The Menstruality Podcast - 134: Natural Approaches to Menstrual Pain, PMS and Contraception (Dr Lara Briden)

Episode Date: February 22, 2024

What causes menstrual pain? Why do periods go missing? Why do we get PMS and how can we treat it naturally? What is happening in our bodies when we're on the pill? What is a good alternative to the pill? We hear questions like these all the time from our community, and in today’s episode we’re talking with a great ally of Red School, Dr Lara Briden who answers all of these questions and more. The conversation is an amazing resource, and one that we hope you’ll share with your friends who may be experiencing challenges in these areas.Our guest, Dr Lara Briden is the author of the Period Repair Manual: Natural Treatment for Better Hormones and Better Periods. She’s also the author of a second book - the Hormone Repair Manual: Every Woman’s Guide to Healthy Hormones after 40. She has treated 1000s of women with menstrual health symptoms, and has a wealth of wisdom and experience as well as an amazing capacity to make complex health topics and challenges seem simple. We explore:Why ovulation is so important, the common false narrative that the pill can regulate the cycle, and Lara’s five favourite alternative forms of contraception.Lara’s lifestyle and diet approaches for menstrual pain - they have supported 60-70% of her patients to relieve their pain. (And when to know if you could be dealing with endometriosis).Underlying health factors that can cause PMS, and how to make it a thing of the past through natural approaches.---Receive our free video training: Love Your Cycle, Discover the Power of Menstrual Cycle Awareness to Revolutionise Your Life - www.redschool.net/love---The Menstruality Podcast is hosted by Red School. We love hearing from you. To contact us, email [e-mail]---Social media:Red School: @redschool - https://www.instagram.com/red.schoolSophie Jane Hardy: @sophie.jane.hardy - https://www.instagram.com/sophie.jane.hardyLara Briden: @larabriden (https://www.instagram.com/larabriden)

Welcome to the Menstruality Podcast, where we share inspiring conversations about the power of menstrual cycle awareness and conscious menopause. This podcast is brought to you by Red School, where we're training the menstruality leaders of the future. I'm your host, Sophie Jane Hardy, and I'll be joined often by Red School's founders, Alexandra and Sharni, as well as an inspiring group of pioneers, activists, changemakers and creatives to explore how you can unashamedly claim the power of the menstrual cycle to activate your unique form of leadership for yourself, your community and the world. Hey there, welcome back to the Menstruality Podcast. Thank you for joining me today. I'm speaking with a great ally of Red School about some of the questions that we hear all the time from our community, like what's actually happening in our bodies when we're on the pill?

If we want to come off the pill, what's a good alternative to the pill? What causes menstrual pain? Why do periods go missing? Why do we get PMS and is there a way to treat it naturally? This conversation is such an incredible resource and one that we hope that you'll share with your friends, colleagues, family who may be experiencing challenges like the ones that I've just named. My guest is the amazing Dr. Lara Bryden. She's the author of the Period Repair Manual, Natural Treatment for Better Hormones and Better Periods. And she's also the author of a second book, The Hormone Repair Manual, Every Woman's Guide to Healthy Hormones After 40, which we looked at in depth in my previous episode with Lara and which I refer

to wrongly at the beginning of this conversation as her first book, so sorry about that. But as you're here, I was a bit giddy. I was very excited to be speaking to Lara because of her wealth of experience and her brilliant capacity to make complex health topics and challenges seem really simple. So let's get started with natural approaches to menstrual pain, PMS and contraception with Dr. Lara Bryden. So hi, Dr. Lara Bryden. Thank you so much for joining us on the Menstruality Podcast. Thanks for having me. I have so many questions. I've been really looking forward to this conversation.

It's nighttime here, early there for you. I've made myself a cup of lemon and ginger and honey tea, kind of inspired by being around you, makes me feel healthy. And yeah, I have so many questions, many of which have come in from our listeners and our community over the years but I just wanted to start with a little bit about your story if that's okay because you're called the period revolutionary you've written two books you know we had a good conversation about your first book um a year or so ago on the podcast. Yeah. And today I'd love to speak about really about the period repair manual. And I just would love you to share what got you into this work. What inspired you to start doing this?

Yeah, you know, I think the kernel, the seed of it all, I've only just figured this out recently. I went back and reviewed, it was actually a marine mammal laboratory study location in the West Coast of Canada, where I was for a little while as an undergrad. And I published or I did a couple of research projects there looking into sex differences in behavior and physiology. And then I went on to publish another peer-reviewed paper in sex differences in foraging behavior. And I just, I realized I another peer-reviewed paper in sex differences and forging behavior. And I just, I realized I've been interested for a long time in female physiology, even

way back when I was a scientist, before I became a naturopathic doctor. So then the progression from that was I just started practicing as a naturopathic doctor in the late nineties and most, not all, but a lot of my patients were women and they were all looking for solutions other than the pill or surgery or whatever it was they were being offered. And so I was able to harness what I'd learned as a naturopathic doctor and put that into practice and discover that it works extremely well. And that surprise surprise women's bodies actually know what they're doing and respond pretty well to just some basic support and we're not broken. And that makes sense because female is a normal physiological state. And the way I phrase it is female is normal. Male is the variant.

I mean, we're both normal, but like, you know, from a biological perspective is you know it's just as logical to sort of you know consider male the quirky variant to physiology so that's I think that was a big part of my work and then you know pushing back obviously for decades now on the pill to a large extent well mainly more just kind of false narratives that the pill can regulate the cycle and pill medications or hormones, like all these incorrect things that I just felt like women deserved to at least know the truth about what they were being offered. And that, just to give it as a case in point like sort of a case study that narrative that the pill can regulate the menstrual cycle as in cause of regular menstrual cycle

is um when women obviously that's not true because pill bleeds are not menstrual cycles the pill just actually shuts down the whole ovarian system and you don't have any hormones at all um apart from the contraceptive drugs that have kind of come in to replace them when women learn that yeah I just did a little poll on my social media about like how did you feel when you figured that out and they're pretty upset sometimes it's like that's just feels like that should have been dated right from the beginning of what we're really doing with these medications and occasionally i'll get like occasionally women say oh yeah no i

understood my daughter explained my doctor explained that it's they're not real periods and i just wanted to take it anyway and that's fine but that's not the message that a lot of women have heard so yeah thanks for getting right in there because i wanted to start by talking about the pill your book starts with the pill and there's so many reasons why people are put on the pill you named many of them and there is a false narrative around it but you know to not fall pregnant to ease pain yes help with acne and skin all kinds of reasons I went on the pill when I was like 17 to 19 really did not get on with it I felt like almost psychotic at times sort of from a mental health perspective I just knew I cannot do this yeah so that that sent me looking for other

methods but yeah could you explain just step by step what happens on the on the pill what happens in our bodies on the pill it depends somewhat which type of hormonal birth control we're talking about but let's talk about the combined pill the one with synthetic estrogen and a progestin, not progesterone, even though it's often called progesterone. It fundamentally works by suppressing ovarian function. So switching off that communication between the brain and the ovaries and suppressing estradiol, our main estrogen and progesterone. And for example, if you were to do a blood test for those hormones while you're on the pill, you'd see none,

like you'd see menopausal levels of those hormones. In their place, you have the progestin, whichever one is in that pill and estrogen called ethanol estradiadiol which is a synthetic estrogen it's quite different from our own estrogen in some ways and um just and um then the the bleed or if you if you dose if you dose the pill in the way that you're going to have a bleed it's really just a withdrawal bleed from those drugs so it's really just time to whenever you happen to you know switch to the sugar pills or stop taking those medications, you'll get a withdrawal bleed. And there was never any medical reason to do that monthly. From the beginning, the whole monthly thing on the pill was 100% just to mimic and kind of seem like a real period to

kind of make it seem a bit more... Well's a whole backstory to it actually just sort of you know mark like originally kind of in terms of um trying to you know push for the legality of the pill and get the church to accept it and stuff there was like this whole thing about oh it just regulates cycles so that started out as just kind of a ploy really to bring the pill to market and give women access to contraception but unfortunately that weird angle has become because at least one in three women take the pills not to avoid pregnancy, but to regulate their cycle. This is what I'm talking about. Like, you know, taking hormonal birth control to avoid pregnancy, obviously, you know, can be valid. And in that case, you're just weighing up the pros and cons and comparing it to other methods and women decide what they want to do.

But to take it to regulate the cycle is, that's why I started, you know, the interview with that example. And I just keep coming back to it because it was such a, I hate to use the word betrayal, but like that's how a lot of women feel. Like it was just such a, it's just, it just leaves women feeling very, yeah, dissociated from, you know, their bodies. And it's the opposite of body literacy, which is that, you know, knowing if and when you ovulate and what your cycles are doing. It robs women of their cycles. And we've had a lot of conversations on the podcast from different women and people who menstruate who have had terrible experiences with the medical world and lots of betrayal,

lots of dismissal. Yeah, that it's a it's a really painful and difficult story. I think it took me a long time to understand. I feel like it's only in the last five years or so that I really got that you don't ovulate on the pill. I know. Yeah And it's huge. This is a huge part of the betrayal. Can you explain why ovulation is so important for us, for our bodies, for our health? Yeah. Well, ovulation is the main event of the menstrual cycle. It's really the event of the menstrual cycle because it's how the ovaries do what they need to do, including how the ovaries make hormones. So the timing of the monthly is all about the timing of ovulation. That's how long it takes on average to ovulate and then have a two week post ovulation period. And that's the timing,

that's the monthly cycles. So if we're not, if ovulation is taken out of the picture, monthly means nothing. So, and one of my key messages as you know is ovulation is important for general health if not just for making a baby so ovulation is very crucial for making a baby obviously but it's kind of been then said well and then therefore I guess if you don't want a baby then you don't need to ovulate that's sort of been the narrative which is so bizarre because that would be like I feel like this is so bizarre because that would be like, I feel like this is a valid analogy. That would be like saying to men, you know, testosterone is only to make a baby.

So if you don't want to make, if you're not ready to make a baby, they'll just switch it off. Let's switch off your testicles and we'll replace your testosterone with this medication that's kind of like testosterone, but not really. And so it's going to make you feel quite different and affect your brain in different ways than testosterone would. But it's fine, because that's what everybody's doing. That's sort of the logic of it. And so we know from the research, it's not just me saying this, that regular ovulatory, as in natural, as in when

ovulation occurs, menstrualal cycles proper menstrual cycles builds health so every you know month we make the beneficial estrogen estradiol and progesterone and those are good for the brain and the bones and the heart and the immune system and you know that just builds health over the the decades and also having a pregnancy is another way to make a lot of hormones and that also i would argue builds health to an extent so by switching it off like for decades is going to impact health and we know that from the research so we know that certainly for bone health we know especially if women girls go on the pill quite young they're they're missing out on their opportunity to have achieve what's called peak bone density and there's starting to be some bit

of inklings of research that you know that's going to translate into other long-term you know risk factors for heart disease and other conditions that professor geraldine prior who you may have had on the podcast and if you've had uh she's a canadian endocrinology professor not yet but we really need to have her on you do need to so she is the absolute champion of ovulation like like she dug in 40 years ago to start talking about ovulation and never let up and she has published like over like 100 or at least a hundred or 200, not if it's 200, but it's over a hundred peer reviewed papers on the benefits of ovulation and pro, so natural menstrual cycles, reduces the risk of osteoporosis, dementia, heart disease, and breast cancer. And by breast cancer, she's tying that in because the progesterone that we make with our natural cycles, arguably, she argues anyway, that helps to reduce the long-term risk of breast cancer. So yeah, there's a lot going on with our cycles,

and they're important. And I think we're, I could say to say, you and I are both cheerleaders for natural menstrual cycles and all the things they give us in terms of general health. And obviously in terms of, you know, more broadly just our enjoyment of life, you know, the hormones every cycle, or we tend to, you know, some narratives kind of think of that as a bad thing, but obviously hormones are their life, you know, are their life you know they affect the brain they affect mood they're yeah they're great yeah and as alexandra and sharni share in their book wild power it's actually an initiatory process the menstrual cycle it's my experience of

it and the way we teach it at red school is it's calling us home to ourselves it's showing us how to be our full selves and be be fully in our power so yes i'm a massive champion of ovulation too yeah so i just a note for anyone listening who is on the pill or has been on the pill for a long time or was on the pill for a long time i just think it's important to say we don't know what we don't know at the time and not beat ourselves up for it. And as you share in the period repair manual, you can recover, you know, you can recover yourself from the pill. Could you share a bit about that? You can.

I mean, the body's pretty resilient. I think it's never too late to start ovulating and get the benefits of that. And yeah, I certainly don't want women to feel like, you know, I mean, they're probably natural to feel somewhat sad about it. But like, there's no reason to feel like shame or anything like that. Because this is just the generation you grew up in, you know, this was the pill has been very normalized for the last two, it's really only been three generations, actually, I think I do predict we're going to look back on this as a kind of very weird time, the era of the contraceptive drugs when it was very normalized but you're not to everyone

listening you know you're not alone certainly i've had lots of patients who've been on the pill for decades and come off and still get to you know have some you know benefits from their own cycles the other thing worth mentioning before we leave the topic of you know i might move on to some other things but um for what it's worth it's an interesting point because the hormonal i do mention the hormonal iud or the hormonal coil um i'm still not a huge fan of it to be honest but um it doesn't suppress ovulation the way the pill does so that's why i kind of clarified at the beginning we're talking about the combined estrogen pill um the hormonal iud is one of the only really the only type of hormonal birth control that can

permit ovulation. Usually it only does so in older women who've got kind of a more robust ovulation. Young women tend to, their ovulation can be more easily suppressed, which makes sense in a younger body, like just kind of a bit more sensitive to things. But yeah, so I guess I offer that especially for anyone out there who's dealing with really difficult symptoms. And we are going to talk about some natural treatments for symptoms today, but I just think it's kind of useful to know that, I mean, there are a bit of nuances here that if something is really, really needed to control pain or bleeding, whatever it is, sometimes the hormonal IUD can be an option, especially in the short term, because still cycle, you still chart potentially on the

hormonal IUD. Yeah. So, yeah. Yeah. I'd like to speak about the alternatives actually, because obviously the pill ushered in so much freedom for women and it's important to, to name that, you know, I'm, I love call the midwife. I don't know if it's a show that you watched. Yeah. There was a time when the pill came in and the women went from just having to have babies after babies, after babies, after actually having some choice and some freedom. Obviously, contraception is so, so important. And you clearly name five alternatives, I think, like natural approaches. Could you run us through them?

Yeah. Well, let's just go through them quickly yeah because we're on the same page you know women deserve well you know everyone deserves access to safe and affordable and you know methods of avoiding pregnancy but I have to start with condoms because I really am a fan I just think you know I don't know about you but I've sort of picked up on some vibe from the younger some of the younger, younger patients that they don't really think condoms are a thing or they think they don't work or I'm like, well, they work, you know, they're yeah. So especially young people need to know that. So that's the thing. And I guess I usually,

especially for maybe teenagers or young people, I would combine that. I think a really potent combination is condoms every time and then easy access to, I don't know what you call it in the UK, but the morning after pill or the Plan B, which is really just like a big dose of the pill that suppresses ovulation. So it's just like suppressing ovulation that month in the unlikely event of a condom mishap rather than suppressing ovulation with month in the unlikely event of a condom mishap rather than suppressing ovulation with the same drugs every month. That's kind of how I see it. I just feel like women should have easy access to that. And of course, it goes about saying condoms for sexually transmitted diseases, just absolutely vital. Yes. Of course. And I went out, I really

should have a little clip. Someone interviewed me a couple of years ago and she went on a little rant, but because, because a lot of, we, I go on to, we'll hear when my patients will say, Oh, but he doesn't want to wear a condom. And she was just like, too bad. If he wants to have sex, it's like, okay, condom or nothing. Like that's, you know, that's what's on the table here. So, I mean, that's being a bit a little bit maybe but like i think yeah i think they can uh they can wear a condom like it's not that hard um and also it's important to get condoms that fit and a good quality one condoms come in different sizes this is really actually quite important so

like you wouldn't wear a shoe that's the wrong size i think men need to get a to have you know have it work and be size i think men need to get a to have you know have it work and be more comfortable and they need to get one that works so that okay so condoms and then um well there's the coils so i did mention the hormonal one already there's the copper coil or copper iud it has pluses and minuses of course like anything um for what it's worth though it doesn't suppress ovulation or affect hormones at all, I would say. So it's actually quite popular with some naturopathic doctors. And it's definitely a highly effective method that you can still cycle and still have all your natural hormones.

And it does make periods a bit heavier. And it potentially affects the vaginal and uterine microbiome. So there's some downsides. I have a couple of blog posts called the pros and cons of the copper IUD and the pros and cons of hormonal IUD. So people can check that out. So condoms IUD. Obviously, the most in my space or natural health space, the most popular hands down is fertility awareness based methods which are all the different variety of ways you can harness the power of fertility awareness to in a very meaningful way avoid pregnancy you have to do

it properly though you have to either know what you're doing or use one of the approved algorithms or i don't do you guys have a if you have specifically recommended resources we can put that in the show notes or yeah we have an episode with a firm practitioner um that i can link to that describes the process yeah yeah and this as you know there's different this technology now there's a couple different approved kind of algorithms for that so it can be done it just i just for everyone listening it's not just a matter of looking at your phone app and seeing when your ovulation window is on your like random phone app. Like that's not going to do it. Like you have to kind of know what you're doing. But it's, it can be effective if you do it right. And so the next

one, so condoms, IUD. I'm going through my head. Yeah. Fertility awareness. I mean, there's obviously things like cervical cap and diaphragm. Those kind of less popular now but those are still options there are other barrier methods i know what it was it was a potential injection coming in for men yes well that was that's one that wasn't even one of my original five but i was going to mention that one today too so this is um they're called vaso-occlusive methods they work by temporarily blocking the vas deferens, which is the tube that puts the sperm into the semen. So there will still be semen, there'll still be an ejaculate, but there will be no sperm in it. And it's done as a in-office procedure with a needle, basically a local anesthetic and a needle and inject the gel. And it's been in the,

it's been in some kind of available in some countries for a while. There's different methods, different brands of it. But one of the methods is currently being clinically trialed in Australia. And I'm so happy that I, you know, I have a connection with Australia. I'm not, I'm Canadian living in New Zealand, but I did live in Australia for a long time. So I just love that Australians kind of stepped up and are doing this. And I know a lot of the pushback on that is, oh, well, men won't do it. But apparently when they launched, they started asking for participants for this study. There was so much interest, the website crashed. Like they got just hundreds of men putting up their hands saying they'd try it, they'd do it.

So I think men are interested. And i think that could be an absolute game changer because it doesn't affect their hormones um every expert i've heard talk about it said it's very likely to be safe obviously they're looking for any unexpected complications but um yeah yeah thank you yeah what goes on then to share more about like what a period should look like all the things that can all the challenges that can arise and you go into them in detail and I'd love to look at three specific areas where like most of the questions come in about menstrual pain restoring missing periods and PMS so starting with pain you know one of the reasons why a lot of people take the pill is because they're dealing with extreme menstrual pain you met you referenced this earlier but does the pill

work as a way to address the pain like what's happening there that's a good question i mean i think anecdotally it does i mean as it partly as in they're not like, well, they're not real menstrual cycle. I mean, there's still a bleed in the sense that the uterine lining is shedding, but the uterine lining would not have undergone all its normal kind of hormonal changes as it would through a menstrual cycle. So I think maybe that's one of the reasons pill bleeds can be less painful than kind of menstrual cycle bleeds. Some people still have painful pill

bleeds though too. So it's not a guarantee. And I guess, okay, I'll try to simplify this. So there's a lot going on with pelvic pain, period pain. There could be lots of different potential reasons. And, you know, one of the big reasons is something called endometriosis. And that itself has been an extremely controversial topic. And there's lots of different viewpoints about that. And even my thinking on endometriosis has shifted a little bit. Another guest for your podcast, maybe I'll just name drop is, if you haven't had her already, is Dr. Peter Wright.

She's a Brisbane gynecologist. She wrote a book on pelvic pain. She zoomed out on endometriosis and just kind of talking about pelvic pain more generally and looking for drivers of pain, almost regardless of whether the diagnosis of endometriosis is there, which is a little quite radical, actually, you can get it all straight from her. So I won't try to paraphrase her or anything. But yeah i mean pelvic pain and pain during periods is affected by inflammation affected by the gut microbiome it is affected to hormones to some extent but not just that it's affected by the nervous system in the pelvis and you know muscle tension in the

pelvis so there's a lot going on and what that can mean though is there's lots of different ways to improve period pain and you could talk more to peter dr peter about that but mean, though, is there's lots of different ways to improve period pain. And you can talk more to Dr. Peter about that. But what I'll say is with my patients, especially teenagers, I find teenage period pain can respond incredibly well. And basically, I don't want to be coy about it at all. Basically, in my experience, a lot of the time, if you just take a few months off normal cow dairy, and I just had a podcast about that and why potentially that's it's to do with how it um normal kind of cows dairy that has a1 casein can in some people not everyone but it can create this immune reaction with mast cells that can

definitely contribute to pain everywhere and period pain so it's just been something i've observed for almost 30 years of clinical practice. So that combined with zinc, because a lot of young women are walking around like zinc deficient just for different reasons. Zinc is a really important nutrient. It's very inexpensive too, which is why I love mentioning it because it's like you can buy it anywhere. And it really, one thing, if you're going to try it, please take it with food. Because if you take zinc on an empty stomach, you could feel sick to your stomach and I don't want that to happen so it's one little thing about it other some other nutrients i talk about in period repair manual can be helpful too

like magnesium generally being fully nourished and healthy and having a healthy digestion all of that can translate into less period pain because our periods are not separate from the rest of our health this is one of the rest of our health. This is one of the key messages of period repair manual is like fix your health and you fix your periods. They're connected. It's not in a, you know, separate too hard basket. So a lot of these things, yeah, I find, so what I generally would say to my young patients is let's just try like not overcomplicate, just, you know, switch to goat or, you know, plant milks for, you know, including avoiding normal cheese and ice creams just for a few months. Not, it's not a life sentence,

but just like for a few months, try it, take the zinc supplement, you know, try to be gentle with yourself in the days leading up to your period and your period and do a bit of movement can really help as well. And especially during the premenstrual time and see where you're at, see how that goes. And some of the time, like at least, I don't know what percentage, like at least 60, 70% of the time, that's it. Like they're pretty good. And I've had so many patients were like, Oh my goodness, my period just arrived. Like I didn't even, you know, I didn't even feel anything. Is that, you know, we're so used to periods being heralded by all these symptoms that the period should actually just arrive with no nothing to maybe some subtle changes as you guys explore in the red school, like subtle changes in energy and mood. And that's fine, like, some of those simple things make no

difference at all, then I am starting to wonder about endometriosis at that point. That's kind of my test for endometriosis is then I start to think, okay, maybe we're dealing with something a little bigger here. And we won't go into that today. You can talk to Dr. Pita about that. But there's other strategies then to kind of get some help from endometriosis. That's really helpful. So I did have a question, you know, when should you go and see someone about menstrual pain? And it sounds like, you know, try these lifestyle and

diet things and see what happens. And then it might be time to go in. Yeah. But another key message is the debilitating pain is never normal. So this is one of the things with endometriosis is, you know, generations of women have just been told, oh, just, you know, just deal with it. That's just what periods are like. But no, periods should not be, I would argue that periods shouldn't really be painful at all. Although a little bit of, you know, mild pain that can be relieved by an ibuprofen, you know, that's fine. Like I wouldn't read too much into that but debilitating like curled up in a ball can't go to work crying vomiting that that is

not normal and I get I so I do think yes you should see a doctor about that the thing is though what I'd actually say read up my and Dr. Pita's books and then see your doctor kind of maybe see it with that with that context because the truth is as we've said that you probably in many cases go to the doctor you will just end up on the pill and i just just say again that's not the even if it can give relief you know maybe use it for a few months to get some relief but then look at i would say go deeper and get some other solutions so that you can have the benefits of your bones and cycles and also not have pain it shouldn't be a trade-off between

having cycles and being in pain like that's not that's a false dichotomy I'm going to pause this conversation for a couple of minutes to invite you to join us for our menstruality leadership program which is starting on March the 22nd and the doors are closing on March the 14th. This program is for you if you know or you sense the power that lives within the menstrual cycle, within menopause, within your cyclical nature perhaps you've read alexandra and shani's books wild power or wise power and you feel called into an apprenticeship with your cycle or with your menopause process as your tailor-made inner guide to self-care to vitality to health leadership if you're suffering with menstrual pain with end endometriosis, PCOS or any of the other

menstrual health challenges or symptoms that we're exploring with Lara today, the MLP can hold you and support you to find a meaningful context that can help you make sense of your underworld initiatory healing journey. You can find out more about the menstruality leadership program at menstrualityleadership.com. That's menstrualityleadership.com. And just before we get back to Lara, I want to share a quick story from one of our menstruality leadership program graduates, Dr. Cree Dai, about her experience of the program. I am excited to share why I chose to participate in the Mr. Alley Leadership Program with Red School. And so coming across Red School was just like a gift because I think the way Shani and Alexandra have put together this work,

it's just so life-giving. Some of the things that I've discovered or experienced while being in the training, and I haven't stopped following them yet for other trainings or other offerings that they have, is that how much I need us. I need us as women, how much I need us. And it really saved my life. Like participating in the menstruality leadership program told me that one thing that I really knew all along is that there's nothing wrong with me. Like I'm not crazy. All of these things that I'm experiencing, it's OK to be who I am and how I show up in this world. My inner landscape has grown. All of the little community inside of me has grown. And I get to live that out as a leader in all the things that I do. As a therapist, I integrate this work into working with individuals,

not just women, not just people with wombs, but also with families, with men, with my son. They are aware of my inner seasons. They're aware of when I am in my inner fall and it's time for me to just slow down and have some time with myself. The way that Shani and Alexandra teach, it is it's like it's like you're talking to a family member. Right. They don't know this, but I actually describe them as my mentors. Because once I had one session with them and I just sat with them and it's just like we're talking in a video that I'm listening to of them, I'm like, oh, they're my mentors. How about recommendations for finding a gynecologist or a doctor who might know a bit more about how to treat? They're out there.

And I don't, I kind of want to name drop you. I was just in the UK. Name dropping, please. Yeah. I did a little event at Oxford University with, and we had quite a few GPs and a couple of gynecologists in the audience talking about doing things differently. I'll email you the names. I mean, I can't remember all the names that were there. And I hate to leave anyone out. And they're out there. There's definitely a few doctors that are just, yeah, trying to do things a little differently. I mean, another way to I have some in period of per manual, I do have some how to speak with your doctor sections. I mean,

you could say to the doctor, look, I'd really prefer not to try some months without the pill. So are there ways I can, you know, working on, you could say I'm working on my diet according to some of these things I've read. And also maybe I'm just going to use like another strategy is just, I talked about ibuprofen or what would you call it? What's the brand name there? Like a, yeah, we call it ibuprofen. Yep. Yeah yeah just kind of timing that if you time that just before the period and during the first day or two i mean it's obviously that's not a natural treatment but it's in you know it's if you're only taking it a two or three days a month that's definitely viable so you could talk to the doctor about strategy like that and also for young

people listening um painful periods can be outgrown too. So there can, as the hormonal system matures and you start to make more progesterone as you get, you know, kind of stronger ovulations. And some women find that period pain sort of reduces, and there's probably other factors with maturity too, that it would reduce. So I don't want young people to think like if they've been hit by some really frightening periods early in their teen years I don't want you to think that's how it's always going to be now like that's you know that's not the rest of your life there's there they the periods might just improve on their own to some extent depending on yeah whether endometriosis is present or not. Oh, it's so helpful. I mean, dairy made a huge difference for me.

I had chronic pain outside of the cycle as well. And as sad as I was to say goodbye to cheese and ice cream, although there are some really good alternatives now, plant-based alternatives, it's made a tremendous difference to my health and my pain levels. I mean, I don't experience it. And actually after having a baby,

my, yes, any menstrual pain at all now yeah I was gonna say that and that is a very real thing a lot of period symptoms do kind of reset or improve after pregnancy but I just want to point like if there has been a history of doctors so I don't want to be in the category of saying oh you can fix your problems by having a baby because obviously that's not a reason to have a baby. And so women, you know, shouldn't be given that as a, and I know that's not what you're saying, but like, you know, there's sort of a bad history of that of doctors saying, oh, just get pregnant and you'll be fine. But for people who are wanting to get pregnant and that's their journey anyway, you can know that a lot of things, not just period pain, but things like PCOS

and some of the other things can just, pretty much disappear after pregnancy yeah let's talk about missing periods so obviously when you come back off the pill it can take a while to get your cycle back if you've been on the pill could you say a bit about that like how what the process of the pill and getting your cycle back? Yeah, well, the very first thing to understand, which I think people will understand from what we've already said today, pill bleeds are not periods. So the last, so when I'm working with patients, they're like, what's going to happen to my period when I come off the pill? It's like, well, what were your periods like before you went on the pill? And, you know, if that was 20 years ago, you be like well you're also 20 years older so we might have to factor that in but in general you know

whatever was happening with your periods before you shut them down with the pill is probably still there right like it's you know the whatever the problem was so um if it was missing like a scenario might be um you know piece i mentioned something called polycystic ovary syndrome or pcos that can cause irregular periods that is not fixed by the pill it can be you know sort of masked by the pill but that's likely still there although it's the pcos is affected by other factors including some women outgrow it um and then also just and i know we're talking about um irregular periods right now but like even other things like premenstrual mood symptoms and pain it's like whatever was there before you took the pill that's still there like it's still gonna it's not like it yeah so people say well i stopped the pill and i lost my period it's like well you the last period you had was 10 years ago

so we have to think about what was happening then. Another scenario might be women who are tending to under eating, which is a very, sadly, a very common reason to lose a period. And that can be, even that can be masked by the pills. So you can, if you're having zero periods, because you're under eating, whether intentionally or unintentionally, and then

you can force some bleeds with the pill for a while and then come off and the periods are still gone like you still have to address that underlying um to eat enough to ovulate and get a period um so it's a it really does require troubleshooting and i know that's harder like we'd like we'd always like to be like okay this is what you take when you stop the pill to get your period. Like it just doesn't work like that. Cause you have to be a detective and think what does the body need? Like what was happening? What is, what is standing in the way? Cause with the starting, with the starting place of the,

your body wants to ovulate. It wants to have a regular period. It would like to do that. It's trying to do that. So if it's not doing that then something that's what i called i called them obstacles to ovulation like something is preventing it so that something could be under eating it could be pcos that something could be a totally unrelated thing like a thyroid disease or something like and this is why the doctor has to rule out like actually one of the classic ones is gluten sensitivity or celiac disease can so i you know once saw a quote in a paper saying every single case of amenorrhea or infertility should be

screened for celiac because gluten will so right so a gluten sensitivity or celiac disease is a very good way to lose a period but not everybody who's lost their period has a gluten sensitivity or celiac disease is a very good way to lose a period but not everybody who's lost their period has a gluten sensitivity right so yeah yeah i'll put a vote in for coming off gluten as well because that's been vital to my pain pain relief okay so coming back to the pill some people come off the pill and think oh i'm gonna have my period straight away is it the fact that they don't get it again is that just because the body's trying to kick back into gear and that takes a while yeah right okay so let's think of someone who was having regular periods before they went on the pill so that their starting place was regular periods and then they go on the pill or or injection or implant as well right also, or the mini pill, those all suppress ovulation.

And then, yeah, when they stop it, they don't, well, you know, in terms of the combined estrogen pill, that's been forcing a regular bleed. So then you stop it, you're not getting those forced bleeds anymore. And so then there's going to be some lag time as your body ovulation kicks back in basically, because your body ovulation kicks back in basically, because your body hasn't ovulated in however many years. And there is a bit of research around that. So the time, so for a healthy woman who was ovulating and then stops ovulating on breast control and then tries to start ovulating again, when she stops it, it's anywhere between, I think three months to 18 months, sort of depending on the type of contraceptive drug that's been used and also depending on the woman.

So, you know, she like, yeah, it sort of just depends on how, you know, how many, one of the most important things is how many cycles a person managed to have before they suppressed ovulation with hormonal birth control. So with my patients, I'd be like, how many years of cycling did you have? Because as many years of cycling as you can get under your belt before suppressing ovulation will really help because the body already learned how to do it to some extent, right? Like, yeah. So it's like, oh yeah, I know what to do now. The brain and the ovaries can start talking to each other again. So that's kind of where there's,

it's going to be quite a big variation. Like there's no, you know, you can, no one can say, oh, it's going to take three months to get your period. Or, I mean, it could take longer, could take six to 12. And one of the things that can happen, and I've talked about this a few times,

is we have these like, these metrics, or be like, okay, if you've been trying for pregnancy for 12 months and you don't fall pregnant, then that's infertility kind of like that's sort of the official. Um, but I'm like, that doesn't work if you are like that, that's, they shouldn't be counting. That should be 12 months of trying when you're ovulating. So that should be 12 months of with regular ovulations and you haven't fallen pregnant okay then that's obviously something's not happening but that shouldn't be 12 months where you're just waiting to get your ovulation back after stopping the pill like that the the counting the 12 months should start after you

start ovulating yeah so there's definitely something for people to think about who are wanting to conceive like it just that there needs to be some time factored in yeah you can't just your body can't just like it's not a switch like. Like you can't just go boom. Okay. Okay. Brain and ovaries go. They might, they're going to need a bit of time and that's natural. Yeah. Yeah. Thanks, Laura. This is all so good. Can we come back to PCOS? Yeah. Could you explain briefly as you are so good at doing what is happening in the body with PCOS yeah it's the situation of androgen excess so androgens being testosterone like hormones um when all other causes when all other explanations for those hormones for androgen excess have been ruled out

so there's other to be fair there's other reasons for androgen excess so this is where you know the doctor has to you know rule those out and look at that. But basically, and this is a, I phrase it this way, because there's lots of weird myths about PCOS and things it's not and things that it, so it's primarily fundamentally about androgen excess. And that's where the symptoms of facial hair, strong jawline acne, weight gain around the middle, lack of periods. It's all associated with a disruption in the communication between the brain and the ovaries. So rather than progressing all the way to ovulation, we just talked about ovulation is how you make hormones. So normally with the communication, you make estrogen on your progression to ovulation, and then you

make a huge amount of progesterone after, and all of that pushes down, both estrogen and progesterone push down on testosterone. So in a healthy, normal situation, there's a little bit of testosterone around, but mostly kind of estrogen and progesterone. And when testosterone, and the ovaries are, and with PCOS, there's different types of PCOS. So sometimes the adrenal glands are making quite a lot of testosterone that's different, but in the normal classic situations, the ovaries that are making more testosterone than they should be. And it's just not allowing ovulation to progress. And then you're just not getting the estrogen and progesterone coming in. So you kind of just stalled, like you're not getting these feedback

cycles that are supposed to be happening. And I did mention that you can outgrow it, actually. And if you do manage to ovulate and start having more ovulations, you can actually outgrow the androgen excess to some extent, which is a continuation of the fact that all young teenagers, so all kind of prepubescent girls are, which is a continuation of the fact that all young teenagers, so all kind of prepubescent girls are pretty much in a state of temporary PCOS. It's not really called that, but like they, they're kind of androgen dominant at that age. And then ovulation kicks in and then estrogen and progesterone kind of pushed down on testosterone. But part of the confusion around PCOS is, is the name, you probably know this, right? The polycystic

ovary, the whole, the fact that cyst is in the name has been very confusing for people, including doctors. It's not about the cyst. Okay. For one thing. So to be clear, there are, there, there are, there is such thing as ovarian cysts and there's all different types and ovarian cysts can be a problem for sure. And they need to be diagnosed. And there's, you know, that there's, that's a whole other conversation with cysts shouldn't even be in the name because they're not cysts. They're really, really just what happens is if there's no ovulation, then lots of little follicles kind of form and none of them progress to the big dominant follicle involved in ovulation. So you have this arguably higher count of small follicles that at one point was called polycystic, but it really shouldn't have been. And the presence, like an ovary with lots of tiny, small follicles and

no egg or follicle that's ovulating is not unique to PCOS, right? Like that can happen for different reasons. Like women who have lost their period to under eating can have ovaries that look like that. Younger women, teenagers, and this is why categorically they say teenagers should never be diagnosed with PCOS based on an ultrasound for sure. Because teenagers, they already have lots of follicles because their ovaries have more eggs. And they're not ovulating as regularly because they're young and still trying to figure out how to do that. And so their ovaries have more eggs and they're not ovulating as regularly because they're young and still, you know, trying to figure out how to do that. And so their ovaries are going to look polycystic a lot of the time, and that doesn't mean anything. So I hope that's helpful because if I would just say to anyone who's been so-called diagnosed with PCOS based

on an ultrasound, you need to just reject that. Like you might have PCOS, you might legitimately have it, especially if you have those symptoms that I talked about, like facial hair, strong jawline, acne, or waking around the middle. But if you don't have any of those symptoms and your cycle's regular and the existence of polycystic ovaries on an ultrasound means absolutely nothing. And I just, this is, the medical world is ready for like a major shakeup on this. And I've seen a few, not just me, it's not just me saying this. I've seen lots of papers lately from experts saying, okay, we need to rethink how we talk about this and try to diagnose it because the ultrasound is not working, which is not to say that ultrasound studies are not

useful for other things. They totally are. I mean, an ultrasound study can help to diagnose an ovarian cyst, which is, as I said, said a different thing and so it's fine to be sent for an ultrasound just don't just be very careful about not thinking you have pcos based on that thank you thank you for busting the myths for us can we talk about pms for the last five minutes or so yeah there's a chapter in the book chapter three the PMS solution three steps to hormonal resilience and I want to read a quote from it because I think it's really exciting let me start by saying flat out that for most of you PMS can become a thing of the past I'm serious PMS responds well to natural treatment and it responds quickly it will be the first thing

to change on your monthly report card. That's exciting. Could you walk us into what is causing PMS? What's going on with PMS? Yeah. Yeah. We can take a few more than five minutes if we have to here. I might need a few more than five minutes. So it's, as you referred there with my phrase, you know, monthly report cards. So our periods, our menstrual cycles, and any symptoms we may or may not experience

with them are to a large extent an expression of general health. So this is even more true with premenstrual mood symptoms because kind of whatever degree of inflammation is going on can potentially show up in premenstrual mood symptoms. And it's because the problem is not the hormones themselves. So actually what we found is in most women who have people who have premenstrual mood symptoms or not, they pretty much have the same kind of hormones going up and down. The issue can be how the brain adapts to those up and down hormones and that adaptation, that healthy kind of resilience or what I call in the book, hormonal resilience, that ability of the brain to just be like, oh, right.

Oh, progesterone is going up. Oh, it's going down. And now estrogen is going down. Like it needs to ride that up and down. And that requires just a degree of resilience that comes from being fully nourished that comes from a nervous system that is you know stable and happy and supported in lots of other ways which is why there's a strong correlation between just chronic stress and premenstrual mood symptoms there's also a strong correlation which is i don't really talk about in the book but between you know

history of trauma and premenstrual mood symptoms. So like whatever the nervous system is sort of is dealing with is going to arguably manifest the strongest during those natural ups and downs in the luteal phase. So the solution is to stabilize the nervous system and primarily, and that can look like different things for different people. I do have a podcast. I'm trying to remember the name. One of my podcast episodes is like six natural treatments for premenstrual mood symptoms. So I do talk about various things in there, including the role, and I'll mention it here is of histamine. So kind of the mast cells and that part of the immune system, it's very active in the brain. And a lot of the symptoms of premenstrual mood symptoms are very close to symptoms of high histamine, sort of anxiety, irritability,

even like fluid retention and rashes and headaches and kind of agitation that a lot of that can look like histamine, which is why I know it's almost diagnostic actually, when there's and kind of agitation that a lot of that can look like histamine which is why i know it's almost diagnostic actually when there's that kind of pms picture an antihistamine can relieve it and there's lots of you know reddit forums and people sharing stories about relieving their pms with various types of antihistamine medications i would take a um my natural approach we already talked about dairy is normal cow dairy normal Friesian cows is contains a type of casein or protein that can in some people really part of what it can do is activate mast cell and histamine that part of the immune system so that is one reason that avoiding dairy can also relieve premenstrual mood symptoms.

So it's important to be fully nourished, like with iodine and magnesium and protein, and a lot of those things can help. It's true what I say in the book, like it's my favorite thing to treat because a lot of the time, not all the time, it's always going to be people, you know, and probably people listening are like, oh no, I've got a very tough case. I get that. I mean, sometimes there can be, you know, very stronger symptoms in a stronger case, but it's pretty resilient. And it can, a lot of the time symptoms can just go or if they send your symptoms sometimes come back, then it can it can be like a good report card. It's like, Oh, yeah, I was jet lagged. Or, you know, I had alcohol is, you know, went out and stayed out late and had alcohol and all of that can translate into premenstrual mood symptoms, like a week later or something, you know, the nervous system

is sensitive in that way. So it's, it can just be information too. And kind of like the way you guys do at red school, like just observing, like not being frightened or upset that, you know, things are going to be a little different in the different parts of your cycle. And like another example would be, it's normal to be hungrier during the luteal phase. Like it's just straight out normal. So one of the things, I think I talked about it in period of perimanual, but certainly in my new book, which is coming in a few months, I talk about. Oh, wow. What's your new book? It's on metabolic health. It's normal to be hungrier in the second half of the natural cycles.

So rather than like be distressed by that or fighting it or upset, like I would say just embrace it, like step into it. It's like, okay, I'm just going to make bigger meals. I need more food. I need more protein. I need, you know, a protein snack in the afternoon or whatever it is to support the body can really help as well. Yeah, that's covered some of the broad points on,

I think on premenstrual mood. And for what it's worth, people, a tendency to strong premenstrual mood can eventually translate into a tendency to perimenopausal mood symptoms. I don't know if we maybe talked about that in our last podcast, but yeah. Yeah, you shared a lot of really important

information in that episode. I'll link to it in the show notes. So yeah. And it's really moving what you said actually about the stabilizing the nervous system and that there's such a big connection between inflammation, stress and trauma and PMS. That was definitely true for me, but then fascinating that you brought in the histamine because that's something that I've only just plucked in the last couple of years like after I gave birth I drank loads of bone broth loads and loads and loads and I felt awful and then I learned that bone broth has a lot of histamine or amines yeah it has so bone broth and like fermented foods and like kombucha and stuff like that for some, for kind of people who are sensitive to histamine can, all of that can feel really not good. Like just kind of make it feel like jittery and edgy.

It's such a complex, nuanced picture for each of us, isn't it? And like you said, it's about turning towards ourselves and being a detective and looking at what's going on and getting advice from people like you. Yeah. I just wanted to share something at the end from your book which is about for me speaks to the power of menstrual cycle awareness because you were speaking about one of Dr. Jolynn Pryor's studies at the start of the book a one-year therapy study which um where 50% of the women 50% of 61 women with menstrual challenges were able to reclaim regular healthy cycles.

And the conclusion that she drew, likely due to learning more about themselves in the supportive environment of the study. An evidence-based indicator that menstrual cycle awareness, particularly in community, is powerful medicine in and of itself in terms of the nervous system regulation stabilizing you know being together normalizing conversations about the menstrual cycle de-shaming the menstrual cycle is is medicine in and of itself for many it's therapeutic yeah yeah absolutely it's beautiful yeah no i do that's in the actually the foreword she wrote for my book that i think that was in Gerilyn's own words. And yeah, that does tie very much in again, back to red school and just body literacy, which is a phrase I love just kind of knowing. Yeah. What your body's doing and just, you know, coming to terms with the net,

the reality of that hormones go up and down and that's how that's we're cyclic beings that's um what's one thing you would say to someone who's really struggling with their cycles at the moment um just in closing like what would what would be your advice for someone trust your body yeah your body knows what to do like i said earlier your body wants to ovulate it wants it you know, you know, wants to be healthier. In my work with 1000s of patients, there's always a way to feel better. Like I won't promise there's always a way to feel perfect. A lot of women, a lot of people can achieve symptomless cycles, I'd say that's the most common experience that you can get there. But for even people for whom I guess are always gonna there might always be some symptoms but they can they can be so much better than they are it truly

is possible and um i think it by trusting our body we're you know rebelling against this also narrative that um you know our bodies are complicated or mysterious. They're not. I mean, they're beautiful. They're complex in a way, but I guess I don't think they're mysterious. I think there's a logic to them and the body will respond

to giving it the support it needs. Beautiful. Thank you so much, Lauren. Thank you for everything you do. Good luck with getting your new book out. I'm really excited about that. And I'll put the link for people to connect with you and your work thank you so much great Sophie all right have a good night

wow thank you for joining us today thank you for listening all the way through to the end and I hope that this conversation inspired you as much as it did for me. And please do share it with your friends, your colleagues, your family, who might be experiencing some of the things that we explored today. A final reminder that the doors for our menstruality leadership program close on March the 14th, so just a couple of weeks to go, and there are a few spots left, and we would love to have you with us. You can find out about it at menstrualityleadership.com. We have payment plans to make it as accessible as possible and you can also book a chat with

our wonderful Lauren to see if this course is for you. You can find out all about it at menstrualityleadership.com and you can always ask us your questions at info at redschool.net. Okay, that's it for this week. I'll be with you again next week. And until then, keep living life according to your own brilliant rhythm.