The menstrual cycle and female hormones.




Each and every one of us are so unique and we all experience our hormones and cycles differently. When it comes to female reproductive hormones, things can feel a little overwhelming as there is a lot to consider.


Simple adjustments to diet and lifestyle are often a nice way to support balanced hormones, however sometimes you may need additional support from herbs, nutrients and other modalities to get the best results.


With the support of your practitioner the hope is to empower you to take control of your hormones and menstrual cycle to feel in control and have all the knowledge available to make the best decisions for you.


Knowledge is always power when it comes to understanding your body. Our aim is to understand what is going on to help us make decisions about how to take control of our health if we are experiencing difficulties.


REMINDER! It is NOT normal to experience pain that impacts on your quality of life, mood changes that make you feel out of control, skin issues that affect your confidence and comfort and your period going missing all together. These are all signs that you may need some professional support with your hormonal health.

 

Stages in the Menstrual Cycle.


Often referred to as 'Seasons'



Menstrual (days 1-5) aka Winter


The menstrual phase is the first 5 days of your cycle, the first day of your cycle is counted from the first day of your menstrual bleed/period. Declining levels of progesterone stimulate a chain reaction of events that eventually leads to the endometrium (lining of the uterus) to shed. This of course only occurs if the endometrium is unfertilised by male sperm, if this occurs, then a menstrual bleed does not occur and instead pregnancy does!


Common symptoms:

  • Heavy bleeding

  • Clots

  • Cramps or pain

  • Radiating pain in your back or down the thighs

  • Fatigue


Using food as medicine to help:

  • Avoid coffee and alcohol, these can often increase inflammation and in-turn, pain. Swap coffee for a medicinal mushroom latte, dandelion tea, cacao or herbal teas.

  • Fatty foods can increase prostaglandin release (which increase pain), avoid processed foods or excess oily foods/takeaway. Small amounts of fish, olive oil and avocados are okay.

  • Aim for easy to digest foods such as soups, slow cooked meals and stews.

  • Avoid dairy and heavy ‘cold’ foods such as ice-cream, milk, iced drinks, smoothies as these are cooling on digestion.

  • Avoiding dairy is important in this phase if you experience pain, heavy bleeding and skin breakouts. The proteins in dairy can convert to inflammatory agents in some people which causes a chain reaction ending in more pain, inflammation and heavy bleeding. Many people find eliminating dairy does wonders for their period issues.

  • Incorporate lots of herbs and spices such as turmeric, ginger, cinnamon, cayenne, cardamom etc into cooking and hot drinks!


Lifestyle adjustments and moving your body:


  • Try using heat over your tummy and back, wheat packs or hot water bottles are great

  • Avoid doing high intensity exercise during this phase, focus on restorative movement such as yoga, stretching and walking.

  • Gentle exercise or movement is actually a nice way to release endorphins which are our natural pain killers, don’t avoid movement all together but just take it slow.

  • Magnesium baths or foot soaks can be great for aiding with relaxation and aches.

  • Take lots of time to rest if you can, this is a period for slowing down and letting your body do it's thing, over exertion during your bleed can lead to worsening of pain and fatigue.



Follicular/Proliferative (days 6-13) aka Spring


In response to rising oestrogen following the menstrual phase, the lining of the endometrium starts to thicken again to prepare for implantation of an egg.

Lowered progesterone permits the pituitary gland to secrete follicle-stimulating hormone (FSH), this stimulates the ovary to begin selection of an egg ready for ovulation.

Increasing levels of oestrogen causes the cervix to secrete cervical fluid, which acts as a natural lubricant, nutrients for sperm to survive and a means of travel in the fallopian tubes for sperm. Many of us might think that this fluid or mucous is abnormal or ‘thrush’, it is absolutely normal and a good indicator of ovulation! In this phase, the fluid is usually sticky and opaque or ‘egg white’ texture. Cervical mucous should not be excessively noticeable or ever offensive in smell, if it is, this may be indicating a bacterial issue such as bacterial vaginosis or another infection and a consult is recommended.


Using food as medicine to help:

  • Consuming foods which aid with oestrogen metabolism and utilisation such as cruciferous vegetables (kale, cabbage, broccoli, cauliflower, brussel sprouts) can support normal oestrogen/progesterone ratios and support your liver to rid excess oestrogen (for those with over production issues).

  • Avoiding alcohol is important as this can cause dehydration, ensure you increase your water intake during this time to aid with cervical fluid production.


Lifestyle adjustments and moving your body:

  • Focus on lighter exercise but movement that gets your heart rate up at the same time. Try hiking, medium intensity walks, swimming or pilates.

  • This is the perfect time for intimacy with yourself or partner, ensure you are practicing safe and consensual sex but make it fun! As this is the most fertile part of your cycle extra caution is needed if you are wanting to avoid pregnancy, but with cervical fluids at their highest this is the time that sex may be the easiest and most enjoyable for you.



Ovulatory (day 13-16)- Summer


Once oestrogen levels reach their highest, the pituitary releases luteinising hormone (LH). This causes the ovarian follicle to release the ovum (egg) in the process of ovulation


Common symptoms:

  • Often people will complain of ‘ovulation pain’, this can often be felt on one side or in alternating cycles. Sometimes this is due to the egg being released from the ovary, however the pain should not be unmanageable or impact on your life.


Using food as medicine to help:

  • Consume foods high in zinc and essential fatty acids, try salmon, oysters, eggs, legumes, pumpkin seeds, small amounts of red meat, flaxseeds and sesame seeds.

  • Foods high in fibre can also help to support hormonal regulation.

  • Foods high in protein are important to consume not only during ovulation but most days, protein is important for implantation and cellular replication. Focus on lean proteins including vegetarian based proteins such as beans, legumes, quinoa etc.


Lifestyle adjustments and moving your body:

  • Since oestrogen and testosterone are at their highest, maximise your potential! High intensity training or interval training is where you’ll find the most benefit, spin classes, bike riding or running are also good choices during this phase to get the most bang for your buck.


Luteal (days 16-28)- Autumn



This is the phase where progesterone is steadily increasing. Progesterone is present to strengthen the endometrium lining (to support pregnancy if this occurs) but it is also important to prevent menstruation. If fertilisation does not occur, then progesterone eventually drops and menstruation occurs.

Progesterone is needed to keep us feeling calm, happy, help us sleep and regulate our appetite and temperature. If progesterone becomes low or does not rise like it should in this phase, PMS can often occur.

Common symptoms:

  • PMS symptoms: moodiness, low energy, bloating, fluid retention, anxiety, increased appetite, cravings, breast tenderness, nipple sensitivity and dizziness.


Using food as medicine to help:

  • Avoid: caffeine, saturated fats, deep fried foods, refined sugars and added sodium. These have been shown to worsen PMS symptoms so best to avoid or limit these foods.

  • Consume progesterone increasing foods such as: beans, broccoli, brussel sprouts, cabbage, cauliflower, kale, brazil nuts, pumpkin seeds, oysters, sunflower seeds, turkey, dried fruit, spinach, cacao and fish.


Lifestyle adjustments and moving your body:

  • Strength training, weights, intense versions of yoga and pilates are great during this phase due to the presence of progesterone, this is a great time to focus on lean muscle gain and overall cardiovascular fitness.

  • Fluid retention can be common in this phase, if this affects you, try slow walking through shallow water at the ocean or dry skin brushing to stimulate your lymphatic system to balance your fluid.


 

Common culprits for hormonal imbalance.



1. Stress.


Stress is experienced differently for everyone. Stress is usually defined as an event or series of events that causes physical or emotional burden to the individual. This can be things like exams, family issues, changes, relationship difficulties, physical illness, work pressure, physical exertion and travelling.

Stress can interfere with the menstrual cycle and often causes temporary cessation of menstruation, heavy periods, irregular cycles, PMS and increased pain.


How does stress affect us physically?

Our nervous system monitors and responds to stress, it is the central point for telling the rest of the body what it needs to do. The ‘hypothalamic-pituitary-ovarian/HPO’ axis has it’s own feedback loop, which is responsible for initiating signals for hormone secretion and regulation. When this axis is disrupted (by stress), imbalances in hormones can occur.

Once the HPO-axis is disrupted, it can stop secretion of hormones that signal release of FSH and LH, which then results in an-ovulation (failure to ovulate). Lack of ovulation can cause issues like worsened PMS, heavy periods, no bleeds, pain and mood changes.

Increased stress levels have been linked to painful and heavy menstruation, so reducing stress where possible is very important.


Common stressors that can affect our menstrual cycle:

  • Excessive exercise (eg: daily intense exercise, athletic training, training for marathons/triathlons etc)

  • Under eating (eg: restricted eating, avoiding food, binging/purging)

  • Weight loss or low body weight, eg; BMI below 20

  • Chronic illness or liver failure

  • Ceasing the contraceptive pill or hormone devices


Given this, it is essential we make every effort to reduce stress and it's impact where possible. This is not always possible on your own, so if you need guidance, seeking support from a practitioner might be the way to go.


2. Hormone disrupters.


Hormone or endocrine disrupters are chemicals that mimic our natural hormones by binding to their receptors, which creates an imbalance in hormone signalling, leading to hormone dysregulation.


Sources include:


Pesticides: in food, soil and water

Flame retardants: clothing, furniture, carpets, car seats and mattresses

PCB’s and dioxins: non-organic tampons, pads, pesticides in food and clothing

BPA: plastic, lining of cans, containers, drink bottles

Phthalates: cosmetics, hair products, perfumes, fragrances, plastics, cleaning products

PFC’s: non-stick coating on cookware


What to do.


  • Eat organic or spray free where possible, or avoid the ‘dirty dozen’ foods, which are most heavily sprayed with pesticides (strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, capsicum)

  • Swap to natural or organic personal hygiene and care products as much as possible, check the labels for added ingredients above

  • Switch your deodorant to a natural alternative, body crystal is a great alternative ($5 from Coles or Woolies)

  • Try essential oils as natural fragrances over perfume

  • Invest in a menstrual cup, period underwear or use organic tampons and pads

  • Use stainless steel or cast-iron cookware

  • Check labels on cans for BPA free and same with plastic containers/drink bottles


3. The OCP or contraceptive devices.


The oral contraceptive pill.


How it works:

There are a few different types, but essentially all of the OCP’s stop the ovary producing an egg each month. The bleed you experience when you take the sugar pills is not a normal period stemming from ovulation, it is bleed due to the acute withdrawal from the hormones in the OCP, not your own. These hormones still stimulate your uterine lining to produce a bleed, however ovulation does not occur whilst taking the OCP which can be an issue as ovulation is the key event in reaching hormonal balance and health.


Although a lot of doctors will use and recommend the OCP for menstrual problems, PMS and contraception, it does not work to regulate hormones or promote healthy levels of female hormones. It simply stops ovulation so you can control when you bleed and prevent pregnancy.


The OCP is known to deplete the body of certain nutrients with long term use, the following are commonly low in individuals taking the OCP:

  • Vitamin E

  • Folate

  • Vitamin A

  • Vitamin B2, B3, B6 and B12

Remember, the OCP is not the only option if contraception is your priority! There are a few different options that may be less impactful on the body (discussed below).


IUD’s.


There are two types of intra-uterine devices. The copper IUD and progestogen IUD (or Mirena).


Although IUD’s have been used for more than 30 years for pregnancy prevention, how they work is still not fully understood. Their main action affects sperm movement and survival in the uterus so sperm cannot reach the egg to fertilise it. The IUD also changes the lining of the uterus so that it prevents the egg from attaching and fertilising. They are said to be 99.8% effective at preventing pregnancy (The Womens, 2020).


Positives:

  • Budget friendly

  • Often less associated hormonal issues (acne, mood changes) than the OCP

  • Long term contraception

  • Said to be up to 99.8% effective in preventing pregnancy

  • Ovulation still occurs (with Copper IUD)


Negatives:

  • Can be painful to insert and remove

  • Bleeding can occur randomly and sometimes for prolonged periods

  • Can cause discomfort during intercourse

  • Can be dislodged or come out

  • Can cause complications if you fall pregnant with one in

  • Can cause increased anxiety, depression or feeling off/not yourself


Always consult with your GP and healthcare provider (such as a naturopath) if you need more information on these as they are not the same scenario for every individual.


 

The Fertility Awareness Method (FAM) and why I love it!




The Fertility Awareness Method (FAM) is a 'natural' alternative to contraception which does not involve taking any hormonal methods to control your cycle. When done correctly, FAM can be incredibly safe and effective at preventing unwanted pregnancies and more importantly taking control of your cycle and getting to know your body more!


Positives:

  • It's free!

  • Non-hormonal (yay you will still ovulate!)

  • Effective for planning pregnancy

  • Increases awareness of your body

  • No need for medical professional guidance

Negatives:

  • Does not protect you from STI's (so please use protection!)

  • Only effective if you have a regular and predictable cycle or if you can accurately monitor your cervical signs


FAM is a way to monitor ovulation and be able to plan intercourse safely and confidently to ensure you are avoiding pregnancy (if this is a priority for you).

Remember, sperm can remain active for up to 7 days in the uterus/pelvic cavity, meaning you can still become pregnant up to a week after ovulation. This translates to a fertile window of around a week, during this time FAM recommends you either abstain from intercourse or use contraception around this time.


There are a few different ways you can safely practice FAM.


Calendar method:

- Charting your menstrual cycle on a calendar or app (see below recommendations)


Cervical mucous method:

- Checking your cervical mucous to track ovulation (see resources here https://www.med.unc.edu/timetoconceive/study-participant-resources/cervical-mucus-testing-information/)


Temperature method:

- Taking your basal body temperature before rising each day.


It’s most effective to combine all 3 of these methods. When used together, they’re called the 'symptothermal' method.


App's that you can use to practice FAM!

  1. Kindara

  2. Flo

  3. Clue

  4. Eve by Glow

  5. MyFlo

  6. Cycles

  7. Glow

 

What can you do to give your hormones a little helping hand:


Testing.


There are a few different practitioner ordered tests that can help to identify any underlying biological issues that may be causing issues with your hormones. These can be discussed with your practitioner. A common hormone test, the Dutch Panel is a comprehensive review of all your sex hormones and can provide an in-depth insight into what is in and out of balance and how to rectify this. The Dutch Test is said to be more clinically accurate compared to cortisol serum or urine samples when testing hormones, see sample report here:

This test needs to be discussed and ordered through a qualified Naturopath.


Other tests such as basic pathology, blood tests or ultrasounds may provide insights, these should be discussed with your healthcare provider.


Practitioner support.


As mainstream medicine often provides limited options for support with menstrual cycle and common hormonal/female reproductive issues, alternative or holistic healthcare providers may have other systems and solutions to these issues. The following practitioners are very well equipped to support you with your hormonal disharmony:

- Naturopaths

- Nutritionists

- Chinese medicine doctors

- Acupuncturists

- Holistic GP's


Diet changes.


As mentioned above with the different phases of your cycle, dietary modifications can be extremely helpful and impactful to support a balanced menstrual cycle. Using food as medicine is simple, cost effective and will all round benefit your health.


Lifestyle changes.


As with dietary tweaks, lifestyle changes are just as important. Figuring out the source of your hormonal problems and working to help that will be the best thing in optimising your health. Simple adjustments such as lowering stress, removing exposure to environmental toxins, getting a healthy dose of sunshine, spending time in nature or engaging in physical activity are a few ways to support positive health.


 

I hope this was helpful and you learned a little bit about your body.


Comment your questions below!


Brooke x



 


Further reading/resources you should check out!


The Period Repair Manual- Lara Briden. https://www.larabriden.com/


Taking Charge of Your Fertility- Toni Weschler. https://www.tcoyf.com/


Information on Dutch Hormone Testing: https://dutchtest.com/dutch-research/


Cervical mucus testing https://www.med.unc.edu/timetoconceive/study-participant-resources/cervical-mucus-testing-information/


IUD https://www.thewomens.org.au/health-information/contraception/intra-uterine-device-iud


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In the spirit of reconciliation, Goodkind  Naturopathy acknowledges the Traditional Custodians of our country, the Yugambeh language group and their connections to land, sea and community. We pay our respect to their elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

 

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