No Period, Now What?: Healing Your Hormones By Eating & Resting with Cynthia Donovan

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Things we dive into in this episode: 

1. The difference between hypothalamic amenorrhea & polycystic ovary syndrome 

2. Assessing menstrual health while taking birth control pills

3. Why carbs and fats are more important than protein in period recovery

📘Resources

• The Period Recovery Podcast

Cynthia Donovan is a Registered Dietitian Nutritionist with over 10 years of extensive experience in the field. Her primary focus lies in serving women with Hypothalamic Amenorrhea, employing her expertise to assist them in regaining their period, restoring their fertility and truly becoming healthy. Passionate about this cause from personal & professional experience Cynthia established the Eat to Regain Your Period Program in April 2020, where she has successfully collaborated with hundreds of women, helping them reclaim both their period, fertility and overall well-being. When she’s not serving women with period recovery you can find her in nature, travelling and having fun with her 5 & 7 year old boys! Website | Instagram | TikTok

📌Episode Highlights

Q&A:

Disclaimer: The following is not professional medical advice. Please consult a doctor regarding birth control, HA, PCOS, and for any other medical questions you may have.

I've been on the pill for about 11 years and I run marathons frequently and I suspect that I'm not actually getting my period. But because I've been on the pill, I am getting a monthly period. Should I expect that when I come off, I might not be getting my period? Isn't there common misconceptions about assessing your menstrual health while you're on the pill?

• Birth control there is gives you synthetic hormones and the monthly period that you're getting is not an actual period. It's a withdrawal bleed because you're not getting any hormones anymore.

• Some common signs of HA while on the pill:

  • Breakthrough bleeding while on the pill

  • Low energy and tired a lot of the time

  • Frequent urination

  • If you've had a lot of injuries or stress fractures

  • Low libido

  • Getting no period while on the pill - your body is in such a low energy availability mode that hormones shut down to the point where even synthetic hormones can't make you have a period

Why are fats and carbs more important or as important as protein in period recovery?

• Carbohydrates are the main source of energy to your body and are the most quickly utilized energy source to the body. It is the most important energy substrate for any kind of performance.

• Carbohydrates are necessary for so many things and processes that happen in your body at a cellular level, as well as fat and protein.

• Fat plays such an important role in hormone metabolism. You need enough body fat in order to have hormones.

• If you don’t have enough body fat your hormone production function properly.

• The reason why you’re missing your period in the first place is because you are not getting enough food!!

• Think of it as eating smarter, not harder. You're going to take up less precious real estate in your belly and not get too full if you focus on fats and carbohydrates because protein really slows the digestion process.

Where do people usually start when it comes to flipping the mindset and also changing the way they look at their meals to start eating enough? What are the typical changes that people need to start to make that you think a lot of people don't realize they need to make it first?

• Start my taking your focus on veggies.

  • They are great for micronutrients, like vitamin A, vitamin C, etc. but you're not going to properly absorb them if you're not getting enough energy, enough food from carbs, fats, and proteins.

• Eat smarter, not harder!

  • Focus more on carbs and fats.

  • Make sure half of your plate is carbohydrates and that half of it isn't just lettuce and tomatoes and very low cal.

• Eat throughout the day.

  • Eating throughout the day helps to maintain your blood sugar.

• Define what a healthy relationship with food and exercise means for you.

• Give yourself the freedom to enjoy all foods.

Thanks for listening! 💖 Stay tuned to Caitie’s website for more episode updates and other exciting programs and resources.

Transcript

Caitie: Low estrogen levels and not getting your period is actually correlated with heart disease. And so this thing that we're like, oh, I can't gain weight because that's gonna increase my risk of heart disease, that's bad for my health, is actually a whole lot of oversimplified bullshit. And we really do need to start looking inside our bodies, not just outside of our bodies, to actually make accurate assessments about what's correlated with positive and negative health and truly redefine health for ourselves. 

Welcome to Whole, Full, & Alive, a podcast helping you feed yourself, feel yourself, and be yourself. I'm Caitie Corradino. I'm a registered dietician-nutritionist, a body image coach, and the founder of Full Soul Nutrition, a method that combines nutrition counseling with a powerful toolkit of somatic healing modalities. I have guided hundreds of clients to freedom with food, their bodies, and every aspect of their lives. I've also been through this healing myself. And on this podcast, I want to help you eat with confidence, embrace your body, form aligned relationships and create a life that you're in love with. I'll share actionable tools, no bullshit stories and interviews that will remind you why you have everything you need within you to feel whole, full and alive. Are you ready? Let's get into it. 

Hey, welcome back to another episode of Whole, Full, & Alive, the podcast helping you feed yourself, feel yourself, and be yourself. Thank you so much for tuning into today's episode. I am so excited to talk to you today about eating enough and resting enough. We have a very special guest on the show today. It's actually a fellow registered dietitian-nutritionist. I haven't had an RD, a fellow RD on the show for like quite a while. So I'm so excited that she's here. 

Before I introduce her though, we're gonna pull over and we're gonna take a deep breath. So wherever you are, whether you're multitasking, listening to this show, or you're just dropping in and tuning in, I wanna invite you to take the deepest breath that you have taken all day today. Take a nice deep breath in through your nose. Feel your back expand as you breathe in, and then exhale, let it out. Drop a bit into your body. Okay, hopefully, if you need three more of those, you take them at any point throughout this episode. And we're going to dive right in. 

I am sitting here today with Cynthia Donovan. She is, as I said, a fellow registered dietitian-nutritionist. She has over 10 years of experience in the field, and her primary focus lies in serving women with hypothalamic amenorrhea, which means women who should be menstruating and are not menstruating. Cynthia employs her expertise to help women regain their period, restore their fertility and become truly healthy. Cynthia is very passionate about this cause from personal and professional experience and she has created the Eat to Regain Your Period program where she has collaborated with hundreds of women to help them reclaim their period and fertility and overall well-being. And when she's not serving women with period recovery, you can find her in nature and traveling and having fun with her five and seven year old boys. Oh, I'd love to hear more about that, Cynthia. Thank you so much for being here.

Cynthia: Yes, thank you so much, Caitie, for having me. I'm so excited to be here.

Caitie: I am so excited to talk about this topic. Now we are going to be talking a lot about fertility and about recovering from losing your period, regaining your period, hormonal health. However, I do want to say on the outset that if you're listening to this podcast and you are not a menstruating person, a lot of the things that we talk about today are still going to apply to you because we are going to be talking about the importance of carbohydrates, the importance of protein, the importance of fat. We're talking a bit about nutrition science today. We are also gonna be talking about the importance of eating enough overall, resting enough overall, which honestly is kind of the opposite of what we hear about a lot when it comes to nutrition. We hear about how to eat less and how to move more. I think a lot of people and a lot of populations might benefit from hearing this conversation. And so I kind of want to say that on the outset, but with that, let's start. Just Cynthia, can you introduce yourself in your own words and just tell us a little bit about why you're so passionate about helping people recover hormonal health in particular?

Cynthia: Absolutely. And I just want to say, Caitie, I'm glad you mentioned, like, doesn't matter if you're menstruating, like eating enough is cornerstone for everybody across the world. And just because maybe you don't have a period, it can affect so many other things in your life. So I appreciate you sharing that. So been a dietician for a long time now. I like to say just over 10 years now until it becomes 20 years, which is coming up sooner than later. But I started out wanting to become a dietician because I wanted to help people be healthy and eat healthier. And so little did I know, I was struggling with my own disordered eating because I thought health at that particular time when I wanted to help other people was to make them be in a ideal body size, AKA someone thinner. 

Anyways, I got into this particular field because I struggled with it. So I was put on birth control when I was really young because my periods were irregular. I was a very active girl. And so I went on the pill for like 10 plus years. Decided to go off when I, just about before I was getting married, I'm like, well, let me make sure everything's working okay. And so I went off and I didn't get a period and doctors assured me it was quite fine. And that, you know, if you want a period, just go back on the pill, and everything's cool. Deep down inside, I knew that wasn't right. So I decided, when I was really ready to have kids, or I need to figure what out is what's going on. So I was misdiagnosed with polycystic ovarian syndrome, which is very common with someone with hypothalamic amenorrhea. I'm going to call it HA for short because it's a mouthful. And so flash forward, I finally figured out what was going on. I had much trouble, I guess, accepting it because here I was, miss dietitian, miss health, miss exercise, pretty perfectionist-like tendencies. Loved exercise. It was my stress relief. I'm like, no way. Like this isn't me. And I don't know if you remember Caitie, if when you were in college learning about HA, but I learned that it was only for someone or it happened in someone that had an eating disorder or super low body weight or was an athlete, the female athlete triad. So I didn't fit the bill of any of those. So I struggled with that.

Anyway, I decided after conceiving my son via fertility treatments and while working towards period recovery of eating enough and resting enough that this is something I'd like to support other women in doing the same because I struggled for over five years trying to get answers. I started the Eat to Regain Your Period or also I'm starting to rebrand as A Recipe For A Period because we focus on enough food, enough rest and mindset. So those are the three ingredients. And I always like to say, even though those are your ingredients, the cooking time may vary. Just a little side joke. And so anyways, I've helped women for the past five years. I conceived my second son, who is now five years old naturally, because I put in the really hard work. It's not easy just to be like, oh, yeah, I'm going to eat some more, and rest some more, and just call it a day. It's much more, you know, there's much more attached to that. And so I can see my second child. And then that's when about a year later, full time went into helping women across the world. So I know that was a mouthful and hopefully that wasn't too much of a tidbit with me, but, now where I'm at aside business, business aside, who I am. I can look back and say, I'm grateful for losing my cycle because it made me show up for what health really was intended for me and the person I truly needed to become, to be able to do this work, to be a mom and many other things. So yeah.

Caitie: Yeah, there's no such thing as a tidbit on a podcast. That's unnecessary. You know, I really do appreciate when people bring their full authentic, real story here. And I appreciate that you shared what you shared about how you feel like you didn't fit the bill of someone who should have lost their period. Right. So I was very much there too. I lost my period when I was 23, 24 years old, and I was not an athlete at the time. And I was also not, underweight quote unquote at the time. And I was also misdiagnosed with PCOS. I feel like this is way too common of a story. I went to an OBGYN who was like, oh, you must have polycystic ovarian syndrome. You must go on metformin. You must go on a birth control pill. And this is just kind of a classic story. 

And what I actually really did need was to eat more and to rest enough. And I wasn't encouraged to do that because my body weight was quote unquote normal. And I really want to thank you for sharing that side of the story because there are so many women who aren't getting their needs met because they are in quote unquote normal bodies exercising too much, not eating enough and not getting their period.

So just before we dive into the listener questions, I actually think it would be good to just pull over one more time and define, you know, HA, hypothalamic amenorrhea versus PCOS, because I think that that is really important for people to understand. A lot of people have HA loss of their period due to not getting their health needs met and they're misdiagnosed with PCOS, which is a autoimmune disease or what is it technically cluster of symptoms.

Cynthia: So I would say more of a cluster of symptoms. I don't know if it has an exact category, but PCOS, well, here's the thing, first and foremost. I can't remember the numbers. There's thousands and thousands more research articles on PCOS than HA. Okay, so that's number one. There's just a lot more information out there. And so for some reason, somewhere along the line, PCOS just became a, I don't know, like a, what's the, I'm trying to think of like a, you know, a common, a commonality, a household like, you know, bring up. And so the big thing here is to look out for is many women, and I don't know if this happened to you or not, Caitie, happened to me, where we go for an ultrasound. They look at the ultrasound or like, oh, you have polycystic ovarian syndrome because we see all these little cysts in your ovaries. And so what I want to tell you is that those little tiny cysts are actually follicles and those follicles cannot mature anymore because you have no hormones to progress them into the next phase of your menstrual cycle. So they just hang out. So they should be there because you don't have any more hormones to progress. 

So you have a menstrual cycle that goes into, you have your menstruation phase, which is your period. You have your follicular phase, which is the first half of your cycle, your ovulatory phase, and then your luteal phase, and then it repeats. And so women with HA cannot get past this follicular phase because they don't have enough LH, they don't have enough estrogen, and so forth to get them to the next phase. So that's one note. So if your doctor just diagnoses you by ultrasound. So Polycystic ovarian syndrome has a criteria. It's called the Rotterdam criteria. And here's where it gets confusing. It is irregular periods or absent periods. I wanna say it's ultrasound confirmation, and then I wanna say androgen levels. And so if you hit two out of the three of those, you're getting diagnosed with PCOS. But here's the thing, a woman with HA can have quote unquote, polycystic ovaries. And she can have irregular or absent menstrual cycles, but it doesn't mean she has PCOS. So what you really want to look out for is androgen levels to kind of note that in women with PCOS, they do get cycles. Like they do get periods every now and then. And where you can have not so much HA, but you can have other menstrual irregularities that potentially could eventually lead to amenorrhea. So it's called a luteal phase defect. And then you can get a regular period every month, but not ovulate. 

So and if you're listening right now, you're like, Oh my gosh, this is like overwhelming. Just to go back to the whole PCOS thing, it's a common thing to be diagnosed with and you want to just ask your doctor for more testing to get your androgen levels tested. Insulin levels are another great thing to test. So, and then the big thing, Caitie, is what are the psychological and the behavioral factors attached to this? Are you an avid, you know, or, you know, I don't wanna call it obsessive because someone told me back in my exercise days, Caitie, that I was obsessed. I'd be like, no, like I'm just being healthy. So I'll just say a regular exerciser, a quote unquote very healthy eater, perfectionist tendencies, basing one meal off the next, feeling guilty around food. I can go on and on. So those are some other like behavioral factors that would typically kind of steer you more to the HA side.

Caitie: Yeah, yeah. So my kind of summary of this is that a lot of people have HA, hypothalamic amenorrhea, they're not getting their period because they are over exercising and under eating. That's been kind of culturally normalized and also sort of culturally like diminished as well. Like, oh, it's not that bad. You're not that obsessed as you're saying. Like you're not like, it's okay. Like you're just being healthy and all of that stuff. And unfortunately, because a lot of people aren't aware of how insidious that is, they're misdiagnosed with PCOS pretty commonly. That's why your story and my story is such a common story, because there are so many people who have been sort of like culturally pushed into over-exercising and under-fueling. It's made them lose their period. It's made them lose their fertility. And that's kind of, that's kind of your mission now is to highlight that. Yeah.

Cynthia: Yes, absolutely. And I just want to say, I was just looking for the statistics, but over 50% or 60% of active women in the US have some type of menstrual irregularities, yeah. So it's a big number. And a lot of these women are wanting to get pregnant, and they go to the fertility center, and they're like, oh, you're fine. Keep eating the way you are. Keep exercising the way you are. So again, it's just become very normalized that you need to exercise all the time and eat super healthy. Think of cave person times, right? So you're in you know, the wilderness, right? And it's usually, you know, there's not a lot of food. And so typically what happens is your cave person brain shuts down a lot of non-essential functions of the body because it's not safe. There's not enough food around. And I'm running from lions. And when I say running from lions, think about your body being an HA, you going for a jog or training for a marathon, your body, when you do have HA is literally looking at that like a lion is chasing you or something very threatening is happening.

So your cave person brain will shut down your sex hormone reproductive system because it's not safe, quote unquote safe enough to produce offspring. And so, and plus you don't have the energy, you don't have enough food for yourself. How are you gonna support another growing being? So, you know, that kind of goes back. It all comes down to Katie, your body just trying to protect you. That's all, and protect future offspring.

Caitie: Yeah, yeah, yeah. And it's something I say to my clients who aren't getting their periods a lot is your body's just shut off non-essential functions right now. Your body has recognized that you're not getting enough energy and that you're being pushed too much and it's saying, okay, what don't we need right now? Okay, we don't need to have a baby. That's not essential for survival. Let's shut down the reproductive system. And it's so crazy how many people don't get even that like very like non-scientific way of saying it, that non-scientific explanation of how female bodies work when they're over-exercised and under-rested. 

So I wanna shift into our listener questions because I think that this first one especially is another kind of problematic thing that's perpetuated sort of in the medical community, which is that you can assess your period health if you're on the pill, it's very hard to assess your period health if you're on the pill. And that's the first question that I got. I would love to kind of shift into this. This person said, I've been on the pill for about 11 years and I run marathons frequently and I suspect that I'm not actually getting my period. But because I've been on the pill, I am getting a monthly period. Should I expect that when I come off, I might not be getting my period? Isn't there common misconceptions about assessing your menstrual health while you're on the pill? So yeah, you want to shift into that?

Cynthia: Yes, yes, it is hard. Okay, but it's not 100% impossible. Could potentially this person have no period when she comes off the pill? Potentially. Absolutely. So what happens is it's a synthetic hormone you are taking each day. Or maybe you're stopping the, you know, you have a different type of birth control pack. But for the most part, it's something daily happening, whether it's a patch, whether it's in IUD. Whatever. So birth control there is giving you these synthetic hormones and this period, this monthly period that you're getting is not an actual period. It's just a withdrawal bleed because we'll just say those four or five, six days of the pack, you're not getting any hormones anymore. 

Now a few things that you can do to assess your health or your period health when you're on the pill. Sometimes women with HA will get some breakthrough bleeding on the pill. So they'll be like, oh my gosh, why am I getting a few days of a period so early on? That's one way. You can tell if I like to call it low energy availability mode. You can tell if you do have frequent urination sometimes, if you've had a lot of injuries or any stress fractures. So those are some ways. Also too, you may not have the libido you would actually have if you actually had a period. Even though the synthetic hormones, I'm not sure how they completely play a role in libido. But if you are feeling very tired, that could be an indication of it. But there's no true real way to be like, you know what? I probably have HA on the pill. Unless and less and less you are taking the birth control pill and on those days you're supposed to get a withdrawal bleed that you're getting nothing. You're getting no period. That means your body is in such a low energy availability mode like hormones shut down that even synthetic hormones can't make anything happen for you. So yeah, so I would say, you know, I can't give you advice whether to go off the pill because I'm not sure the reason why you were on it, but if you're curious about what's going on with your body, I would talk to your doctor and explore.

Caitie: Yeah, yeah, that was a good, thorough answer. Thank you for that. I feel like the pill is one of those really spicy topics in women's health, of course, right now, because there is a lot of all or nothing thinking about it. There is a lot of people who are saying, we need to go off the pill, it's toxic, it's this, it's that. And then there's also a lot of people who are saying, who are very protective of the pill, which is very important, because I do think that like anything else, we have to find this neutral gray area where we say, hey, there's downsides to being on this, such as it's very hard to assess your menstrual health when you're on the pill, when you're taking synthetic hormones. Also obviously unresearched side effects, unresearched things, a lot of problems with this. Why do we not have contraceptives for men? And at the same time, it can play a purposeful and functional role for a lot of people who maybe need to be on the pill to alleviate certain side effects of things. People who need to be on the pill to regulate their cycle for whatever reason, there are lots of reasons to be on it. It's also a contraceptive. It's also, is that purpose. 

And I think that when we're giving out the pill like water, and for me personally, when I had disordered eating when I was 16, 17 and I was at a very low weight, I stopped getting my period after getting it for like three years and my doctor put me on the pills away from me to get my period back and there was no education provided on how that wasn't actually my period that I was getting. I find that really problematic and mind blowing as well that a medical professional said to me, let's put you on the pills so that you get your period back as if that was my period. And that's just what I thought when I was 16, 17. And right? How crazy is that?

Cynthia: Yeah, I know. And it's still happening to this day, Caitie. I mean, and just, I'm so glad you brought that up because guess what? The pill, if your cycle is absent or even a regular, to a certain extent, we'll just use PCOS as an example, the pill is not a treatment for it. It is just kind of a band-aid. And it doesn't kickstart anything. It doesn't jumpstart anything. It doesn't make your real hormones do anything different. There is an underlying reason to this. So just being careful out there and advocating for yourself. Ask the questions, you know?

Caitie: Yeah. Yeah, if there's anything that I hope you could take away from this podcast is to just ask the right questions at your doctor's office, advocate for yourself, maybe prepare a little bit, maybe work with a provider like myself or Cynthia, who can help you create the right list of questions to bring into your medical appointments as well, because it is all too common that we're using the pill as a band-aid. It is all too common that people aren't receiving appropriate education about what the pill actually does to our bodies. So thank you so much for asking that question. I think that the answer to it will serve a lot of people. 

So now we're gonna shift into food because the second listener question that I got was why are fats and carbs more important or as important as protein in period recovery? That's the whole question. And I think that this question was asked because I think we see a lot of stigma around fat and carb consumption that we don't see around protein consumption, especially in the athletic world, in the fitness and exercise world, people are like protein, protein, protein. And when we're talking about recovering your menstrual cycle, hormone recovery, fertility, there is a little bit more emphasis, especially I think in your content Cynthia, about fats and carbs. And so I would love if you can share a little bit more about the science of why fats and carbs are important, why we talk about increased fat and carb consumption when we're talking about hormone recovery, and whatever else comes up for you when you hear this question.

Cynthia: Yes, absolutely. So I want to say, like you said, protein is more emphasized in the world for whatever, for many reasons, not the right reasons, if you were to ask my personal opinion. 

Caitie: Right? There's reasons.

Cynthia: There's so much messaging and misinformation around it that it does all these magical things. And while carbs and fats, like, are evil. But anyways, all of the women I work with come to me already consuming enough protein. I never have to worry about them getting their protein consumption in, even when they're vegan. I don't. They know how to get their protein in. The science behind carbohydrates, well, first of all, carbohydrates are the main source of energy to your body, the most highly quickly utilized energy source to the body. It is the most important energy substrate for any kind of performance. And for many of the women I work with, they are working out on a regular basis. And carbohydrates are necessary for so many things and processes that happen in your body at a cellular level, as well as fat and protein. And fat plays such an important role in hormone metabolism. You need enough body fat in order to have hormones. If not, it's going to be like, okay, well, not enough body fat around, not enough fat consumption. Okay, well, I'm not turning my hormones back on. And so all of that is used to make proper hormones. 

But here's the biggie here. The reason why we're missing our period in the first place is because we are not getting enough food. It's like a negative bank account balance, right? You're in this negative balance and you only have a fixed income, right? You're, you know, got a nine to five job and you can only put so much in the bank. But yeah, you like to get your nails done, your hair did, all the things that are kind of extra, right? And so then look at it as your body, as you're in this energy deficit, over time, you have created a negative bank account in your body.

So you need to not only eat what your body needs to do for the day, like breathe, have your heartbeat, maybe you got to go to work, like the essential things. But then here you are on top of it moving because, you know, exercise is your thing. So many other reasons why we're exercising and that you're not able to put enough money or food back in the energy deficit bank account. Fat contains much more energy per gram than carbs and protein. So think of it eating smarter not harder. You're going to take up less precious real estate in your belly and not get too full if you focus on fats and carbohydrates because protein, if we focus too much on protein, it really slows the digestion process, which could be good in some cases, but not in the case of HA, and also fills up our belly a little bit more than we need to, which will make us too full to eat enough food throughout the day. Which, again, we need enough food throughout the day, but then we also need to put money back in, not in our savings, but to get us out of that negative, that bank account or energy deficit.

Caitie: I like the term precious real estate in your belly. I really like, I really like to think of it that way. I feel that it is so important to underline a few of the things that you said. First of all, how carbohydrates are the body's preferred source of energy. If you are working out consistently, if you are an active human being, and if you are just a human being in general, carbohydrates are your body's preferred source of energy. And they assist in the metabolism of proteins and fats. I tell my clients that all of the time your body's not efficiently metabolizing proteins and fats without sufficient carbohydrate intake. And as you said, fats are so, so important for hormonal health. I kind of like to think of it in more of like a visual way. It's like fats are like nourishing and like giving the juice like to your hormones and keeping the functions and the systems of your body going in that sense. And as you said, they have a higher amount of energy per gram than proteins and carbs. And that's exactly why you want them right now. You want to have enough energy. 

I think that overall, culturally, we look at nutrition in a way that's like, how do we eat the least energy possible? That's become far too normalized when people who really do need to re-nourish their bodies end up looking at nutrition the same way. It's very dangerous. And you really do have to flip the entire way you think about nutrition from this cultural norm of how do we eat as little as possible to how do I eat enough? And so when you're working with clients or maybe you can actually even speak about your own fertility recovery, where do people usually start when it comes to flipping the mindset and also changing the way they look at their meals to start eating enough? What are the typical changes that people need to start to make that you think a lot of people don't realize they need to make it first?

Cynthia: Yes, I think I'd like to say first, you know, chill with the veggies. Like we got to chill with those veggies. Like I just veggies are not the like I feel like they're put on such a pedestal. And guess what? All those beautiful micronutrients, the vitamin A, vitamin C, all the things that are in vegetables, you're not going to be properly absorbing them if you're not getting enough energy, enough food from carbs, fats, and proteins. So I always like to say, chill with the veggies. And then let's eat smarter, not harder, focusing on more carbs, more fats, making sure half of your plate is carbohydrates and that half of it isn't just lettuce and tomatoes and very low cal. Making sure you're eating throughout the day, not saving all your calories to the end of the day, or not eating when you're hungry. Even if you just ate, because that used to be a thing for me. I'm like, I just ate. Like, how could I be hungry? Well, mind you, I was eating a grilled chicken salad with hardly any carbs and fats in it. Well, that's why I was hungry, you know? 

But you're in essence starting to relearn how to eat because we've been fed a lot of misinformation over the years. And even when I was in dietetic school, becoming a dietician, I felt like I learned a lot on how to increase my eating, my disordered eating. Right. So we're relearning how to eat. We're really learning what foods will give us energy, which is foods that have carbohydrates and fats in them and some protein. I'm not saying to exclude the protein. Thinking of things that you're fearful of, like maybe it's the fear of weight gain, maybe that's holding you back from eating more. And ultimately food is your friend, not your enemy. And we have to look at our bodies as like putting energy in our tank, like putting fuel in our tank so we can do the things we want to do in our life. Go the places we want to go. And if you really truly love exercise, like you might say you do, because I could have told you that. I mean, I do like to move, but not in the ways I used to move. So if you truly love it and you truly want to be healthy, it's starting to relook at what is health for me and, you know, how can I start to switch my eating over to focusing more on carbs and fats and some protein and giving myself the freedom to enjoy all foods.

Caitie: Yeah, thanks for sharing all that. I appreciate that you mentioned the fear of weight gain because obviously that's a massive confounding factor that Cynthia and I have not really talked about. We could do a whole other episode about navigating the fear of weight gain. It's a topic that I talk about very frequently on the show, body image, all the time, right? It's so easy to get education on, yeah, you need to eat enough carbs, you need to get enough fats, you need to start resting a little bit more. And it's so hard to actually implement those things if you're dealing with this very insidious, very maybe even unconscious to you, fear of weight gain. That's what I see a lot of clients struggle with when they get so far along in period recovery. They're like, okay, yeah, I'm ready to go all in. And I'm like, okay, so why aren't you? And there's that deep, dark, as I said, sometimes subconscious fear of weight gain because we've been saying, we've been using the words culture and society and normalization like a million times throughout this episode. And one other thing that is culturally society, a societally unfortunately pushed forward is that, yeah, we need to be as thin as possible. And we are living in a really scary time of weight loss drugs and the cascade of ozempic and the cascade of plastic surgery and the idealization of thinness has made, honestly, in my opinion, full comeback after we did start to make a little bit of progress in body diversity, in my opinion. And so that is another factor in this too, yeah?

Cynthia: Yeah, absolutely. Weight gain is the number one fear of all the women I work with. And you know what? No one, not one woman ever said, yeah, I'll gain all the weight and I can't wait to gain all the weight. And we just have to think of like for how long, like when did this fear of weight gain start for you? It could have been 30 years. It could have been 15 years. It could have been one whole year of finding out, which I'm pretty sure it's been more than a year for all of us. You know, I used to fear weight gain too, and that if we're fearing weight gain, whether it's for image wise, whether it's for health purposes, knowing that your health is so on the line when it comes to HA, you're impacting your fertility and you might be like, well, I don't want to have babies. Okay. But your heart health, there's many, many emerging research studies now that due to the low levels of estrogen, it is increasing your risk for heart disease. And heart disease in the US is the leading cause of death in women, not to mention bone health. 

So, you know, if health is truly important to you, I like to say, let's try to do our best to set this fear on a shelf, but also simultaneously work at the fear, because if we just shove it under the rug, it's still gonna be there after we get our periods back. But how do we simultaneously refuel our bodies, but also start to dig deep into, why are we fearing weight gain so much? Because as you know, Caitie, is much bigger than this number on the scale. There's so much more attached to it.

Caitie: Yeah, no, thank you for mentioning that note about heart disease, because I actually am hearing a lot of oversimplified statements about heart disease and how obesity is the cause of heart disease. Being in a larger body is the cause of heart disease. And I appreciate that you pointed out that low estrogen levels and not getting your period is actually correlated with heart disease. And so this thing that we're like, oh, I can't gain weight because that's gonna increase my risk of heart disease, that's bad for my health is actually a whole lot of oversimplified bullshit. And we really do need to start looking inside our bodies, not just outside of our bodies, to actually make accurate assessments about what's correlated with positive and negative health and truly redefine health for ourselves. And you mentioned redefining health for yourself when you were trying to recover from your own fertility problems. So I'm curious, how did you use to define health when you were in dietitian school and when you were initially inspired to become a dietitian, and how do you now define health?

Cynthia: So previously, this is many years ago, like 10 years ago now, health meant for me, flat stomach, healthy BMI, eating quote unquote clean, lots of vegetables, lots of protein, maybe a cheat meal on the weekend, 80-20 rule, 80% of the time eat healthy, 20% of the time eat whatever I wanted. Going to the gym every day. I would say that was my definition of health then. And of course not gaining weight, oh my gosh, that would have been the worst indication of my health. So now I look at food as all foods fit. I'm going to put food in my body that is healthy to me, and that looks different every single day. And majority of the days though, it looks like a good amount of carbs, good amount of fat, and some protein as well. Because I know now my body doesn't get filled off of a grilled chicken salad with just a ton of vegetables. It looks like exercising when it feels good for me. I do follow a little exercise routine. But if I don't feel like doing it that day or I feel tired or I'm sick, I move on. Before I would be stressed the heck out. So it is exercise in my life on a semi-regular basis that brings me joy.

I love being in nature. Meditation had become a big part of my life. Exercise that grounds me, breathing, taking time for me, and not being a over-functioning type A person, letting things flow a lot more. So health looks completely different. And weight, my body fluctuates, and I would say per season and I no longer look at weight gain as the enemy and I look at it as well, if this is what my body needs, this is what my body needs. Oh, not to mention a healthy, regular ovulatory cycle, the most important thing. And I use that as my vital sign of like, okay, oh, my period's a couple days late, what's going on? Or, oh, ovulation seems to be a little bit later, what's going on? So it's a really great indicator for me to know if something is changing within my body.

Caitie: Thank you. Thank you for sharing that. And I'm curious just because you mentioned having a completely new relationship with exercise than what you used to have when you were an athlete and then when you were just really sort of on a rigid exercise schedule. What would you say is too much exercise? And in what way do you think people kind of misunderstand that a little bit? I know I see with clients a lot, a lot of my clients don't think they're over-exercising when in fact they are over-exercising because I do believe that over-exercising is kind of what's normalized a little bit.

Cynthia: Yes. Well, I can tell you, Caitie, back in the day, I used to exercise seven days a week on my quote unquote rest days. It was a long walk or maybe a gentle jog or something. So I never completely rested. Now I rest. I'm probably only active three, four days tops a week. And if you told me then you're over exercising, I would say get the hell out of here. No, I'm not. Like, no way. No way. Was I? Yes, I was training like a friggin athlete, but for no, for no reason other than to control my body. Now I can tell you three to four days of, I would say mostly body weight movement. I like to hike, I do some biking, some rock climbing. It's a mix of all different things. And I can tell you because I feel my body appropriately and I give myself plenty of rest, I am stronger than I ever have been in my most active days. 

Caitie: And how do you know that?

Cynthia: How do I know that? Based on, so one example, I used to run before and I hated running. The only reason why I ran was because I wanted to burn calories. Now I run because I just feels good and I like to get outside and I am also starting to train for some maybe races just in curiosity to see what my body does and how I could run a 5k now versus before. It's like I enjoy it. I'm faster and my recovery is like, I mean, it's like I didn't even run because the recovery is that quick. So that's how I can tell. That's just one example. And yeah, it has nothing to do with aesthetics, but my endurance and my strength, being able to do like headstands and handstands, things that I find fun and that are joyful for me. That's kind of how I can tell. And I don't obsess over it. I'm not like, you know, if I miss a day, I'm going to lose my strength. I'm going to lose my endurance.

Caitie: What I notice most about the way you're talking about your movement routine is how relaxed you are when you're talking about it. You're like, oh yeah, I like going on some walks. I like to walk outside and like hiking and strength train a little bit. I'm gonna run some races, I think maybe, and I like the way I feel when I'm training for them and 5K. When someone is exercising too much and you ask them what their exercise routine is, their answer has so much tension in it, you could cut it with a knife. It's like, I do three days at the gym, through to the leg, blah, leg, string, blah, and then I run for 3.5 miles at this altitude and there's so much tension in it. And that's also, I think, kind of just like the normal vibe of exercise reels on Instagram. There is a lot of like real girls lift heavy and let's replace your eating disorder with an obsession with strength training is a really common pipeline that I see too. And I appreciate how you can acknowledge your enjoyment of movement and the joy that you have in movement and in handstands and in moving your body in just such a relaxed way. That is what I hope for everyone is that we get to experience the joy of movement with a relaxed, within a relaxed association with it.

Cynthia: Yes, yes. And I would have, I really found love to be out in nature, you know, climbing mountains and doing those things, which I probably would have never allowed myself to do because I had to always get to the gym and check that off the box before I can do anything that was extra. So yeah, night and day change. And I do wish that for everybody. And it's 100% possible to make happen.

Caitie: Yeah. And look, stress is also a really big piece of the puzzle and nature is incredibly stress relieving and this metaphorical reminder of how slow we're supposed to move and how we're supposed to allow our bodies to go through seasons and fluctuations. As you said before, your body changes seasonally. My body does too. It's not these like massive changes, but my body fluctuates seasonally. And once I made peace with that and I started letting my body be a part of nature rather than this piece of like technology that I needed to control, my entire life changed. My entire day changed because I didn't have to orchestrate my day around the control of my body shape and size. So much stress is relieved when you're not orchestrating your day around the control of your body shape and size. 

And so I love the work that you're doing. I think it is so important for more people to be talking about hormonal health, to be talking about chilling it on the veggies because I think that veggies are amazing, scrumptious, very micronutrient filled and too much color on your plate is a problem often. We do need calories. Calories are energy. Energy is life. Calorie restriction is life suppression. We can't forget that. And so I'm excited for people to check out your work a little bit more. Can you just say where people can find you and how we can stay connected?

Cynthia: Yeah, so you guys can find me on Instagram and my handle is @period.nutritionist and that's spelled P E R I O D dot nutritionist. I'm also on TikTok is the same username. You can find me on my own podcast called The Period Recovery Podcast. And I think yeah, that would be the best way to reach me in hopes to inspire you to get a healthy regular menstrual cycle. And I like to say, I don't only want to support you in getting your period back, but I want to also help you start living again and get your life back.

Caitie: There is no health without quality of life. And so it isn't just about getting your period back and like racing to this arbitrary finish line of like, okay, you got your period. It's also about getting your quality of life back. And inevitably, when your body is healthy enough to have a regular healthy menstrual cycle, yeah, hopefully parts of your personality will come back. Hopefully parts of your more free flowing, healthy relationship with food come back. And yeah, I think a lot of my clients who are needing to recover their hormonal health are like, oh, well, all recovery means is getting my period back. Why would I want that? It's a lot more than that. So thank you for saying that too. 

All right, thank you so much for tuning into today's episode. I will be back here next week actually with another guest. I am so excited about that. If you enjoyed today's episode, please leave a five star rating on Apple or Spotify or wherever you tune into the show. I am so grateful that you're here. Take another deep breath before you head into the rest of your day and we'll be back soon. Bye.