The Appetite Episode #74: 

Diet, Exercise, and Your Period: What You Need to Know

Is it normal to lose your period when changing up your diet or exercise routine? Nicola Rinaldi, PhD joins the podcast today to discuss her journey to recover her period once it was lost, and offers her wealth of knowledge on hypothalamic amenorrhea (aka the loss of one’s period). Drawing from the research in her book, No Period. Now What?, Nicola joins Carter Umhau, LMHC and Opal Co-Founder Julie Church, RDN, CEDRD-S, CD to explain how even small caloric deficiencies can cause disruptions in menstruation, how weight bias impacts the treatment of this, and why menstruation matters beyond fertility. 

 

Links: 

No Period. Now What?  By Nicola Renaldi, PhD 

 
Helpful info sheets and chapters (free downloads):
 
 
Blog posts:
Time to recovery is not associated with length of time period was missing, http://noperiod.info/time.
Time to recovery after going all in: http://noperiod.info/time2.
Birth control pills and HA: http://noperiod.info/bcp
Why estrogen, progesterone don’t jumpstart cycles: http://noperiod.info/progesterone

Connect with Opal: 

www.opalfoodandbody.com

Facebook: https://www.facebook.com/Opalfoodandbodywisdom/

Instagram: @opalfoodandbody

Twitter: https://twitter.com/opalfoodandbody?lang=en

Youtube: https://www.youtube.com/user/OpalFoodandBody/videos   

Thank you to our team…

Daniel Guenther at Jack Straw Cultural Center: http://www.jackstraw.org/

Editing by Hans Anderson: http://www.hfanderson.com/

Music by Aaron Davidson: https://soundcloud.com/diet75/

Host and Producer Carter Umhau: www.carterumhau.com

Podcast Transcript:

Carter 0:07
hello and welcome to the appetite a podcast brought to you by opal food and body wisdom an eating disorder treatment center in seattle washington i’m your host carter i’m how a therapist artist and writer and the appetite is all about issues of food body sport and mental health today we’re going to be bringing our eating disorder focus into the medical realm opal co founder and nutrition director julie church and i are talking with Nicola Rinaldi author of no period now what a guide to regaining your cycle and improving your fertility this conversation focuses on a condition called hypothalamic amenorrhea which to put it simply is the loss of one’s period this condition can happen more easily than you might assume when someone is either restricting their food intake over exercising or both we know that hypothalamic amenorrhea is quite a hefty name so know that we’ll be referencing it as h a throughout the podcast our guest nicola rinaldi has a phd in computational biology from mit and joins us today to talk about her own relationship to food and body and how it impacted her menstrual cycle years ago this impact resulted in a long research and recovery process to regain her cycle and improve her fertility she is now sharing all of her research and in her new book nicola has a library of knowledge on the topic of ha whether you’ve ever lost your period or not whether you are thinking about fertility or not this conversation is incredibly helpful for those that work with eating disorders or anyone that has a uterus nicola thank you so much for joining us today in the studio

Nicola 1:46
thank you so much for having me it’s such a pleasure to speak with you

Carter 1:50
and we also have nutrition director at Opal julie church here as well

Julie 1:54
hello

Carter 1:57
so nicola i’d love for you to just kind of give us a little bit of information about your background and what you do and how you got into the work that you do

Nicola 2:08
absolutely so my background is i have a phd in computational biology and i sort of got into that field because i was looking around for something that i could do sort of post graduation that would give me a lot of flexibility in terms of having a family and being able to work and computational biology seems like a great choice because i feel like i could work part time and i could you know work at home that kind of thing so i did that and as i was finishing up my degree i was starting to think about a family and getting pregnant and so i went off the pill and i didn’t get a period and around the same time i had also been reading more about getting pregnant and you know i read a lot of places lose weight to have a healthy pregnancy lose weight to have an easier time getting pregnant so some of the people in my lab but we’re going on a diet and i was like perfect timing i’m gonna go on a diet this is about a month before i went off the pill and you know i lost a lot of weight in that month and clearly my body was not happy with me in hindsight i was like duh but at the time i you know i had no idea what was going on like why am i not getting my period and you know i saw a bunch of doctors and didn’t really get any good answers from them so that sort of led me to an online community of women who were likewise suffering from what they would eventually i was diagnosed with hypothalamic amenorrhea and being a scientist i started looking at the medical research and i got to know you know about 500 women who are likewise experiencing ha and sort of observing their interactions with their doctors and just what it took for them to recover their periods and now sharing my experience and so eventually a lot of work a lot of them were saying you know so much you should write a book and in my life situation was kind of perfect i actually just had my third child around this time and i was like yeah actually i should write a book about it because it was just so little information at the time there’s so much more out there about it now which is absolutely fantastic but you know at the time there was very little especially when i was going through it i you know i searched on the web and there was literally nothing about hypothalamic amenorrhea or missing periods so it was you know it’s really hard for me to kind of figure out what was going on so yeah i mean i incorporated a lot of the scientific literature i did a survey of 300 of the women that i had met through this board and included that data which i think is really helpful because there’s a lot of misinformation about who’s actually suffers from hypothalamic amenorrhea and how long it takes to recover instead of all that kind of data in the book as well you know as well as my story and the stories of many of these other women because i think it’s really helpful for people to hear the perspective of others who are going through the same thing so that’s that’s how it all kind of came about well

Carter 5:04
so so when you started putting all these pieces together you said that you were exercising and you went on a diet you said that kind of casually like it was just part of what you were doing at the time was it a big surprise that you started realizing like oh that these things are connected

Nicola 5:23
yes absolutely because i mean you read so many places like exercise is healthy and exercise every day and lose weight and you know make sure you don’t eat the wrong things and don’t eat too much and it’s just such pervasive messaging that we get all the time so the idea that it would cause me to lose my period was nowhere on my radar screen and then when i when i went to the doctor the first time i was like you know i have i did just you know cut my calories and i lost some weight and you know do you think that could play a part in initially yeah well maybe and senior she she sort of said maybe you could increase your food a little bit and maybe you could tell your exercise a little bit and so that’s what i did and it really didn’t help and i think you know having much more hard and fast guidelines which is what i included in my book and we can certainly talk about that if you guys want to is really really helpful for knowing sort of what the levels are at which you do need to eat and support your body and feel your body and how much exercise is okay and what types of exercise are okay

Julie 6:23
so i think as even as a dietitian in the field when i was kind of learning about some of these things you’re right i didn’t learn about this more specifically and certainly wasn’t guided as what do you do if you have a client that comes in and but i also think just definition wise i would love for you to to give us what you would as a good simple as simple as possible i guess but with some science yeah of what is this what is ha

Nicola 6:51
so the typical diagnosis is three months or more without a period but i think one can sort of get an idea even sooner than that depending on lifestyle choices etc due to the hypothalamus which is the one of the major control centers in your brain being suppressed so there are a few different ways that the hypothalamus can be suppressed the biggest one is through an energy deficit because your body has certain functions that it has to do all of the time you know it has to pump through blood and keep you breathing and it needs to send energy to your brain we’re moving around all day so that’s expending energy and so it needs to take care of all the things that needs to keep us warm and that all takes energy and if we’re not providing enough energy for all of those functions then it has to make a decision well what am i not going to do and maintaining the reproductive system is a really easy thing to shut down because we do not need to have children so we don’t have to have a period every month from our bodies perspective you know that’s a very easy thing to shut off we’ll often lose body fat or we’d like to start feeling colder because that’s a way for our body to save energy is by not warming us up as much and then there are a whole host of other sort of negative side effects based on the body just not having enough energy to do all the things that you need to do and again this is so much pushed by the society that we live in which focuses on women being as small as possible and that sort of being the ideal you know body type and you know even more so now like you not only have to be small you have to exercise a lot and you have to have muscles and sometimes that is not necessarily compatible with a fully functioning hormonal system let alone everything else so that’s the major driver of amenorrhea in most women other components can be stressed from exercise so when we exercise particularly at high intensity that increases cortisol levels and cortisol and some of the other associated hormones can suppress the hypothalamus and similarly mental stress can also suppress the hypothalamus and as you know it’s the same pathway of increased cortisol and other stress hormones

Carter 9:05
so can you can you go back and say a little bit more about what the hypothalamus is supposed to do when it’s functioning well

Nicola 9:11
so the hypothalamus controls many of our other hormonal organs so it secretes gonadotropin releasing hormone which then goes to the pituitary which then secretes follicle stimulating hormone and luteinizing hormone so that’s that’s what controls our reproductive system the hypothalamus also secretes adh and forgetting what that stands for right now it’s involved in making sure that we have the right amount of water in our body so we don’t have too much too little it’s a silent trip and releasing hormone which then causes the pituitary to secrete tsh thyroid stimulating hormone which goes to the thyroid gland so it really controls so much of what our bodies do it secretes some of the hormones that cause us to feel Hungry or full. So you know, it really is a master control center. And when we’re not supplying our body with enough energy, it’s controlling all of those other things to shut down to conserve energy as much as possible.

Carter 10:13
So it sounds like in a way, someone’s loss of period is kind of like a canary in the coal mine, like there’s Yeah, it’s the first sign that something’s wrong.

Nicola 10:21
That’s a great way to look at it. It’s not always true for everybody, there can be women who are not supplying their bodies with enough energy who do maintain their periods throughout their women that have severe anorexia, for example, who can maintain their period. So part of it is genetic as well. You know, there was a really elegant study done a few years ago in monkeys. And they showed that there are monkeys that are high stress sensitive, so they lose their periods very easily with either just moving to different cage or a small reduction in calories. And then there are monkeys that are able to maintain their periods through a lot of, you know, physical and mental strength. And I think the same is true in people. So some of us have a tendency to lose our periods more easily than others. Interestingly, there was one study that looked at length as luteal phase, which is a time between when you ovulate and when you get your period and found that women with a naturally shorter luteal phase were more likely to lose their periods. So I know that’s true. In my case, my luteal phase tends to be about 10 days. And you know, obviously, I lost my period pretty easily. But I just think that’s a really interesting correlation. Yeah,

Julie 11:31
I just want to what so aligned with what you’re sharing, and when I heard you speak, at the Boston Children’s Hospital, female athlete conference, just this last year, in June, it just sparked just so much, because the ways that you’re integrating the word stress with a little diet, you know, stress with a bit more exercise stress, with lack of period with all of these things. I just love that, because so many of these things feel like, Oh, this isn’t that big of a deal. Yeah, I know that in my early career, the eating disorder world certainly also was allowing for many people to be without a period and continuing to kind of be like, Oh, it’s not that big of a deal.

Nicola 12:13
Yeah, they’re at a quote unquote, healthy weight, right? That quote unquote, healthy weight is still really low.

Julie 12:20
Yes. And they’re like, well, I don’t know, you know, maybe this is just what you’re just active. It’s okay. And yeah, I don’t. So I just, I love that there’s so much more awareness through your work and your advocacy. So

Nicola 12:34
thank you. So, another really another really interesting thing is, she’s when you look at it from an evolutionary perspective, you know, we certainly have had times in our in our species history when there’s been a lot of starvation. And if you think about it, like women who did not recover their periods, would not have been able to have children, and therefore that’s not in our gene pool. So our gene pool is made up of people who were able to recover their periods after in times of starvation. So I always like to say that to women who are working to recover a period like because there are doctors who will say, Oh, you know, you’re never going to get it back. And, you know, maybe you’re just broken, it’s like, no, that’s not actually true. You know, there’s, there’s so much hope for women who are experiencing this so that they can recover their periods, you know, through eating more, exercising less. And sometimes it does take a little bit of a jumpstart. And there are ways to do that. So I do have a chapter in my book called still no period, which is for those women who have sort of done the work towards recovery, and maybe still aren’t having a chariot yet. So differently, doctors often will say, Oh, just take the birth control pill or just take estrogen and progesterone. And that doesn’t actually restart natural cycles. Like I think is a really good goal for everybody. Because there’s so much benefit to having the monthly fluctuations in estrogen and progesterone and all of the other hormones that are associated with our menstrual cycle.

Carter 13:59
I would love to know about some of the benefits of menstruation because, you know, as, as women, I think, periods get such a bad rap anyways, right? Like, what you know, the loss of a period for some people, especially with an IUD or birth control is something that they want, they want to get rid of the inconvenience of a period. And so a lot of women, understandably, wouldn’t be tuned in to why it’s helpful, why it’s important, why it matters, why we should be worried about that. Can you speak to some of why it helps our bodies and why it’s important beyond fertility.

Nicola 14:36
Yeah, absolutely. Obviously, fertility is a big issue because you can’t get pregnant if you’re not ovulating. And there are ways to sort of force your body to ovulate but they’re not physiologic and they do work for some people. But one of the other benefits of recovery is realizing that you don’t have to control your eating as particularly as you have sort of been led to believe You don’t have to exercise quite as much as you’ve been told you to not have to exercise every day, you don’t have to exercise when you’re feeling sick or anything. So that’s one of the big benefits of recovery beyond just the period, and being able to ovulate and get pregnant. So many other systems are impacted by our hormones. One of the easiest ways to see this is to look at women who are postmenopausal, so then their reproductive systems have shut down for good. And there’s so much evidence that once a woman hits menopause, her bone density decreases markedly. Cardiovascular Health is impacted. There’s a, there’s a big increase in cardiovascular disease once a woman goes through menopause. And there are also some suggestions in the literature that there is a tendency towards, you know, increased neurodegenerative disease or earlier new neurodegenerative disease in women who go through menopause prematurely, so that they go through surgical menopause because of problems with the uterus or ovaries or what have you. So those are three main areas. And then there’s also just more superficial things like when you don’t have a lot of estrogen in your libido usually goes missing in action, your hair and nails can be very brittle, you can lose your hair, you can lose sleep, because you wake up a lot in the middle of the night to go to the bathroom. This is actually something I learned fairly recently, when I was doing research for an article, there are receptors in your bladder that basically sense the urine. And when you have low estrogen, your bladder lining is thinner. So those receptors since the urine earlier, and so you end up having to go to the bathroom more like

Carter 16:51
so cool.

Nicola 16:54
I mean, there’s just so many benefits to the increases in estrogen and progesterone that we get on a monthly basis. And it’s not the same to be on birth control or on hormone replacement therapy. Because the estrogen or artificial estrogen and progesterone levels that are provided by those are not physiological, they’re not getting up to the same high levels that we do as we’re approaching ovulation and then again, after ovulation. So there are also studies that have found that while birth control pills can prevent loss of bone density in somebody who’s not getting a period, the average loss of limb density is about two and a half percent a year. So the birth control pills prevent that, but they don’t. Women are not increasing bone density, as they should be certainly in their teens, 20s, even early 30s. So having a natural menstrual cycle where you are ovulating every month and getting the benefit of the estrogen progesterone. And you know, there are multiple other hormones that are involved as well, we just don’t know, as specifically the you know, the effect of them. But getting those benefits is so important. It’s not really about the bleed. It’s about the ovulation and the hormones that are associated with that the bleed is just kind of, you know, that’s the way that the new cycle starts. But it’s you know, it’s it’s much more about ovulation than it is about getting a period.

Julie 18:16
Yeah, I know that we don’t do a good job of sort of celebrating when young girls get their period for the first time. And we don’t know all of those things, I don’t think and so there isn’t always this celebration, I think people link it to maybe to fertility and sexuality and kind of coming of age a lot. But what about all of those other things that wow, like you’re maturing and your body is going to have this new system that’s going to keep you well for a number of years and

Carter 18:46
a system that’s functioning every day of your life, not just the week that you’re bleeding. Yeah, right. People don’t talk about what’s happening, but the rest of the time,

Nicola 18:55
right. And they can, it can periods can also be challenging, because they can be uncomfortable. And you know, there can be a lot of things that go wrong in terms of, you know, endometriosis, or fibroids, and you know, so there’s a lot of other things that can cause periods to be uncomfortable and for people to try and get rid of them. And you know, I’m certainly not going to say that, you know, somebody has to choose being in like severe pain every month over taking birth control pills to control their, you know, to control that. But I do think that we need to be talking a lot more about the benefits of menstrual cycles for everybody. And, you know, maybe in those cases somebody might choose not to, but it should be much, it should be much more awareness of all of the positives that we that we do get from the cycling hormones.

Carter 19:45
Absolutely. So I want to shift gears a little bit and here’s some more about, you know, some of the expectations around who is suffering from ha, like, it sounds like there’s often been a stereotype that it’s the thinner person like the smaller Body means that there may be a loss of period. Active, highly active, what are the implications of some of this weight bias?

Nicola 20:09
Oh my gosh, it’s it’s enormous. I think that there are, it’s a couple of different things. So one is that women who are not in that sort of typical age, a body type, their diagnosis, they’re often told they have PCs. And, you know, that can lead to some further negative consequences. Because a lot of times when when PCs are told, you know, exercise more, eat less, don’t eat carbs, we’ll all which are, you know, not necessarily helpful for PCs, anybody that has PCs, I encourage them to look for alternative ways of managing those hormonal issues. But certainly in somebody that’s lost a period because of AJ, all of that stuff is just going to make things worse. So getting the correct diagnosis is really important. And weight is not a diagnostic criterion for either hypothalamic amenorrhea, or pcus. It’s just not part of the equation. So there are women of all body sizes that have joined my Facebook support group, it does tend to be when in smaller bodies. But that doesn’t mean that for somebody with higher BMI, that this is not their issue, it very well can be and particularly women with higher BMI are often encouraged to eat less and exercise more and lose weight, lose weight, lose weight, and so that can certainly Cause you know, amenorrhea in women of any body size, and also not just in women. So obviously, for the amenorrhea part that’s just for women, but men can experience many of these negative side effects as well of just the diet and exercise mentality. So there’s a condition it’s should have been renamed relative energy deficiency in sports. And that sort of encompasses both men and women and the negative consequences of not getting enough energy to support everything that your body needs to do.

Carter 21:59
So if you were if you wound up being diagnosed with ha, what is the recovery process? Like you talked a lot are you doing? You mentioned that you had a whole process that you started going through that that was a season of life? What does that entail?

Nicola 22:15
So the short answer is that it’s about eating more, eating all food groups, and cutting out high intensity exercise. So overall, we tend to need a lot more energy to have a lot higher energy intake on a daily basis than what we’ve been told by the popular media. So you have to remember that our bodies are again, you know, they’re pumping blood, you’re breathing, your brain is working, your muscles are working, your cells are creating protein and DNA on a daily basis. And then we have all the general movements that we do during the day. It’s called non exercise activity thermogenesis. And anytime you’re walking around, you know, to go to the bathroom, or the kitchen, cooking, standing, all of that is burning energy. And it takes you body energy to digest your food. So all of that adds up to a lot more than serves the popular culture tells us. So we often have to rethink what we’re eating, and the reasons for eating. And you know, I’m hungry. As you know, a lot of times we think I’m hungry, I shouldn’t eat, because it’s not my meal time yet. But when you’re working to recover from each day, you feel hungry, you eat, because your body is sending you a signal saying, I need energy I need, you know, I need fuel for all these things that I’m doing. So I think can be really helpful to think about food as fuel, as opposed to sort of all of the shame and guilt and negative associations that we often have based on, you know, all of the things that we’re told about how awful it is to be in a larger body. And you know, we just need to keep eating as little as possible. And all of that stuff

Carter 23:53
is also interesting with this being you know, a medical diagnosis. Typically, people do think I think you said this earlier that like, you know, when you have a cold or when something’s going on, like your body needs, maybe a better diet or it needs, you know, more exercise, a lot of people will go to those things for defects. And this is really counterintuitive. Were actually, I think, for a lot of people, some it’s that you actually need to exercise less and eat more and be less controlled about those things and find more of that freedom instead. Which is something about that sounds like it would, of course, for someone especially struggling with an eating disorder, cause all sorts of challenges within that. And the recovery and rest process would be really different than maybe some might assume.

Julie 24:43
Yeah, and the exercise maybe to speak to what the exercise recommendations are when? Because I don’t think you got into that specifically. Yep.

Nicola 24:51
So for exercise, I recommend cutting out high intensity exercise or at the very least cutting down you know, whether somebody can do that or not, or how easy it is, really depends on so many factors. So the best thing to do for regaining your period is to cut out high intensity exercises. But that’s not always, you know, it’s really hard to do. And so, you know, sometimes people will decrease the intensity, decrease the amount, you know, I certainly would say, you know, if you’re exercising now, no more than four days a week, probably limiting to about half an hour, I need to give that a try and see what, see if you get your period back. And eventually, every time you kind of get tired of the waiting processes, like okay, now I’m ready to go all in and cut out my high intensity exercise. So what I, what I define as high intensity is heart rate over about 100 beats per minute. And this is based on a study that was done by hill at all. And they looked at increases in cortisol based on exercise intensity. So they looked at people, they took the same people and had them do no exercise. 40% is Max intensity, 60% and 80%. At 40% of Max, they were essentially no changes in cortisol or other stress hormones, and 60% of Max, there was about a 25% increase. And 8% is Max, it was about an 83% increase in stress hormones. So given that it’s the stress hormones that can suppress the hypothalamus, I recommend 100 beats per minute as sort of being about 50% in max intensity for the average woman in her 20s or 30s. You know, they can, it’s a rough ballpark. But I think that’s a good place for people to kind of, again, to have a target and idea of what does high intensity mean, and the reasons why that recommendation is made. So when I did the survey for my book, I asked people about how much exercise they had continued to how much exercise they were doing. My expectation was that it would be overall amount of exercise that was correlated with period recovery or not. And I was actually quite surprised to find that low intensity exercise did not really seem to have an impact, it was very much more so the high intensity exercise. So that’s that’s sort of another place that that recommendation comes from is my empirical experience.

Julie 27:16
And I think I remember you mentioning this in your talk, just the special considerations for athletes in that of like, considering timing of when one might take the time to get their body in a state of being able to demonstrate, again, could be in an offseason, or could be in a time when they’re not training intensively for something, you know, for the general population that’s just sort of exercising for fun, or without some sort of big intent or performance needs, you know, they can maybe pick the now but I maybe speak to what other considerations might be specific to an athlete.

Nicola 27:46
Yeah, I mean, certainly for somebody who is a competitive athlete, it’s definitely much more challenging to just say, Okay, I’m just gonna go cold turkey, and you know, quit my exercise, you know, especially if you have like a fellowship or what have you. So I think the most important thing in those cases is to really ramp up the eating, probably work with a dietitian to make sure that you are fully feeling exercise, and there’s no hint of weight loss, particularly in women who perform in the sort of, quote, unquote, lean sports like endurance, endurance running, and that kind of thing. That can be this idea that being in a smaller body is helpful for performance. And while it may be true in the short term, I just know so many stories of women who’ve had one great season, and then you know, injury, injury, injury, and that that’s the end of their career. So I think focusing on really making sure you eating enough not losing weight, and you know, maybe even gaining some weight, to have the longest career that you possibly can be, it might be worth considering going on hormone replacement therapy, if you’re in that situation, so that you are able to you know, you’re maintaining your bones, at least where they are hormone replacement therapy seems to be better than birth control pills. And the reason for that is that the hormone replacement therapy is done through a patch that’s put on your skin of estradiol. So that is not processed to your liver, whereas the oral birth control pills are in there’s a woman called IGF one that has actually decreased by the oral birth control pills and played a role in bone density. So this is a, you know, a mechanistic explanation for why hormone replacement therapy is recommended over birth control pills. And this is some work of Dr. Katherine Ackerman at the Boston Children’s Hospital. So certainly, I would encourage anyone who’s sort of in a situation to look at some of that research and, you know, speak to your team physician or, you know, teen dietitian about you know, some of these options,

Julie 29:44
awesome amount of knowledge that you share and information. Honestly, I know that for many people, it’s gold, like I know that some of our listeners will listen and be like I’ve never had somebody shared this information and in a succinct way and I know that your book is, is available to people too. And they can read even more about it. And like you say more of the stories and more of the gift that that is, but I, I know that so many out there do crave to better understand their bodies. And there’s been such a gap in how this has been treated for so many. And so for so many years that we don’t as women have this ability to talk this fluidly about what is going on in the value of these things for our health. So I, I appreciate hearing it.

Carter 30:30
And I argue for doing all this research. Yep. That’s incredible.

Julie 30:34
Yeah. Yeah.

Carter 30:36
Do you know anything about how the cardiovascular system is impacted by Ha.

Nicola 30:42
So most of what I know comes from the studies of women who have gone through menopause or in surgical menopause, or there are also some studies that have actually found that there is a higher likelihood of having a cardiac incidence. In the luteal phase, I don’t remember exactly, I think I have it in my book. But there’s a lot of evidence that estrogen is important for heart health, and estrogen is involved in the elasticity of our arteries, that she has very low estrogen, then your arteries are less elastic, and therefore that can cause that can cause issues with your heart. I’m not a cardiologist. So I don’t completely understand that. But there’s also Dr. Cassandra, she felt at Mount Sinai is just completing a study of women wear hypothalamic amenorrhea, and looking at their cardiac health and whether the exogenous estrogen is helpful in improving those parameters. So it’s definitely an issue, it’s not something that’s been studied nearly as much as the bone density. So at this point, it’s sort of it can have an impact, but we don’t know. We don’t know enough to really get a strong parameters around exactly what is happening. But again, you know, bone health is impacted. Cardiovascular Health is probably impacted, you know, brain health is probably impacted. I know that women that have been in my Facebook support group, have said to me, like, wow, you know, I didn’t realize how much of fog I was in before, you know, when I was not eating enough. And now, I’ve been eating more. And I feel like I can think more clearly. And, you know, so there’s just, there’s so many benefits to fueling our bodies properly, it has an impact on our gi system. Many women struggle with bloating, and constipation, and you might even be IBS symptoms. And those tend to go away when they start to actually feel their bodies and eat enough. I think some of it probably comes from the GI system slowing down to try and extract every last calorie out of the food we’re eating. And it also can happen that sometimes when our bodies are shutting down, they’re trying to conserve energy, maybe they’re not making the hormones that are needed, or the enzymes that are needed to actually digest our food properly. So they just I cannot sing the benefits of recovery enough, honestly.

Carter 33:00
Yeah, I’m just sitting here listening to this list. And I’m like, oh, my goodness, this is the entire the whole system of the body.

Unknown Speaker 33:10
Yeah, right. Yeah. No part

Carter 33:12
of the body that’s not impacted in some way. And this is incredibly important. People think that losing weight is so just all around good.

Unknown Speaker 33:23
And it is

Carter 33:24
mostly not. It’s overwhelming. Yeah, I

Julie 33:28
love that. Also the words you use recovery recovery from hypothermic Amory, obviously, it’s a hopeful statement, but we an eating disorder world think about recovery and talk about that, too. So think it’s a kind of a neat way to say like you can put your mind to this, it can be something that you pursue, and there’s hope in there. So

Nicola 33:48
I think it’s great. And I would, I would like to invite any of your listeners to join my Facebook support community, it is incredibly helpful to have other people who are going through this to talk to you because for many of us, we’re the only person that we know who, you know, we sort of been the sitting one, the, you know, the skinny one, and then having to back off some of that identity can be really, really challenging. And especially if you’re going it alone, you know, you’ll have friends saying, Oh, I wish I wish I could eat everything. I wish I could eat all that ice cream. And you know, inside you’re going like, but this is really hard, and there’s nobody to talk to you about it. So having having that community I think can be really, really helpful and supportive in the revolt recovery process.

Carter 34:34
If people wanted to join the support group, how would they find you on Facebook?

Nicola 34:38
So it’s a an HTTP, no period dot info slash support. I’m also on Instagram at no period. Now what that said, you know, that’s a good place to find my stuff. And then my website is www.no period now what.com so that has links to the E book and the paperback paperback is also on Amazon. And I’ve written a lot of blog articles about different aspects of amen area and recovery and supplements and you know, a lot of supplements that are recommended that are not necessarily helpful that don’t really have evidence supporting them. So I talked about, you know, talk about a lot of those. I talk about energy balance and distributing your foods for the day, that’s a really important part of recovery is making sure that you’re not doing intermittent fasting.

Carter 35:32
Well, thank you so much. Thank you for all those resources. And we’ll make sure to link those in our description box so people can find you most easily. It’s been so wonderful getting to talk to you and learn so much. I feel like I have just taken in so much new information which

Unknown Speaker 35:50
Thank you.

Carter 35:55
Thank you so much for listening. And thank you to Daniel Gunther jack straw Cultural Center for sound engineering to Aaron Davidson for the appetites, original music and to Hans Andersen for editing. Join us next time. Bye

Transcribed by https://otter.ai