Financial Feminist - 229. The Cost of Period Pain: Hormones, Endo, PCOS, and More with Kate Helen Downey

Episode Date: April 28, 2025

Let’s be real — periods are a huge part of life for millions of us, but we’re still taught to suffer through the pain, stay quiet about the discomfort, and not ask too many questions. In today��s episode, I'm joined by Kate Helen Downey, host of the incredible podcast CRAMPED, who is on a mission to change that. We’re getting into everything you should have been taught about your body but probably weren’t –– the truth about hormones, the reality of living with endometriosis (endo) and PCOS, why the system isn’t built for menstruating bodies, and how period pain is affecting our wallets, careers, and overall health. If you’ve ever wondered whether your pain is "normal" (hint: if it’s wrecking your day, it’s not!), or felt dismissed by doctors when you tried to get answers, this conversation will make you feel seen. We’re breaking down the phases of your hormonal cycle, what debilitating period symptoms might be telling you, and why advocating for your health — even when the system is stacked against you — is an act of radical self-care.  Kate’s Links: Website:  https://www.katehelendowney.com/  CRAMPED podcast: https://www.katehelendowney.com/cramped Instagram: https://www.instagram.com/katehelendowney/  TikTok: https://www.tiktok.com/@kateiscramped  Read transcripts, learn more about our guests and sponsors, and get more resources at https://herfirst100k.com/financial-feminist-show-notes/229-periods-hormones-endo-pcos-and-everything-you-need-to-know-with-kate-helen-downey/ Looking for accountability, live coaching, and deeper financial education? Check out our exclusive community! Join the $100K Club: https://herfirst100k.com/100k-pod Our favorite travel and cash-back credit cards, plus other financial resources: https://herfirst100k.com/tools Not sure where to start on your financial journey? Take our FREE money personality quiz! https://herfirst100k.com/quiz Special thanks to our sponsors: Squarespace Go to www.squarespace.com/FFPOD to save 10% off your first website or domain purchase. Rocket Money Stop wasting money on things you don’t use. Cancel your unwanted subscriptions by going to RocketMoney.com/FFPOD. Quince For your next trip, treat yourself to the luxe upgrades you deserve from Quince. Go to Quince.com/FFPOD for free shipping on your order and 365-day returns. Netsuite Download the CFO’s Guide to AI and Machine Learning at NetSuite.com/FFPOD. Masterclass Get an additional 15% off any annual membership at Masterclass.com/FFPOD. Indeed Get a $75 sponsored job credit to get your jobs more visibility at Indeed.com/FFPOD. ZocDoc Visit Zocdoc.com/FFPOD to find and instantly book a top-rated doctor today. ResortPass Visit Resortpass.com and use code FFPOD to get $20 off your first ResortPass experience. Learn more about your ad choices. Visit megaphone.fm/adchoices

Periods are a monthly part of our lives. So why do we know so little about them? And why is our pain not taken seriously? Let's get into it. ["Feminist"] Hi, financial feminists. Welcome back to the show. I am so excited to see you as always. My name is Tori. I'm a New York Times bestselling author. I'm a money expert. I've helped over 5 million women be better with money. And I host this show, which is the number one

money podcast for women in the world. So if you're joining me, you're in very good company and I appreciate your support as always. I'm just going to plug it right off the top. Please share this episode. Please share this podcast. Self-promotion is always a little weird. Okay. It's always a little weird to come on here and be like, share the, share the shit that I do, share the shit that I produce. But I'm here to tell you that running a feminist company is really hard.

It's hard on a good day. It's especially hard right now. And there's a lot of noise in the podcast base from a lot of bros with microphones who shouldn't have microphones. We just appreciate you sharing this show. It's free for you. We have almost 250 episodes at this point. And there is so much valuable stuff that you can use to not only change your money, but change your relationships,

change your health, change your entire life. And if you've ever gotten an ounce of value from this show, please share it. It's the easiest way to keep making this show available and accessible to you and to everybody listening. This is expensive for us to produce, but free for you all. And we really appreciate you sharing feminist media always, but especially right now.

It's the easiest thing you can do. It doesn't cost you any money to share this show with somebody you think might love it. So we really appreciate it. This episode is very fun and it's back to our roots at Financial Feminist, which is not just talking about the financial, but talking about the feminist. Kate Helen Downey is the host and creator of Cramped,

a podcast investigating why we know so little about period pain. Previously, she worked on shows like Pushkin's Revisionist History, Wondry's Scam Influencers, and Descentelle and Glamorous Trash. Specializing in creating entertainment out of information, she is the co-founder of Caveat New York City and used to give renegade tours of the Metropolitan Museum of Art with Museum Hack, and she assistant directs operas in New York City Opera. Today we are talking about Kate's journey from having what she calls death cramps

to finally getting an endometriosis diagnosis and everything she learned along that journey. I learned more in this episode than I learned in decades of being somebody who menstruates. We get into how our hormonal cycle works, how the world isn't built to accommodate that cycle, and the broad effect on our time and our wallets, this is something that will single-handedly change your life. I learned this a couple years ago, that basically every single day of your menstrual cycle will cause you to have different energy levels, different bandwidth, different workout or

diet needs. But of course, we live in a patriarchal world and a calendar and a timeline that is built based on men's bodies. A content warning, we are talking about some bodily functions that often accompany periods and bodies in general, okay? This is very refreshing and open,

but we wanna be transparent about that. So I don't think there's any reason to not have children around, but if you wanna do some education first, great, amazing. This is a really powerful episode, especially to share with the women and the people who menstruate in your life. This is a perfect conversation starter about period pain, about endometriosis, about PCOS, about anything that's going on for you and your reproductive system. So let's get into it.

But first, a word from our sponsors. This episode of Financial Feminist is sponsored in part by Squarespace, Quince, Gusto, Rocket Money, Indeed, and NetSuite. Build a beautiful website to get your message out into the world with Squarespace. Squarespace was the first purchase I made for my business way back in 2016. And it's still one of my number one recommendations for business owners or individuals building a website. Go to squarespace.com slash FF pod to save 10% off your first website or domain purchase. Treat yourself to everyday luxury at an affordable price with Quince. I just bought myself a brand new winter coat from Quince, not even with a gift card with my own hard earned cash. That's how much I love Quince. Go to quince.com slash FF pod for 365 day returns plus free shipping on your order.

Did you start a subscription to watch that one TV show or that movie that you just couldn't find anywhere else, but you now just got the bill because you forgot to cancel, Rocket Money's got your back. Cancel your unwanted subscriptions by going to rocketmoney.com slash ffpod. Take the headache out of payroll with Gusto. Get three months free when you run your first payroll at gusto.com slash ffpod. Get a $65 sponsored job credit to get your job's more visibility at indeed.com slash ffpod. sponsor job credit to get your jobs more visibility at indeed.com slash FF pod. Download the CFO's guide to AI and machine learning at net suite.com slash FF pod.

Our next ad is with somebody that I have been looking to partner with forever. Like I have tried to work with them because I love them so much. It's resort pass everybody. If you do not know what resort passes, basically what happens is you get to access luxury hotel amenities. So the fancy pools, the spas, the cabanas without needing to stay overnight. It is one of my favorite travel hacks. You go over to resort pass and you can use the really nice fancy infinity pools at the all inclusive resorts where you get free food for like less than 100 bucks a day. I have done this in Mexico. I was staying at an Airbnb and they didn't have a pool. So I literally went with Christine and we had an amazing day at a very nice all inclusive

resort where I got to lounge by their pool. And also included in the resort pass was like a five course luxury French meal with wine pairings. Daypasses start at just $25. So if you're ready to upgrade your day, head to resortpass.com and use code FFpod for $20 off your first booking. That's resortpass.com code FFpod because even one day away can feel like a true getaway. So we'll probably yell knowing, knowing the topic of this conversation is going to piss me off. It will. I promise.

Kate, I'm so excited to have you welcome to the show. Can you tell me why you do the work that you do and why it's so important? I mean, the short answer is I do the work that I do right now because I suffered alone for 22 years. And I don't want anyone else to feel that way. We of course want people to listen to the episode, but you open your own podcast with this story of a particularly bad period and what you call death cramps. Can you share an abbreviated version of that story?

And it sounds like maybe this was the impetus for realizing, oh, this isn't normal. Yeah, I had definitely realized it wasn't normal before this. I'll take you through this because I feel like this was the most egregious time that this happened. So I was working at a restaurant. I was a waitress in my early 20s while I was in college. I was working at a fancy restaurant, the fanciest place I'd ever worked at. You know, not a whiskey bar, not a seafood shack, but a fancy restaurant. Yeah. A fancy restaurant in Boston. And you have to wear the like crisp white shirt, the fun tie, multi-course servings.

So I was working a lunch rush. I was so caught up in like getting everything right, you know, pleasing the chef, making sure I wasn't screwing up any orders. And all of a sudden I realized, oh, fuck, I have cramps. And for me personally, that realization is never just like, damn, that sucks. It's like this is an emergency. I might be in real trouble here. What makes me realize I have cramps and they might get really bad

is my whole body breaks out in a sweat. Like it does right before you throw up with the like, the nausea, my back hurts very badly. It's not just in my stomach or like in my lower belly. It is like a full body experience. So I realize, okay, I have to get to a bathroom right now. I grab a waiter who has been nice to me, even though it's because he wants to sleep with me, but like, whatever, I'll take the

niceness. I tell him, I am having an emergency. I have to go. Can you please cover my tables? Here's a bunch of information about the tables that let, and he's like, yeah, okay. What's happening? I go to the employee bathroom. There's one employee bathroom. It's the only one. I lock myself in. I take off my white button down because I know it's going to get drenched in sweat. If I don't take it off, I kneel down at the toilet and I say, all right, here we go. Let's let's see what happens here. An unknown amount of time later, I wake up on the bathroom floor

because what happens when I have horrible cr later, I wake up on the bathroom floor because what happens when I have horrible cramps is I throw up every 10 minutes until there's just bile coming out. It doesn't stop because it isn't about what's in my stomach. It's about the amount of pain that my body is in. My stomach just gets rid of anything just in case it might help. I have diarrhea alternating with the throwing up, which is so fun.

And the waves of pain that go through my body are so intense that I often pass out. And that's actually great because when I pass out, it kind of short circuits the whole process. And when I finally wake up, I am no longer in pain. So I pray to pass out. I pray. So after I wake up on the floor of the employee bathroom at this fancy restaurant, I sit up. I wake up because someone is knocking

hard on the door and yelling my name. There's no windows. I don't have my phone on me. I don't know how many hours it's been that I've been locked in this bathroom. I turn around and there is a outline of my body in sweat. That's how much the sweat pours off of me when this happens to me. I like get my shirt back on and I kind of stumble out. The lunch rush is over. Everyone thinks I've been like doing drugs in there. I have to tell my manager like,

really sorry that this happened. This is a medical thing that happens to me sometimes. And I try, I get my ass home. So that's one, just one time that this has happened to me. One of the worst timings, one of the worst places that it has happened, but that is not an unusual experience for me when I get my period. Kate, was that every month? Was that like every month's experience? No. Okay. No, it's intermittent. In psychology, it's like the intermittent reinforcement is the most powerful.

So it doesn't happen every single month, but it does happen every three or four months. Okay. I'm not usually the speech, so this is the soon end of the episode. So broader conversation from that story, because we're going to talk about period pain, we're going to talk about all of that, but we live in a society that one does not understand women's bodies, two does not care about women's bodies or menstruating people's bodies, or quality of life, and three, like misunderstands it to the point where you are passed out on the floor

after basement and attic situations here. I like that terminology. That's what my mom, when we were, one of us has food poisoning, she's like basement, attic or both. I'm using that. Yeah, great. So, and yet it's, oh, you were doing drugs in the bathroom. So can we talk about what at a societal level is going on when menstruating people have their periods and sometimes they're debilitating, or at the very least, they're uncomfortable for five to seven days. Like society does not understand that.

No. And part of it is that we don't talk about it. It's a chicken egg situation that like, I don't know which came first, but society can't understand and be empathetic to something that they don't know exists and they have no context for. I'll give you some numbers just so that, because I think without these numbers,

it can be very much like, well, everybody's got a weird medical thing. Everybody's dealing with some weird pain. So when you're talking about menstruating people, people who are ovulating, people who are menstruating, 95% of menstruating people experience some kind of pain with menstruation. And so that can range a lot.

That can be just your quote unquote average period cramps, which what is that? We don't know what is normal because we don't talk about it, but just some discomfort, a little bit of aching, something that is not going to screw up your day, but you're just going to kind of go, oh, this sucks. OK, maybe take an ibuprofen. You're fine. Ninety five percent of menstruating people are experiencing that kind of pain up to 30

percent. And some this is a number that has been reached through, I can talk about later why this research is bad, why this data is like not great, but at least 30% of menstruating people experience debilitating period pain, severe period pain, period pain that keeps them from doing their day-to-day activities. So they may not be throwing up and having diarrhea and passing out, but it stops them from doing their day-to-day activities. So they may not be throwing up and having diarrhea and passing out, but it stops them from doing, from going to work, from taking care of the people that they take care of, from taking care of themselves.

30% of menstruating people worldwide is something like 355 million people. And so that's the scale we're talking about here. And I like to bring up those numbers because when we say, oh, severe period pain, I think a lot of people think like, oh, this happens to 2% of the population. This happens to just like a few people. It's so many people.

And it's not once a year, it's sometimes 12 times a year, once a month. And yet we have no representation of this kind of anywhere in media. Like we have some representation of periods, like just periods, that recognition that they occur. Like we're still fighting for that. Like stories about that. Period pain and severe period pain, we have no cultural reference point for that. The thing I think about all the time is like, okay, so if 95% of people are experiencing some sort of discomfort, and then at least 30% are experiencing like intense physical symptoms, this is on top of, you're just bleeding.

Like, you're bleeding for five, typically five-ish give or take days. Like, and I just think about all of the time that for us as menstruating people, we have to walk through our lives, or picking up children at school, giving presentations at work. I remember giving, I was literally speaking at the Forbes 30 under 30 conference,

having cramps. And I'm like, Oh my God. So there's one part of me that is like, this is so fucked. And this is so crazy that this does not get discussed and is not given the space and the understanding that it needs. And on the other hand, I'm like, how fucking badass are we though that our bodies are in constant flux and change? And how strong are we that we live our lives anyway? So can we maybe talk about when we're thinking about periods? You have this great sentence in your bio that you sent, quote, because having a microphone gives you more answers than having a uterus.

What's going on in that quote for you where you're like, okay, microphones giving you more answers than just being someone in existence? Yeah, that statement came out of like my frustration and and rage of going 22 years without getting real help or a diagnosis. And part of the reason I made the podcast was this frustration and this rage. So I've had this pain since I was 14. Intermittently, obviously I've been to doctors. I ask doctors about it. I've been to so many doctors and asked them, what is going on? Why do I have this pain? And I've experienced everything from total dismissal, just like, oh, it's cramps. What do you, you know, this is not that big a deal.

Have a heating pad on it. You're fine. Yeah. Have you heard of ibuprofen? Yeah. Like, you're like, no, I'm throwing up the ibuprofen, guys. Yeah. And that's a whole other section of the process that is what my friend Sydney calls her pill window, is the amount of time you have between when you start being in pain to when you're throwing up so much you can't

keep meds down. And it's like, you got decisions to make in that pill window. But so I've heard everything from total dismissal to look, you're, we don't know what it is and you're just going to have to figure it out. So I also heard the first doctor I ever went to for this when I was 14 told me, yeah, some women have bad periods and it usually goes away when you have your first kid. And it's like, what am I supposed to do with that as a 14-year-old? Which also, like, the research does not back that up. There are some people whose cramps get worse after they have a kid.

There are some people whose cramps get better after they have a kid. It is entirely individual. But again, that that is the solution, which is like, oh, just wait however long, maybe forever if you don't have children. There's such bullshit. Yes. To answer your actual question, I didn't find real answers to what I was experiencing, how to help myself, like what my diagnosis was until I literally got a microphone, started making this podcast, and sat down with doctors

and experts to interview them. And it was so infuriating to me that as a patient, as just a person with a uterus experiencing pain, I did not rate, well, good enough care or enough curiosity to get information about this and to have something to go on. But as a podcast host with a microphone interviewing someone, I was able to get in contact with those experts, ask them the questions that I needed answered personally, and get those answered. And that, to me, is so, so upsetting.

So when we're talking about the symptoms and even maybe pulling from the research you've done or the conversations you've had, what is a quote-unquote normal symptom versus something that is not normal and probably is something more serious is going on? Yeah, a huge part of this problem is we don't culturally or or as patients, have information about what is normal and what is not normal. I remember in fourth grade having a sex ed class where they told us about what was gonna happen

to our bodies. I remember getting sample deodorant. I don't remember being told, hey, if you feel anything more than this amount of pain or these symptoms, talk to somebody. I think that would go a long way, but that is not the focus. Quality of life, not being in pain, is not the focus of that education. The focus of that education is making the people around you more comfortable by giving you deodorant, telling you to shower more, telling you to use menstrual

products so that you don't make anyone else uncomfortable. So a normal amount of pain is ideally none. Like this is a normal bodily function so just like if it hurts really bad when you take a shit like it shouldn't hurt really bad when you have your period. The process of having your period involves having a muscular organ, your uterus, squeeze and so you might feel discomfort. You might feel a little aching. The squeezing of having your period involves having a muscular organ, your uterus, squeeze. And so you might feel discomfort. You might feel a little aching. The squeezing of your uterus can be involved with like your abdominal muscles and the muscles

in your lower back. And so a lot of people feel a little bit of achiness or soreness in their lower back as well, sometimes even down into your hips, because those tiny pelvic floor muscles are like deeply involved with all of the muscles of the uterus. And so beyond that, also like, you might get hungry, you might get cranky, like, those are all things that... Period hurts too.

Yes, and period poops... Yeah, your poops get a little crazy. Period poops are related to cramps, the same prostaglandins, which are little hormonal messengers that cause your ut related to cramps. The same prostaglandins, which are little hormonal messengers that cause your uterus to cramp, also cause your colon and your intestines to cramp the same way. And so that's why period poops happen. And so that's normal.

That's part of the hormonal messaging that's happening. You might, yeah, have cravings for different foods, you might notice changes in your emotional receptivity, but those things should not in any way interfere with your life. They should not be making it difficult for you to do the things you have to do. That is the baseline. If any symptom is, whether it's emotional, whether it's physical, whether it's pain, if anything is making it so that you are having

a much harder time showing up in your life the way you want to, that's a problem. And that's something that your health provider should be able to help you with. And that is just not what happens most of the time. Yeah, I know for me, it's definitely, I feel like a faucet for five days. Like the faucet's just on. And I jokingly, my periods were a lot more manageable when I was on a hormonal birth

control and then I got off of it about two years ago. And day two and three of my periods are full murder scenes. Like they are just murder. Like I am changing ultra tampon every like two and a half hours. Yeah. And for the most part, other than the general discomfort, I have one bad period a year. I actually just had it last week and I'm so sorry. It's OK. It's not throwing up.

It's like a really bad cramps and a lot of discomfort. But I'm lucky where I have a pretty normal period. And it sounds like for folks listening, a little bit of cramping, feeling like a faucet, period poops. I'm definitely, I'm sensitive on a good day, yet alone the days before my period. Oh my gosh, anything sets me off. So I think that's all normal. But for people listening, if it is pain that is just like, you're like, I should be taken seriously with this pain, or any sort of discomfort, that's when you should talk to somebody. Is that right? Yes. And if you talk to somebody and they don't have anything for you, if they don't run any tests, if they run a test and it comes back normal and they say, well, that's the end of the

road, go talk to somebody else, go find somebody else. And that's easy to say and hard to do. And I know it puts all of the work on us and that shouldn't be the case, but we have to go get the help we need and we have to be educated about it because it's not out there for us a lot of the time. So there are doctors out there who will take you seriously, who will help you. There are so many people I could recommend to follow on Instagram or TikTok. Dr. Karen Tang is an amazing resource.

She posts all of these videos about like people will ask about their symptoms and she will run down like it could be this, ask for this test. It could be this ask for this test. If this comes back normal make sure they run this test. So she almost gives you like a playbook to go into the doctor with which is so incredibly helpful. And we need that because a lot of the time we are dismissed or we're told go on birth. Because birth control can help people's symptoms, depending on what the underlying cause is. The other kind of galaxy brain thing that I will say, and try not to get too deep into because it honestly has broken my brain completely, our hormones run everything in our bodies and our lives. We are living in a world that is not built for us. We are living in a world that is constantly telling our bodies

that we're in danger and we're in an emergency, and that affects our hormones in such a way that our periods can be way worse. One doctor I talked to calls periods the fifth vital sign. It's like your blood pressure, It's like your heart rate. It's a really important measure of your overall health, but it is not treated that way. We don't gather data on it that way.

We are asked, do you have normal periods? And we say, yeah, they're regular. They're the same every time, but we're not asked, how much are you bleeding? We don't have an easy way to measure how much we're bleeding. If you're bleeding, if you're filling up a super tampon in two hours, you're probably bleeding too much.

You're probably low on iron. That could be causing or caused by a thyroid issue. And then we get into a whole world that is very scammy and weird of hormone balancing. And yes, that is so full of like landmines. And yet our hormones are very real and they affect our like quality of life so much. Even if your hormones are tested and they come back normal quote unquote,

within normal ranges, that doesn't mean that you are not feeling legitimate pain or suffering because of an issue with your hormones. I'm literally have, I have thyroid issue symptoms on another tab open. So we're gonna- And be careful cause that's also a rabbit hole to dive down, but-

Yeah, I'm like fatigue. Yeah, I feel tired, weight gain. Yep, who knows? Bloating or swelling in the face. I mean, maybe. This is and wow, if you if you Google it, if you look it up on Tic Tac, you're going to find 9000 people who want to sell you supplements to fix it. That would do absolutely nothing.

And then they're like, are your is your cortisol high? Do you know? I have literally a whole episode coming up where I'm like, is my cortisol high? Is that what's been causing all these problems? Will a supplement from TikTok fix me? And we talk to it. Definitely not, but like it's Donald Trump as president. I think all of our cortisol is too high.

Yes, exactly. Exactly. I'm sorry. This is the world we live in once in a lifetime. I would like precedented times, please. Exactly. Yeah, it's like truly the thing that fixes, this is so frustrating, but like the thing that fixes cortisol imbalance and like, because it's true if your cortisol is too high, progesterone makes cortisol and progesterone is what we need for like easier,

better periods. And so if you are using up cortisol, you don't have enough progesterone. And so if you are using up cortisol, you don't have enough progesterone. The fix is to not be stressed out and to rest more. And it's like, go take a walk. Okay. Yeah. Like we either can do that. We're either privileged enough to be able to change our lives to be able to do that or we're not.

And if we're not, we can't do that. So boy, oh boy. Kate's story is just getting started. When we come back, we are talking about the hormone cycle of our periods and why it's important for us to know this information about our bodies, as well as the truly astounding cost of just having a period generally.

Stay tuned. This podcast is brought to you by Squarespace. Squarespace is the all-in-one website platform designed to help you stand out and succeed online. If you need a website, you've got to use Squarespace. We've all been on terrible websites that don't look pretty and don't function well, and Squarespace is the place to build a beautiful website without you having to know how to code. Squarespace gives you everything you need to offer services and get paid all in one

place so you don't have to use a bunch of different services, a bunch of different software platforms. You can do it all on Squarespace. You can get paid on time with professional on-brand invoices and online payments. And you can streamline your workflow with built-in appointment scheduling and email marketing tools. They also, like I said, have cutting edge design. Anyone can build a bespoke online presence that perfectly fits their brand or business without needing to know how to code. They offer a complete library of professionally designed and award-winning website templates with intuitive drag and drop. We love the drag and drop. Head on over to squarespace.com for a free trial and when you're

ready to launch your brand new website, use promo code FFPOD to save 10% off your first purchase of a website or domain. I like saving money, and I know you like saving money, which is why you listen to this show. But if you're wondering where your money's going and how it's getting spent, and also are you spending money on things that you don't really like,

that's where Rocket Money comes in. Rocket Money is a personal finance app that helps find and cancel your unwanted subscriptions, monitors your spending, and helps lower your bills so you can grow your savings. You can see all your subscriptions in one place and know exactly where your money is going, and for ones you don't want anymore, Rocket Money can help you cancel them. Their dashboard also gives you a clear view of your expenses across your accounts. You can easily create a personalized budget with custom categories,

and you can get alerts if bills increase in price, or if there's unusual spending activity, or if you're close to going over budget. Rocket Money has over 5 million users and has saved a total of 500 million in canceled subscriptions, that is half a billion people, saving members up to $740 a year

when using all of the app's premium features. Cancel your unwanted subscriptions and reach your financial goals faster with Rocket Money. Go to rocketmoney.com slash FF pod today. That's rocketmoney.com slash FF pod rocketmoney.com slash FF pod. One of the things that I've learned in the past couple years that blew my mind that I'm like, why didn't somebody teach me this? Is that it's not just your five-ish days of a menstrual cycle. Your cycle is happening in phases and those phases impact your mood and your hormones and

your energy levels and your pain. So can we talk about like those four phases, what's happening in our bodies throughout our whole menstrual cycle, not just the days we're bleeding? Yeah, absolutely. And I'll preface with, I am not a doctor. There are people who know way more about this, but I am happy to give just like a top level overview. So we start in your menstrual phase, which is, that's what's counted as day one. It's a cycle, so it doesn't really matter

what day you start counting, but for medical stuff, you start counting day one of your period when you are bleeding. So that is what some holistic practitioners call the body's winter. So that's when kind of a lot of hormone levels are low. Your uterus is like getting rid of the endometrial lining that it built up to potentially house a baby,

to nourish a baby, and it's, you know, scrapping that for the month and saying, "'We gotta start over.'" So you are bleeding, you are probably lower energy while you're bleeding. It's typically thought of as like, "'Not a time you should be out being social.'" Not that you can't.

Of course you can. But your body and your hormones are craving rest, craving downtime. After that, whenever you are finished bleeding, we move into a cycle called follicular and that it's called follicular because it's referring to the follicles in your ovary. Every month you have multiple follicles that might. Of course, you have all the eggs that you're ever going to have. And a crazy fact is that you're you have all the eggs that you're ever gonna have. And a crazy fact is that you're born

with all the eggs you're ever gonna have. But because you're born with all the eggs you're ever gonna have. If I have a kid, my kid was in my ovary when I was in my mom's ovary, which is crazy. But anyway, the follicles are the potential eggs in your reserve that are maybe going to get released this cycle, and they fight for domination. Multiple follicles start maturing every cycle and they like

get selected by a very cool process. So one follicle rules them all at the end of the day. At the end of the follicular phase, you release an egg. You ovulate. During the follicular phase, that's sort of the body's spring. So things are getting a little, things are warming up. You're getting a little bit more energy. You're feeling probably like getting towards higher energy, more social, more active.

When you ovulate, a bunch of things are happening with your hormones, you're in your follicular phase, the lining of your uterus has been thickening and regrowing in preparation to maybe house a fetus. And when you ovulate, you get the spike in luteinizing hormone and then a spike in estrogen. And this causes a release of the egg. So then you're in your ovulatory phase. This is the highest energy. This is when you want to do like your big workouts, your run your marathon. This is when you have the most energy,

you're the most social. A hormone expert that I talked to, it was really interesting to hear her perspective on this. When we have a lot of estrogen flowing around in our system, we tend to be more social, more outgoing, even more verbal. And when we have more progesterone, higher progesterone in our system, that is more of a nesting thing. That is rest. That is stay home for the night. That is like when you want to rot in bed. And so not only do those hormones affect your behavior, but your behavior can affect those hormones. And as a yapper myself, I'm like, wow, okay, maybe I have high estrogen. Not just that I have it and it makes me talk, but I talk and it makes me have higher estrogen. Maybe. Well, regardless, after ovulation, we get into the luteal phase.

So the luteal phase is when all the crappy stuff happens. It's the body's autumn. Progesterone is building this whole time and estrogen is dropping. The progesterone building is what thickens that endometrial lining. What it's waiting for is did this egg get fertilized? The progesterone comes from a little thing on the ovary after the egg is released called the corpus luteum. It's also called the yellow body. It produces progesterone,

which makes the lining of your uterus build even more. And if the egg is not fertilized, that corpus luteum breaks down and leads to a very quick drop in progesterone. That drop affects things like serotonin, but it also releases prostaglandins, which signal to the uterus to cramp, which starts your period. And then we're back at the beginning of the cycle.

But the luteal phase is where people often feel PMS. If you notice that you're PMS, you're cranky, your food cravings, your energy is really low, that all happens usually in the lead-up to your period and once you get your period those symptoms ease pretty quickly and that's because what you're feeling, what's giving you those symptoms is this progesterone, this higher progesterone. Everybody reacts differently to that higher progesterone, everybody reacts differently to that higher progesterone. Everybody's processes are different. But once that progesterone drops, we usually feel a lot better.

Yeah, I want to blow up my entire life in the little. Well, and that's what I'm talking about when I say nothing in this world is built for us. We have these 24 to 30 day cycles where our energy is vastly different week to week, like area of the cycle to area of the cycle, our lives, our entire structures are built around men's hormonal cycles, which are 24 hours. It's why we have a nine to five. It's why our working day, like we work during the day and we have fun at night and then go to sleep.

Like that is based on men's hormonal cycles. The fact that we are supposed to be consistent, there's this expectation we don't even think about that like from week to week, we're supposed to get the same amount of work done. We're supposed to work out the same amount. That's just not realistic for our bodies and expecting us to live that way

is what is putting stress on our hormonal systems. Yeah, I think for anybody listening where you've never heard this before, please do more research and we'll actually help you for guests to talk about it because it is something that changed my life. And I do think about it and I'm really glad you brought the seasons up because that's how I think about it. And correct me if I'm wrong, I believe spring and fall are the longest with winter and summer being the shortest. So your menstruation is shorter, but also your fun, sexy time, summer, is also short.

The spring, the build up to summer is long, the build up to menstruation is long. So when I start realizing that, and again, not everybody has this luxury, but there are certain things I try to do during phases that I know are going to be supportive of that. I have not fully gotten to the point where I've had my team be like, we're only recording podcast episodes when I am in summer. But you know, so they're reached for. But I have realized even at the gym, that one's the very, the one I can see a ton because

I lift weights. I can see a ton because I lift weights. I can see, I lift a lot more weights. I can lift a lot more and it feels easier when I am not either menstruating. I actually don't typically lift weights at all when I'm menstruating because of low back stuff. I'm nervous about that. But also during luteal, like it's so interesting.

So spring and summer is where I do a lot more of my literal heavy lifting. We have to learn how to think about this so differently because, like you said, we are programmed to think like, oh, we have being on our period and not being on our period. And that's, those are the two, like, phases of our lives. And it's the same way with exercise. Like you're talking about, that is something so obviously physical, it's easy to notice the difference. I have struggled a lot

because in my mind for a long time, I was either working out, which meant like really intense hit classes or like going for long runs or half marathons and like achieving things like physically and or not doing that at all. But those were the two modes for me. And I have had to totally change how I think about taking care of myself, how I think about exercising when I am able to exercise and move my body. Even if that's like super gentle yoga in the luteal phase or just taking a walk, my symptoms are way better. And if I overdo it, if I go on a really hard run in my luteal phase, I pay for it. I suffer.

That is not what my body needs. And so we have to stop letting external expectations run how we take care of ourselves. Yeah, I mean, what we talk about all the time on this show, that an act of protest, right, is getting money, or an act of protest really more broadly is, like, stop believing that you have to conform to a system to your point, and I wrote about it in my book, that has not been built by or for you. So if you can slow down and understand and actually ask yourself,

what do I feel like doing today? Not what I should do or not what like society wants from me, but like what is, what are my actual energy levels? What do I actually feel like doing? And we live under capitalism, so you can't just fuck off and play around sometimes. But if it is just, okay, I am going to, yeah, not push myself and not go to my crazy gym where I'm going to lift heavy weights and I just need a walk today, great. Or if it means, okay, I need to take some time off and work from home today, like there's some flexibility that we can have.

And there's a lot of this is also in social obligations too. Then this is something as a Yapper, as an extrovert, I struggled with a ton because there were times when I had social things that I had committed to. I had people who were expecting me to show up somewhere. And I was, if not in pain, I had nothing to give. I was not in a place to be able to show up and be social. And I did not wanna say no, and I forced myself to do it.

And I paid for it. And so part of that too has been, and that requires being in a social support network that understands, hey, I can't come to your birthday party tonight. I'm really sorry, let's get lunch next week. And I will treat you to lunch, we will celebrate you, but I do not have this in me.

And I think being in my 30s has really helped with managing that, making decisions about how my energy and my social time is spent. But that's really hard. And as women, we are socialized to show up for other people to our own detriment. And we have to not only think of our work and our money that way of I'm sure you've talked about this before on the podcast, but like thinking of your time, not as money, but the same way you think of your money.

Your time and your energy of like, I have limited energy, I have limited wellness. How am I going to spend that? What aligns with my values? And what do I have to say, sorry, no, you don't get my energy today? To switch gears a little bit, can we talk about the actual cost of periods, like the financial cost? Because, let me check my notes. You said you spent $14,622 on cramp treatment in 2024. Tell me, where did that money go? And also, how much are we spending as people who menstruate at the

individual level? And we'll talk about the societal level in a second, but like how much money are we spending trying to manage our pain? Yeah, okay. Well, and mine is an extreme case, and I want to like preface this in that you don't have to spend $14,000 to properly manage your pain.

I'll go like on average first, and then come back to like exactly what I spent my money on, but on average first and then come back to like exactly what I spent my money on. But on average, menstruating people spend about $20 per cycle on menstrual products. And so the average ovulating person has about 450 periods in their lifetime, which ends up being about $9,000 you're spending on menstrual products over the course of your life, which again, we have 12 periods a year. We are like, that doesn't sound like a lot, but it sure adds up. And that changes depending on what state you're in, what the taxes are like.

The most expensive place to have a period right now is New York State, partly because of the taxes. One of the cheapest places is Ohio. And that's like literally, it's $20 on average in New York and it's $12 on average in Ohio. So this varies a lot. Some of this is a pink tax thing. Some of this is just a regular like taxes are higher in New York thing. But that's a lot of money. And that's just for people whose menstruation is no problem. That's for anyone who has a period managing their period in a healthy way.

When we get into like having period pain and how you manage that. So here's I'll do a really quick breakdown of like what I spent this money on. About 4800 of that was just what I pay in health insurance premiums. I pay $400 a month in health insurance. And I did not go through my health insurance to get my period pain treated and diagnosed. And I can get into why I didn't later. But I was paying that in case I got hit by a bus or got strep throat or something,

while I paid out of pocket for my period pain treatment and diagnosis. And so the rest of that roughly $10,000 was spent on specialists, pelvic floor physical therapy, an integrative nutritionist, supplements, medications, and tools to help with my pain. And that was over the course of a year. And I don't have a lot of money. The reason I, this was, this is savings that I would have loved to spend on something else. Will I ever be able to buy a house? Probably not.

But I did not save this 14,000, this $10,000 to spend on period pain. Right. And that is the cost, unfortunately, of managing it, but also getting good health care. So yes, very briefly, can we talk about why did you have to go to somewhere else? Why did you have to like go out of network in order to get the care you needed? Yeah. So I'll preface this with I probably could have gotten some treatment for this pain through my network. I did a lot of research and heard a lot of stories. I spent a lot of time on subreddits for period pain, on other communities where people were talking

about their journey to get a diagnosis and to get treatment. And what I learned through this and through talking to some specialists was that when you go through insurance, you are only getting the care that your insurance provider thinks you should have. And when it comes to things like period pain and the conditions that most often cause severe period pain, like endometriosis, PCOS, fibroids, very often the insurance companies do not have the most up-to-date information or there simply isn't enough information or research done for them to be able to cover the

appropriate treatment. So using my own case as an example, based on my symptoms and pain specialists I talked to, I was told, you probably have endometriosis. You should go see a specialist. If I had gone to my gynecologist through my health insurance, what probably would have happened is they would have said in their little seven minutes that they're allowed to spend with me, they would have said, okay, well, to figure out if, well, here's what they had done in the past is they had sent me for an ultrasound.

My ultrasounds, every time I got them, came back normal. And that would always be the end of the road. That would be, we got an ultrasound, there's nothing weird about doing the physical exam, nothing was weird, nothing was weird in the ultrasound, we didn't see anything, so it's what you're feeling is normal, nothing was weird, nothing was weird in the ultrasound, we didn't see anything, so it's what you're feeling is normal, nothing is wrong. And I was told that for 22 years,

and I knew something was wrong. I knew what was happening to me was not okay, not normal, something was wrong. And so it took going to an endometriosis specialist here in LA, which cost over $800 just for the initial appointment and exam. But in that initial appointment and exam, she went through and reviewed all of my previous imaging, all of my previous medical records, sat with me and asked me lots of questions about my experience, my quality of life, my symptoms, did an exam, and told

me at the end of this hour she spent with me, I'm 95% sure that you have endometriosis. Technically endometriosis is not diagnosable without laparoscopic surgery, which is where it's a minimally invasive surgery where they cut four, five little holes in your belly and send in cameras and equipment and fill your belly up with gas so they can see what's going on. They take little samples of where they think endometriosis might be, send them to a lab, and the lab confirms if those cells are the same kinds of cells that are inside the lining of your uterus. So that's how you get diagnosed is fucking surgery.

Like it's not efficient. There are lots of research projects being done right now to try to find a better way, a less invasive way to diagnose, because when you go through insurance, obviously they're not going to cover anything that isn't confirmed diagnosed. So you end up with, if you go through insurance, you might end up with subpar surgery because, and again, we talk about like this, this is overarching over like

every aspect of our healthcare system, of our culture, of our society, is not informed, is not interested or curious in improving this, and they do not know about this. So gynecologists might not get a lot of information on endometriosis despite the fact that one in ten people with uteruses has endometriosis. It is the number one cause of painful periods. And yet, gynecologists are generally not trained on this. And if they are trained on this, they are not trained well enough to know that most of the time you can't see it on an ultrasound, which is what happened to me.

So many people are turned away, are told there's no way they have endometriosis. I was told there was no way I had endometriosis because I have light periods. I don't bleed heavily. And so I was told, there's no way you have it. Over and over and over again. Go see a specialist. They're like, no, that has nothing to do with it. I'd be so curious to know if you're listening on Spotify, leave a comment and let us know how much you think you spend on period products a year. When we come back, we're talking more about endometriosis, PCOS, and how to get our doctors

to listen to us and take us fucking seriously. We'll be right back. I have used Gusto since 2018. First as an employee and now as a business owner. And let me tell you, I'm not just saying this because it's an ad, it's the best payroll slash HR platform we've ever used. They offer flexible benefits, simple onboarding and more.

They'll even tell you how much your paycheck is worth in bananas. I don't know why that's my favorite thing, but if you want to take your thousand dollar paycheck and go buy bananas, it'll tell you how many bananas you can buy. Gusto takes the pain out of payroll benefits in HR and puts the joy back in running your business.

It is delightful, easy to use software, accessible online from anywhere, and you get unlimited payroll for one monthly price. There's no hidden fees. You can get the W-2s and the 1099s you need for tax season. It helps you manage your health benefits, the 401Ks, but also offer letters, onboarding checklists, and software setup. Right now, our listeners get three months free when they go to gusto.com slash ffpod.

Yep, three months of payroll, benefits admin, and more. Totally free. Again, that's gusto.com slash ffpod. Vacation season is nearly upon us. I can feel it. I can taste it. Every time we get a little bit of sun here in the Pacific Northwest, I'm like, oh, give me more of this.

I need more of this. Quince has got me covered for vacation season with all of the luxury upgrades I deserve. Like lightweight European linen styles from $30, washable silk and comfy lounge sets. They also have premium luggage options and stylish tote bags. And the best part of it all is that Quince items

are priced 50 to 80% less. They only work with factories that use safe, ethical, and responsible manufacturing practices. So you know you're doing good while also getting real cute. I would be talking about Quince, even if they weren't a sponsor, they're fantastic. For your next trip, treat yourself to lux upgrades you deserve from

Quince. Go to quince.com slash FF pod for 365 day returns plus free shipping on your order. That's Q U I N C E dot com slash FF pod to get free shipping and 365 day returns. Quince.com slash FF pod to get free shipping and 365 day returns quince.com slash FF pod. I think the conversation is changing a lot because you're right. I didn't hear the word endometriosis 10 years ago or PCOS, but I feel like a lot, really probably because of social media, the democratization of this information, many of my close friends now have endo or PCOS diagnosis or like treatment plans. Can we talk a bit more about, if you do know the difference between both of these and what kind of symptoms someone listening might go, oh, maybe I should look into this more.

Yes, absolutely. So to get to the basics, endometriosis and adenomyosis are very, are caused basically by the same thing. And again, not a doctor. You should talk to a doctor if you think you might have this. But the lining of your uterus, your endometrial lining, is made of cells that react to hormones like estrogen and progesterone to thicken to house a baby. They don't know why, but for one in ten people, these cells end up in places outside the lining of the uterus. And that's endometriosis.

So if you have endometriosis, you have cells and this can be one or two cells. This can be a big group of cells. They are living somewhere. They are implanted somewhere in your body that is not the lining of the uterus where they're supposed to be. That means that wherever they are,

most often it's on the ovaries or the bladder or the intestines, but there have been confirmed cases of it in people's lungs, in their brains, in their noses. Wherever these cells are in your body, they react to hormones the same way the cells that are inside your uterus do, where they thicken based on the progesterone and they bleed based on the drop in progesterone.

And so that means if you have endometriosis, you have spots in your body that are bleeding. You're bleeding internally every time you get your period. That in itself is a problem, right? That shouldn't happen. That blood has nowhere to go. It creates a lot of irritation and inflammation wherever it is. Your body doesn't have a way to deal with this other than like, something is wrong. White blood cells, go get it. Like figure it out, protect it. And so what you end up with is a lot of scar tissue

called adhesions that basically glue your organs together. So if you have, say, some endometrial cells on your bladder and your bladder, you know, the organs in your body, they're all next to each other, right? Like there's no like space between them. So if you have endometrial cells on your bladder that are bleeding and getting inflamed every month for years and years, the scar tissue that forms ends up basically gluing your bladder to maybe your uterus or maybe your intestine or maybe the side wall of your pelvis. And so that causes problems with whatever organ it's attached to. The problem is this endometriosis can be anywhere and it causes different symptoms depending

on where it is. So the biggest symptom to look out for is period pain. Although if you have endometriosis that doesn't mean you always have period pain. I highly suspect because my sister also has horrible periods, has never gotten a diagnosis, I now have the diagnosis of endometriosis. I suspect she does. Our mom has never had painful periods. That doesn't mean she doesn't have endometriosis because it is highly genetic.

So a big, big symptom is period pain. There is an estimation that 70% of severe period pain is caused by undiagnosed endometriosis. My doctor thought it was even higher, probably closer to 90% of severe period pain is caused by undiagnosed endometriosis, my doctor thought it was even higher, probably closer to 90% of severe period pain caused by undiagnosed endometriosis. So that's a huge one. Is PCOS similar symptoms, severe period pain, maybe heavy bleeding? Like what is telltale sign typically a PCOS? Yeah. So PCOS is different. It does not have anything to do with the lining of your uterus or the cells being

somewhere else. PCOS is a condition where your hormones are really out of whack. It's really a hormonal disorder, but it leads to having a lot of cysts on your uterus. So polycystic multiple cysts, of cysts on your uterus, so polycystic multiple cysts, but it also can lead to like hair growth in places you don't want hair growth. The big symptom of PCOS other than pain is really irregular periods. So people with PCOS may not ovulate or because of those cysts on their ovaries, they may not have a period for months at a time and

then have like one really bad period where it's almost like months of period blood coming out at once. And so that's a different disorder with a different treatment, but it also can cause really bad period pain. So basically the big takeaway everybody is that if you are in severe pain or even like the pain that is debilitating you or preventing you from being able to do your daily life, it's time to go see a doctor. Yes. And if that doctor doesn't have anything to say to you about that, it's time to see a different doctor, even if you have to pay for it, if you can. Because unfortunately, we live in a system where you have to pay for it, if you can. Because unfortunately, we live in a system where you have to pay for better care.

Right. What are you saying to the doctor to get them to take you seriously? Like, what is that script? Yes, that's a great question. The biggest thing that you can say is this is affecting my quality of life. These symptoms are making it so that I cannot do

the things I usually do in my life. There have been studies about how women communicate pain and how men communicate pain differently. And for men, it is usually, men usually communicate pain based on what they can and cannot do, whether that's like physical movements like my shoulder hurts and so I can't like lift it above here or oh I can't drive the car or whatever.

They will talk about it in terms of functionality, whereas women will often talk about their pain in terms of emotionality. They'll describe how it hurts and what it feels like, and they'll also describe what it is keeping them from doing in terms of like social and emotional responsibilities. Where like, oh, I can't go to my friend's party. I can't even like listen. It hurts so much, I can't like listen to my friend talk. And this, not that this is our fault,

but what ends up happening is that doctors tend to prescribe antidepressants and anti-anxiety to women when they complain of pain and painkillers when men complain of pain. And look, this is not, I'm not saying we have to act a different way. But if like in order to get appropriate care, we need to change the way we're describing something, do it. Yeah. I mean, it's like negotiation we talk about all the time is like, you might still be met

with, like, you should just be grateful. But there are certain things you can say as a woman. You can play the game without completely like giving away your agency. And that's what we're talking about is if you can change or subtly alter the way you're describing things, knowing that the system's fucked anyway, like, it might mean you get the care that you deserve, unfortunately. Yes, and you can play the game knowing it's a game

and knowing why you have to do this and working to change it, but you still have to get care somehow. Well, and that was one of the questions I wrote down too, is we've discussed a lot on this show, and I've done a lot of listening and research about just that we do not take women's pain seriously. We just never do. And I don't know if you've listened to the Retrieval's podcast,

have you listened to that? Yeah, of course. Okay. So, I've brought that up on the show multiple times, but if you guys have not listened to it, basically a nurse at the Yale Clinic was stealing fentanyl, so the pain medication, and women were getting egg retrievals done with no pain relief at all. And they would say, oh no, I'm in a lot of pain. They'd bump up the fentanyl. Sorry to interrupt. This is a procedure that involves having a giant needle shoved through your cervix. So you need pain meds. Yeah. And I think it was dozens maybe. They

don't even know how many women because it was saline, right? It wasn't fentanyl. And so dozens, potentially more than dozens of women went through this procedure without any sort of pain management. And I always get to the point in this show where I'm just like, everything's fucked. But like, I don't know if I have a question. Maybe just talk to me about

why we don't take women's pain seriously, what we can do about it. I don't know if I have a question. Maybe just talk to me about why we don't take women's pain seriously, what we can do about it. I don't know. It's just, ugh. That's my official statement is ugh. I don't know. It's just, it's so fucked. It is.

And I like research, I spent the last year deep dive researching into exactly this and being like, look, I know this is true. I know that we as a society, we as a medical organization do not take women's pain seriously. Why? Why in 2025? Why? And the reasons are complicated and many, but ultimately we as a society are not invested in women's quality of life. And that really touches everything.

The things that would have to happen to change this are pretty massive. And so at a certain point you look at inertia, right? Like who is benefiting currently? What would have to change? And who would it benefit to change? And who is in the positions to make those changes happen? And that is really what it comes down to. So you have this quote, quote, more than anything, what my money got me was bodily autonomy, which is basically our entire fucking mantra at HFK. So can you break that down for us in this context? Like, money got me bodily autonomy. What did that mean?

Yeah. So I realized that going, I've gone through insurance my whole life. I was lucky enough as a kid, my dad had good insurance through the teachers union. And so my family has always been like, and so my family has always been like, have insurance, go to the doctor through insurance. If it, and you know, we're, we've generally been pretty healthy, so we haven't had to explore options outside of that. So, and when I was in my twenties, I was working in theater. I would, I did not have money to make these kinds

of decisions and I never did. And so suddenly having my first experience of paying I did not have money to make these kinds of decisions, and I never did. And so suddenly having my first experience of paying for medical care outside of the insurance system was incredible and mind blowing and so upsetting because it was so good. It was the first doctor's appointment I've had in my life where I felt like the doctor was actually

seeing me as a person was on my side, was trying to understand exactly what I was experiencing and then was very invested in explaining to me exactly what was happening in my body and why I was experiencing what I was experiencing and what my options were. It was not prescriptive. It was not, hey, take birth control or like, don't bother me with this. It wasn't dismissive. It was taking me seriously and giving me options. I left that appointment with a list of other specialists I could call, and this is an appointment with a surgical specialist. And her answer was not, yeah, let's schedule you for surgery.

You have endometriosis. What we do for endometriosis is surgery. That's what it is. It was, surgery is one option, but in my opinion, the best way to treat it is to take down inflammation, which might address all of your symptoms and concerns, and we might not even need to do surgery. But at the very least, we should get your symptoms down and your inflammation down so that if you decide to do surgery, your recovery will be easier and better. And having those options,

being given resources and then being told, it's up to you. If you want to schedule the surgery tomorrow, we can, but it's up to you to decide what's best for you. And then of course, none of the specialists, none of the pelvic floor physical therapy, the integrative nutritionist, the supplements, none of those further steps I took were covered by my insurance,

but they helped me immensely and I was able to make those choices because I was able to pay for it. After the break with our sponsors, we're wrapping up our conversation with Kate, talking about the mental health impacts of fighting for care and being dismissed by doctors, the impact of periods on the economy and our wallets as a whole, and the toolbox Kate has developed to get through her period pain. Stay tuned. If you're serious about investing, you need to know about public.

What sets public apart is how they give you the tools to make informed investment decisions. They built their AI tool called Alpha, and it doesn't just tell you if a certain investment is performing well, it tells you why the performance is happening. So you can really understand what's driving your performance and your portfolio. The best thing about Public though, and the reason I'm really talking about them, is their retirement accounts. You can open up an IRA, whether that's a Roth IRA, a traditional IRA, and Public is the place to do it. You can fund your account in five minutes or less at public.com slash ffpod and get up to $10,000 when you transfer your old portfolio over.

That's public.com slash FF pod. Paid for by Public Investing, all investing involves the risk of loss, including loss of principal. Broker services for US listed, registered securities, options and bonds in a self-directed account are offered by Public Investing Inc, member FINRA and SIPC. Complete disclosures available at public.com slash disclosures.

Can we talk about the mental health impact of all of this? Right, we're talking about physical pain, and that is awful. And then you talk about going decades without any answers or any solutions and also just navigating all of this. What kind of mental health impact did this have? Yeah, I actually have an episode of the podcast where I interview my therapist about the mental health impacts of untreated and undiagnosed pain. And it's one of my favorite episodes. There are so many and the most interesting one that she brought up that I had never thought about was the gas lighting aspect. And this gas lighting is a word that is very overused in our parlance now, but when you are having an experience and you go to an authority figure or to someone who is supposed to help you with that and take you

seriously and the message you get over and over again is no that's not happening to you or what you're experiencing isn't real or isn't important or isn't legitimate, you experience a split in your, because at that moment, someone you trust, someone who is there to help you is negating an experience of yours, that creates a split in your perception of there is what I know to be true about my body

and my experience, and then there is what I am being told is true by the outside world. And that split, like, and we talk about like, we could talk about big T-trauma and little T-trauma. Like, did any of my doctors physically sexually assault me? No, that's big T-trauma. Like, that is a different kind of trauma, but we're talking about a kind of trauma that affects how you seek help in the future

How you think about your own body and your own experience how you treat others who have similar experiences? That stays with you and it causes you to discount a lot of other experiences that you might have That you might know are bad or like painful, but other people are telling you, no, it's fine. That's normal. That's there's nothing wrong with that. We're talking a lot about the individual cost, mental health, money, time, energy. Can we talk about, I mean, fuck the GDP at this point, but like, can we talk about the GDP impact of like, I think about all of the time, both the time we lose as menstruators to period pain and the energy loss. If I'm this powerful already, can I imagine

if I wasn't menstruating? My God. So can we talk about the larger societal impact too, of the impact on the GDP, how period pain really affects all of the outcomes of societal progress. Yes. Okay. And first, I want to dive into what you just said, which is, imagine if I wasn't menstruating, which is the trap we get stuck in constantly. This is what we get sold is that like what is what our bodies do naturally is there's something wrong with it because it keeps us from fitting into a structure that no, you're sorry, you're expected to.

And I'm not saying we have to love everything that happens to us when we menstruate. It sucks. It sucks a lot. No, but you're saying imagine if I was a round peg for the round hole, as opposed to what if the hole was square because I'm also square. Yeah. Exactly. Exactly. What if we had options to live in a way where menstruating didn't create problems, where things, structures were actually built to hold that. It's not that we would be more productive if we didn't menstruate, it's that we are seen as less productive at the time when we are have less capacity for it, when we

are probably overperforming during that summer, during ovulation, we are, but does that get focused on? No. So you're, there's nothing wrong with you. There's nothing wrong with menstruating. There's nothing wrong with your hormones being fucked up because they're in a fucked up situation. And so I want to make sure that when we're thinking about this and we're talking about this, especially when we get into talking about the GDP, we are not talking about loss of production or loss of value of an employee, like the problem is that menstruation is happening. The problem is that we live in a system that is not optimized for that and that is creating

friction around this totally normal, natural, crucial thing that our bodies do. With that said, yes there is a huge effect to period pain on the economy on an individual level and on an entire economy level. On an individual level, if you are a person who has a part-time job and only gets paid if you show up to work and you have severe period pain, you're fucked. Like you're fucked if you can't show up to work and you have severe period pain, you're fucked. Like you're fucked if you can't show up to work. And on an economy level, people, there is an estimation that it's something like $4,000 per person per year

in productivity is lost because of period pain. And that's not just people not coming into work, that's people coming into work but being in so much pain that they can't do the amount of work that they usually do. That's called presenteeism. And again, that's not the person with a period's fault. That is the fault of a system that doesn't allow us to rest and care for our bodies.

That's the fault of a system that doesn't take period pain seriously enough to treat it, so it's not a problem for that person. In terms of the entire economy, there's not a lot of studies about this, but the one that I did find out of Australia and estimated that the cost of period pain to just the Australian economy was about $9.5 billion a year. And so this is what like gets a bug up my ass so much is that like, yeah, we can talk about like how much,

like obviously how much period pain affects menstruating people's quality of life, but it also affects everyone. It affects shareholders. A mystery I still don't have an answer to is why don't pharmaceutical companies want my money? Like they are profit-driven or like profit-driven organizations.

There is a huge market of people who are in pain. I clearly would pay anything to not be in this pain. And there isn't anything for me to throw my money at that will solve this problem for me. I mean, there's oxycodone, which leads to other problems, right? So like there is stuff, but there's problems with that too.

But like, if you made a pill that made me not throw up when I have my period, I would pay you a thousand dollars a month for that pill. Like I don't want to, but I would. We've had a previous guest on the show and we've talked about this a bit, so I'm not going to get too much into it. But the other part of this is like we've all heard about, you know, developing countries where girls no longer go to school once they get their periods because they

don't have the products they need. They don't have the support that they need. So this is, we're talking really truly first world problems here too. Now, not to discount people's pain, but there's also, you know, as soon as you get your period when you're 12, you're done going to school. You're done thinking about any sort of life outside of your current lived experience. Your education's done. You're potentially, this is your time that you're now getting married off to someone much older than you. So that's the other part about this too that I think about all the time is, of course, the cost of you and I in the United States and anybody listening in, you know,

typically a more developed country, but there's also the folks who will never ever get any sort of health care, any sort of access to bigger, better opportunities because they're menstruators. Yes. And I don't talk a lot about that on my podcast because that is not my lived experience and I don't have expertise in that area. Like the whole can of worms. Yeah. Right, right.

And I think I believe in, you know, what is the biggest thing that's going to help the most amount of people and change the quality of life for the most amount of people? Yeah, the podcast I'm making about period pain is probably not the biggest priority for someone who was not able to pursue education or a life that they wanted because of the situation they were in. So yeah, there are certainly other priorities, but I also think we as a country like to look at how quote unquote bad things are in other places and focus on that. Rather than solving our own problems.

Exactly. Great. Yeah. Agreed. Yep. So my last question for you before I let you plug away, give us the remedies that have worked for you. Yes, okay. Someone's listening. They're like, I need help. Yes, it is.

So I have a toolbox basically. Like I, over the course of the last 22 years that I've had what I call death cramps, I have found lots of things that help some. And if you combine them all together, Like I, over the course of the last 22 years that I've had what I call death cramps, I have found lots of things that help some. And if you combine them all together, sometimes they help a lot. So first and foremost, ibuprofen, always the hero. One thing you have to be aware of with ibuprofen is it's very hard on your stomach.

So if you are a person who has stomach ulcers or other stomach issues, ibuprofen might not be the best choice for you. There's also naproxen sodium, which is sort of an alternative to ibuprofen, does very similar things. The biggest thing with ibuprofen, which I did not learn until earlier this year, is you have to take it before your cramps start.

Because it is a prostaglandin blocker, what it does, why it is so effective, is that it blocks prostaglandins from being connected to the receivers in the uterus or anywhere else in your body. But in order to be maximally effective, you take it before your cramps start. Why no one tell me this?

Why? Exactly. Exactly. I know it's so it's like how much pain could I have avoided if someone had been like, what if you start taking it before you get your period? It's like preemptive ibuprofen, I guess. Yes, it's prophylactic. It's literally, it prevents the cramps before they start.

It is annoying because it does mean you have to track your period. And like I have, I use a free version of a period tracker. It probably sells my data. I don't know, that's not my highest priority. So I use a period tracker and I'm lucky to have very regular periods. So I then put it in my Google calendar. I put a range of days that says period question mark so that when I hit and I try to make that start two days before my period is actually expected to come, when I get that Google alert, I just stop, I start popping a couple of ibuprofen and not even like every four hours, just like a couple times a day, just get it in my bloodstream,

get it going. And then if I start feeling the beginnings of cramps or I start bleeding, I start taking two every four hours. Again, not a medical doctor. This is information that I have heard from other sources and worked out myself. This may help you if you get severe cramps because a huge problem I would have is that pill window of like I would get cramps and then really quickly they would get so severe that I was throwing up and couldn't keep

anything down long enough for it to get into my bloodstream. So getting the ibuprofen in my system before the cramps even start, because a lot of times I get my period in the middle of the night and my cramps start in the middle of the night and I get woken up by having to throw up. Not pleasant.

So that was huge for me. Some people can take their ibuprofen once their cramps already start. It still works. It's just, if you have an issue with throwing up, if your cramps get so bad, sometimes there's like a runaway process with prostaglandins.

And you can just, if you can bite that, if you can nip that in the bud by taking it prophylactically, do it. So that's like the number one biggest thing in my toolbox. Similarly, and this is, this sounds a little woo-woo, red raspberry leaf tea. Red raspberry leaf tea is really effective. There have been studies that have shown that it is as effective as ibuprofen if taken before your period. Technically what it does to your uterus is something called toning, which I'm not totally sure what that means.

So if someone knows what that means, please contact me and tell me what that means. But pregnant people drink it before labor. It seems to just like increase circulation to the uterus and help it be healthier. So that works super well for me. And then once I got into loose leaf teas, I like started adding other stuff that is like anti-inflammatory, like chamomile and cinnamon and like it's delicious.

And it's so fun to be a little witch with my teas. But I also start drinking red raspberry leaf tea a few days before my period. The only thing that I have ever found that helps me once my cramps are already bad is Valium. And again, not a doctor, not doing medical advice. I didn't get prescribed Valium by a medical doctor. I got prescribed Valium by a psychiatrist.

Not, but still for cramps. Because I was on SSRIs, I went in to like have a checkup and he was like, how are you? And I was like, bad. I went to the ER for cramps the other day and it like didn't help. And he was like, oh, do you want me to prescribe you Valium? A lot of my patients who have periods like say that it helps them. And I was like, yes.

So I have a small prescription of Valium that luckily my current doctor believes me when I say it helps me and I get like five pills a month and I hoard them and if I feel like I might be getting really bad cramps, the ibuprofen hasn't been working or I didn't remember to take it or whatever, I'll take a Valium and that helps. Other people have told me that like muscle relaxants are really helpful, similar to Valium. Those are kind of the big items in the toolbox. Otherwise, I have found that like addressing my gut issues for endometriosis has really helped. Anything that causes inflammation that you can address really helps because any pain is going to be worse if you already have a high level of inflammation in your body. Meditating, it sucks. I hate meditating. I really hate that it

works. But anything you can do to take your nervous system down a few pegs and like help your body, remind your body you are safe, you are cared for, you're okay, maybe that's meditating for you, maybe that's something else, taking a bath, whatever, and gentle exercise the week before my period. So yoga, walking, moving but not stressing my body out. I'll also say everything that Kata said throughout this episode, right? The cycles, understanding when to push yourself physically or emotionally, socially, when not to, that is a huge tool that a lot of us don't have because again, we were never taught it. And so for me, the past couple years learning that is like, okay, I'm not going to go lift weights because it's going to aggravate my back

and potentially throw it out while I'm menstruating. So I'm not going to do that. So those are also, it's really important to understand your energy levels, how you're feeling at different points in your cycle, and then adjusting your calendar accordingly. That can be so helpful. But also thinking of that as a way that you are taking care of yourself and optimizing your energy so that you are able to give more when you're

able to give more and not that it's like a downside or like a shitty thing. I avoided taking care of myself for so long because I hated the idea that I couldn't do everything everybody else could do. And changing that point of view to like, I'm doing this so that I can take care of myself better, so that I can do all the things I want to do, rather than like I have to not do a bunch of stuff I want to do to take care of myself. Kate, thank you for your time. Thank you for your expertise. Thank you for sharing your story. I am so sorry your periods are as shitty as they are, but I really appreciate you helping

other people who need to navigate this as well. So tell me about Cramped. Tell me about where we can find you. Plug away my friend. Thank you. Thank you so much for having me. This is, I love this podcast. I have learned so many incredibly, I love this podcast. I have learned

so many incredibly useful things from this podcast. So the fact that I get to share something here is really, really meaningful to me. That's very nice. Thank you. So Cramped is a podcast, a limited series podcast, 10 episodes. It is out right now. It goes through my experience and my search for answers to my severe period pain, but it also is a deep dive into why this is an issue in 2025, why this has not been solved, and all of the different factors and areas of our life that we wouldn't expect it to touch, that it does touch, and it affects greatly. You can also find me on Instagram at Kate Helen Downey or on TikTok at Kate is cramped.

And I share a lot of things that I have learned from experts, especially on TikTok. Amazing. Thank you, Kate. Thank you. Thank you so much to Kate for joining us. You can listen to her podcast cramped wherever you're listening right now. And you can follow her on Instagram at Kate Helen Downey. Thank you so much as always for being here, Financial Feminists. We appreciate your support and I hope you have a kick ass day. We'll talk to you soon. Bye. Thank you for listening to Financial Feminist, a Her First 100K podcast. For more information about Financial Feminist, Her First 100K,

our guests and episode show notes, visit financialfeministpodcast.com. If you're confused about your personal finances and you're wondering where to start, go to herfirst100k.com slash quiz for a free personalized money plan. Financial Feminist is hosted by me, Tori Dunlap. Produced by Kristen Fields and Tamesha Grant. Research by Sarah Shortino, audio and video engineering by Alyssa Midcast, marketing and operations by Karina Patel and Amanda Lafue. Special thanks to our team at Her First 100k. Kalyn Sprinkle, Masha Bakhmakeva, Sasha Bonar, Ray Wong, Elizabeth McCumber, Darrell Ann Ingman, Shelby Duclos, Megan Walker, and Jess Hawks.

Promotional graphics by Mary Stratton, photography by Sarah Wolf, and theme music by Jonah Cohen Sound. A huge thanks to the entire Her First 100k community for supporting our show.