Menstruation - Annika Nourishing New Life

November 24 2021

When to have your lab tests done?

annikanourishingnewlifecouk_main Blood tests, Fertility awareness, Hormones, Menstruation blood tests, difficulty falling pregnant, ovulation

Getting your blood drawn at the appropriate time in the day and in your cycle can be really helpful, to determine what’s really going on in your body.

Some lab tests you should be fasting for, others don’t really matter if you have eaten or not.

Some of the lab tests recommended should be taken in the morning after fasting overnight, such as: blood glucose, insulin, and am cortisol. The cortisol is more a timing issue of taking the lab sample within 30-60 minutes (or as close as) of waking and not so much because you need to have fasted.

LH and FSH are helpful to look at during the beginning of your cycle. Day 3 is optimal.

Male hormones don’t change too much depending on your cycle. If they are elevated, they are typically elevated, doesn’t matter if you are on your period, ovulating, or about to bleed.

You really only make an appreciable amount of progesterone if you have ovulated or are pregnant. So, if you have it tested early in your cycle before ovulation would take place, it won’t tell us much. Likewise, if you have a longer cycle, more than 35 days, getting a day 21 progesterone won’t tell you anything more than you didn’t ovulate “yet”. I always recommend women get progesterone tested seven days after ovulation. See my blog on ‘The power of ovulation’ and ‘Truth about getting pregnant on day 14’

Getting any other tests done like oestrogen, prolactin, AMH, SHBG, vitamin D or vitamin B12…. these are also tests you can have taken any time. Something like oestrogen is helpful to know what point of your cycle you were in during testing, and based on symptoms, your practitioner might request it to be drawn at a specific time.

November 24 2021

The power of Ovulation

annikanourishingnewlifecouk_main Fertility awareness, Hormones, Menstruation, Ovulation, PCOS amenorrhea, difficulty falling pregnant, irregular or absent periods, menstruation, ovulation, Polycystic Ovary Syndrome

Ovarian hormones, oestrogen, and progesterone are beneficial for health. This indicates natural ovulatory menstrual cycles are beneficial for health because ovulation is how women make hormones.

Men make testosterone every day, so you might think women do something similar, but we don’t. Instead, women make hormones as a surge of oestradiol leading up to ovulation and an even bigger surge of progesterone after ovulation.

It’s an elegant system that sometimes results in a baby. Even when ovulation does not result in a baby, it’s still worth doing because regular ovulation delivers the beneficial hormones that the body absolutely expects to have.

Benefits of ovulation

Every monthly dose of oestradiol promotes muscle gain, insulin sensitivity, and the long-term health of bones, brain, and the cardiovascular system.

Every monthly dose of progesterone reduces inflammation, regulates immune function, and supports the thyroid, brain, bones, and breast tissue.

The benefits of ovarian hormones are both short-term by making women stronger, and long-term by building metabolic reserve and health.

Obstacles to ovulation

Hormonal birth control

Hormonal birth control stops ovulation, which is, of course, its purpose. It switches off ovarian hormones and replaces them with contraceptive drugs like ethinylestradiol and levonorgestrel which can cause hair loss and other side effects.

Tip: There’s no progesterone in any type of birth control.

The physiological difference between our actual hormones and the contraceptive drugs of birth control affects every system in the body. Compared to women who cycle, women who take contraceptive drugs have altered brain structure and a greater risk of depression and autoimmune disease.

Undereating (to include carbohydrates)

Losing ovulation and periods because of undereating is called hypothalamic amenorrhea. It’s not a disorder, but rather a smart, adaptive decision by the brain to pause reproduction when there’s not enough food to safely make a baby.

Polycystic ovary syndrome (PCOS)

The hormonal state of excess androgens or testosterone can cause anovulatory cycles (cycles with no ovulation) and is usually associated with insulin resistance. Reversing insulin resistance with diet, exercise, and natural supplements such as inositol can help to restore ovulation.

Tip: Before you embark on any kind of calorie-restricted or carb-restricted diet for PCOS, take care that your diagnosis was not based solely on an ultrasound or an AMH blood test. Those tests are not reliable and may have resulted in you being told you have PCOS when you actually have hypothalamic amenorrhea.

In conclusion, ovulation is so important for women of childbearing age, but not just to make a baby.

November 24 2021

The truth about getting pregnant on cycle day 14

annikanourishingnewlifecouk_main Basal Body Temperature, Fertility awareness, Hormones, Menstruation, Ovulation difficulty falling pregnant, menstrual cycles, menstruation, ovulation

You do not need to ovulate on day 14 to get pregnant.

Only 10% of the population of women with a 28-day cycle even ovulate on day 14, this means a 21-day progesterone blood sample is likely to be misleading for many of us.

If you are ovulating you are likely doing so 10-14 days before the end of your cycle when your next period would start. That means if you have a 40-day cycle length, ovulation is most likely to occur between days 26 -30. If you have a 60-day cycle then it would be days 46 – 50. If you average 35 days, then you are likely to ovulate from day 21-25. See my blog on ‘Ovulation is what makes progesterone’.

I have seen plenty of women conceive when they ovulated late into a long cycle. If you have been told you don’t ovulate because your cycle is longer, then you were told something based on incomplete data. If you were told you don’t ovulate because they drew progesterone levels on day 21 of a longer cycle, the same thing applies.

So how can you tell if you are ovulating?

Many women move straight to ovulation predictor kits – also known as OPKs. This isn’t recommended for a few reasons, but especially for PCOS, where you can see a lot of false positives. I recommend instead learning what cervical mucus is and investing in a basal body temperature thermometer. Starting to collect data on the mucus your body makes and when your temps go up and down can literally tell us not only “if” you are ovulating, but also “when”.

You can ovulate with PCOS. Many of us can do so with a simple diet, lifestyle, and supplement tweaks. Many of us, it’s that simple to go from “infertile” to “fertile”, just getting us to ovulate. Then there are other things to learn, like how to time intercourse, how to support progesterone levels, and so on. But, be assured, you can get pregnant at different points in your cycle. Remember, it is possible to be a mum even if you have PCOS – I’m living proof and would love to support you on your journey.

November 24 2021

Heavy flow and endometriosis

annikanourishingnewlifecouk_main Endometriosis, Heavy flow, Hormones, Menstruation Endometriosis, heavy flow, menstruation, pain

Heavy bleeding is defined as producing over 80mL of blood per cycle and may also manifest as the following:

▫️Having a flow that soaks through 1 or more pads or tampons every hour for several hours

▫️Having to double up on pads to control bleeding

▫️Needing to change pads or tampons overnight

▫️Having menstrual periods lasting longer than 7 days

▫️Having large blood clots

▫️Having a flow that keeps you from doing things you would normally do

Many things can cause heavy bleeding. Endometriosis is one of them.

Iron deficiency is common in endometriosis. Since iron is carried by the red blood cells, bleeding during menstruation leads to loss of iron. As your body attempts to make up for this loss, iron is pulled from stores within the body leading to a heavier bleed and increased risk for iron-deficiency anaemia.

Some people with endometriosis (and adenomyosis) produce more prostaglandins, a pro-inflammatory chemical responsible for the period. Prostaglandins can cause abnormally aggressive contractions that contribute to heavy bleeding.

Endometriosis alters the balance between oestrogenic and progesterone in some people, which is related to heavy bleeding as oestrogen builds the uterine lining and can cause the growth of things like polyps or fibroids (which also contribute to heavier bleeds).

3 Tips for heavy flow and endo

1. Get enough iron daily – low iron can contribute to a heavier flow. Iron is also needed for the CYP enzymes that support oestrogen metabolism. Consume eggs, legumes, wholegrains and grass-fed meat.

2. Get enough omega-3s – Prostaglandins cause uterine contractions that may result in heavier flow. Omega-3s like those found in oily fish, flaxseeds, eggs and walnuts can offer an abundance of prostaglandin formation.

3. Support proper oestrogen metabolism – Elevated oestrogen, or poor oestrogen metabolism causes growth of the endometrial lining (i.e. heavy flow). I usually recommend a DUTCH test to get a clearer picture of oestrogen metabolism.