Autoimmunity has been termed one of the biggest growing public health concerns of recent years. A study carried out last year and published in the Lancet found, that up to 10% of the UK population have a diagnosed autoimmune condition. Today we’ll be exploring what we mean by an autoimmune condition, why are they so difficult to diagnose and what kind of lifestyle change can we start to implement to have an impact.
Menopause is often viewed as a single life event, but it’s actually the culmination of a gradual process that begins with perimenopause. Technically, menopause itself is defined as having gone 12 consecutive months without a menstrual period, marking the end of the reproductive years. Yet, instead of focusing solely on this endpoint, or worrying specifically about perimenopause or menopause, I would love for us all to be more in tune with our cycle and how best to support our health and body at every stage of life.
A lot of our health issues arise because we have been taught to accept certain symptoms as normal rather than seeing them as signs from the body that something is wrong. By learning to support our unique circumstances, symptoms and how best to support them, we can help to make huge improvements to our health.
That being said, it’s particularly important to zone in on any symptoms during the perimenopause, so let's talk about it.
In this article, I’ll outline what to expect during perimenopause, how to recognise the symptoms, and ways to support your body as you navigate this life phase.
When to Start Thinking About Perimenopause
Perimenopause may begin as early as our mid to late 30s. While every woman’s journey is unique, women who have experienced hormone-related symptoms in their teens or twenties - such as irregular cycles, severe PMS, or mood swings - may find that these symptoms intensify if they haven’t been addressed previously. And by addressing them, I mean looking into the root cause and restoring the body systems from a holistic perspective as well as treating symptoms with pharmaceuticals, like painkillers or birth control. If we’ve been doing solely the latter, it might be unreasonable to expect that we are going to sail through perimenopause and menopause with zero problems. So if any of the above symptoms resonate with you, it’s worthwhile working with a health practitioner to try and manage them, rather than simply masking them.
Understanding The Stages of Perimenopause
Perimenopause simply means the time ‘around’ menopause. It is when hormones start to change in anticipation of menopause. The average duration of perimenopause is four years, however it can last for as long as ten years.
There are several stages of perimenopause where the hormones fluctuate - this is why the blanket HRT approach that we are familiar with, is not always the answer in the early stages:
Early Perimenopause: In this stage, oestrogen levels begin to fluctuate and we tend to have more cycles where we don’t ovulate and progesterone levels drop, leading to symptoms like shorter menstrual cycles and signs of oestrogen dominance, such as bloating or breast tenderness. This period can also bring on mood shifts or fatigue.
Late Perimenopause: As perimenopause progresses, periods become less frequent, and oestrogen levels start to drop. You may notice skipped cycles or longer gaps between periods.
Menopause: Menopause is defined as twelve consecutive months without a menstrual period. This is the official marker of the transition, but the symptoms and hormonal shifts can continue for years after this point.
As we enter perimenopause, and our bodies experience shifts in hormone production, we often associate only oestrogen and progesterone with this phase. However, our adrenal glands also play an important role in maintaining hormonal balance, particularly by producing testosterone, which the body can convert into oestrogen. These glands are primarily responsible for managing our response to stress, so if we are constantly stressed, the adrenal glands may become overworked, leading to burnout symptoms that can overlap with perimenopausal symptoms. This is why managing stress is crucial during the perimenopause years, so here are a few ways we can manage it.
The Importance of Food and Lifestyle Choices
Now that we understand what’s happening during perimenopause, let’s talk about proactive steps we can take to support our health.
Balanced Nutrition and Blood Sugar Management: With dropping oestrogen levels, our bodies may become more insulin resistant, making it harder to stabilise blood sugar. To manage this, it is key to keep our protein intake up, whilst avoiding simple carbohydrates and including lots of great sources of fat to balance blood glucose after meals. Incorporate complex carbohydrates and focus on whole grains and fibre-rich foods to avoid blood sugar spikes
Essential Nutrients for Thyroid Health: Many women experience thyroid issues in their 40s, as hormone levels change. Nutrients like iodine, iron, zinc, and selenium are essential for thyroid function. A balanced diet that includes seafood, leafy greens, nuts, and seeds can help to provide these nutrients.
Stress Management and Self-Care: Setting boundaries and prioritising yourself can be one of the most empowering - and challenging - exercises during this stage. Ask yourself where you want to spend your energy. Activities that bring you joy, whether it’s a daily walk, quiet moments in nature, or creative pursuits, can help lower stress levels and support adrenal health. It’s so important to find something that helps you clear your mind. Meditation and mindfulness practices may not resonate with everyone, but finding a way to clear your mind - even if that means simply observing your surroundings while walking- can make a difference.
3 Surprising Symptoms of Hormonal Change
Hormonal shifts can create some unexpected changes in your body. There are over 100 symptoms associated with perimenopause. Here are a few common, yet surprising, symptoms linked to perimenopause and menopause:
Frequent UTIs: Lower oestrogen levels can affect the urinary tract, leading to an increased risk of infections.
Itchy Skin: As oestrogen declines, skin may become drier and more prone to irritation or itchiness.
Reduced Libido: Hormonal fluctuations can impact your libido, a symptom that may come as a surprise if it wasn’t an issue before.
Embrace Your Body’s Signals
Rather than seeing perimenopause as something to dread, it can be a chance to really understand your body and listen to its needs. By learning how to support your health through food, lifestyle, and mindful practices, perimenopause most definitely can be navigated with a sense of clarity.
Remember, this journey is about honouring your body’s signals and giving yourself the care and attention you deserve. If you’re feeling stuck, reach out for guidance - it’s never too early (or too late) to begin supporting your health in meaningful ways.
One of the things that I regularly hear normalised is missing periods, often being written off as suspected PCOS without further investigation. However, this dismissive approach can potentially lead to serious underlying health issues going undiagnosed. In this piece, we’ll dive into two conditions that can cause irregular or absent periods: Polycystic Ovary Syndrome (PCOS) and Hypothalamic Amenorrhea (HA). While they may present similarly on the surface, understanding their differences is crucial for proper diagnosis and treatment.
You may not have heard the term ‘endocrine disruptors’, but I can guarantee you will have encountered them more or less every day for most of your life. It’s incredibly common for most people to be completely unaware of them, when the reality is they are a silent threat lurking in our everyday environment. Endocrine disruptors are chemicals which can interfere with our body's hormonal systems, and are far more prevalent than most people realise. From the food we eat to the products we use on our skin, endocrine disruptors have become an unavoidable part of modern life. And whilst it's impossible to eliminate all exposure, there are practical steps we can take to minimise our contact with these harmful substances and support our body's natural detoxification processes.
Understanding Endocrine Disruptors
Endocrine disruptors are chemicals that can interfere with the production, release, transport, metabolism, or elimination of our natural hormones. They can mimic oestrogen in problematic ways, block the action of hormones, or even alter hormone levels altogether. This disruption can lead to various health issues, including developmental problems, reproductive disorders, and possibly contribute to the development of certain cancers.
In terms of where they are often found, the answer is, in short, everywhere. They are in plastics, pesticides, personal care products, and even in our food and water. Common endocrine disruptors include:
1. Bisphenol A (BPA) in plastic containers and tin food cans (it’s also found in receipts!)
2. Phthalates in flexible plastics and many personal care products
3. Pesticides and herbicides used in conventional agriculture
4. Flame retardants in furniture and electronics
5. Per- and polyfluoroalkyl substances (PFAS) in non-stick cookware and water-resistant clothing
The Invisible Impact on Health
The effects of endocrine disruptors can be far-reaching, yet often very subtle. They've been linked to various health conditions, including:
Reproductive issues and fertility problems
Developmental delays in children
Hormonal imbalances
Thyroid disorders
Certain types of cancer
Metabolic disorders, including obesity and Type 2 diabetes
The connection between endocrine disruptors and metabolic health is particularly concerning, as these chemicals can interfere with our body's ability to regulate our metabolism and overall energy balance. Not to mention that when our liver becomes overwhelmed with toxins, the body often stores these harmful substances in fat tissue, creating a vicious cycle that can contribute to weight gain and difficulty losing weight.
Practical Steps to Reduce Exposure
Whilst it's impossible to completely avoid endocrine disruptors, we can take steps to minimise our exposure. We have most control over our home environment so here are some things to consider:
In the Kitchen:
Choose organic produce when possible, especially for the "Dirty Dozen", which is a list of fruits and vegetables with the highest pesticide residues - search Dirty Dozen for the country you live in as these can vary between Europe and the US
Use glass or stainless steel tupperware instead of plastic
If you do use plastic tupperware, avoid heating your food in it - transfer it to a heat-resistant container and then heat up
Opt for more natural cleaning + laundry products - there are some fantastic brands out there - a website like WellEasy lets you choose from a selection that they’ve carefully curated [ Use code HORMONIOUSLY10 for 30 day free trial and money off your first order]
Personal Care:
Choose natural, fragrance-free personal care products. I love Therapi Honey Skincare [HORMONIOUSLY for 10% off order] for nourishing skincare, and Evolve [HORMONIOUSLY15 for 15% off] is a great option for body care.
Opt for epsom salts in the bath rather than scented bubble baths
In the Home:
Remove shoes before stepping into your house to avoid bringing in dirt and chemicals from here, there and everywhere
Use an air purifier that has a HEPA filter, especially in the bedroom and even more so if you live by a main road
Choose natural fibre clothing and bedding wherever possible
Dust and vacuum regularly to remove the buildup of dust which can have chemicals sitting in it
Get rid of all scented plug ins and air fresheners - choose essential oil diffusers instead
Water:
Use a high-quality water filter for drinking - TAPP provides multiple options including whole house filters or counter top options that are made of glass
Consider a shower filter to reduce exposure through skin absorption - TAPP also provides shower filter options
Supporting Your Body's Detoxification
Detox is a word that’s thrown around as if it’s something we need to do intentionally, yet our body is an expert at naturally detoxing if it has the right environment to do so. It’s important to support our body’s natural detoxification process so that it is able to eliminate any endocrine disruptors that have made their way into our system. Here are some of my recommendations:
Eat a diet rich in cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) to support liver detoxification
Include foods high in antioxidants, such as berries and leafy greens
Stay hydrated to keep your bowel movements regulat to help move toxins out of the body
Incorporate regular exercise into your routine as it helps stimulate the lymphatic system, aiding in toxin removal
Try to jump in a sauna to allow the toxins to sweat out
Prioritise quality sleep, as this is when the body performs a lot of its detoxification
Use stress management tools, as chronic stress can impair detoxification. Think about things like meditation or deep breathing to regulate your nervous system
It's important to remember that we're all doing our best with the information we have. There's no such thing as perfect when it comes to avoiding endocrine disruptors, so the goal is progress, not perfection. Start with small, manageable changes and gradually incorporate more as you become more aware and comfortable with the process.
Whilst endocrine disruptors can feel overwhelming, remember that every small step counts. By making informed choices about what we bring into our homes and put into or onto our bodies, we can significantly reduce our exposure to these harmful chemicals.
If you’re the kind of person that feels excited at the prospect of booking your restorative getaway, booking your flight and then not having to worry about anything else. We’ve got you. From picking you up at the airport, making sure you’re comfortably transported to the retreat space and looking after the entire itinerary while you’re there.
The only extra you need to consider is whether you’d like to book in for a massage or extra restore 1:1 session with Kam during your time with us.
Here’s an imagined snippet of what to expect on your rest, recover, revive retreat with us this year.
You’ve just arrived off your transfer and we’re there to meet you at the Quinta with a menagerie of enthusiastic pets (some friendly dogs, cats and Lucky the domesticated goat) that also call this gorgeous place home. You’ll be shown to your room and then we’ll all regroup to share some snacks and talk through our itinerary for the week.
We’ll all take a moment to think about what has brought us here and what we would like to get out of our 5 days together – this will help you shape your decisions in line with your goal, like whether to wake up for mindful movement in the morning or maybe just enjoy a bit of extra sleep.
Your time at the retreat is all about you making meaningful connections with people but it’s also really important to connect with yourself and tap into what you need the most out of your time with us.
After establishing your personal goal you'll be invited for a walk around the Quinta so that you can get your bearings and know where to meet for planned activities, workshops and our lovely meals together. The food had rave reviews last year and you can let us know about your dietary requirements in advance so that that is another thing you won't have to think about for your holiday.
After the walk around there's some free time, you might want to lounge by the pool, take a quick dip in the river or schedule your massage for later in the week.
We'll all have dinner together and after dinner we'll be holding an optional welcome + Solstice ceremony, more details to follow.
You've woken up and gotten your bearings, it's always takes a few seconds to orientate yourself when you wake up and you register that you're not at home. This morning you've got the option to join a slow flow yoga (bring a jumper the mornings can be a bit misty and chilly before the sun warms up the valley), or maybe you'll choose to have a leisurely morning, read your book and then make your way to breakfast with everyone.
Today's retreat theme is routines and rituals for stress management - we'll start exploring the kind of things we need and want to put in place long term to ensure that we can regulate our nervous system.
Anyone who has done one of my group courses or done 1:1 sessions which address any hormonal concerns, has heard me talk about our stress response [ rememeber – it’s primary goal is to keep us alive]. The stress response underpins every other process in the human body. If the stress response perceives danger, everything else is de-prioritised until the stress response knows we are safe again. Unfortunately, our lifestyles are not set up to send regular messages to our stress response that we are safe, quite the opposite in fact. Constant alerts on our phones, anyone with an iphone who uses ‘radar’ as an alarm clock, emails from work colleagues that grip our stomach with fear – these all stimulate our stress response and we’re frequently on high alert. What calms us down? Time in nature, regulating breathwork, slow walks, laughing with friends, hugs, being out in daylight first thing in the morning.
Today we’ll be heading out on a group hike to appreciate nature and explore our surroundings then when we get back, some downtime and a lovely lunch will be waiting for us. After lunch, we'll be identifying some of our key stressors in our life (through stress bingo) and identifying what we can control. Then you've got afternoon free time so for some, an adventurous paddle board down the river, maybe you've booked a massage or time to chill by the pool. We've got a gentle afternoon workout guided by Lisa, that won’t overload our stress response and then finishing off with a guided rest and restore session with Kam to round off the day before a delicious dinner is served.
Day 3 - What's on the Schedule?
Our theme and focus for today is all around balanced energy.
We'll be exploring the relationship between blood glucose levels, stress + energy and we’ll also touch on the impact of our circadian rhythm and for those of us who have periods, we’ll check in on the link between where we are in our menstrual cycle and the impact that has on how we balance our blood glucose.
We will slowly be getting a bit more fiery with movement as well because if we build more muscle - we become better at processing glucose in our body!
What does our day have in store?
A morning movement flow followed by a gorgeous balanced breakfast - today you’ll be learning why for some people I recommend always having breakfast within 2 hours of waking.
This morning’s Health Workshop, if it’s chilly we’ll stay cosy next to the fire until the sun is over the valley. We’ll be talking tips and tricks to make sure we’re choosing balanced meals longterm, as well as some easy lifestyle swaps to lower blood glucose spikes after meals.
Today’s leisurely lunch will be followed by an introduction to Strength Training led by the wonderful Lisa. If you’re already there’ll be a chance for you to do an ability appropriate session with lots of focus on form.
As always, lots of free time to adventure or relax - whatever your energy levels are guiding you to do. Then we’ll be treated to a Sound Bath - to calm our stress response to get us into rest + digest mode so that we can enjoy (and effectively digest) our delicious dinner.
Welcome to another beautiful day at the Quinta. It can be chilly in the morning so make sure you’ve got your jumper and cosy socks on while we wait for the sun to come out and warm us all up.
Today’s theme is about our digestion and our microbiome and how these areas impact every aspect of our health. We’ve got morning movement before a delicious breakfast. We’re then moving into a short health workshop exploring the powerhouse that is our microbiome and how we can support it - we’ll hang out by the fire if it’s still chilly, or we can sit by the pool if the sun is already out.
After we’ve had time to digest – Lisa will be leading us through a pelvic health and lifting workshop – this is for everyone – not just those who have been through pregnancy. Once we’ve connected to our breath, engaged our cores and lifted with the most precision we’ve ever lifted - it’ll be time to head in for a lovely lunch.
After lunch you’ve got time to relax by the pool, read in your room, have a massage or maybe go off on an exploratory walk or canoe on the river, whatever takes your fancy.
After some downtime we’ll be learning all about how to make your own fermented food at home with a fermentation workshop – your new found skills will set you up for a healthy microbiome for sure! For those worried about the after effects of fermented foods (you know I’m talking about farting don’t you) we’ll be able to talk through why this happens and how to change the foods or quantities to manage this and maintain your social life.
Don’t fill up on all those ferments though – we’ve got a delicious dinner to enjoy as well. After dinner is your own time, maybe you want to chat around the fire, you might want to stargaze from the jacuzzi and you might want an early night – anything goes.
Today is our last full day at the retreat – the theme we’re exploring is ‘Letting Go’ and this is all centred around liver health. We’ll be thinking about our toxic baggage – both in terms of chemical exposure and situations that don’t serve us anymore.
What does that look like in terms of our daily schedule? Great question. This morning’s movement flow will pick up the energy a bit – we’re at the Revive portion of the retreat and we’re ready for a bit more fire.
After our flow, the most important meal of the day - we’ve got our lovely breakfast. Then we’ll go straight into our toxic baggage workshop – which is all about identifying how to reduce toxic exposure from an environmental perspective. We will also be thinking other situations in our lives that could be contributing to resentment – as there is a big liver link.
We’ll then head into a short but sweet strength session (even though we’ll have way less toxic baggage to carry around, we still want to be strong). We’ll have some time to freshen up before we enjoy our lunch.
Straight after lunch we’ll have a quick walk to make sure we’re supporting healthy blood glucose levels and we’re also going to forage some fresh herbs from the surroundings. We’ll do a super quick blending blitz so we learn how easy it is to make a powerful gut + liver supporting blend. Then the afternoon is yours to relax or adventure, whatever mood takes you.
We’ll gather for our last dinner all together and after dinner we’ll have a closing ceremony around the theme of letting go of what doesn’t serve us. This is all about what you want to take home from the retreat but more importantly, what you want to leave behind and let go of.
Unbelievable that the time has flown by - this morning is the time to make the most of those beautiful valley and river views as we’re getting ready to head home.
Today’s schedule is a fiery morning workout and then a slightly later closing brunch. We’ll be celebrating the new bonds we’ve made, sharing the habits we want to bring home with us and swapping details with some new connections.
Then it’s about getting the last of your stuff together to make the airport transfer. Saying our last goodbyes to the beautiful space, to Pete and Kate and to the menagerie of therapy animals who have been keeping us company for the week (NB not technically certified therapy/service animals).
Will you be joining us?
A topic I delve into with all my clients that often requires revising at follow up sessions. This article explores:
The nervous system and its role in rest
Cortisol and all of your other hormones, and how rest (or a lack of) affects them all
The seven types of rest
Small changes you can implement for long-term benefits
As the days get colder and the hours of daylight are rapidly declining, a lot of people report that their mood is negatively impacted. The first thing to remember is that you are not alone in this feeling, there is nothing wrong with YOU, try not to give yourself a hard time. Now, there are a few things you can try, which might help.
As it gets colder and darker, we spend a lot more time inside than during the summer months. This reduces our exposure to natural light, which can have a huge impact on our serotonin production. Serotonin is a neurotransmitter that helps to boost mood - we have receptors in our eyes that stimulate the production of serotonin in response to light exposure.
You might guess where I’m going with this…exposure to daylight in the early part of the day - as soon after waking as possible, can help to boost your mood. When it’s cloudy, you need to stay outside for longer. If you are put off by the weather at the moment or simply cannot get outside then another option is to try a SAD lamp (SAD stands for Seasonal Affective Disorder). Switching on your SAD lamp at a strength of 10 000 Luxe for 30 minutes per day helps the body to produce serotonin in the morning and helps to support the circadian rhythm of the body.
Get your vitamin D levels checked. One of vitamin D’s functions in the body is to support your mood. If you feel like you’re struggling, mention this to your GP and ask whether it’s possible to have a blood test to check.
There is a general guidance to take a vitamin D supplement of 400IU daily between October to March in the UK, for some people (a lot of people) this dose just isn’t going to cut it. The best thing to do is to check your levels and then get the support of a practitioner to make sure that you are taking an appropriate dose.
There is also a caveat here, which is that, just because something falls within a ‘normal’ reference range, doesn't always means optimal - feel free to get in touch if you have questions about this.
NB - it is also absolutely possible to overdo it with vitamin D - please remember more isn’t always better, dosage is important.
What’s my next top tip? I’m glad you asked. This is another one to support our serotonin levels and that is to make sure you are getting enough roods rich in tryptophan. What the hell is that? Oh, sure, it’s an amino acid, which is the precursor to serotonin - that’s our mood boosting neurotransmitter from earlier. It is also the precursor to melatonin, our sleep hormone.
So what kind of foods are rich in tryptophan? As you can imagine, as an amino acid, protein-rich foods are a good source;
Chicken
Eggs
Cheese
Fish
Milk
Turkey
Veggie sources of tryptophan:
Peanuts
Pumpkin + Sesame Seeds
Tofu + Soy
This isn’t an exhaustive list and if you’ve tried all of the above, why not take a look at my previous post on the microbiome - as this could be having a big impact on your mood <3
Confidence in our bodies can vary day to day. Something that can very quickly erode body confidence is when we feel our body isn’t doing what it ‘should’. As September is PCOS awareness month, I wanted to dig into what’s going on with PCOS and what kind of lifestyle change you might want to put in place if you want to manage your symptoms.
PCOS stands for polycystic ovarian syndrome – a condition that can include some or all of the following symptoms:
Irregular menstrual cycles,
Weight gain and/or difficulty losing weight
Decrease in breast size,
Hirsutism (aka dark, coarse hair growth on the face and body)
Acne (especially along jaw line)
Anovulatory cycles (lack of ovulation)
Thinning hair on the scalp
Fatigue and sleep issues
PCOS – where to begin.
Polycystic ovarian syndrome is a touch misunderstood. Essentially the problem is high androgen hormones and a lack of ovulation, which results in the characteristic symptoms we associate with the condition. What is less spoken about are the different contributing factors behind the condition, and the fact that the name of the condition could be considered a bit misleading. A very common problem is that individuals are told to lose weight and eat less (too simplistic, unsurprisingly) but if you are undernourished, especially not getting enough starchy carbs, you will also stop ovulating, so you’ve still got the issue of anovulation, only now it’s got a different cause.
What’s in a name?
Polycystic Ovarian Syndrome suggests cysts on the ovaries – wouldn’t you say? In fact, what shows up on scans is over developed ovarian follicles. Our follicles are what releases an egg during ovulation – it is normal for multiple to develop at the same time, my favourite analogy is that its a beauty pageant type situation, the winner releases the egg. However, in PCOS, the ovulation isn’t always happening, resulting in the ‘string of pearl’ appearance of the ovaries, a series of follicles. An ovarian cyst is a fluid filled sack that grows on an ovary, being diagnosed with an ovarian cyst does not technically mean you have polycystic ovaries.
Sub-Types of PCOS
In order to have PCOS, you need to have a susceptibility to it, however, there are different contributing factors that will be driving the symptoms. In order to effectively address your symptoms, you need to get to the bottom of what’s driving it. Technically, if you get to the point that you’re not showing symptoms, you’re not in a PCOS state anymore, however, you’ll still have a susceptibility to it. The 4 main drivers, or sub-types of PCOS, coined by Dr. Lara Briden, are insulin resistance, inflammation, adrenal androgens and post-pill PCOS. In order to determine your sub-type, you can work with a functional medicine doctor, nutritional therapist or naturopath who can support you to get to the root cause of your symptoms.
Insulin Resistant PCOS
Insulin resistance is a state of high insulin - your body isn’t responding to insulin and its feedback mechanism then produces MORE insulin.
High insulin drives up androgen levels.
Symptoms of Insulin Resistance can include but aren’t limited to:
extreme thirst or hunger
feeling hungry even after a meal
increased or frequent urination
tingling sensations in hands or feet
feeling more tired than usual
frequent infections
Inflammatory PCOS
Inflammation can push up Testosterone levels (an androgen). If inflammation is a main driver it’s important to get to the cause of the inflammation and address it.
Some symptoms that might suggest inflammatory PCOS are:
Joint pain
Digestive Issues
Headaches
Inflammatory Skin issues
Adrenal PCOS
Best known for the stress response, the adrenals also produce some of our sex hormones and the precursors to them. If the only elevated androgen is DHEA-S, this suggests the adrenals are over-producing DHEA-S, this is normally determined by genetics but can be modified with lifestyle and supplements.
Signs and symptoms are all PCOS-type symptoms.
Post-pill PCOS
Some forms of the pill suppress androgens, the body then wants to produce more androgens, the pill then continues to suppress. The result when you come off can be a temporary increase in androgen production.
If periods were regular before taking hormonal birth control, your PCOS could be post-pill.
Lifestyle factors to manage your symptoms:
Firstly, if you have symptoms of insulin resistance, it is really important to seek the support of your GP to help you manage this, alongside making lifestyle changes.
Insulin Resistant PCOS
Avoid high sugar foods and drinks e.g. soft drinks, desserts (even with natural sugars)
Strength Training to increase insulin sensitivity
Increase Magnesium-rich foods - Speak to a practitioner to consider supplementation
Inflammatory PCOS
Identify foods that drive inflammation for you
Address digestive symptoms (you can work with a nutritional therapist or naturopath to support you)
Zinc-rich foods - Speak to a practitioner to consider supplementation
Adrenal PCOS
Address your stress levels - both perception of stress and implementing activities that help support your stress response
Reduce food and drinks that put a strain on your stress response (caffeine, alcohol, excess sugar)
Speak to a practitioner about supplements to support your stress response
Post Pill PCOS
Patience (sorry, I know that one is annoying)
Eat enough - under nourishing is a nightmare for healthy ovulation
Zinc-rich foods - Speak to a practitioner to consider supplementation
The above are a starting point, if you have had a PCOS diagnosis and you’re struggling with seeing an improvement and you feel like you need support alongside what you’re getting from your GP then know that there is help available and you don’t need to do it alone.
I was recently asked some really interesting questions on the basics of gut health. If you’ve heard people talk about the gut microbiome but you feel a bit clueless, this article is for you:
The gut microbiome is the combination of bacteria, yeast and viruses that line our digestive tract. These organisms work in harmony with us and among other things play a key role in our immune function, support digestion and produce key vitamins. If we lack certain key strains or an overgrowth of others, this can result in issues regulating the immune response, being more vulnerable to pathogens (things that cause disease) in our food and environment, problems breaking down and getting spent hormones out of the body in a healthy way, uncomfortable digestive symptoms and ultimately the development of disease.
As well as physical symptoms of disease, the gut is also responsible for the production of a lot of neurotransmitters and is closely linked to our nervous system. There is a huge link between gut health and brain health. There is also a lot of 2-way communication between the gut and brain, via the vagus nerve, it is responsible for moving us between the stress response (sympathetic response) and our rest and digest (parasympathetic response). The gut - brain connection (gut-brain axis) is widely recognised and is why there is an understanding of the big link between mental health and gut symptoms.
One of the contributing factors to mood disorders is the gut-brain axis - the microbiome has a big impact on this communication system.
Lower levels of commensal (or beneficial) bacteria can have a detrimental impact on mood - this is because certain bacteria will have an impact on more serotonin or GABA production in the gut (neurotransmitters linked to more positive or calm responses)
In addition a compromised gut lining (resulting from but not limited to - a previous infection, low levels of commensal bacteria, an overgrowth of inflammatory bacteria) can result in higher levels of inflammatory chemicals circulating in the body, which can be a factor in depression and low mood.
Some other areas impacted by a disrupted microbiome (aka dysbiosis):
Sleep
Cognitive function
Period Pain
Glucose Regulation
Development of autoimmune conditions
Sex Hormone Imbalances
Other Microbiomes in the body (skin, vaginal, pulmonary etc)
Gut health is crucial in terms of understanding health and the body and I don't think we should underestimate its impact. As with everything, you can't look at the gut in isolation and you need to understand it in the context of the whole person, symptoms, health history. We are only at the tip of the iceberg in terms of fully understanding the impact the gut microbiome has on our health and ongoing research.
If you’re looking for top tips to keep your microbiome tip top, here are my favourites. Make sure you focus on the basics before you start trying to biohack - chewing your food enough and staying hydrated are the absolute starting points when it comes to gut health.
Ensure that you have variety in your diet. A diverse range of foods in the diet will have a positive impact on the gut microbiome. Vary the grains you're eating, add nuts and seeds to your salads, choose different varieties of vegetables, use herbs and spices in your cooking. If you're in a food rut eating the same things every week, just challenge yourself to add in 1 or 2 new foods per week.
Also try and aim for more wholefoods and less processed foods.
For those of you familiar with burnout - you’ve skirted around it or your energy, motivation and/or health has full-blown flatlined - you might have noticed that it can become your achilles heel.
You recognise that you need some recovery time but as soon as you start to pick up again you slam your foot back onto the accelerator and expect to get back to the top speed you were operating at before. I’m afraid I’m here to tell you something you might not want to hear. If the only thing you change is taking a short break from your commitments, spoiler alert - you haven’t addressed what is going on in your body. You could be right back to feeling frazzled before you know it.
My first experience of burnout was in my 20s - at 27 I didn’t know what was wrong, I was experiencing anxiety, depression, fatigue and a compromised immune system (2 kidney infections and a lung infection in the space of a year). I quit my job as I recognised that I wasn’t coping with the stress and I genuinely thought that would solve the problem. Unfortuantely - what I hadn’t accounted for is that the body’s response to chronic stress is that it down-regulates many other processes that are not required for immediate survival in a dangerous situation - bye bye effective digestion, ta ta tip top immune response and see you later sex drive. There is some work required to recalibrate these systems and support the physiological processes to power up to their former glory.
I am not going to lie to you - the stress management side of things was by far the trickiest thing for me to get right. It was only when I was in my third year of my nutrition qualification - working full-time during the week and studying at weekends, that I HAD to face up to the fact that I still had a BIG problem with stress management. There was a small disagreement at home and I had a full-on panic attack. Nothing like the body sending you a panic attack as a sign that something is awry. Essentially I was flirting with my old nemesis of burnout and I realised my adrenal glands (responsible for stress hormone production) deserved better. I resolved to learn how to put myself first and I am proud to say that I took this seriously and I made some big changes.
Cue pandemic…… In February of 2021 I did my health MOT with a blood test and my comprehensive hormone test. I. HAD. DONE. IT. AGAIN!!! I knew I was tired, I’d been working hard, I’d rushed to see family over that Christmas break. I was heading to burnout city once again - how did I know this?
The hormone test I use looks at your stress response (as well as oestrogen, progesterone and testosterone). The test results include daily cortisol production (cortisol is our main stress hormone), free cortisol and inactive cortisone. My test results were telling me that my energy levels (free cortisol) were a thin veneer that would soon crumble as I didn’t have much left in the tank (metabolised cortisol - total production). My body was about to put me into standby mode - this is how I like to think about it - the body can favour inactive stress hormones when you’re going through chronic stress as high levels of active stress hormones flying around aren’t desirable for the body in the long-term. When your body puts you into this mode - this is when you start experiencing the inability to get out of bed, the low mood, low motivation, low energy, sluggish digestion, sluggish immune system.
To the untrained eye - this free cortisol pattern looks alright…
Given the 2020 experience - it was no huge surprise to me that I was almost in the burnout boat again. The Pandemic and the way the world and our lives have changed had a massive impact on me and my adrenal glands were really telling the tale. I had also taken on some big projects and had lost a lot of time for myself. Although I’d previously learned how to support my body to recover from burnout, I hadn’t acknowledged the impact of the pan-demo and my results were what really made it real for me. When you live on your own - there is no one to point out how many hours you’re at your desk, the fact that you haven't left the house that day or that hummus isn’t a good enough source of protein for your dinner - of course it is easier to slip into unhealthy habits.
Are you someone that needs to see some evidence on paper before you start to put yourself and your health first? Or have you learned to listen to the signs that your body is sending you?
Do reach out if you’d like to have a conversation about avoiding or recovering from burnout.
Why oh why - when we’ve already got a case of the January blues is it that those of us who are hit with period problems, menstrual misery, hormonal horror shows - often get hit the hardest in January?
As with any health related issues - there is never one single thing that contributes to this. In the words of Spike from Notting Hill (the 1999 Rom-com) ‘it’s a combination of factors really’.
Let’s consider some of the leading factors that lead to ‘period problems’
nutrient deficiencies
blood sugar imbalances
digestive distress (the microbiome could be contributing to a lot of issues including painful periods and recurrent infections like thrush and BV)
hormone haywire (this could be high oestrogen, recirculating oestrogen, low progesterone etc.)
a dysregulated stress response
Period Problem Pie Chart
So if your December was a lot of mince pies and chocolate for breakfast and not quite the rainbow of fruits and vegetables you normally aim for - that could well contribute to lower levels of nutrients. That is also a recipe for a blood sugar rollercoaster aka blood sugar spikes and subsequent dips. This can lead to mood swings, inconsistent energy and sugar cravings throughout the day
What about if you indulged in a bit more alcohol than you normally would? That can definitely result in lower levels of B vitamins and Magnesium.
If the sprouts and veg were more garnish than the main part of the plate then you could well have been consuming less fibre than normal. Your poor gut bugs have been struggling through against all odds (less fibre, more alcohol, more sugar).
Higher levels of sugar and alcohol can contribute to higher levels of oestrogen circulating in the body - if our oestrogen is high relative to progesterone we can experience exaggerated symptoms of PMS like mood swings, pain and water retention to name a few.
What about stress? We can’t escape it, this time of year can be very stressful. Rushing around trying to find presents for everyone, making time to see everyone - all under the massive umbrella of potential restrictions changing meaning all plans get cancelled - nightmare.
Not to mention the sugar, alcohol and possibly less sleep than normal all contributing to stress in the body - note to self - coffee and mulled wine do not effectively hydrate so you might also have to add dehydration to the list of stressors on the body.
A combination of the above factors can combine into the perfect storm of a horrible January period.
A particularly miserable menstrual January experience for me was when I still worked in an office, I had just eaten lunch and then things took a turn for the worse and I ended up sweating profusely in the bathroom for 45 minutes with hideous cramps before proceeding to throw up the entire contents of my stomach.
I ended up lying partially clothed on the bathroom floor for a while in a vain attempt to cool down. It was horrible.
So how can we counteract the effects of a frivolous festive season and see an improvement in period pain, mood swings, fatigue, nausea and bloating? Here 5 easy to implement recommendations to get started:
Opt for nutritionally dense foods - richly coloured vegetables and complex carbohydrates (rather than highly processed options that have been stripped of nutrients)
Ensure that all your meals and snacks have a source of protein and healthy fat to slow down any blood sugar spikes after eating
Support your microbiome with complex carbohydrates and remember that we should be aiming for 30g of fibre per day #fibreaudit
Lots of people are aiming for Dry January this year - if that isn’t your style then you can aim to reduce the amount you are drinking - try swapping every other drink for an non-alcoholic or low alcohol alternative
Commit to 10 minutes per day of a stress lowering activity - a walk in nature, colouring, or listening to a guided meditation
Would you like to get back on track with your hormone health?
Do you need more than just a January tune up?
Book in a call with me so that we can talk through your options on how to work out the best next steps for you.
Before we dig into symptoms that you have been told are “hormonal”, PMS or simply part of being a woman it is really helpful to do a very quick back to basics review of the menstrual cycle.
They key players being discussed today are oestrogen and progesterone and the main event of the cycle - OVULATION.
Oestrogen - we have 2 oestrogen surges as part of our monthly cycle - one just before we ovulate and one a few days before our period. This is significant because some of those dreaded cycle symptoms, particularly headaches, migraines and mood swings, can actually be linked to declining levels of oestrogen after a peak.
Progesterone - this is only produced in significant amounts after ovulation - because the follicle that releases the egg then becomes a little progesterone factory. Progesterone is a hormone that can be very calming and support sleep. It does also have it’s downsides and can be linked to the less desirable symptom of constipation.
Cycle Tracking:
Day 1 of your Cycle is the first day of your period - the first day of your proper bleed - spotting before that technically counts as your previous cycle.
The day before your next period is the last day of your cycle.
So if you’re tracking your cycle and counting the days you count from Day 1 up until the day before your next period.
Only 13% of women have the average cycle length of 28 days - according to a study using data from the Natural Cycles app.
The main event of the cycle is ovulation - the assumption that you ovulate on Day 14 of your cycle is based on that average cycle length of 28 days - your cycle is unique to YOU. You normally ovulate between 10 to 14 days before the onset of your period. So you can look at your previous cycles and count back to see when your ovulatory window is. If you have a longer cycle that is 35 days, you are going to ovulate somewhere between Day 21 and Day 25. If your cycle is much shorter - say 23 Days, then you will be ovulating somewhere between Day 9 and Day 13.
We also don’t necessarily ovulate every month - but that’s another post in itself as well.
So when you are noticing symptoms throughout the month - keep a note of what Day of your cycle you are noticing them and you may find that certain symptoms always happen around the same time in your cycle. The more information you have and can share with whoever you are working with (doctor, nutritionist etc) the more targeted the approach can be.
NB For anyone who is on hormonal birth control, you aren’t having a menstrual cycle as the hormonal birth control is disrupting the communication of the hormones in your body (more on this on another day)
