Energy and Mood throughout the Menstrual Cycle

Christina Valenzuela, who is a certified instructor in the Boston Cross Check method of Natural Family Planning, shares insights into the patterns of energy, mood, and social personality that women experience throughout the monthly menstrual cycle. She shares tips on how to use this cyclical energy pattern to our advantage, and red flags for when symptoms deserve medical investigation. She also shared these resources:

Dr. Lara Briden
https://www.larabriden.com
The Hormone Repair Manual
The Period Repair Manual

Megan Faller
https://thealignedcycle.com
The Aligned Cycle

Christina Valenzuela
https://www.pearlandthistle.com/#/
Cycle Prep curriculum

Telehealth through My Catholic Doctor
https://mycatholicdoctor.com

Lisa Hendrickson-Jack
https://thefifthvitalsignbook.com
The Fifth Vital Sign

Dr. Elisabeth Raith-Paula
https://second.wiki/wiki/elisabeth_raith-paula
What's Going on in my Body

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• Email femammalpodcast@gmail.com
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Logo design: copyright Darragh Hannan

Transcript

[00:17] Greer: 
Hi, this is Greer, your host for Femammal, the podcast that holds space for women to explore what it means to live well in our bodies and celebrates moving through this world as female mammals. Today's guest is Christina Valenzuela, who has been a certified instructor in the Boston Cross Check method of Natural Family Planning since 2013. She now owns a business called Pearl and Thistle, where she offers innovative resources to help Catholics share lifelong body literacy with their families, friends, and parishes. She resides outside of Boston with her husband and four children. Christina received her undergraduate degree in philosophy and theology from the University of Notre Dame and her Master's in Theological Studies from Harvard Divinity School. In our conversation today, she shares insights into the patterns of energy, mood, and social personality that women experience throughout the monthly menstrual cycle. She offers us tips on how to use the cyclical energy pattern to our advantage and red flags for when symptoms deserve medical investigation. Welcome, Christina. I am so excited to be having this conversation with you because I feel like so many of us, when we are getting educated about menstruation and hormones and what we as female adults will go through, we tend to focus on that physical experience of bleeding and fertility. And for those of us who struggle with gynecological conditions, maybe pain, but we maybe miss out on information about how menstruation and fertility can be a full body experience and effects on emotions and mood and social connection and energy. So I'm excited to talk about those ideas with you today.

[02:27] Christina: 
Oh, my goodness. I wish the podcast could capture the vigorous head nodding that I'm doing right now. Because absolutely everything that you've said yes, this is part of why I entered into this work, is that even as a Natural Family Planning instructor, somebody who teaches couples how to understand their fertility, even opening up into this space of saying, hang on a minute, this is a whole new window of information into ourselves that has value beyond just fertility information. I think I didn't realize that until I had been teaching for about seven or eight years when I actually started thinking about how I would want to teach my daughter and what is she going to learn about menstruation and cycles. And that's when it dawned on me, like, there's actually a lot more to say. So I'm excited that we can talk about it.

[03:18] Greer: 
Oh, absolutely. So to start, can you give us a crash course on the hormonal shifts that menstruating women experience throughout the month?

[03:28] Christina: 
Sure. Yeah. There are different sorts of ways that we can talk about the cycle, and I don't think there's any one standard way that we have to think about it. So the typical way that people think about talking about cycles in the first place is kind of what we call the ovarian cycle, which means that in the first part of your cycle, in the ovaries, a follicle is developing and an egg is maturing. This is called the follicular phase. And so in this phase, in the sort of gearing up towards ovulation phase, estrogen is the hormone that is driving so much of the activity in our body, in our brains, in our ovaries, everywhere. So estrogen is the hormone there. And then after ovulation, that follicle that's been producing an egg will actually become a different organelle within the ovary itself. It'll become something called the corpus luteum. And the corpus luteum will actually produce a hormone called progesterone. Progesterone is the pro gestation or pregnancy hormone. And so at that point, it's not as if estrogen just disappears. Estrogen actually sticks around in pretty high levels, but we produce progesterone in such high amounts that they just dwarf the estrogen. So in the second half of our cycle, what's called the luteal phase, we have this progesterone dominance. And so those are kind of the two main hormones that we think of when we think about energy and moods. There are many others involved, including testosterone, luteinizing hormone, follicle stimulating hormone. But I think estrogen and progesterone are kind of the two dominant ones that we tend to think about.

[05:10] Greer: 
Thanks. That was really helpful. And what would you say that hormones have to do with mood? I mean, I remember being very moody in puberty, having these huge mood swings that was very hard to deal with. But what kind of influence do hormones have into adulthood?

[05:29] Christina: 
Yeah, I like to take a step back. And it's funny because we talk about being moody and being hormonal, and that's kind of a signifier of women's issues, right? Oh, she's being moody. Oh, she's being hormonal. Everybody is hormonal and moody all the time. This is just how our brains and our bodies work together. So hormones are always pulsing through our body and influencing our moods, influencing our energy levels and things like that. It's just that with the woman's cycle, we tend to focus on these reproductive hormones, and we've kind of given them a sort of character or a life all of their own that's independent of what we think about as sort of normative of the, I don't know, the typical hormone body experience. So when we talk about these cyclical hormones, specifically estrogen and progesterone, they can be characterized by a couple of different things that do affect our moods. Estrogen tends to be the connection hormone. Estrogen is all about building up relationships, getting yourself out there. It's the hormone that's building up prior to ovulation. And so under the influence of estrogen, women tend to be a lot more outgoing. We tend to thrive on connection, whether that would be having a higher libido and being more attracted and a more attractive to men. But also just like networking and social time. This is a great time for women to be around women and to be very social in that way. So that's what estrogen kind of does for us. Progesterone, as the pregnancy hormone slows us down a little bit. Progesterone makes us more sensitive to things around our environment, more sensitive to our own moods. Some women even say that progesterone makes them more sensitive to colors and sounds and tastes. I haven't experienced that, but I know some women who are that in tune that they think it does. So that's kind of a basic difference is that estrogen is the building up, high energy, forming connections. Progesterone is the slow down, take space, connect to your environment sort of hormone.

[07:46] Greer: 
I love that way of framing it, and it illuminates for me--I struggle to answer that question of are you an introvert or are you an extrovert? When people ask me that question, because in my mind, it depends on which week of the month you ask me that question. I have two weeks where I am very extroverted and I have those first two weeks of my cycle. I would love to go to a party and I'd love to be in a crowd of women or a group having that kind of high energy experience. And the second two weeks of the month? No, I'd like more quiet time, more space, more distance.

[08:24] Christina: 
Yeah. I would say that you have quintessentially described kind of the basic distinction between these two hormones. And I think that's funny that you mention it in terms of introversion and extroversion because I have always thought that I'm an extrovert. And I have tended to think at times when I am more introverted, especially at the end of my cycle, I'm like, what's wrong with me? Right. I think of myself as an extrovert. I feel introverted right now. What's wrong? When really the question shouldn't be are you an introvert extrovert to begin with? It should be where are you in your cycle? What is your body asking you to do right now? How are you forming relationships and connections in different ways throughout your cycle? Had I been aware of natural cyclical changes that happen with most women, I could have been more prepared to ask that question and say, like, how is my body asking me to respond differently or to connect differently with people? At this part in my cycle, I wouldn't have had that internal thought that anything was wrong with me unless I had already given myself that expectation in that label. Right. That's such a great reflection.

[09:31] Greer: 
And you've just given me another thought, which is usually I hear people define introversion and extroversion as being about where you get your energy. Do you feel energized by a crowd or do you feel energized by reflective time on your own? But I'd like to turn that on its head and say, where do you feel like you have energy to offer? Do you feel like you have energy to offer to the crowd? Or do you feel like you have energy to offer through reflection and more distance, and both are valid.

[10:05] Christina: 
Oh, my goodness. Well, I love that. I love the way you said that, because if you think about it, progesterone, that second half of the cycle hormone that progestation or pregnancy hormone, I mean, it is fundamentally geared towards connection with another person still. So in the first half of our cycle, we're all about like, let's try to get pregnant. Right. In the second half of our cycle, our body is already like, okay, if I am pregnant, let's nurture that life. And so regardless of where you are in your cycle, there's a profound connection that your body is asking you to form. It's just a question of whether that's a physically external connection with other people or whether that's an internal connection with the life that you may be nurturing inside you. Right.

[10:52] Greer: 
And that has so much value for the wider community. Regardless of whether you've actually conceived a life or whether you're even interested in conceiving a life, you've got this whole direction of energy going on that's so interesting.

[11:08] Christina: 
Yeah.

[11:09] Greer: 
So I'm definitely a person who experiences very challenging moods the week or even two weeks sometimes before my menstrual period. I can be very short tempered, I can be sad. I can have just a level of anger that I don't get any other time. How would you say that more positive moods are also driven by our hormonal cycle too, though.

[11:34] Christina: 
Yeah, well, I guess the thing is what's driving you to feel those emotions so strongly and to experience that as a negative thing? Right. We're like, oh, I'm on edge, or I feel like I'm not responding well to things. But at its core, what you're experiencing in that last part of your cycle is just heightened emotions and heightened sensitivity to your environment and to people around you. And that's actually a wonderful thing if you were pregnant, heightened sensitivity to your environment is a huge survival skill. It's a huge benefit. Right. In our modern world, we're a little bit divorced from that, and so we tend to see it as a sort of disruption in our otherwise predictable responses to stimuli. Right. But we have to think about how even that which we experience maybe as a negative thing is in and of itself actually a positive is a survival thing that is built into our bodies, into our person. But if we back it up and we talk about different hormones as well, the reset that happens with hormones at the beginning of our cycle, for example, the first few days of our period are actually incredibly clearing experiences, like, with the physical clearing of our body that happens with the shedding of lining. There's actually a clarity of thought. And so if you were trying to, for example, align your work schedule with your cycle, the first few days of your cycle are a time when you want to be doing like, big vision planning because you have this clarity that you may not have at other parts in your cycle. That's a huge positive. When you're gearing up towards ovulation and you have that estrogen pumping and it's telling you to form connections, that's a huge positive. It's a social positive. And so I think just getting curious about what we feel throughout our cycles and challenging ourselves to see, well, how would this particular thing actually benefit us as a society, as individuals? That would be a good place to start rather than kind of defaulting to what we're trained to do, which is like, oh, I'm being hormonal and moody and that must be a woman thing and therefore it's a bad thing. I think we should give ourselves permission to get curious about how our emotions change throughout the cycle and to put that challenge in front of us to say, well, how is this a good thing? How could I use this to my advantage right now?

[14:11] Greer: 
I love that reframing. It's been slow work. But I have really gotten to a place in my life where those sort of perceived as negative emotions, I no longer put that negativity on them. Because I've seen now how that sort of quickness to anger has sometimes become the self-righteous anger that I need to use to channel, to advocate for someone who needs advocating for or to push forward with a project that really needs that extra energy. And it took that last straw feeling to ignite that for me. So it's not necessarily a negative thing, even though we've been socialized to perceive some emotions as good and some emotions as bad.

[14:57] Christina: 
I love what you said because Dr. Lara Briden, so she just came out with a book called The Hormone Repair Manual. For a long time, her Period Repair Manual was a text that I recommended to a lot of people, and specifically The Hormone Repair Manual is about menopause. And she makes this point that society labels menopausal women as particularly difficult to get along with, that maybe they're quick to temper or they will take no nonsense. And she talks about this kind of trope of the woman who is past menopause, who just doesn't care anymore. She doesn't care what people think, and she speaks her mind and she says, that's actually a good, freeing thing because for so much of our lives, women are, we're sensitive to the way that different things play out in interactions and in relationships. And we don't want to step on toes and we don't want to make people angry. But her point is that there's value in a woman being free from that pressure and being able to speak her mind. And we should own this as women, as something that is part of the sort of second puberty of menopause. So she kind of makes that point writ large that you were talking about at the end of your cycle, feeling like you have permission to be righteously angry about things or to feel these emotions where in other parts of your cycle you may feel a little more conciliatory.

[16:22] Greer: 
Oh, I love that. And you mentioned if you're trying to align your work or your initiatives with your cycle moments, where it's easiest to do those visioning during your first few days of your cycle beginning again when you're on your period. I do want to shout out to the women who don't have that in them because they, like me, are just completely felled by period cramps and have no energy. So I think there's that kind of breadth of experience too, like these are trends, but then there might be other realities going on below those global trends with you as an individual as well.

[17:11] Christina: 
Oh, absolutely, yeah. And one of the things I guess I should be even more careful about in speaking is that I had awful debilitating cramps for many years, and I ended up, I think, just hitting the jackpot because after I had my first baby, it kind of all resolved itself. But for many years, for about a decade, I went through exactly what you're describing of just like absolute horrible pain and incredible fatigue. And I don't think that I would have had the head space to think about cycles honestly in the same way as I do now. But I am careful to reflect on that experience and to say, while we want to talk about trends, we also should not say that these are prescriptive. I have a friend who has ADHD, and she says what you experience with your cycle is very different from what I experience. And I'm like, absolutely, yes. So there are also those many, many faceted ways in which our experiences are unique and different.

[18:16] Greer: 
And so what I'm hearing is that the value is learning to pay attention to your own experience and figuring out how to work with that. So one thing I do because I still have really bad period cramps the first couple of days of my cycle is I try to do kind of busy work at work, like very rote reporting that I could do with half my brain on those days if I have that flexibility. And so whatever you as an individual find to align to that resonates for you is really the value.

[18:51] Christina: 
Yeah, absolutely. And one woman who does some very interesting work in this area, I just want to give her a shout out. Megan Faller has a business called The Aligned Cycle. And what she does is she'll take kind of like the basic research on energy levels and moods and productivity levels and things like that that we have. But she will help you learn how to chart your energy levels and moods with your own cycle and then to kind of work around the particular, I don't want to say symptoms necessarily, but that's a good word here that you experience at different phases and to kind of maximize your personal rhythms with your cycle. So if you're interested in that and the work that she's doing, her name is Megan Fowler, and she has a business called the Aligned Cycle, which is really interesting to look into.

[19:41] Greer: 
I'll give you a word that someone gave me that I love: Signals.

[19:47] Christina: 
Yeah!

[19:47] Greer: 
Replacing PMS with premenstrual signals instead of symptoms has been really liberating for me.

[19:53] Christina: 
I like that; I'm going to steal it.

[19:55] Greer: 
Please do. So, could you elaborate more on the way that this dynamic pattern of moods and energy levels and social engagement works together for our overall mental, emotional and social health? When you look at that full cycle playing itself out?

[20:16] Christina: 
Well, that's a big question, Greer. Yeah, so I want to just start kind of from the super macro level and to say that even raising this question of how should this cause us to think about society is a huge one, because for so long we have taken it as normative that a 24 hours circadian rhythm is the way to live life. And I see so many women in many different spaces, whether they're religious spaces or secular spaces, claiming this territory of cyclical living. And I think that there's a lot of experimentation that needs to happen in the modern workforce and in kind of a lot of the structures that we've built around spaces where women are to accommodate that and to think deeply about how we could be more responsive and respectful for women as a whole. How can women better occupy those spaces and flourish in those spaces if society were to take this concept of cyclical living seriously? So that's just like a big thought experiment that we could go off on a whole tangent of more concretely. The way that I like to think about all of this is kind of what you were saying earlier, is that this is something that is a gradual unfolding. I don't expect my clients who come in to learn about fertility awareness to jump on the train right away and be like, oh, right, I'm going to maximize my work productivity levels to my estrogen levels. That's a switch that doesn't turn on right away. And so a lot of the work that I'm doing is trying to build out ways that we can slowly develop this concept of body literacy. Introducing girls from the onset of their periods at puberty to this idea that we respect what our body is trying to tell us, that from the beginning, we learn to listen to what our body is saying to us and to respect that and honor that. And then what that does is it allows us to be more generous and responsive to our friends. And I have an anecdote about that if we wanted to explore that particular thing. But just introducing that from the very beginning, this concept that you have permission to listen and respond in generosity to what your body is telling you, and then we build from there. Right. Then we have teenage girls who already know how to listen to what their body is telling them, who already have some tools developing to be able to respond, even in high school or college, to this concept of cyclical work patterns and how robust we would be then as mature women, if that has been part of our growing up experience with our bodies from the beginning. 

[23:24] Greer: 
I am so excited about this perspective, and I want you to share that anecdote. 

[23:28] Christina: 
Sure. So I have this program called Cycle Prep, and it's just a pre-recorded video course for parents and daughters to learn about cycles and periods. So it's not just about periods. It's not just about looking at bleeds. It's about understanding what's going on throughout the whole cycle. And so at the end of Cycle Prep, I have this section that I call Building a Culture of Care, where I talk to the girls specifically about how we are responsible for caring for each other. And so when you pack a period kit, you pack extra supplies for your friends and you let them know that you have things. And we offer help to one another so that nobody ever feels alone and that we feel co-responsible for taking care of each other. And then part of that also is learning when our friends say, oh, I really don't feel like going swimming today. Right. We don't get upset about our friends backing out on things. Instead, we respond generously and we think about, well, maybe her body is telling her that she needs to rest instead of going out to the beach. So I talk about this in the video course, and I had a mom come back to me and she said, Christina, I have to tell you, my daughter had this playdate scheduled with her friend. They'd been planning it for forever. They were going to go on this big hiking expedition. It was going to be so much fun. And the day of the hike, the friend called and was like, I don't really feel like going hiking today. I'm going to bail. And she said, my daughter, whose initial reaction would have been to throw a temper tantrum, right, and to get all upset about her friend bailing on her, actually paused and said, you know, Mom, I wonder if she's on her period, and if she wants to rest, could you call her back and just invite her to do a movie night instead of the hike? Maybe she would rather do that. And so the mom got in touch with a friend and she accepted the invitation, and the girls had a wonderful time. So it just goes to show you, when we take the minute to pause and to think about how our social interactions may be reflective of these cyclical changes, that we can still have robust, beautiful, wonderful friendships, even if we need to change our plans sometimes to accommodate each other. So I loved that story and I thought it was such a beautiful, simple but profound way that we can instill these values in our girls from the beginning.

[25:57] Greer: 
That's wonderful because unfortunately they're going to be going out into a society that is in many ways hostile to the cyclical rhythms that women experience and ask and demand that we be equally energetic in the same way all the time. And that's not realistic. And if we could do more attitude adjustment as a society to begin to perceive that in some ways our cyclical rhythm is a superpower. I mean, we have this built-in release valve when we have these big emotions leading up to our periods that's very healthy. That's a moment to have that experience of emotion and then let those big emotions go and be reset and be ready for the rest of the month ahead. That's very healthy. We as a society need more of those release valves.

[26:54] Christina: 
Right? Well, we're talking about this in the context of just being aware of cyclical changes that we may be going through and our friends may be going through. But beyond that it instills the virtue of magnanimity and creating space for other people to try and understand where they're coming from. And boy, don't we need more of that just in life in general, right? 

Greer: 
Absolutely. 

Christine: 
Any point where we can give our children permission and explicit permission to pay attention to other people and to take them into account, I think we should seize that, whether that's in psycho education or wherever you find it. When we're talking to our kids about relationships growing up yes.

[27:38] Greer: 
We've both alluded to pretty negative experiences with pain in our past. And when your clients are expressing pretty severe symptoms, not signals, I'm talking symptoms of significant pain, maybe really significant mood issues where that low mood or where that anger is just extreme beyond anything that they are able to cope with in a daily way, when do you start to recommend that people get maybe some medical consultation on that? 

[28:19] Christina: 
Right away. Basically I tell my clients, and I have a charting guide for girls and even in Cycle Prep I touch on this, that while it is very common for us to have these sort of severe symptoms, a lot of women experience them in various ways, it's not actually normal in the sense of being what should be the normative experience. Our bodies are actually designed to do this work in a healthy and regular way. And so when we are experiencing any symptom which is so severe that it's interfering with our ability to interact with people and to function on kind of just a baseline level in our daily life that's a sign that your body is crying out for help, that your body is saying hey, there's something off here. And so I'm really sensitive to the fact that society often tells us like oh, this is just a woman's curse. You need to suck it up. Right. And I try to beat that out of clients as soon as I can. If I ever hear them saying that, I will say, no. You are allowed to be upset about the pain that you're experiencing. You don't have to accept this, and you are allowed to ask for help. And so I'm not a medical professional. I can't directly help them, but anytime they bring me a concern like that with their cycles, I have some basic supplements and things that I can point them towards. But my first answer will always be, you deserve help. You should stop hiding under this I need to suck it up mentality that we've been taught to have, and you deserve to go get help. I don't know if that directly answers your question.

[30:03] Greer: 
Yeah, I think that point was so helpful about, if this is disrupting your activities of daily life, then it's something that deserves medical investigation.

[30:16] Christina: 
How many teenagers are told, oh, just, periods are painful? I mean, I didn't know as a teenager that my periods were inordinately painful. I didn't know that not everybody ended up puking their guts out or, like, almost passing out when they had their periods. I just kind of assumed that they did it at home, and I was the only one who was doing it in the hallways at school. We need to be explicit about that and tell our girls, like, you should not be living with this pain for 15 years before a doctor will even give you the time of day. That's unacceptable. In what other area of life, maybe I'm getting angry right now, in what other area of life is it ever okay to tell somebody that they just need to suffer for 20% of their time? Right. And then will only take you seriously if you're trying to get pregnant? Right. Like, this is just not acceptable health care. And we should empower our girls to stand up and to voice what's going on in their bodies so that doctors understand that there is a need for them to respond differently. That's really loaded.

[31:33] Greer: 
I completely agree with you, and I really appreciate you highlighting this because it is such a pervasive issue, this sort of normalization of female pain. It's absolutely insidious. And unfortunately, that attitude is often an insidious attitude that medical professionals themselves still carry, whether that's because of their own medical education or the attitudes that they were socialized with. So what's some of your advice for advocating for yourself once you get in front of a medical professional, and especially if that medical professional is maybe being dismissive about your mood symptoms, if they're being dismissive about the level of pain that you're saying you're in?

[32:22] Christina: 
My tactic has been avoidance. I've definitely tried to go toe to toe with a doctor. And if they're unwilling to budge, if they're actually being dismissive and they're being condescending to you in any way, whether it's because of period pain or anything else that you're experiencing, you need to run away from that doctor. And unfortunately, that's a very privileged thing to say because I know that we don't have just a whole lot of doctors that we can turn to. Sometimes you live in a small community or you don't have a lot of access to doctors. One of the things that I think has really changed, I want to say, in the last three years is the advent of legitimate telehealth options. And so I just want to make people aware of that, that if your doctor is being dismissive and you really don't have any other local options to try, it is worth going online and trying to find somebody who is a restorative reproductive healthcare professional and you can find them in lots of different areas. There's one website called My Catholic Doctor which is completely telehealth. You don't have to be Catholic to use their services, but they have plenty of providers on there who fit this restorative reproductive health care model and they do everything via telehealth. And there's lots of other ways that you can access doctors remotely now. So that has sort of been my go to recommendation, is to see if you can find a provider remotely, if you can't find somebody locally. And oftentimes a lot of the labs and the things that you would need done can be done remotely. Somebody could put in orders for a local lab and you could submit to a doctor who's a couple of states away. As long as they have insurance in your state, you can still get that covered.

[34:07] Greer: 
Yeah, I think you definitely need to find someone who first and foremost believes your narrative about your own life, believes you when you say that you have these symptoms and who is willing to take investigative steps to understand that better, instead of feeling threatened by not knowing right away what the answer is for you.

[34:32] Christina: 
I think you hit the nail on the head there is that doctors, we do need to respect the people who have shelled out tons of money and tons of time and really are invested in this service profession. I don't want to make doctors the enemy. I never want to make any one group of people the enemy. But it is hard for doctors when somebody comes in and challenges them on something that they don't know about. And I'm here to tell you that your medical professionals do not receive very robust training on cycles and periods. They get a very brief presentation for the most part on female reproductive anatomy and an overview of the cycle. And then here's what birth control is good for. So it may be the case that they just don't know and they're acting out of sort of defensiveness or just ignorance. And so being as understanding as we can of the people who are in these service professions, but also at the same time, not settling for somebody who does turn that around and makes you feel like they're condescending or dismissive and won't listen to you.

[35:44] Greer: 
And another challenge that doctors and patients are facing is the way medical appointments are booked and billed. I mean, it's these 15 minutes increments. And so the doctor is already walking into the room with a sense of pressure, almost this, I have to solve your problem in 15 minutes. So if you walk in and you're also feeling maybe flustered, maybe embarrassed, maybe you aren't used to talking about these things, especially with someone you've never met, maybe it can be hard for both sides. So I have found that it really helps me in advance to spend 20 minutes maybe writing out all the symptoms I want to talk about and if I have information about my cycle pattern, if my bleeding has been off for some reason that I don't know yet, if I can come armed with information that'll really help me not get flustered and forget something.

[36:38] Christina: 
Well, and that's a good point too, because even the way that we present information, the accuracy of terms, it's so hard because you kind of have to be an expert going in to know what to say, to kind of prompt some responses sometimes. So I had an incident one time where I had been complaining to my doctor that I'm having these dizzy episodes. I'm just so dizzy so much of the time. And I was telling this person this for a year, I would go in and say, I'm so dizzy. And at one point, I used the word vertigo. And she took a step back and she was like, is that what you've been talking about? I was like, yeah, being dizzy and having vertigo, like the same thing. She's like, no, dizzy is lightheaded. And I was like, in what world is dizzy lightheaded? Wow. And so that completely changed the way that she approached me. So, again, a very easy thing to do is to just arm yourself with terminology and kind of key markers. So if you go in and you say, I have heavy bleeding, that's kind of a subjective assessment, right? If you can go in and tell your doctor I'm experiencing 105 ml blood loss with my period, that's going to stop them in their tracks, right? So kind of knowing what the parameters are for normal cycle bleeding patterns, and you can get those in a number of books. I've already mentioned the period repair manual by Lara Briden. The Fifth Vital Sign by Lisa Hendrickson-Jack. These are all wonderful resources to just arm yourself with knowing what is normal and how can I kind of quantitatively assess my cycle parameters to be prepared to explain exactly what's going on in a concise way that my provider is going to be able to understand?

[38:25] Greer: 
And for those of us who don't bleed into like a little beaker to measure our period. Something I have found helpful is when I'm capable of using tampons, which is not all the time because I have vaginismus and it's very painful, but when I am capable of using tampons, I can bleed through a super size tampon in 45 minutes.

[38:48] Christina: 
Oh, girl, no.

[38:50] Greer: 
So you got to tell your provider that's the level of, tell them I had to change my tampon after 45 minutes and maybe they'll pay attention to that.

[38:59] Christina: 
Yeah, you can even go online and there's like, conversions that you can do about approximately how many milliliters of menstrual fluid does a regular tampon have? A super sized tampon, a regular pad. You can kind of go online and do those conversions and you can see that as well. So if anybody's listening here, I want to say anything more than 80 blood loss is typically considered excessive and is worth medical investigation. So that's your kind of hallmark, 80 ml, ladies.

[39:30] Greer: 
Thank you. And maybe another helpful thing is just the sheer amount of information on the Internet about disorders or concerns that didn't get enough airtime in medical school. And maybe don't go and try to diagnose yourself on WebMD, but maybe do learn about a variety of diagnoses that relate to the symptoms you're experiencing and be ready with some of the words saying, could you investigate if I have this or that? Because I'm experiencing these symptoms. And I've started to wonder if it relates to a diagnosis like this or that.

[40:14] Christina: 
Yeah, and the other helpful thing, too, is if you're experiencing cycle issues, a lot of us maybe do period tracking, but actually learning how to chart your cycle with an actual method to be able to know how long is my luteal phase, when am I ovulating in my cycle, what do my temperature shifts look like? These are all incredibly powerful diagnostic tools that, if you track them alongside with other symptoms or signals, right, can be really, really helpful to your provider. So I was able to go in, I was having migraine issues, which surprise, surprise, were related to this vertigo stuff that I was experiencing that my doctor was dismissing because I didn't use the V word. And so I had one provider and he said, you're a woman, it's probably hormonal. Let's start talking about that. And I said, Actually, I can show you with my chart that these do not track with my hormonal patterns. There's something different going on. And this neurologist was like, oh, that's cool. Let me see that. Right? He had never had anybody be able to he's like, well, that just saved us about six months of diagnostic time. So, ladies, if you have things that you're concerned about with your cycles or if you have other things going on in your body and you're thinking, maybe this could be tied to my cycle, learning how to actually chart the biomarkers of your cycle is an incredibly powerful tool to have in your pocket.

[41:44] Greer: 
I love that anecdote in part because so many times when women are experiencing difficult symptoms, doctors might assume that it is driven by our cycles. And a lot of things are tied to our cycles, but not everything, right?

[42:02] Christina: 
Yeah. And the most common issues with migraines with women would be hormonal, but in this case, it wasn't. So it's always helpful to just have that available to help your doctors as best you can.

[42:14] Greer: 
Yeah, absolutely. Going back to mood a little bit for some of us who struggle with low mood as a premenstrual signal, do you have advice? You mentioned maybe some supplements on how to alleviate that a little bit or better manage it?

[42:31] Christina: 
Yeah, I mean, again, I'm not a medical professional, so I have to tread very carefully. But there are a number of supplements, I think if you're experiencing kind of borderline, what we would call PMDD, like premenstrual Dysphoric Disorder, or if you have severe PMS, there are a number of supplements that are specifically formulated to help balance that out for women. So, like a standard women's supplement, like, I don't know, an over the counter, just women's multivitamin is not actually formulated to help with that. So what you want to do is you want to find a supplement that is specifically formulated for cycle balancing health. So some of the common ones that I'll have clients look into always with permission from their doctor to check things out. But there's one called Optavite PMT, which is a cycle balanced supplement. There's another one called Brazen. There are flow vitamins. So these are a specific type of supplement that you would want to start adding in under the direction of your care team. But a typical women's multivitamin may not actually have what you need. You want to kind of be targeted in your approach there.

[43:39] Greer: 
That's really helpful to understand. You just threw out PMDD for those who have not heard of that before. Could you elaborate about that a little bit more?

[43:48] Christina: 
Yeah, Premenstrual Dysphoric Disorder is kind of the ugly cousin of PMS. So PMS, premenstrual symptoms or premenstrual signals, I like that, it's really kind of to a certain extent it's normal because what we're describing is we're describing heightened sensitivity. We're describing basically pregnancy symptoms because our body is in the early stages of pregnancy, whether or not we are actually pregnant. That's a little confusing, but hormonally our body is preparing for pregnancy in this time. And so it's common to experience things like bloating and food cravings and it's harder to fall asleep. Right. These are kind of the classic signals of your luteal phase. If you get into a situation, though, where you're experiencing, some people have anxiety that flares up, some people have depression, some people have something that is just very severe in their luteal phase. And so that's when we kind of switch over to saying, this is more than PMS. This is actually a dysphoric disorder. It's really the severity of the symptoms that come out when we're talking about the distinction between those two things, as far as I understand it. 

[45:03] Greer: 
That's so helpful. Do you have any other advice on learning to listen to our bodies well?

[45:09] Christina: 
I think the best advice I can offer is to be patient. And I think I'm speaking to myself here. Number one, be patient. Because body literacy, as any type of literacy, it takes time. And so we're not going to go, I say it this way, that when we're building literacy for our children, we don't start them with Shakespeare, right? They learn their alphabet and then they learn simple sound combinations, and then we maybe do phonics or we do whole language or however we're going to approach it, right? And then many years later, we get to Shakespeare. And so if you are just starting this journey of body literacy and learning to listen to your body, be generously patient, be super abundantly patient with yourself, and don't expect things to come right away. The second thing I will say is really try to fill yourself with positive scripts. This is something that I was looking into when I was learning how I wanted to craft my cycle prep program. And I was noticing that there's a big difference in literature, which is kind of tells things flat or tells things as if like, oh, well, this is just like the woman's curse. You got to learn about this compared to other literature that had these positive messages that your body is doing hard work with a cycle, your body is doing important work, your body is doing good work. Your body was designed to do this. Your body can do this. And when I started reading these things, I was like, AHA, this is what I want to put in my program. And then I had this strange experience where for the first time in my entire life, I had my next period. And I wiped and there was a ton of blood. Normally my reaction would have been like, oh my gosh, I can't believe this. It's so gross. My first thought was, wow, my body did a lot of hard work this last cycle to produce this much fluid. And I realized what I had done for myself, that by being intentional about seeking out these positive internal scripts, I had actually changed the way I thought I had changed my initial reaction to my period. So that would be my second piece of advice, is we have to unlearn a lot of things. And it's going to be hard if we want to embark on this journey of thinking more positively about our bodies, but we can do it. And we need to give ourselves the space to take time to learn that and to be patient as that unfolds.

[48:04] Greer: 
That thought work is so powerful. I had a very similar experience when I started understanding how our menstrual cycles are fertility cycles, but they also are these emotional and energy cycles, and that can be fertile in its unique way. Not related to creating a new baby, necessarily, but maybe to creating a stronger sense of community, or maybe to leading to a new project or some other fruitful thing in your life.

[48:41] Christina: 
Absolutely.

[48:42] Greer: 
Yeah. And if you can plug into that ebb and flow of energy, it can be so empowering. And it definitely changed my attitude towards my cycle, which has been a difficult thing to manage for much of my life, but then started to feel like a superpower, started to feel like something that was a gift, had a purpose. And it even, I think, diminished the level of pain that I feel monthly because I think my brain was no longer struggling against it and I was more open to it. And so there's definitely a level of physical pain, but I think sometimes our attitudes about a situation can enhance that physical pain. It's not that the pain is just in our heads, but our attitude towards a situation maybe can enhance the level of pain that we're experiencing. And so when I was able to change my thought process about this, it also allowed the pain to amp down a little bit.

[49:50] Christina: 
You are 100% correct about that, actually. Dr. Elisabeth Raith-Paula, she created something called the Cycle Show. She's a German physician, and in her book, What's Going On in My Body, she talks about this. She explains this to girls that our brain does magnify our emotion and translate them into pain. And so if we grow up in an environment where we're taught to fear our periods or to think of them as a huge inconvenience that we should be angry about, that actually amplifies the pain signals that we're giving our bodies when we have our periods.

[50:26] Greer: 
Wow.

[50:27] Christina: 
So you figured it out, Greer, you didn't even need research to figure it out. You got it. 

Greer: 
But that's so validating. 

Christina: 
Yeah, it should be.

[50:35] Greer: 
Oh, Christina, I have loved this conversation so much, and I am so excited for the work that you are doing for women, and especially the work that you're doing to make it a better world for the next generation of women. So thank you for joining me today.

[50:51] Christina: 
Thank you for opening up all of these conversations. I am privileged, I'm honored to be a part of this.

[51:02] Greer: 
If today's episode resonated with you, I'd love to hear from you. You can email me at femammalpodcast@gmail.com. That's femammalpodcast@gmail.com. You can also follow this podcast on Facebook. Just search for Femammal Podcast and you will find a community of people who are interested in living well in our bodies. And of course, I'd love for you to rate this podcast and leave a review wherever you download your podcasts. Until next time, be well.