Episode 025: Irregular periods and other issues with the menstrual cycle are something I’m constantly asked about. So I decided to dedicate a whole show to it for this week’s episode of Real Health Radio.
During the show I cover the main reasons why a woman can be having problems with her cycle or problems conceiving. We look at the issue from all different angles and explain how different scenarios can lead to similar complaints.
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Chris Sandel: Welcome to Episode 25 of Real Health Radio. You can find the show notes and the links talked about in this episode at www.seven-health.com/25.
Welcome to Real Health Radio: Health advice that’s more than just about how you look. And here’s your host, Chris Sandel.
Hey, everybody. Welcome to Real Health Radio. This is going to be another episode where it’s me just riffing on a specific topic myself. But before I launch into that, I just want to mention that I’m currently in the process of taking on new clients. I take on clients twice a year, so once at the start of the year and once in the midpoint, and I’m doing that at the moment. I opened it up a couple of weeks ago, and I’m already about halfway full.
I work with clients for a period of 5 months where we have a consult for an hour every two weeks. I have clients all over the world, and consults are done via Skype. They can be done via FaceTime or phone if people prefer. So if you’re not based in the UK, this isn’t a problem; more than half the people I work with are based in Australia or Canada or the US or Germany or other places around Europe or around the world.
If working with me appeals to you, then the first step or the start of this is by us having a free initial chat. This allows me to find out more about what you want help with and what you’re wanting to get out of us working together, and it gives me the opportunity to explain how I work with clients and how the process works. Basically, it lets us see if we’re the right fit for one another. I only want to work with people I truly believe that I can help and people who are on the same page, and this chat allows us to work out if this is the case.
If you’re interested in finding out more, then head over to www.seven-health.com/help. There’s going to be more details there. If you’re interested after reading that page, then click on the link that’s at the bottom that says ‘Apply to have a free chat’, and I’ll get back to you within 48 hours and we can arrange a time that works for both of us. So if you’re wanting to start 2016 with some help in regards to your health or nutrition or body image or food issues, then go over to www.seven-health.com/help and get in contact.
With that out of the way, let’s get started on today’s show. This episode is all about a woman’s cycle, and specifically looking at why women can have problems with it. When I say problems with it, I mean that cycles are too short or they’re too long or periods are being irregular or periods are not showing up at all. It can also include different symptoms that a woman’s getting leading up to her period or during her period or really at any point during the cycle.
There’s 13 real major reasons that I want to go through as part of this podcast. Often people can have issues because of multiple reasons, a number of these different reasons I’m going to go through, rather than it just being one. This list is by no means exhaustive; there are undoubtedly going to be ideas that I have missed out on, but I feel that this is probably a pretty strong starting place for you to start thinking about things if you are having issues.
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Let’s start with the first reason, which is stress. When I think of issues with a woman’s cycle, the first thing I think of is stress. When most people hear the word ‘stress’, they think about things like working long hours at work, being in an unhappy relationship, not being able to pay the mortgage or the rent, the death of a friend or family member, or moving house – normally big and obvious stressors. But really, this is a rather narrow way of looking at what stress is. Stress is much more pervasive than just these big events. From my experience of working with clients, it’s normally the small day-to-day stressors that are slowly chipping away at their health.
Let me define what I mean by the word stress. Stress is any physical, mental, or emotional factor that causes the body to make an adaption. The body is always trying to keep itself in a state of homeostasis, and a stressor is something that pushes the body out of that normal range and causes the body to make changes to bring it back to where it should be, or at least to attempt to bring it back to where it should be.
Stress is a normal part of everyday life, and there is no way that it can be avoided. You shouldn’t be trying to avoid it. But what you want to do is give the body what it needs to be able to mediate the stress so it’s able to make the adaptations that are being asked for. When it starts to cause a problem is when you’re having 10 or 20 things that are all asking for energy and all asking for adaptions, but you’re not providing the body with what it needs to do this. This is when stress then causes a problem.
So in a general sense, whenever I first start seeing someone with issues to do with their cycles, stress is the thing I think of first and foremost. The survival order within the body is: safety and security first; then sustenance, meaning food; and then sex or procreation. Unless your body feels safe and secure, your body puts a lot of its other jobs on hold. And when I say safe and secure, I mean physically, mentally, and emotionally. Its primary focus is getting you out of harm’s way, and it will put its efforts and resources into achieving this goal above all else.
When your body is under stress, it pulls the blood away from your digestive system, from your reproductive system. Historically, stress was about fight and flight. You were being chased by a lion or you were chasing a lion. If there was an argument between tribes, they would go to war with each other. While we’ve become more civilised, the mechanisms for stress are still based on how we evolved over millions of years.
If someone is working long hours, they aren’t getting much sleep, they’re having long gaps between their meals, and they’re not eating enough – all of which are stressors on the body – then the body is going to be spending its focus on getting the body out of harm’s way rather than looking at things like libido or procreation.
The other way of looking at this with stress is stress is really about energy regulation. Lots of nutritionists talk about balancing blood sugars, and you may have heard this term before. Managing the stress response is largely responsible for this. Whenever there is stress, and whatever that stress may be, the body wants to deal with it by bringing energy to the situation. So you go too long between meals, you then turn on stress hormones to bring energy to your cells to try to fix that situation. Same thing happens if you’re running for a line or you realise you sent an email that you shouldn’t or you see guys approaching you on a dark street. All these create the exact same response of increasing stress hormones that, amongst other things, are trying to bring energy to your cells to deal with that situation.
One of the easiest ways of getting that energy in that time of stress is by diverting it from long-term health and instead just focusing on using stuff to get out of harm’s way. Reproduction is not very high on our list of priorities when you’re running from a real or proverbial lion, so it halts or severely minimises the energy that it’s giving to the reproductive system and uses it to get out of harm’s way or uses it for more of the short-term things that it thinks are more important.
This also makes sense when you think about sex and procreation, not just the hormonal cycle. The act of sex uses up calories. How many will vary depending on what you’re getting up to and for how long, but the real energy drain for a woman comes if she actually gets pregnant. The average pregnancy costs the body 50,000 calories, and breastfeeding costs about 1,000 calories a day. At some level, your body knows about these requirements, and it avoids it if there’s not enough energy to start with or it thinks that it’s in an insecure situation where that energy could be potentially disappearing.
Despite the doom and gloom I’m pranging with stress, it is amazing how hearty the body can really be. I want to share an excerpt from the book Why Zebras Don’t Get Ulcers by Robert Sapolsky. It’s one of my favourite books of all time and is one of my go-to resources for all things stress.
He talks about in this book a study that was done in Nazi concentration camps conducted by Nazi doctors. In a study of women in the Theresienstadt concentration camp (I know I’ve absolutely butchered that name). The name of the concentration camp doesn’t really matter, but when they did a study of women in a particular concentration camp, 54% of the productive age women were found to have stopped menstruating.
This isn’t really surprising. Starvation, slave labour, and unspeakable psychological terror are all going to disrupt reproduction. But of the women who stopped menstruating, the majority stopped within the first month in the camps, so before starvation and labour had pushed fat levels down to that decisive point. Many researchers will cite this as a demonstration of just how disruptive even psychological stress can be on reproduction.
But the surprising fact is really the opposite of that: despite starvation, exhausting labour, and the daily terror that each day could be your last, only 54% of those women ceased menstruation. So reproductive mechanisms were still working in nearly half the women. Undoubtedly, certain numbers of these probably had anovulatory cycles, which means they were menstruating but they weren’t actually ovulating. But still, that reproductive physiology still operated in an individual who was under the most intense of circumstances, and that is absolutely extraordinary.
Stress in one form or another is going to be linked to all the other reasons for the cycle problems I’m going to go through in this podcast, and this is because stress really is the inability to meet the demands of the body. But rather than oversimplifying things and saying it’s just stress, I’m going to cover the other reasons for why it’s causing a problem.
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The next thing is a phenomenon known as the female athlete triad. This is a group of three different symptoms that are commonly seen in female athletes. Symptom 1: an eating disorder such as anorexia and/or bulimia or severe to moderate calorie restriction. This can either be intentional or it can be unintentional. Number two is amenorrhea, which is lack of menstruation, or oligomenorrhea, which is irregular periods. The third thing is osteoporosis or osteopenia. That’s the thinning of bones or low bone mineral density.
Up to half of competitive female runners have menstrual irregularities, and highly active girls reach puberty later than usual. For example, there was one study where they were looking at 14-year-old girls, and approximately 95% of the control subjects at 14 had started menstruating, whereas only 20% of gymnasts and 40% of runners had.
While the name would suggest that this is something that only happens to athletes, it’s something I see as common with lots of women who do exercise. With so many people’s focus on aesthetics, the exercise that people are doing can make changes that are very much about the body and not so much about creating health, and it can be pushing them further away from health.
Everything in physiology follows the rule that too much can be just as bad as too little. In practice, I see lots of women who are exercising excessive amounts, or at least in excessive amounts in comparison to how much they are eating. Exercise is a stress on the body, as I said earlier, but just because it’s a stress, doesn’t mean it’s inherently bad. But if you’re not eating enough to match up with these extra demands from exercise and you keep this up consistently, then it can start to affect your cycles.
I would also expand on the term of exercise as well. This isn’t just if someone is going to the gym. It could be someone who has a very physical job. I live out in the country, so there’s lots of horse stables and horse yards, and if someone is spending their days mucking out stables all day, pushing wheelbarrows, getting hay bales, working around the fields, this is a lot of physical work, especially in the wintertime. So if someone is in this situation, they’re basically in a sense doing movement or exercise all day. Same thing if someone’s job is say landscape gardening. There are probably other jobs that fit that bill as well.
I know these don’t really fall under the bracket of what the female athlete triad is really about, but I do think that the same principles apply. Lots of physical exercise with not enough food can lead to problems with your cycle and problems with your bones, among other things.
The people who are most affected by the female athlete triad are those with low body fat. Sure, I think too much exercise for anyone can have an impact on a woman’s cycle, but it’s typically those with a low body fat where it gets to the stage where they’re skipping cycles or their period’s not showing up at all.
I now want to break down some of the components of the female athlete triad, because on their own they can cause a problem.
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Low body weight or fat percentage is the next issue. I know I’ve kind of covered this already when talking about the female athlete triad, but it can easily be a problem on its own, even without excessive amounts of exercise.
On average, it’s estimated that for women, anywhere around 17-18% body fat is where problems become more likely. As that percentage goes down, the likelihood increases. This doesn’t mean that you can’t have a body fat percentage of 15% as a woman and still get your period; it just means that you’re more likely to have problems.
While we are constantly told about the fact that everyone is overweight or is obese, this is not the people who I’m regularly seeing in my practice. I do see people who would fall into this category, but a lot of the time I’m seeing women who are much thinner than this and are on the other end of the scale.
Sure, most of these women regardless of their weight still want to be losing weight, but it’s normally for purely vanity reasons rather than that the extra weight is because of their health. They’re women who are a UK size 12 but want to be an 8 or a 10, and this would be someone who in the US is a size 8, but they want to be a 6 or a 4. They’re typically people who are already in a ‘healthy weight range’, but are still getting lots of symptoms. They’re either trying to lower their weight because they think it will help even more or they’re trying to lower their weight for other reasons.
For a lot of these women who become clients who are on that lower end of the scale, getting irregular periods or no periods at all, when I suggest that they eat more and they start to put on weight, this simple act of them increasing their weight and their body fat percentage brings back their periods or alleviates a lot of their symptoms. Just reinstating some of that weight can in and of itself start to help with those symptoms.
I’ll also add that it’s not always just about body fat percentage or what the body fat percentage is, but where your body is used to sitting. Our bodies have an internal thermostat of where they’re happy to keep us and will typically fight pretty hard to keep us there. Someone, for example, could have a body fat percentage of 35%. They then go on a restrictive diet that’s not really supportive to their health. They’re cutting calories. Through that process, they manage to get their body fat percentage say down to 25%.
At this range, in theory, they shouldn’t be having problems with their cycle, or it shouldn’t have stopped. But for the body and where it currently wants to be, it’s much lower, and it will want to defend against further weight loss and attempt to get the body back to where it was previously and where it felt comfortable. One of the ways the body can do this is by conserving the energy and shutting down or minimising non-essential functions like reproduction. So in this situation, someone could get issues with their cycle that would normally be associated with someone with very low body fat simply because of how the body views the weight change they’ve just done.
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The next reason for issues with a woman’s cycle is undereating. I’m going to break these down into two different sections. There’s undereating in general or undereating of specific macros, which I’ll cover in a second.
Undereating in a general sense should be pretty obvious by now. When you’re not taking in enough, the body has to turn on more stress hormones and focus more on safety and security instead of procreation. Not enough food equals the body diverting resources from reproduction, and this can lead to periods ceasing, to irregular periods, and lots of different symptoms during and leading up to a cycle.
This can be intentional, with someone going on a diet or taking it even further and getting a full-blown eating disorder, or it can be unintentional, with someone trying to be healthy and eating lots of salads or raw or steamed vegetables and doing lots of juicing. They don’t think that they’re undereating and they’re not really trying to; they’re just eating foods that they believe are healthy, and these foods happen to be very low in calories.
The next cause with the undereating is looking at the different macros. Macros is short for ‘macronutrients’ and refer to carbohydrates, proteins, and fats. In the world of dieting, one of these macros is normally being demonised. This follows a cyclical pattern; things come in and out of fashion. If we go back to the 1910s, 1920s, protein was the enemy. We were told to keep it low if we wanted to remain healthy. This is when the Kellogg’s cereal company started up and was partly in response to this fear around protein.
More recently, in the 1980s, 1990s, fat became the enemy. Fat-free products became the rage, and everyone was trying to keep their fat low. Then from the 2000s onwards, carbs have now become the enemy. The popularity of Atkins kicked this off, and then other low carb diets started up. More recently, the paleo community in a lot of ways have been flying the ‘carbs are bad’ flag.
Give it another 10 years and things will change. Maybe protein will become the bad guy again and we’ll feel so silly for trying to avoid carbs as we’re doing at the moment.
Honestly, none of the macronutrients are inherently bad. None of them singlehandedly cause poor health. All of them can cause problems when they’re in too high or too low amounts, just like basically everything else to do with health or within life. While most diet books create some kind of villain to get you to avoid it, I prefer to go for less sensationalist tactics and let you know that they’re all fine for human consumption and should be eaten to provide good health.
What I want to do is look at how having low amounts of each of these macros can create a problem with your cycle or with your period. Let me just say that none of this stuff is set in stone. There are people who can eat a very low fat or a very low carb diet and have no problems with their cycle. If that is you, then great. But if you are intentionally keeping these things low and you’re getting problems, maybe it’s something worth changing to see if it helps.
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Starting with carbohydrates, carbohydrates are your body’s preferred energy source. This is energy so that you can think and run, but also energy to run your various systems, including your reproductive system.
Keeping carbohydrates too low means that the body has to use more fat and protein as an energy source. To convert fat and protein into energy in decent amounts is actually part of the stress response, and it’s an adaptive mechanism. When you’re doing this continuously, it means the body’s in a constant state of low grade stress, and as I talked about earlier, you want to be doing things that are shutting off stress, not perpetuating it, because otherwise it will hamper your ability to have cycles and ovulate.
Carbohydrates are also incredibly important for liver function. The liver and detoxification has a huge impact on hormones. The liver breaks down most of the reproductive hormones, so it’s important for regulating hormones at different points in your cycle. If you aren’t taking in adequate carbohydrates, the liver doesn’t have sufficient energy to be able to do this.
So, while low carb diets are the craze these days, for most they aren’t very good from a reproductive perspective.
The next macronutrient is protein. Of all the women I see with problems with their period, a large percentage of them have been past vegans or vegetarians. Even when this isn’t the case, regularly it’s people who are suffering with hormonal issues and they’re eating a low protein diet, and often doing it unintentionally.
When protein is broken down, it’s broken down into amino acids. These amino acids are used for every system, organ, and transaction within the body. Basically everything in the body is protein-dependent, so when protein is too low, it has a very far-reaching impact.
There are two things I want to focus on in relation to protein and reproduction. The first is that protein is one of the raw materials that is used to create hormones. If you’re not taking in enough protein, there’s not enough to create your reproductive hormones in the first place. The second relates to detoxification and liver function. When your liver is detoxifying, it needs certain substances for this to happen. One of the most important of these is protein, and more specifically certain amino acids. When it doesn’t have these, hormone levels can get out of balance, and the liver isn’t able to perform its normal regulatory functions.
This is something that can then link into a phenomenon known as oestrogen dominance. This is because protein and the liver are so important for breaking down oestrogen, and when this isn’t happening, it can increase in proportion to other hormones, like progesterone. Oestrogen and progesterone should be in a good ratio to one another, and when there’s a low protein intake and poor liver function, this ratio can get out.
If you’re eating a low protein diet – and often this is unintentional – it can be having an impact on someone’s cycle. This is something I’ve worked a lot on with clients and is a very common reason for problems.
The final macro is fat. Fat is probably the macro that has been most maligned out of all of them. While carbs are taking a pretty bad bashing currently, it doesn’t really compare to the all-out assault that fat’s taken for probably the last couple of decades. Fat is crucial for your cycle because it’s so important for hormone production. I mentioned that protein is part of the raw materials that hormones are made from; fat is the same. When fat is too low, there’s not enough to make the basic building blocks for those hormones.
Fats are also used to regulate sex hormones. They are needed for the production of hormone-like substances that help with hormone amounts and with hormone signalling. Fats are also needed for the absorption and utilisation of fat-soluble vitamins, and they are vitamin A, vitamin D, vitamin K, vitamin E. These vitamins are all incredibly important for reproduction.
Just like carbs and protein, a low fat diet can have a devastating effect on the menstrual cycle. While the normal dietary practice is to blame one of these macros for all of your problems and tell you to keep them low, this isn’t true. They all have their role to play and can be important.
Someone having a poor diet is probably a separate category for why or how problems can arise. Maybe they are taking in enough calories; maybe they’re not even restricting any of the macros, but their diet isn’t really supporting them. This could be because they’re eating poor quality food, so they’re missing out on certain vitamins and minerals. It could be how they’re structuring their eating, so what’s going on with their meal timings. Maybe they’re trying to do intermittent fasting but that just doesn’t work for them.
It could be even following a diet that on paper is good and actually works for lots of people, but it’s just not appropriate for that individual or for you. I could spend a whole podcast on this, but I’m going to save that for another day. What I will say is that food quality can be really important, even if someone is eating enough calories.
Looking at the structuring and the pattern with eating is equally important. I’ve actually covered a lot of that in a previous podcast that I did on keeping a food log. If it’s of interest to you, then I recommend you check it out. I’ll put a link to it in the show notes, which you can find at www.seven-health.com/25.
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The next potential cause for issues with a woman’s cycle is being overweight. In some cases, I think this is due to the weight itself. This means having someone lose weight by whatever means will repair the problem – but honestly, this is normally when someone’s weight isn’t very high. An issue with this, I would say, is also that improvements only stay if the weight stays off long-term, and the way that most people diet and attempt to lose weight leads to the weight being regained later on, and often with some extra for good measure.
While being overweight in and of itself can cause a problem, you need to then be looking at ways that someone can keep that weight off long term if it is even possible. But most of the time I think that being overweight is just correlated with the problem, but isn’t actually the cause. In the case someone is overweight, they may be more likely to be getting problems with their cycle, but it’s not the weight itself that’s causing it.
There’s a big thing in science about the difference between causation and correlation. Causation is A causes B. Correlation is where A and B happen together, but one doesn’t necessarily cause the other. If the problem isn’t caused by weight, it’s just correlated with it, then losing weight on its own will make very little difference. But if someone loses weight and it’s lost in the right way because they’re making changes that actually improve their health, then things will improve.
Or alternatively, the person could see improvements in their cycle through changes to their diet and their lifestyle and exercise and all that stuff, even if their weight stays the same. This is very common with clients that I work with.
I’m a big fan of the Health at Every Size movement. You can be metabolically healthy while being overweight or obese, just as you can be unhealthy while keeping a ‘normal’ body weight. So much of the focus these days is on weight loss at all costs, and diets are evaluated on their ability to shed weight in the short term with very little looking into or investigation on other factors.
So if you are overweight and you think that this might be contributing to your period troubles, then first and foremost, the focus should be on improving health, improving habits, improving your metabolism, that side of things. Weight loss is rarely the magic solution that takes away someone’s health problems, but it potentially can be if the changes that are made are also about improving health and not just about losing weight.
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The next reason for cycle issues relates to hormone production. When I’ve talked about this kind of thing before, it’s always been in a webinar or a presentation or a blog post where I can provide a visual aid. Being a podcast, I don’t have any of that, so I’m going to do my best to explain things and hopefully you can visualise what I’m describing.
For hormone production, there are different steps that take place. This is specifically for steroid hormone production. You start at the top with a raw material, and from this raw material you then create a hormone. From this hormone you then create further hormones that then can flow from it. Different hormones can be useful within their own right and act as a hormone, but they can also be the raw material building blocks for a further hormone.
I want you to imagine that there’s a flowchart. At the top of that flowchart is the raw material, and from it different hormones are created in a sequence or steps, and I’m going to walk you through it now.
At the top of the flowchart, the raw material for making these hormones is cholesterol. I know most people consider cholesterol as this big, bad thing that causes heart attacks and cardiovascular disease, but it is really important and has lots of beneficial roles within the body. Your body uses cholesterol to make all your steroid hormones, which include your different sex hormones.
The majority of cholesterol that is in the body is made in the body and it’s made in the liver as opposed to coming directly from the diet. When I said earlier on that you use proteins and fats to make different hormones, the first step in this is to use those proteins and fats to create cholesterol. If there’s a problem with a woman’s cycle, then low cholesterol could be a problem, meaning that there isn’t enough of the raw materials to start that first step, so there can’t be enough hormones flowing from it because there’s not enough of that cholesterol.
Next down that flowchart you have cholesterol being converted into a hormone called pregnenolone. Pregnenolone is the mother hormone that all of the rest of the steroid hormones flow from. This means it’s really important that the body’s able to convert cholesterol into pregnenolone so that that flow can happen. For some people, this is where the problem lies. If the body’s not able to produce enough of that pregnenolone, then the flow’s not going to happen, and subsequently women can get problems with their hormones and with their cycle.
To make the conversion from cholesterol to pregnenolone, you need proper thyroid function, and specifically the thyroid hormone T3 that’s important as part of that conversion. The thyroid is the master gland that controls metabolism. It sits in the neck, around the area of the Adam’s apple. If it’s not working properly, then that conversion is reduced.
If you look back on historical medical books, testing for cholesterol was originally used to test for thyroid issues well before it was used to diagnose cardiovascular disease. If someone had high cholesterol, a low functioning thyroid was then suspected. I actually did a whole podcast recently on thyroid function and covered this in pretty good detail. I actually got a ton of positive feedback about it from people, so I would highly suggest checking it out. Again, I’m going to link to it in the show notes.
Apart from just T3, you need adequate amounts of vitamin A and copper to make that conversion from cholesterol to pregnenolone. If this isn’t happening, then there isn’t going to be enough of that raw material, that mother hormone, to create the rest of the sex hormones. In this situation, you could have a case where there is high cholesterol or normal levels of cholesterol, but you have low amounts of pregnenolone.
From pregnenolone, hormones can go in a couple of different directions. One direction is to be created into a hormone called progesterone, and from progesterone it can then be further converted into different stress hormones like cortisol and cortisone. The other way is to use the pregnenolone to create a hormone called DHEA, and then from DHEA the body converts this into lots of the reproductive hormones – things like oestrogen and testosterone and other hormones.
In an ideal world, people would produce the right amounts of each of these various hormones from pregnenolone so you have the right amounts being shuttled off to make progesterone, to make DHEA, and then flowing on from there. Unfortunately, what happens all too regularly is that people have stressful lives, and whereas previously stress used to be a short-lived experience with a body response that was about life and death, it’s now turned on constantly.
As I keep saying, survival is paramount in comparison to the body’s need to procreate. This means that whatever pregnenolone is then being produced, the stress pathway gets first dibs. In times of stress, the pregnenolone, or a high amount of it, is shuttled off to make cortisol and cortisone, leaving limited amounts available to use to make reproductive hormones.
Hopefully this description of hormones was easy enough to follow. I hope I’ve talked about it in a way that you could visualise it or understand it. But really, at different stages along that chain of events of things being converted, problems can arise, and each of these different problems can have a knock-on effect to a woman’s cycle.
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Medication is the next cause for problems with a woman’s cycle. Medications like antidepressants, antipsychotics, and anti-inflammatory drugs can disrupt your cycle and cause you to skip periods or to have them more frequently. Many of these drugs actually elevate a hormone called prolactin, and prolactin can block a number of other hormones and really disrupt reproductive hormones.
These drugs can also be an added burden to the liver, which can also be part of the problem. As I mentioned earlier in the section about macros, the liver is incredibly important for hormone regulation, and if it’s not able to keep up, then certain functions will be missed.
Let me just clarify by saying that I am not a doctor. Not for one minute am I saying here to come off medication. I want to be really clear about that. All I’m saying is that if you are on these kinds of medications and you’re having problems with your cycle, they could be partially responsible for why that is.
Contraceptive medication obviously also affects your cycle, but that’s their intention. But contraceptive medication can also come with side effects and lead to other symptoms as well.
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Lifestyle factors are the next potential cause. Your day-to-day life can have an impact on your cycles. I’ve already mentioned exercise and the problems it can cause when people are doing too high amounts of it for what they’re giving back to their body in terms of food. There are countless factors that could come onto the bracket of lifestyle factors, but I want to touch on just three of them: alcohol, smoking, and recreational drugs.
Starting with alcohol, alcohol even in quantities that don’t cause liver damage or damage to other organs can cause irregular menstrual cycles. There’s really no magic amount that if you cross, you start seeing problems. The amount will differ from person to person. But if you are having problems with your cycle, I would start to look at how much you’re drinking. If you are regularly participating in binge drinking, then it might be useful to have a break or at least start to see that that could be part of the problem.
Smoking both depletes and increases the body’s need for certain vitamins and minerals. These include B vitamins, particularly B5, B6, B9, and B12, vitamin C, vitamin E, selenium, and magnesium. Lots of these are needed for healthy reproduction, not to forget the need for liver function as well. These are being used up and depleted with smoking. There’s less to go around, so it makes it more likely there’s going to be issues with reproduction as well as other issues.
With smokers, they have a greater chance of not ovulating, often with a shorter follicular stage, which is the first half of the cycle. Smokers have an increased risk of shorter luteal phase as well, so a shorter second half of the cycle. While this may sound like smoking is always going to lead to shorter cycles, if someone isn’t ovulating, cycles can be much longer or much more irregular.
Obviously, the amount that someone smokes is going to make a difference. Someone smoking one or two cigarettes a day is going to be a very different impact than someone smoking 20 or 30 a day. But if you’re a smoker and you’re having problems with your cycle, it could be a contributing factor.
An interesting side note: if you are trying to quit smoking, research suggests that smokers have a difficult time quitting during their period or during the luteal phase of their cycle, which is the second half of the cycle. So if you are wanting to quit, the first half of your cycle after your period has finished is statistically the best time to start.
Recreational drugs can also have an impact on period length. For some clients, recreational drug use is actually a pretty regular facet of their life; it’s something they’re doing every month, sometimes more regularly than that. For others it’s very occasional. It might be they go to a summer music festival or something of that nature. For lots of clients, it’s just not something they do.
Recreational drugs can have an impact on vitamin and mineral status as well as liver function. Sometimes the problem I’d say isn’t necessarily the drugs per se, but the other situations that the drug-taking causes. For example, someone may stay up all night, which means they miss out on sleep. This means that that has an impact on their circadian rhythm; this also means they may be sleeping a lot of the next day. Drugs can also have an impact in terms of how much someone eats, with the tendency for them to be eating less if they’re having things like cocaine or MDMA or eating increased amounts if they’re having things like marijuana.
So it’s often these other factors that can have just as much of an impact as the drugs themselves, especially if someone’s using them fairly frequently.
I don’t want this to sound like an after-school special. People can choose to do whatever they want with their lives and they can live their lives the way that they see fit. But if you are using recreational drugs or drinking alcohol or smoking and this is something that is fairly regular, it’s possibly going to be contributing to issues you’re getting with your cycle.
00:41:30
The next potential cause for issues is to do with shift work. This probably fits under the bracket of lifestyle, but I wanted to mention it separately. While we have the ability to have 24-hour light and stay up all night, this is not how we evolved. Our bodies follow a circadian rhythm, which is a 24-hour cycle of when hormones are naturally high or naturally low and certain functions are turned on or off depending on the time of the day. This circadian rhythm is based on the light and dark cycles and the cycles of the moon and the sun, as woo-woo and hippie-ish as that sounds.
Unfortunately, shift work disrupts the circadian rhythm. A study of 119,000 women found that those working evenings and nights had a 33% higher risk of menstrual problems, with irregular periods and fluctuations in how long they lasted. The more your work schedule fluctuates, the more likely you are to experience problematic periods. One study found that women who worked rotating shifts were 23% more likely to have very short cycles (that’s less than 21 days) or very long cycles (that’s 40 days or more).
While the focus here is on shift work, really anything that disrupts regular sleep patterns can be causing an issue. As much as possible, we want to be following the natural rhythms of the sun and the moon with our sleeping. Anything that messes with this too much is going to be having a negative impact.
Something like shift work may not be the easiest thing for someone to change. If you are a nurse or you’re a flight attendant, it’s not so easy to stop working shifts without having to leave that job. What I would say is that it’s rare that any one of these causes creates problems with your cycle singlehandedly. If you’re working shifts, it will mean that you’re probably starting from a more difficult place, and you may have more things you have to do on top in comparison to someone else. But there’s no reason that it isn’t achievable. If you are a shift worker, I don’t want you thinking “Oh my God, I need to leave my job,” but it is more likely it’s going to have an impact.
I’d also add to this that I think it might not be the shift work per se a lot of the time, but other impacts that it has. In a similar vein to the comments I just made about recreational drugs, someone who is doing shift work may be getting less sleep. Maybe they have longer periods between their meals or have more erratic eating. Maybe they eat unhealthier food. Maybe they do less exercise. I’m just speculating on all of these; I’m not saying that this is definitely the case. But it could be affecting these other areas of life, and this is how a lot of the impact is playing out. It’s not just the circadian rhythm; it’s all these other things.
00:44:35
The next area is specific illnesses that can be having an impact on your cycle. This can be things like polycystic ovary syndrome or endometriosis or fibroids or a thyroid condition, diabetes, eating disorders, advanced liver disease and different sexually transmitted diseases. All of these diseases are going to have different symptom profiles, so there’s nothing I can specifically say to look out for, but it might be worth keeping a record of your various symptoms and then seeing if it matches up with any diseases. If so, then go to a doctor and get stuff checked out. Go get some tests done.
I just mentioned polycystic ovary syndrome and endometriosis. Again, this is something I’ve previously done a podcast on. If you are getting problems with your cycle, I would really suggest checking it out. Again, I’ll link to it in the show notes. The link is www.seven-health.com/25.
00:45:40
The next cause of period problems can be things in the environment, so environmental or occupational toxins. Xenohormones, also called xenobiotics, are synthetic chemicals that have a hormonal influence on all living creatures. They are very pervasive in our environment, and they’re disrupting hormonal health.
Working in jobs where you’re exposed to xenohormones can have a huge impact on the body. These kinds of jobs include automotive manufacturing and repair, paint and nail polish/varnish, the electronics industry, industrial cleaning, metal part degreasing, dry cleaning, glues and fibreglass, fingernail polish remover, carpet laying, farming with petrochemicals derived from pesticides and herbicides and fungicides. The majority of xenohormones are estrogenic in effect, meaning that they have a similar effect to oestrogen in the body, but their impact is often much stronger.
It’s not just xenohormones; it can be real hormones in the environment. For example, because so many women are or have been using hormonal contraceptives for so many years, this stuff is then peed out as part of normal detoxification, it makes its way into our water supply and back into our taps, and now we’re drinking those hormones as part of our drinking water.
I know that sometimes hearing this kind of stuff makes people want to vow to only eat organic food, to never use cosmetics, to want to do liver cleanses to rid themselves of this stuff or to get all their water from some untouched well – and I don’t think this panic is warranted in a lot of situations. There’s literally no way you can avoid this stuff. The people who are most greatly affected and the ones who probably should worry more are those who are exposed to this stuff in their day-to-day jobs, the jobs I went through at the start. They’re going to be exposed in much higher amounts and absorbing much higher concentrations, and they’re going to be more likely to have problems.
I have created and included a handout in the show notes that includes a list of endocrine disruptors and where they appear. Endocrine means hormones, so hormone disruptors. If this is something that you want to focus on, this will show you things you can stop using in your everyday life or at least start to find alternative forms or products that don’t contain these certain chemicals.
00:48:20
The final reason for problems with someone’s cycle can be due to their constitution. Your constitution is that mixture of things that you inherited and those that you’ve acquired through life, particularly dietary and lifestyle factors from the first couple of years of your life.
Sometimes there may be a specific cause you can find. For example, there may be something constitutionally wrong with a particular gland in the body (for example, the pituitary). The pituitary is located in the brain and produces a number of hormones, like follicle-stimulating hormone, luteinising hormone, and prolactin. If there is something wrong with this organ, you can be either deficient in these hormones or you can be producing them in excessive amounts.
In practice, what I’d say is I find that people have constitutional weaknesses – things that even at a very young age were a problem or have been a problem for a very long time for them. For example, even in good health, they’ll have very sensitive digestion and are more likely to have problems with this. Or there’s someone who has a much weaker immune system and they’re so much more susceptible to getting coughs and colds or the flu.
The opposite of this is also true; people have constitutional strengths – systems that no matter how bad things get, they are unaffected. You have heroin addicts who are able to have four or five kids where there’s someone who’s health-conscious and does all the right things, but they struggle to conceive.
I really think it’s useful to recognise constitutional strengths and weaknesses that you have because it can help you be realistic about things. If you’ve always had problems with your cycle in good times and bad, maybe this is going to be a weaker area for you. This isn’t to say you can’t greatly improve it or even get to a point where it’s causing no symptoms at all, but when life gets tough or things go wrong, it’s likely that this weakness is going to be the area where problems are first noticed, so it’s important to realise where you have these weaknesses and strengths so when do things go awry, you have some context to it.
That’s the factors that can affect your cycle, or at least some of the main ones. If you struggle with your cycle for one reason or another, have a think about your current life and your situation and think about all the things I’ve gone through. Where do you think this could be causing a problem? What are the one or multiple things that could be more likely to be causing an issue?
This is something I work on a lot with clients and that clients seek me out to get help with. I know often when people think about working on fertility, it’s from a place of wanting to conceive. While I do work with clients to help with conception, a lot of the time it’s women who simply want to have more regular periods or less pain or other symptoms, or their period has gone MIA and they want help to have it return.
As I mentioned at the start of the podcast, I’m currently taking on clients. If what I’ve gone through in this show has resonated with you or sounds like something you want to get help with, then get in contact. You can go to www.seven-health.com/help, and you can have a read about how I work with people, my costs, etc., and get in contact for that free initial chat. It’s totally obligation-free, and we can see if we’re a good fit for one another.
That’s it for this week’s show. I hope you found it useful and helpful. I’ll join you next Thursday, when I’ll be back chatting with another guest. Until then, take care of yourself and have a good week.
Thanks for listening to Real Health Radio. If you are interested in more detail, you can find them at the Seven Health website. That’s www.seven-health.com.
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