In this episode, EWG President and co-Founder Ken Cook talks with Lo Bosworth, author, influencer, and founder and CEO of Love Wellness, a women’s personal care brand that uses emerging microbiome research to explore gut, vaginal and hormonal connections in women’s bodies.
Cook and Bosworth discuss the pervasiveness of endometriosis, a disease faced by 10% of women and girls. The disease causes uterine tissue to grow outside the uterus and can cause severe pelvic pain and fertility issues.
Bosworth recounts her endometriosis diagnosis and the lack of general study and attention to the disease. She talks about starting her business, Love Wellness, and her collaboration with medical professionals to build formulas that support women’s bodies at the microbiotic level.
Bosworth believes in a holistic, science-backed approach to women’s personal care. Her company’s products avoid toxic ingredients that can be found in many mainstream personal care products.
She also says medical advocacy for oneself is important in a subject matter rife with misinformation about the effectiveness and safety.
Ken: Hi, Ken Cook here and I'm having another episode. I'm really excited to speak with my guest today, Lo Bosworth. Many of you probably knew Lo during her days on the Hills and Laguna Beach. She's also an author, influencer and founder, and CEO of “love wellness.” Full disclosure, love wellness products mostly fall outside of our wheelhouse and then have gone through the EWG Verified® process.
That's not a knock on them. As you may remember from past episodes, our verified partners have found the verified process as being long, difficult, exacting, and a huge pain in the ass. But what I find really interesting is the road Lo took to launching Love Wellness in 2016. She was inspired by her own experience with chronic conditions like chronic fatigue, vitamin deficiencies, and endometriosis.
Like so many, especially so many women, she had to be very proactive and persistent in order to get a diagnosis. And to find total body care to support her on her wellness journey. Lo has been outspoken about her diagnosis, which is often stigmatized even though endometriosis affects roughly 10% of reproductive age women and girls globally.
Let me say that again. Endometriosis affects an estimated 10% of reproductive age women and girls globally. I have many friends who have experienced it. It's a chronic disease associated with severe life-impacting pain and can cause infertility. Now going by the numbers, both EWG and this podcast have an audience that is mostly assigned female at birth, and mostly between the ages of 30 and 50.
Some of our most listened to episodes have been about puberty, fertility, endocrine disrupting chemicals, and we hear from folks again and again that they first come to us, to EWG, when they or someone they love might be suffering from an illness, or they're trying to avoid health outcomes that they see in their older family members.
Or they wanna do everything they can to protect their kids' developing bodies. So today. We're taking self-care, we're taking functional medicine. The need to self-advocate, the stigmas around female health issues, to spread the message that pelvic pain is not normal and not something that women just need to tolerate.
So Lo, it's such a pleasure to have you on the show. Thanks for joining me today, and congratulations on your recent marriage.
Lo: Thank you. I'm so excited. Ken, I remember when I met you, you're such a firecracker. I was like, oh my gosh. He's putting me on the spot right away. And so I have to say, I've been a little bit nervous to come on to show because I'm like, what questions is he gonna ask me?
Oh my gosh. But. I think we'll be okay. It's nice to see you.
Ken: Well, I think we're gonna be great and I think I'm going to learn a lot. And one reason I wanna learn a lot is so that in the future I can mansplain these things to some women, right? Because how exciting could that be? There are all kinds of health issues that, because our medical system has been so male centered and the conversation around it has been so male centered, with the exception maybe of breast cancer, there are many other issues that just get ignored.
Now, I'll give you one example Lo. Some years ago, I got to know Padma Lakshmi, through work we were doing on food issues. And in our conversation, she mentioned that she was working on endometriosis because she herself has suffered from it.
We spent a whole day lobbying to get more awareness in congress about endometriosis, both for research and for funding purposes. And the thing that really stood out to me was how little awareness there was of this condition that is so common in women. And I know this is something that you have definitely experienced.
And have talked about. And for me, I was just shocked. Not just men members of Congress. I mean women senators, women representatives, who didn't really know that this was a big freaking health deal for millions and millions of women.
And in the aftermath of our visit and there've been other people lobbying for this too, there was a pretty significant increase in funding to understand endometriosis. Because when I, you know, I was going around with Padma, she said it required surgery to discover that it was really endometriosis that had been affecting her. But you have founded your company. Actually, before we start into the medical stuff, why did you start Love Wellness and what does Love Wellness do?
Lo: Sure. So yes, I am interested in talking to you about endometriosis because I have endometriosis and I had surgery for it earlier this year, and I'm familiar with Padma’s group Endo found and support it. But yes, let's talk about Love Wellness. I started my company in 2016, so we're going on a decade now, and I was sick at the time.
I was depressed, I was anxious. I was dealing with a lot of women's health issues that were chronic, and I suspected some gut health issues also. And that information and research gap that you talk about. My company is really the response to that. And so we are focused on supplements and women's personal care products that really support women through their journey into adulthood and beyond.
And what I discovered through my own illness, which turned out to be vitamin deficiencies, which is like 10 years ago, nobody knew what I was talking about. Now I think we have an understanding of like, food quality in our country and how easy it is to have a vitamin deficiency. 90% of Americans have one.
But you know, I was really reacting to a lack of scientific research on women's bodies, lack of understanding of the gut vagina microbiome connection in women's bodies, the gut brain connection in everybody's body. And I was also at the drugstore all the time focused on all of these legacy brand products.
And my biggest thing is that I was like, none of these products work for me. In fact, a lot of them make me feel worse. Not better. And why is that? And I started to really hone in on ingredient lists, which is something that the EWG does really well. And as I created my business, I relied on the EWG quite a bit to help me form my perspective and thesis on how we should be formulating women's care products so that they're more effective and cleaner and safer for women's bodies.
And so what we have now is vaginal probiotics, personal hygiene products, a variety of things that focus on these sort of easy to address but potentially chronic women's health issues. And were available in Walmart, in Target, in CVS, in Ulta, on Amazon. And the first couple of years that I was in business, I got a lot of raised eyebrows.
And why are you the one to do this and how can this be legitimate? And the reality is, is that I'm a woman in this body and I am personally experiencing these things every single day. And so why don't I have the right to do something about this? First and foremost. The second is, I'm a problem solver.
I am particularly curious and I'm relentless by nature, so I don't have to be a medical doctor to hire a medical advisory board to provide me with the information I need to then make a consumer brand that fits the actual needs of women, right? I don't see a lot of doctors that are founder CEOs. People are like, you don't have a medical background.
I'm like, I bring the expertise to the table people. I listen, I learn, I can read, I can do research. And so what we've done is really changed the status quo on the women's care category from one that was particularly outdated to one that is coming into the modern age, but still relies on limited data, limited research, and as a company that only makes supplements and cosmetics, I'm very limited in what I can say about my products legally.
How they can actually help women's bodies. Like we know that the FDA has very strict rules and regulations around this category, which is good. But in the instance of women's care, I think that we could be doing more.
Ken: And so, when you first realized that you wanted to consult medical experts, doctors, researchers, scientists, and so forth, what were your early conversations? Who did you reach out to? When people have an interest in learning, as you just described, and a capacity for it, and a willingness to open doors, that maybe someone who's a little more buttoned down wouldn't open.
That's why I thought we had a great early conversation standing there at our popup, because you seem to have decided to crack that code. How did you do it?
Lo: Yeah. You know what's interesting is that when I was, you know, first starting my business, I started to do a lot of research and I was going to OBGYN’s and I was getting what I felt were very cookie-cutter answers and just here's the same prescription over and over again.
And when I would bring up a part of the body or, you know, something I had read about that was not connected specifically, you know, to the focus of an OBGYN often, I was told, well, you should go see a gastroenterologist. And I very quickly started to understand that Western medicine trains doctors to focus on their area of expertise for better or for worse right.
And instead, I had to shift my focus towards doctors that were approaching a new way to think about Western medicine. And that is through the lens of a holistic healthcare provider. I don't even think a lot of people know what the word holistic means. It sounds woo-woo. You say holistic, you're like, what does that mean?
And it just means somebody that can connect the dots between, you know, the gut and the vagina, the gut and the brain, things that I just talked about right? Can one system of the body influence positively or negatively another part of the body? And so when I started to talk to doctors that were much more clear about that being their area of focus or expertise, that's when the doors started to open for me.
It was interestingly enough when I started to look up doctors that were OBs, but you know, very experienced in like pelvic floor disorders that I started to discover that there were people with areas of specialization outside of just, you know, I’m the classic OB, and it was a gynecologist in New York City.
She was the one that helped me learn about boric acid suppositories as an alternative treatment to yeast infections versus Diflucan, which is just an oral antifungal that's prescribed to you. And she said, you know, this was used for decades by women who needed to treat yeast infections and like, why don't we try this for you?
It's super old school, but like let's do it. And it was that doctor and that experience that started to change my relationship with this women's health focus and have an understanding that the book as it's written, may not be the one that we should be following.
Ken: Yeah. Yeah, exactly. And you had your own journey with endometriosis. How did that unfold? It just drives me crazy that this is a condition that has been so ignored for so long. And yet afflicts so many millions of women.
Lo: It does, yeah.
Ken: If I may ask, what was it like for you? How did you, how did you get diagnosed?
Lo: It was tricky. Like Padma, it required surgery for a clear and real diagnosis.
There is no good test that is currently available that can diagnose endometriosis. Here's my story. My husband and I have been on a fertility journey for a while and we were doing IVF last year, and when I was single, before I met him, I had done a few rounds of egg freezing where you just harvest eggs and then you freeze them to turn into embryos at a later date.
And my AMH levels were low when I was 33. I did get very many eggs and so early on my doctor was kind of like, hmm, you're otherwise healthy. Like, why are you experiencing these low AMH and low egg retrieval levels?
And as my husband and I got closer to considering having a baby, my fertility specialist, Dr. Sheeva Talebian at CCRM, who is a fabulous doctor, by the way, world class said, you know, you don't have a lot of embryos, you don't have a lot of eggs, so I need to check off every single box on my list before we even attempt an implantation with you. And that means a huge list of blood tests.
And one of the things on her list also was a Receptiva biopsy, which is a biopsy of the uterus that is so painful. Oh my gosh. But they take a piece of your uterus and if it comes back and shows inflammatory cells in it, it is suggestive of endometriosis, but it's not a confirmation. Right.
So when I said there's no good test, there are tests that can suggest, but there is no 100% you have endometriosis unless a surgeon literally opens you up and sees uterine tissue outside of the uterus.
Ken: And we should say that's what endometriosis is. I was astonished at the many places it can grow.
Lo: Yeah. So it's uterine tissue that grows outside of the uterus, and we're not even quite sure how that happens.
It's suggested. That it gets in the blood and spreads almost like a cancer metastasizes to a certain degree, but we still don't know definitively because again, we're not doing a lot of women's research. Dr. Talebian said the next step is surgery, and I was like, there's nothing in between.
And I ended up having surgery again in New York City with Dr. Farr Nezhat, who is an endometriosis expert and had my abdominal pelvic surgery, and yes, I had endometriosis. You know, it was all over my pelvis, specifically, kind of like in the back of my pelvis, like against my spine. And so he removed that tissue. He also removed a number of fibroids and he removed my appendix, interestingly enough.
Because even your appendix can get inflamed with endometriosis. But it's so interesting because when I go back and look at my health history, I have had a lot of symptoms of endometriosis. But no doctor put the puzzle together.
Ken: So what? What were the symptoms? Because someone listening to this is going to, I hope, if they're having any of these symptoms, a light bulb's gonna go off. So would you mind saying in your case what it was?
Lo: Sure. So I've always had really chronic back pain, and what was confusing for me is I have a herniated disc in my lower spine from a car accident when I was a kid. So I just always assumed that it was this herniated disc.
However, you know, I've been to the hospital for special surgery and they're like, it's not bad enough to require surgery. We don't know why you're in so much pain. Post endometriosis surgery, my back stopped hurting immediately. In fact, when I was in recovery from surgery, I woke up and I thought to myself, still in my drug haze.
Huh? My back doesn't hurt.
Ken: Wow. Oh my gosh.
Lo: Instantly after surgery, instantly.
Ken: Oh my gosh.
Lo: Painful periods definitely part of the story in the year, but it was only in like the year and a half leading up to surgery. It was not, you know, a decade plus of painful periods, which is atypical.
I think I also had a lot of neurological symptoms of endometriosis. I think some of the depression and anxiety could be linked to the endometriosis. When you have a full body inflammatory disease why wouldn't your brain be affected by that? When my doctor went back and looked at my egg levels, embryo levels a MH, she's like, oh, well all this can absolutely be affected by endometriosis.
It can affect egg quality and can affect fertility. Which is why she checked it to begin with. Before attempting a pregnancy.
Ken: Good doctoring. I know. My gosh. I'm so glad for you that you, you found her.
Lo: But you have to be your own advocate is really what I've learned.
Ken: So important
Lo: Before starting my company and through starting my company is that you have to be your own advocate and you have to be willing to get the answers for yourself and to get the help that you need.
Ken: Yeah. Even with the best medical help, there's never a time where being your, you know, most aggressive, effective advocate is not necessary. I mean, you have to do that.
Lo: Yeah, absolutely. To kind of go back to the doctoring of it all, and something that I've learned through my experience running my company is this focus on research that is valid and observational and anecdotal information that is “invalid.”
And I think that you're gonna find a lot of doctors that are either on one side of the fence or the other, right? You're gonna find a doctor that says I will only use validated clinical data, right? If it has not been proven in a clinical study, double-blind placebo, it is irrelevant in my practice.
I will not listen to it, et cetera, et cetera. And look, I know that this opens up the door for a lot of woo-woo stuff to come into play,
Ken: No question.
Lo: But I think that when it comes to women's health specifically, there has been such a lack of research and funding that we do have to consider some of these new treatments and therapies as potentially beneficial.
And I'll give you an example. So I started taking NAD in the year leading up to our most successful IVF cycle and eventually implantation 'cause now I'm almost halfway through pregnancy.
Ken: Hooray. Wait a minute, wait a minute. Hooray.
Lo: Thank you. So we're so excited. I'm about 20 weeks pregnant now, due in January. But I started taking NAD about a year before a very successful IVF cycle.
And this was even before my endometriosis surgery that we did this cycle. And I was also taking Ubiquinol and other supplements that some doctors say, no clinical data, irrelevant in this practice. Don't do it. My fertility doctor was like, you know, anecdotally in my practice I'm seeing a lot of great results from women that are taking thing A, B, and C.
I've even spoken to her about it afterwards, and I think as a medical professional, you have to make room for what has not necessarily been proven yet, but you're seeing through observational studies or anecdotal evidence as working. And if you're not open to that, then I think that that is problematic.
And I really struggle with medical doctors who take that particular stance and POV.
Ken: Yeah. You know, and I think part of the problem for public health today and for the practice of medicine is a lot of it comes down to there isn't time, there isn't money for you to pursue those things.
And when the backdrop, as is the case with endometriosis and other issues that are distinctively associated with women, when you don't have the research backing for it, there's no place to go with those hunches. That is really what cuts us off, I think, from some of these explorations and leaves it in an uncomfortable place where you got woo-woo over here. And regimented so-called evidence-based medicine over here.
But in between, there are problems that need to be solved and neither camp is capable of doing it effectively.
Lo: Yeah, I started to understand that much more clearly a few years ago and at Love Wellness, and I'm starting to see other consumer brands do the same. We are taking on the investment in clinical research ourselves, at least at the product and formula level, right?
Because I don't have enough money to go figure out what is causing endometriosis and how to solve that within my company, but we have enough money to do clinical research on our vaginal probiotic, by way of an example, right? We launched multi-strain vaginal probiotics in 2016, and people were like, what is this even for?
And now, almost a decade later, with the backing of clinical data, we've proven that our vaginal probiotic formula supports the vaginal microbiome, supports vaginal pH levels, supports a calm environment, supports fresh vaginal odor. You know, all of these things that we suspected in the early days, we have now been able to prove as a brand.
And so it really is falling onto consumer brands to make the investment, to do the research, to prove to consumers that products, you know, can walk the walk and talk the talk.
Ken: So give me an example of a study that you did or how you went about that and who helped advise you, you know, to really come up with the information that you were seeking? For the efficacy,
Lo: Sure yeah, I mean, there are different laboratories and groups out there that are partnering with consumer brands to effectively perform clinical research, whether it's a perception study, a double blind placebo, you know, there are sort of like levels.
And it really depends on the investment that a brand can make right. A double blind placebo is remarkably expensive, but for one of our products, our pH balanced cleanser, we worked with a third party group that helped us put together the study, helped to get the people into the study and, you know, execute against it appropriately.
And I'll give you a little product information, our pH balanced cleanser is fragrance free, paraben free. It's one of our products that we really relied upon the EWG to help us model our ingredient list. And it looks and sounds like a lot of kind of European standards when it comes to cosmetics or you know, ingredient labels, and it's a personal hygiene product.
You know, you use it on very sensitive skin down there, and so you don't want it to cause irritation. You don't want it to disrupt vaginal pH because that can lead to yeast infections and BV and like I was using all of these legacy brands with crazy ingredient lists and I was getting infections and skin irritation.
They're microbiome disruptors, skin irritants, and endocrine disruptors. I said, okay, let's put our pH balanced cleanser in a study where we prove that daily use of this product does not disrupt vaginal pH, because a lot of our competitor products do. And so we put it through the clinical study and the result on that specific point was that 100% of our study participants reported no disruption in vaginal pH with daily use of our pH balanced cleanser.
So that required, you know, actual pH tests to be done over time. And we're taking on the work that I don't know, you would hope that government or a big pharma or somebody would do,
Ken: of course
Lo: But they're not doing, I think McKinsey recently said that 1% of non-cancer research and innovation is focused on female specific conditions in the United States. Only 2% of medical research dollars are dedicated to female specific health issues, despite women making up half the population
Ken: And the better half of the population.
Lo: But like the government is not doing the work on our behalf, and so consumers and civilians have to do the work on our own behalf, right?
Like, just like you're an advocate at the doctor's office, if you are a brand owner or a consumer, you have to advocate for yourself well enough that this work gets done.
Ken: Well we might have to get you to Washington and do another round of lobbying to increase some of this research because look, you didn't have to do all this research.
You could have just invested in marketing that made claims right?
Lo: Correct. Yes.
Ken: Yeah. But you went to the trouble. And from our very first conversation, I was determined to have a longer conversation with you on this podcast because it seems to me that people don't realize that when you're at these frontier areas relative to mainstream medicine and health, there are two different ways to go.
One is just to accept a claim that is out there and market the hell out of something and say it's going to be good for your health. And the other is to say, hey, you know, let's borrow from the structures of medicine and science and see if this actually does produce the results that we're looking for. Which it sounds like, of course, you did.
Lo: Yeah. In the position I'm in, the only thing say you can be as responsible and a steward of doing the best that you possibly can on behalf of the consumer. Because there is a lot of bad out there, and that's exactly what I was trying to get away from when I started my company.
You know, it's like there's all this bad, this stuff that doesn't work, and all I want is relief. All I want is for somebody to take me seriously and to help me feel better and for it to be easy.
Ken: Yeah. You know a standard OB is not in the position necessarily to do the research. You have to have a structure around it. And so the fact that we've got generations of underinvestment in these areas, not not listening to women when they've said, Hey, you know, this is a, there's something wrong, my periods are extremely painful. Or in your case, I have this back problem that can't be explained by a slipped disc or damage from an auto accident.
It really does feel like if you don't fit into the standard of medicine to look at certain symptoms and associate those with certain causes, if that's not solving your problem, then doctors often just say, well, I, you know, I can't help you or go to a psychologist, right?
Lo: Mm-hmm. Yeah, absolutely.
I mean, I think it's tough to be in a situation where you put so much faith and reliance into the medical community and hope for good results, right? And it's not until you're dealing with a chronic illness or a chronic issue that you start to see the cracks in the system and like really like where the areas of opportunity are, which is something that has really been a guiding light for me as I have navigated the process of building my company.
And I kind of mentioned this earlier on when we were chatting, but let's talk about probiotics as an example, because I think that there can be so much benefit from taking probiotics for specific need states. But a probiotic is considered a supplement by the Food and Drug Administration, and by law a supplement can make a structure function claim.
It cannot make a health improvement claim, a disease or infection claim. But we know definitively now that probiotics are improving different microbiomes throughout the body. And we know definitively now that the vaginal microbiome and the gut microbiome are connected. And by improving the gut microbiome, the vaginal microbiome's health improves.
And when your vaginal microbiome is in a constant healthy state, you are less susceptible to infection, you are less susceptible to infertility, you're less susceptible to a whole list of women's health issues that could be addressed earlier on, with a simple supplement, but because I cannot communicate to you legally, that a vaginal probiotic can help prevent chronic yeast infections or can help prevent chronic BV.
How am I supposed to really move the needle, right? In this country when it comes to women's health. When there are these preventative therapies that are out there, but like I cannot legally tell you what they can really do.
Ken: So are you finding like-minded people who are running companies offering products within the restrictions the FDA requires about health claims, but companies along the lines of your company coming together and trying to advocate for a breakthrough on how to deal with this policy structure, this regulatory structure and maybe get some work done?
Lo: No, but that's a really good idea and maybe something that I should take away from this podcast and talk to you about further on. Because I think that
Ken: Yeah, I'd be all about it.
Lo: You know, so much of what is written as law is so outdated and does not work for the time that we live in now. You know what I mean?
So that's something that you could definitely consider. I also think it's hard to call up your competitors and be like, Hey, wanna chat?
Ken: Well, that's it. But you know, I agree. But then I've noticed within companies that participate in the EWG verified program, some are very small, like, you know, kind of almost make it in their kitchen small, and some are big.
They do talk to one another. They're glad to be pushing for cleaner formulations, safer ingredients, healthier, healthier products. Now, I don't think it's an accident that a lot of those companies are founded and run by women. I'm just saying. I'm just saying I don't think it's a coincidence.
Lo: Well, we have to solve our own problems. Right. Nobody else is gonna do it for us.
Ken: Exactly right. It's as it turns out, and you know maybe this is something we can not take away from this podcast and, and think about working on, because it seems to me a group of entrepreneurs coming to Washington and making the case that
Hey, you know, we need to solve this regulatory issue and the, probably the way to solve it is to develop clinical trials, clinical methodologies to actually develop the evidence. And I have to say, part of the problem is the origination of regulations around supplements where the supplement industry did not want certain things required of them.
And the FDA said, well, if you won't go through those steps, we're not gonna give you the ability to make some of the claims you'd like to make. So again, it's rooted in old debates that it's time to bring some fresh voices to, and I think you're one of 'em Lo Bosworth.
Lo: Thanks. That's very nice.
Yeah, I think there's a lot of very interesting antiquated guardrails around O-T-C-O-T-C, monographs, drug approval processes, all of these things that you know, the public would really benefit from taking a hard look at. Things that we run into every single day as a brand that really is trying to move the needle forward, but we simply can't because of, you know, regulation that is in place.
Ken: Yeah. And, and also because there are plenty of brands out there who are saying, we believe this is the case, let's just make a marketing claim.
Lo: Mm-hmm.
Ken: That edges right up to a health claim, but legally falls just short.
Lo: You still might get sued by a plaintiff's attorney!
Ken: Yeah, no, you might. You still might.
And but I think that's the frontier area that's worth exploring and would love to follow up with you and figure out how we can do that. And I'm so thrilled by the success of your company, but I'm even more thrilled that you got a baby on the way after a lot of hard work and a lot of effort.
Lo: Thank you so much. I appreciate it. Well, it was such a pleasure to chat with you. I mean, we could talk for hours and hours about all the stuff I'm angry about and all of the good stuff that we're doing.
Ken: And lots of good stuff. And you're, you're bringing some good stuff to, some very bad stuff and I'm so grateful for the time we've had, Lo. So let's connect again soon. And I'm serious, I think we need to get you down to Washington and tell your story.
Lo: Let's go.
Ken: Thanks, sister.
Lo: Thanks, Ken.
Ken: Thank you low Bosworth for joining us today, and thank you out there for listening. If you'd like to learn more, be sure to check out our show notes for additional links to take a deeper dive into today's discussion.
Make sure to follow our show on Instagram @kencookspodcast, and if you're interested in learning more about EWG, head on over to ewg.org or check out the EWG Instagram account @environmentalworkinggroup. Now if this episode resonated with you or you think someone you know would benefit from it, please do send it along.
The best way to make positive change is to start as a community with your community. Today's episode was produced by the Remarkable Beth Row and Mary Kelly. Our show's theme music is by Moby, and thanks again for listening.