79:: The female brain on motivation & discipline (how estrogen influences our brain throughout the menstrual cycle!)

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Let's Wellness Girl chat about the

interplay between motivation, discipline,

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the female brain, and our menstrual cycle.

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Welcome back to Wellness Exists, the Pod.

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I'm your host, Dr.

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Kelsey Vic, a board certified

orthopedic doctor, physical therapy,

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and a pelvic floor physical therapist.

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And before we dive in, this is my first

podcast that I'm actually recording after.

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I've already said thank you on all

social media platforms, but at the

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top of the podcast, I just wanna say

thank you so much to all of the new

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subscribers, new followers, people who

have shared the podcast in some way.

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I am so grateful.

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It's one of those things where anytime

I see the numbers just shoot up

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like they have over the past week or

week and a half, I just wanna thank

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every single one of you guys who

supports and just benefits from the

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education that I'm putting out there.

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And the.

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Behind the scenes effort that I'm

putting in to try and make these

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podcasts entertaining, but also super

useful and help you leave them feeling

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better about yourself, but also have

more knowledge about your body as

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a woman and your brain as a woman.

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So I'm just so grateful and I don't think

words can really say how grateful I am.

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So just know that I am so thankful and.

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I hope you guys can feel that even

through the audio, through the visuals,

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whatever it is that you're listening

or watching on, I'm just very grateful.

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So thank you.

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if you would like to leave a review

on Apple or Spotify or whatever

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platform you're listening on, I

would greatly appreciate that too.

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But just thank you so much for supporting.

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It means the world to me.

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Now back to motivation and discipline,

we've touched on this topic before and

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I think there's an interesting interplay

between motivation and discipline, our

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brains, but then also our hormonal cycle.

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So we'll talk about all of that today

and why you might feel more motivated

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during certain parts of your cycle

and then have to rely on discipline

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during other parts of your cycle.

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When we think about motivation and

discipline, what comes to mind?

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For me, motivation is the one I want.

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Motivation is like the exciting term.

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When I have motivation, it

means I'm more creative.

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I picture it almost like this

wave coming to me, picking me up

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and carrying me with the wave.

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it just comes to me.

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It's not something that I

necessarily cultivate, except if

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I cultivate it based on action.

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A lot of the times, if I perform

an action, I will be more motivated

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to perform the next action.

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So that's the only time it's

relatively in my control.

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Other than that, it's

sort of ebbs and flows.

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Sometimes it's based on a new

creative idea that comes to me.

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Sometimes it's based, again,

like I said, on actions.

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But it's almost always pleasant

and it's something that I want to

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act upon if I get motivation for

an idea or a behavior or an action.

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It's something that I want to do

and want to follow through with.

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So motivation breeds action for me.

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Just like that wave carries me along

and if I'm thinking of the ocean or

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like a swimming pool or something where

that wave just takes me and I ride

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along with it wherever it takes me.

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So I don't know what you guys think

of with motivation, but that's what I

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think of when it comes to motivation.

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It does wax and wane throughout my

cycle, so we'll talk about that later.

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And what really got me interested in this

topic, probably about a year ago when I

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started researching the interplay between

some of our chemicals within our brain

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and then also our hormones as women.

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Discipline.

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On the other hand, it's

something that I have to have.

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It's usually something that I have to do.

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Motivation is I want to, discipline

is I have to, it's this strong word,

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but when it comes down to being

disciplined, it's never that fun for me.

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I don't think of discipline

as like motivation where

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it carries me on the wave.

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I think of it more as like after that

waves died down, now I have to swim.

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I have to put in that effort.

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That's discipline to me.

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It is usually not glamorous, and it's

usually based on something that I

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have to do rather than motivation,

which is something I want to do.

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So what does neuroscience

have to say about all of this?

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Let's start with motivation or

the want to part of the equation.

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Motivation is heavily linked to

dopamine and we've chatted about

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dopamine on this podcast before.

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If you wanna sort of circle back, I

think we've built our dopamine mini, so

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I'll try and link that link below where

we get into the science of dopamine.

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But we can think of

dopamine as a messenger.

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It's the messenger that is in charge

of reward, motivation, pursuit.

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It helps us predict when good things might

happen, and it helps us to go after those.

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So dopamine is that messenger chemical

involved in all of those things,

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but it is definitely the messenger

chemical involved in motivation.

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It also helps with movement.

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I have to mention that as my little

physical therapist heart, but we'll

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talk about the motivation, rewards

side of dopamine today rather than

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the movement control side of dopamine.

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So the dopamine pathway for motivation,

dopamine is produced in released in

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response to a lot of different variables.

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I'm sure you guys have heard of a

lot of them, but it's released in

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response to something good happening,

an expectation or anticipation of a

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reward or accomplishing a certain task.

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It's released with music, with eating

enjoyable foods, with exercise, trying new

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things, social connections, celebrating

progress, gratitude, so many things.

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produce and release dopamine, both

internally in the states that we feel,

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but then also behaviorally like exercise

or eating a food that we really enjoy.

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So we'll get a little neurosciencey,

but dopamine's produced in the ventral

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pigment area and travels to a different

part of the brain to actually create

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that feeling of motivation and drive.

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So produced in one part, travels to the

other part, and that area of the brain

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is in charge of helping to motivate

and get us to actually pursue a goal.

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So from a women's health perspective, how

do our hormones and the various phases

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and cycles of hormones throughout our

body, within our menstrual cycle actually

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affect our dopamine, our motivation,

and our ability to pursue a goal?

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Estrogen acts as a dopamine amplifier.

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estrogen increases production of dopamine,

it reduces the breakdown of dopamine.

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It makes dopamine receptors

more responsive, and it

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blocks dopamine re-uptake.

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So in all ways, it amplifies dopamine.

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So as estrogen peaks within our menstrual

cycle, we can expect our levels of

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motivation and drive to also peak.

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So I don't know if you guys track your

cycle or are tuned in to when you feel

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more driven throughout your cycle or

a little bit less driven and have to

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rely on discipline a little bit more.

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But I started probably noticing

the cyclical pattern about

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a year and a half ago or so.

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And we've done an episode on it

related to how to build your schedule

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around when you might feel more or

less motivated throughout your cycle.

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But I thought it would be interesting

to dive into the true like hormonal

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physiology and neuroscience

around it so that we are all more

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aware of when we should maybe.

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Lean in to motivation versus rely

on discipline a little bit more.

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And I think it's truly one of those

things, not necessarily cycle syncing

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your mindset or anything, but I think it

allows us having this knowledge of what's

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going on within our bodies, hormonally,

neurologically, all of that helps us

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to give ourselves a little bit of grace

and then to use those times in our

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cycle when we feel super motivated or.

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We're willing to approach opportunities

in order to go after something, but then

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also give ourselves a little bit of grace

on the other side of it when we might

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feel a little less motivated, when we have

to rely a little bit more on discipline.

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So let's start with motivation.

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But in our menstrual phase,

so days one through five-ish,

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that's this low hormone phase.

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So both progesterone and estrogen

are relatively low, so estrogen and

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dopamine are both at their lowest.

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Again, estrogens.

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That dopamine amplifier tasks

that might be rewarding typically.

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Feel like they require more effort and

you may need more external motivation

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during this phase in the follicular phase.

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So days, one-ish through 14, but usually

after that menstrual phase, so days one

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through five, so this is on that back mid

to back half of that follicular phase.

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Estrogen starts low and rises

throughout our follicular phase.

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So if estrogen amplifies dopamine,

we expect dopamine, and therefore our

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motivation levels to also increase

steadily throughout that follicular phase,

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which is that days one through 14 ish.

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During the ovulation phase, that

is our peak reward system activity.

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Imaging studies have also shown

that our brains light up more in

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response to rewards during this phase.

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And then lastly, our luteal phase

as estrogen drops in our luteal

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phase, so do our levels of dopamine.

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We expect decreased motivation,

requiring more effort to feel

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rewarded during this phase.

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So overall in this luteal phase,

we expect to be a little bit less

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driven and less enthusiastic overall

about pursuit of any sort of goals.

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So that's the motivation

side of the equation.

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Let's look a little bit into

the discipline side of it.

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Or the have to side of the equation.

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Discipline is a top down approach,

and anytime we talk about top down or

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bottom up, when we're talking about

neuroscience, we really are talking about

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the central nervous system, primarily

the brain's executive control over

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all of the different processes that

happen below, So our brain being the

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top down approach, our brain decides

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What actions we produce,

a bottom up approach.

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Things like exercise can have that

bottom up approach for motivation,

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where exercise can increase our

dopamine levels in the brain.

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So that behavior of exercise, that

action of exercise can influence our

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brain or that bottom up approach.

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So we have a command center or CEO of

our brain known as the prefrontal cortex.

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And if we're getting any sort of

signals, whether behaviorally, whether.

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Neurologically, , whether chemically,

our prefrontal cortex can actually

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override some of those signals.

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So when our dopamine's low, our prefrontal

cortex can actually override it and

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say, oh, I know you probably have

low motivation right now given your

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dopamine levels are a little bit lower,

but we have to complete this task.

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That's where that top

down approach comes in.

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That's where the command center, the

CEO really has to step in and say,

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I know you might not feel motivated,

but you have to be disciplined

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in order to accomplish this task.

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So the prefrontal cortex sends brain

signals down the pathway to help regulate

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other brain regions to produce the action

that we want, or really that it wants.

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Since what we want might differ from

what our prefrontal cortex wants or

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knows that we want long term, but

we might not want in the short term.

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So we can actually override

our brain's impulses and

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signals when motivation is low.

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The discipline headquarters in the

dorsal lateral prefrontal cortex,

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which is just fancy terms for the

location in the prefrontal cortex.

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So you can think of the prefrontal

cortex as just that command center,

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that CEO, and there's a lot of different

regions within that prefrontal cortex

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that are involved in discipline.

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All of these fancy terms make

it sound more complex, but just

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think of it as the command center.

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So the discipline headquarters are

in the dorsal, lateral preferential

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cortex, and that's a specific area

within that command center, that CEO,

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that structure that can help us override

some other signals that we're getting.

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So the discipline headquarters have a few

jobs, one of 'em involving working memory.

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So it allows us to hold our goals in mind.

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When motivation is low, it

allows us to switch strategies.

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So executive planning, if plan

A is not working, it allows us

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to switch strategies to plan B.

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It offers inhibitory controls, so

stopping yourself from doing something

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you know you shouldn't be doing,

and it creates structure so it's

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involved in planning and organizing.

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So it helps to create that structure,

especially when you don't feel like it.

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Okay, so another part of the

prefrontal cortex, the ventral medial

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part evaluates short-term pleasure

versus long-term consequences.

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So this is where we might be a little

bit more tired or just low motivation

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working on a certain project, this

is the area that sort of evaluates is

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this short term want or desire going

to help me reach my long term goals.

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So it cues us to say, Hey.

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That rest or that nap might not actually

help you reach the goal that you have in

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mind of finishing this project and getting

it back to school or your boss or whatever

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deadline you have set for yourself.

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So it evaluates that short-term

pleasure versus that long-term

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goal you have for yourself.

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And lastly, when it comes to discipline,

the brain has an alarm system, the

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anterior cingulate cortex, if you care

about location or names of things, but

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it's basically the alarm system, And it

sends an alarm when what you are driven

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or not driven to do, as determined by

dopamine, is in conflict with what you

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should do as determined by your goals.

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So after that evaluation process, if

there is this disconnect, this alarm

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system kicks in to say, Hey, this is

not going to help you reach those goals.

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Let's reevaluate the situation.

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So the alarm system sounds, sends

signals back to the command center

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to say, we need you to step in here

with a little bit of discipline.

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So let's talk about it in practice

a little bit just to get a more

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well-rounded picture Of how

discipline works within our cycle.

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So let's say you're in your

luteal phase, dopamine is low,

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you're feeling low motivation,

but you have a big project due.

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The anterior cingulate cortex

senses this disconnect.

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So it's the alarm system.

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It alerts the CEO or the command center.

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The prefrontal cortex.

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The prefrontal cortex sends inhibitory

signals to stop avoidance behaviors.

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So you're trying to avoid that project.

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This prefrontal cortex, the CEO

of the command center, overrides

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that to inhibit some of those.

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Lazier things that we might

wanna do when we have lower

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dopamine and lower motivation.

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The prefrontal cortex also continues

to keep the long-term goal recognition

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part of the brain online to remind

you like, Hey, remember this goal

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you have for yourself or this

goal that you wanna accomplish.

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Remember that this current momentary

want or desire that you have is short

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term, where that is your long term goal.

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And then lastly, the brain overrides

low motivation and relies on

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discipline to accomplish the task.

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So from a women's health

approach, estrogen also

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actually enhances discipline.

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It's not one or the other.

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There's a strong interplay between both.

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So the way estrogen also amplifies

discipline is that it enhances working

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memory to hold long-term goals in mind.

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There's easier switching between plan

A, B, and C, stronger inhibition to

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override low motivation, and there's

increased prefrontal cortex control.

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So this is where the body, you're like,

why couldn't it be a different way?

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Why can't estrogen help one and

progesterone help the other?

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That's just not how it's built.

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And progesterone actually has a complex

relationship with both motivation

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and discipline that we don't quite

understand yet, which is why we're

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strictly talking about estrogen.

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But research is conflicting on

progesterone's effects in each

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phase of our menstrual cycle when it

comes to motivation and discipline.

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But estrogen has pretty

strong effects with.

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Both dopamine and discipline, which

is why we are looking at it through

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the lens of estrogen primarily.

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But during a high estrogen

phase, not only do we have more

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motivation, but we also have more

discipline when motivation is low.

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So motivation can wax and wa,

even in that high estrogen, high

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dopamine, high motivation phase,

like it can still wax and wane.

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And if it does tend to decrease

during, let's say that later part of

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the follicular phase when we expect

high dopamine levels, high motivation.

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If you happen to drop in, your

dopamine levels have a little lower

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motivation, estrogen can kick in to

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enhance discipline during

this phase as well.

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So it does both.

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Discipline is especially important

in the low estrogen phases.

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When motivation is low, we have

to override the pull of relative

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laziness with a top down approach.

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Again, enacting

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that top down approach,

pressing that override button to

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override some of those lazier.

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Low motivation habits that we

might have in those lower estrogen,

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lower dopamine phases of our cycle.

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so how can we maximize both motivation

and discipline throughout our menstrual

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cycles as women in the high estrogen

phase, the late follicular to ovulation,

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to a little bit of early luteal?

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We can approach opportunities.

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We can create a structure

to rely on later when.

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Motivation's low.

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Sometimes creating that good solid

structure to be more disciplined

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with later on can really help.

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We can take on new creative and

challenging projects, and when dopamine

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is high, let motivation lead, but also

use discipline to narrow our focus, build

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habits, and prevent impulsive decisions.

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In those lower estrogen phases

of our cycle, we can rely

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more heavily on discipline.

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Understand it might take

more of that top-down effort.

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So if you're having trouble

overcoming that barrier to start

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that task or to finish that task,

just give yourself a little bit of

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grace knowing that your brain is

actually trying to work through that.

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We're trying to get that command center on

board to override some of those impulses

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that we have to maybe be a little bit

more lazy or lean into some of those

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desires that we want, that might not

help us reach those long-term goals.

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So it's a way to just give yourself

a little bit of grace too by knowing

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how your brain's working and how your

hormonal physiology is working as a

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woman in those lower estrogen phases.

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You can also let discipline lead and use

small strategies to increase motivation.

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So breaking up large goals

into small attainable goals.

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That way when you accomplish a

goal, you accomplish a task that

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dopamine's gonna elevate anyway.

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So that's that bottom up approach.

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You're doing a behavior that is naturally

going to elevate dopamine no matter if

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: 00:16:52

you're in that lower estrogen phase.

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: 00:16:54

You can also exercise and you might

have to lean more on extrinsic rewards

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or external rewards, in order to feel

more motivated during a certain task.

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: 00:17:03

In this lower estrogen phases.

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: 00:17:04

So again, that early follicular

phase, that late luteal phase, you can

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: 00:17:09

focus on current routines rather than

trying to build and maintain new ones.

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: 00:17:12

That's a follicular

phase Kelsey thing to do.

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: 00:17:15

Build new routines, set goals, set

reminders, really structure her day

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in the most efficient way possible.

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: 00:17:22

And then luteal phase, Kelsey is like.

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: 00:17:24

oh my gosh, what was I thinking?

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: 00:17:26

There is no way I can complete all

these tasks in the day, and that's okay.

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: 00:17:29

If you struggle with this, maybe try

and stick to your current routines

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: 00:17:33

rather than creating new routines.

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: 00:17:34

On top of that, you can use external

rewards and structure more and be

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: 00:17:39

patient with yourself because your

brain's working a little bit differently.

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: 00:17:42

A fun fact to end on successful

discipline actually increases dopamine.

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: 00:17:46

When your brain overrides low

motivation to complete a challenging

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: 00:17:49

task, your brain releases dopamine

as a reward for that effort.

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: 00:17:53

The cycle continues making the next

action that much easier to do because

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: 00:17:57

you have those elevated dopamine levels.

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: 00:17:59

A little bit more motivation

to complete that next task.

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: 00:18:02

This is probably one of my

favorite topics to research.

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: 00:18:04

So I hope you guys enjoyed this episode.

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: 00:18:05

I hope you learned a lot from it.

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: 00:18:07

I'd be happy to dive more into the

science, but I like to try and position

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: 00:18:12

this education in the like fun way.

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: 00:18:15

And educational way, not like super in

depth, neurosciencey, just enough to where

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: 00:18:20

we can all understand our bodies a little

bit better without getting into the weeds.

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: 00:18:23

But if you wanna get into the weeds,

I'd be more than happy to take us there.

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: 00:18:27

So you guys just let me know.

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: 00:18:28

I hope you enjoyed this podcast and

I'll see you guys again on the next

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: 00:18:31

episode of Wellness Fixes the Pod.