Episode 62: Ask Me Anything!
I put it out to our Hormone Hub Facebook Community last week to “Ask me anything” for the podcast… AND you didn’t hold back!
In this episode I answer all of YOUR questions about what we can do when it comes to:
– Getting a better night’s sleep
– The link between not sleeping and belly fat
– Why our periods which have always been clockwork are going crazy
– Are migraines linked to our cycle…even though the specialist said it wasn’t
– All things HRT – dosage, types, side effects AND More!
With all the questions, two things really stood out for me…
1. The need for more awareness and conversations around WHAT happens to our bodies in the lead up to menopause
2. The need for personalised support. There were NO two questions that were the same. We all have different health and hormonal challenges and frustrations and they need to be addressed as such.
I hope you enjoy this episode, I certainly enjoyed putting it together and I’m happy to give you the answers of what you want to know!
Of course in a podcast, I can’t provide specific health advice, so they are “general” answers, but I’ve done my best.
Enjoy,
Kylie x
Links and Resources
You can follow The Hormone Hub podcast over on Apple Podcasts, Spotify, Google, Amazon or wherever you’re listening right now.
And, if you enjoyed this episode, please leave me a rating and a review? Thanks!
Transcript
Hello, hello and welcome back to this episode of The Hormone Hub. Now this is a really fun episode. I put questions out to our [00:01:00] hormone hub Facebook community to ask me anything, and I would answer it in a podcast and our community didn’t disappoint. You guys came up with some great questions. And it really highlighted a few things for me.
So a, you know, that ongoing need to, you know, educate women around, you know, what actually happens to your body during perimenopause because we are never taught this. And you know, like, I feel like I bang on about it all the time. But obviously women who are fairly new to our community or haven’t been with us for, for as long a time, you know, don’t know, and no one ever tells us, you know, what happens to our body during perimenopause and menopause.
So we’re gonna hit on some of those great questions, how it impacts your cycle, how it impacts your overall health, and the other thing that the questions really highlighted was the importance of an individual approach to healthcare. Okay, so there was no two women had the same question or even the same health concern.
So it goes to show, you know, what [00:02:00] you definitely don’t need is just a one size fits all kind of support approach. You know, we are all different. We’re all on at a different stage in our hormonal journey. And therefore, and we’ve all coming in with different health concerns, different, you know, needs.
So, you know, this is where we do need very personalized support. You know, we are not a blanket, you know, one size fits all. So hopefully today we will answer some of your questions and you’ll get a lot out of it. And I think I’ll make this thing a, a regular episode because it was, you know, obviously a lot of questions, you know, ladies want answers to, and it was a lot of fun for me to do.
All right, so let’s jump in. So our first couple of questions are all around sleep. Alright. So first up, Chrissie asked, you know, what can I do to help sleep? And I think this is a really good question because for a lot of women, you know, losing or waking up in the middle of the night and losing that ability [00:03:00] to be able to stay asleep for longer periods, you know, does become harder.
And you first tend to notice this in perimenopause. For some women, they get the night sweats along with that, but for other women it’s just hard to stay asleep. So there are a few things that we can do to try and improve our sleep. So first up, we want to establish a regular sleep schedule and stick to it as much as possible.
So this means going to bed at the same time, getting up at the same time. It also means, you know, not being on your phone for the two hours before you go to bed. So we wanna minimize that blue light. So if we think we’re flicking through our phone and scrolling through our phone, that’s kind of like giving our brain, you know, a movie on steroids.
Cause our brain has to keep up with all those images. So definitely, you know, I know in our house we have a no phones after dinner rule. And that can certainly help. So there’s the blue light and also just that, that [00:04:00] constant stimulation. So yeah, no phones in the bedroom that extends to TVs, iPads, laptops, you know, all of those things as well.
So if you can limit your exposure to blue light as much as possible, it’s gonna help you sleep. Making sure your room is cool, dark and as quiet as it can be. Avoiding caffeine, alcohol, nicotine, sugar before bedtime. So that means no more snacking after dinner. Also, you know, considering relaxation techniques.
So deep breathing meditation, yoga can also, you know, help you unwind after bed. And also when it comes to dinner, we want to, what can wake us up in the middle of the night is when our blood sugar dips. So when we sort of hit that 2:00 AM 3:00 AM our blood sugar can dip. So we wanna make sure that we’re having a really balanced meal at dinnertime.
So this in means including some protein which is gonna stable out your blood sugar and also including [00:05:00] a small amount of carbs. So, you know, I find a lot of my clients when we, you know, we, we’ve all been scared of eating carbs at night for so long, but when we introduce those carbs back in, you know, it helps the, the quality of our sleep.
And definitely the quality of the carbs is what we want to look at. Now Mel asked a great question, and how does the lack of sleep cause belly fat? And now that it is, I love this question because it’s looking at then the relationship with your hormones. So when we sleep, we’re on that circadian rhythm.
So our circadian rhythm makes us feel sleepy and makes us fall asleep. And then, you know, it’s cortisol, which is our stress hormone kicks in the morning to get us up, get us out of bed. But what happens is when we don’t get enough sleep, that whole circadian rhythm is thrown out and then our body produces more cortisol.
And cortisol is a hormone that helps us regulate stress. Now, high cortisol levels have [00:06:00] been associated with an increase in belly fat, and it’s kind of got that again, that chicken and the egg. You know, when we are tired and we are not sleeping, we’re also more likely to make poor food choices. We’re also more likely to skip our, you know, getting up and going for a walk in the morning cause we’re tired.
So, you know, we’re looking for those, those sugary, the more carby sort of foods to keep us going, to lift us up. You know, we’re tired so we are missing our, our workout, so that’s gonna impact our weight as well. But also another thing is our blood sugar is off. So when we are, you know, reaching, we are tired, we are reaching, our blood sugar’s low, we are reaching for the sugar, reaching for the carbs.
It’s going to trigger our insulin response. And insulin is another hormone that, you know, specifically triggers our body to store weight and generally around the belly as well. Now the other thing that can happen when we are not [00:07:00] getting a good night’s sleep is it can throw out our hormones that regulate our appetite.
So specifically leptin. So leptin is our hormone that tells us that we are full. Now, if that hormone isn’t working, and remember all of our hormones are connected, so if one is out, all is out. So if our melatonin’s out because we’re not sleeping, it’s gonna throw out our cortisol. Cortisol’s gonna throw out blood sugar, blood sugar’s gonna throw out leptin.
So you can see it’s got that, that domino effect. So leptin is the, the hormone that tells us that we’re full. It tells us that we’ve satisfied we’ve had enough, but when we haven’t had enough sleep and our blood sugar is low and we are just sort of want to, we are in survival modes, so our cortisol is high.
Leptin thinks it’s all too hard so it just doesn’t show up. So that’s why we can kind of keep eating, keep eating, and we are constantly snacking cause we are looking at lifting up our blood sugar but also waiting for leptin to kick in and it [00:08:00] doesn’t. So you can sort of see how all of those things stack up and trigger, you know, our body to store weight around the belly.
So, yeah, great question. Thanks for that Mel. Okay, so next question was all around headaches and migraines. And this is really good because I don’t talk about this a lot in, you know, podcasts and in my blogs, but it’s certainly something that we work with, with a lot of our clients. So Anita said she’s 48.
She’s been experiencing migraines for the last few years around her cycle and very disturbed sleep. Now, this is a great question. Like I said, migraines can be certainly a common symptom of menopause and disturbed sleep can contribute to the frequency and also the intensity of, of migraines.
So it’s important, you know, to circle back to establishing those healthy sleep habits and also trying to [00:09:00] avoid triggers that might be causing migraines. So quite often it’s food sensitivities. You know, also foods such as alcohol, chocolate, cheese, coffee, you know, they’ve all been sort of linked back to migraines, avoiding stress or minimizing stress, cuz stress can be a big trigger, for migraines as well. Now, you know, increasing things like magnesium, Taurine, particularly in the lead up to period. So in between ovulation and when you are, you know, that day one of your bleed, that can help enormously as well.
And also too, it’s, it’s important to track it so you can, you know, so if you start tracking then we can, you know, put a link back to when those migraines, you know, does it start at ovulation? Is it worse at ovulation or is it actually worse during your bleed? Do you have headaches in between?
So, so starting to track it and starting to, you know, and then we can manage it, [00:10:00] and sort of play with those doses of magnesium and Taurine. And it could even be that we need to look at some sort of, you know, oral micronized, progesterone just to help support and lift those progesterone levels for sure.
But definitely, you know, there’s a correlation with, you know, perimenopause and an increase in migraines. Now, just linked to that, to that, Kathy asks, you know, I’m suffering from head pressure, pain in my left temple and my eye is it related and what can I do to manage it? Now, kathy, I would love to sort of dive deeper into this for you, but you know, it also not knowing your health history, I can’t give specific answers, but certainly if there’s anything that you are concerned about a hundred percent, I would recommend getting it checked out medically because we do want to sort of make sure that there’s nothing, you know, sinister, you know, and there’s a good chance there’s not, but we just wanna rule out anything, [00:11:00] any cause for concern, specifically, you know, when you’ve got such a specific pain, I would want to get that checked out first. But then, you know, certainly we can then look at what foods is it, where is that is it at in your cycle? And you know, we can link it back, but at a hundred percent we want to, it’s essential to rule out any other medical conditions that might be triggering that.
Right. Okay, so onto some perimenopausal symptoms. So Judy says, my period was four days later last month, four days later this month. Normally I’m like clockwork. What could you suggest, if anything? And this is definitely a sign of, you know, your body transitioning to menopause. So again, track your periods, because it’s good to sort of like monitor those changes.
But I also wouldn’t be overly concerned because what happens as we go through perimenopause, in some cases our periods can get, [00:12:00] you know, further apart and lighter, you know, and, and that’s part of it in, for some women, the periods become more closer together, heavier, some women can go, you know, 8, 9, 10 months without a period.
And then all of a sudden they’ll get a humdinger of a period. So it’ll be heavy. It’ll be clotty, it’ll be revolting. And it’s almost like your body has a last hurrah. And this is actually more common than you think. And then, you know, cause we’re officially in menopause when we haven’t had a period for 12 months.
So yes, if you have that humdinger of a period, Yes, we do start the countdown for 12 months again from that last period. So it can be annoying. There’s no rhyme or reason to it, but it’s, it’s just, you know, part of it. And then Erica says, why do I get the symptoms of a menstrual cycle with cramps, swollen breast, fatigue, but actually only get it once a year?
So it’s [00:13:00] possible for us to cycle even if we are not getting a menstrual cycle, likewise it’s possible for us to have a menstrual cycle and if we’re in perimenopause, we may not actually be ovulating. Okay? So our body is still sort of working through those cycles, but it may not be that, you know, it might be, we get the, the cramps, we get the, like the symptoms of a menstrual cycle without actually getting a period.
Okay. So we’ve still got, it’s still indicating that we’ve got the hormone fluctuations, and like I said, it’s not uncommon for women to experience irregular periods or changes in your menstrual cycle as you transition through perimenopause and menopause. Okay, now Jane has asks, do you have to have removed a one centimeter polyp and a two centimeter fibroid?
She’s also got a very tiny cyst on her ovary. Her nutrition’s [00:14:00] great. She’s scrutinized it to a T, on target with cycle. Initial issue was menstruating for three weeks, and prior to that was irregular, low in iron and blood tests. Everything else was pretty good. Okay, so having a, a small polyp, cyst or fibroid, doesn’t necessarily mean that it has to be removed.
Like quite often these will sort of dissolve and, you know, your body sort of just reabsorbs them. It all very much depends on the size and the location of the growths as well as any symptoms that you might be experiencing, You know, if low iron, you know, is generally linked to a sort of a heavier bleed, so it’s certainly worth investigating, you know, other things that can be affecting your menstrual health. So with polyps, fibroid, cysts, things like that, that sort of indicates to me that, you know, the, the ratio of estrogen to progesterone is [00:15:00] out and you tend to, which is normal through perimenopause and those higher levels of circulating estrogen can trigger this, and again, certainly if there is any concerns, you know, get it checked out medically, we just wanna make sure that there’s nothing else going on. But certainly there’s, yeah, a lot we can do with, you know, stress habits, sleep habits, exercise habits, as well as nutrition and, Yeah, if you are menstruating for three weeks at a time, you know, this is again, not uncommon.
But yeah, certainly it would, you know, I would expect that to be indicating low blood. So we need, oh, sorry, low iron. So we need to address, you know, are you getting enough iron rich foods in your diet? Are you getting lots of liver friendly foods in your diet, which is gonna help process that excess estrogen.
Okay, now Brandy says her period has been irregular for two years. It ranges from a 17 day cycle to a 62 day cycle. How long can something like this go on? I’m also gaining weight and have changed nothing in my diet, have upped my exercise, and I’m [00:17:00] not sure where to go from here. I’ll be 50 on October. Liz said, I’m the same. One was so late. I seriously started to wonder if I was pregnant. Very next day after I said to my partner, hope it’s not pregnancy. It arrived. It was awful. Heavy clotting, disgusting mess. And you know what this is so common and it is, yeah, welcome to perimenopause ladies. This is where your hormones are fluctuating.
So you get big surges in estrogen and progesterone, big drops in estrogen and progesterone. It’s normal for your cycles to become further and further apart. So, you know, for some women it happens outta the blue. For other women it happens, you know, quite suddenly. So it can be a bit of a shock.
And yeah, pregnancy potentially is on the radar. But certainly, you know, menopause is when we haven’t had a period for a year. So having those bigger and bigger and longer gaps in between your cycles is certainly a normal part of that. I [00:18:00] hate to say it can go on for years, but you know, if you are turning 50 in October, the average age in, you know, western sort of society for women to go through menopause is 51. So, you know, you’re very close to the finish line there, so hang in there, uh, it’s frustrating, you know, not knowing what’s going to happen, why things are changing, but also too, you’ve got the weight gain there, so nothing’s changed in your diet. And it can be, you know, just as our levels of estrogen decline, as our hormones decline, we are more susceptible to cortisol and also to insulin.
So they’re two of our big fat storage hormones, which can be triggering that weight gain. So, you know, that’s where we need to work on supporting your hormones, you know, more so than looking at, oh, do we need a, a diet? Okay, now we’ve got some questions on H R T, which is great and I love these, these [00:19:00] questions and it is really important and I just sort of wanna say again, I can’t get too specific on the answers, but I can talk generally, for you to answer your questions in a general sense rather than give you specific health advice cause you know, I don’t know your health history. I don’t know the reason why you’ve been prescribed this, but happy to answer your questions in a general sense. So Heidi says she’s 47. She’s been on bioidentical hormone replacement for five years, so she’s taking testosterone, progesterone, and she’s saying her estrogen level so, so far has been okay. Now, She wanted to know about the ratio of estrogen to progesterone that works for for most women. And what level of testosterone is the happy place? Okay, so again, it’s very individual and depending on your previous health history. So, we would ideally, you know, and the fact that [00:20:00] you are on a, a range of hormones is perfect.
The actual, it’s difficult to give you an exact ratio of estrogen to progesterone because not one thing works for everyone, every woman’s hormonal needs are unique. However, a general rule of thumb is to aim for a ratio of one to one, up to two, to one, with progesterone being the higher number.
As for testosterone, you know, the, the happy level, the perfect level of testosterone, varies hugely from woman to woman. And it depends on things like your age, your overall health, your lifestyle habits, because testosterone, you know, if we go too high, for instance, so with women who’ve had previous history of polycystic ovaries, you know, it can sort of link to insulin sensitivity.
So there’s, there’s that to be mindful of as well, so yeah, so very much can vary from person to person and very much dependent on [00:21:00] individual health factors and you know, what your actual symptoms are as well. So I know that’s not a specific answer, it’s a bit general, but yeah. It’s, yeah, it’s, it’s hard to give you a specific answer in a podcast.
Okay. Now Liz asks, should women over 65 take estrogen either orally or as pessaries? Now this is super interesting because whether or not women over 65 should actually even be taking HRT is very much a topic of ongoing debate within the medical community. So, you know, in Australia the advice is, you know, take HRT for up to 10 years post-menopause. In the UK I know that they are now advocating for longer term use of H R T.
Now the thing is, it also depends on your health status, your risk factors, and [00:22:00] also your personal preferences. So women who’ve experienced surgical menopause or what they call premature ovarian failure, so early menopause, you know, may benefit from H R T to manage symptoms, you know, protect against bone loss and things like that.
But on the flip side, HRT does carry some risks. So you do have increased risk of blood clots, stroke, breast cancer. So it’s important for you to be able to have a, you know, an informed conversation with your health practitioner about the potential risks and the benefits of H R T for you. Okay? So definitely, you know, taking estrogen over the age of 65 should be something that, you know, you discuss with your doctor and certainly taking it via pessaries is in, you know, a much lower dose as well, and it’s gonna be localized to that vaginal area. So I’m[00:23:00] not wanting to assume, but I’m assuming that that is for Vaginal dryness and you know, given its localized dose, you know, it potentially would have lower risks.
So, yeah. So I hope, I hope that helps. Now Margarita asks a really interesting question. She’s taking, uh, estrogen and progesterone and she has her period two to three times a month. How do you regulate your hormones to stop your period? She’s 55. So thank you Margarita, for answering the question. So it sounds like you might be experiencing some breakthrough bleeding.
So this can definitely be common, particularly when you are starting hormone therapy or you’re adjusting your dose. Again, not knowing the reasons. You know, are you still ovulating? So yeah, it could just, well be that you need to adjust your dose and even the type of hormone therapy. It’s also worth noting that some [00:24:00] women may continue to experience periods even while they’re on hormone therapy.
So yeah, to stop your period altogether, it would be something that, you know, have you actually gone through menopause and is it a pill bleed that you’re experiencing? Yeah, I’m just not, I can’t give you a definitive answer there. But definitely I would be looking at the dose and definitely you should not be having a period two to three times a month.
Okay. So Jo asks, how long can you stay on HRT patches? She’s been on it for about six years, and she’s also been on the pill and has perimenopausal symptoms. Okay, so my question here would be, why are you taking the pill and why are you also taking HRT? So the pill is a synthetic progestin, okay?
So it’s not a progesterone. So the pill will naturally put your body into a chemically induced, uh, menopause as it suppresses [00:25:00] ovulation. Now there’s no set limit. As I said earlier, how long a person can stay on HRT for. And the patches. The patches again, are really relatively low dose and relatively considered low risk.
So it very much depends on your individual health factors and symptoms. But I would be sort of looking at switching out the pill for a oral micronized progesterone, rather than, yeah, I don’t see why you would be on the pill and h r t at the same time. So that would sort of be my question there.
And again, I don’t know your health history. I don’t know the reason why your doctor would’ve done that. And if I’m sure, well, I don’t wanna assume that they had a good reason. Maybe it’s just the way that they do it. But yeah, definitely I would be questioning that. And can you switch out the pill for a oral micronized progesterone?
Because I think, yeah, in my experience, that women [00:26:00] do better on that. Okay, and Annabelle, final question from Annabelle. What is a good minimal estrogen level for bone protection and joint pain? What is the progesterone level needed to balance out this estrogen? Okay, so and again, the optimal estrogen progesterone levels for bone protection, joint pain, you know, varies so much on individual health factors and symptoms. And it’s important too to remember that H R T isn’t a magic bullet. It is not just going to come in and magically fix all of your issues. We still need to look at diet. We still need to look at lifestyle. We still need to look at, you know, Emotional wellbeing as well.
So I would be looking, if you’re looking for joint, uh, sorry, bone protection, I would be looking at, you know, incorporating calcium rich food into your diet every single day, you know, regardless of H R T or not. So, you know, [00:27:00] and most, the most bioavailable calcium, you know, isn’t necessarily from dairy. We get a lot of calcium from nuts, from seeds, leafy greens, small edible fish with, you know, like sardines, mackerel, you know, things like that.
You can also, you know, you want a good quality bioavailable calcium and Caltrate ain’t it ladies. We also wanna make sure that vitamin D levels are good, vitamin K is in your diet as well. And then definitely progesterone as well as estrogen, uh, together. And again, you know, it’s the reason you’ve gone on H R T, you know, is that will help. And where you are at in your perimenopause menopause journey will help with what doses that should be. And again, you know, you might need to play around with it sometimes, but certainly I’d be looking at diet, at lifestyle, you know,[00:28:00] strength training, you know, supporting your bones that way as well.
So ladies, this has been super fun and I hope you’ve enjoyed it. So thank you to Annabelle, Jo, Margaritha, Lee, Liz, Heidi, the other Liz, Brandy, Jane, Erica, Judy, Kathy, Anita, Mel, and Rose and Chrissy for all of your questions. So I will do more of these episodes. I think, you know, I, I certainly learn a lot because I was sort of like, oh, okay, these, this is what you really wanna know.
So it was great for me and I’ll be able to sort of put more content, out for exactly what you’re all after. But like I said, you’re all individual. You all had a million different questions and I hope today I’ve been able to help answer them. All right, thanks ladies, and I’ll see you in the next episode.