Dr. Lara Briden: How To Regain and Regulate Your Period #40
25 April 2019
Dr. Lara Briden ( @larabriden) is a naturopathic doctor and the period revolutionary—leading the change to better periods. Informed by a strong science background and more than twenty years with patients, Lara is a passionate communicator about women's health and alternatives to hormonal birth control. Her book Period Repair Manual is a manifesto of natural treatment for better hormones and better periods and provides practical solutions using nutrition, supplements, and natural hormones. Now in its second edition, the book has been an underground sensation and has worked to quietly change the lives of tens of thousands of women across the globe.
Today's episode is jam-packed full of information. Dr. Briden talks about the menstrual cycle, why it's so important, how to regain and regulate your period.
- Hormones women need to be aware of and that are involved in the cycle. (5:36)
- Why women need to have a healthy and regular cycle. (7:32)
- Average Length of a cycle (10:41)
- How long the bleed should last (11:14)
- How much menstrual fluid should you lose during your cycle (11:18)
- Pain isn't a symptom or normal. (seek medical advice if suffering severe pain) (11:44)
- Causes of heavy periods. (13:05)
- Healthy Period color (16:15)
- Causes for a lost or irregular period (17:34)
- Why you shouldn't rely solely on an ultrasound for a PCOS diagnosis (19:00)
- The average age to get a period (24:22)
- Why the Birth Control Pill is not the answer to regaining or regulating your period (24:50)
- Dietary tips for regaining your period (28:08)
- Should you follow Intermittent Fasting (33:26)
- Lara's biggest pieces of advice for regaining your period (35:25)
- Should you avoid fruit if you suffer from insulin resistance (41:13)
- Lifestyle factors for regaining your period (43:05)
- Supplements for PCOS (44:50)
- Lara's word of encouragement (45:40)
You can find the transcript of this episode below.
Despina [00:02:26] Episode 40 welcomes a very special guest and that is Dr. Lara Briden.
[00:02:31] Dr. Lara Briden is a Naturopathic doctor and the period revolutionary leading the change to better period informed by strong science background and more than 20 years with patients.
[00:02:44] Lara is a passionate communicate about women's health and alternatives to hormonal birth control. Her book, Period Repair Manual, is a manifesto of natural treatment for better hormones and better periods and provides practical solutions using nutrition supplements and natural hormones. Now in its second edition, the book has been an underground sensation and has worked to quietly change the lives of tens of thousands of women across the globe.
[00:04:47] Dr. Lara Briden, thank you so much for coming on the podcast today.
[00:04:54] I'm excited to delve into today's discussion, which is on the topic of the menstrual cycle. So we'll be talking all about periods and ovulation, everything women should and need to know.
[00:05:05] This is a topic I truly believe is important and should definitely be spoken about a lot more and it certainly is now. Thanks to you and other experts and advocates.
[00:05:16] So there's a lot to talk about when it comes to our cycle. So we obviously won't be covering everything. But before we get into addressing the female cycle and answer some of those frequently asked questions, can you briefly cover the hormones women need to be aware of and are involved in th cycle.
Lara [00:05:36] OK. Yeah. So kind of a period cycle 101 overview?
[00:05:42] Well, the two main hormones we make are estrogen and progesterone and we make estrogen in the first part of the cycle leading up to ovulation.
[00:05:52] Ovulation is the main event of the menstrual cycle. We should speak about that today. And then we make after ovulation, we make progesterone, which is the hormone we need to keep our periods from being too heavy or too painful or too difficult in some way and then so ovulation is not just the release of an egg, which we would need to make a baby. But it's not just for making a baby. Obviously, ovulation is how we make the hormones. We need to be healthy, including estrogen and progesterone.
[00:06:22] And then there are various hormones that can interfere with ovulation that might be important in our conversation today they are hormones like insulin and testosterone and thyroid, those will have an impact on how easily we can ovulate and have regular cycles.
Despina [00:06:40] Yep, exactly.
[00:06:41] So as you said, we'll be covering these hormones as we go through the discussion.
[00:06:46] So very often women, you know, when you're growing up, you're not really aware of the importance of a healthy and regular cycle. So growing up, I too just thought a period was just about having babies. But having a healthy cycle is more than that.
[00:07:03] So you published a post on your blog called If You're Not Thinking About Ovulation, You Are Not Thinking About Your Health. And this post was an open letter to every clinician, personal trainer like myself and blogger who offers health advice without taking taking into consideration and thinking about periods.
[00:07:20] So apart from, you know, why are periods important. Why is ovulating so important.
Lara [00:07:28] Yeah, why is regular ovulation important?
[00:07:30] Two things.
[00:07:31] One, it's our monthly report card.
[00:07:34] So it's a good indicator that everything is OK with health, including the diet is it's the right diet that you're getting enough to eat because it's quite easy to lose your period or stop ovulating from under eating or under eating carbohydrates.
[00:07:52] A lot of that was kind of one of the main points of that post, my open letter is basically know to being the necessity to make sure that your female clients are eating enough to keep menstruating.
[00:08:06] So the ovulation being the monthly report card is the first reason that it's important.
[00:08:12] The second reason that it's important is that is what I said earlier. It's how we make the hormones that we need to be healthy. And just to be clear, so some examples of how estrogen and progesterone are important for general health.
[00:08:24] Estrogen, if you knew this, but it's anabolic. So it helps to build muscle mass. It improves insulin sensitivity. It's good for the gut microbiome. It improves intestinal integrity, so reduces intestinal permeability or gut. That's just many of the some of the things that estrogen does.
[00:08:45] And progesterone is really important for healthy immune function, it can help to prevent autoimmune disease. It's good for the brain. It can help with sleep and mood and bone health.
[00:08:57] Actually, both hormones are really important for the long term health of bones, which is one of the reasons why women who don't ovulate, whether it's because they're not having periods or because they're on the pill or hormonal birth control that suppresses ovulation. Women in that situation have reduced bone density compared to women who cycle naturally.
[00:09:19] So that's a very clear example of why naturally cycling and ovulation is important for health.
Despina [00:09:27] And I think a lot of women aren't aware of these. Like having a regular cycle for bone health. And it's just sad because, you know, like you said, women are so chronically under eating and over exercising. And it's really important that they are aware of these long term health risks and benefits of having of ovulating and having a regular cycle. It's not just about, you know, losing weight and being able to see your abs cause, you know, had a post one saying abs are cool, but so are healthy hormones.
Lara [00:10:03] So, yeah, exactly hormones are better.
Despina [00:10:08] Exactly.
[00:10:08] So it is definitely, definitely really important. So we are constantly receiving signs from our body through our symptoms that, you know, sometimes things aren't right.
[00:10:19] So this can be seen in our period. So our period is always telling us, you know, where things are going well, it's a report card. We know when things are not going so well.
[00:10:29] So what should women be looking out for? What are some of the signs of a healthy cycle and when things might be going wrong? How how can you assess what she'd be looking for?
Lara [00:10:41] Yes. So the the the parameters of a healthy cycle is that it comes that the period comes anywhere between every twenty one to thirty five days. If you're an adult every 45 days, if you're a teenager or early 20s. And that's counting from day one of the bleed.
[00:11:01] So that that's that defines a healthy cycle. That's usually if you have a cycle that is of that length, that's a good sign that ovulation is occurring, which is what's important.
[00:11:13] The other parameters is that the bleed itself shouldn't be more than seven days and you should should not lose more than about 18 milliliters of menstrual fluid.
[00:11:23] So. That equates to four tablespoons. So for all the days of the cycle, which is actually not very much to get it looks like quite a lot when it's in the cup, the menstrual cup or the tampon.
[00:11:36] But it shouldn't if you really add it up in my book Period Repair Manual, I talk about ways to quantify how much menstrual fluid you're losing.
[00:11:45] And the other parameter is that it should, the period should arrive basically symptom free, like relatively symptom free, so no strong mood symptoms or headaches or cravings or breast tenderness or anything like that and no strong pain. It's common to. It's pretty common to have a little bit of period pain.
[00:12:05] But actually pain is never normal and severe pain is never normal. So anyone with debilitating period pain needs to be alert to the fact that it could be something like endometriosis, which I talk about in my book.
Despina [00:12:19] Exactly because I think there's this whole thing where when you on your period, you know, your pain is no more like when we grow up thinking we should be going through this pain when, like you said, a little bit of pain is fair enough like blood is coming out of our bodies. It's somewhat normal.
[00:12:39] You can experience some kind of pain, but when you're in severe pain, that can be the reason of a chronic condition or endometriosis or something.
[00:12:50] So and like you said if you're suffering with too much blood loss, what is the possible cause for that? So what might be causing heavy blood flow?
Lara [00:13:05] OK. Yeah, let's talk about that.
[00:13:07] I want to say, first of all, I think most women should get to the point where they have no pain at all with periods. That's what my my patients experience. So that's the benchmark for what it can be like for many of us.
[00:13:19] In answer to your question of what could be some underlying reasons for heavy periods.
[00:13:26] Yeah, I have a blog post called called How to Treat Heavy Periods with diets and natural Progesterone. So in that blog post, I talk about a few of the underlying reasons.
[00:13:37] One, just to rule out is a problem with thyroid. So underactive thyroid can cause heavy periods. So usually most doctors will screen for that, or at least they should do a thyroid test, a blood tests, just to make sure that's not the reason.
[00:13:52] Being low in iron can actually make periods heavier, which is and it becomes a vicious cycle because then if you have heavier periods, then you become lower and iron. So iron is a very important mineral for women. We get it from red meat and eggs. But we do need to sometimes take iron, which can be quite helpful.
[00:14:12] Other reasons for heavy periods, it can be well, actually not that uncommon. It can be a have something called a coagulation disorder or like a blood a blood clotting disorder, which the doctor should rule that out.
[00:14:25] These are things for the doctor to take a look at. In my book, I have a section called How to Speak to Your Doctor and I have some questions where you can ask the doctor. You know, I have these heavy periods. Has thyroid been ruled out as a coagulation disorder, been ruled out?
[00:14:39] And then some of the more common reasons is and which we mentioned, or a similar condition called ademonyosis, which can cause heavy periods.
[00:14:49] Another reason is PCOS. So the hormonal condition, PCOS. It can look like all different things, it sometimes causes no periods at all, and those very light periods sometimes which, you know, you talk about why that is sometimes for some women it can cause what look like quite irregular, quite heavy periods. And the reason that happens is because there's such there are cycles where no ovulation has occurred.
[00:15:14] So there's no progesterone made, which is the hormone that's made after ovulation. And progesterone normally has the effect of lightening our periods. So you're not making that, then you can have periods that are too heavy and also go on for too long.
[00:15:29] A really good marker of PCOS is bleeds that are more than seven days. So ten days or two weeks or something might happen sometimes with PCOS.
[00:15:38] So it's important when you're treating heavy periods to try to identify why they're happening and then treat the cause.
Despina [00:15:46] Exactly.
[00:15:47] You always have to get to the root cause. So get a blood test and speak to your doctor, get them to ask you the exact questions and get to that root cause.
[00:15:57] So the other thing I wanted to ask why we're talking about healthy periods.
[00:16:02] What is a healthy period color? Because that's a very common kind of thing. People might see different colors. What is the color you should be looking for?
Lara [00:16:11] Oh, I see.
[00:16:14] A lot of it depends on how quickly it's flowing.
[00:16:17] So like if the flow is if you have a fairly decent flow, it's going to be brighter red. When it slows down, when it's lighter, it's going to look a little bit darker because just because the iron in the blood has a tends to oxidize.
[00:16:33] So it is normal to have clots anywhere up to about the size of a what I would call it in Australia like a 20 cent piece or it depends what a coin about that big so that you're more likely to form clots if you're flowing heavily. The body has had a chance to the anti-clotting natural anti-clotting agents to work.
[00:16:57] So yeah, there could be different reasons, to be honest with my own patients, I don't look too much. I don't worry too much about the color.
[00:17:07] Just knowing that sort of varies depending on how quickly it flows.
[00:17:11] I guess the other thing is if you're anemic again, low iron, the blood will be paler. So that's something to be alert to.
Despina [00:17:17] Interesting.
[00:17:18] So we covered reason, some reasons for lost or irregular periods like PCOS, or under eating and over exercising.
[00:17:26] Is there any other reasons for the causes of lost or irregular periods?
Lara [00:17:32] Yeah, they are actually quite a few reasons.
[00:17:34] And again, the doctor. So in my book I talk about the first step. If you haven't had a period for a few months and you're not sure why, obviously the first step is to see the doctor. So the doctor has the opportunity to rule out there could be problems with something called prolactin.
[00:17:48] There can be a few different reasons and the doctor also needs to rule out pregnancy. It's worth pointing out that even if someone maybe hasn't had a period in a long time, you could become pregnant at any month because you can become pregnant without ever seeing a period. So it is worth always during that pregnancy test, just to be sure.
[00:18:08] But then at the end of the day, it usually the lack of a period usually comes down to one of two things which I'd like to talk about because there's quite a bit of confusion between them.
[00:18:19] So one we mentioned under eating that's called hypothalamic amenorrhea and two PCOS, which is in some way it's kind of an opposite condition to hypothalamic amenorrhea or underrating, because PCOS typically is associated with insulin resistance or might be a situation where you need to eat less sugar or less carbohydrate potentially.
[00:18:45] But the problem is the diagnosis of PCOS is not scientific. It's not the way it's conducted, unfortunately, a lot of the time is not very accurate.
[00:19:00] So, for example, some doctors will mistakenly diagnose PCOS with an ultrasound and say, look, you have polycystic ovaries. Therefore, you must have this condition because you're not having periods.
[00:19:12] But here's something really important to understand. You can have hypothalamic amenorrhea or lack of periods due to under eating or under eating carbs and and show polycystic ovaries on ultrasound. So that ultrasound test doesn't really mean anything.
[00:19:30] The true diagnosis of PCOS, there has to be some evidence of high male hormones and more than just a few breakouts on the skin. A bit of acne, that's in my view, not enough to qualify for high male hormones or has to be some evidence on blood test or facial hair or something pretty significant.
[00:19:52] Plus, tests I use a lot I talk about in my book and in a couple of blog posts, I've written, I wrote a blog post about maybe it's not PCOS where I talk about using the pituitary hormone, LH or luteinizing hormone to try to distinguish between hypothalamic amenorrhea and PCOS.
[00:20:11] And it's quite easy to do. You know, the doctor can help you with that or women can look at their own results if they've had it on early in their cycle or just a few parameters. As long as you don't get it, as long as you don't get a period within two weeks after the test, then you can use that LH reading to try to understand if you have high LH, meaning PCOS or low LH, meaning hypothalamic amenorrhea.
[00:20:36] I'm trying to put this information out there because I've spoken to so many patients and readers who've been told they have PCOS when they don't. And at the same time you can have PCOS and not know it because maybe your ultrasound is normal and no one has really thought to explain to you that having a period every three months and a period the last 10 days is not normal. And that could be a sign that PCOS is happening.
[00:21:02] So I hope that helps to clarify that.
Despina [00:21:05] That is so true. I think that PCOS, which is very much too much overly diagnosed and you need to really do to delve deep with tests and not just rely on ultrasound.
[00:21:21] And personally, when I was diagnosed, I don't I still don't know if I even had PCOS cause it just everything was just I just don't trust everything was done correctly. But the last time I did a blood test and ultrasound, everything came back fine. Sommes gonna say it's all good, but it's so confusing.
Lara [00:21:44] Well PCOS is reversible.
Despina [00:21:46] Yes.
Lara [00:21:46] So it is very possible to meet the criteria at one point and then when your health improves, then you start having regular ovulation and your testosterone goes down, your LH goes down. Then you sort of no longer qualify for the diagnosis. Although in a situation where you did have those those things really happening, there is always the possibility, the vulnerability to it coming back, if you were to ever change your diet and not eat healthy.
Despina [00:22:20] Yeah, exactly.
[00:22:21] You can reverse it, but you need to continue with your specific diet and your lifestyle, otherwise their symptoms kind of come back. So you really need to be consistent. But yeah.
Lara [00:22:36] Yes, yeah.
[00:22:37] But on the other hand, I just finished by saying, if you if you are, for example, to your listeners, if you're low carb and you've been low carb for a while, you just can't get your period, your period is not coming and your are confused as to what's going on, please do at least consider the possibility that maybe it is not PCOS. Maybe it was hypothalamic amenorrhea and was diagnosed as PCOS, in which case it's worth looking into that a little bit further because you might need to eat more.
Despina [00:23:07] Because I think when women are diagnosed with PCOS, when and it's not, it can really affect you mentally and that can obviously cause a whole bunch of other stuff.
[00:23:19] So I definitely think it's important that your actually if you do have this diagnosis, that you actually you actually do kind of have a more just throw a diagnosis out and label someone with this because it can effect some women negatively.
Lara [00:23:39] Of course, it causes anxiety, makes you think you got something wrong with you.
[00:23:42] A lot of experts are concerned about this actually, the overdiagnosis of PCOS and the rather casual use of the label and given a label to women.
Despina [00:23:54] Exactly.
[00:23:55] So what is the average age or when is the healthiest age to have a period?
[00:24:03] So I know I've got a lot of messages from younger girls who they obviously they don't know if they PCOS, they haven't gone to a doctor yet and they just you know, people at school are saying, I've got my period and they get, you know, upset and anxious.
[00:24:19] So when is this healthy age when you should should be getting it?
Lara [00:24:23] The initial range is anywhere between 10 and 16.
[00:24:27] So. If by 16, there's nothing happening, no periods. Yeah. It might not be PCOS. Like it could be lots of other things.
[00:24:37] So it is definitely worth seeing the doctor at that point to try to understand. Why there's no period coming, is it underrating, is it?
[00:24:47] Just to say it's important to mention at this point that don't let your doctor just put you on the pill saying we'll just give you a period that way because pill bleeds are not periods.
[00:24:59] So. As we've said, a real period is all about ovulation. It's about what your ovaries are doing. It's about making hormones and having these cycles.
[00:25:10] The pill works by shutting down the ovaries and then inducing what is essentially just a drug withdrawal bleed, which could, it doesn't have to be monthly, it could be not at all. Or every few months or the monthly bleeding of the pill doesn't mean anything.
[00:25:27] And. At best, it masks the underlying problem, which she really needs to try to figure out. And at worst, it makes it worse because by suppressing the ovaries partially at a young age, it can make it that much harder to get the ovaries to start doing what they need to do. When you actually come off the pill.
[00:25:45] I see so many stories like that, I have a couple of patients stories in my book like that where a woman went on was given the pill quite young when she was still a teenager. And then when she came off in her 30s ready to try to have a baby and found that she couldn't ovulate straight away, which actually makes total sense when you think about it, you've been on a drug that suppresses ovulation. It can take a while for that to come back.
Despina [00:26:09] Yeah and I think when I was diagnosed with PCOS and they told me when I was 18 and they gave me the birth control pill. Obviously when you're that age and you don't know what PCOS is and you're freaking out because you don't have a period, your you take that, you're just like, oh, awesome, I take this drug and I'm going to get my period back.
[00:26:28] But like you said, it's not a real period for withdrawal bleed and makes stuff a lot worse.
[00:26:35] There's so many risk factors and I experience quite a few of them.
[00:26:39] But the worst one for me was the swelling of my left calf, which I thought was thrombosis. So I immediately came off it, which might you know, you should consult a doctor before you come off any drug.
[00:26:52] But at that age, I was obviously scared. So it's definitely got some really bad risk factors. And like you said, you shouldn't just go on it just because the doctor said that. Obviously, we all want to trust and believe our doctors know what's best for us, but don't feel we shouldn't feel like we have to go on the pill when it's not going to treat PCOS, as it doesn't get to the root cause. And you really need to obviously find out your root cause before taking the pill.
Lara [00:27:27] And yes there are lots of other options that the pill is not good medicine for PCOS even remotely. And there are lots of other things that work. That actually work can help to reverse the condition rather than just mask it.
Despina [00:27:42] What would be some dietary tips for regaining period, your period?
[00:27:47] So obviously with PCOS, there are different types of PCOS. So it will obviously differ if it's adrenal or insulin. Sometimes carbs can change and we're all different as well. What would be, you know, just some of those key facts you would recommend?
Lara [00:28:08] OK, this is an important part of the conversation.
[00:28:10] So in my book period, Period Repair Manual, I provide a flow chart that it really need to go through to try to identify what is the best diet.
[00:28:18] So step one is it truly PCOS or is hypothalamic amenorrhea. Which we've just talked about.
[00:28:24] So if it is hypothalamic amenorrhea or under eating, the best diet is just to eat more like way more like twenty five hundred calories a day. Plus probably 200 grams of carbohydrate starch a day just to try to get the period back. So that's a that's that situation.
[00:28:44] So if it but if it's not hypothalamic amenorrhea, if it truly is PCOS, then the next step in the flow chart is to determine if you have insulin resistance. And that does not mean testing blood glucose. That means testing insulin if possible, if the doctor will do it. Or at least looking for signs of insulin resistance.
[00:29:04] So insulin resistance or pre-diabetes or metabolic syndrome goes by different names is typically associated with weight gain around the middle. Kind of that apple shape. And so if that's the situation that's that's even without a blood test, that's a pretty good indication that there is insulin resistance.
[00:29:24] So then I like to quantify it with my patients, like to know how insulin resistance they are by measuring insulin and then for diet.
[00:29:33] Actually, I find when the most important first things is to cut sugar. And by sugar I mean high, I mean concentrated fructose in the form of desserts, soft drinks, so ice cream cakes, sweetened yogurts, including date balls and museli bars and a fruit juice already and everything dessert like. Just stop that at least for a few months because that can that I find that reverses it. That's one of the fastest ways to try to reverse insulin resistance.
[00:30:06] It can be really helpful while you're doing that to make sure you have protein three times a day especially protein in the morning seems to have been good for everyone and particularly good for reversing insulin resistance.
[00:30:19] And then obviously eating a good number of vegetables in the next step for insulin resistance will be deciding how much starch is appropriate.
[00:30:29] I'm not a fan of a kind of a very low carb diet for women, but I think someone with definite insulin resistance does need to consider reducing carbs in the form of starch as well.
[00:30:41] So sometimes what I'll say is recommend a low carb breakfast. So a kind of high protein, low carb breakfast, a few veggies in there and then no snacking, then lunch and dinner still with a focus on the protein. But maybe by dinnertime you can have a little bit of some kind of starch with that, like a sweet potato or a potato just to help with sleep and the gut microbiome.
[00:31:06] So that would be for insulin resistance.
[00:31:09] And then, yeah, the other type.
[00:31:12] So in my book, I talk about basically four or five types of things to us based on the underlying driver, whether it's insulin resistance or post-spill or inflammation or as you say, adrenal PCOS.
[00:31:28] I guess the next one to talk about is, well, the post-pill PCOS is really just about kind of a waiting game, having more time off the pill.
[00:31:35] I talk about a couple of herbal medicines that can help to restore periods post-pill.
[00:31:41] Wouldn't say that there any specific dietary recommendations with that apart from just healthy eating.
[00:31:46] The inflammatory PCOS is if there's signs of a food sensitivity like gluten or dairy, typically are the ones or potentially other sensitivity with the idea that those foods sensitivities are generating inflammation that's interfering with ovarian function and therefore irregular ovulation.
[00:32:08] So in those situations.
[00:32:12] One of the most important dietary changes to remove those food sensitivities. So that needs to be assessed on an individual basis.
[00:32:19] And then Arenal PCOS is actually quite interesting.
[00:32:22] It's a totally different condition, even though it's like it's called PCOS. It's actually a situation of having excess male hormones from the adrenal glands, not the ovaries.
[00:32:32] And the treatment is for adrenal gland. So I talk about in my book B vitamins and magnesium and some of the herbal medicines that can help to regulate what's called the HPA or hypothalamus pituitary adrenal axis. That can help.
[00:32:50] That can help to lower adrenal androgens combined with maybe one of the natural anti androgen supplements that I discussed. That is one strategy.
[00:33:01] I think for diet for adrenal PCOS, is just about eating in a way that keeps blood sugar stable so that you don't have unstable blood sugar worsening stress.
[00:33:13] Yeah, so that that would be just having again. I think I'm a fan of three regular meals per day. Three solid meals, no snacking. Just that's how most of my patients eat.
[00:33:25] Sometimes I do a little bit more intermittent fasting like you should be finished eating by 7 o'clock and don't start until in the morning until 9:00 a.m, something like that. That would be a 14 hour, 14 hour overnight fast. That can be helpful for especially for the insulin resistance type of PCOS.
Despina [00:33:44] That's personally what I do is why do that kind of. Not the specific, you know, as people do intermittent fasting where you know, the traditional one.
[00:33:53] But I would stop eating at 7 and eat at 9am. And I think that the food just really helps. At least you could do while sleeping. You gain quite a big chunk of your fasting window done. So if you just eat a little bit earlier rather than eating dinner at 9 p.m. or 10 p.m., like people tend to do and then just go to bed. You just eat a little bit earlier and then, you know, you've done intermittent fasting. You've got the benefit. And does it feel so overwhelming, so it's an easier way.
Lara [00:34:24] Exactly. And if it has big a beneficial outcome on health, it's just that simple change of not eating in the evening.
Despina [00:34:33] Exactly. And you mention when it comes to hypothalamic amenorrhea that you should obviously eat more food and eat a lot more carbs. And this is something that I when I was trying to regain my period, I had to eat so much more food.
[00:34:50] And I know a lot of our listeners and just, you know, young girls or women that just really fear eating more food and eating more carbs because they think carbs equal fat. And, you know, eating too much fat is going to make you fat.
[00:35:06] What piece of advice would you give to these women? Cause that would seem like for me, that hit me was I really wanted to to get my period back for the health reasons. So I kind of put that in my mind. That was kind of what I tell people. But what would be your kind of advice?
Lara [00:35:26] Well, here's something to consider.
[00:35:28] Yes. If you need to eat more to ovulate and get your period, then it's totally worth doing from every perspective, because both estrogen and progesterone are good for me, are important for maintaining a healthy body weight. This is what I say to my patients.
[00:35:42] So. Yes. I mean, eating more potentially could cause a little bit of healthy weight gain. That's normal. Actually most of my patients don't gain as much as they think they're going to.
Despina [00:35:54] Exactly.
Lara [00:35:55] They just kind of come back up a little bit more to normal. Then when they start ovulating, that's the reward, right?
[00:36:02] Then your female hormones kick in and they have a natural slimming effect.
[00:36:06] So there is this kind of finish line. If you can get to ovulation, then you're fine. Everything is just so much easier. You don't have to micromanage your weight with, you know, with eating all the time. You can just eat more consistently, normally feeling satisfied. And your female hormones will do a lot of the work for maintaining a healthy body.
Despina [00:36:25] So everything just normalizes after you get your period.
[00:36:29] Your body's clever. It just kind of sorts itself out.
[00:36:33] And we've obviously our body, we keep saying this. We have this set point where everybody feels safe. So you need to reach that specific weight where your body feels comfortable and then, you know, you'd regain your period.
[00:36:49] And what I came to discover is that if someone went through an eating disorder like I did, just so many random things I've overcome, but it was like you really need to reach that weight that you were before you lost your period and eventually just eat two thousand above calories. And obviously, if you're coming back from an eating disorder, you're not really focusing on the calorie content, which is why you should just eat as much as you can.
[00:37:20] Even if you're not really hungry, just kind of eat the food just to know that you're getting enough of the caloric quantity that you require. So it's definitely can be a struggle if you're coming back from an eating disorder. But like you mentioned, it's for healthy overall wellbing.
Lara [00:37:41] Yeah.
[00:37:43] Well, that's important to mention.
[00:37:44] So if there's been an eating disorder, which is extremely common, as you as you know, it's important, I think in most cases to have a counselor on board or someone to kind of coach you through that and support you.
[00:37:57] And yeah, and and just know that it's even if you're not counting calories, it's about.
[00:38:03] Feeling like you deserve to be satisfied with food, you know, eating enough, eating to feel good, and once one thing that's worth mentioning is that that includes having a digestion that's healthy enough to eat enough.
[00:38:16] So one of the things that I run into with a lot of my patients is that they potentially might want to eat more, but they reach a limit as to how much they can eat because of they're just bloating or discomforts and we'll sort of unintentionally eat less because of that.
[00:38:30] So if that's happening as well, then often an important thing can be to do some treatment for digestion so that they can naturally feel hungry.
[00:38:40] I say to my patients, it's normal to feel hungry. It's actually a sign of health to feel hungry and wants a big meal. That's that's a good sign.
Despina [00:38:49] Yeah. Because I think we're just kind of living in a way that we have to suppress our appetite when, you know, feeling those hunger cues are normal.
[00:38:58] We shouldn't be feeling guilty, for example, we'll have lunch and then, I don't know, 20 minutes later, you're hungry. You should you should eat, especially for overcoming this eating disorder reason why you lost your period is definitely just about eating when you're hungry. And, you know, just it should just focus in on the bigger picture and the most important thing, which is your hormones and your health and not focusing so much on your weight and, you know, comparing food to saying, you know, this food's good in this food.
[00:39:31] And a lot of the time I think if you've been going through an eating disorder, it's good to also maybe just indulge in those foods you've been restricting for so long. I think this you're obviously so stressed and saying you can't eat this produces more stress. And I think just eating foods that you keep saying are bad helps you regain your period.
Lara [00:39:57] Totally I agree.
[00:39:57] Yeah, I don't like I certainly don't like the whole concept of clean eating or that certain foods are clean and certain foods are bad. So I don't take that approach of my patients at all.
[00:40:08] Although the only thing I would say is if if you know, there are foods that upset your digestion. You probably not worth having too much of that just because then it can make it harder to eat other things.
[00:40:17] But there's so many other foods that are high calorie that can be enjoyed without any digestive discomfort.
[00:40:27] Sometimes with my patients who are trying to eat more. I will just make the point that you almost can't afford to eat low calorie foods. So I might say eat fewer salads and said focus on the higher calorie foods like meat and potatoes and avocado and olive oil and obviously some steamed vegetables as well for their beneficial fiber. But focus on some of the higher calorie foods and that it's much easier to reach the two thousand or twenty five hundred calories per day by doing that.
Despina [00:40:55] Exactly.
[00:40:56] And the other thing I want to ask you is this such a frequently asked question is obviously you should cut back on the sugar if you have insulin resistance. What's the thing with fruit? Because everyone's always freaking out about fruit.
Lara [00:41:12] Yes. fruit is fine. No fruit it is fine.
[00:41:15] So, first of all, the sugar part of it really only comes into it if you definitely have insulin resistance.
[00:41:22] So for that whole other group of women who don't have insulin resistance or maybe recovering from hypothalamic amenorrhea, then you don't have to worry about sugar.
[00:41:31] But for the group of women who do have insulin resistance, it's about high fructose, that's the way I see it.
[00:41:38] So no fructose, is fine. Fructose itself is fine. The amount of fructose you get in fruits is not a problem. It's when it's a dessert, even a natural even, you know, honey or maple syrup and date balls. And when it's if it what I say to my patients as if it tastes like dessert, then it's too much sugar. If it's whole fruit, that's fine.
Despina [00:42:03] Awesome, it's good to clarify that up because obviously people always think fruit is bad. You need to cut that out.
Lara [00:42:11] No. It might, yeah. In my book, I talk about it a little bit more precisely. Even people who have insulin resistance can probably still have about, like fifteen grams of fructose three times a day.
[00:42:24] So there's a threshold per meal and and I'm just taking fructose of 15 grams of fructose is probably like a cup, a small, or a teaspoon of honey or a couple pieces of fruit or something like that is fine.
[00:42:36] It's only when you get way above that by having a whole smoothie or juice or something that it starts to be a problem.
Despina [00:42:44] Sure. Glad we could clarify that.
Lara [00:42:47] Yeah.
Despina [00:42:49] We've we touched on diet. Can you touch on a few lifestyle factors that you should probably do, like with regards to exercise? What we know for certain types of PCOS what would be better when you're trying to get your period back?
Lara [00:43:07] Well, again, it depends if the problem has been hypothalamic amenorrhea, misdiagnosed as PCOS, then the general recommendation might be to not do too much exercise, although I still like to think you can do the amount that you enjoy as long as it's not a competitive athlete level exercise, in which case you really do need to get some advice about the amount of calories you'd need to try to keep up with that amount of exercise.
[00:43:33] But for PCOS, for insulin resistance PCOS.
[00:43:39] I'm sold on the idea that I think some resistance exercose, like some strength training is probably one of the best ways you could do it as part of a whole program.
[00:43:48] But the advantage of strength training, improving muscle tone and muscle mass is that that increases insulin sensitivity.
[00:43:57] Muscles are great for insulin sensitivity and reversing insulin resistance. So, yeah, I would say that's that's a big part of it.
Despina [00:44:04] Yes, I definitely agree with that.
[00:44:06] I think you just know trying to build some muscle is good for insulin resistance and just overall health is just good to have some muscle on you.
[00:44:16] So it shouldn't be, you know, feared. And I think I know women are kind of coming to the fact that it's not bad and they're trying to you know, you're seeing more women in the gym whicih is pretty cool, so it is good to address.
Lara [00:44:26] Yes muscle is good.
[00:44:30] Muscle is a hormonal organ as well. So it's not just strength. It's actually for metabolism and hormonal health.
Despina [00:44:39] Exactly. So true.
[00:44:41] Awesome. So is there anything you would like to say to kind of wrap the episode up, what's the final thing you would like to say?
Lara [00:44:47] Yeah.
[00:44:51] Well, I just want to I do want to mention two supplements for PCOS, which are maybe three supplements that are really superstars for this condition. And then give a final message to.
[00:45:01] So the supplements I talk about them in my book, but also on my blog.
[00:45:04] Magnesium helps to reverse insulin resistance.
[00:45:10] Zinc is really good at lowering male hormones, androgens, helping to support ovulation and also I'm sure your listeners have heard about inositol.
[00:45:19] It's a supplement that has been clinically trialed a few times for PCOS and outperforms almost any other medication. It's inexpensive. It's easy to take any brand will do a big fan of inositol.
[00:45:33] So those are a few supplements to look at that you could do in combination with the diet and exercise.
[00:45:39] And then my final message is that it's easier than you think.
[00:45:43] You know, even if you've been, as we said before, can be quite frightening, quite disheartening to be given this diagnosis, you think there's something wrong with my body. I'm never going to get there.
[00:45:53] Most women, my experience with most patients is they can reverse out of a PCOS diagnosis usually. Sometimes it takes longer than others. And even if you don't fully reverse out of it, you can at least improve things significantly to the point where you're having regular periods and then therefore getting the benefit of your own hormones.
[00:46:15] To say again, having your own estrogen and progesterone kick in is good for both metabolism and body weight, but also good for reversing PCOS because progesterone itself helps to normalize how ovaries function the next cycle and can help to reverse this.
[00:46:33] So it kind of becomes a self-reinforcing as soon as you start to ovulate your further and you know you're moving further and further away from PCOS.
[00:46:41] So I hope that helps women out. I hope that's encouraging. It's they can see and I'm sure your community of listeners and viewers, lots of success stories of reversing PCOS.
Despina [00:46:54] Oh yeah, for sure.
[00:46:55] It's definitely you know, you have to be patient, but it certainly does happen.
And from my experience, I didn't see a period for like six years and I managed to get it back. So if I can get it back off six years, then.
Lara Yeah, well done.
But yeah, just have to be patient and consistent with your diet lifestyle and think everything, fingers crossed everything will be, as you said, work out depending on the situation.
But I think this episode was definitely valuable. So informative. Thank you so much for coming on. Before we wrap up, can you share how our listeners can connect with you?
My blog is larabriden.com.
My book is Period Repair Manual and all of my social media is @larabriden.
So I'm on Instagram, Twitter, Facebook. I love to connect with people there.
Despina Awesome, I will link everything in the show notes, your book, your blog, everything will be there.
Highly recommend that you buy the book and follow and check out the blog, so much great information.
And again, thank you so much for coming on the podcast. I think our listeners will have benefited and learned something. So thank you so much.
Lara Thank you.
Hey there! I am Despina Pavlou, founder of PCOS Oracle and online coach. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.
Esme Rose: The Importance of Listening to your Body and Finding Balance while on your Healing Journey #65
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