Understanding Female Anatomy: Straight Talk with Dr. Jolene Brighten


In a world where the perfect vulva is pushed by cosmetic surgeons and online forums, one expert is breaking down the reality of the female anatomy. But when it comes to labia hypertrophy and the incomprehensible husband stitch, who can women trust to make the right decisions for their bodies? Tune in for some straight talk that will leave you empowered and educated.

“Just because you’ve been told they’re the expert, doesn’t mean that you relinquish your power, your control, your bodily autonomy.”

Dr. Jolene Brighten


Jolene Brighten is a board-certified naturopathic endocrinologist, clinical sexologist, and prominent leader in women’s medicine. She has gained international recognition as a speaker, clinical educator, and medical advisor within the tech community. Jolene is a faculty member at the American Academy of Anti-Aging Medicine and part of the MINDBODY Green collective. Her work has been featured in numerous prestigious publications such as Forbes, Cosmo, and The Guardian.




(Timestamps are approximate)

00:07:32 – Vulva Appearance and Color Variations,
Dr. Brighton discusses how the vulva can vary in appearance and color, from having sparse hair to having a lot of hair. She also explains that the color of the skin can range from mahogany to pink, and that changes in hormones can cause variations in the pigmentation of the vulva.

00:12:03 – Bias in Gynecological Medicine,
Dr. Estima and Dr. Brighton discuss how bias can be created in gynecological medicine due to the lack of representation of variations in anatomy in medical textbooks. They explain that the white body is often positioned as the standard by which all clinicians are taught, and that there is often a lack of representation of variations in female anatomy.

00:23:55 – Becoming Cliterate,
Dr. Brighton discusses her book, “Beyond the Pill,” and how it addresses the hormonal fluctuations that impact female sexual health. She also discusses her recent certification as a sex counselor and her work in promoting sexual health education.

00:14:49 – Embryonic Development and Provider Bias,
Dr. Stephanie and Jolene Brighten discuss how provider bias exists and how it impacts medical treatment. They mention the embryonic development of the labia majora and testes and how it highlights the fascinating intricacies of the body.

00:17:14 – Labial Hypertrophy and Labiaplasty,
Jolene explains labial hypertrophy and how it can impact daily activities like bike riding. She also discusses the issues with labiaplasty and how it is a problematic and predatory behavior by some cosmetic physicians. Jolene recommends consulting with a board-certified plastic surgeon and understanding the risks and expectations before considering the surgery.

00:21:03 – The Husband Stitch,
Jolene explains the problematic practice of the “husband stitch,” where doctors put an extra stitch in during post-birth suturing to make the vulva tighter. She discusses the patriarchal origins of the practice and its lack of understanding of vaginal function. Jolene emphasizes the importance of getting a second opinion and advocating for your bodily autonomy.

00:25:28 – Tightness and Tenting,
Dr. Stephanie and Jolene discuss how the idea of a “tight” vagina is a myth and how it is a fundamental misunderstanding of the structure and function of the vagina. They explore how vaginal muscles are under the control of hormones and are receptive to sexual stimuli.

00:29:04 – Understanding Vaginal Fluids,
Brighten breaks down the different types of vaginal fluids, including discharge, cervical fluid, and arousal fluid. She explains how estrogen affects the production of cervical fluid, and why it is important for maintaining a healthy vaginal microbiome. She also emphasizes the need for lube and discusses different types of lubes for different activities.

00:32:43 – Debunking Myths About Vaginal Odor,
Brighten clarifies misconceptions about vaginal odor and discusses how it can be affected by factors such as sweat glands and bacterial overgrowth. She explains that every person has their own unique scent and taste, and that a vagina should not necessarily smell like plain yogurt.

00:35:45 – The Scent of a Healthy Vagina,
The hosts discuss the idea that a healthy vagina should smell like yogurt, but Brighten explains that this is because plain yogurt contains lactobacillus acidophilus. She notes that everyone’s scent is unique and discusses how hormones can affect vaginal odor, with testosterone being a key factor.

00:39:08 – The Menstrual Cycle and Vaginal Odor,
Brighten explains how the menstrual cycle can impact vaginal odor, with changes in hormones such as testosterone and progesterone playing a role. She emphasizes that the goal of the menstrual cycle is ovulation, not just the period, and encourages a better understanding of the phases of the cycle.

00:43:26 – Misconceptions about the Hymen,
The hymen has been misconstrued as a proof of a woman’s virginity, which is a male-dominated truth. However, the construct of virginity is a societal construct that is not based on science. The hymen serves the purpose of protecting the vagina in infancy from fecal matter getting in there.

00:48:09 – Impact of Glucose and Insulin on Sexual Function,
Balanced blood sugar is the foundation of hormone health. Insulin resistance can lead to brain fog and hanger attacks. Increased insulin can decrease sensitivity of the clitoris and lead to erectile dysfunction. Glucose and insulin have a significant impact on sexual function.

00:49:02 – The Importance of Blood Sugar Regulation,
Adrenal health and insulin regulation are the foundation of hormone health. Brain fog and hanger attacks are early warning signs of blood sugar dysregulation. Erectile dysfunction and clitoral sensitivity can be affected by blood sugar regulation. Continuous glucose monitors are useful for monitoring blood sugar levels.

00:53:41 – The Inaccuracy of Judging Health by Appearance,
Health cannot be judged by appearance. Body type does not indicate health levels. Medications, thyroid dysfunction, and birth control pills can cause obesity. The double-zero phenotype can indicate internal inflammation and high LDL cholesterol, which can lead to heart disease.

00:57:07 – Stress Management in Perimenopause,
Stress management is the most important skill to acquire in perimenopause

00:57:43 – Perimenopause and Society,
Dr. Estima and Jolene Brighten discuss the challenges of being a modern woman going through perimenopause in a society that is not set up for women to succeed. They also talk about the lack of support for caregivers of children and elderly parents in the United States compared to other countries.

00:59:41 – Managing Stress and Prioritizing Self-Care,
Dr. Estima and Jolene Brighten emphasize the importance of managing stress and prioritizing self-care to support adrenal gland health during perimenopause. They also discuss the negative effects of not getting enough sleep, hydration, and nutrient-dense food.

01:02:31 – Adrenal Glands and Cortisol,
Dr. Estima and Jolene Brighten explain the importance of the adrenal glands in producing cortisol, epinephrine, and norepinephrine stress hormones. They discuss how chronic stress can lead to cortisol dysregulation and the need for restorative sleep and stress reduction techniques to support adrenal gland health.

01:04:35 – Superwoman Complex and Prioritizing Self,
Dr. Estima and Jolene Brighten discuss the “superwoman complex” and the pressure on women to be everything to everyone. They emphasize the importance of prioritizing self-care and recognizing the need for rest and downtime, rather than constantly sacrificing oneself for others.

01:10:50 – The Impact of Dysregulated Glucose on Hormones,
Dysregulated glucose and insulin can have a downstream effect on testosterone and estrogen dysregulation. It’s important to address these issues to achieve hormone balance and overall health.

01:11:25 – The Importance of Feeling Safe for Sexual Health,
Feeling safe and secure is vital for healthy sexual function. The nervous system needs to feel aligned with hormone levels for penetrative sex. Many coaches have emerged to offer guidance on cultivating balance and energy alignment.

01:12:41 – Gender Roles and Masculine and Feminine Energy,
Gender roles have been a major factor in how women approach their lives. The idea of masculine and feminine energy is not bound by gender or sex, and it’s critical to find balance between hustle and rest.

01:17:29 – Finding Joy for Hormone Balance,
Women have often sacrificed hobbies and joy for the sake of success or societal expectations. This sacrifice can result in a danger signal that shifts the body into adrenal hormones and progesterone shutdown. Finding joy and relaxation is crucial for hormone balance and overall health.

01:22:17 – Resources for Hormone Balance,
The “Is This Normal?” book offers a 28-day program for hormone balance, and there is also a digital cookbook available. The program includes meal plans, recipes, and guidance for optimizing hormones, including insulin, thyroid, and adrenal glands.


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I’m Dr. Stephanie

Part geek, part magic, and all the way passionate about being a well-lived woman.

I want to throw my grandkids in the air in my 70’s. I want to be squatting even more weight than I am now, and putting my OWN luggage in the overhead bin. Sound like weird goals? For me these are just some of the little things that represent a life well-lived.

My health is MY job – I’ll be damned if I rely on luck, ‘good genes’ or a cocktail of drugs that over promise and under deliver.

The Betty Body is my first book-baby, and a collection of what I’ve learned after thousands of clinical hours, hundreds of conversations with the world’s top experts, and most importantly…

This book is an outline of what took ME from “rock-bottom health” at 38, to being my own version of a Betty in my perimenopausal mid 40’s. A woman who is physically strong, full of energy, enjoys mental clarity, great sex and a joyful family life. Is it all roses? Of course not. But I have the stamina and tools to deal with the push and pull of life so that it doesn’t turn into chronic stress.

I want this for you too. Let’s go Bettys!