Start here- Your Period

Understanding what your menstrual cycle (period) is and how it works, is the key to having control over your hormones. Here we understand, what a normal period is. It is only from here that we can then understand how hormone imbalances may be affecting our health, and make lifestyle choices like contraception, food and exercise that our suit our current needs and future goals.

Overview

A textbook period is 28 days, however it can be normal to have a period anywhere from 21 days to 35 days (up to 45 days if you’re still a teenager). Your period is split into 3 phases; early phase, ovulation and late phase. As you may know, hormones change during these phases, this is to help grow and mature the egg, release the egg and allow it to attach to the uterine wall for a little swimmer to come and fertilise it. Sounds simple, right? It is a beautiful nuance between the brain, gut and reproductive organs that creates these changes. When something is off, everything else alters. Hence hormonal issues but more on that later, let’s start with understanding what happens when everything is working as it should.

Early Phase

Also known as the follicular phase, this is where your body grows and develops your egg to get ready to be fertilised (maybe). Oestrogen is the dominant hormone here, as it’s like super juice, it helps things grow in females bodies. One of which is your eggs (other things like muscle and bone too). This phase spans from the first day of bleeding to ovulation. It is the only variable part of your cycle, so that’s why you may be a 28 day girl, but your BFF could be a 35 day girl. It can be normal for some women to have a couple of days of spotting before ovulation as oestrogen dips and progesterone is still low, this is most common in fit women).

Ovulation Phase

This is the ‘New Years Eve, BALL DROP’ moment. Once oestrogen levels hit their peak and the brain perceives it is safe to fall pregnant, ie. no outer stress on your body or reason for your cortisol (stress hormone) levels to raise (of which there is a few), the brain will release a hormone called Luteinising Hormone (LH), this signals the release of the egg, only then will progesterone be created. So if no ovulation, no progesterone. This might be fine for a couple of months, but the more often this happens, the more ‘out of whack’ the ratio between oestrogen and progesterone can get. Ovulation has been linked to a more resilient mental state, healthier digestive function and stronger bones as we age. So it’s more than just being able to fall pregnant. Ovulation is key, it occurs over 1 day, but you’re fertile window is generally around 3-6 days, because that’s how long sperm can live for. 

Late Phase

This length of this phase is pretty well locked in, it ranges from 10-16 days depending on the woman. Here is where your Progesterone dominates (Up to 100x more than oestrogen). Progesterone is important for with-holding a pregnancy as it helps to develop the cervical mucous. Practically you can notice thicker white discharge around the earlier stages of this phase. When your body detects the egg is not fertilised, oestrogen and progesterone spike (around 5 days before bleeding) and then rapidly drop off, this drop off in both hormones triggers bleeding and the start of your next period. Note: The hormone spike in both of your hormones 5 days before your period has been linked to the PMS signs we can experience… Read on below for a run down on how your hormones can impact the rest of your body.

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PhD Exercise Physiologist and Nutritionist

Dr. Stacey Sims 

Hormones tell our body what to do. How to eat, sleep and even when to grow. They give us our appetite and sex drive. They help us have babies, They make us happy, sad and giddy in love.

In men, these hormones are pretty stable day in and day out (though they certainly change over a lifetime). In women, however, it’s another story. And that story centres around the menstrual cycle.

Oestrogen Why Do we care?

Oestrogen’s primary role, if you forget everything else is to; Build and grow things! In technical terms it is an anabolic hormone. It does great things for us like; develop our follicles into eggs ready to be fertilised, protects our bones by making them strong and helps to prevent alzheimers. It has also unfortunately been known to feed female cancers because of its ‘growing’ nature, allowing damaged cells to grow and replicate. Oestrogen is sourced from several areas; It can be produced in your body (endogenous) the best kind, from plants (Phyto-oestrogens) and from plastics or non-organic compounds (Xeno-oestrogens and synthetic oestorgens). As a general hard and fast rule, endogenous oestrogen and phyto-oestrogens promote good health and xeno-oestrogen’s are like the evil twin, that promotes the negative affects of oestrogen.  Check out these recipes high in naturally occurring phyto-oestrogens. Also this website has a great list of chemicals to check for and avoid on your skincare and makeup. 

Progesterone Why Do we care?

Remembering this bad boy hormone is dominant in the late phase of our cycle, it has a calming affect on our brain, and has been called an anti-anxiety hormones. It boosts our feel good chemicals (serotinin), is sleep promoting and acts like a repellant with water, hence why we can be having more frequent trips to the lou and feel bloated in the later stage of the cycle. When our hormones are out of balance, or our progesterone levels are low, we can notice; PMS, insomnia, anxiety, migraines, miserable periods, irritability, and even rage. These symptoms can come around Peri-menopause when we stop ovulating regularly, more on that here

If you're on a contraceptive pill, the answer is no. You won't ovulate. That is how the pill works, it stops ovulation and the bleed is a drug withdrawl. If you're not on hormonal contraceptives, the best way to tell is your Basal Body Temperature (BBT), other signs like PMS and mucous changes are also signs that most likely point to 'yes' when talking about ovulation. 

Yes you can. You should be noticing some mucous changes around the middle of your period. Think, thin egg white and cottage cheese *note: these should be relatively odourless, if they smell, it could be a sign of infection like Bacterial Vaginosis (speak to your Healthcare practitioner)

No darrlingg... The hormones in the 'pill' are synthetic so work to stop pregnancy but don't provide all the great effects your natural hormones do. Intact they stop normal production, especially of natural progesterone.

Hormonally when we bleed is when both our oestrogen and progesterone are both low. 

If you're bleeding and the blood dosen't look fresh or it's out of character for you, it's a good idea to go get your coochie looked at by a professional, it could be something and it could be nothing. Best to get it checked out, for peace of mind. 

"

Founder of TSOM

Dr. Anthea

The best person to control your health is you. Arm yourself with knowledge, have the courage to act on that knowledge, and live in your power.

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Puberty

Boobs, Butt, Pubes, BO and the beginning of your period. Welcome! Puberty can be a bit of a scary and confusing time. Everything is changing. Our changing hormones act like puppeteers and our body follows along. If you ever think you’re alone, don’t worry you’re not. If you’re going through changes at different times to your friends, don’t worry that’s normal. We’re going to go over, what you can expect, what’s normal and how you can learn to listen to your new superpower, your period. 

Periods- Puberty

When should I Get my first period?

Everyone get’s there first period at different times, this is based on what your mum, her sisters and your grandmother generally experienced. Other things like the body fat, also contribute to your brain releasing period stimulating hormones. Generally you will get your first period 2 years after your breasts start to bud and your pubic hair develops. (around 12-14 years old, however as young as 9 and as old as 16). 

If you are very skinny and super active, you can expect to get your period later than your friends. If you haven’t gotten your period before 16 years old, you need to look into why this might be the case, usually from over exercising and under eating. 

If you’re noticing changes in breast tenderness, moods and bloating but no period, this can mean that your period is close, or that your vaginal opening isn’t open enough (hence no blood can come out). This is rare but a doctor can help you with this. 

How do i know when my first period is coming?

You can often feel like there are butterflies on your lower stomach, like around the area of your bladder. You may also notice bloating, breast tenderness and soreness, more BO than usual, some spotting in the weeks before hand and sometimes pain. It’s always a good idea to have a go bag with pads, tampons a change of undies and a spare school dress in your bag just incase. 

What else can i Expect to change?

Your body typically follows a timeline ones changes start to happen. Things like severe stress and anxiety can play around with your hormones and this timeline, but effectively you can expect these changes to occur like ‘wonky’ clock work. 

Around 6 years old
Growth Spurt
This is called Adrenarche. It basically means that your stress glands (adrenals) start working more to produce hormones to help you grow!
Around 6 years old
3-4 years later
Breast Budding
Your body now enters Gonadarche, which basically means that now your breast start to get some fatty tissue behind them and more hormones are starting to kick in
3-4 years later
Not long after
Pubic Hair
You'll notice armpit hair and also hair over your pubic area. You will also start to notice you'll need to start wearing deodorant now. The sweat, mixed with hormones make the bacteria on your skin smell.
Not long after
1.5 years after
Bone growth starts to slow
Once your growth spurt starts to slow down your growth plates begin to start to close over. This is thought to be a big signal to the hormone centre of your brain that it's time for your first period.
1.5 years after
2 years after Breast Budding
First Period
Welcome! Your first period has arrived, this is good news! It's a result of your body working behind the scenes for many years, and guess what?! It's a sign that things are working how they should. Sure it can suck sometimes, but when we understand how to help our periods instead of silencing them, we help our whole health.
2 years after Breast Budding

What is a normal period?

In the beginning when our periods are just starting out, they can often be irregular and longer in duration. They can be heavy, light, painful and painless. Moral of the story, they can be all over the place, and it’s nothing to be concerned about. 

After around 2-4 years, your periods should have normalised, this is because the connection between the hormone centre in your brain and your ovaries are basically best friends now. They can be a bit temperamental in the beginning so they need some time to figure each other out and develop a deep connection 😉

A normal period looks something like this;

  • Lasts between 21-35 days
  • Bleed is from 3-7 days
  • Blood is a cherry red colour
  • There should be minimal pain (noticing that there is more activity going on down there is normal, but debilitating pain is a sign that your hormones are out, or you have elevated inflammation)
  • Minimal clots (if you do have some, they shouldn’t be any larger than a 10 cent piece)
  • Similar colour throughout, if you notice they are black or dark brown, this is old blood and tells us you’re not ovulating regularly. 

Is it going to be painful?

While it is common for your period to be painful, it isn’t normal. 

In the beginning when our hormones are trying to find their balance, things can be a bit more painful due to higher amounts of oestrogen and inflammatory chemicals called prostaglandins. Overtime though this should subside.

If your periods remain painful, looking into why is the best option. Common causes can be stress, endometriosis (particularly if you have a family history) and poor liver function. 

Should I go on Contraception to fix my period issues?

Your period is your superpower. It’s like an added vital sign that is always whispering and granted sometimes shouting at us that something may be off. 

Going on contraception to fix your period issues, contrary to popular believe doesn’t actually fix your period issues, it just puts a mask over them by artificially changing your hormones. This may be fine in the short term, but the longer your natural hormones are out of whack, it can become harder to regulate them when you want to get to the bottom of things. 

Every one needs to chose the best option for them, and sometimes you just need to be out of debilitating pain and discomfort. Remember when your periods go back to ‘normal’ on hormonal contraption this is artificial, a great thing to do is to change your lifestyle and focus on liver, gut and stress health to get to the bottom of your hormonal imbalances. 

What hormonal Contraception should I go on?

Talking to your GP is the best place to go for advice with medication. Remembering that everyone is different, and even know one of your friends may be using one form, it may not work best for you. We have a much more detailed breakdown of contraception here

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Reality TV Star

Khloe Kardashian

“I just think that knowing about your body at any age, whether it’s educating yourself on fertility, getting mammograms, going through puberty – whatever it may be, is really important. I just really encourage women empowerment and being comfortable talking about these issues.” 

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Irregular cycles

Not knowing when your cycle is coming can be annoying when you want do to things like; wear white pants, try for a baby or leave the house without the fear of not having a tampon. It’s annoying but it’s usually a way the body tries to tell us something is off. The brain isn’t signalling our hormones at the right times in our cycle, and our hormone balance becomes out of sync. Whether you’ve got your first period, you’re entering menopause or you’re somewhere in between, it’s important to understand what is normal and what’s not. 

Pay Attention and listen

Our body is pretty frick’n impressive. It is looking after over 1 trillion reactions right now… Telling your stomach how to digest that delicious burrito, stay awake, not over heat, sit up, balance your blood sugars, stop you from ripping the head off your annoying co-worker… You get the drift. It’s pretty crazy, amazing cool. So when something is a bit off, we know there is something off with the body. Like when we have a temperature it can be a sign that our body is fighting off some kind of infection. When our period is off, and not regular it can be a sign that our brain, hormones and gut aren’t communicating as affectively as they could be. Every woman is different, but there are some general boundaries that our body should stay in. We can’t just rely on what is common to dictate what we view as normal. Let’s remove some of that confusion though, shall we daarhhling. 

Irregular-cycles

Just Starting Your Period?

YAY! Welcome to the club daahrrling. You just got your crazy amazing super power that helps protect your brain, your heart, your gut, your immune system and your bones. It can also feel like less of a super power and more like super annoying in the beginning and we get it…The fear of blood on your school dress, missing out on social events and school because of pain and having to sleep on a towel so you don’t bleed through onto the bed sheets sucks.

Your period doesn’t need to be an excuse to miss out on PE class or why you start to 

The more natural periods you have (remember when you’re on the pill you don’t have a period) the more your health becomes resilient in the long run. They’re like deposits into your long term health money bank. It’s NORMAL to have irregular cycles in the beginning. Your brain and ovaries are still figuring out their rhythm. Like a dance between two beginners, vs a dance between two veterans. Your cycles can last up to 45 days normally when we first start to get them. They should shorten down to around 24-34 days, after 6 or so periods. 

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Remember when we bleed it means our core female hormones are at their lowest.

Powering into Menopause?

“Heeeeeeyyy Baby! Who ha! Am I in Menopause?” What does menopause mean? Basically our brain and ovaries don’t really want to dance with each other as much more. It starts with not ovulating as much. Hence a period here or there… They can be super heavy because oestrogen gets a lot higher compared to progesterone, then they both drop off. 

You can tell you’re in menopause if:

  • Your oestrodiol levels are low
  • Your FSH and LH levels are super high

Basically your brain is trying to tell you to ovulate, but your ovaries have no more juice left in them. (Also you will go through menopause if you have a full hysterectomy too)

 

 

Somewhere In Between?

Ah yes, welcome to your late teens, 20’s, 30’s and 40’s. Where we want to avoid getting pregnant, then want to at least want the ability to fall pregnant, then definitely want to get pregnant, then maybe avoid it again. We don’t ask much of our bodies do we? Thankfully when we give our body everything it needs, and rule out conditions that are completely out of our control, we can kill it… and rely on other things in our lifestyle to get pregnant when we want. FYI our period isn’t just there for us to fall pregnant. It helps tell us whether our hormones are in balance and helps us have strong brains, bones and hearts. 

Irregular cycles here are most likely due to a couple of things; 

  • Stress, this is the main way that your brain can basically hi-jack your ovaries and say ‘Noooo Waaay! It’s too dangerous out here for your body to withstand a pregnancy let alone bring a baby into the world’, keep in mind ‘Stress’ can be physical, chemical or emotional
  • PCOS: This is when we can’t control our blood sugars and a whole cascade of things happen resulting in no ovulation aka no egg being released and a cyst forming instead. 
  • Under-eating: This basically means your body doesn’t have enough calories to create and maintain your hormones as well as a baby. It’s technically called hypothalamic amenorrhea… Sounds suuuuper fancy. Basically you need more calories in, so your brain can chill and make all of your health promoting hormones.
  • Have you just came off hormonal contraception? It can take up to at-least 3 months for the synthetic hormones to be filtered out of your system (providing your liver and gut are working) for things to start to get back to normal. Be patient grasshopper. If it’s been longer than 3 months you should consider talking to a professional about what you can do. 

A couple of things to rule out or consider; 

  • Are you pregnant? 
  • Could you be going through early menopause (this is usually genetic or from surgery. Get some bloods to checked for this one!) 

Why Do we care?

Regular periods are a great measure of how our bodies core functions are going. When they happen regularly and routinely then we can have an educated guess that our female hormones are functioning as they should. Timing to avoid pregnancy or to conceive can be a lot easier this way too!

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Spotting

Having bloody discharge in the middle of your cycle, or when it’s not due to come. Normally you can see a little on toilet paper after you wipe, or in your knickers (hopefully not those new expensive ones though!) It’s usually down to hormonal imbalance, but can less often be a sign of more sinister things. It’s always good to let your health professional know when it first starts to happen, or if anything changes. Health responsibility is the new cool gals. 

Why am i spotting?

If we remember why our vagina bleeds in the first place, it’s always tied to a drop in both oestrogen and progesterone. Hence why we have a fake bleed when we stop taking the active pill and move onto the sugar pills, if we’re on contraception. 

So if we keep this in mind we can work backwards and find out why we may be spotting. The number one cause being that our oestrogen drops below the lower limit just before ovulation (you know when the ball drops). This is common in women who are fit, are exercising a lot, or have very little body fat. 

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B.hsci. B.app.hsci Chiropractic. Masters womens health medicine (studying)

Dr. Anthea 

Pay attention to what your vagina is telling you about your entire body.

Other Reasons

As we mentioned if this is something new, or something that has been going on for a while but you haven’t brought yourself to get checked under the hood, now would be a good time. Our periods and when we bleed from our vagina tell us a lot about what the F*#% is going on with our whole body, not just our reproductive organs. It could be from things like pregnancy, cancers, infections and global body issues. No need to stress out and run to the worst case scenario in the beginning, mention it to your doctor and let them do the investigating.

What the F*#% do i do about it?

Well first, if this is new, go get checked under the hood. The really nasty stuff is rare, but it does happen, and depending on your family history and genetics you may be at a greater risk. Once all the serious stuff is ruled out, then it’s time to look at balancing your hormones. 

Regulate your Oestrogen levels

If this is too low we can expect bleeding. Sometimes this can be low because we are really quite skinny, as our fat is another source of oestrogen. It can also come on if we’re super stressed- stress glands also produce oestrogen. A perfect storm of this is when we’re training really hard and pushing our bodies physically to be super fit. We need to remember that our bodies aren’t the same as mens, this is a good thing! We can use it to our advantage, we just need to know how. For tips on exercise visit here 

We can also boost our natural oestrogens by eating them. Phyto-oestrogens are a great way to boost your levels and get in all the other necessary ingredients women need, all at the same time. Check out our Girl-Powder recipe here. 

Boost your Progesterone 

Progesterone is made when we ovulate. No ovulation no progesterone. If this happens a lot of times, even the slightest dip in oestrogen can trigger bleeding. Progesterone is also a great brain calmer, bone and gut looker-afterer. For more info on how to best insure ovulation check out this page. Also remember if you’re on ‘the pill’ you don’t ovulate. 

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Polycystic Ovarian
Syndrome
(PCOS)

Not knowing when your cycle is coming can be annoying when you want to wear white pants, try for a baby or leave the house without the fear of not having a tampon. Whilst annoying, irregular cycles are a sign that our brain isn’t signalling our hormones at the right times in our cycle, and our hormone balance becomes out of sync. Whether you’ve got your first period or you’re entering menopause, it’s important to understand what is normal and what’s not, because while chronic anovulatory cycles have an impact on our fertility they also have bigger consequences on our overall health. 

PCOS

What is PCOS?

With all acronyms it’s much easier if we break it down, so we can really understand what’s going on. PCOS stands for Polycystic Ovarian Syndrome. Poly (Many), Cystic (Cysts- these are formed when ovulation doesn’t occur and the fully developed egg isn’t released), Ovarian (Ovaries), Syndrome (Caused by many interconnected systems that aren’t functioning properly). 

So basically, PCOS is when your body is in a chronic state of anovulation (no ovulation), because some of the systems in your body aren’t working properly and so your brain can’t tell your ovaries to release an egg. 

What does PCOS look like?

Typically someone with PCOS will have some if not all of the following signs and symptoms: 

  • Jawline Acne
  • Chin, Nipple and Neck hair
  • Head hair thinning
  • Irregular periods
  • Periods every 2 weeks
  • Heavy periods (over 80mls roughly 8 tampons)
  • Light periods (Less than 10mls)

Remember PCOS is a diagnosis of exclusion. Meaning, you’re diagnosed with PCOS when all other potential causes for hyperandrogegism (male features: nipple hair, deeper voice, jawline acne, facial hair, head hair thinning) and menstrual dysfunctions (irregularity, heaviness, lightness) are ruled out. If you’re experiencing any of the above symptoms, and in particular if they have come on rapidly, it’s a great idea to get checked by a doctor to make sure they’re not symptoms of something else going on. 

If not PCOS What else could it be?

Commonly: 

  • Hypothalamic Amenorrhea (HA)

We know, that’s a big confusing daunting word! Basically what it means is that you’re not getting your period (amenorrhea) because the hormone signals from your brain (hypothalamus) are saying it’s not safe to fall pregnant. Why does it think this? Well in this case, it’s due to low carbohydrate and calorie intake. When our brain registers that we’re not eating enough, it’s famine protecting skills kick in… One of these skills is to stop us from ovulating so that we don’t fall pregnant in a famine, smart right?! Only thing is, when this happens we don’t get a period and we also develop weak bones, heart dysfunction and our brain cells don’t work as they should. Not great at all. 

So what do we do about it?–> First if you’re suffering from an eating disorder, seeking help from a mental health professional is your first step. Then it’s about committing to increasing your calories to at least 2500 a day, and making sure you include lots of complex starchy carbs in there (150-200g/day), treat possible gut dysfunction with things like probiotics, ensure your living environment is not stressful, you have 25mg of Zinc a day and your insulin and iodine levels are up to scratch (a GP can test these for you)

  • Polycystic Ovaries

Polycystic Ovaries occur when a dominant follicle isn’t released because ovulation isn’t triggered. The main difference between them and PCOS is that they’re not a characteristic feature of a specific hormonal disorder. They result from functional issues in the follicle development OR from prolonged internal ovarian androgen levels–> This happens when we haven’t ovulated in a while, and he cause for that could be numerous things. 

 Less Common:

There are many reasons why you may be experiencing menstrual irregularity, and they range from chronic stress to more serious issues with your organs. So let’s chat about what your doctor should be checking for when you have menstrual irregularity or loss: 

  • Are you pregnant?
  •  Thyroid disorders (Blood test) Have trouble with weight loss, or gain, feel tired, constipated or diarrhoea 
  • Hyperprolactinemia (Blood test) Can have vaginal dryness, lactation and loss of libido
  • Androgen excess causes such as (Issues you were born with, androgen secreting tumours (rare), severe insulin resistance, cushings syndrome, and male pattern hair growth/loss that is for unknown reason) –> All of these can be tested for by your doctor, and ruled out with specific history and examination tailored to you. 

Main differences between PCOS and HA...

PCOS

  • Absent or irregular cycles
  • Polycystic ovaries
  • Normal or high fasting insulin
  • Bleed from a progesterone challenge
  • Hirsutism and elevated androgens
  • Period or two when first stopping the pill
  • Any age can out grow it
  • High LH to FSH ratio

HA

  • Absent or irregular cycles
  • Polycystic ovaries
  • Low fasting insulin
  • No bleed from progesterone challenge
  • Possible mild hirsutism 
  • No period when stopping the pill
  • More likely under 30 but can happen at any age
  • Low LH to FSH ratio

What tests should i be getting done?

You want to simultaneously rule out any nasty causes as well as figure out the driving force causing this dysfunction, so in that case here are something you can get tested:

  • At home pregnancy test
  • Thyroid (TSH, TPO antibodies, TBG) (Blood)
  • Prolactin levels (Blood)
  • Iodine levels (Urine)
  • FSH and LH levels 
  • Internal ultrasound for ovarian cysts
  • 2 hour oral glucose tolerance test
  • Fasting lipid profile
  • Serum testosterone (if you have moderate to severe hirsutism) (be sure to see DHEA-s levels to see if the main cause is stress)

There also some other tests that can be done but these are dependent on your specific history and your doctor will help you through those. 

 

Source: Clinical Gynecologic Endocrinology and Infertility 8th Edition pg. 522 

"

Doctor of Naturopathy

Lara Briden

PCOS is not one disease, PCOS is androgen excess

What do i Do about it?

PCOS isn’t one disease, it’s androgen excess caused by chronic dysfunction in your body. These dysfunctions can be categorised into 4 different subgroups, you can categorise yourself, based on the results of the tests above.

  • Insulin Resistance

Main focus here is to reverse your insulin resistance, you can do this through:

  • Movement and strength training
  • Metformin (prescribed by your doctor)
  • Berberine (Talk to a naturopath)
  • Magnesium (Liquid is the best absorbed, we recommend this one 
  • Make sure you’re eating plenty of protein (good quality, try not to overdo the animal protein)
  • Reduce high-dose fructose (Crappy food, and try and limit sugary fruits)
  • Post-pill

Post-pill causes of androgen excess can occur because the synthetic hormones in your pill can be derived from testosterone, and work to actually up-regulate your androgens, which causes higher amounts of sebum than before you started the pill

  • Make sure you’re getting enough zinc (around 25mg/day)
  • Avoid dairy and gluten
  • Inflammatory

If you’re someone who has achy joints, eczema or suffers from an autoimmune disorder, the chances are that your inflammation is the main cause of your androgen excess

  • Omega 3’s are a great anti-inflammatory and have been shown to help women with PCOS
  • Avoid inflammatory foods (Wheat, dairy, eggs, corn, high fructose foods)
  • Adrenal
Around 60% of your total androgens are made from your ovaries and the other 40% are produced from your stress glands (adrenal cortex), so if you’re cycles are regular, the chances are that your androgen excess is being produced from your adrenal glands, not your ovaries
  • Get on top of your stress (reading the SD Protocol is a great place to start)
  • Consider taking adaptogens to help regulate stress gland function, we recommend these ones
  • Meditating and practicing other stress relief techniques (You may need to tell someone to F off and we’re all for it. 
  • Taking a good quality magnesium is important for adrenal function too. 

Download your Free PCOS ebook

Polycystic Ovarian Syndrome (PCOS)

This cheat sheet was designed to go along with the associated podcast episode. If you're struggling with PCOS and want to understand how you can manage it naturally... Download your free cheat sheet today.

Endometriosis

Endometriosis is a long standing, inflammatory condition made worse by ebs and flows in oestrogen… Causing the growth of endometrial tissue outside of the uterine cavity. It effects the whole body and is caused by underlying imbalances and miscommunication between your bodies different systems. It’s not just bad period pain… Don’t let anyone ever tell you different dahrrling!

What the F%#k actually is it?

Basically it’s where the tissue that is naturally in your uterus and sheds every month is also be found in other parts of your body, most commonly in your abdominal cavity and around your rectum… Places it shouldn’t be. 

This tissue is naturally sensitive to changes in your oestrogen levels, so your symptoms change when you have your natural menstrual cycle (Hence why the pill is often recommended to flatten the natural hormone fluctuations). The tissue grows in the first half of your cycle when oestrogen peaks and then triggers a bleed around the time of your period when oestrogen drops. Bleeding into your abdominal cavity or anywhere else in your body for that matter is NOT FUN! It’s not just bad period pain y’all!

Signs and Symptoms

Symptoms can vary dramatically from person to person because they largely depend on where that nasty extra tissue is growing. 

Commonly associated with symptoms of: 

  • Chronic Pelvic Pain
  • Infertility
  • Heavy painful periods
  • Severe bloating
  • Vaginismus is often associated
  • Pain when poo’ing
  • Pain during sex
  • Poor gut function (Constipation, diarrhoea, IBS)
  • Anxiety/ Depression

Endo is prone to progression and recurrence. 

Starting your period at a young age and short menstrual cycles have been associated with increased risk for endometriosis.

What's Actually Happening in your body?

Basically in short. No one really knows why some women get endometriosis and some don’t. There is no ‘bug’ that attacks you and causes endometriosis, however it is thought that there is a mismatch and imbalance between your genes, hormones, environment (things you eat and drink) and your immune system. — This basically explains the underlying cause of may autoimmune conditions. There is no one cause, instead it’s your bodies way of showing you that the automatic processes in your body are off and something needs to be done. 

In women with no endometriosis, their level of endometrial oestrogen and chemicals that either contract or relax your uterus (prostaglandins) are low. Women with normal levels of progesterone (People with PCOS or women with regular cycles) also help to reduce the high levels of oestrogen and keep your hormones in check. In Women with Endometriosis they have 3 distinct differences: 

  • High local oestrogen production
  • High local prostaglandin (inflammation) production
  •  Resistance to actions of progesterone

What tests tell Me i have it?

The techniques used to diagnose endometriosis currently are quite invasive, however recently there has been revelations in ultrasound machines and quality of reading the results. 

You can have a hint that you may have endometriosis from the signs and symptoms above, also having an ultrasound will give you some idea also. These techniques however aren’t specific enough, hence why it takes on average 7 years for women to be diagnosed with endometriosis. 

Diagnosis is given with an exploratory laparoscopy or an ‘ex-lap’ for all of your Grey’s Anatomy fiends out there. This basically consists of surgeons going in for a key whole surgery (3 small wholes in your stomach), having a look around and burning or cutting off the extra endometrial tissue that shouldn’t be there. 

Based on where, how much and what they find, your diagnosis varies. You can be graded from 1-4. 

These grades are not based on the level of pain you experience. Someone with a grade 2 diagnosis may experience greater pain that the most severe tissue growth of a grade 4. 

Can other things be affected too?

  • Fertility
  • Hypothyroidism
  • Chronic Fatigue syndrome
  • Rheumatoid Arthritis
  •  Other autoimmune conditions

Things that make it worse?

Pregnancy has a protective effect that helps to decrease severity of endometriosis. This impact however tends to decrease overtime. Breast feeding and multiple pregnancies also help to decrease endometriosis, and the risk increases the longer time since last childbirth. 

Heavy alcohol consumption and caffeine also may increase the risk of developing or worsening endometriosis. This is thought to be because of their impact on hormonal imbalance and damage to the liver making it harder to breakdown and excrete hormones.

The incidence of endometriosis is increased in women that experience their first period at a young age, have short menstrual cycles and experience menstrual pain. 

What can I Do about it?

From the current research, it is thought that to the best of our knowledge that endometriosis is an inflammatory condition that is made worse by oestrogen. 

Conventional methods of treatment: 

  • Often put on contraceptive pill to flatten fluctuations in hormones
  • Can be recommended drugs that block the action of oestrogen
  • Exploratory surgery called a laparoscopy where they remove excess tissue from places it shouldn’t be
  • D+C that burns off excess tissue inside the uterus
  • Hysterectomy: As a last resort to remove the uterus and ovaries so that our natural production of hormones is halted. (Note this cannot be reversed and you will be put on hormone replacement therapy afterwards)

Reduce Inflammation and Co-ordinate immune response 

  • Focus on healing the gut and removing inflammatory foods (Often these include: wheat, dairy, eggs and corn–> You can get an IgG Food sensitivity blood test that tells you exactly what’s triggering your immune system and inflammation)
  • Omega 3 supplementation
  • Magnesium supplementation
  • Reduce stress in your life. This helps to balance your stress hormone which then helps to regulate your inflammation

Balance Hormones (Oestrogen)

  • Removing inflammation is a great way to help your gut regulate your hormones
  • Support your liver 
  • Eat based on what phase you’re in, in your menstrual cycle
  • Vitamin B complex to help regulate hormones
  • Decrease stress baby! If you’re stressed than all of your hormones go haywire. 

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.

Fibroids

Ever notice that your periods have become heavier? Or last a bit longer? This can be due to hormonal imbalances which may be due to your natural progression into the end of your fertile life, however it can also be due to hormonal imbalance and or benign (non-deadly) growths inside your uterus called ‘Fibroids’.

Who is most likely to get them?

It is estimated that around 70-80% of women will develop uterine fibroids at some point in their lifetime. They become more prevalent throughout our menstrual life, peaking in prevalence around our 40’s and tapering down in menopause.  

Somethings can increase your likelihood of developing them, such as; 

  • Out of balance hormones
  • Afro-American ethnicity
  • 40-50 years of age
  • Obesity
  • History of poor pregnancy outcomes
  • Getting your first period at a young age (prior to 12)
  • Mum, sisters or aunties that had fibroids (there is some genetic link)
  • Too much caffeine (this tends to create hormone imbalances)
  • Inflammation from poor diet

How do you know if you have them?

You can have an inkling that you may have fibroids by answering the questions in the above ‘Self-Health Check’ section, however the only way to really tell is through a couple of different scan options:

  1. Transvaginal Ultrasound–> This is the ultrasound machine you see in movies that is about the thickness of two of your fingers and is well shaped like an 🍆 🍆 🍆 It’s inserted into the vagina and gets a clear picture of what the inside of it’s walls look like.
  2. Sonohysterography–> This is also inserted into the vagina but is the thickness of a pen and quite long, this is so that it can go further into the uterus and investigate higher up.
  3. Hysteroscopic surgery –> This is often where surgeons with explore your uterus through your abdominal cavity and look to find (if there are any) and remove fibroids at the same time.

Self-Health Check for fibroids...

These symptoms can be signs of other conditions, however may mean that you have fibroids.

  • Spotting before your cycle is due
  • Feeling of fullness in the uterus, lower abdomen or back pain that is different for you
  • Heavier than usual menstrual bleeding
  • Pressure or pain with intercourse
  • Abnormal or erratic pelvic bleeding (some cause bleeding and others don’t, it’s down to where they’re located)
  • Past history of trouble maintaining an early pregnancy or spontaneous abortion

** If you’re experiencing abnormal bleeding when you’re not menstruating (Pregnant or menopausal) You should consult your doctor as soon as possible as you need to consider other possible causes before thinking it is the fibroid, it may be there as a coincidence.**

Where do you get them?

They can be anywhere in, or around your uterus.  Their location often is the reason why women experience different symptoms. Often times fibroids go un-noticed and are nothing to worry about, unless they are creating heavy blood loss leading to iron deficiency, problems conceiving or issues with debilitating pain.

"

MD, PhD Gynaecologist

Dr. Shawn Tassone

Generally they’re not a problem, until they’re a problem.

Why Do we get them?

The high prevalence of fibroids in the last premenopausal years, when anovulatory cycles are more frequent leading to a decline in progesterone, implies a greater role of oestrogen than progesterone in the formation and development of fibroids. 

This can be why women who suffer from other conditions fed by high oestrogen eg. Endometriosis, also suffer from fibroids. In this sense, looking at why you have higher amounts of oestrogen (poor diet, poor liver function, toxic substances from the environment, stress, genetics) can help to understand the underlying cause of your fibroids.

 

What should i do about my fibroids?

If they’re not causing you any symptoms or effecting your life, the medical profession suggests to leave them alone. If you view your fibroids as a symptom of hormonal imbalance you can focus on improving this: 

  • Support your liver (Milk thistle and plenty of green leafy vegetables) 
  • Decrease stress (we recommend reading SD Protocol, for a easy to understand and implement tool for balancing your stress) 
  • If you’re peri-menopausal speak to your doctor about bio-identical progesterone cream
  • The basics: plenty of water, sleep and reducing refined sugars and alcohols. 
  • If you’re experiencing severe symptoms such as high blood loss, debilitating pain –> Than you need to talk to your doctor about your medical and surgical options. (Often prescribe oral contraceptives, however these only mask your symptoms, NSAIDs for the heavy bleeding and cramping, or a hysterectomy in severe cases)

References

  1. Reis F, Bloise E, Ortiga-Carvalho T. Hormones and pathogenesis of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology [Internet]. 2016 [cited 5 February 2021];34:13-24. Available from: https://doi.org/10.1016/j.bpobgyn.2015.11.01
  2. Ulin M, Ali M, Chaudhry Z, Al-Hendy A, Yang Q. Uterine fibroids in menopause and perimenopause. Menopause. 2019;27(2):238-242.
  3. Lisiecki M, Paszkowski M, Woźniak S. Fertility impairment associated with uterine fibroids – a review of literature. Menopausal Review. 2017;16(4):137-140.

Periods &
Lifestyle

Your periods have been dubbed your 5th vital sign. So just like your pulse, what do you do when it’s telling you something is out of whack? Instead of masking what it’s try to tell you, we can use specific ways of exercising and eating throughout the cycle to help feed into the strengths of our period. 

Remember if you get any signs like theses; irregular, painful, dark clotting blood, acne, very very light, spotting, absence… then your period needs some TLC.

Exercise & Food

Unlike Men who have a 24 hours clock, women have both a 24 hour clock and also a 28 day clock. Our hormones vary considerably over a month, ebbing and flowing giving our body exactly the right amount of hormones at the right time to literally grow and egg ready to be fertilised, it’s f*ck’ing insane! 

Because of our the world is set up, we think we have to be the same day in and day out, be productive and get shit done, but that’s not how our body works. Every cell in our body has hormone receptors, so when our hormones change throughout our cycle, it means so do we. We need different things and we get different superpowers throughout, it can be annoying when we don’t know how to read it, but it can be oh so AH-MAZING when we learn how to harness our hormones and they become our superpower!

Stage of cycle

Dominant Hormone

Main Purpose

Exercise

Food

Menstrual

(Day 1-7)

Testosterone

Reset

Any form of high intensity exercise here will backfire and result in fat storage. We're lacking enough of our 'building' hormones to make any positive physical change, and therefore can have a negative stress on the body.

 

Walking, breath work and gentle yoga are great here.

Increase intake of protein and healthy fats

Ie. Red meats, kidney beans, buckwheat etc..

 

Fruits with low GI

Eg. Blueberries and blackberries.

 

Seafood and also seaweed are great too.

Follicular

(Day 8-14)

Oestrogen

Growth

Harder workouts are great here. Think about cardio boosting

Phyto oestrogens are the focus here, they will help build and regulate your bodies production of oestrogen. (The girl powder is great here)

 

Oats are great,

Sprouts and things like beans and sauerkraut too.

 

Probiotic foods are also great (opt for a non-dairy based yoghurt)

Ovulation

(Day 15- 21)

Oestrogen & Testosterone

Release and Fertilise

HIIT, intervals, hard training will respond well with your body because oestrogen and testosterone are high. Make sure it’s not over 30 mins if you have signs of hormonal imbalance like; dark red and clotting menstrual blood, jawline acne, painful periods, irregular, light or spotting)

Heaps of veggies and green leafy’s in this stage will help to detoxify your added levels of oestrogen

 

Fill up on Veggies and fiber.

Eg. Spinach, capsicum, strawberries, raspberries.

 

Generally don’t need as many carbs so can feel satisfied with light grains like quinoa.

Luteal

(Day 22-28)

Progesterone

Foster

In the beginning your hormones are still relatively high so things like strength pilates or intense yoga are good.

 

In the later stage (last 3-4 days before new cycle) try calm yoga and pilates, or walking

Generally need more calories in this stage of your cycle (hence cravings).

Having complex carbs like sweet potato, beams help to give you carbs and also balance blood sugars.

 

Body needs more calories:

Think brown rice, sweet potato, chickpeas, pears, apples, walnuts etc…

 

These will help to fill you up, detoxify your oestrogen levels and also regulate blood sugar levels.

**Remember if you have hormonal imbalances no more than 30 mins exercise**