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#153: Kathryn Stewart on Missing Periods & Hypothalamic Amenorrhea: Food, Exercise, and Female Health
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In this episode of the Kate Hamilton Health Podcast, I am joined by registered dietitian and sports nutritionist Kathryn Stewart to discuss Hypothalamic Amenorrhea (HA) - a condition where periods stop due to under-fueling, over-exercising, and perceived stress on the body.
Kathryn explains what HA actually is, why it’s becoming increasingly common, and why so many women are told their missing period is “normal” or nothing to worry about. Drawing on both clinical expertise and personal experience, she shares her own journey with HA, the lack of education and support she encountered, and how that shaped her work supporting women today.
Together, we explore:
- Why period loss is a health signal, not something to ignore
- The role of energy availability, nutrition, and exercise in cycle health
- Common misconceptions around carbs, fats, fasting, and “healthy” habits
- Why HA affects more than fertility - including bone, heart, and mental health
- What restoring your period actually involves, and why it can feel harder before it feels better
EPISODE HIGHLIGHTS:
00:00: Introduction & why this conversation matters
02:13: Meet Kathryn Stewart & her mission
03:00: Kathryn personal experience with losing her period
05:10: What is Hypothalamic Amenorrhea (HA)?
06:36: How food, exercise & “invisible stress” affect the cycle
11:45: Hormones, misdiagnosis & why HA is often missed
24:08: Long-term health consequences of missing periods
27:06: Bone health, calcium & estrogen’s role
32:48: Kathryn’s clinic approach to period recovery
34:56: Breakfast, snacks & under-fueling patterns
35:28: Fueling exercise without giving up movement
37:26: Why fasting often backfires for hormonal health
39:30: Eating more: fear, bloating & the “speed bump” phase
42:59: Balancing carbs, fats & protein properly
45:38: Planning meals for busy schedules
49:13: Mindset, mental health & rebuilding trust with food
54:00: Individualised exercise adjustments
56:26: Quickfire questions
58:49: Final thoughts & where to find Kathryn
Links & Resources:
- Connect with me on Instagram here
- Learn more about KHH coaching here
- Connect with Kathryn on Instagram here
- Visit Kathryn’s website here
If you enjoyed this episode, please subscribe, leave a review, and share it with friends who might benefit. For more health and fitness tips, follow me on Instagram and TikTok @katehamiltonhealth.
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Transcript
Introduction to Hypothalamic Amenorrhea
00:00:07
Speaker
Hello and welcome back to another episode of the Kate Hamilton Health Podcast. In today's episode, we chat all things periods. So be ready. I sit down with Catherine Stewart, who is known online as her health dietitian. Catherine is
Catherine's Specialization in Female Health
00:00:24
Speaker
a registered dietitian and sports nutritionist specializing in hypothalamic amenorrhea, HA as it's also are known as, irregular or missing periods, fertility optimization and long term female health.
00:00:37
Speaker
Her work centers on helping women nourish their bodies adequately, rebuild trust with food, restore their menstrual cycles and move away from restriction, fear and confusion around nutrition.
00:00:49
Speaker
Catherine's professional focus is deeply informed by lived experience. Despite
Personal Journey with Hypothalamic Amenorrhea
00:00:53
Speaker
formal training in dietetics, she personally struggled with hypothalamic amenorrhea and found a striking lack of education, recognition and support for hormonal disruption within the traditional training and health care.
00:01:07
Speaker
That experience led her to dive deeply into the research, evidence and clinical nuance of menstrual dysfunction, energy availability and fertility nutrition. Today, Catherine supports women across the spectrum from missing or irregular periods to cycle restoration, fertility preparation and prenatal nutrition using a compassionate, non-restrictive and sustainable approach. We
Understanding the Prevalence of HA
00:01:29
Speaker
base most of our conversation around HA, hypothalamic amenorrhea, which is a really fancy name for loss of your menstrual cycle or your period. This is a really, really informative topic.
00:01:41
Speaker
conversation and even if it is not something that you have experienced it is something to really educate yourself on because this is something that's becoming a hell of a lot more normal in today's society for a variety of different reasons which we talk about this is a really really important conversation and I'm really really proud to be able to share this with you so please do listen please do enjoy and I really hope that it does help you
00:02:13
Speaker
Catherine, welcome to the podcast. Thank you for having me. I am so excited to chat. Before we get into us you know, we kind of go through exactly what it is that you do. Let's start off with your mission. What is your mission?
00:02:24
Speaker
I
Mission to Restore Menstrual Cycles
00:02:25
Speaker
was thinking about this last night, but I would say my mission is to help females with no period or regular periods have a path to regaining their period and regulate in their period as well, when maybe they're not getting the answers that they might need or the support that they might need as well in terms of that journey.
00:02:43
Speaker
Yeah. What led you to this mission? So that's a very, very specific mission and a very, very important one yeah and and very relevant, which is what we're going to obviously talk about through this podcast. But is there a story behind this why this is so important to you?
00:02:59
Speaker
Absolutely. Yeah, I always say I'm a really selfish dietitian. If it happens to me, I'm going to get into it. um So when I was younger, I lost my period, I would say for at least, at least one and a half years, but I was on the pill before, so I'm pretty sure there wasn't much happening in the background with my natural hormones at that time. And whenever I lost it, I suppose I went through the ignore stage, this is okay, it's not an issue, to then go on to the GP to discuss it. And I always remember when I went, I can remember these, it was like, my BMI is normal, I'm a dietician and I don't want to conceive. And so like it wasn't really a, it didn't seem like a priority to them or an issue to them. So, you know, when a health professional isn't too concerned, then am I going to be too concerned?
Catherine's Experience with Period Loss
00:03:39
Speaker
Whilst also maybe having that underlying knowing that something wasn't right and that it needed addressed as well. So I heard the word amenorrhea in that appointment and I remember going home and Googling after that as a dietitian in the four years of studying I did and then doing sports nutrition after I'd never ever heard of hypothalamic amenorrhea which is losing your period due to stress, over exercise, weight loss. and So I Googled the life out of that kind of came to thinking okay maybe amenorrhea means hypothalamic amenorrhea and a lot of the things are ringing true for me but there was no support in that
00:04:12
Speaker
area in terms of period regain and I resentfully, I always say resentfully, regained my period at that time because I wasn't sure it was like the blind leading the blind. I didn't know whether I was doing the right thing. If this was maybe making the issues worse, was it actually PCOS or something different? And I suppose I just wanted to become the support that I didn't have in that time. And I went through that process and maybe I didn't start working with people with no periods until maybe two or three years after when I saw someone with disordered eating and no period and thought,
00:04:42
Speaker
wait a minute, maybe I can actually help and kind of know a way out of um of this for that client and a way that I could support them too. So I think maybe having the personal experience and knowing how people feel before, during and after their period loss journey and is super helpful. And I just love talking about periods.
00:05:02
Speaker
<unk>s Me too. yeah But with your period loss, yeah and now looking back, do you know what caused it? Like what external factors? Is it stress? Was it sport? Was it under eating? Or was it a combination of everything? I think often people want to blame stress because it means maybe they don't need to address the food and the exercise. And I would say when I lost my period,
00:05:24
Speaker
I didn't feel stress all. Now I'm like a little stressful. So maybe I'd like to go back to that part. But I probably didn't feel much either as well because I knew I was under eating and restricting too much in that time. So I definitely knew it was my and obsession around calories and tracking calories and being quite rigid with food.
00:05:43
Speaker
To unsuspecting eye, I would always go out for dinner. i would like eat all I would have. my mum's nice buns that she was making but it was what happened before and after that that maybe was the issue in terms of compensating or adding in extra exercise for that. I was also quite rigid in terms of having to do certain amounts of exercise but again to the unsuspecting I maybe went to the gym four or five times a week and I walked to and from work at that time so it didn't look excessive and to me I thought well I'm not an athlete so This isn't excessive exercise. I still have breakfast, lunch and dinner. I bring snacks with me to work. I have chocolate, like a little bit of chocolate every day. So I know that I was probably kidding myself in terms of there not being any issues when maybe the issues were building until I couldn't ignore
Impact of Exercise on Menstrual Health
00:06:31
Speaker
them. And maybe the period loss was the couldn't ignore sign that I needed.
00:06:36
Speaker
And what did your training look like if you were training four or five times a week? What kind of exercise were you doing? I can remember so vividly. I worked in Nottingham at the time and I suppose it was my first job. i was like, yes, I'm earning my own money. I joined Virgin Active Gym there, which is probably the fanciest gym I've ever been in. And I always remember going through the turnstiles there and being like, I cannot wait to leave this place. And I used to always think, I was like, how do people enjoy the gym or exercise? Because I was like, this pains me to do. But I would always do it. And I do know what I was doing and in my training. I don't think I followed a program, but I knew that I would be tracking the calories on like a treadmill.
00:07:13
Speaker
or a cross trainer or a bike. So I know it was maybe more cardio based because if I was doing weights, I couldn't see how many calories I was burning. So I thought that was a bit of a waste of time. So there was that connection with yeah exercise and burning calories yeah that you might have done a little bit of resistance training, but really you were there for the cardio machine. Oh, absolutely. yeah Yeah, definitely. If I couldn't see how much I was burning, then I thought it was a bit of a waste. So like yoga and those sorts of things, I thought, not a chance. yeah Would I be wasting my time doing that? so And then I also walked to and from work. I could have easily got a bus, but I thought, I'll get up earlier and walk to work. And I do enjoy working or walking, but I'm working as well. I do enjoy walking, but maybe walking the same journey every day, five days a week. And I worked in a hospital that time. So it was a really big hospital. I remember...
00:07:58
Speaker
not trying to get more steps but just tracking how many steps I did and it was like 8,000 by just being in hospital not even getting hospital. Without the walk to and from. Without the walk to and from without then going to the gym after or before as well. So I think I was trying to do it all yeah whilst also tightening the reins and food and activity. Yeah, like your body was probably burning quite a significant amount calories because you were on the go from yeah morning to night. Yeah.
Risks of Calorie Tracking Apps
00:08:23
Speaker
And then what kind of calorie range were you in? And I know that's all very relative depending on the person and the size. Yeah. You know, as a young person who would have body would have been burning calories.
00:08:33
Speaker
I have no clue what it would be and I'd maybe be bit hesitant to say an exact amount in case someone who is listening to us might think, um but I remember the first year of uni and like one of my friends saying, oh, like, have you ever heard of my fitness pal? And I was like, no, what is this? So then I downloaded it and obviously it gives you a set amount of calorie goals. We all know what set amount. Like a 1200 or 1400. So I definitely probably was in and around that, maybe given a bit of leeway for activity and it maybe did. And it definitely did fluctuate the weekends versus weekdays. But the reason why I was asking that is because like that, with like and I would get a lot of messages on social media about, you know, what calories should I start on my fitness pal? Well, you know, because, you know, you set up my fitness pal. Yeah. And it will be like, you know, how active are you and how how much weight do you want to lose per week? think that's the most harmful question because who's going to be a half a pound, a pound, a pound and a half or two pounds? Everyone's going to pick two pounds. Yes, of course. Please. Like, let's get it done. Yeah. And then straight away, it's going to give you like twelve hundred calories on average. And yeah, that that was kind of yeah yeah my question around it, because I really like my there's ah obviously calorie requirements are very different person to person. course. Body size, age, yeah so many different factors.
00:09:46
Speaker
But for most women, that number that my fitness pal is giving you is going to be highly under Yeah, exactly. And similar to maybe a four year old. And I'm not against calorie track. And I think it's a useful tool for a short period of time. But yeah when I was thinking about like the timeline, I in my head thought, oh, maybe I did that for two years. But I started uni in 2011 and I got my period back in 2017.
00:10:11
Speaker
seventeen So like that's a long time and I'm sure there was fluctuations between that but that's a long time to be cracking the whip when it comes to food and exercise. So like if someone's calorie tracking it shouldn't be for years and years on end. It's in an educational tool but I even while I was studying to be a dietitian at that time i was using or relying a lot of external trackers to determine how much I should eat and maybe ignoring the internal signals. Exactly. And I think that's a really good point. And, you know, I do talk a lot about tracking calories with clients and some clients will track kind with calories. Some people won't. It's really important. Your your mindset behind it, I think. And if you are, if if someone listening is tracking calories, just make sure you're doing it to be like, am I getting enough fiber? Am I getting enough protein? Exactly. Using it to as a am I actually fueling myself well rather than, oh, God, I have to restrict this, that and the other. And how they're feeling as well, because, you know, probably if I was tracking other
00:11:09
Speaker
things then like I definitely had more sluggish digestion wasn't going as regularly I definitely was more preoccupied with food I definitely would be a little bit stressed about the idea of going out for food and how maybe I would manage that too as well but for a lot of the time when I was doing that I was on the contraceptive pill so I probably just thought everything's taken away hunky dory in the background little did I know and we get away with a lot in our and it's kind of in our 30s and 40s we really need to start healing what's happened but in relation to hypothalamic amenorrhea have I said that right? I don't
Defining Hypothalamic Amenorrhea
00:11:44
Speaker
even know if I say it right so hypothalamic amenorrhea
00:11:47
Speaker
What is it exactly? So I know you've we've kind of we've danced around it here just in this kind of introduction. But what exactly is it? And yeah like how would you define it, I suppose, first of all?
00:11:58
Speaker
So it's that I suppose maybe a more scientific answer would be it's a disruption to the Hypothalamic, pituitary, ovarian axis axis. And I would say the hypothalamus is one domino, the pituitary is another domino, the ovaries are another domino. And it's like the dominoes aren't connected and and not going on to each other. So that then suppresses the first hormone moon that's suppressed by the hypothalamus in response to stress, activity, over-exercise, under-eating. The hypothalamus then interprets that stress. It's kind of like the project manager. of everything. So, you know, the team's food might get stressed. It thinks, how are we going to cut down on this stress? So it suppresses a hormone code called gonadotrophin-releasing hormone, which then knocks on to suppress luteinizing hormone and follicle-stimulating hormone, which are involved in ovulation. And then that knocks on to suppress progesterone and estrogen. So it's basically an energy-saving condition
00:12:46
Speaker
to allow the body to prioritize energy for the absolute essentials like pumping blood around the but ah body, pumping oxygen around the body as well. Because it's nice to have regular digestion, it's nice to have a regular period, but when it comes down to it, ultimately the body's goal is to keep you alive and to keep things taken in that way. So it's an energy saving mechanism, but it is a condition and it's functional in terms of it's in response to the stress that your body interprets.
00:13:12
Speaker
And that stress may not be being stressed, like which we'll which we'll dive into now. But and I think what's really important here as well is to note that like people might be like, obviously, Kate, if we're talking about periods, but it is a hormonal issue because I think when we think about hormones and I'm glad you mentioned different hormones there and different glands, we we tend to think of you know, estrogen, progesterone and cortisol. And that's all. You know, it's I think some of us might even think, just or do we have more hormones than that? You know, but that that there's other things going on that, you know, are connecting the brain to the ovaries to, you know, like there's a lot yeah going on there that is affected. Yeah, that's taken along, I suppose, in the background that we don't necessarily know. Like I probably had only ever heard of estrogen and cortisol has maybe had a bit of airtime in the past few years. But i don't know if I'd have heard of that in the past either as well or any of those other hormones. And maybe that's something that came after my own experience. I didn't ever know anything about the hypothalamus or pituitary or those hormones being suppressed when I was going through getting my period back but then through going back and looking at more research and evidence and reading up on it then I kind of learned that in hindsight and was able to piece together my I suppose my experiences with the science and how that maybe tied in and fit the puzzle pieces together.
00:14:27
Speaker
Yeah, I think what's really important that you have said here as well is that, you know, the likes of digestion or a period are not essential. You know what mean? So if you your digestion is off or we're not even going to talk about digestion, we put that aside. yeah But if your periods are irregular or you stop getting a period,
00:14:47
Speaker
It is a sign that your body has gone into survival mode yeah for whatever reason that and I remember at the horology event. I don't know if it was you or one of the other wonderful ladies that were talking that said your period is like your monthly report, your monthly health report. yeah Once you get your period, it's regular enough. You know, you can be like, yes, great, good health this month. well yeah And sometimes it's kind of just like the fifth vital sign for females, but also in periods of like wartimes, famine, like the birth rate fell.
00:15:15
Speaker
Women weren't getting their periods as well, but like it wasn't something that was recognized. It but probably was accepted in that time. OK, that makes sense. But that was like famine. Maybe not, you know, an external factors influencing the ability to get enough food. Well, that's it, because if you're in a famine, you're not eating. But like isn't that where it comes from? Like, even if we go back to like caveman times, you know, that when the men went out to get the food and if they didn't bring back enough food, yeah women would stop getting periods because they wouldn't have had enough food. So they that that would be your body's sign. I don't know I heard this. That would be your body's sign that we can't reproduce. It's not safe. There's not enough food to feed someone else. Yeah, because ultimately your body's thinking, okay, if we're having a period, do we have enough energy? Should conception happen? And and absolutely, there was no spare change when it came to that energy when I had hypothalamic amenorrhea. Not that that was never my goal around that time, but I also remember listening to a podcast, not health related, where they were talking about being in fight or flight and sex drive and things like that. And they were, this might be a little bit crude, But they were like, you know, no man is going to war and being on the war line with feeling like their libido has increased in that moment. So it can also impact meals. And I suppose maybe that's more relative energy deficiency in sport or testosterone deficiencies that it can impact as well. And I suppose maybe I've and boxed myself in calling myself her health dietitian. especially now i'm working a little bit more in fertility as well and I suppose that involves two sides but yeah it definitely is maybe more fight or flight and just the stress in the body but it doesn't need to be I feel stressed it can come from ah other sources
00:16:48
Speaker
I think there's a huge there seems to be i don't know whether it's just because I'm in the other female health space, yeah but there seems to be a huge increase in the normalization of not having a period. And that's not by no means pointing the finger at anyone and saying, oh you think it's normal and, you know, there's something wrong with you. Not at all. But I just think the more women who seem to have lost their period, the more than it just seems socially acceptable or normal and maybe they've gone to a doctor and actually sorry I know people who've lost their period who've gone to a doctor and the doctor's like well there's nothing wrong and you know yeah everything seems to be fine and I know this is a conversation you were we were having beforehand as well that you know if the medical professional the doctor tells you yeah everything is okay then like what do you even do there you know it's yeah it's becoming more normalized and I i think
00:17:35
Speaker
like, correct me if I'm wrong, that it would have been much more kind of an issue with athletes and maybe people who have seriously disordered eating or eating disorders. Whereas now I think maybe it's the rise in health and fitness and people are running marathons and they're training for high rocks and they're, you know, they're doing bodybuilding shows or photo shoots, you know, is another big thing at the minute. Yeah.
00:17:54
Speaker
There's a huge rise in it, isn't there? Yeah, definitely. And also, i think, like, you know, maybe it's accepted that you would lose your period if you hadn't eaten sorters. Maybe it was previously accepted a little bit more that you would lose your period if you were an athlete. But I know I see plenty of clients who...
00:18:09
Speaker
you know, compete to a very high level. But I also see plenty of clients who train regularly and they are doing way more than maybe those athletes that are competing for very high level sports or teams as well. So and also, you know, typically people who lose their period look, quote unquote, very healthy on paper. They're active. They're eating well again, quote unquote as well. and But it's very hard as someone and maybe most of the females I work with, they're maybe in like their 20s or early 30s. Like it's very hard if you're not from a health care background as well to question a health care professional. Like I would never have done that whenever I went to see the GP. I just kind of brought the information and thought, let's see how this goes. You know, I would never went back and be like, here, actually, this is this or no, I don't think this is right. So it is difficult to advocate for yourself. But also there can be, you know, GPs have to know so much about everything. So I know sometimes I say like, oh, you know, someone's went to the doctor and they've been told this is normal and that's not the case. Like, I'm sure it's so difficult for them to have to try and pinpoint if they don't have as much experience or knowledge in that area as well. And maybe I feel the opposite where maybe it's being spoke about more and more. not being accepted as much, but that's probably the type of people who are contacting me and saying, you know, I know something's not right. But I would say that most of the females I work with went up through a period of ignoring and accepting that this is okay for a while until like that kind of inner voice, so maybe gut feeling kind of builds and builds till they think, okay, maybe this is something I need to address.
00:19:38
Speaker
Yeah.
Diagnosing Hypothalamic Amenorrhea
00:19:39
Speaker
How do you go about getting a diagnosis of HA? HA being it' how we shorten it. is Oh, yeah, definitely. HA. Because like, obviously, there can be other things going on. Yeah. and particularly, like I work with a lot of women who are over the age 40. So, you know, as we get mid to late forty s we're talking perimenopause as well. But, you know, there there can also be a lot of women in their forty s who are training for marathons or high rocks that, you and it can be like, oh, it's just my age. Yeah. Or, you know, that these I would imagine if you kind of are under fueling and overtraining and you are dealing with perimenopause, that's going to make it a shitload work harder, yeah hell of a lot worse.
00:20:15
Speaker
would imagine. Because I always say menopause is a natural process where gradually ovaries stop and slow down working and oestrogen production slows and reduces whereas hypothalamic amenorrhea is a condition where then oestrogen production slows or stops or is suppressed. So there can be a crossover in terms of symptoms which can also be pretty tricky as well and I suppose the more I learn about menopause the more I'm maybe more hyper aware of maybe those you know age groups where people might be like late 30s early 40s of perimenopausal symptoms coming in and as much as I have the personal experience and a lot of client experience with different um scenarios of people losing their period I always encourage people the first stop is to go to see your GP yeah get your bloods done and like describe your diet and lifestyle as well because that's a really important part in terms of the diagnosis yeah that's why I said to even if you're not asked to tell them. Come with the information, bring the list, bring the plan. and but I can't remember, ah so there was a study in Australia, I think, done, and it was, I always get this confused, 86% of people diagnosed with PCOS
00:21:21
Speaker
or diagnosed with the HA would have been diagnosed PCOS had they not been asked diet and lifestyle questions. So there is a little bit of a crossover in the diagnosis. So obviously, you know, it seems silly. You go with no period, they'll rule out pregnancy. You know, and some people might, that might be the very thing that they're wanting their period back for as well. They will check their bloods in terms of iron and thyroid. You might be referred for a pelvic ultrasound as well. And that might be through a gynaecologist that will do that as well. And I suppose they're looking for anatomical reasons or physical reasons why you're not getting a period. then you might be referred to an endocrinologist or you might be referred back to your GP as well to discuss further. I suppose if someone maybe isn't getting a clear answer, then it can be very difficult for them to think, okay, let's, you know, I've read this is what it takes to get my period back, but I don't know why it's missing in the first place. I don't know, is it hypothalamic amenorrhea? Could it be PCOS? So it's very hard to lean into that recovery process without a diagnosis. So I'd always try and push for a diagnosis. And whilst I see a lot of people and I think, oh, like it definitely sounds as if they have HA, I would always encourage them to get a diagnosis first, even just for throughout the process that we work on. Sometimes there can be a bit of questioning and think, what if?
00:22:27
Speaker
this isn't the case and I'm making things even worse by what we are Yeah, because as a dietitian, you are not giving a diagnosis. They need to have the diagnosis to come to you and then you're there for the solution and the recovery plan. Yeah. And sometimes that might mean, you know, switching to a different GP or pushing for like an endocrinology referral or Can someone come to you if they're like, I've missed my period or I'm missing my period. I've been to the doctor. I keep getting cast aside. Yeah. Like, can people come to you for you to help them advocate for themselves to get the diagnosis to start? Yes, I don't mind writing a little letter saying, pretty please. Thank you. I'd be so grateful if you could check this. But also, I suppose, ultimately, I'm looking at fueling activity nutrition. So even if someone's having regular period, you know, I would still look at those things and whether they have a diagnosis or not, I kind of would be able to look and say, OK, let's look at all other symptoms, digestion, which we'd mentioned before, maybe sleep. It's quite often people will wake early. They'll not be able to get back to sleep. They'll struggle getting sleep or they'll sleep in issues, maybe night sweats sometimes as well. Looking at energy levels and also mood and also feeling cold, like cold hands and feet all the time. That's definitely something that I struggled with, but I just always say home.
00:23:34
Speaker
Cold wifey, I'm always cold, when that's not the case as well. So I suppose a diagnosis is good to have, but we can still be working on things to hopefully try and correct food-wise, nutrition-wise and lifestyle-wise that might be feeding into those hormonal issues and no period as well.
00:23:53
Speaker
So if we leave because we go into the solution and kind of what you do now in a minute. But before we do, if someone is listening and they're kind of have just kind of been leaving things be and be like, oh look, this is just the way I am. This is normal for me. What are the health consequences to long term lack of periods like with not dealing with finding out what's going on underneath? What are the potential health consequences?
Health Risks of Untreated HA
00:24:14
Speaker
Yeah, I suppose most people think of fertility as the first line because if you're not having a regular period, chances are you're not ovulating, chances are it's going to take a longer time to pregnancy or it's going to be quite difficult to become pregnant. So that is a consequence of hypothalamic amenorrhea. To my knowledge, there's no long term consequences once you regain your period on fertility, which is reassuring. But I would say that's the driving factor for me seeking help, even though I was in my 20s, was single. Was definitely not wanting to try for a baby, but it was a background like... But most young women are going to think that, you know, if you want to have a family someday and if you haven't got a period, you're like, shit, better sort this shit now. Yeah. And I suppose it's something I'm like, whoa, OK, like this is I know this is my behaviours that are feeding into this. So if this is something I correct, maybe I want to dip a toe in terms of what that might look like. But the key and most long term health consequence or most serious long term health consequence of hypothalamic amenorrhea is bone loss or low bone mass. So females with hypothalamic amenorrhea tend to have up to 15% lower bone mass than those who have a regular period or equivalents. And you can lose up to 2% to 3% of your bone mass per year of no regular period. That's not to scare people. I've already calculated I probably lost about 5%. you know, in terms of me having no period. But you also, a lot of people lose their period, maybe in their early 20s. Maybe they haven't reached their peak bone mass at that stage, but also focusing on calcium, vitamin D, but also adequate nutrition. And sometimes people think, okay, well, I'll protect my bone mass by doing more weight-bearing exercise. But the key factor in terms of optimizing bone mass will be restoring your period and helping in terms of increasing those estrogen levels. So bone mass is a key factor. Stress fractures are much more common. In athletes with amenorrhea, about a third will experience a stress fracture, whereas only 5% of those with a regular period might do as well. And then also heart health. So oestrogen helps the blood vessels to stay flexible. So can help in terms of regulating total cholesterol LDL, which is the cholesterol we don't want too much of, and HDL, which we want more of. So it helps to regulate those levels. So quite often, people with no period or low oestrogen, hypothalamic amenorrhea, might go to the GP and they say they've got high cholesterol, okay, we'll cut down on fats, make sure you're being active. Suddenly they're dieting and exercising. Yeah. Oh my God. Again, something that I probably learned along the way. So they're kind of like the heart health, bone health, fertility, kind of the key things that people think of, but also digestion wise, per sleep, it can impact your mood. And I suppose with mood, It can be a chicken and egg. Like, was it low moods fed into this stress or actually has a lack of energy and poor energy availability fed into low mood and irritability? Yeah. So it's difficult to know what came first. And females with hypothalamic amenorrhea have higher scores in terms of depression skills, anxiety skills, and difficultly coping with day-to-day tasks. But again, not sure if it's cause or effect when it comes to that.
00:27:06
Speaker
I think that bone density piece is absolutely huge. And I'm so relieved it's finally becoming talked about so much more because it's not something that women think about. Like, and for for decades, it's been all about getting smaller and smaller and skinnier and skinnier. And, you know, that diet culture. And I was listening to a podcast recently where they were discussing how we now have this frailty epidemic of postmenopausal women. yeah that didn't strength train that didn't know how to adequate adequately fuel themselves and that there's proven that its there's an increase in dementia and things like that in women as well because of yeah like that it's all tied in together yeah definitely and i again it wouldn't concern me if someone said to my twin he's like this will affect your bone mass I'd be like I don't care but I'll worry about that when the time comes. Whereas I always say to people, we work hard enough, we want to have good retirement. We don't want to be bouncing in and out of the fracture ward. And females already have a way higher prevalence of fractures than males. But I suppose going through puberty, pregnancies, menopause, all those sort of things, there are fluctuations in hormones. So it's what we can do and control and to try and optimise that as much as possible. And I did work in a fracture ward for a while and definitely there was far more females in it than there was males. But the recovery statistics for that maybe weren't too good either as well. So we want to try and optimize things for future. And women are living longer than men, but they're not necessarily living better.
00:28:30
Speaker
Like, you know, women are suffering longer, I think is what the statistics are as well. And when I retire, want to be going on holidays with my friends. Oh my too. I have adventures to be having. like And it's funny, like i I'll be 40 on my next birthday and I'm just like, my mum is in her late 60s, so she's still quite young, but I'm noticing her getting older, you know, and my aunties and, you know, like, and it's,
00:28:50
Speaker
like but not more so my mom, really, you know, and I notice her yet that and I'm you know, she started doing things like she's going to aqua aerobics and now she's got something she's got arthritis and she's got, you know, some joint issues and stuff. So so she can't really lift weights, but she's going to her aqua aerobics and she's doing a bit of yoga and she's actively trying to do this now. But like this information wasn't available to her generation. Yeah, and also maybe with the food side of things, some people cut down, maybe then they switch to plant-based milks or maybe they don't, maybe they make their porridge in water now and they don't add milk in, they're cutting down the calcium sources, yeah maybe they don't add in cheese, but you know, most people are maybe having the yogurts and the Greek yogurts. But then the calcium intake might be going down as well. So I say a large part of that is just the education around it and how important calcium is. And I think like we're going through each of the nutrients. Protein has been very popular. Fibre is getting a lot of air time now. I'm sure calcium will be coming soon in terms of making sure that we focus on that too. And it's so funny, like I actually remember as a child, my mom being really big on the calcium drink. yeah I had to have a glass of milk with dinner because you have to get your calcium in. But we were living in an age where it's very trendy to be lactose intolerant. Now, sorry, I know some people are lactose intolerant, but there's a lot of people that just cut out dairy because they're like, oh, you know, I don't think dairy is good for me. And that can be the case. But how do we make sure we're getting enough calcium if we're taking away yogurt, cheese, milk out of our diet? And you can absolutely support bone health by not taking dairy as well. like yeah The plant-based options are fortified as long as they're not organic. If they're organic, by law, they're not allowed to add calcium into it. But also when you add in calcium into an oat milk or almond milk or soy milk, it usually sediments towards the bottom. So you need to give it a good shake before you... Otherwise you're just getting it all at the end the carton. And maybe people don't like the plant-based cheeses as much as, you know, they might like the plant-based milk. So it's thinking, okay, well, are we prepared to have, you know, three milky drinks a day or three plant-based milks a day? Does that count if we have it in our coffees? Yeah, lattes, matches are a very good way. You know, actually, I suppose you want to use the trends to your advantage. So. Yeah, like match is very trendy. If we can then get in a lot more calcium through the milk and that then. Because I've noticed like I'd have three coffees a day, which I do think I need to reduce to two because my, you know, my stress levels. I do think I could probably I would probably be better on a little less. But anyway, I do have three coffees a day. But when like I'd be tracking that sometimes, I'm like, I actually get a decent amount of protein in through to my through my tree coffee. So yeah the calcium there counts as well. That's good. I just wondered was there ah like did the caffeine counteract the calcium?
00:31:16
Speaker
Not to my knowledge, but I suppose... You'd want to be getting in other ways as well. Yeah, and I'd be thinking, in okay, are we having... If we have a milky coffee, at least there's some nutrition with that, whereas sometimes caffeine can suppress our appetite a little bit and make us feel like, okay, we've got a boost in energy. We don't want to be having coffees instead of our meals, but just if we're trying to get that extra boost, that you know it does count. And I wish i liked coffee. I wish I could get that caffeine hit, but I don't. So I'm very aware that when I'm talking about coffee and caffeine and cutting down or maybe just being mindful of that, that like...
00:31:44
Speaker
I don't enjoy it I love tea um instead. So, you know, there's nothing. Coffee and caffeine won't prevent your period come back unless you're using it as a meal or a snack replacement. Yeah. Yeah. And you're using it to get through the day. yeah you're absolutely You're not listening to your body. Whereas if you can it like I it's funny, I didn't drink coffee for years, like all through school, college. Like I was never into coffee. And it's only I think it must only be about like three years ago or something. that I actually started. Yeah, I was like, know anything I'm going to get into coffee? I stopped drinking a few years ago. So like I like would never, like I don't drink at all anymore. But my thing is I love going out during the day and going to a nice coffee shop. Whenever I buy a tea, I think I've been rinsed here. Like this is a teabag and a drop of milk. So maybe I'll go for hot chocolate. And yeah, because like coffee out is always nicer than at home. Whereas tea out is never as nice as tea at home. That is so, you yeah, that's so true.
00:32:34
Speaker
Isn't it? So that's why I always need to cash in in the tray bakes or the buns because I'm like, okay, I've just got something I could make it, make it home so yeah so easily. But I do like coffee cake. So, you know, maybe that's it. Yeah. And you have to have something nice with it. Exactly. yeah Well, anyway, that was a little off topic. Let's talk about what you do in clinics. So, you know how. So if someone comes to you and like, I haven't had my period for six, seven months yeah or whatever, or even longer, you know, into a couple of years and you kind of they go, they get a diagnosis.
00:33:03
Speaker
Like, what is the solution? I'm sure it's probably very individualized, but what kind of things are important to start prioritizing to really get your hormone health back on track?
Approach to Regaining Menstrual Health
00:33:13
Speaker
I mean, usually I work with people over 16 weeks. it used to be eight, then it was 12, then it was 16, because I just feel like it maybe needs a longer yeah period of support. And when anyone's working on maybe um trying to regulate their periods if they've been irregular or trying to restore them, like you think a menstrual cycle is between 21 and 35 days. So really, if I'm only working with someone for the eight weeks, how much a week change are we going to see? So usually I always go over like all of the history, if there's been any bloods, investigations, when they think they lost a period, was there any contraceptives? In between, did they come off the pill and then lose it? And then also looking at through diet, lifestyle, stress and activity. And usually in the first week, we usually just pick out two to three things that are maybe obvious to me that are like the low hanging fruit in terms of what someone could change. Because someone might be walking the dog a couple of times a week and the next person could have an active job. So I always say is your work a workout. If you work in a hospital, you're probably on your feet all day. If you're a personal trainer, physio, you're on your feet all day as well. If you're guarding, if you work outside, a manual job. yeah like Where that is already a high baseline of activity and then we're doing more on top of that as well. But also looking at the food, are we eating consistently and regularly?
00:34:18
Speaker
Is it maybe more focused on tipping the so and the side of higher protein, higher fiber versus maybe higher energy foods as well? Then I kind of take them through a process. So maybe one week we might look at okay, let's just take the meals and maybe make it a little bit more digestible because I suppose I'm like a fixer and I want to give people solutions and all the solutions that they can start on. But it can be quite overwhelming to unpick habits of maybe a lifetime or a very long period of time. So maybe one week we look at meals and let's recalibrate and balance these, make sure that we're getting adequate carbohydrates and fats, which is not as cool as getting more protein or fiber. at the moment went as well. we're looking at that, making sure there's adequate portions of that as well. My bugbear is that the breakfast portions are always smaller than lunch and dinner. So like two scoops of oats is the same as one slice of bread in your sandwich at lunch. And there's no reason why breakfast should be smaller than lunch, if anything, you know. We should be making sure that we're having an adequate breakfast, especially if someone's working on period regain. Then looking at snacks, are they there? And also what are they made up of? Is it more like yogurt fruit, yogurt fruit, yogurt fruit? Or are there some, you know, nuts in there? Is there something with carbohydrates in It could be toast, cereals, granola bars, or some baked options, dried fruit, bananas. And then also looking at your exercise.
00:35:31
Speaker
One, with exercise, always think, one, can we feel what you're already doing a little bit better? Because I think people are terrified to maybe reach out for help when thinking, okay, I'm going to need to give up all this activity and I really enjoy it. Or maybe they see their friends at the gym or there's like a social aspect to it. Or it could be... So you're not trying to take things away that people enjoy. Yeah, and I suppose like in times gone by, maybe I've been like, well, okay, this person is not going to get their period back if they're doing like CrossFit four mornings a week. And I've been proven to be wrong. So, you know, with that, like we feel that person was like, I am not going to give this up. So was like, okay, like let's work together to make sure it's really well fueled. And that took a little bit of time in terms of being able to adjust tolerate food. before morning activity as well. So we'd look at fuel and existing activity first. Looking at the timings, can we maybe push it to later in the day or make sure that definitely we've had at least a meal or snack before. And then maybe looking at the type. So is there a lot of high intensity activity, high rocks, crossfit, running, those sorts of things. Could some of them be substituted for something that's a little bit lower intensity? Because often people think, okay, well I need to quit this exercise for a while, not forever.
00:36:37
Speaker
And then they sit at home resentful of the fact that they can't do do it. So does that mean you get next door in bed? Or does that mean that you can actually do your food shop during during the weekend? and You don't need to do it the weekend. Or can you catch up in that series or have a little bit more time for yourself? But a lot of people who maybe lose their period aren't used to having time for themselves. I think a lot of people in general, maybe now it's time for ourselves. It's what's left over at the end of the day. rather than scheduling in what we can do. So I always think of those three pillars and think how we could tweak things for that individual person. So I suppose like the balancing means and making sure we're kind of prioritising carbohydrates and fats will not be any different for one person versus the next person. But the changes and the scale of changes might be different depending on the start point yeah and similar with activity. Yeah. And depending, I suppose, as well. Yeah. On how much they need to fuel on on the activity and how much they're willing to. to bent Let's look at the nutrition side of things first then. So you would recommend obviously breakfast, super important, regular meals throughout the day. I'd imagine you are not a big fan of fasting. Absolutely not. Not good for female health, really, isn't it?
Importance of Balanced Meals
00:37:40
Speaker
sometimes people will just delay breakfast a wee bit longer. Like, it could only be two hours after they're getting up that then they have breakfast. yeah But actually pushing that a little bit earlier because, you know, it can be part schedule, part of it. More than this can be really busy for a lot of people. But it can also maybe be... Well, if I delay this and push this out, then if I feel hungry later, I've still got all my snacks and meals to be going through. And then you're kind of maybe disturbing the natural hunger signals because maybe you're ignoring a little bit of hunger in the morning time.
00:38:06
Speaker
And then there's more food squished into a shorter space time. This is a huge issue, I think. And I think a lot of women do this where it's like, I'll say just in case, you know, because I'm always hungry in the evenings. But what a lot of people don't realise is they're always hungry in the evenings because of the blood sugar level drops and from...
00:38:23
Speaker
leaving big gaps yeah and yeah their their body is trying to catch up if you've tried to lose weight and didn't get results here's why the plans you followed were built for perfect people with perfect lives not for women with jobs stress cravings kids and days that don't go to plan also there's no such thing as perfect That's why Nourish Her, my online coaching program, works.
00:38:46
Speaker
We build a plan around your lifestyle so that you lose weight without restriction. Build strength with workouts designed for your level and finally stop the cycle of restarting.
00:38:58
Speaker
If you want predictable progress instead of waiting for motivation, if you want a routine that survives real life, if you want results that last, go to the link in the show notes.
00:39:09
Speaker
and join the women who chose the smart approach instead of the hard one. So, like, I love to hear you say this. And I think, you know, when people ask me about fasting, I really like fasting. You know, I really like to go 12, 14 hours without eating. And, you know I've read it's good for this, that and the other. I'm like, OK, stop eating after dinner and don't eat till breakfast. But no one wants to do that. Everyone wants to skip breakfast. Everyone wants to have their evening snacks and not eat till lunch. Yeah, that's so true. Yeah, it's like you can fast while you're asleep and the evening and the... Definitely more comfortable with Erin on the side of hunger than Erin on the side of fullness. So a lot times people will be like, I didn't have that snack because in case lunch was a wee bit earlier and then I'd feel too full. But often when actually they do that, they realize that was a comfortable level of fullness or they haven't been used to feeling full and actually feeling full. Like if food takes up
00:39:56
Speaker
and or food takes up an area outside your body, it's going to take up space inside your body. And I suppose it's recognizing it's normal to feel full after meal. Whereas a lot of females I work with have been used to feeling that like kind of low level of hunger, which can be ignored. kind of scary then to feel full. And maybe fullness feels like too full or stuffed. And it can take a little bit of time for your gut and stomach to adjust. So like I always feel really mean when people come to me, they start work and they feel like, OK, I've rested more and now I feel more tired. I'm eating more and now I feel more bloated and I'm eating more and now I feel more hungry. And I'm like, great, this means that we're making changes. But all of those things can be absolutely terrifying because if someone's starting to eat a little bit more, challenge their relationship with food or if there is any disordered eating behaviours in the background, then the idea of eating more and it not paying off and then feeling full can be very scary. But that's like the speed bump. We'll get over the speed bump and things will settle. But if we kind of go halfway up the speed bump then we can run back to the restriction or actually think, no, we'll not eat regularly, then you're going to have to go through that phase again.
00:40:56
Speaker
It's funny that you say that because it's the exact same obstacle to fat loss. So like I work with women who are, you know, who are trying to lose body fat yeah and and in a sustainable way. And the the biggest complaint I get when people start working with me is my calories are too high or, you know, if they're not tracking calories, you know, I'm eating I'm eating too much. i'm just so full all the time and they can't get over it. Or even, you know, they get really fixated on the scales and that if the scale is not moving, the scale is not moving, but then like they're losing centimeters and inches and they're, you know, you can see it in their photos, their genes are getting looser at the scale. But like, but the scales isn't moving. And I'm like, yeah, but you're eating more protein, you're eating more fiber, you're hydrating better. Yeah, you're using your muscles like, you know, trust the process. And but I think a lot of women yeah in relation to to dieting, you know, and, you know, and people who, you know, who want to get to a healthy you might be, you know, overweight and want to get to a healthy weight, they give up.
00:41:49
Speaker
Because when they do it the right way, they and and they're feeling full. And that's hunger is actually the enemy to fat loss. Yeah. Because you need to feel full. It's the same principles. It is the same principles. In terms of just regularly and reconnecting with those signals as well, too. And being able to listen and tune into what your body needs as well. But I always describe that phase as like you're walking through mud walking through glue. Like it doesn't feel intuitive at all. And you're probably quite ready. But it's the cliche, isn't it, of trusting the process. And it's just interesting that it's a similar resistance either end of the scale, really. Yeah, definitely. That in the middle, when you push through that resistance and you do trust the process, then you enter into the area of health and optimising.
00:42:33
Speaker
Yeah, optimizing And there's a lot of freedom in that, but there's also, for some people, it can feel like there's freedom in restriction and freedom in a lot of control. And it can feel like, oh, like how would I get from there to feeling in that fullness, feeling my hunger as well? can be feel really way off. But also, a lot of you know times when I work with females, they might say, eat out at the weekend. I'm happy to go out. I'll have P.S. 3 on Saturday. you know yeah We'll eat on Saturday night. But then they tighten the reins during the week. And I suppose then their experience of trying to allow themselves to feel the hunger is the weekend and then pulling back after as well. So it's kind of like I always describe it as the finger in the edge of the cliff. You're allowing yourself a little bit of leeway, but you're still pulling back the reins on the control. And that can be terrifying if you actually can't think of a time when we were able to trust our hunger versus maybe letting external factors.
00:43:24
Speaker
yeah control that as well. So like I always like could try and educate people on hunger and fullness and feeling that fullness and honouring your hunger down the line but in the initial phases of period regain you know it's unlikely someone will regain their period if they were waiting for to feel hungry before eating because usually usually their hunger is a little bit more suppressed so sometimes you need to eat to feel hungry.
00:43:43
Speaker
Yeah, which is kind of the opposite way. Interesting. I want to talk a little bit on the mindset side and the mental health side of of that. But I want to circle back to that because while we're still talking about nutrition, I want to talk just a little bit about carbs and fats because this is you know a common misconception, yeah which is getting better with the right people putting out the right information on on social media, let's say. We
Role of Fats and Carbs in Hormonal Health
00:44:06
Speaker
need fats. We need carbs. It isn't like you said, just protein and vegetables. I know vegetables are carbohydrates to a certain degree. They are carbohydrates, but we need other carbohydrates as well as our vegetables.
00:44:18
Speaker
Yeah. And with my clients, I always say, you know, unless it's sweet potato, we're not going to notice a carbohydrate at the moment. Yeah. because I like to keep it as a separate food group, really. I'm like, you know, protein, carbs, fats, yeah vegetables. Yeah, exactly. Yeah, exactly. i always say like protein, fats, color and carbs in terms of that. But with the fat, like fat is the flavor. So like when people have a big, massive meal, they can feel physically full, but maybe there's loads of protein and loads of fiber in that. But then they always need something sweet after or they're always craving something. And that's more of the satisfaction factor. So if we're getting enough of the fats in, then...
00:44:52
Speaker
I always describe it as like a meal at home versus a meal out. Like maybe after a meal out, you're like, I'm stuffed. Like not even bothered by that dessert menu. I'm making the same equivalent meal at home. You might be like, right. OK, like need. Yeah, I need my tea and chocolate. Yeah. I definitely experienced that a lot. And it's only yeah, it's only in recent years because I like I like that. I would have always been low fat yogurts and, you know, low fat everything kind of. And I would always have like my lunch or whatever. And then I would have to have the chocolate bar afterwards. And it was introducing whether it's the nuts, the seeds, the avocados. Yeah. Even like I make this like chicken sandwich, like if my clients listening, laughing because always talk about my chicken sandwich because people are always like, what will I make for lunch? There's nothing wrong with a sandwich. I make this chicken sandwich. But, you know, basically be like, you chicken salad bits or whatever.
00:45:34
Speaker
Cheese, two slices of bread, throw it on the on the sandwich maker. oh yeah But I started to add half an avocado mashed up in there. Gives a gorgeous texture. But I actually, even though I know, like e theory, that's going to make you feel fuller. Yeah. I couldn't get over how much of a difference that made to my satisfaction after the sandwich. Yeah, yeah, exactly. And sometimes it could just be allowing yourself to explore those things and monitor and see because, you know, one meal might be really satisfying to one person, might not be satisfying to other person. Or like, I love sweet breakfast. Like if I go to a cafe and there's pancakes or French toast or something like that, like I'm absolutely going to go for that. But maybe after night out, I want something salty. So, you know, if I stuck to this sweet breakfast after night, I might feel more sick or feel like, oh, I still feel like that hasn't really ticked the box for me in terms of that area of hunger and fullness and appetite. So interesting, and even realizing there's different types of hunger. There's like the practical hunger, which might be you never see some of the young children leave the house without snacks. But then as adults, we forget that we need snacks as well or we're comfortable going a little bit longer. But practical hunger could also be doing a so shopping list or batch cooking or just planning. OK, like this is going to be a really long meeting. I need to make sure I have a bigger breakfast before or that some handy or discreet snacks. It is about planning ahead, isn't it? Like it is just like we would say this with our clients as well. We need you need to be a day ahead of yourself. Like at least yeah just, you know, just plan your meals for the next day before you go to bed. the You know, if you have a busy day, obviously, if you have a quiet day, yeah you can go with the flow. yeah But like and I would really structure my day around that. I'm a bit like a toddler. I don't come out without snacks or knowing that I'm going somewhere for lunch because I just and I hate I hate feeling hungry. yeah But I was minding my six month old nephew the other day. And like I had my three kids are older now, so it's great, you know, but I forgot to have lunch and then I had like a physio appointment and I had forgot to have lunch and I got back from I was driving home for the physio. like, oh, my God, I'm starving. And was like, oh, my God, it's nearly three o'clock. I haven't eaten since nine. What? And I was like that. You forget how busy life can get because I wasn't used to that routine. But it's just so important. And there's appetite. disruptors as well where like ah your body doesn't know a busy schedule for member and building so if you are go go go go go and a lot of times with the females I work with it isn't necessarily that they feel stressed but if they I always tell write out your schedule and give it to a friend or family member and be like what do you think about this and usually there isn't time to catch a breath because it's just go go go go grow the whole entire day so if that's the case then when you get home evening time you're a little bit more relaxed, you have a little bit more time, then sometimes there can be a surge in hunger and it can feel a bit counterintuitive to be like that hunger isn't to do with dinner or the evening snapshot, it's to do with earlier in the day and making sure that we're kind of planning ahead in terms of that as well because it it doesn't feel natural. you know, if I needed to take antibiotics, I wouldn't wake up morning and be like, well, i can't wait to have my antibiotics. I need to set alarms, reminders, post-its, all those sorts of things. And when you're doing new kind of structures, habits in terms of food, then it needs to be like that as well. So usually I get my clients to keep a food diary and they probably think I never give it a rest, but I'm like going through be like little tweaks because no one needs meal plan to get their period back. They just need to tweak the existing meals that they're already having to make them more satisfying and also
00:48:47
Speaker
a little bit more balanced in terms of making sure there's enough energy within them. And then, you know, you don't want and a meal plan that's like, this is my period again meal plan. And once it's back, then I go back. to Yeah, exactly. Because meal plans don't work long term. yeah And like I always say that as well, like eat the way you eat. Just let's try and make it a little bit healthier step by step. Of course. And even that will help to learn in terms of like, okay, if I was to have this meal, what's it missing? Or like if you know someone's used to having soup at lunch, like but they have bread with it, we can balance out with adding little bit more protein into it or adding something with fats for the flavor. And whilst maybe soup and bread is filling in the moment, and soup occupies a kind of a larger volume,
00:49:24
Speaker
then the hunger kind of can surge later on. So yeah it's just, I suppose you're learning habits for a lifetime. And whilst we're tipping in higher energy, higher fats at the moment, that kind of we almost need to overshoot. We're like banking spare energy for the body to really reassure it that there's definitely enough energy that it can safely redirect it towards the hormones.
00:49:43
Speaker
Yeah. And that craving thing is a huge thing across the board for a lot of women, isn't it? Like that evening time eating, the uncontrollable hunger that they have dinner and then they can't stop or or they they do restrict themselves, but it's all they can think about. And it's really, really disempowering, isn't it? And it's really kind of debilitating. Yes. Like I know obviously and like let we'll dive into the mindset side of of of all of this now. But like so there can be emotional attachments to it. But a lot of like a lot of you know people will say, oh, I emotionally eat.
00:50:13
Speaker
But sometimes a lot of it can actually just be structural in your meals, can't it? Yeah, absolutely. not having the right balance of protein carbs fats not having the right amount of meals in the day and have them spaced out properly and that can actually make a huge difference and that's like to make those changes first see where you stand yeah be surprised at how much of a difference that makes to your cravings and don't be afraid to not save enough for your evening time whether it's calories or whether it's you know eating time like just trust yourself and trust your body a little bit more
00:50:44
Speaker
Yeah, and and like I suppose like usually we start with like the structured eating. There's a lot of structure maybe in terms of meal time and snack time. It's what they need to include and maybe go on more to flexible eating where there's a range of times so you know yeah where we're still keeping and maintaining the regular eating. And then usually like in the last session, if someone's got their period back and things are looking regular, we discuss like next steps in terms of, okay, what would reintroduce and some more activity look like and how might we balance that in terms of still making sure that we maintain and keep our... menstrual cycle as well but also maybe moving more towards intuitive eating where actually before we needed all of those structures in to ensure we ate enough like what does that feel like and whenever you do the hunger and the appetite work then that can really help as well too because like i don't let myself get too hungry because my first sign of hunger isn't a rumbled stomach it's being really irritable and annoyed at everyone hungry So, so yeah yeah, I just know I'm not a nice person when I'm hungry. So like I want to eat regularly for that reason or, you know, or even if I've been sick or ill in the past, like or something bad has happened, like like I lose my appetite. I'm like, OK, to the smoothies we go because I don't want to feel worse or like and the food to feed into those issues. Find little hacks to get the nutrition into you in a way if you're not feeling hungry. And it's normal to lose your appetite at certain times, but it's how we can
00:51:58
Speaker
I suppose, do better than we were doing before, where we wouldn't just not eat. Like, can we at least get in some regular snacks yeah and smaller meals, even if they aren't as much as what we maybe were going for before? That it's not about being perfect. Yeah, course. It's more the patterns over individual meals or snacks. Yeah. And like I can imagine like this. Yeah. You do need to spend this over a long period of time to to change these things. I would imagine you get a lot of resistance for this habit change in relation to mindset and, you know, like particularly if there's if there's disordered eating patterns that have caused this. Do you find is that something that you you work through with clients or are there times where you do refer that they need to work with psychologists as well? Yeah, I would always say if someone's struggling to make the changes that definitely therapy or cycle psychologist input is super helpful because ultimately like, you know, most people know what they need to do. They've contacted me for a little bit of additional support and guidance and maybe reassurance that that's definitely what they need to do. But there can be underlying things that have fed into the way they eat, the patterns, yeah why they exercise, when they exercise, all those sorts things. So it definitely would never be wasted in terms of any therapy or psychological input
00:53:06
Speaker
I'd say a lot of the people that I see in my own clinic, I've kind of reached the end of their tether yeah and they're like, okay. They're ready change. Yeah, exactly exactly. But I always say to them, you're feeling great in this first month, but in the second or third month, there's definitely going to be a slump. So like yeah write down how you feel now and the positives that you're feeling so you can look back on that. But I also gave maybe some journal prompts and things like that, like what does a healthy relationship look like food? Or do we know anyone with that? Or, you know, what things can we do to comfort and soothe when we have taken away the restriction and taken away the exercise? Because really, you're kind of, it's like a maze that you're trying to go out of whenever you're feeling that discomfort. And if you used to go for like the restriction route or increasing activity route, well, if you take those away, you need something else. You need something else in lieu of that as well. But once the period comes back, then everyone always forgets that for you. But it is difficult. And sometimes, I know it sounds very traumatic, but I do describe it as the stages of grief because it can be anger, resentment, bargaining.
00:54:05
Speaker
Well, maybe I don't need to do this. You know, this seems like too much. Sure. They aren't doing that over there. And then also acceptance. And I suppose maybe most people are at the acceptance phase when we start working together. But I always do like I make no qualms about the fact that their body and weight might change. But it will also, they will feel more dramatic because we make changes quite quickly in the first month and then we're tweaking and preening in month two, three and four and monitoring different signs. So once someone gets appeared back, all makes sense. But along the way, maybe they notice increased discharge or increased libido or their digestion gets better, their sleep and better energy is getting better as well. So it's good to pick out those little bits of evidence to reaffirm.
00:54:45
Speaker
Yeah, this is needed and this is our goal. What about exercise? So I know again, how long is a piece of string? You're not going to have the same kind of advice for everyone. And you kind of touched on it a little bit already. But like, do you get clients to pull right back?
00:55:01
Speaker
No, I don't. I usually like ah we always take a week and discuss exercise and not always the first thing is how we can feel a little bit better. But I'd always educate in terms of like, look, these types of exercise, like the HIIT and the higher intensity running are going to be more stressful and feeding into this issue much more at the moment. Like, what do we think in terms of could we substitute them for something a little bit lower? Could we split up the rest days? Most people save the rest days for the weekend and then they chuck everything in and Monday to Friday when they're really busy with work and they're trying to, you know, tick all the boxes as well. So can we spread those out? and So I suppose it is very individual. There's never no blanket...
00:55:35
Speaker
a amount that I would recommend and you know it's nice to do some movement and activity but we'd also explore the relationship with exercise and there are some questionnaires like in terms of exercise addiction questionnaire or compulsive exercise tests that we might go through and just just to give a bit more insight into okay maybe I thought there wasn't an issue here but you know, I'm scoring pretty high in this or, you know, these things in terms of being flexible with activity or being able to prioritize other things above activity actually are quite tricky.
00:56:01
Speaker
If someone struggles with activity, I would say it is going to be easier to reduce than if you get an injury and you have to stop. And that's really confronting. And a lot of clients I've worked with recently have got injuries. And I say, this is like you're on the motorway and you're trying to get into the other lane and there's a teeny gap. Like, this is the gap. We're going to get your period back because your body has been like, we've given you enough subtle signs and you're not listening to them.
00:56:22
Speaker
Now it's crunch time. Yeah, very individual for different people. For some people, they'll be open to stopping or reducing for a short time. But for most people, we maybe tweak the fuel and and the types and the time at first. Baby steps, because obviously change, like a you know this discomfort, like any type of change, yeah life change is going to be.
00:56:40
Speaker
uncomfortable. Yeah. So it's
Balancing Exercise and Recovery
00:56:42
Speaker
about, isn't it about like stepping out of your comfort zone, pulling back a little bit more than you'd like, you know, if fueling a little bit more than you like, but trusting the process and not taking away anything completely. But maybe it might be moving the gym session to Saturday whenever you actually have a bit of breathing space to go rather than be like, i need to get up. that I'm setting up a really busy day as well so looking at all those and also any activity most people think oh you know what activity do you do you go to the gym or you run but they don't mention the walk to work or cycling to and from places or being on their feet all day with work too yeah they don't yeah think about those things yeah
00:57:14
Speaker
Right. To finish up, can we do a little quick fire round? These are just a quick fire questions. OK. They're personal, not that personal questions. Oh, OK. ask most people, sorry, ask everyone these questions and the whole purpose is just 10 questions, is to show everyone that there's no such thing as perfect. There's no one size fits all for health. They're just one word answers. OK. OK. Oh, one word. OK. Sorry. No, sorry. One word. Short. One word answer. OK. So quick and to the point.
00:57:41
Speaker
Favour food. Probably like cakes or buns, tray bakes. Anything sweet. I know people call them different things. In the north we call any sweet thing a bun. bun. But tray bakes, yeah. Okay, love it. Favourite exercise?
00:57:54
Speaker
Walking. Me too. Yeah. What time do you get up at most mornings? Seven with a five minute snooze. Love it. How many hours do you sleep? Oh, I'm trying to work on this ah like seven and a half, seven to seven and a half. We're actually very similar. and Your favourite hobby?
00:58:13
Speaker
Favourite hobby? Tennis. Do you drink alcohol? Yeah. Do you meditate? No. but Sometimes if I, Shavasana is as much as a meditation as I get and that's a nice night time. Do you have a morning routine?
00:58:29
Speaker
Yeah, I love a cup of tea in bed. I really, and yeah. I'm like a little granny. But I love that that's your morning routine. It's not like I need to list five things I'm grateful for and I need to go and put my feet in the grass and I need to... Well, no, sometimes I go through phases of doing that, but they do not really maintain. Yeah, i like a cup of tea and then to breakfast. tea in bed always stays yeah at part of the routine. cup of tea you very soon after a food fall. So, you know, it's not suppressing appetite. Yeah, exactly. A cup of tea into breakfast. yes but Love it, love it. What annoys you?
00:58:56
Speaker
What? About anything. me I would say, you know, if I'm driving from Dublin to Antrim, maybe sometimes I get a little bit of rude rage. So the cortisol levels go up then. Yeah. Last question. And this can be more than one word. and I mean, I think I've done more than one word. for president yeah What does the word health mean to you?
00:59:16
Speaker
I think it means nutrition being part of it, but not being the whole puzzle. yeah And that it there's flexibility within that. And it's not restriction. It's more about what we can add and enhance as well.
00:59:30
Speaker
Yes. A waffly answer. love it Catherine thank you so much for giving me your time oh I've loved this this has been great thank you so much thank you and if anyone wants to like go to your to find out about your clinic reach out to you is website Instagram where's the best place for people to find you yeah a website I would say I've been on it five times this year there's not much happening there but there's information on it but most information probably people get on Instagram or TikTok it's the same of both I know I should have a strategy So at herhealth.dietitian is probably the best place. Or if you want to email me, Catherine, K-A-T-H-R-Y-N, at herhealthdietitian.com.
01:00:04
Speaker
Amazing. And we'll share all that in the show notes as well anyway. Thank you so Thank you so much. yeah Thank you.
01:00:10
Speaker
I just want to say thank you so much for listening to the podcast. And if you haven't already, do go back and listen to some of our previous episodes. Stay tuned for future episodes. So the best thing to do here is to make sure that you are subscribed to the podcast. It also makes such a difference to me if you do. So if you haven't subscribed yet, please do. And if there's any episodes at all that you particularly enjoy, please Please do share it with your friends, share it in your WhatsApp groups, share it on your stories. Please do tag me. I always love to hear it.
01:00:41
Speaker
Follow us on social media. You'll find me at Kate Hamilton Health on Instagram, TikTok, Facebook, YouTube. Until next time, thank you for listening.