Your Cycle and Your Health

Have you seen this recent article from the Guardian on why it’s unnecessary to have a period? I saw a post responding to this article on instagram recently and immediately pulled up the article; at first glance I was annoyed and frustrated that someone could write something so misleading and as I sat with it I felt sad and disappointed for all the women who would read it and take it to heart thinking it is no big deal or of no consequence that they are on hormonal birth control thinking it will either “fix” their condition or remove the inconvenience of bleeding. Of course we all have a right to our own opinion and I am not going to point fingers and tell others they are wrong for having beliefs that differ from my own. So I thought I would share my thoughts around the discussion.  

Having a menstrual cycle is normal, beautiful, and part of human life. Without it none of us would be here and it is meant to be celebrated! I won’t say I jump for joy when I start my period each month but I do appreciate that I have healthy, regular cycles after working hard to regulate my cycle and treat my own hormonal imbalances. I love seeing periods becoming normalized, talked about, breaking down the walls, and shedding (no pun intended) light on the subject.  

Like many women my age I grew up thinking having a period was gross and something to be ashamed of. I hated having my period and was put on oral and hormonal contraceptive at the young age of 15 to “control” my heavy bleeding and severely painful periods. I was unaware of the challenges and imbalances it would create for me and went on and off of it for most of my 20’s. It wasn’t until I was in my early 30’s that I began to realize how much I appreciated having a normal period and learned how to use my cycle to my advantage. (By the way, if you haven’t read Woman Code by Alissa Vitti, I recommend it.) Even though I still experience heavy and painful periods I know I am doing what I can to support my body without added and synthetic hormones.

I’d like to address a few things that came up for me as I read the article referenced above.  Oral and hormonal contraceptives were introduced in the early 60’s as a way to prevent conception and control family size. In that time infertility was less common. Today, it is a whole other story. Now it is used to prevent conception, decrease unwanted menstrual symptoms and “treat” or “fix” diagnosed menstrual conditions. These menstrual conditions are serious and need to be seen as what they are, the body showing signs that need to be addressed, not covered up. These conditions often accompany severe symptoms that are debilitating for many women. These conditions show up in my office every day and often are the very things that prevent many of my patients from easily conceiving when they decide to stop taking their contraceptive after years of use. “The Pill” doesn’t fix the problem, it is only a bandaid. It also causes your ovaries to shrink, thins the lining of your uterus, and may worsen hormonal imbalance.  

When we experience discomfort during our cycles, instead of reaching for something to cover up the pain, I encourage you to consider why those symptoms are there in the first place.  Here are a few examples: polycystic ovary syndrome, fibroids, ovarian cysts, endometriosis, dysfunctional uterine bleeding, amenorrhea, and premenstrual dysphoric disorder. These are just a few, but many are linked to larger health problems that should NEVER be ignored such as insulin resistance, thyroid problems, metabolic problems, cardiovascular problems, anemia, depression, anxiety, endocrine disruption, and hormonal imbalances. They each have their own complications and range from mild to severe that can be detrimental to fertility, carrying a health pregnancy, linked to cancer, and more.  

So… yes it is nice to not bleed every month or experience PMS, but is the cost of convenience worth it? My answer is no. My hope is that by raising awareness around these conditions and normalizing menstrual cycles we can help future generations of women to celebrate their bodies and their cycles.

Foods to Optimize Fertility

Foods to optimize fertility

Balanced blood sugar is the foundation of hormonal balance and the first step in optimizing fertility. It starts with what and how we eat – every single day. We also know that to optimize our fertility we need to minimize stress. By ‘stress’ we are not talking just about everyday stressors like driving in heavy traffic or running late to catch a flight; it is any perceived stress your body experiences (such as mismanaged blood sugar). Nowadays this can occur daily, sending our bodies into overdrive and keeping us in fight/flight/freeze mode. When we are under stress our body puts reproduction and digestion on the back burner in order to direct all resources toward survival.  

What foods best support your fertility? Ideally, most of the foods we consume should be organic as well as pesticide and chemical free and in their whole and unprocessed form. If all organic is cost prohibitive you can  focus on keeping the ‘dirty dozen’ organic, as well as 100% organic meat, eggs and full fat dairy. You can check the Environmental Working Group for an updated list of the Clean Fifteen and the Dirty Dozen. To support our body in making hormones we want to eat lots of omega rich foods such as avocados (the fertility superfood), wild-caught salmon, pastured organic eggs, walnuts, almonds, sunflower seeds, flax seeds, coconut, and olive oil.  Focus on foods rich in antioxidants and beta carotene like dark leafy greens, blueberries, raspberries, blackberries, red grapes, yellow and orange vegetables like carrots, squash, sweet potatoes. These will provide lots of nutrients our bodies need. Cruciferous vegetables are full of fiber and contain DIM to help with estrogen metabolism. They also protect our bodies from harmful chemicals. For men lycopene-rich foods like tomatoes help to support sperm count and eating a diet rich in antioxidants will help with sperm motility and morphology.

If you are trying to conceive it is helpful to eat as if you are pregnant. This means focusing on warm cooked foods, lots of broth such as bone broth soups and consuming warm or room temperature beverages. It is also important to stay hydrated. This also means ditch the caffeine, coffee can negatively impact fertility and studies have shown that if you’re undergoing IVF it can reduce your success rate by as much as 50%. Even though green tea seems like a healthy choice since it is high in antioxidants it can actually decrease blood flow to the uterus. That is something we definitely don’t want for conception!

For balanced blood sugar the Mediterranean diet has been found to be the most supportive.  This focuses on healthy fats, lean proteins, nuts, seeds, and lots of fresh veggies. Here the slow burning carbohydrates keep your blood sugar stable and prevent the crash and burn you can experience from sugar laden products.  

To ensure our microbiome is running smoothly focus on probiotic rich foods such as sauerkraut, kimchi, yogurt, or kefir. A healthy microbiome will ensure the estrobolome works well, helping your body metabolize and get rid of excess estrogen through phase 1 and 2 detoxification. Many studies have shown that if you’re trying to conceive, eating full fat dairy is beneficial.

If you want to take this a step further you may consider eating for each phase of your cycle to support hormones throughout your menstrual cycle. During menses you will want to eat more blood building foods such as dark berries, beets, mushrooms, black sesame seeds, kidney and black beans, and sea vegetables as well as lean proteins. During the follicular phase and ovulation phase focus will be on egg development and building a good endometrial lining to support a strong and successful implantation. This is the time to eat more raw vegetables to support estrogen metabolism. During the luteal phase you may notice you feel more hungry, this is because your body has a lower resting blood sugar rate.  Here the need for more slow burning carbohydrates increases and foods such as sweet potatoes, root vegetables, brown rice, and quinoa are optimal choices. These slow burning carbs will help to boost progesterone production which is necessary for a healthy pregnancy.

If you are looking for more support consider working with a fertility specialist!

Eat Your Way to a Better Menstrual Cycle

We all know by now how much our diet and lifestyle impacts our physical, mental, and emotional health and well-being. This is especially true for women in terms of our hormonal body clocks. Just as we aren’t meant to eat the same food day after day, we are also not meant to exercise or live the same way each day. Our hormones are constantly changing in an intricate dance and when we take care of our bodies properly within the dance, all works magnificently. But when we don’t live by this model of syncing our diet and lifestyle it can be detrimental to our health and well being. This model of care was developed by the founder and creator of Flo Living, Alissa Vitti. This amazing practitioner is someone I recommend all my patients look to for dietary and lifestyle advice and recommendations around supporting hormonal balance. Many practitioners are now singing the praises of living a life that supports our hormones and fertility and it all starts with diet!  It is such an amazing compliment to Chinese medicine and more importantly, it works! I encourage you to check out Alissa Vitti’s website and blogs to learn more!

In Chinese medicine, we have a very similar view; the body is in a constant dynamic of change, never static. When we adopt healthy changes we can decrease the degree the pendulum will swing in each direction and therefore decrease the negative and pesky symptoms we experience. This is why acupuncture treatments vary, because your symptoms are never the same. By treating the body as a whole and selecting points that target each phase of your cycle, the hormones will be supported. But this work does not stop when you leave the treatment room. By integrating diet and lifestyle changes, you will see great changes in the health of your menstrual cycle. This means a decrease in cramps, less bloating, optimal digestion, decrease in breast swelling, decreasing PMS symptoms like anxiety, depression, and headaches before your cycle. The changes you make encourage healthy bleeding, showing a deep vibrant red colored blood, no spotting before or after, regular cycles, and removing stagnation that leads to clots. The changes boost your energy, stopping uterine and ovarian cysts and fibroids, as well as supporting weight management.  And my favorite – boosting your fertility and allowing for optimal ovulation for implantation and supporting a healthy full term pregnancy. This practice has also been proven to put certain conditions like PCOS (polycystic ovarian syndrome) and endometriosis into remission as well and a new research study shows that is can stave off early menopause by three years!

So what is cycle syncing and where do you begin? According to the research it all starts with regulating your blood sugar, then implementing exercising according to each phase, and eating different foods to support each phase. Research has also found that we can implement different times in our cycle to put our focus on making big decisions, prioritizing projects, or making plans. Research also shows that avoiding caffeine is necessary in the treatment of hormonal imbalance due to its impact on the breast tissue (leads to fibroids) and its negative effect on cortisol.


So what are the four phases and what exactly is a healthy cycle? Ideally a healthy menstrual cycle is 27 to 32 days, and menses or bleeding will last five to seven days that begins with moderate flow, not spotting, a deep rich red color that maintains a flow for three days, then begins to taper off slowly and ending by day seven. The first phase is the menses phase lasting 3 to 7 days, the second phase is the follicular phase lasting seven to 10 days, the ovulation phase lasting three to four days, then the follicular phase lasting 10 to 14 days.  

In the menses phase the hormones are at their lowest and as bleeding begins and estrogen drops, you will feel a sense of relaxation or relief. In Chinese medicine the menses phase is dominated by qi transformation, it is important to regulate qi and blood, promote the complete discharge of blood, allow a smooth transition of yin to yang and allow for the smooth flow of liver qi and blood. From a western perspective progesterone drops off, estrogen peaks and drops and the focus is on bleeding. This is the best time for self analysis and journaling.  Foods to focus on are nutrient dense, low glycemic, seafood and veggies to replenish and support the kidneys and blood. A good time for rest and recovery.

In the follicular phase the hypothalamus tells the pituitary to send follicle stimulating hormones to the ovaries to release the egg and estrogen will increase. In Chinese medicine the follicular phase is dominated by yin because we need yin and blood to fill the uterus. It is important to nourish kidney yin, blood, and support the spleen to fill the chong and ren with blood to promote optimal ovulation. This is the best time to tap into creativity and stimulating projects. It is also a good time for social interaction. Foods to focus on are fresh and light foods with high phytoestrogen content. This includes flax meal, raw veggies, beans, seeds, and lean proteins. This phase is a good time to try out new exercise classes and a great time for cardio workouts.

In the ovulation phase there is a sharp rise in follicle stimulating hormone and an increase in luteinizing hormone. The egg will release into the uterus and allows for estrogen and testosterone to rise. In Chinese medicine qi will need to transform yin into yang, or transitioning from the 1st half of the cycle to the 2nd. Here the goal is to course the qi and move blood, blood and yin are at their highest now and it is time to promote the movement of qi and blood. This is a good time to connect with your community since energy is high and communication is at its easiest. Foods to focus on are lighter grains, lots of fruits and veggies, and steamed or raw foods.

In the luteal phase the corpus luteum grows, progesterone rises, the pituitary stops follicle stimulating hormone, and estrogen continues to rise. In Chinese medicine the focus is on yang energy, its important to course the qi and move blood. Your acupuncturist will also focus on regulating the liver qi, calming the mind, and harmonizing the chong and ren meridians. It is important to maintain kidney yang to support implantation and pregnancy if that is the goal.  This is the time energy begins to decline and PMS may occur. It’s a good time to turn your energy inward and practice self care. Focus on foods that are rich in B vitamins, magnesium, and fiber to stabilize blood sugar and promote healthy elimination through the large intestine and liver. These foods include roasted veggies and grains like brown rice.

Now that you know a little more about each phase of your menstrual cycle from a Chinese medicine and Western perspective you can begin to incorporate some healthy changes and enjoy a happy and healthy period. To learn more check out Flo Living and give your acupuncturist a call!

{All images in this post are from Duvet Days.}

Vitex and Female Wellness

Everyone loves a quiz so here is a quick one:

Vitex is:
a) Kitchen Blender
b) Organic Shampoo
c) Herb for Female Health

If you picked ‘c’ you get the red star sticker!

What is vitex?

This herb, also known as Chaste Tree BerryChaste Tree Berry, is one of the best female health herbs available and happens to be a Western herb, native to Greece and Italy. It is known to to regulate the menstrual cycle and reduce premenstrual symptoms, making it a popular choice for many women, but an added benefit is that for those desiring to conceive, it also boosts fertility. It has been proven to help during pregnancy when there is a history of miscarriages, and it can be helpful in stimulating milk production after birth.

How vitex works

This gentle, nourishing and harmonizing herb has a regulating effect on the pituitary gland. It impacts what is known as the “hormonal feedback loop,” or the hypothalamic-pituitary-ovarian axis, as it helps to bring the system into balance gently. How it works is fascinating: by increasing secretion of luteinizing hormone (LH) and mildly inhibiting follicle stimulating hormone (FSH), it indirectly boosts the production of progesterone, helping the chances of achieving and maintaining pregnancy. This lengthens the luteal phase is which promotes ovulation to occur. By increasing progesterone, vitex helps to alleviate many common PMS symptoms that arise from low progesterone and promotes fertility by balancing the menstrual cycle allowing for ovulation to occur at its optimal time.

Vitex works best when taken long term and to receive the full benefits it can take up to six months. It’s most effective when healthy habits are already in place. I encourage patients to take vitex after getting off birth control to help normalize the cycle and find your natural rhythm. It’s important not to take vitex while on birth control pills or any other hormones as it can disrupt the cycle further due to its effect on progesterone.

Vitex in pregnancy

Vitex is safe to take through the first trimester of pregnancy and even into the second, however, stopping vitex ‘cold turkey’ when pregnant may cause hormonal changes and is not advised. Often women are encouraged to wean off over time or 1 to 2 weeks. This is particular to each individual and you should always consult your OB or midwife for what is best for you. The general consensus of the literature is that taking vitex in the third trimester is thought to promote lactation too early.

Vitex for fertility

For fertility patients using methods to conceive such as IVF or other technology-assisted reproductive methods, vitex is not for you, as it does impact hormones. But if you are trying to conceive naturally, vitex can help. I believe it is best to have your hormones tested at your doctor’s office to help determine if indeed you are low in progesterone. Additionally, once you are pregnant, taking vitex can help to maintain a healthy pregnancy through the first trimester.

Below I have listed many more benefits that vitex can have on female reproductive health.

  • Reduces advancement of mild endometriosis
  • May help to prevent miscarriage if due to low progesterone
  • Relieves premenstrual tension
  • Helps amenorrhea
  • Balances hormones to regulate the menstrual cycle
  • Helps prevent uterine cysts which are often due to low progesterone or
    excess estrogen
  • Helps to stabilize menses after stopping birth control
  • Promotes fertility
  • Helps to stimulate milk production when used after birth for 10 days or
    greater
  • Helps clear up skin from hormone related break outs
Winter

How to Exercise for a Healthy, Happy Menstrual Cycle

Are you ready to better understand your menstrual cycle and learn how to exercise in harmony with the different phases of your cycle for optimal health and happiness?

Now that the holiday season is in full swing, our calendars are filling up. Holiday events and parties leave little time for self-care and exercise; instead we find our plates filled with delicious and tempting holiday treats. It’s easy to fall out of the healthy, positive patterns we spent all year working toward; patterns such as regular exercise, healthy eating, and getting plenty of rest and relaxation. I know it may seem I’m jumping the gun a little by encouraging your New Year’s resolutions for smart exercise habits, but it’s important to know that what we do all through this month has a big impact on our menses once the celebrating is over.

It’s easy to fall into an exercise rut, doing the same thing day after day, especially in a crossfit nation singing the praises of ‘no pain, no gain.’ But this notion is simply not true and has the potential to cause us to feel even more exhausted and less productive in our daily lives. The major negatives being that the ‘no pain, no gain’ idea can lead to painful, heavy, unpleasant menstrual periods and complications with fertility, pregnancy, and postpartum issues. Ideally, menstruation should be painless with minimal discomforts like mood swings, heavy bleeding or clots. These are all signs that something may be out of balance; there are steps that can be taken to ensure a smooth flow of qi and blood, reducing pain and promoting a healthy and balanced menstrual cycle. Exercise is vital in promoting optimal health and wellness as well as preventing disease. Over the next few months I’m going to be doing a series of blogs on how to exercise properly for a healthy menstrual cycle, to promote fertility, have a healthy pregnancy, and support postpartum phases of life.

Phases of the Menstrual Cycle

To begin, it’s important to outline the four phases of the menstrual cycle.

  • Phase 1 starts the first day of the menstrual cycle and lasts until about day 7.
  • Phase 2 is post-menstrual which lasts 7 days after the onset of menses, likely day 7 through 14.
  • Phase 3 is mid-cycle or ovulation phase, often lasting from day 14 through until day 21 (though it may occur on day 12-15).
  • Phase 4 is the premenstrual phase, this begins about 7 days before you start bleeding. It is
    important to note that a healthy menstrual cycle can be between 28 to 32 days, depending on the individual.

In Chinese Medicine these phases are explained in the form of yin and yang transformation. Yin and yang are opposites, but they cannot exist without one another; they are continuously transforming into one another. This is seen in nature with the change of the seasons, winter into spring and so on. We might compare the changes of seasons to the hormonal changes in our bodies throughout the menstrual cycle.

The yin half of the cycle begins at day 1 when bleeding occurs. During this phase the follicle and the lining of the uterus grow in preparation for ovulation, fertilization, and implantation. This phase is dominated by blood and qi, both very important in the symptoms associated with menstrual disturbances when out of balance. During this time it is very important to avoid strenuous or vigorous activity, instead focusing on gentle activities like yin yoga or light walking. You may notice your energy is directed inward, a desire to spend time alone or the need to rest. In phase 2 the uterine lining begins to grow back, the focus is on building the blood and yin so that it may properly perform the function of filling the lining and the follicles. At this point the yang begins to grow, this is the best time for vigorous exercise like jogging or aerobic activity. You may notice you feel more happy, social, and creative during this time.

As phase 3 begins, yin peaks and begins to transform into yang promoting ovulation and the release of the egg out of it’s follicle. Here you will feel your most creative; this is a perfect time for activities like dance or classes that require more mental stimulation. For me this would be step aerobics. Even as a former ballet dancer, I could never pick the combinations of step aerobics up!

Now in phase 4, yang is at it’s peak and progesterone will increase and begin to warm the uterus providing a perfect place for the embryo to develop if pregnancy is achieved. This increase in body temperature is a direct response to the increase of yang as it grows in this phase. During this phase you may notice you’re beginning to feel more introverted, sensitive or that PMS symptoms begin to occur. This is an optimal time to decrease vigorous activity, focusing more on lighter activities as the body prepares for phase 1 to begin again. Therefore during phase 4 and 1 it is important to not let the body become overly fatigued from vigorous exercise.

This December I encourage you to consider these 4 phases of your cycle and to exercise accordingly to promote a healthy and happy period. This is a great time of year to try new classes, whether it’s yoga, ballet barre, creative movement or dance classes. Many studios offer holiday specials with gift certificates for your loved ones. Why not give the gift of movement this year! I wish you all a very Merry Christmas or Happy Hanukkah and Happy New Year!