The Birth Control Illusion: What Hormonal Contraception Does to Your Body | Tierra Duncan

Most of us went on birth control at 16 or 17 and never thought about it again. But what if it's been quietly affecting your mood, libido, bone density, and more — for decades — and no one told you?

In this episode of Between the Sheets with Dr. Z, Dr. Stephanie Zwonitzer, DNP talks with Tierra Duncan, author of The Birth Control Illusion: Reclaiming Hormones, Health and Your Cycle, about the gaps in women's health education around hormonal contraception — and what informed consent should actually look like.

What you'll learn in this episode:

• Why estrogen, progesterone, and testosterone are "whole body" hormones, not just reproductive ones
• How synthetic hormones in birth control differ from your body's natural hormones — and why that matters
• The real link between birth control and mood disorders, low libido, vaginal dryness, and bone density loss
• Why the "period" you have on the pill isn't a real period (and the surprising marketing history behind it)
• How birth control is often prescribed for symptoms (acne, cramps, heavy periods) instead of addressing root causes
• Non-hormonal alternatives, including the fertility awareness method and copper IUD trade-offs
• Why postpartum birth control decisions deserve more caution and conversation
• How tracking your cycle can help you understand your energy, mood, and body better — without falling into rigid "cycle syncing" rules
• Why sleep, stress, and nutrition play a bigger role in hormone health than most people realize

This is the conversation so many women wish they'd had before they ever started birth control — and one worth having now, no matter your age or stage.

🎙️ Guest: Tierra Duncan, author, educator, and women's health advocate
 🔗 Book: The Birth Control Illusion (Amazon, Audible, Kindle, Barnes & Noble) | YouTube & Instagram: @tierraduncanauthor | Website: tierraduncan.com

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Transcript

Stephanie Zwonitzer (00:01.052)
Welcome back to Between the Sheets. I am excited to have you guys here today. We are going to tackle a topic that not a lot of women even know they need to tackle, birth control and what it does to your body. I have guest Tierra Duncan here. She is an author, educator, and advocate.

She has had her own journey with birth control, which opened her eyes to the many gaps that exist in women's health education. And she is trying to clarify this for us. She's done research on it and she is here to open our eyes. Welcome, Tierra.

Tierra Duncan (00:31.778)
Thank you. I'm excited to be here.

Stephanie Zwonitzer (00:33.974)
Yeah, me too. You know, one of the things that I think is so interesting is as women, many of us went on birth control 16, 18, whenever we became sexually active or we were told that was how to deal with bad periods and cramps and things like that. And we don't really give it a second thought. Like, it's just birth control. It's been around forever. Everybody I know is on it. So let me just take it. And that's not really...

as accurate, right? So I want before we get into all of the nitty gritty, I want to hear your story and kind of how you came to be in this niche.

Tierra Duncan (01:05.506)
Yeah, yeah. I, to your point, the average age that a woman starts birth control is 16. And I was only a year outside of the exception on that. So I started at 17, but not because I was sexually active or trying to prevent pregnancy. I had excruciatingly painful periods. And for me, it got to the point where I went to the hospital. I thought that something was,

really wrong with me medically. They couldn't find anything. then shortly after I was diagnosed with endometriosis. So the conversation was go on birth control. That'll fix your pain. And that was it. And I was 17 when this happened. And if I'm going to be honest with you, exactly what you said, a lot of us go on it and then we don't think about it. I trusted that that was going to happen for me. I didn't have the excruciating pain anymore.

I started experiencing other symptoms that I did not link to birth control, but ultimately I was on some form of hormonal contraceptive until my early thirties. So that's quite a long time to be messing with your hormones. And during that timeframe, started group coaching classes, got into individual coaching one-on-one. And I found as I was working with women that I was running into a lot of the same issues. They were, you know, quote unquote,

Stephanie Zwonitzer (02:14.25)
Yeah.

Tierra Duncan (02:32.866)
doing everything right with the nutrition and their fitness, but we were having mood disorders or things with bone density or nutritional deficiencies. And I was like, man, what is going on? And I started realizing that I was pretty ignorant about cycle health, about cycle awareness, about our period, how powerful it is, and how birth control affects it. And that for me was very like, wow.

Stephanie Zwonitzer (02:54.54)
Yeah.

Stephanie Zwonitzer (03:01.899)
Mm-hmm.

Tierra Duncan (03:01.982)
I'm in this fitness health industry and I don't even know the basics of women's physiology. You know, I had to take a step back, I had to be a little humble and I started doing some research and four years later, four and some change, that didn't turn into a book called The Birth Control Illusion, Reclaiming Hormones, Health and Your Cycle and it's really about education. All the education I wish that a lot of us had at 16, 17, 18 and

There is no judgment. If you have this education and then you decide, I still want to take hormonal birth control, that's great. You just need to be fully informed about what the trade-offs might be. And if you experience any of those trade-offs, you can have those conversations with your doctors about what other alternative methods or how to adjust.

Stephanie Zwonitzer (03:39.873)
Mm-hmm.

Stephanie Zwonitzer (03:53.676)
Yeah, it's so interesting because as I'm listening to your story, I have such a similar one. I went on at 18 because my mother didn't want me on that before that. And so by 18, I was able to make the choice myself. I until my early 40s, the only time I have been off hormonal birth control was when I was pregnant with my two kids. I went off, got pregnant, went right back on and

I've been in medicine for over 20 years. I was a nurse, I'm a nurse practitioner. I was never taught how detrimental this could be. even if it's not that detrimental to you, just the background of what it is doing and what it may be responsible for when you think these other things like your depression and your anxiety and all of these other things have no link to that. And it wasn't until I really got into sexual medicine and women's health

that I started going, my gosh, this is affecting me. And I started looking at what I know you're gonna talk about all these different side effects and things and being like, holy crap, I've had these for years and I never even knew to attribute them to hormonal birth control. And I'm off of it now because I refuse to keep having that in my body.

Tierra Duncan (05:07.886)
Absolutely. And for women that might be listening to this that are like, okay, but I'm in menopause. Like I don't care. I'm in perimenopause. If you are someone that's transitioning, doctors will still prescribe birth control as a form of HRT. And I know this is not an, I'm sorry, hormone replacement therapy. And I know this is not an HRT conversation, but the question of birth control in synthetic hormones is relevant throughout our lifespan. And also this idea of

we have signs and symptoms that we are told to dismiss and ignore and it's normal. And again, that is very relevant to menopause as well. And it's just like, you know, this overarching theme of through puberty, through our reproductive years, it's a perimenopause and menopause. Women are consistently told, deal with it. And the more that, and I'm sure this is the case for you, the more that you learn about sexual health and women's health, you're like, no.

Stephanie Zwonitzer (05:57.12)
Mm-hmm. Yeah.

Tierra Duncan (06:04.802)
We don't have to deal with it. This doesn't have to be normal just because it's common.

Stephanie Zwonitzer (06:09.652)
Absolutely, absolutely. And to your point about the perimenopause timeframe, the hormones in birth control, number one, like you said, are synthetic, and number two are at higher levels than we would give you with HRT. So it's an easy fix for gynecologists or paramedic cares who don't know any better. Here's some hormones, right? But it's not great. It's actually detrimental to you. But let's go to our ladies who are

using it for birth control. Okay, let's start there. We don't want to get pregnant. You know, maybe it's the bad periods and PMS things, whatever. But we definitely don't want to get pregnant. What are let's start with, we chose birth control, we didn't know there were other options, we chose the oral pills. What are some of the things that women may experience while they're trying to prevent this pregnancy?

Tierra Duncan (07:03.502)
Sure. So I'll kind of step back a little bit just to talk about our sex hormones, right? So we talk about, we hear about estrogen, progesterone, and testosterone. And one of the key factors, something that I learned throughout this process of research, I kind of just assumed that, yeah, these are reproductive hormones. Why would I care? But in fact, they're full body hormones, meaning that estrogen, progesterone, and testosterone interact with

Stephanie Zwonitzer (07:27.02)
Hmm.

Tierra Duncan (07:31.726)
your brain, your cognition, desire, motivation, energy, bone health, the way that our bones break down and regrow, cardiovascular health, which is directly attributed to arousal in the genital region, mood, estrogen is great for, stable estrogen is great for serotonin, feeling good and dopamine.

Stephanie Zwonitzer (07:43.36)
Yeah.

Stephanie Zwonitzer (07:46.71)
Mm-hmm, that's right.

Tierra Duncan (07:58.51)
Progesterone is our calming hormone, which helps with anxiety and depression. And again, testosterone is going to be that drive, that motivation. And I was kind of blown away by like, oh my goodness, how do we not know that these hormones aren't just one thing? Testosterone is not a male hormone. It's a full body, everybody hormone. So taking that knowledge and then applying it to birth control,

Stephanie Zwonitzer (08:19.893)
Yeah, one thing.

Tierra Duncan (08:23.618)
These synthetic hormones, specifically synthetic estrogen, which is usually ethanol estradiol, and synthetic progesterone, which is progestins. Really important thing to understand is they do not react to the body the same way your natural endogenous hormones do, right? Natural estrogen and natural progesterone are quickly metabolized, so they don't affect the body if you try to take them orally.

That's why doctors created these synthetic versions, but they do not give you the same benefits, those calming benefits, the way that we ovulate, all that. So they're there to suppress ovulation, suppress the communication between your brain and your ovaries, and change your cervical mucus and your uterine lining. And there are different types of birth control. So the pill, for example,

contains both synthetic estrogen and progestin, or something like a hormonal IUD is progestin only. So those are important factors to consider, especially if you are interested in various types and find that maybe you're responding to one more negatively than the other. Common symptoms that people will find are gonna be nausea, breast tenderness, headaches, on the more extreme side, mood disorders, especially for young women, anxiety, depression.

suicidal ideation in kind of again, those more extreme cases for something that's long lasting like depo provera bone density is a really significant consideration and Blood clotting which is scary, but it happens. I have a girlfriend that had a stroke in her late 20s and It was attributed to the pill. So it does happen. It's is it rare, of course, but it's still clinically significant

Stephanie Zwonitzer (10:02.251)
Yes.

Stephanie Zwonitzer (10:12.608)
Mm-hmm.

Stephanie Zwonitzer (10:20.544)
Yeah. One thing that I found really interesting is when we're talking about hormone replacement therapy, there was this study back in the early 2000s, women's health initiative and hormones were terrible. They cause cancer, they cause dementia, they cause stroke, whatever. Those hormones that they checked in that study were synthetic, Conjugated equine. Yep. Yep. Exactly. So what's interesting to me is

Tierra Duncan (10:40.142)
Were they the conjugated equine or whatever? Yeah, yeah.

Stephanie Zwonitzer (10:49.116)
That affected women being treated for perimenopause and menopause, but never surfaced in the discussion of birth control. Birth control just rode right through.

Tierra Duncan (10:59.33)
Yeah, whoever their PR team is, right? For birth control, crushed it. Yeah, and that's something that I find that really kind of reset my whole focus. Birth control is medication. And culturally, we don't think of it that way. It's so in kind of ingrained in the zeitgeist of gynecology and kind of a woman's journey. don't think it's medication. And like all medications, there are

Stephanie Zwonitzer (11:15.361)
Right.

Tierra Duncan (11:28.568)
trade-offs. And I think if you had told somebody like everybody needs to go on blood pressure medication at 18, you're like, are you out of your mind? Why? Birth control is very effective for preventing pregnancy, but it's often prescribed for things that have nothing to do with pregnancy, acne, painful periods, heavy periods. So now not only is it this medication that's being widespread, but it's being prescribed for things that there might be other

underlying causes that we can address without having to go directly to medication.

Stephanie Zwonitzer (12:00.652)
Yeah.

Stephanie Zwonitzer (12:04.18)
Right, right. No, you're so accurate. And I think what's really interesting is, you like you were saying, the hormones are whole body. I found it fascinating as I was doing my hormone research and getting certified in DHRT. There's more testosterone receptors on the heart than anywhere else in the body. And you would think it would be the penis or the clitoris because that's where arousal is, right? Like, but it's the heart. There are more estrogen receptors in the brain.

than in our reproductive area. There's so many different things, like you said, that these hormones are involved in. So when we're trying to control one tiny little thing of not getting pregnant or not having acne or not having cramps, and yet it is systemically affecting every system in our body because these hormones are involved in every system in our body,

man, that takes on a whole nother level. And like we need informed consent for birth control. We need a lot more education before we just throw these women on it. And me personally, when you're talking about the depression and the suicidal ideation, I had postpartum depression after my son. I thought that's all it was. But I went on birth control as soon as he was born. And so not only did I have crazy hormones going on,

because I was postpartum and your fluctuations are huge, but now I'm synthetically trying to control things. And I was suicidal. I had a hard time taking care of my babies. There were times where their dad would come home and he'd be like, when's last time the kids ate? And I would just look at him like, great question. You know, and thankfully that didn't happen a lot, but there were days that that happened. And by the time I got help, here's your antidepressant. No one

ever talked to me about how that could be related to birth control and what other options I would have to prevent pregnancy that might be less with those symptoms.

Tierra Duncan (13:58.54)
That is, first of all, I am very sorry to hear you went through that. And that is unfortunately a very common story. I also experienced postpartum depression and postpartum anxiety. Luckily for me at that time, I said no to birth control because that is one of the first things, hey, you're fertile now, get on this. We need our bodies to be able to regulate and going back to the education piece,

Stephanie Zwonitzer (14:15.468)
Thank you.

Tierra Duncan (14:27.924)
something that women don't understand is when you become pregnant, the placenta takes over on hormone production for progesterone and then the type of estrogen changes. It's estriol instead of estradiol. And so when you deliver your baby and then you deliver the placenta, that machine that was giving you all those high hormones goes, and so you're, I want women to know that it's physiological. You are not crazy.

Stephanie Zwonitzer (14:32.758)
Mm-hmm.

Stephanie Zwonitzer (14:40.939)
Mm-hmm.

Tierra Duncan (14:57.198)
The things you're experiencing are incredibly valid. And if somebody is in the position that you were in, please seek help, right? And it's not just psychological, it is literally your biology. But your mention of the antidepressants, I'm actually writing my third book right now, and it's about antidepressants. Because women, I call them like the four horsemen of women's prescriptions. We have birth control.

Stephanie Zwonitzer (15:09.643)
Mm-hmm.

Tierra Duncan (15:26.99)
Maybe you gain weight or you have issues with weight. We go on GOP1s, we have mood disorders, we go on antidepressants, we have focus issues, we go on ADHD meds. And my goal long-term is to do education on all those mechanisms. But going back to birth control, like the idea that we always just prescribe, prescribe, prescribe, and we never get to the root cause. And it really takes away our power as women.

Stephanie Zwonitzer (15:35.798)
Mm-hmm.

Stephanie Zwonitzer (15:51.595)
Mm-hmm.

Yeah, it does. And it's interesting because I have my clinic, Revive, and we do health and hormones. And most of what I do is perimenopause and menopause for women and TRT for men and sexual health things. But there are some women younger that want to come in because they have PCOS or things like that. But what I find is I developed Revive with a non-conventional medicine, right, where you can spend more time. We can do more testing. We can talk about all of these pros and cons.

When you go to a conventional doctor's office, you get 10 to 15 minutes with that person. That's very difficult to bust through all of the potential side effects. What's going on? How are you mentally, physically, all of these things? And so it's honestly, our medical system has it wrong. Number one, we're not taught the things. Number two, because we do things based off of what insurance allows us to do,

we're not able to give people the time that they need to actually explore all of this stuff. And so I think, you know, some of these concierge styles and things, clinics that are coming up really are a benefit to our patients to be able to tackle these topics and spend the time to get there.

Tierra Duncan (17:11.66)
Yeah, it's changing the game. And I know not everybody has the resources for that. For me, going to finding a functional medicine doctor during my transition off birth control was a lifesaver. And you're right, the conventional system is symptom-based and symptom-focused and not there to treat root causes, right? And I know that's a very general statement and I know that'll probably upset some people, but it's not because people are...

Stephanie Zwonitzer (17:13.419)
Mm-hmm.

Stephanie Zwonitzer (17:28.406)
Mm-hmm.

Tierra Duncan (17:39.982)
malicious. It's because there's insurance, but also I'm seeing 20 patients a day or 30. How many patients? You tell me this is how you feel and I want you to feel better. I know this medication will help with those symptoms. So I'm doing my best with the knowledge that I have and I want to make sure I'm giving you what you need. And that's just kind of how the system is. But you're absolutely right. 10, 15 minutes. You can barely get someone's health history. Right. And then, you know,

Stephanie Zwonitzer (17:54.454)
Mm-hmm.

Tierra Duncan (18:09.422)
I don't have this experience as a clinician, but as a coach, I'll ask somebody questions and they'll be like, no, no, no, I don't drink or whatever. And I'm like, okay, but you said you, what's occasional, what's this? And you're like, no, I actually drink two glasses of wine every night. You're like, well, okay. Sometimes it takes a little bit more time to dig further or you don't think about something because you've normalized it as a part of your behavior.

Stephanie Zwonitzer (18:17.452)
Mm-hmm.

Stephanie Zwonitzer (18:25.856)
Yeah. Yeah.

Stephanie Zwonitzer (18:34.624)
Yeah. Absolutely. I had a patient tell me he gave up drinking two years ago, but he has a beer every night.

Tierra Duncan (18:40.034)
Yeah, that literally, yeah. And I'm like, okay, know, that's important. Yeah, yeah, yeah. Yeah, yeah, exactly, exactly. And it takes time to get to those truths. It is an unfortunate side effect, but I think what you're doing and what other places are doing is gonna really change the game. I'm excited for kind of this transition into more individualized and personalized care.

Stephanie Zwonitzer (18:44.478)
Yeah, that's actually still drinking, sir. That's just not drinking hard liquor.

Yeah.

It does.

Stephanie Zwonitzer (19:04.492)
Yeah.

Stephanie Zwonitzer (19:08.81)
Yeah, I agree. It's a revolution for sure. So let's talk through some of these side effects that maybe women don't even really realize. For example, your libido.

Tierra Duncan (19:20.652)
Yeah, so this goes to understanding testosterone. There is, we have something called sex hormone binding globulin. And I like to tell people to think of it as like a taxi service, right? Your hormones jump in there, they're in your system. And while your hormones are in there, like testosterone, they can't affect the tissues or affect the systems. So really it's free testosterone, those that are not in the taxi.

Stephanie Zwonitzer (19:25.046)
Mm-hmm.

Stephanie Zwonitzer (19:31.456)
Mm-hmm.

Tierra Duncan (19:50.764)
that are making you feel aroused and helping with lubrication and doing all those things. So with synthetic hormones with birth control, specifically synthetic estrogen, it has a tendency to raise SHBG, that sex hormone-blinding globulin, meaning there are more taxis and less free testosterone. This doesn't happen to every woman.

Stephanie Zwonitzer (20:17.42)
Mm-hmm.

Tierra Duncan (20:18.06)
but where the downstream effects of that now, again, it affects drive motivation. Synthetic estrogen is meant to suppress ovulation, and ovulation is where you get slippery egg white, not discharge, excuse me, lubrication, right? Because you wanna have a baby and you wanna make sure the sperm has an easy route. So now you're dealing with less desire potentially.

Stephanie Zwonitzer (20:30.006)
Mm-hmm.

Tierra Duncan (20:47.766)
lubrication that is not conducive for your comfort. And then also, you know, potential vaginal dryness comes from that. And so it can be very subtle at first, but you may find just less interest in sex. Or if you still have desire, the physical changes don't make it comfortable because you're not something that increases our desire. We're built. Fertility is built to make us want to have sex. That's just

Stephanie Zwonitzer (21:15.403)
Mm-hmm.

Tierra Duncan (21:15.906)
when we ovulate is ready to go. And when you flatten that, yeah, you just may be like, I could use it or lose it, right? So that's one of the potential side effects to libido.

Stephanie Zwonitzer (21:27.392)
Yeah, it's really fascinating. I don't think anyone realizes, or most women don't realize, that that could be related to their birth control.

Tierra Duncan (21:34.914)
I mean, I definitely had impact with that. And then for women that potentially have like a vaginal ring or even like a copper IUD, your vaginal microbiome can be affected by that. So now you potentially have yeast infections or bacterial vaginosis or, and obviously that's not something pleasant. Some women feel implants, right, in that area and that can make sex uncomfortable. everything, it's not set in stone that someone's gonna feel this way, right?

Stephanie Zwonitzer (21:56.588)
Tierra Duncan (22:04.642)
definitely things to consider and they're not just you being a woman.

Stephanie Zwonitzer (22:09.356)
Yeah, absolutely. So if women are experiencing these side effects or listening right now and thinking about getting on birth control, what are some alternatives that they can prevent pregnancy but maybe not have so many hormonal disruptions?

Tierra Duncan (22:26.754)
Yeah, totally. I think first understanding your cycle is really important. We're actually only fertile in a very short window. That 12 to 24 hour period for ovulation is when that egg releases, looking for sperm, that's when you're actually fertile out of that entire cycle timeframe. For most women, it's between 21 and 35 days. The reason we give it a five day window around there is because sperm can live up to five days. So...

we'll just say five days within your cycle. If you can understand that and track that, and you have regular cycles, you can use the fertility awareness method, FAM. That's what I use now, and that's what I've been using for years. And then if I'm around that time, we use contraceptives, we use condoms. And you get all the benefits of ovulation without having... And obviously...

Stephanie Zwonitzer (23:21.963)
Yeah

Tierra Duncan (23:23.622)
And to make it really clear, there's no 100 % guarantee for pregnancy prevention except for abstinence. And that includes, you hear those crazy stories, I took a hormone IUD and I had a topic pregnancy, or I still am not pregnant and luckily was able to have the baby. Like it happens. There's no 100 % unless you are just not having sex. So that's a method. And then again, contraceptives.

Stephanie Zwonitzer (23:29.814)
Correct.

Tierra Duncan (23:50.188)
And again, I mentioned the copper IUD, that is the non-hormonal method. But to go to the point of the copper IUD causes its localized inflammation. So for some women, they experience heavy prolonged periods due to that increased inflammation, which can be very uncomfortable. And there is some research. It's not conclusive that it could actually affect a quality long-term. So again, not yes or no.

Stephanie Zwonitzer (24:16.236)
Hmm.

Tierra Duncan (24:20.458)
Everything you're doing to impact your body systems will likely, internally, will likely have some sort of trade off. You just have to decide if that's what you want.

Stephanie Zwonitzer (24:29.44)
Yeah, absolutely. Yeah, I mean, we're certainly not here saying don't go on birth control and have 27 children. know, that has a, you know, that's gonna have its own effects on you.

Tierra Duncan (24:36.846)
If that's what you want to do, you do you. Yeah.

Yeah, yeah.

Stephanie Zwonitzer (24:45.996)
But, you know, I think it is. It's just having the information to make the decision that's best for you.

Tierra Duncan (24:53.286)
Yeah. And you might again, decide that like the pill, I can't handle synthetic estrogen. So I'm going to go to a mini pill, which is progestin only, or I can't do the implant because that's this long lasting systemic. I'm going to do a hormonal IUD, which is technically more localized, but it still gets into your bloodstream. You may feel better on one than the other. And that's really between you and your provider, but you cannot make that decision without understanding what symptoms to look out for.

And even though I tell women, whatever you want to do, I also want to step back and say, your period is an insight into your health. We don't think of it that way, but what's that book? Your period is the fifth vital sign. I would love for women to think of their cycle, especially someone that had an incredibly painful cycle, as something that you can kind of take back and feel powerful and

Stephanie Zwonitzer (25:36.981)
Yeah.

Tierra Duncan (25:49.43)
be aware of how you feel in it and so that it doesn't become this thing that you dread or you know, wish to be rid of or can't, I can't wait for menopause. actually let's try to push that off as much as possible. Periods can be so amazing. And I just wish more, I wish we could reframe it.

Stephanie Zwonitzer (25:58.668)
Yeah.

Yeah.

Stephanie Zwonitzer (26:09.908)
Yeah, absolutely. I know one of the other things that you researched quite a bit was the cycle and how it affects our daily life and things like that. Can you talk a little bit about that?

Tierra Duncan (26:15.618)
Yeah.

Yeah, yeah, every, again, every woman's gonna feel different through different phases of her cycle. But I didn't, a lot of us think of menstruation in our period is just bleeding. But really it's this, it's four phases with bleeding being like one sliver of this whole thing. And it's your brain and your ovaries having this communication.

Stephanie Zwonitzer (26:41.74)
Mm-hmm.

Tierra Duncan (26:44.224)
you, again, going back to that ovulation piece, that's kind of really the star of the show. As we, the first phase is the follicular phase. So that's when the follicles are maturing. That is what allows estrogen to rise. And we get those really amazing benefits, those cognitive benefits, those energy benefits. And for a lot of women during the like follicular to ovulation phase, they're feeling ready to go and motivated and all those things because of that really beneficial rise in energy.

or excuse me, estrogen. Then luteinizing hormone comes in, we release that egg, that follicle that had the mature egg turns into the corpus luteum, and that is what creates progesterone, right? And then we get to really get the benefits, those calming benefits, the things that prevent that, right? Anxiety and depression has that relationship with bone health and cardiovascular health. When you bypass certain elements of that, now you're...

not producing meaningful progesterone or estrogen and then.

Bless you. And then not getting those benefits. And then with menstruation, everything drops and you may feel off, right? For some women, being able to track those changes can help you make better decisions in your day to day. For me personally, my endometriosis impacts ovulation now more than a desmenstration. I actually feel not great a couple of days before ovulation. So I take that into consideration. do

Stephanie Zwonitzer (28:02.623)
Mm-hmm.

Tierra Duncan (28:17.61)
more anti-inflammatory supplements, stuff like that. And during the luteal phase, I feel great. So for me, I will just be more aware and make minor changes to see how I feel. But for other women, it could be the opposite.

Stephanie Zwonitzer (28:31.892)
Yeah, but it's neat to kind of track that and to watch how it affects you because you can actually adapt your life to this. So you can go out with your girlfriends, do harder workouts, things like that when you have that energy boost. And then when you have that more calming progesterone time, maybe do some more yoga's and some walks and not such intense exercise. Maybe plan some time where you don't go out every night of the week and you kind of just allow yourself that slower timeframe.

Maybe during that high energy phase, you really hit hard at work and try and get through a project so that during that calming phase, you can kind of chill and just review everything and finish all the details and that kind of thing. It's actually really empowering to learn your cycle and make life choices based off of it.

Tierra Duncan (29:21.248)
Yeah, I do want to do a small caveat there. I am not a fan of cycle syncing as a temp.

Stephanie, you and I have different cycles. Like I just said, I do not feel good around ovulation, but the little teal phase is usually when I actually up my intensity for my workouts, because I feel better and feel more energized. if you and I, and I want to say cycle syncing is like established templates that you should do X, Y, and Z at certain points of your cycle. What I would advise women is like you said, track your own symptoms, reflect on that.

Stephanie Zwonitzer (29:55.212)
Mm-hmm.

Tierra Duncan (29:57.664)
and then make those day to day or week to week changes so that you feel better and stronger. So I kind of want to separate that because I know, unfortunately, cycle syncing gets sold as a narrative or program or whatever sometimes. And it can be very limiting. If you feel good, you're like, maybe I shouldn't go for a run because I'm not supposed to. No, dude, if you feel it and you're sleeping well and you're eating well and you like ready to rock and roll, then go rock and roll.

Stephanie Zwonitzer (30:10.122)
Yeah, bad right now, Yes.

Stephanie Zwonitzer (30:27.008)
Yeah, absolutely.

Tierra Duncan (30:27.17)
I just don't want women to feel limited by that. It's really going to be your individual response.

Stephanie Zwonitzer (30:33.9)
100 % and that's why as I was describing that I wasn't saying, know, you're luteal or whatever. It's just when you are feeling higher or lower or whatever you can plan accordingly. But you're right and even from cycle to cycle what worked last cycle might be slightly different this cycle might especially now that I'm in perimenopause and all that my cycles are ridiculous, but you know and my cycles change every month and how many amazing days I have and how many slower days I have and all that so

Tierra Duncan (30:38.786)
Yeah, absolutely.

Stephanie Zwonitzer (31:01.482)
You're right, you can't completely predict each cycle to each cycle. Like hey, day seven through nine, I'm gonna go out and paint the town red, and then days 13 and 14, I'm gonna not do anything. So you can't do it exactly that specific, but if you pay attention to your cycle, there's a lot of apps that you can put in, like your mood, like how you actually feel during the day and stuff. And if you kind of pay attention to your patterns and how you feel over time, you can kind of make those adjustments as to

Tierra Duncan (31:09.783)
Yeah, yeah.

Stephanie Zwonitzer (31:31.392)
you know, when you want to maybe do more or less. But again, it can change from cycle to cycle. It's very individualized. I absolutely agree with you.

Tierra Duncan (31:38.81)
Yeah. And fortunately or unfortunately, as women, we are very sensitive to our inputs. So let's say I have a two and a half year old girl. Let me tell you, the amount of crud I get from daycare, right? So I might have like a cough or a cold or an upset stomach. And then that can lead to my cycle being different the next month, right? Or I have a really stressful project at work.

Stephanie Zwonitzer (31:53.643)
Yes.

Stephanie Zwonitzer (32:02.166)
Mm-hmm.

Tierra Duncan (32:06.338)
And that might change. So we're very sensitive to our inputs, our stress, our nutrition, our movement, getting sick, traveling. And so even if you don't have a good cycle or two, that doesn't mean there's anything wrong with you. But you're not going to know that if we're not tracking.

Stephanie Zwonitzer (32:23.242)
Yeah. Yeah, I found it very interesting to start tracking because I kind of like in the back of my head kind of knew, especially when I was on the pill, obviously I knew when my period was coming. It was calculated. But I didn't really pay attention to like when I felt higher or lower or whatever. It was just, this is my period. I'm getting some PMS. I'm getting whatever. And since I've come off of the pill, I've been a lot more in tune with

How am I feeling? When am I feeling it? All of those things. And it's very eye-opening to me and empowering to me to make daily choices based on how am I actually feeling today? What is my body going through? It really helps you be more in tune to what's going on with you.

Tierra Duncan (33:08.91)
Yeah, I'm actually really glad you brought up bleeding on the pill. So this is a really common misconception that if you are the patch, the pill, I'm trying to think of the ones that you cycle on and off, like three on one off. I think I might be missing one. Yeah, thank you. The ring. So there's this misconception that the bleed that you have on these forms of birth control is a period. It's not. It's called, it's what's called a withdrawal bleed. And to kind of make that distinction because

Stephanie Zwonitzer (33:21.832)
Yeah, like the maneuvering.

Stephanie Zwonitzer (33:31.901)
Right. Yeah.

Mm-hmm.

Tierra Duncan (33:38.754)
birth control suppresses ovulation, you can't have a true period without ovulation. And that can make it confusing. You're on the pill, you think you're bleeding or you think you're having that, but really what's happening is that when you have that week off, your hormones drop and your uterine lining just sheds, but it's not that natural process. And what's really interesting, when the birth control pill was invented,

Stephanie Zwonitzer (33:47.68)
Mm-hmm.

Stephanie Zwonitzer (33:51.852)
having a regular period.

Stephanie Zwonitzer (33:59.885)
Mm-hmm.

Tierra Duncan (34:08.654)
Initially, they didn't have that withdrawal period, but one of the co-creators was a very religious man. And in order to make the pill more, what's the word I'm looking for, pleasant or appealing, that's sort of appealing to other religious people, they added that withdrawal bleed as a kind of like a...

Stephanie Zwonitzer (34:25.952)
Yeah.

Stephanie Zwonitzer (34:34.314)
Mm. Okay.

Tierra Duncan (34:36.428)
to make you feel more normal about losing your cycle. So really it's not even a biological necessity for you to have a withdrawal bleed. And that's why you see in other forms of birth control, women can have sporadic or lose their menstrual cycle altogether. Cause that's not technically needed because you're not actually having a real period. But yeah, it was a marketing tactic. Isn't that interesting? Yeah.

Stephanie Zwonitzer (34:39.476)
interesting.

Stephanie Zwonitzer (34:59.38)
Interesting. Yeah, yeah, I didn't know that. That's amazing. So yeah, yeah, learn new something new every day. That's great. What else would you like our women to know in regards to kind of this sexual health cycle birth control area that we've been talking about?

Tierra Duncan (35:04.398)
It worked.

Tierra Duncan (35:19.628)
Yeah, so something that I also like to focus on is the things that are in within your control. So the third part of my book, so first part is all about hormones, second part is all about your menstrual cycle and birth control, and the third part is all about lifestyle. We don't, I think a lot of us don't understand just how critical sleep, stress, nutrition of movement are to our daily function, how we operate.

Stephanie Zwonitzer (35:25.324)
Hmm?

Stephanie Zwonitzer (35:41.612)
Mm-hmm.

Tierra Duncan (35:45.91)
and how those play with our sexual health and our hormones. I'm a really big proponent of understanding those elements and also kind of just giving some guidance as to why these things are beneficial from a mechanism and scientific standpoint, not just getting an eight hours sleep, but why? Why do I care about eight hours of sleep? Why is that important? So yeah, I would like women to know that you have more in control than what you think.

Stephanie Zwonitzer (36:03.916)
Mm-hmm.

Tierra Duncan (36:14.274)
based on those lifestyle factors. And that's, again, really powerful.

Stephanie Zwonitzer (36:18.058)
Yeah, yeah. I think sleep is one of the most underrated things that we can do for our overall health. It is constantly something I tell people about both men and women for your hormone balancing. So much happens while we are asleep to repair ourselves, to balance ourselves. And if you are getting interrupted sleep, not enough sleep, you know, those kinds of things.

something is not going to be right in your body because of that. And that is one of the first things I always talk to people about is let's fix your sleep first and give it a few weeks and see how you feel because that alone can fix a lot.

Tierra Duncan (36:59.278)
That's why in the lifestyle section, I start with sleep. Because you and I are on the same page. The idea that you're going to have the ability to effectively manage your emotions and stress, that you're going to make good decisions around your nutrition, that you're going to have motivation to move without the foundation of a good night's rest, forget it. You're immediately in survival mode, and you're not thriving.

Stephanie Zwonitzer (37:02.486)
Yeah.

Stephanie Zwonitzer (37:19.072)
Yep, completely agree. Yep. Correct. And then it throws your cortisol, which is one of your other hormones off, which affects your sex hormones. Or like I like to say your sex and whole body hormones, because we've as we discussed earlier, they are throughout the whole body. But I appreciate this discussion so much here. This has been very enlightening to myself and I'm sure to all of the listeners. Where can people find you? How can they read your book?

Tierra Duncan (37:31.04)
Yes.

Tierra Duncan (37:35.116)
Yeah. Yeah.

Stephanie Zwonitzer (37:48.318)
go ahead and give us some information about you.

Tierra Duncan (37:50.446)
Yeah, yeah. So the book is out on all the normal platforms. Amazon, I I did audio version, audible version, Kindle, Barnes and Nobles, like anywhere you can find a book online for different formats, you can find it. I have a YouTube channel, Tierra Duncan author. I put out all kinds of just content. I do interviews like this when I talk to really cool people in this space about

kind of all things women's health from training to postpartum. yeah, yeah, you're really cool. Look, I'm all about, look, the more that we can talk about sex, the better, right? And I also have an Instagram, tiara Duncan author, try to keep it easy. And my website tiaraduncan.com. If you just put tiara Duncan, you'll probably find me. But this has been wonderful. Thank you, Stephanie.

Stephanie Zwonitzer (38:23.712)
Does that mean you're calling me really cool?

Stephanie Zwonitzer (38:41.032)
Awesome. And just Google it. Yeah, absolutely. Thank you so much for being here. And we will certainly put all those links in the show notes for you guys as well. So as you're driving around town right now, you don't have to try and write this down. So we will put Tierra Duncan's information in the show notes. Thank you so much for being here. This has been an amazing conversation. Yes.

All right, everybody, don't forget to check out reviveish.com for all your health and hormone and sexual wellness needs. And as always, go have some fun between the sheets.