In today’s episode, Dr. Lisa and Dr. Toni continue discussing menstrual cycles and periods.
In this episode, we cover:
Tracking your menstrual cycle
How to figure out when and if you are ovulating
Different methods of testing hormonal imbalances causing period problems
Traditional Chinese Medicine patterns linked with period issues
Some benefits of using menstrual cups over tampons and pads
How you can use the four phases of creation to maximize your high productivity times over the month
How do you figure out if you’re having a normal period and menstrual cycle?
You can track your menstrual cycle using:
Basal Body Temperature (BBT) – your temperature generally increases sharply after ovulation by about 0.5oC or 1oF
Ovulation signs – your cervical fluid becomes wetter and tends to have consistency of raw egg white, position of your cervix rises up in vaginal tract and becomes softer with feeling like the tip of your nose
Ovulation Predictor Kits – measure luteinizing hormone (LH) in your urine – generally rises 12 to 36 hours before you ovulate, but not 100% accurate, as you can have LH surge without ovulation
Progesterone Ovulation Kits – measure progesterone – generally rise 24-36 hours after ovulation
Less used are different fertility monitors like Clearblue (that uses detecting estrogen and LH levels) and Daysy (that uses your basal body temperature and period tracking)
Salivary ferning tests looking at increased levels of salt in your saliva before ovulation due to estrogen, monitors to measure electrolytes in your saliva and vaginal sensors to detect ovulation – will these become more common in the future?
Period tracker apps like Period Tracker or MyFlo, or just mark your Google calendar when you start your period
How do you figure out what is causing your period problems?
Further testing for hormonal imbalances and nutrient deficiencies:
Blood vs. saliva vs. urine (such as DUTCH or CHI)
Test on 7 days before your next period (around day 21 depending on the length of your menstrual cycle) or throughout the month if you have irregular menstrual cycles
Blood Sex Hormone Binding Globulin (SHBG) and thyroid panel (TSH, free T4 and T3)
Blood iron status: hemoglobin, iron/transferrin saturation, ferritin (iron stores)
Consider getting abdominal and transvaginal ultrasound imaging requisitioned by your family doctor or gynecologist to rule out issues with your uterus or ovaries if you have abnormal bleeding or abnormal menstrual cycles
Traditional Chinese Medicine patterns impacting your menstrual cycle:
Liver Qi Stagnation – associated with PMS, menstrual cramps and clots, type A personality, overwork, stress, anger, excessive cold exposure
Spleen Qi Deficiency – associated with changes in digestion and bowel movements like loose stools around period, excessive alcohol intake, too much raw/cold food, anxiety, worry
How can you improve your flow of Qi and blood (plus save money over time)?
The phases of your monthly cycle plus the energy of each phase are as follows:
Menstrual (Dark of the Moon): Looking within, reflecting on what’s working and what’s not working in your life, letting go, course-correcting, deeper connection to intuition
Follicular: Creativity and new beginnings, high physical energy, desire to be out and active
Ovulation (Full Moon): Open to maximum cross-fertilization, connecting with community, heightened communication skills, magnetism
Luteal: Decline in physical energy, energy turns inward, nesting, administrative, detail-oriented tasks feel like priorities, slowing down
If the year were the macrocosm of the month, the phases line up like this:
Winter = Menstrual
Spring = Follicular
Summer = Ovulatory
Fall = Luteal
Adjusting to the different phases of the menstrual cycle is being used by the U.S. Women’s soccer team and is covered in the MyFlo app created by Alisa Vitti https://www.floliving.com/
Today’s Mama Must Have:
Dr. Toni loves her Diva Cup as an easy and economic alternative to pads and tampons.
Dr. Lisa is enjoying some cheesy reality TV shows, including Four Weddings and Seeking Sister Wife as a little break from real reality. Dr. Toni fully supports this, as she is a longtime Survivor fan (yes, it is still on TV) and got sucked into Love is Blind on Netflix recently.
Thank you for joining us today!
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Please tell your perimenopausal mama friends about us, too!
In today’s episode, Dr. Lisa and Dr. Toni are discussing some of the basics around our menstrual cycles and periods.
In this episode, we cover:
What a normal period is
The hormones involved in your menstrual cycle
The four phases of your menstrual cycle
Common (but not normal) things you could be experiencing with your period and menstrual cycle that are signs of abnormal function
Menstruation could be considered your 5th vital sign, after heart rate, blood pressure, breathing rate and body temperature.
What are your first memories of your period?
Most of us in North America don’t experience some of the celebrations around the appearance of a girl’s first period, unlike some cultures around the world. You might think about your period as an annoyance, something to hide or embarrassment.
As a woman, you are a cyclical being. You experience ebbs and flows of different hormones throughout the month – estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, as well as prostaglandins (chemical messengers that stimulate uterus to contract).
Your menstrual cycle is impacted by moon cycles, since the different phases of the moon shifts the movement of fluids, especially salt water. It can also be impacted by stress, blood sugar, liver and gut health. These can cause different imbalances and problems that are common, not normal!
If you are taking a birth control pill or have an IUD with hormones, you need to be aware that it is masking your natural menstrual cycle.
The age range for menarche, or your first period, is 9-18 years of age. Back in 1840, the average woman’s menarche was 16.5 years of age, while now it’s between 12-13 years of age.
Why has this changed? It’s possibly impacted by different environmental toxins you are now exposed to that your grandmother wasn’t exposed to, and a lot of these new chemicals are hormone disruptors.
Normal menstruation includes:
4-7 days of flow
26-32 days long
Average flow is 30-50ml (1 regular pad or tampon can hold up to 5ml)
Starts bright, cranberry red in colour and ends bright, cranberry red colour
No PMS or cramping
Viscosity of jello that hasn’t set
Cervical fluid (aka vaginal discharge) changes
Consistency and predictability is key
4 Phases of the Menstrual Cycle:
Menstruation: previously released egg doesn’t become fertilized, estrogen and progesterone drop, your endometrial lining is shed. Day 1 = 1st day of your period flow
Follicular (proliferative) phase: overlaps with menstruation
Starts on Day 1 – your brain releases FSH to tell your ovaries to create follicles, or sacs with immature eggs in them
The healthiest egg will be released during ovulation
You are born with all of your eggs (vs. sperm made every 2-3 months)
You used to be an egg in your mother’s ovaries before your mother was born and in utero in your grandmother! See here to learn more.
As the follicle matures, your body releases estrogen to build your uterine lining so you’re ready to implant a fertilized egg if there is sperm available
Ovulation: typically between day 10-17 of your menstrual cycle WHEN FERTILE
Rising estrogen triggers your brain to release LH, which stimulates one of your ovaries to release the mature egg
Mature egg travels down the fallopian tube to the uterus and can be fertilized anywhere during this journey for up to 24 hours. It’s possible for another egg to be released after (like Dr. Lisa and her fraternal twin!)
Your cervix starts moving up your vaginal canal and opens up, releasing your cervical fluid with a consistency like raw egg white that can hang out! This quality of cervical fluid supports fertility as it helps sperm swim up to egg
Your basal body temperature (BBT) changes – on average, you could have an increase of 0.5oC 12-24 hours after ovulation. You may also get a slight temperature dip right before you ovulate
Ovulation predictor strips test LH, not necessarily ovulation! You can have LH surge without an egg release
If your egg isn’t fertilized, the follicle turns into the corpus luteum, which releases progesterone to keep uterine wall thick and gets uterus ready for implantation,
The length of your luteal phase is based on how long progesterone is maintained, rise in temperature from progesterone
Estrogen remains low
In perimenopause, you may have low progesterone levels and may not ovulate with every menstrual cycle
If the egg isn’t fertilized, the corpus luteum is dissolved into your body, levels of estrogen and progesterone drop, and you get your period (restarting the menstruation phase)
If you get pregnant, the fertilized egg tells your body to release hcG and stimulates the release of progesterone to support the thickness of the uterine lining
Abnormal Menstrual Issues You May Be Experiencing:
Old menstrual blood from your last period
Caused by stagnation, low progesterone, possible scarring from past C-section, D&C, abdominal surgeries or trauma
Can be helped by:
Arvigo abdominal massage or other bodywork like osteopathic, craniosacral, yoga therapy
Castor oil packs or topical use (not during period, as it can speed up flow)
Progesterone support with vitex, B vitamins, oral micronized progesterone or progesterone cream
Addressing root causes of low progesterone, like stress!
Heavy bleeding, clots, spotting or your period keeps starting and stopping:
Often linked with high estrogen and could be a sign of fibroids, endometriosis or polyps (get ultrasound imaging and further assessment from family doctor or gynecologist!)
Can also be caused by low iron or low thyroid function
Consider iron supplementation or estrogen detoxification support for the liver with DIM/I3C, herbs like yarrow, capsella, milk thistle, curcumin/turmeric, green tea, NAC/GSH
Support bowel movements, increase fibre to bind extra estrogens and other toxins
You might need extra bile support if your gallbladder was removed
Limit your beer intake due to the estrogenic effect of hops
Short flow, light flow, missed periods, longer cycles:
Can be caused by low estrogen, most likely in late perimenopause as you are nearing menopause!
Can happen if you are underweight and/or overexercising; typically in younger women
increasing your intake of protein and fat, including cholesterol for hormonal building blocks from eggs, or plant sterols
Ground flaxseeds, traditional forms of soy (like miso, tofu, tempeh)
Bioidentical hormone cream, or herbs like caulophyllum, cohosh, red clover
Your period comes every few weeks/ you have shorter cycles:
Low thyroid function and low progesterone are both likely in perimenopause
Can be from high levels of estrogen or inflammation
Why should you avoid NSAIDs like naproxen (Aleve) and ibuprofen (Advil, Motrin)?
They negatively impact liver function, can cause leaky gut and deplete your body from critical nutrients like folic acid, melatonin and iron.
Tylenol is not better! It reduces your levels of glutathione, which is a crucial antioxidant for your brain and liver.
PMS: things come out that may be unaddressed or suppressed – no filter!
Symptoms: headaches, breast tenderness, bloating, stool changes, sleep disturbance, breast tenderness, food cravings, fatigue, mood swings, change in libido, hot flashes/heat symptoms during sleep (perimenopause)
What’s your hormone imbalance? Low progesterone, high estrogen, low thyroid
Don’t forget about possible low iron!
Supplements and herbal support for PMS:
Reduce caffeine in coffee, tea, chocolate
Consider low-dose iodine for breast tenderness
Today’s Mama Must Have:
Dr. Toni has used the Period Tracker app for many years to track her menstrual cycle. It was super helpful when she was working on getting pregnant, as well as when she was working on not getting pregnant!