The Uneducated PT Podcast - Episode 88 – Periods, Fertility & Female Health with Kathryn from Her Health Dietitian

Episode Date: June 4, 2025

In Episode 88 of The Uneducated PT Podcast, we’re joined by the brilliant Kathryn, the expert behind Her Health Dietitian, for a deep and empowering conversation about periods, fertility, and all things women’s health.Kathryn is not only a wealth of knowledge when it comes to hormonal health, nutrition, and fertility—she’s also an absolute joy to listen to. Her passion for educating and supporting women shines through in every minute of this chat.Whether you’re a health professional or someone wanting to better understand your body, this episode will leave you informed.We dive into:Athletes and common HA issuesKey nutrition strategies for hormonal balanceHow to support fertility Myths and misconceptions about periodsPractical tips for clients Kathryn’s approachable and vibrant personality makes complex topics feel relatable and digestible. It’s a must-listen for anyone working with women—or simply is one.Follow Kathryn on Instagram @herhealth.dietitian for more insights.

Hello and welcome to the uneducated PT podcast with me, your host, Carlo Rourke. The goal of this podcast is to bring on interest and knowledgeable people from all walks of life, learn a little something from each conversation and for you, the listener, just learn something from each episode. So don't forget to subscribe to the channel, press the box below, show some support and I'll see you on the next episode. Can you tell us a little bit about yourself and what led you to become a dietitian who's obsessed with periods?

I want you to go into, you know, the whole background story. Okay. Yeah, well, you know, whenever you flatter someone by asking them questions, fuggled up. Why did I become a dietitian? I really, I remember thinking in the careers in school. I was like, I want a job where I can finish at 5pm and I can wear my own clothes. So that was initially, now I think I like the idea of uniform where you don't need to think about what to wear. Yeah, yeah, I'm the same.

Yeah, my mom and sister nurse is my dad's a farmer and I just feel like I didn't really want a job. I needed to touch too many people. So I didn't think nursing was maybe for me. I was really interested in home economics whenever I was in school, but I'm not a good cook. I love baking, but I'm not a good cook. And to be honest, maybe like sadly in a way, I was overweight as a child,

and I always remember being very aware of that. And I think I became a dietitian, like very heavily influenced with I want to know how I can lose weight or eat better or those sorts of things as well. And I always remember throughout my dietetic degree, I thought, I'm going to like finish this. I'm going to do sports nutrition. I'm going to help people lose weight. And that is my probably least favorite area of working in now. And maybe it's a run and joke in one of the clinics I work in that I never see kids. I'm like adults only because I just feel like I know who like when children are brought to clinic and maybe they've been referred or you know they're overweight. Like that's such a sensitive topic and they know why they're there. And yeah. I suppose it maybe just brings back to my inner child and maybe more of my issues then as well. So why did I become dietitian?

I was interested in food. I want to wear my own clothes. And I liked the idea of people needing my advice, I think, as well. And even throughout dietetics, I've always loved working in areas where people are actively seeking out your advice. So I've worked in gut health before. Like when people have, this shit, excuse my French. like if they're they're gonna need someone to chat to be about that or really like take on board your advice and like seek out that advice as well

and what else did I work in? I did some sports nutrition really thought I wanted to work in sports nutrition got too many rejections from Irish rugby that I thought maybe this is a sign. Yeah, I read that. I read that you wanted to be a sports nutrition and work with rugby teams. I would imagine that's a really hard, a narrow avenue to get into. Yeah. And maybe the more I learn about that,

that doesn't really help with. mine not wanting to work too many evenings or weekends that sort of job so not for me but actually when i did sports nutrition it was an avenue at my first job was in nottingham in england and it was so much fun like working the big university hospital like great nightside great lunch breaks great tea breaks and i love that job i always thought i wanted to move home so i thought i'll do sports nutrition masters as an vehicle or an avenue to move home and then i just started to settle in nottingham as i had to move home so that's typical but um i did the sports nutrition masters and at the time i with all those job reductions i was like okay maybe i'm not meant to work in this area um but now in the area i work in

it serves me really well because a lot of people are coming and they're very active and maybe not feeling well enough for that activity and then that's impacting their hormones as well so i don't know if i've answered that question i think gabby and you know what it's for anyone who's listening who might actually want to go down the avenue of becoming a dietitian i think you have think what you've just kind of explained is how many kind of different areas there is to kind of or how many different rabbit holes there is to go down there there's actually so much to it in so many spaces that you can work in and I always say I'm a selfish dietitian if it happens to me I'm obsessed with it um so like you better believe when I hit menopause that will be my key yeah

that will be the key that will be my key area it's already a very interesting area um at the moment and some of that actually crosses over with some of the work that I do too so um yeah lots of different areas for people to work in and like it's different strokes for different folks like some people love weight management some people love the got side of things and but I think where I've landed is not an area that I ever thought I would work in or ever seen coming but maybe now I look back I can see all the little pieces we're joining together to lead me to work in this area yeah Steve Jobs has a great quote where he says like you can't see things going forward it's only when you look back all the pieces come together that's to be just terribly misquoted but

But my mom loved to come up, so I'll pass it on to her. So tell me a little bit then about the work that you do now and how you kind of fell into that. So at the moment, I work for myself, but I also do a few days in a clinic in Dublin, Dublin Nutrition Centre. And then I also work one day a week for a clinic in London, the food medic, as well. And then I do some bits on my own. So the work I do specifically that I focus on is helping females with H.A. or hypothalamic aminorrhea.

I know that's a bit of a mouth. but for anyone that doesn't know what it means, it's basically when you lose your period due to overexercise stress, under-eaten or weight loss, or maybe quite often, a combination of all of those things. That also crosses over into fertility

because a lot of people come to me and the typical person I would get, and I always say, it's a lot of teachers. Really? Yeah, I've got, you know, dietitians and nutrition, it's very common as well. I've had it myself too, but people can't.

Maybe they've, like, you know, gone through all the stages of life, they've got engaged, they've built a house, their mind now, they've moved into her house, they come off the pill, or then they start trying and nothing's happened, or they realize that they don't actually have a period, and then that's when they start to dig a little bit deeper and maybe realize that their lifestyle and diet might be having an impact, so I help females to regain their period and optimize fertility. And more recently, with the fertility side of things, I think I see so many females come to me, but it takes two to time go, and even if someone's going through, you know, sperm donor, or

egg donor, you know, that is so important in terms of the success of pregnancy and also the health of the unborn child as well. So maybe migrating into a little bit more of the meal fertility as well or always passing on to the females that are seeing me and just making sure that they're aware that that is also important too. Yeah, because like it seems to me of people that I've spoken to that it's more and more common, more and more common than ever people struggling with fertility issues. Yeah, and I think the more you know, the scary it is, I read this quote and it was like my two biggest fears, I've never related so hard, is getting pregnant and not been able to get pregnant. I think you spend half your life. That's so good. That's so good. It's so true,

isn't it? Isn't it that you spend half your life praying or, you know, a lot of your like growing years, praying you'll not get pregnant? And then, you know, all of a sudden, it's a flip of a switch and you're like, wise isn't this happening or, you know, and you never really hear so much, maybe more so people are talking about but unless you work in that area or if you're someone close to you who struggled with it you never really hear of of that happening like I know my parents didn't know that that was you know as common as what it is but actually one and four pregnancies don't make it past 12 weeks so it's so common and the stats are so high in terms of people struggling to get pregnant or staying pregnant as well okay well let's get into a few of the things so first for an ignorant man and ignorant men

listening and people who aren't sure about this topic. So why does this happen to women? Why do women lose their period? Or not, don't have a period. Sorry. So I'd describe it as like if your phone is in one or two percent battery and you have a really important call, say revenues calling you or something like that, really important call. I could use my phone to go on TikTok, Instagram and I do heavily, ASOS, new in the works. But I'm not going to do that if I'm waiting on an important call. So the sole purpose of having a phone is calls and messages, you know, when people are buying these dump phones these days to just have the calls and messages. So if I had very low battery, I'm going to prioritize absolutely essential things that that phone needs to do. So I'll X out of all

those apps that I don't need. And I would count the apps as your hormones and your menstruations. So we're going to save a battery or save energy in terms of your body by stopping periods because they're very energy intensive and use a lot of energy. And also that can knock on to digestion and temperature regulation, sleep and things like that. So basically it's an energy. balance where there's not enough energy coming in and there's too much going out so there's no spare change left over to optimally be fueling all these nice add-ons in your body like regular digestion and regulating your temperature no cold hands and feet and also your periods and menstrual cycles as well so basically it's a smart way of the body trying to conserve energy but in doing that then it can also

impact your long-term health and also your fertility in that moment as well yeah that makes that makes perfect sense. You said that, I read that you said that, like, losing your period doesn't have a certain look. So when you're talking about that and you're talking about not having energy, you know, the first thing that comes to my mind is people underway, et cetera, et cetera. So what do you mean by it doesn't have a usual look? So with, H.A., you don't have to be underway.

I'd say 90% of the people I see are within the quote unquote healthy or normal BMI range or potentially higher. So in the criteria of the diagnosis of H.A., it's low estradiol, a history of weight loss, vigorous exercise or stress, but vigorous exercise could be a long dog walk every day for one person or it could be doing high rock straight and five days a week. So the stress that people's bodies feel is very different to the next person. A lot of people I see will compare myself to be like, well, my friend does this, this, this and she has a regular period. So that's not fair. And potentially it is for straightling, but it's also worth. what your body needs and is interpreting as well.

And also then the third criteria is no period for at least three months after having your first period as well. So with a certain look, half of females with hypothalamic ameneria will have a history of or have disordered eating or an eating disorder. But it's very common in athletes and almost 40% of athletes who have hypothylomic aminorea have a quote unquote normal or healthy BMI. So while it is really common in disorder eating and eating, and eating disorders, it's not a criteria for getting diagnosed by it.

And that's why sometimes maybe it can go under the, we're sweeped under the carper or just wait until you are trying to get pregnant or, you know, go in the pill or any of that questionable advice. That's interesting that it's very common in athletes because I'm from the public perception outside, it's athletes are healthy, athletes are always training, athletes are working out. Why is it so common in athletes? Well, if you think about athletes, like they're very diligent with their food. They've got a training schedule, but people are very active outside of that.

So a lot of people I see wouldn't call themselves athletes, but I've seen people who compete for their country. And a lot of people I see train 10 times harder and 10 times more and are way more active than someone who is competing to that high level as well. So with athletes, I suppose they are turning a little bit more. they might be more likely to be tracking their food. I know whenever I studied sports nutrition, they said there's the aesthetic side of it, the performance side of it as well. And they can sometimes cross over,

but quite often people focus on merging them when actually performance is key in terms of sports nutrition. Even if people have come to see me in the past for sports nutrition, it's very heavily influenced by their aesthetics or, you know, getting their weight town. And whilst there is weight making sports, that that is important. It is a fine, fine line between making sure that your body is getting enough energy. And secondary, aminery is when you have had a period and you lose it. Primary is

whenever you've never had a period by the age of 15 years of age. That kind of used to just be sweeped onto the carpet or maybe not as recognised as having impact on bone health in the future, whereas now it's getting a little bit more recognised. People might go bring their daughters to the GP and they'll be referred to an endocrinologist to look into that a little bit more. But with secondary aminarea the prevalence in the general population of females is three to five percent and it's up to 50 percent in female athletes so it's super super high so i'm not going to lie when i see these intense competitions like high rocks crossfin i always think oh i wonder i'd love to do a study um and you touched on bone health as well that bone health gets it gets impacted by by this

yeah so um estrogen or estradile um it protects bone so it's bone protective um so where When it naturally dips when you have no period because it takes a lot of energy to make estrogen. That dips if you have no period if you have hypothalic amine, so your bones are less protected. So there's less bone formation. And if you think about when people go through the menopause, what do they focus on bone health, muscle mass, heart health. And those three things are super important in next shape. When people regain their periods, I've never seen anyone in person who hasn't also gained a significant amount of muscle through that as well. their bone health also is something to be monitored

and especially for like a 15 year old who still doesn't have their period their peak time of growing and laying down bones that they have for life so if their eastern's low then that's where it's important to consider that that's not going to have a long-term impact or looking into that in a little bit more detail.

Is there any sports for let's say 15 year old women that you see where it's more prevalent than others in terms of losing their periods? Yeah, definitely. like anything that's getting swimmers, horse riders, maybe more like running cross-country. And there's absolutely nothing wrong with those sports. It's just that, you know, you can lose your period intentionally.

Well, no one loses it intentionally. So you can be in an energy deficit intentionally or unintentionally. So if you take, for example, someone who swims and they have to be in the pool, half-five-hour morning they're getting up, they hit the ground running, straight into the pool. Maybe they come out, they're rushing to school. They usually maybe have their breakfast in the car. Then they're into school.

They forgot their lunch. or maybe they forgot a snack. And their body is in fire or flight to some extent. So that's going to suppress your hunger hormones. Maybe they're training after school or they're doing a different sport within school as well. So quite often it's a lot of time schedules. Or if I started marathon running,

usually I come home from work or on the way home from work, I'll have a snack. But maybe I'm running straight out the door to do a long run and I come home and I can't be bothered to cook dinner. Or maybe it's late and I'll just have a smaller dinner. So I haven't intentionally eaten less, but my activities went up and my food has went. down as well. But definitely in those, and I would say high commitment sports, like, you know,

anyone who does horse riding when they're younger, they're used to cleaning out the horses and leaving in time. They're used to hard work and being out early and out late as well. So, yeah, probably a lot of those types of activities it's more common in. What is your opinion on the pill and girls on the pill? I feel like I have to be very careful about this because obviously the pill has enabled woman to be able to work. Sorry for asking the most controversial question of the day. I want to get cancelled. I was in the pill whenever I was younger.

I never had any issues with my peers that I can remember before going on the pill. But that probably coincided with me going to university and me being able to make all my own food. And I vividly remember living with them. Girl, she's my friend. And I remember she lost weight. And she was like, oh, I track it.

And my fitness pan, I was like, what is my fitness pal? And that's probably when the slippery slip began. But at that time, I was still getting a bleed on the pill. So in my head, I thought, I've got a record period. There's no issues. I didn't even know. No period was a thing. It was never part of our university degree in terms of studying to be a dietitian.

But that could be an issue. So a lot of the things I've learned along the way, I've been through personal experience and then also self-sake, me trying to figure out what's going on with me. But the main issue you have with the pill is that people go on it and they're not told that the bleed is a withdrawal bleed. it's not a period. So they think things are hunky-dory until they come off at, maybe they come off and they think, okay, one month, two months is fine, three months,

why is there no period happening? But when I was on the pill, I didn't notice that it did impact my mood or anything like that, I would say probably the vast majority of that was done to me not eating enough while I was on it too. So certainly I would be 100% against it in terms of getting your period back because it's just mask and issue. you'll come, well, you'll need to or you'll want to come off that pill at some stage down the line and you'll be stuck in the same position. Yeah. But obviously it does serve a purpose in terms of contraception.

So if I ever was working with someone, they asked me their view on that. I would say, in terms of what we're working on, we can work on, are we regularly eating? Can we improve the fuel in terms of any activity or look at the types and timings and fuel of activity? But it's their choice in terms of if they're going to stay on it and just want to educate them in terms of that bleed is not a period. Yeah, that makes sense. That makes sense. Very diplomatic.

Very defensive. And can I ask you a question then? So, okay, let's say someone has lost their period and they want to get it back. Like, what are some of the strategies, some of the steps that they can take to achieve this? Number one, I would say is probably regular eating. So I always say it's like giving your body a little pat on the back. You know you might have dinner at 8pm, but if you've had lunch at 1pm, your body doesn't necessarily know you're going to have dinner at 8 p.m. So it's thinking, oh my gosh, the stress signals.

they're already they're already kind of spinning so regular eating is super important because regardless if you have a massive Christmas dinner

like my family of Christmas dinner probably at like 1pm and we're always like oh my gosh can't eat till Tuesday by 5pm

I'm thinking a little like Christmas sandwich would go down well so naturally your blood sugars dip in that time but when your blood sugars are dipping consistently

and similar times each day then that's going to increase the stress in the body and the crux of hypothera is stress in the body and the body

reacting to that stress so number one's regulating to making sure that you're eating every three-ish hours and that you're waking. So if people get up later in the weekends or on holidays or things like that, that's grand. But in your waking hours, making sure you're eating within one hour of waking and every three hours then three out the day. So that might require just a little bit of tweaking or schedule. But I would say school and teaching is great for the little break, the lunch after school

all those sorts of things. Sometimes people might run into work or, you know, they're going into work and then they don't have time for breakfast so they grab something to go but then they're having a late lunch with the client in the afternoon. It does require people to be a little bit more diligent but I probably spent half of my teenage years thinking I was a

bottomless pit when I actually just need to eat regularly and balance my meals. So that was something to, so number one, regularly and number two making sure that we have enough fats and carbohydrates in meals or even just that they feature because a lot of times I see people and there is a very limited amount of those nutrients and making sure that snacks are more carbohydrate-based. Again, if you're snacking on Greek yogurt or just some fruit, there's very little carbohydrates

in that. So if we're trying to rent any dips in blood sugars, maybe that's not helping. I always say it's like fueling for a marthen. Your glycogen loaded. So you're always thinking, could I add a little bit of jam or honey or add a fruit juice or smoothie? Could I have a little bit more pasta? Could I add bread on the side with the lasagna?

you for that. So it's like training for a marathon, but we're not running as much, hopefully. Anyway. Yeah. And is there anything else? So making sure that you're eating regular meals at regular times, making sure that you're getting enough carbohydrates and fats, is there, is there anything else that you see that helps people? Definitely looking at the type timing and fueling of activity. So I think people sometimes are a little bit scared to maybe work with me because they think, oh my gosh, like I love running. So like it's such a deep. stresser for me or I really like going to gym. Like the gym is a community for a lot of people.

I know that's a lot of your work focuses on that. And definitely there's no question about that. So they kind of think like, well, you know, and sometimes it is identity for people as well. Like they're known as a runner. They're known as being really healthy or they always eat like really healthy meals or those sorts of things. So it can be thinking about what that looks like for them. But there's no one size fits all.

Like I always remember this girl I saw and she always did crossfit maybe three or four times three or four mornings every week and i thought i was like i don't know if we're going to get this period back if you're doing this year she did get her period back but the fuel in for that activity was way more than she would have considered um yes a pre-exercise snack before so i always start with can we fuel it better and if we're going to reduce it can we reduce the um solo activity like go for run with your friends but do we need to run by ourselves or individually so you're getting that kind of community social aspect and alongside it yeah that makes sense and I always think about the quote like there's no it's not you're overtraining it's that you're under fueling for that type

of training so obviously eating more is going to enhance that as well and then in regards to like even time frames if someone has lost their period and then they start kind of incorporating these actionable steps like how long does it take for people to to get that period back like what's the the longest you've seen people take and it's different for different people like I would say it depends on what scenario they're coming to me someone's like right we want to have a baby ASAP that's a massive motivator and then has a little bit of a time pressure

to it sadly as well so they will probably dive into all of the changes but a lot of people come with the history of eating disorder or disordered eating and you're also one picking a lot of those things along the way so whilst we might want to increase the carbohydrate and fat content of their diet, we might need to go for more of the acceptable carbohydrates or like ones with maybe a little bit of healthy yellow. And that's absolutely fine. Avocados of fat, so is Nutella. It doesn't matter if avocado is easier to eat, then that's fine. We can add more of those

sorts of things in. So it depends in terms of how quickly someone can make the changes. But I always say the direction of change is most important rather than the speed of change as long as it's going the right direction because it's like walking up the stairs. If you lunge up them like in elf, whenever he goes up that escalator, you're more likely to fall down, whereas if we take it step by step, it's okay to give your brain a little bit of time to catch up and you to deal with the changes that we're making along the way. Usually if I work with females, I work with them over four months. It used to be two months, then it was three months, and I feel like four months just gives us

a little bit of time. And I would say probably 60 to 70% of those females do get their period back in those four months if we're ticking all those boxes along the along the way but the key thing to begin with is definitely looking at the regular eating and making sure that we're increasing energy content of your diet if there is a little bit more of the kind of residual disorder deen traits there it can just take a little bit longer and that's that's okay um because you're still gradually correcting that energy deficit so you're still lower in the risk of any long-term impacts in terms of

that. If you look at the studies, which are very few of, they will say, I think it can take up to one year and to get it back. But I would always say to someone, if you've made changes and your period hasn't came the next month, you need to make more changes. You don't just sit there and magically, it's all going to fall into place. And obviously I didn't mention in that, but I always think about the bend diagram, there's food, there's exercise and there's stress. And stress is a massive impact. So we can't talk about food and exercise without thinking about the stress that someone might be under, even if they don't realize or feel that stress. Yeah.

Yeah, there's so many components to it. I suppose like it's like anything in nutrition. You're not dealing with robots who are just like, oh, eat this number and, you know, this will happen. It's like you're trying to encourage behaviour change and improve relationship with food and probably any kind of underlying psychological problems and issues that are going on. Yeah, yeah, definitely. And a lot of time with stress, it more is just the schedule. Like whenever I think back to all right, I didn't feel one bit stressed.

In fact, I probably thought, lethal, no period to worry about it for a while, until I read more about it and then I started to panic myself. But for stress, like everyone is go, go, go, go, go, go. And like, people prioritise productivity and the hustle culture and even, like, on social media and like those time stamp days where it's like three minutes and then we do this and this and this. Like, we really do glorify being so, so busy when like a lot of probably emotional and dysregulation. comes from not allowing yourself, time to just be. You know, I always think about, like, when I was younger, me and my mom would like go collect my granny and we'd go shop and she'd just be sitting in her son room, no books, no phone, nothing, just sitting.

Imagine doing that now or even if you go into a waiting room, everyone's on their phone. No, I'm guilty of this as well, so I'm not, you know, preaching to the choir, and then like that. But, yeah, I suppose at one time I listened to this podcast and it was a fertility doctor and he said a lot of times women come to me. and they describe their schedule and their lifestyle, and he always asks them, where are you fitting a baby into this?

And that's a good way of thinking about it. Obviously, it's a very sensitive thing to be discussing, but like if someone is go, go, go all day, how would their body be preparing for a baby? And that's the sole reason we have periods is to allow us to become pregnant, hopefully with that. But, yeah, the schedules is a big one in terms of the stress. And maybe a practical one as well,

that people can address too. Yeah, that makes sense. That makes sense in terms of how busy we've got as a society and that everyone feels like they constantly have to be productive and stuff like that. And I suppose that's probably one of many things that is contributing to the rise in infertility. Yeah, which is a tricky one.

And even like, you know, when I was in, you know, I never thought I'd be recommending yoga or breathwork or anything like this, but here we are. Can I ask you another question then in terms of fertility and stuff like that, is there anything you see floating around the internet that like isn't rooted in evidence and might be damaging and like things that kind of bother you about this kind of topic being misconstrued? What would it be? I would say like with fertility, like it's, you know, if you go to gastroenterologist,

you're probably going to get very similar advice. If you go to one fertility clinic versus another fertility clinic, it does vary quite a lot. And I suppose when someone, is in that position when they're trying to conceive. It's such a sensitive topic and, you know, people will go on recommendations on, like, what has worked for other people. So, I would say probably the most obvious one is supplements.

Like, there's a lot of people on a lot of supplements. And even the burden of waking up and taking, like, eight or ten tablets is so, so much. So, like, a lot of times if I was working with people in terms of fertility, we always review all the supplements, just to give them the peace of mind. like is this making difference? Am I taking the right time?

You know, is it worth it? Is there a cheaper version that's maybe just as good to have? And there's so many new supplements coming out. I can barely keep up myself. So I can't imagine how someone who is going through fertility treatment is looking at that. So there probably is a lot of other things too that I can't think of off the top of my head. But I think when people are trying to conceive, they will go hell or high water to try. to conceive and that's a very vulnerable group of people in terms of like if I was trying to

conceive I would absolutely be eating up anything I see on social media that work for one person I'm going to try it as well so sometimes it can be pairing back and seeing what's been done or even I listen to your podcast with his was it Kieran Russell yes yes and he was talking about um meal fertility and that and even just knowing about like the DNA fragmentation test because most clinics will do the sperm analysis and then that's grand back to the woman and to see what other tests and we can do there so even just knowing about those additional tests can be helpful so um let's say you've you've helped the client to get their period back and they're they're looking to conceive um is there is there any steps after that that you recommend or like what what is the next kind of step a lot of the times

once they get the period back we need to track it see is it regular because you can get your first period back but you've got no clue if it's going to come the second month and you've got no you might know your period length, but you don't necessarily know your cycle length. So usually it can take three-ish months for your cycle to settle down into what might be your quote-unquote normal type range. So we'd look at how long is there period lasting the bleed? How long is their cycle? Are they ovulating within that? And is there any kind of PMS signs or indicators that their period might be coming as well? And then also educating just on the fertile window, like when are you most fertile and what signs to look out for in terms of population? All these things

well I didn't get taught it in school. I think we got taught like this is a pad and this a tampon. And it didn't really go beyond that as well. I think Dolly Alderton has a book. I can't remember what it's called. My little sister is reading it. And she talks about discharging me like, oh my gosh. Like what is this?

And like the fact that it's normal and should be happening, but is never spoke about it is mad to me. And a little bit of a taboo subject. I also think in social media, I'm like, am I getting like, you know, shadow band, all this time by mentioning period because I heard that that was like a shadow ban term at one stage but we'll see do you notice that is there do you think there's more talk on social media about it or do you feel like you're swive against the current no I absolutely think like even just in terms

of educating about cycles like that I would say like when I do any content social media about that that probably gets picked up a little bit more or you know more saves or sense or things like that because people want the knowledge or even like Dr. Hazel Wallace, the food medic. She's based in London. She just brought out a period called not, a book called not just a period. And it's more just about, I suppose,

educating females and men on the menstrual cycle on what to look out for. So sorry, in terms of your question after they get the period back, probably tracking is super important, knowing when your fertile window is, but there's also some foods that can be important in terms of fertility,

like maybe more of the unsaturated fats or low glycemic. index carbohydrates and also some plant proteins too for females and it seems like whole sources of dairy rather than low or no fat are and better for them and then also looking at any preconception multivitments or what would be useful for that person some can help to preserve egg quality and there may be over a certain age then that might be more useful to look at like co-enzyme cutem is one of those so we'd maybe then hone in on a little bit more of the fertility at that stage. What about the relationship with exercise? Because I remember even a couple of years

ago when I was working as a trainer, I remember a few girls coming in to me and saying that they were trying to conceive and it ended up being the first time exercise and then after a couple of months they ended up conceiving. What's the relationship between exercise and fertility? I suppose it depends. If someone has insulin resistance, then it can help to potentially improve their fertility as well. And the intensity, I suppose, like exercise is going to be beneficial for 99.9% of people, but it's just the intensity and frequency that usually needs to be looked at. So like if someone works like a long shift and then they're going and doing a really intense workout, like that's a very stressful on the go day.

Maybe can we move the day that they're doing that intense workout to a different day? Or maybe just incorporate in some slower movement within their week or maybe swap or switch out. a few sessions. But if say someone was struggling with PCOS and they had a little bit of insulin resistance, then definitely the weight bearing exercise is super important for those females in terms of making the insulin a little bit more sensitive. Okay, interesting. And what about sleep? What role the sleep playing this? Oh, absolutely. Well, human growth hormone peaks whenever we sleep, but only if we're getting enough sleep. Even if you're tracking your temperature throughout your cycle, it will consecutively rise for three days after a female ovulates. But in order for that

check in the morning time, before you have a glass of water before you check your phone, but only if you've had at least four hours consistent sleep before that, which obviously makes it difficult for shift workers. So per sleep can increase stress on the body and can also disregard it your hunger and cravings too. So if your body's feeling low in energy, you're either going to want to have a nap or find some sugary foods. There's nothing wrong with either of those, but we might also want to just look at sleep hygiene and trying to optimize that as much as possible.

I would say if people have hypothermic amin, and they are in quite a large deficit. Quite often, they struggle getting to sleep and staying asleep, and that's purely from the dip in blood sugars. Your body is literally keeping you awake to go and seek out food. So again, like really an H-A to menopause. In menopause, your body stops producing as much estrogen in hypothyphthalmic amine area,

it doesn't have enough energy to produce that estrogen, but bone health is important in menopause. Heart health can also suffer in hypothylamic aminorrhea, so it can be quite common for females to have high cholesterol. And if you think about these females, go on to the GP, they're usually very active, they eat very healthy, and they're usually on the go. So if that GP isn't really aware too much about hypothyphthalmic aminorea,

see how cholesterol, and they get told to reduce the fat in their diet, or maybe exercise a little bit more, and that can exacerbate things. even further. And also, sorry, in menopause, people struggle a lot with sleep or night sweats, and sometimes they can occur in hypothylamic amine area as well. Going back to H.A. and every gain in periods, what is your opinion on, like, intuitive eating versus, you know, tracking your calories, etc., etc.? I have never needed to tell someone to track their calories in order to get their period back,

but I would, the females I work with, I would get them to fill out of food journal and take a few pictures of food. There's no nutrition feedback on it because usually maybe that has sparked the HA and the disorder to eat and the tracking. So it's unlikely that that's going to help to bring it back. And quite often I find if clients are really keen to track,

it's to make sure that they eat just enough, but absolutely no more. And it's not as fine in art as that. Like it takes different amounts of food for different people, sometimes people need to make loads of changes sometimes people don't need to make too much sometimes people can continue exercising sometimes actually having a little bit of a break is the last missing possible piece for people

so definitely having maybe less numbery focus in terms of tracking can be helpful during hypothermic aminearria recovery but even like very rarely would I even calculate out someone's calorie intake because there is a book called no period now what and they always quote if you go all in you need 2,500 calories. But if I get that in two meals, I probably still wouldn't get my

my period back because there's a big long gap between that. So the consistency of making changes and the regularity of eating is super important as well. That makes sense. What if you have a client who has this fear of weight gain when trying to get them to the kind of regular meals? I would always do a little disclaimer at the beginning. Before I ever worked with anyone saying, I used to, you know, kind of skirt around it and I was like, look, you probably, your weight probably will change. Do we need to track it? Probably not. And also, like if I was trained for a marathon and carbloading, my weight would change because I'm eating more carbohydrates and every one gram of carbohydrate attached to three grams of water. So it's not a true weight gain.

But also if I was to see some in person in clinic, their weight will change. But I've never seen anyone's weight being wholly that that change has been fat, that the muscle mass, it also increases as well. Because you're in a little bit more of a calorie surplus. So you're able to build a little bit more muscle too. So if you're just tracking your weight at home and checking yourself, then I suppose it is bringing a lot of attention to something that is taking up a lot of your headspace already. So it is a trick you on because your body does change. I always say it's like going through a mini puberty again and females bodies do change a lot through the life cycle.

If you go through like puberty, menopause, pregnancy, all of those sorts of things as well. So there's no set amount in terms of the weight gain that it might take. It might be also looking at, okay, before if someone did lose weight, what was. your weight in the round then but I rarely have a weight goal for the clients that I work with it's more food goals that we might work on that makes sense and what I suppose what do you what would you like more women to know about about this topic um probably that it's way more common than they think it is yeah yeah um and I suppose it's not something that's talked about as much like PCOS is really well known and it's the cause of secondary MNRA, so losing your period whenever

you already had it, in 30 to 40% of females, but HA is responsible for 30%. So like, you know, HAA is very similar in terms of the prevalence, but it's much lesser known about. And also, so I would say that I want them to know that even if they get told their bloods are normal and they've had no period after coming off the pill for three months, that's not normal, and requires further investigation. And if their GP, like some GPs are amazing and really well read in these areas, but they also need to be well read in so many areas. So I've definitely not blaming GPs in terms of that.

But I would also, if someone is struggling to get a diagnosis or struggling to get answers, I would ask the GP to either refer them to gynecologist to get an aldersound and then onto an endocrinologist. Because a GP can diagnose IBS, but a gastroenterologist can diagnose IBS and really get into that and say right okay what is happening let's look at you know the signs and symptoms and that's similar to an endocrinologist and looking into hypothalmic amineery as well isn't it funny that it's so common yet like you touched on there that there's not that much research on it yeah and I think more and more is coming out a lot of the research there was an athlete and I think that that's amazing

that they do have those like um what we say uh cohorts um but then people think that they need to be an athlete Like when I lost my period, I was probably going to the gym three or four times a week and walking every day, try and get my 10,000 steps. And a lot of H.A. recovery goes against the quote-unquote healthy and advice of move more and eat less or reduce fats or don't eat too much carbohydrates. And sometimes when I work with people and I'm saying about some snacks, like I always get asked, like aren't they full of sugar? But, you know, sugar is the body, glucose, is the body's main source of energy, the brain's main source of energy. as well. So I always relate that to like or you know, will I eat too much? Is the equivalent of being like, what if I save too much money? No one's ever worried about saving too much money. Sadly, I'd love that to be aware of mine.

What do you love most about your work? I like seeing the results and seeing and hearing of people getting their periods back. But I also love hearing of like people being like, I was telling my mom about like I got my first period or like you know my partner was like oh my gosh like it's your period or like on other people around them being a little bit more aware of this side of things too and and also hearing about people's lovely supportive partners like if they you know wanting to come off the pill and they understand like okay this isn't you know working for them in terms of contraception or you know them being open to knowing more about the menstrual psych on female health as well yeah do you think

more men are having conversations about it like even in the dietitian space do you notice that? Yeah, I think. I think so, yeah. And especially if they see their partner potentially struggling with this for a long period of time and trying to seek out help and things like that, then I think it's really good that they're being a little bit more well read

in terms of it too. But yeah, I definitely think it's being spoke about more and, you know, there is a lot of meal PTs and like a lot of people I would say would be like, oh, I'm working with the PT, but they're aware of what we're doing at the moment. And that's really good. to hear that and to have that knowledge in that area also.

What kind of support do you think women need more of furthest? What kind of support would we say? I suppose it does tie into like diet culture and all of those sorts of things. Of knowing that like, you know, we are not the same as meals in terms of our training and how our body interprets that stress also. so probably what do more females need to know more about it? I would say probably just being aware that it can happen. Like I've never ever heard of whenever I was growing up of you losing your period

or what that might mean, like apart from pregnancy. And actually, you know, H.A. is very opposite to pregnancy in terms of you don't have a period for a completely different reason as well. So I remember whenever I lost my period and I was younger, maybe I told my friends and I was like, I'm not pregnant. but like that was the only other thing that they could think about and I kind of was like oh like no one that ever heard of this so I'm just not going to talk about or other people are talking about their periods and I didn't have a period um so you know I had no clue what I would feel like in the run up to my period

or anything like that yeah yeah because what I'm thinking I'm just thinking in my head let's say like like a young girl who doesn't have access to much funds and and you know doesn't really kind of have this information I hand to them you know might be working all the time you know probably doesn't have a nutritionist, doesn't have a trainer, doesn't have a dietitian, probably need psychological help maybe. Like, there's so many different avenues that people might need help with this,

like, engulfed in kind of, you know, productivity, hustle culture, because, you know, they're trying to, trying to make a living. And then also on top of that, like you said, okay, where also probably wants to have a child and like where, where am I going to find time to do this? Like, society doesn't really,

set people up to kind of drive in this area, does it? No, no. And like, I think it's becoming more recognition. Like, even if someone does have a regular period, like, there's very much like more yoga, sound bath, meditation, you know, all those sorts of things kind of coming out. Walking grips. Like in grips. All those sorts of things that have a community.

Or also, like, I read this thing that people are happy. No, I read the headline. I didn't click into it. that people are happier if they do more granny hobbies. And I've always been saying this crochet, doing puzzles, reading, all those sorts of things where you don't need to be on your phone. And it's also just slowing you down as well. So I'm actively trying to incorporate those in because when people, or when I moved to Dublin,

I was like, well, okay, I'll go to this run club. I'll do this here. And which are all great. But I also needed to be like, I need to join a book club or I need to join something that I'm like sitting down and have a little bit more rest. And there's so much more, which is cool, of all of those sorts of things coming out

where you can have a community in different areas. But if someone didn't have the funds, I would say to them to read the book, no period, now what? Because it is a very good reference guide in terms of, like,

I wouldn't read it, chapter one, chapter two. I would go to like flick it and see, okay, X does, I think that's relevant to me and just read

because it has like the information, but then it also has like some personal story. within that. I'm sorry, I forgot you said about the track versus intuitive eating. Definitely we'd want to, once someone gets their period back and it's regular,

move towards more intuitive eating, but also within the context of honour and your hunger, knowing that when you're very, very busy in your bodies and fight or flight, that hunger might be a little bit dysregulate. That makes sense. Granny hobbies, I love that.

I brab-la. I know. Oh, yeah, my gosh didn't catch. So I'll need to go again. That's really good. Last two more questions. So, so in regards to social media, obviously, do you think that's kind of hindered or helped this message? well personally maybe I'm biased but I definitely think it is um helped like when I lost my period I vividly remember the GP flicking through an a to set of clinical conditions being like

amenorrhea and that's like the only word I had to go and I was like let's google aminorea whenever I got home and it took me so long to figure out like is this me is not what if it's what if it's not so definitely I think it it impars people to have more um more information at their fingertips. And like a lot of the endocrinologists maybe would refer to me. I'd refer to them. Like they're booked out. They don't even have a wait on list. And I do think it's because people are more interested in their hormonal health cortisol is a very popular topic at the moment as well, which is great that people are having more of this knowledge and taking their health into their hands and being proactive in terms of that. So I personally think that it's a good thing. But obviously

within that, there can be, you know, the what I eat in a day video. and all those sorts of things that potentially aren't too. So you're not a fan of 75 hard or any of them though? I always think I'm biased. Again, I am biased because if someone shouts to me in the gym, I want to do the exact opposite. So I don't know. Do we need to do two workouts today?

Probably not. I'm sure there's different versions of it that might be a better one to go for, 75s a long time. 75s. Very diplomatic again. What's next for your work? Do you know what? I was sending my friend I had on my vision board that I wanted to do a podcast and then you asked. I'm delighted about this.

So I think I took a break from social media for a year while I moved to Dublin because I thought either I could hopefully thrive in social media and be a hermit or make, you know, make connections in Dublin. So I took a break for a year. That was great. Now I'm back on and I'm trying to navigate that without getting burnt out. I do really like, and I think, like, you know, people who I never thought would watch my videos, who I know, be like, oh my gosh, like, what about, like, you know, what about my period?

And they're a meal and they've got no clue. Or like, I know my dad watches my TikToks, but he will never bring them up. So the Farman wants a more appealing movie. But, yeah, maybe like pushing that, see what opportunities come throughout that. help more people because like it is a way of communicating and educating people that this is an issue. Say if I was, it's not the same, but like say if, oh, I wanted it. I thought I had eczema in my face. You better believe I was in TikTok. Exema. What can I do to try and sort this? So it is like where people use is their Google nowadays. So the whole reason many years ago I started the social media was because

I was complaining to my sister's like, oh my gosh, like they put this up and there's no evidence behind this and she was like well you can stop complaining or you can like give people the information then that you think they should have so here we are yeah well like like we just said for someone who might not have any resources to for help doesn't know where to go you know this is their free resources to kind of maybe get them on the journey that they need to be on hopefully crossed um if people want to find out more about the work that you do where can they go to find you can they reach out can they work with you uh give the listeners all the information So I do have a website. It's very new. Probably been not about three times. It's called

herhealth dietitian.com, I think. I'm also in social media at herhealth.dietian as well. So that's probably where you'll find most of the information. You can send me a message on that or you can email me at catherine at herhealthdietion.com as well. So that's probably where you'll get most of your information from or any links to. And if someone want to work with me, again, I would just drop me a message in social media or drop me an email. And then we'll could chat about what works best because I do mainly focus on hypothalmic gaming rea but I also work with females who have a regular period and are trying to get pregnant or who are pregnant and maybe just need a little bit of reassurance in terms of

food wise from that point of view. Okay deadly we'll have everything in the show notes. Katrin thank you very much for today. It's been a pleasure. Thank you.