I think that we talk a lot about menopause on this show and we talk a lot about how much of a taboo it's historically been and how little it was discussed. I often talk about the fact that, you know, my mother never talked about that. She definitely never talked about her menstrual cycle either. So, you know, it's something that I learned at school in biology and otherwise. Hazel Wallace: Absolutely, And when we map the graph of progesterone rising with increase in metabolic rate and also increase in cravings, they almost all increase in tandem together. Hazel Wallace: Yeah, absolutely. So if we kind of look at menstruation, that days of bleeding, as we mentioned, an anti-inflammatory diet's, really important from reducing that inflammation, which will help reduce symptoms, but also support your immune system during that time because your bleeding and because iron deficiency anemia is so prevalent in premenopausal women.

Jonathan Wolf: I think I missed quite a few things, but I love it. Thank you so much for coming in and hopefully we'll figure out how to follow up with some studies to push forward the science here. And so, for the past three years (in between COVID shifts at the hospital), I’ve dedicated most of my time to researching how to help women live healthier, happier lives. And The Female Factor was born. But if you find that exercise is the last thing that you wanna do, or that doing something high in intensity is something that would make you feel worse. Low intensity exercise in particular. Yoga, there's a lot of trials around yoga and the benefit in menstrual symptoms and also PMS, and that's likely because. Hazel Wallace: there's actually very little to no research done around the changes to the microbiome during menstruation, there's some emerging and when it comes to advising women about gut symptoms around menstruation, for example. I often say, you know, you could try a probiotic, but there's absolutely no trials looking at how probiotics could improve gut related menstrual symptoms, which blows my mind. Hazel Wallace: Well, the research kind of points to all forms of moderate intensity exercise, and so that's really anything where you can kind of hold conversation, but maybe you can't sing. So brisk walking. It could be riding a bike, it could be going to an exercise class, it could be going for a run. I think it's very individual and you know, While I can sit here and say, you should be doing three times a week exercise and it should be of this intensity.

Hazel Wallace: Team. Yeah, absolutely. I think the more I've researched the hormone estrogen in particular, I realize how powerful it is as a hormone for all aspects of health, and not just in women and men as well, because we often talk about estrogen and progesterone as. These female sex hormones, and while they are high in women, they're also in men, and so they have really important effects in other aspects of health. Their primary role will be in reproduction and across the menstrual cycle. The main goal is to release an egg during ovulation and also to prepare the wombs lining to support a pregnancy and. The Food Medic Podcast. Available on Spotify, Apple, and Global, Dr. Hazel invites leading experts to share evidence-based advice on healthy living while clarifying conflicting well-being information you often find online.

We also tend to suffer with conditions that will keep you awake, so, Women are twice as likely to experience anxiety and depression in their lifetime experience. Things like overactive bladder, so having to wake up in the night to go for a whee and heartburn or reflux is also more common as a general rule, although it varies from household to household. Hazel Wallace: There was a research paper done on athletes, female athletes taking part in the last Olympics, and they were asked if they could choose any day in their cycle. To perform, to do their final event, what day would it be or where in their cycle. And majority of athletes said just after their period, and that is that high estrogen phase where we have seen from the research that there tends to be higher muscle building, potential, better mood, higher motivation levels, and a small increase in performance.

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The quality of our sleep. It's also quite interesting in that some studies have even looked at how our sleep architecture changes in that second phase. It also covers to how to eat to ease the menopausal transition and staying active during pregnancy as well as countless other female specific issues. Jonathan Wolf: And why is it so complicated, Hazel? So I think I had a, like a really simplistic idea, something to do with the estrogen. It goes up and. Down because you wanna trigger like an egg. That's the start of potentially having a baby. You're describing something much more complicated, like what's going on and do we have any understanding about why it affects all aspects of a woman's body rather than you might think it's like just going to affect, you know, your womb.

And whether that's something that we've all thought about from a societal point of view, you know, a lot of us will relate periods PMS to chocolate. There's also a kind of a breakdown in protein, a higher breakdown in protein during that phase, and also a higher breakdown of fat. So I'm a nutritionist and a lot of the work that I do will be how to optimize your nutrition in that phase. But there's also LH and F S H, and there's some higher up hormones as well from the brain. These hormones fluctuate across the month, the very start of the month, the first half of the cycle, we call the follicular phase, and the second half we call the luteal phase. And then we've got ovulation sandwiched in between. But as we've just said, and you know, in this entire podcast episode, we're very different from a kind of a hormone profile point of view, but this also changes our physiology, our metabolism. Even our anatomy. And so it's really important that we take that into consideration. And this is why we know so little about the menstrual cycle and even when we do research on it, just taking calendar methods. And so the first five days typically could be up to seven days, will be the bleed or menstruation or what most people know as the period. And that's when we're in a low hormone phase. So estrogen and progesterone are the lowest that they are across the cycle. And then after that, we move closer to ovulation and estrogen comes up in peaks just before ovulation and progesterone remains low. Hazel Wallace: Yeah, so over 90% of women report. Experiencing premenstrual symptoms, and there are over 150 of them from bloating to low mood to irritability, gut symptoms, headache, breast tenderness. The list is endless, but you're right in saying there's a spectrum of how women experience this and the terminology's really important, so while over 90% of women experience premenstrual symptoms, a smaller percentage, about 20 to 40% experience, premenstrual syndrome. This is where the symptoms are so debilitating that they interfere with day-to-day quality of life, and we see this pattern emerge. One to two weeks before the next period, typically a week before, and it should end or get better when your period starts.How the menstrual cycle affects what you eat. We'll even find out if there's scientific evidence behind cycle syncing. I learned a lot and I believe you will too. Would definitely like to make sure that we captured alongside just sort of both nutrition and lifestyle changes that you, you might be able to make. You know, across this, this cycle. The policy says that reproductive health is allowed, but in practice their technology is still rejecting it,” Rotman said, explaining that images of uteruses are often mistakenly flagged as nudity, and words like period, menopause, endometriosis and vagina also commonly triggering sexually inappropriate warnings. Hazel Wallace: Yeah, absolutely. And you know, these hormones also have far-reaching effects with other hormones, so there's a lot going on and there's a lot of influences within our body, but like you said, it is, it's a lot more complex than just a five day bleed.

And particularly on women premenopause, exactly because of what we've been discussing today, which is this sort of complexity of, the change in women's responses during the cycle means that historically, particularly for things like nutrition research, they would've had to have two or three times as many women in a study to try and sort of average out the changes that you're seeing. This is the go-to book for coming to terms with the chronic pain and managing symptoms through lifestyle tools. Hazel Wallace: Yeah, absolutely. And I think we know, obviously how powerful the link is between our gut and our brain and our gut and our immune system and all these other systems. So it makes sense that there's a link between our menstrual health and our gut. And you know, even when it comes to estrogen, we know that there's an. In response, a spokesperson for Meta, Ryan Daniels, said, “We welcome ads for women’s health and sexual wellness products, but we prohibit nudity and have specific rules about how these products can be marketed on our platform.” Like a lot of estrogens metabolized as well in the gut. So it's really important that we're optimizing our gut health across our menstrual cycle. And also, you know, with menstrual cycle related conditions like PCOS and endometriosis, I suspect there's a really strong link there as well. And we do see some gut dysbiosis in conditions like PCOS.

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Jonathan Wolf: All right. All yeses so far. Can the food that women eat affect how they feel throughout their menstrual cycle? Jonathan Wolf: All right. Okay. Does the stage of your menstrual cycle actually change your body's metabolism? So if we think about nutrition, First and foremost, I mentioned in the beginning that menstruation is an inflammatory response, so our body is in huge inflammation because it's going through a big process. There's a lot of shedding going down, and we need to support that as best we can, which we can. Jonathan Wolf: I was gonna say, nevermind, they're the only ones who get pregnant, which having been through this period, time definitely messes with your sleep. So, Jonathan Wolf: and I think a lot of people will have been surprised about that. Before we dive into that, I'd love to, just to start like right at the beginning, like what is the menstrual cycle? How does menstruation work? You know, I've heard there are these different stages, but a lot of people I think, have thought about it as like you have a period every so often, and so it's just a few days in the month and you're already saying that's not really right. Could you help to unwrap that for us?