is not about somebody who wants to have cosmetic surgery because they broke their nose playing lacrosse or maybe they don't like the fact that they were born with lips that are very small and receded. So they go and they have plastic surgery or even if they want to correct an issue with their genitals, with their labia because it's uncomfortable or just somehow got distorted during a surgical procedure. That's not what we're talking about. This is really the extreme of looking in the mirror and seeing someone that really doesn't exist. It's seeing the monster when there's really just somebody that's probably attractive, but yes, has some imperfections here and there. So that's great advice, Dr. Juliana. We appreciate you and we appreciate the takeaway and for any of you that are feeling like you have, may have this type of issue. We strongly encourage you to get the kind of cognitive behavioral therapy and support that you need to make you feel better about yourself and living a good life, a healthy life where you can love Mia Vietta. - Yes, and I'll double down on the last part too, which is I love it when I hear mental health terms being something that people are using and educating themselves and others about. But when it gets to the point that we're using it so that it is desensitizing, I'm using it correctly, but it prevents some people from really getting the help they need. So it's both shame reduction and also causing a hurdle for those to come in and we're not saying that wanting to change your appearance is a definition of it, but it's the level of intensity. It is the way that we talk about a lot in medicine is the quality of life is being impacted by the way that you perceive and are fixated on something. That's what we're talking about with being diagnosable. And again, there's lots of suffering that happens up until that, but the diagnosable part is something that is serious and needs intervention in order to have relief from and understanding the difference in that terminology is really what we're hoping to educate today. And as always, Jerry, just love what you and Ph.M. are doing and educating and you will hit any topic. And especially those that might be others avoid. So I always appreciate you. - Likewise, likewise, we appreciate you as well, Juliana, and we also appreciate all of those who listen and so remember to tune in again and do love Miha Vita. The love Miha Vita podcast is proud to be sponsored by Ph.M. Pharma founded by healthcare experts. Ph.M. Pharma is dedicated to providing research driven pharmaceutical grade solutions for the complex physical changes women experience throughout their lives, whether you are navigating hormonal shifts, seeking better intimate wellness, or simply looking for science-backed self-care. Ph.M. Pharma's Miha Vita product line is rigorously tested to ensure safety and efficacy without the use of hormones. Don't settle for good enough when it comes to your body. Visit Ph.M. Pharma.com to explore our full range of solutions designed to help you live vibrantly at every stage. - Thank you for joining us on the love Miha Vita podcast. Love Miha Vita means love my life. And that is a mantra we should all live by. Please like and subscribe wherever you get your podcasts and remember to follow us on social media and on Ph.M. Pharma.com. Thank you and be well.