Hair Loss & Hair Thinning: A Naturopathic Approach to Finding the Root Cause

Hair loss can be stressful and deeply upsetting. For many people, changes in their hair affect confidence, identity and self-esteem. In clinic, I often see women in their 30s, 40s and 50s who feel frustrated because their hair suddenly feels thinner, flatter, or is shedding more than usual.

Discovering a solution for hair loss or hair thinning is not always straightforward. Hair is influenced by hormones, nutrient status, stress, gut health, thyroid function, immune balance and more. This is why a quick-fix shampoo or supplement rarely addresses the real cause, and may delay you getting the answers and support you need. Sure, give the hair and nails multi a go if you want to, but if you’re not seeing hints of improvement after a month then you need to knuckle down and start looking at getting some answers.

The good news? With the right assessment and a root-cause approach, improvement is absolutely possible.

First: What Type of Hair Loss Are You Experiencing?

Understanding the pattern of hair loss gives us important clues.

General Thinning

Diffuse thinning across the scalp often suggests:

• Iron deficiency
• Thyroid imbalance
• Hormonal shifts (perimenopause, postpartum)
• Chronic stress
• Telogen effluvium

Patches of Hair Loss

Well-defined bald patches may indicate Alopecia areata. This is an autoimmune condition where the immune system targets hair follicles.

Strand Breaking

If hair is snapping rather than shedding from the root, we look at:

• Protein intake
• Nutrient deficiencies (zinc, biotin, silica)
• Thyroid dysfunction
• Chemical or heat damage

Receding Hairline or Thinning at the Crown

Often associated with:

• Androgenic alopecia
  This pattern can affect both men and women and is driven by androgen sensitivity.
• This can be impacted by increased tension on hair such as overly tight hairstyles.

Widening Part Line

Common in women 30-50, especially during:

• Perimenopause
• After stopping the pill
• Postpartum
• Periods of chronic stress

Identifying the pattern helps determine what systems we need to investigate.

The Key Nutrients for Healthy Hair Growth

Hair follicles are metabolically active, and so they need adequate nutrients to grow strong, thick strands.

Important nutrients include:

• Iron (Ferritin) – Low ferritin is one of the most common contributors to hair thinning in women.
• Zinc – Essential for hair follicle repair and immune regulation.
• Protein – Hair is made from keratin, a protein structure.
• Biotin & B Vitamins – Support energy production and follicle function.
• Vitamin D – Plays a role in immune balance and follicle cycling.
• Iodine & Selenium – Support thyroid function, involved in hormone balance and glutathione production.
• Essential Fatty Acids – Help maintain scalp health.

It’s important to test rather than guess, supplementing blindly is not ideal.

Hormones and Hair Loss

Hormones are one of the biggest drivers of hair changes, particularly for women aged 30-50.

For Women

Hormonal hair loss may be linked to:

• Oestrogen fluctuations (perimenopause)
• Low progesterone
• Elevated androgens (testosterone, DHT)
• Thyroid dysfunction
• Coming off hormonal contraception
• Postpartum hormone shifts

Artificial hormones that are androgenic (certain contraceptives or medications) can reduce the size of hair follicles over time.

Women may experience thinning along the part line or crown, a classic presentation of Androgenic alopecia.

For Men

Men commonly experience:

• Receding hairline
• Crown thinning
• Genetic androgen sensitivity

While genetics play a role, gut health, inflammation and nutrient status can significantly influence progression. Supporting testosterone metabolism by reducing the dominance of DHT can also be helped with some herbal medicines such as Saw Palmetto, and nutrients.

Stress, HPA Axis Dysfunction & Hair Loss

Chronic stress has a profound impact on hair growth.

When we are under prolonged stress, the HPA axis (hypothalamic-pituitary-adrenal axis) becomes dysregulated, often referred to as “adrenal fatigue.” This impacts cortisol rhythms, thyroid function, and sex hormone balance.

One common result is Telogen effluvium.

This occurs when stress pushes hair follicles into the resting (telogen) phase prematurely. Hair shedding may begin 2–6 months after a stressful event such as illness, trauma, burnout, or major life change.

If you suspect stress is a factor, I explore this deeply in my Beat Burnout eCourse, where we address nervous system regulation and HPA axis recovery.

Autoimmune Causes of Hair Loss

Hair loss can sometimes be immune-driven.

Alopecia areata

Characterised by round bald patches, this condition reflects immune system dysregulation.

When I see this in clinic, we investigate factors such as:

• Gut permeability or dysbiosis
• Inflammatory triggers
• Food sensitivities
• Stress load
• Thyroid antibodies

Supporting immune tolerance and reducing inflammation can help stabilise progression.

Photo by Tamara Bellis on Unsplash

We Need to Identify the Cause

Hair loss is not a diagnosis, it is a symptom.

Before treatment, we ask:

• Is this hormonal?
• Is there a nutritional deficiency such as low iron?
• Is thyroid function suboptimal?
• Is there autoimmune activity?
• Is stress disrupting the hair cycle?
• Is gut absorption compromised?

This is why personalised assessment is so important. In some cases you may need to be referred to a specialist who can investigate further with a biopsy, however it can be helpful to also start taking a holistic approach with these tests. (Not all of these tests need to be done at once).

What Tests Might Be Helpful?

1. Blood Tests (Starting Point)

I often recommend:

• Iron studies
• Full thyroid panel and thyroid antibodies
• Vitamin D
• B12
• Zinc
• Hormone panel (depending on age and symptoms)
• Autoimmune markers

2. DUTCH Test or ENDOmap

A comprehensive dried urine hormone test can assess:

• Cortisol rhythm
• Oestrogen metabolism
• Progesterone
• Androgen level and metabolism

This is particularly helpful for women in perimenopause or with complex hormonal patterns.

3. HTMA (Hair Tissue Mineral Analysis)

This test can provide insight into:

• Mineral imbalances
• Stress patterns
• Mineral metabolic rate

4. If You’re Not Improving, Look Deeper

The gut influences almost every aspect of health – including hair.

Looking at gut health involves assessing symptoms, history and potentially doing a thorough gut health workout such as with a stool analysis that measures the microbiome, as well as markers of inflammation, intestinal permeability and more.

Poor gut health can impact things like:

• Absorption of nutrients
• Chronic inflammation
• Hormone detoxification (e.g. may contribute to excess DHT, or poor oestrogen clearance)
• Gut-brain interaction

Poor nutrient absorption alone can stall hair regrowth, even if your diet appears adequate.

Types of Hair Loss Explained

For clarity:

• Androgenic alopecia – Gradual thinning due to androgen sensitivity.
• Alopecia areata – Autoimmune-related patchy loss.
• Anagen effluvium – Rapid loss during active growth phase (often due to chemotherapy or radiation).
• Telogen effluvium – Sudden shedding after stress or shock.

Each type requires a different approach.

From a Traditional & Herbal Perspective

In Traditional Chinese Medicine, hair is closely linked to Kidney and Spleen energy. Deficiency patterns may reflect chronic stress depletion.

In Western naturopathic terms, we would often interpret this as HPA axis dysfunction (commonly called adrenal fatigue), where prolonged stress has altered hormone signalling and metabolic resilience.

Supporting nervous system recovery is often a foundational step in treatment.

Apart from addressing the factors I’ve previously mentioned, I will often include the use of herbs that support circulation and hormonal health.

How Long Does It Take to See Improvement?

Hair growth is slow, so patience is essential.

General timelines:

• Reduced shedding: 6-8 weeks
• Baby hairs visible: 3-4 months
• Noticeable thickening: 6-9 months
• Full cycle improvement: ~12 months

Hair follicles cycle slowly. Sustainable improvement comes from addressing the underlying cause, not masking symptoms.

Frequently Asked Questions

What is the most common cause of hair loss in women 30-50?

Hormonal shifts (perimenopause), low iron, thyroid dysfunction, and chronic stress are the most common contributors.

Can stress really cause hair loss?

Yes. Chronic stress can trigger Telogen effluvium by pushing hair into the resting phase prematurely.

Should I take a hair supplement?

If your hair loss is severe I don’t recommend starting without testing. Hair supplements can help, but only if they address your specific deficiency. Many people may notice an improvement from taking the generic hair loss supplements but it can be worthwhile to investigate first.

Can hair grow back after thinning?

In many cases, yes – particularly if follicles are still active. Early intervention improves outcomes.

When to Seek Support

If you’ve noticed:

• Ongoing shedding for more than 3 months
• A widening part line
• Patchy bald areas
• Hair thinning after illness or stress
• Hair changes during perimenopause

It’s time to investigate properly.

We take a root-cause, evidence-informed approach to hair loss and thinning. We combine functional testing, hormone assessment, nutrient optimisation and nervous system support to create personalised treatment plans.

Book a consultation in person or via telehealth if you’d like guidance tailored to your unique presentation. The sooner we investigate, the sooner we can support regrowth.

The post Getting to the root of Hair Loss appeared first on Alison Mitchell Naturopath.

Not long after you blew the candles out for your 40^th birthday cake, you likely started to notice some subtle shifts in how you were feeling. Maybe you started feeling a bit more irritable, anxious, or sluggish. Perhaps your menstrual cycle started to alter. Or maybe your libido took a hit. While menopause occurs around 50 years of age for most women, it’s possible to start experiencing the hormonal shifts of perimenopause –  the period of time that leads up to the time your menstrual cycle stops for good – in their early 40s.

Here are some of the most common questions that people have around perimenopause, and what can be done to help support their hormones naturally.

What are the symptoms of perimenopause?

Perimenopause is a time of hormonal fluctuations, and with this many symptoms can occur. Some of the most common symptoms that women experience sleep disturbances, mood swings, reduced stress tolerance, lowered libido, hot flushes, menstrual irregularity, changes in menstrual flow (may be lighter or heavier than usual, sometimes with significant increases), bloating, brain fog, joint or muscle aches, hayfever, itchy ears, fatigue, vaginal dryness, increased tendency to thrush or BV, and headaches/migraines.

Why do women get perimenopausal symptoms?

Unlike after menopause, when hormones are at a lower state and symptoms can occur because of these low levels, in perimenopause symptoms can be caused by the fluctuations of oestrogen and the gradual decline of progesterone. These hormonal shifts can cause the adrenal response to stress to be affected, which also means that stress can be harder to deal with.

Why do hormones change in your 40s?

Hormonal balance is largely a result of regular, healthy ovulation. The follicular phase, the time between the start of menstruation and ovulation is a time of abundant oestrogen, and then in the luteal phase, oestrogen declines (with a few spikes) while progesterone levels come to the show. It is all dependant on ovulation.

For this to all work in harmony, many factors need to be working seamlessly, such as stress hormones, inflammation, mitochondrial health and nutritional health. The previous cycle will affect subsequent cycles, as low progesterone often triggers higher levels of FSH.

As oocyte (egg) numbers decline and mitochondrial health depletes, the signals of the HPO axis in perimenopause are altered and ovulation doesn’t occur every cycle. This results in a gradual decline in progesterone, and fluctuating levels of oestrogen as the brain tries to adjust to the fluctuation of irregular ovulation.

Photo by Jonathan Borba on Unsplash

What is the difference between menopause and perimenopause?

Perimenopause is the time leading up to the definitive marker of menopause, the time when there has been 12 months since the last menstrual bleed. You are perimenopause in the time leading up to this moment, and post menopausal afterwards. Menopause is the umbrella term that incorporates all of these. It is worth noting that it is still possible to experience a random bleed in the post menopausal period, and if this occurs you should discuss with your health care practitioner as while it can be a renegade menstruation, it can also be a sign of something more concerning.

Should I take supplements to support my hormones?

Not everyone needs to take supplements, and many nutrients can be obtained through your diet. But there are a lot of people who aren’t eating enough of the vitamins and minerals that are essential for healthy hormones and nervous system health, or have genetic polymorphisms which increase their demand for certain nutrients.

These are some of my favourite supplements to support the perimenopausal period:

• Magnesium glycinate – this is important for nervous system health, blood sugar level regularity and is important for hormone creation and detoxification.
• Taurine – I often prescribe this alongside magnesium, as it can help with improving mood and energy (it interacts with GABA receptors, producing a calming effect). It is also important for bile acid formation and mitochondrial health.
• Ubiquinol – The activated form of Coq10 is more effectively used in those who are over 30 years of age. CoQ10 and its activated form ubiquinol are important for mitochondria health, which has many wide-reaching benefits including cardiovascular health, energy, immune function, skin health and other anti-aging properties and more.
• Collagen – As oestrogen lowers, the body’s ability to make and repair collagen reduces, so supplementation can help to offset some of this loss. Collagen can be helpful for improving skin, bone and joint health, and often is useful for digestive health concerns.
• Phyto-oestrogens – In particular, soy which is abundant in isoflavones have a regulating effect on hormones. Isoflavones have been studied abundantly and found to be helpful for managing menopausal symptoms, as well as being protective against several of the long-term risks of menopause such as osteoporosis and cardiovascular disease. It is protective against many forms of hormone-dependant cancers. I advise avoiding the overly refined forms of soy products, and opting for those made with the whole bean such as traditional soy foods, or milks made from the whole bean rather than the isolate.

There are many more nutritional supplements that can be beneficial, as well as herbal medicines that can support you through this period. I discuss these in more detail in my ecourse Natural Menopause Support. Alternatively, get in touch with your health care practitioner to help work out what your individual requirements are, as well as what doses you may need.

How do I know if I’m going through perimenopause?

This is a very common question, and unfortunately it doesn’t have a simple answer. Hormone testing can provide some insight into whether you are getting closer to perimenopause, but it can be difficult to interpret because of the fluctuations that occur in perimenopause.

The best way to know if you are going through perimenopause is taking several factors into consideration such as your age, your maternal family’s menopausal experience, your symptoms – notably your cycle regularity and whether this has changed.

Blood tests may show a gradual increase in FSH (follicle stimulating hormone) and a decline in progesterone. Oestrogen levels can fluctuate in perimenopause, so they may be high or low. After menopause when you have not ovulated for at least 12 months, oestrogen and progesterone will be considerably lower, and FSH will usually be much higher.

How to lose weight in your 40s

It may seem like losing weight as you get older becomes more of a struggle, and that’s because your hormonal shifts cause your metabolic health to change. Insulin resistance is a by product of reduced oestrogen, which makes losing weight, especially around the abdomen more difficult than it was when you were younger. If there are other hormonal imbalances at play such as PCOS, oestrogen excess, thyroid dysfunction or chronic stress/HPA dysfunction this can also contribute towards difficulty losing weight with standard methods.

Assessing your hormonal situation is the first step to identify barriers to weight loss, and then you can make diet and exercises choices that will work best for you.

In the majority of cases the staples of weight loss still need to come into play, such as ensuring you are eating the correct amount of calories, exercising and maintaining muscle mass, and getting adequate sleep.

GLP-1 and GIP medications are becoming more popular, and while they can be very helpful in the weight loss journey they do have side effects and risks that need to be managed. As with any other weight loss approach, they are not a long term solution but can be helpful whilst other factors such as diet and lifestyle habits are improved, and hormonal imbalance is supported.

When should I consider HRT?

This is an individual decision and needs to be done in collaboration with your health care practitioner. Menopausal Hormonal Therapy (MHT), previously known as Hormonal Replacement Therapy (HRT) has had many advances in safety and can be used to help navigate the symptoms with low oestrogen, progesterone and/or DHEA. In perimenopause, progesterone therapy is more commonly used cyclically, with oestrogen being more beneficial only in the times when low oestrogen occurs. As oestrogen fluctuates in perimenopause, it is often not used until after ovulation has ceased.

Some people experience negative effects from taking MHT, but this doesn’t mean that MHT is not for you, but rather that you need to have your individual needs taken into consideration. If you feel worse from MHT, this may be due to poor detoxification of oestrogens or because your hormones are still fluctuating too wildly, as taking additional oestrogen when it is already high can cause issues such as heavy bleeding, headaches or mood changes.

You may be able to find out if you are not detoxing your hormones properly with a test that assesses the ratio of your hormone metabolites, such as the DUTCH test or EndoMap.

Should I see a naturopath for perimenopause?

Perimenopause and menopause are one of the most common reasons that people seek help from a naturopath, and for good reason. There is so much that can be done to support people going through this transition naturally, including supporting symptoms and hormonal fluctuations with herbal medicine, nutritional supplements to reduce symptoms and improve wellbeing, and education and guidance around diet and lifestyle adjustments that can help to both reduce the symptoms of this time and reduce the risks associated with after menopause such as osteoporosis, genito-urinary changes and cardiovascular and metabolic health.

Because this is such a common thing that people seek help with, I have created an ecourse – Natural Menopause Support – which provides an abundance of education about what is going on in menopause and perimenopause, as well as guidance on navigating the remedies that may be helpful.

As you move through your 40s, understanding and supporting your hormones can make a world of difference to how you feel each day. Perimenopause doesn’t have to be a confusing or uncomfortable time — with the right nutrition, lifestyle support, and individualised care, you can navigate this stage feeling strong, informed, and in tune with your body.

If you’d like to dive deeper into natural ways to manage symptoms and restore hormonal balance, you’ll find plenty of guidance in my Natural Menopause Support eCourse, where I share practical tools and naturopathic insights to help you thrive through perimenopause and beyond.

The post How to Support Your Hormones Naturally in Your 40s appeared first on Alison Mitchell Naturopath.

Imagine this scenario – you’ve been getting symptoms such as vulval itching and redness so you treat it with an over-the-counter thrush cream. The symptoms go. Must have been thrush, right?

It happens again later, but this time the treatment doesn’t work. So you try something else – maybe a pessary or an oral antifungal. Still getting symptoms…

Eventually, you get a swab from your GP, but the results don’t show anything definitive.

So you do a bit of research and decide to go on a strict anti-Candida diet and take several strong natural products that wipe everything out.

But now your gut’s feeling off, you’re anxious about everything you’re eating, and somehow you’re no closer to answers.

You go back to your doctor, and this time you’re given an antidepressant.

How did you end up here!?

Now take this story, and swap out thrush for recurrent UTIs, or BV, or interstitial cystitis. It’s a common journey for so many people, and it can be incredibly frustrating when symptoms keep recurring and you’re left without clear answers. Sometimes things do get picked up early and treatment is straightforward – but often I hear variations of this story, where people don’t fully know what’s causing their symptoms, or they’re led to believe it’s just something they have to live with. Others are placed on long-term medications they don’t feel comfortable with or are never told there may be an underlying imbalance.

A different approach –

When looking into vaginal microbiome health it’s important to have a good idea what you’re working with.
Most people are familiar with the classic symptoms of Candida/thrush – itching, redness, discharge. But sometimes it can present in less typical ways – for example, with only skin irritation or splitting, and no discharge at all. And importantly, Candida is just one type of imbalance. There are many microbes that can disrupt vaginal health – including bacteria linked to BV or chronic UTIs, and others that can trigger inflammation or discomfort without a clear “infection.”

So how do you find out what the cause is?

First and foremost we look at signs and symptoms. The colour, texture, sensations and odour of vaginal discharge can be very informative. Then we can narrow down whether the environment is too acid or alkaline, something that has a big impact on determining what sort of microbes can grow.

After examining symptoms, we can look at vaginal pH – an easy thing you can do at home to monitor the fluctuates from day to day. Vaginal pH is a good indicator of whether the condition is bacterial or fungal, and can show changes before symptoms appear.

A typical swab performed by the GP can also provide a lot of insight. Things like the presence of clue cells, leucocytes, what can be cultured, and whether bacteria appears to be there regardless of whether we know what type it is or not. However, Candida and other microbes don’t always show up on the day of testing, especially in cases of RVVC (recurrent vulvovaginal candidiasis), which can wax and wane.

This can often be enough. But if we need to dig deeper a more in depth vaginal microbiome test can be helpful.

There are several versions of vaginal microbiome testing available, currently my preference is through Nutripath which I discuss in the below video.

What is a microbiome?

A community of microorganisms that exist within an area of our body contributing to that spaces function and wellbeing. In female reproductive health we commonly refer to the vaginal microbiome – that microbiome that exists within the vagina and also affects the vulval tissues, as well as the endometrial microbiome (impacting the uterus and surrounding fluids) which may be different depending on cervical competency, and the peritoneal fluid microbiome. In the case of RVVC and chronic BV the vaginal microbiome is the most relevant.

Unlike the gut microbiome, the vaginal microbiome is meant to be relatively low in diversity. In most people, it’s dominated by Lactobacillus species, which help keep the environment slightly acidic and defend against invaders. There are variations in the vaginal microbiome based on hormonal stage (e.g. puberty, pregnancy, menopause) and even across the menstrual cycle. The type of lactobacillus that is dominant may vary based on your genetics, referred to community subtype (CST).

Signs of vaginal microbiome imbalance

• Itching in the vulval or vaginal tissues
• Redness or irritation
• Discomfort or soreness of the vulva or vagina that’s not related to
• Discharge that does not fit the typical ovulation discharge pattern
• Discharge that has a fishy, yeast, acidic, or “rotten/off” smell
• Recurrent UTIs
• Splitting in the creases
• Gushing or watery discharge (a clue depending on the microbe involved)
• Symptoms that flare or change during different phases of your menstrual cycle

Underlying Drivers of Vaginal Microbiome Imbalance

There’s no single cause for microbial imbalance. Often, several systems in the body interact and contribute. Here’s a breakdown:

• Gut health: Our gut is integral in almost all facets of our health and wellbeing. The impact of gut health on vaginal health may be different to what you may think. While older theories linked gut Candida to vaginal thrush, newer research shows this is unlikely due to the gut’s low-oxygen environment. RVVC is not typically caused by reinfection from the gut. Our gut health has an impact because of it’s influence on things like our immune system, hormonal balance, nutritional status and inflammation levels such as histamine tolerance. While gut candida is uncommon, and if present does not typically cause RVVC it is still important that we support gut microbiome in chronic dysbiotic cases.

• Oral health: Poor gum and oral health can drive systemic inflammation, which in turn can affect microbial balance elsewhere in the body.

• Immune health: An immune system that’s either overactive or suppressed can make it harder for the vaginal microbiome to stay balanced. Histamine excess can perpetuate chronic vaginal/vulval symptoms and can cause a heightened reaction when candida is present. There is a relationship between hormonal imbalance and mast cell activation issues that can feed RVVC.

• Hormonal balance: Both high and low oestrogen can create imbalances. In cycling women, this may lead to fluctuating symptoms throughout the month. In menopause, reduced oestrogen means less glycogen in vaginal tissues – a critical food source for Lactobacilli – leading to lower populations of these protective microbes. PCOS can be associated with a unique discharge pattern, and hormonal contraceptives like the OCP can alter both microbiome composition and typical discharge characteristics. Supporting hormonal balance is often a key goal in treating vaginal dysbiosis.

• Stress and nervous system regulation: Chronic stress can shift immune function, disrupt hormonal signalling, and create conditions in which opportunistic microbes thrive.

• Medication use: Antibiotics, antihistamines, and even some hormonal treatments can alter microbial environments by reducing protective species.

• Diet and lifestyle: High sugar and low-fibre diets, synthetic underwear, scented products, improper use of soaps or douching and certain sexual practices can disrupt pH or microbial stability.

The Complexity of Candida and RVVC

Recurrent vulvovaginal candidiasis is notoriously difficult to manage. One major challenge is timing – it may not show up on a swab done at your GP’s office if you’re between flares. But days later, symptoms can spike again.

And while low Lactobacilli is often linked to chronic Candida, this isn’t always the case. Some women have recurring Candida issues despite normal pH and healthy levels of Lactobacilli. In these cases, the key lies in addressing deeper factors – not just treating the yeast, but looking at immune regulation, inflammation, and systemic triggers.

The Broader Impact on Fertility and Reproductive Health

A disrupted vaginal microbiome can affect far more than just comfort. Studies link dysbiosis with higher miscarriage rates, IVF failure, and unexplained infertility. It may also fuel systemic inflammation via LPS production, worsening conditions like endometriosis and adenomyosis.

Both male and female reproductive microbiomes play a role in conception. The quality of the vaginal environment can influence sperm survival and how the sperm and egg interact.

What Can Be Done About It?

Effective treatment requires more than just “killing off” whatever shows up in a test. This is where working with a practitioner can make all the difference.

I’ve completed extensive training in vaginal microbiome care and offer tailored support – including custom pessaries and individualised treatment plans that target your unique underlying drivers.

A treatment strategy will typically involve:

• Supporting and regulating hormone balance

• Calming inflammation

• Addressing metabolic health and blood sugar regulation

• Modifying lifestyle and sexual practices as needed

• Supporting local vaginal tissue repair and resilience

• Enhancing immune function

• Restoring nervous system regulation and reducing chronic stress load

• Optimising diet, nutrient intake, and specific nutritional markers

• Identifying and targeting key pathogens where necessary

• Using timing strategies to prevent symptoms before they begin

• Balancing vaginal pH

• Supplying prebiotic fuels to feed beneficial microbes

• Using specific probiotics

References

Bradfield Strydom, M., Nelson, T.M., Khan, S. et al. The impact of fluconazole use on the fungal and bacterial microbiomes in recurrent Vulvovaginal Candidiasis (RVVC): a pilot study of vaginal and gastrointestinal site interplay. Eur J Clin Microbiol Infect Dis 44, 285–301 (2025). https://doi.org/10.1007/s10096-024-04999-1

Ono, Y., Kobayashi, Y., Shimada, S., Fukushi, Y., Yoshino, O., Wada, S., & Yamada, H. (2024). Uterine Endometrium Microbiome in Women with Repeated Implantation Failure Complicated by Endometriosis. Journal of clinical medicine, 13(16), 4605. https://doi.org/10.3390/jcm13164605

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Understanding and treating missing periods naturally.

Hypothalamic Amenorrhoea (HA) is a condition you may have been hearing about more frequently lately. Despite being a bit of a mouthful to pronounce, this condition is unfortunately more common than many women realise. In simple terms, HA occurs when your brain stops communicating properly with your reproductive system, causing your periods to go completely AWOL! Let’s explore this condition in depth to help you understand what’s happening in your body.

Understanding Primary vs Secondary Amenorrhoea

Before diving deeper, it’s important to understand the difference between primary and secondary amenorrhoea:

Primary amenorrhoea refers to when a young woman hasn’t started menstruating by age 16, despite having undergone other normal pubertal development.

Secondary amenorrhoea, which includes Hypothalamic Amenorrhoea, occurs when menstrual periods that were previously normal and regular stop for three or more consecutive months in a woman who was previously menstruating.

Photo by Rodolfo Sanches Carvalho on Unsplash

What is Hypothalamic Amenorrhoea?

Hypothalamic Amenorrhoea exclusively affects women, as it’s directly related to the female reproductive system. This condition is characterised by the absence of menstrual cycles for three months or longer, and in some serious cases, periods can disappear for years.

HA stems from disruptions in your hypothalamus function – a small but mighty structure located in your brain. The hypothalamus serves as the control centre for numerous vital bodily functions, including:

• Regulating body temperature
• Managing hunger and thirst signals
• Controlling blood pressure
• Governing your sleep-wake cycle
• Influencing sex drive
• Orchestrating hormone production and activity

When the hypothalamus senses that your body is under stress, it responds by reducing the production of gonadotropin-releasing hormone (GnRH), which subsequently affects the release of follicle-stimulating hormone (FSH) and luteinising hormone (LH) – both crucial for ovulation and menstruation.

What Causes Hypothalamic Amenorrhoea?

Several factors can trigger this protective response from your body:

• Nutritional deficiencies or inadequate caloric intake: Your body needs sufficient energy to maintain reproductive function
• Excessive exercise or overtraining: This can occur across many activities and sports, not limited to any particular field. Even regular fitness enthusiasts can experience HA if their exercise regimen is too intense relative to their individual needs and caloric intake
• Chronic or elevated stress levels: Both psychological and physical stress can disrupt hormonal balance
• Low body weight or rapid weight loss: Even if you’re not clinically underweight
• History of oral contraceptive use: Some women experience delayed return of menstruation after stopping the pill
• A combination of these factors: Often multiple stressors compound the effect

It’s important to note that susceptibility to HA varies significantly between individuals. Some women can maintain intensive exercise routines or experience temporary stress without losing their periods, while others are more sensitive to these factors. This is why comparing your diet and exercise regime to others isn’t a good idea – your body has its own unique thresholds and requirements.

Many women experiencing HA don’t fit any stereotype. Even moderate caloric restriction combined with regular exercise and everyday stress can be enough to trigger this condition in susceptible individuals.

Why Does My Body Stop Menstruating?

From an evolutionary perspective, your body has sophisticated mechanisms to protect you during times of perceived threat. When your brain detects signals of potential famine (insufficient calories), physical danger (excessive exercise), or emotional threat (chronic stress), it essentially puts reproduction on the backburner to conserve energy for survival.

Think of it as your body’s wisdom – if resources are scarce or conditions aren’t optimal, it’s not an ideal time to support a pregnancy. Your body prioritises vital functions over reproductive capabilities until conditions improve.

The intricate hormone cascade that regulates your menstrual cycle requires everything to be working in harmony. When disrupted, the delicate balance of oestrogen, progesterone, LH, and FSH becomes compromised, resulting in anovulation (lack of ovulation) and subsequently, no menstruation.

It’s important to note that while HA is a common cause of secondary amenorrhoea (periods stopping after they’ve been established), other conditions such as PCOS, thyroid disorders, and premature ovarian insufficiency can present similarly. This is why proper diagnosis through a healthcare provider is essential.

Signs and Symptoms of Hypothalamic Amenorrhoea

Beyond the obvious absence of menstruation, you might experience:

• Low energy levels and fatigue
• Mood changes, including anxiety or depression
• Disrupted sleep patterns
• Reduced sex drive
• Dry skin and brittle hair
• Cold intolerance (feeling cold frequently)
• Bone density concerns (if prolonged)
• Difficulty concentrating
• Digestive changes

Comprehensive Approach to Managing Hypothalamic Amenorrhoea

Restoring your menstrual cycle requires a holistic approach targeting the root causes. As a naturopath, I find that a balanced strategy incorporating lifestyle modifications, nutrition, targeted herbs, and supplements offers the most effective path to recovery.

Nourishing Nutrition for Hormone Health

• Increase caloric intake: Most women with HA need at least 2,000-2,500 calories daily, sometimes more depending on activity level and body composition
• Prioritise carbohydrates: Adequate carbohydrate intake is absolutely crucial for hypothalamic function and hormone production. Your brain relies heavily on glucose, and including plenty of complex carbohydrates is essential. Include foods like sweet potatoes, pumpkin, whole grains (freekeh, quinoa, buckwheat, rice), sourdough bread, legumes, and starchy vegetables to provide essential energy for hormone production
• Include quality protein: Aim for 1.2-1.8g per kg of body weight from varied sources like eggs, fish, legumes, and quality animal products
• Prioritise healthy fats: Your reproductive hormones are made from cholesterol and require adequate fat intake. Include avocados, olive oil, nuts, seeds, and fatty fish in your diet
• Don’t fear dietary fat: 30-40% of your calories should come from healthy fats to support hormone synthesis
• Support gut health: Consume fermented foods (yoghurt, kefir, sauerkraut) and prebiotic fibres to maintain the gut-hormone connection (Note: fermented foods may not be suitable for those with histamine intolerance)
• Important: Under no circumstances should you attempt a low or no-carb diet when dealing with HA – your body needs carbohydrates to signal reproductive safety

Supportive Lifestyle Practices

• Effective stress management: Practice daily meditation, journalling, or gentle breathwork
• Prioritise sleep quality: Aim for 7-9 hours of uninterrupted sleep in a cool, dark room
• Connect with nature: Forest bathing (shinrin-yoku) has been shown to reduce cortisol levels
• Sunlight exposure: 15-30 minutes of morning sunlight helps regulate circadian rhythms and vitamin D production, both crucial for hormone health
• Mindful breathing: Practice 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8) several times daily to activate your parasympathetic nervous system
• Create boundaries: Learn to say no to excessive commitments that contribute to your stress load

Appropriate Exercise Modifications

During recovery from HA, it’s crucial to scale back high-intensity exercise until regular menstruation returns. Consider these gentler alternatives:

• Restorative yoga: Focus on yin or gentle hatha practices that activate the relaxation response
• Pilates: Build core strength without excessive cardio stress
• Mindful walking: Particularly in natural settings at a conversational pace
• Gentle swimming: Non-weight bearing and relaxing for the nervous system
• Mobility work: Maintain flexibility without taxing your adrenal system

Once your cycles have returned consistently for 3-6 months, you can gradually reintroduce more intensive exercise while carefully monitoring your menstrual health.

Herbs & Supplements for Hormonal Support

Herbal Allies:

• Adaptogenic herbs: Help balance the body’s stress response and support adrenal function
  • Withania (Ashwagandha): Helps reduce cortisol and supports thyroid function
  • Rhodiola rosea: Enhances stress resilience and energy without stimulation
  • Holy Basil (Tulsi): Balances stress hormones and supports metabolic health
• Nervous system supporters:
  • Chamomile: Gentle calming effect without sedation
  • Passionflower: Reduces anxiety and promotes restful sleep
  • Lemon balm: Uplifts mood while calming the nervous system

Targeted Supplements:

• Acetyl-L-carnitine: Supports LH production and egg quality
• Magnesium glycinate: Essential for over 300 enzymatic reactions, including hormonal pathways (300-450mg daily)
• Zinc: Critical for reproductive hormone function and thyroid health (15-30mg daily)
• Vitamin D3: Many women with HA have insufficient levels (2000-5000 IU daily, based on blood levels)
• B-complex vitamins: Support energy production and stress response
• Omega-3 fatty acids: Provide building blocks for hormone production (1-3g daily)

When to Seek Professional Support

Recovery from Hypothalamic Amenorrhoea typically takes 3-12 months, depending on the severity and duration of the condition. While some women see improvements within weeks of implementing these changes, others require more time and personalised support.

If you’re experiencing:

• Absence of periods for more than 3 months
• Symptoms that significantly impact your quality of life
• Concerns about fertility or bone health
• Difficulty implementing lifestyle changes alone

It’s time to seek professional guidance. As a naturopath specialising in women’s hormonal health, I can help identify the specific factors contributing to your HA and create a personalised recovery plan that addresses your unique needs.

Your Path to Hormonal Balance Starts Here

Hypothalamic Amenorrhoea is not just about getting your period back—it’s about restoring your body’s natural rhythms and creating sustainable health practices that support your hormonal wellbeing for life.

If your periods have disappeared or become irregular and you suspect Hypothalamic Amenorrhoea might be the cause, I invite you to book a consultation today. Together, we’ll investigate the root causes of your hormonal imbalance and develop a comprehensive plan to restore your menstrual health naturally.

Your body wants to heal—sometimes it just needs the right support to find its way back to balance.

References

Abou Sherif, S., Newman, R., Haboosh, S., Al-Sharefi, A., Papanikolaou, N., Dimakopoulou, A., Webber, L. J., Abbara, A., Franks, S., Dhillo, W. S., & Jayasena, C. N. (2021). Investigating the potential of clinical and biochemical markers to differentiate between functional hypothalamic amenorrhoea and polycystic ovarian syndrome: A retrospective observational study. Clinical endocrinology, 95(4), 618–627. https://doi.org/10.1111/cen.14571

Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., Murad, M. H., Santoro, N. F., & Warren, M. P. (2017). Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. The Journal of clinical endocrinology and metabolism, 102(5), 1413–1439. https://doi.org/10.1210/jc.2017-00131

Meczekalski, B., Katulski, K., Czyzyk, A., Podfigurna-Stopa, A., & Maciejewska-Jeske, M. (2014). Functional hypothalamic amenorrhea and its influence on women’s health. Journal of endocrinological investigation, 37(11), 1049–1056. https://doi.org/10.1007/s40618-014-0169-3

Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., & Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad–Relative Energy Deficiency in Sport (RED-S). British journal of sports medicine, 48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502

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I am thrilled to welcome Carissa back from maternity leave! After spending precious time with her beautiful baby girl, Poppy, Carissa is returning to practice and will be available for online consultations on Thursdays. In addition, she will be the primary practitioner handling email consults, making it easier than ever to get expert naturopathic support from the comfort of your home.

Get to Know Carissa

What’s your favourite thing about being a naturopath?

My favourite thing about being a naturopath is based on one of the naturopathic principles “the healing power of nature.” It truly amazes me just how interconnected we are with the planet; how herbs and nutrients can support the body in restoring balance. It’s really rewarding working with nature to guide my clients toward better health with the tools we can find in our backyard!

What’s your latest obsession?

Right now, my latest obsession is kids’ nutrition, especially since my little girl has just started solids. I couldn’t resist diving deep into it! I’m loving the book Boob to Food—it’s been a great resource for creating healthy, nutritious meals for my bub (and hub). I find myself reading it weekly and picking up new tips every time.

Current herb obsession and why?

If I had to choose a favorite herb, it would definitely be the beautiful dandelion! It’s such a versatile plant—supporting everything from digestion to detoxification. Plus, it makes such a delicious tea. It’s hands down one of the herbs I use most in my formulas, and I’m always amazed by its benefits.

Favourite meal?

My favourite meal would be grilled salmon with sautéed greens (especially broccolini, kale and Brussels sprouts) with roasted pumpkin or sweet potato—yum! I could eat this every day.

Favourite conditions to work with?

Some of my favourite conditions to work with are skin issues like eczema, psoriasis, and dermatitis. I can really relate to these conditions, as I was that typical eczema kid growing up—constantly battling flare-ups due to a poor diet. It wasn’t until I discovered naturopathy that I started to find real relief, and now I’m passionate about helping others do the same.

What is something that you’ve learnt about pregnancy and motherhood since becoming a Mum?

Wow, where do I start? Since becoming a mum, what I’ve learned more than anything is just how incredibly adaptable the female body is, especially during pregnancy and motherhood. Our hormonal system is so complex, and it’s fascinating how it shifts and changes to support us through every stage—from conception to birth and beyond! What strikes me the most is the way our bodies respond to the demands of motherhood, from breastfeeding to the emotional rollercoaster we experience, and how everything is interconnected. As a naturopath, I’m in awe of how our bodies are designed to nurture and care for our little ones while keeping us balanced, even through all the changes we go through.

Carissa has a special interest in working with children’s health, pregnancy, and all aspects of skin health. Whether you’re looking for support with your little one’s health, navigating pregnancy and postpartum wellness, or addressing skin concerns naturally, Carissa brings her expertise and compassionate approach to every consult. Of course, as a fully trained naturopath, she is well-equipped to work with a wide range of health conditions, offering tailored, holistic solutions to support your well-being.

One unique aspect of working with Carissa is the incorporation of iridology into her consultations. Iridology is the study of the iris (the colored part of the eye) as a reflection of overall health and genetic predispositions. By analyzing patterns, colors, and markings in the iris, Carissa can gain valuable insights into your constitution, organ function, and potential areas of imbalance. For online consults, we make this process simple: before your appointment, we will send you instructions on how to take a clear photo of your iris and email it to Carissa. This allows her to integrate this valuable tool into your consultation, providing a deeper level of understanding and personalized recommendations.

Carissa also utilizes drop dose herbal prescribing, a method that involves using highly concentrated herbal extracts in small doses to create profound therapeutic effects. This gentle yet powerful approach allows for precise, individualized treatment, making it particularly effective for sensitive individuals, children, and those with complex health conditions.

Carissa is excited to reconnect with both new and existing clients and support you on your health journey. Whether through a video consult or an email consultation, she is here to help you feel your best with evidence-based naturopathic care.

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When we think about polycystic ovary syndrome (PCOS), we often focus on the elevated testosterone levels associated with the condition. But did you know that PCOS also involves imbalances in oestrogen? In fact, women with PCOS often experience prolonged exposure to high levels of oestrogen due to an extended follicular phase. This extended phase can contribute to many of the symptoms associated with PCOS.

Let’s take a closer look at how oestrogen plays a significant role in PCOS, how this prolonged follicular phase leads to oestrogen dominance, and why it’s important to consider hormonal balance beyond just testosterone.

PCOS: It’s More Than Just High Testosterone

Yes, elevated testosterone is a hallmark of PCOS, but it’s not the only hormone at play. In women with PCOS, the menstrual cycle is often disrupted. Specifically, the follicular phase, which is the first half of the cycle where oestrogen rises to prepare for ovulation, can become much longer than normal. When ovulation doesn’t occur regularly or at all, the body experiences a prolonged period of high oestrogen without the counteracting effects of progesterone, which rises after ovulation, released from the corpus luteum.

This extended exposure to oestrogen contributes to many of the symptoms experienced by those with PCOS, but aren’t always easy to be explained by the evelated levels of insulin and testosterone. So keep in mind it’s not just about high testosterone—oestrogen plays a big role, too!

Signs of Excess Oestrogen in PCOS

If you have PCOS, you might be familiar with some of the signs of oestrogen dominance, such as:

• Breast tenderness
• Heavy or prolonged periods
• Bloating or water retention
• Mood swings and irritability
• Weight gain, especially around the hips and thighs

These symptoms are the result of an imbalance between oestrogen and progesterone. When oestrogen is allowed to remain elevated for too long without progesterone to balance it out, you may start to notice these classic signs of oestrogen dominance.

The Phases of the Menstrual Cycle

To understand how oestrogen dominance happens in PCOS, let’s briefly review the phases of a normal menstrual cycle:

1. Menstrual Phase – This is when you get your period, and the uterine lining is shed.
2. Follicular Phase – Oestrogen rises as your body prepares for ovulation. For many women with PCOS, this phase can be prolonged.
3. Ovulation – Ideally, a mature egg is released during ovulation. Oestrogen needs to peak in order to trigger a surge of LH, which then triggers the egg to be released from the follicle. For many women with PCOS, ovulation doesn’t occur regularly, leading to what’s called an anovulatory cycle, or an extended follicular phase.
4. Luteal Phase – After ovulation, the remainder of the follicle from which the egg from release – the corpus luteum – releases progesterone. Progesterone levels rise in the luteal phase, which balances the effects of oestrogen. However, if ovulation doesn’t happen, there’s no significant rise in progesterone, leading to relative oestrogen excess.

In PCOS, it’s common to have anovulatory cycles, meaning ovulation doesn’t occur, and the body doesn’t produce the necessary progesterone to balance out the high oestrogen levels. This leaves many women stuck in an extended follicular phase with prolonged exposure to oestrogen.

How Testosterone Can Convert to Oestrogen

Another important factor to consider in PCOS is how testosterone can be converted into oestrogen. This happens through a process called aromatisation, where testosterone is transformed into oestrogen in the body’s tissues, including fat cells. For women with PCOS, who often have elevated levels of testosterone, this can result in more oestrogen being produced, contributing further to the oestrogen dominance that many experience (Xu et al., 2024).

Increased Sensitivity to Oestrogen in PCOS

Interestingly, not only are oestrogen levels higher for longer in many women with PCOS, but there’s also evidence to suggest that their oestrogen receptors are more sensitive. This means that even if the levels of oestrogen aren’t dramatically high, the body may respond more strongly to it, intensifying the symptoms of oestrogen dominance (Xu et al., 2024). This heightened sensitivity further contributes to the hormonal imbalance that can make PCOS so challenging to manage.

The Impact of Endocrine Disrupting Chemicals (EDCs)

As if managing PCOS wasn’t complex enough, exposure to endocrine-disrupting chemicals (EDCs), such as bisphenol A (BPA), can further complicate the hormonal picture. Research has shown that women with PCOS often have elevated levels of BPA in their plasma, urine, or follicular fluid. BPA can mimic oestrogen and bind to oestrogen receptors, increasing their activity. This leads to more pronounced symptoms of oestrogen dominance and is linked to insulin resistance, polycystic ovarian morphology on ultrasound, and even markers of chronic low-grade inflammation (Srnovršnik et al., 2023).

If you have PCOS and are concerned about environmental factors like EDCs, it’s worth considering ways to reduce your exposure to BPA and other hormone disruptors, as these chemicals may worsen the hormonal imbalances associated with the condition.

Read more about endocrine disrupting chemicals and their impact on hormones and fertility here and here

Low SHBG Levels in PCOS and Its Effect on Oestrogen and Testosterone

Another key factor in PCOS is the role of sex hormone-binding globulin (SHBG). SHBG is a protein that binds to hormones like oestrogen and testosterone, controlling how much of these hormones are “free” and active in the body. Women with PCOS tend to have low SHBG levels, meaning they have more free (unbound) oestrogen and testosterone circulating in the bloodstream. This not only contributes to higher androgen symptoms (like acne and male pattern hair loss) but also increases the effects of oestrogen on the body (Emanuel et al., 2022).

Want to Learn More About PCOS?

If you’re dealing with PCOS and want to dive deeper into understanding how these hormonal imbalances affect your health, I’ve written several other blog posts on this topic. Check them out here:

Busting PCOS Myths

A Holistic Guide to PCOS

If you’d like to know more about hormones and how they affect your health and wellbeing, and how you can support your hormonal wellbeing and cyclical health, I would love you to look into my e-course The Cyclical Woman

Final Thoughts

PCOS is a complex condition that involves more than just high testosterone. The extended follicular phase, lack of progesterone due to anovulation, increased aromatisation of testosterone to oestrogen, and heightened oestrogen receptor sensitivity all contribute to the hormonal imbalances experienced by those with PCOS. By understanding how oestrogen plays into the bigger picture, you can take steps to manage your symptoms more effectively and work towards achieving better hormonal balance.

References

Emanuel, R. H. K., Roberts, J., Docherty, P. D., Lunt, H., Campbell, R. E., & Möller, K. (2022). A review of the hormones involved in the endocrine dysfunctions of polycystic ovary syndrome and their interactions. Frontiers in Endocrinology (Lausanne), 13, Article 1017468. https://doi.org/10.3389/fendo.2022.1017468

Srnovršnik, T., Virant-Klun, I., & Pinter, B. (2023). Polycystic ovary syndrome and endocrine disruptors (bisphenols, parabens, and triclosan) – A systematic review. Life (Basel), 13(1), 138. https://doi.org/10.3390/life13010138

Xu, Y., et al. (2024). Roles of estrogen and its receptors in polycystic ovary syndrome. Frontiers in Cell and Developmental Biology, 12, Article 1395331. https://doi.org/10.3389/fcell.2024.1395331

The post PCOS and Oestrogen: The Hidden Hormonal Imbalance You Need to Know About appeared first on Alison Mitchell Naturopath.

New research suggests that dysregulated iron has a role in the formation and progression of endometriosis.

It’s not uncommon for people with endometriosis to have been diagnosed with iron deficiency.

Several years ago, I wouldn’t have blinked an eyelid at the inclusion of an iron supplement in the regime of someone with endo, but given some of the emerging research, I am starting to be concerned.

While the research refers solely to endometriosis, it’s likely that this also relates to adenomysosis.

Here is a TLDR: Endometriosis is the presence of cells from inside the endometrium sitting elsewhere, where they shouldn’t be. This causes inflammation and pain. When the endotriosis cysts bleed in response to the hormones at that time of the month, iron escapes into the area. This iron contributes towards an inflammatory reaction that perpetuates endometriosis. If endometriosis is on the ovaries, where is commonly can be, this can affect the egg maturation and quality. You can have dysregulated iron because of a deficiency of other nutrients that regulate it. It is possible to feel iron deficiency symptoms and to have iron overload in the endometrial cells causing the inflammation.

Photo by ian dooley on Unsplash

Okay phew. If you’re still reading, let’s get a bit more detailed.

In order to understand this, I want to discuss the concept of ferroptosis.

If you remember much from high school biology, the term apoptosis or autophagy may ring some bells – it’s a type of programmed cell death that occurs. Well ferroptosis is similar, but this is a lot more inflammatory, as there can be an accumulation of lipid peroxides, which causes oxidative stress, worsening inflammation. Ferroptosis seems to be associated with a few other inflammatory conditions as well, but because it’s a newish concept, the understanding and research is still growing.

Ferroptosis seems to be worsened by dysregulation of iron in the body. This could look like not having the right co factors for iron to be used properly (copper and retinol)

In people with endometriosis, iron overload in the reproductive tissues, alongside the presence of altered iron homeostasis causes problems. Too much iron in the cells causes increased intracellular oxidative stress via the Fenton reaction, which worsens inflammation. Free iron in endometriosis cysts is significantly higher (100-1000 times) than in other types of benign cysts.

Iron may be high in these cells because of the bleeding of endometrial cysts that occurs in response to hormonal triggers each cycle. But when iron levels are dysregulated because of deficiency of co-factors, this will likely be much worse. Plus, you may also still feel the other symptoms of iron deficiency.

The cells in endometriosis cysts seem to form a resistance to ferroptosis. But unfortunately the granulosa cells (the cells in the ovaries) do not. Ferroptosis in follicular fluid has an association with poorer oocyte quality (egg), which may be part of the reason why fertility is impaired in those with endometriosis.

The research is still growing. It’s possible that modulation of ferroptosis is going to be a new treatment strategy for endometriosis. But for now, we can work on a few things. Reducing inflammation and oxidative stress e.g with ubiquinol and maybe vitamin e. And also making sure we’re not taking iron if deficient without the necessary co-factors.

By the way – head over to the GUIDES section on my instagram page and read through my iron information to help understand more about iron cofactors.

PMID: 37296777

PMID: 19165662

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Guts and Girl Bits Episode #51

In this episode I interview Women’s Health Physiotherapist Brooke Blair (previously Hile) about her health journey. We discuss how naturopathy and women’s health physiotherapy can work alongside each other. We chat about period pain, bladder health, prolapses, rectoceles, constipation and of course, poo.

This episode was recorded in early 2020 when the COVID-19 outbreak had just begun in Australia.

Listen to the audio:

Get in touch with Brooke

https://www.herhealthphysiotherapy.com.au/ 0423471651 Instagram

 

 

Guts and Girl Bits is now on teachable where you can find a collection of e-courses on womens health, children’s health and more.

http://gutsandgirlbits.teachable.com

Subscribe and listen to the other podcasts here:

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Transcript

Alison Mitchell 0:00

Hi everyone, you’re listening to Guts and Girl Bits, I’m Alison Mitchell a practicing naturopath, and I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is general and does not replace consulting with a health care practitioner. Hi everyone welcome to Guts and Girl Bits. Today, I’m joined again with the lovely physiotherapist, Brooke, no longer Brooke Hile… We have a newly married woman- Brooke Blair! Welcome.

Brooke Blair 0:40 Thank you.

Alison Mitchell 0:42 It’s so exciting. You had a little surprise wedding didn’t you?.

Brooke Blair 0:47 It was a bit stressful, having everything happening with Coronavirus around the time of it but it worked out perfectly and it was beautiful, and everyone was surprised, which we didn’t think they would be.

Alison Mitchell 1:00 I was certainly surprised when I found out

Brooke Blair 1:05 Noone was expecting it, which was good.

Alison Mitchell 1:07 Yeah. And so for everyone listening, we’re kind of in that stage at the moment of that level one lockdown but Brooke was able to sneak her wedding her surprise wedding in just before all of these massive isolation started so it was literally like two days before.

Brooke Blair 1:25 Two days before they stopped all weddings unless it was just the five people there so we’ve managed to have 60 I think 55 to 60 of our closest family and friends and it was perfect. It was very good timing. Couldn’t we couldn’t. If we hadn’t had it a day later, it wouldn’t have happened.

Alison Mitchell 1:45 so exciting and today we’re going to be talking about your personal history and how you’ve gotten into your realm of work and how you and I have come to work together as well so yourself as a women’s health physio and myself as a naturopath and talking about some of the areas that these two types of modalities really mesh nicely together. So, if you haven’t had a listen before, Brooke and I have done some really interesting podcasts on how your body changes during pregnancy, and about hypertonicity, which is like when your pelvic floor is really overactive and causes vulval and vaginal pain, and also we talked about mastitis and how physiotherapy can be helpful for that. So have a listen to some of those if you want to as well. And yeah, let’s get started let’s talk about your history.

Brooke Blair 2:45 Yeah, it’s a very long one. So I’ve got lots of notes here about where everything started, but I feel like. So I did get into women’s health physio therapy in my third year of uni and everyone says to me they say why, why women’s health like that’s such a bizarre area of physio to get into. And if you have asked me in my second year of uni, I was definitely going to be a sports physio had never considered the realm of women’s health, that was just something really bizarre and weird to me and pregnant women were terrifying because what if you lay them the wrong way or something like that so that was not in my realm, at all. But then in our third year of uni we started covering women’s health, and we were lucky enough to be taught by the wonderful Taryn Hallam who is amazing in the women’s health physio world and all women’s health world in general. And so that’s what really started my love of women’s health. And then I think it kind of made sense when I then started to look back at my history as to why it sparked my interest. So when I was younger I think I started getting my period when I might have been 13 or 14. And they were horrendously painful, and I would have one or two days of school each time I got my period, or I would just have to sit at the back of the classroom, sometimes I take a heat pack with me, definitely always armed with my Panadol my Nurofen Naprogesic when that was around as well, and I was trying everything and still was in a lot of pain, and even though my mom had gone through the same thing she would just say to me, it’s all right darling like it’ll be okay this is just your period and you’ll get better. And it obviously didn’t. So eventually we ended up going to see a gynecologist, and my options she basically said yeah sounds probably like you’ve got endo. Options are, we do a laparoscopy, which is the operation that you know about where they open you up and they check and see if you’ve got endo there and at that stage I think they were still burning it out rather than removing it. So it was that as an option, or the pill. So, as a 14 year old who was not sexually active, had never heard of any of these things before. My mum was a bit like I don’t really want her on the pill and I don’t really want her having an operation. So eventually we did come to the conclusion to go on the pill that seemed kind of like the lesser of two evils. At that point in time. And it didn’t really do anything other than giving me the ability to be able to stop my periods, a little bit so I’d still get my breakthrough bleeds when I got a period, it still sucked, and I hated it. So I think it would have been so I went on it when I was 14, and then stayed on it until uni, and in that time I was still having lots of issues, not only with my period but with my bowels. So, it would have been in year 10. So 2010 I might have been 15 Maybe 16 And I’ll never forget it. I was constipated for four weeks over Christmas, we were away on holidays and it was the most horrible most uncomfortable four weeks of my life and my mum just kept saying well you know have some bread maybe that’ll be good for you but I felt like I was up to my eyeballs in things inside of me. So I was in lots of pain before and after that I was bloated I was uncomfortable. So there was a lot going on in that side of things as well, so things just weren’t great with my bowels, things weren’t great with my hormones my periods. So eventually we got home from holidays and we went you know what this is just ridiculous I tried gluten free diet I tried dairy free diet. I was still getting abdominal pain, period pain, the whole shebang still constipated and then I’d get diarrhea for a little bit. So that was really fun. So we thought, let’s maybe start to yeah so fun, so we thought let’s start to look into it a little bit more. And the first avenue that we went down was we went back to the naturopath. I mean, the gyneocologist sorry, you came in a bit later. We went back to the gynecologist who said right, let’s do the laparoscopy then and let’s just see. So, I had my laparoscopy just before I started at uni, where they did find they confirm that I had Endo, but also she said I had a very distended bowel at the same time. So she said that might be something worth looking into as well. So she’d removed my Endo, or however much she could remove of it. Put me straight back on the pill so nothing there really changed. And then from there, my periods, pretty much stayed exactly the same, we I skipped them so that I was only having three maybe four periods a year. And my gut and my bowels still were horrendous, so I then went to a gastroenterologist and did a colonoscopy endoscopy, which he came back and said well you’re not intolerant to anything but you’ve got irritable bowel syndrome. And at that point in time I went, Oh cool, like I’ve got a diagnosis it all, it all makes sense. Knowing what I know now I’m like, okay, that just tells me that I’ve got the symptoms, I’ve got it gives me nothing else but all right. Um, so from there I trialed a FODMAP diet, which really stressed me out because I felt like there was not a lot I was able to eat, and if I do eat something that I wasn’t meant to, I got stressed about it, which made me realize a lot of my gut problems were made worse by stress. So it made a lot of sense that in year 10 I was constipated for four weeks because that was around the time I had school certificate. Then, around HSC, I would get bowel issues because it was that time and everything was stressful. I’m starting uni, it was really bad because I was really stressed at uni. So then the FODMAP diet added that extra layer of stress of I know I shouldn’t be eating this but I have nothing else that I feel like I can eat right now, I’m stressed about it and it’s not going to do me any good. So then it kind of all just culminated and became this really vicious cycle that was quite horrible. And so I never really got to the bottom of that except for going, Okay, I know that stress really affects me so I’m going to try and avoid stress, which is not always easy to do, as I’m sure you’re aware, but I managed to sort of go okay if there’s a scenario that I’m putting in, I can try and not stress about it, and then hopefully my gut will be okay, but my gut also gave me a really good indication of when I was stressed so I knew that I needed to do a bit more self care and take care of myself a little bit more. Then to add on top of that I started getting thrush really chronically, which fantastic. So I probably would have been all through uni, I would have thrush, at least once every two to three months, sometimes I would trade it but it wouldn’t really be 100% So I just keep having these thrush flare ups wondering why my vagina just felt so horrible all the time. Around that time I’d also become sexually active so sex was quite painful and uncomfortable. Of course, having thrush and being irritated in the vagina didn’t help anything. So there was those things that were starting to happen at the same time as well, which then come the time that we were in our third year covering Women’s Health physio, and we started to talk about how all of these conditions can really be affecting one another, and that conditions of the uterus, of the vagina can affect the bowel and conditions of the bowel can affect the bladder. Thankfully I never had any bladder conditions. But just knowing that there was that really big Interplay it made me go well hang on I know I’ve got endo technically they didn’t find anything on my colonoscopy, so maybe I don’t actually have a true bowel issue, but maybe there’s something that’s happening that’s got to do with my endo that’s causing things to be a little bit flared up and so then I started really loving women’s health and that’s how I got into it and just the idea of pain with sex which I’d experienced and pregnancy, which I haven’t experienced yet will one day soon, maybe. But yeah, all of those different conditions but I think a lot of women get told, Oh, it’s just a period you’ll be fine or, you know, it’s fine. You’ll be okay just take some Panadol and everything will be okay, or yeah pain with sex is normal, get over it. A lot of those really resonated with me because I’ve been through a lot of them and I didn’t really feel like I had any answers as to why those things were affecting me. So that’s why I so much love women’s health and love being able to work with you because we can kind of cover things from both sides, both the anatomical side and the muscular side, as well as what’s happening at an internal cellular level and hormonal level, and being able to actually start to get to the bottom of things, which is really nice.

Alison Mitchell 12:42 Oh my gosh, it’s, it’s such a connected thing everything’s all so connected, and all of those things working together. Oh my gosh what a journey.

Brooke Blair 12:57 Yeah, so it took some time it’s still ongoing as you know we’re currently working on lots of things at the moment. But I think that having been through all of that has made me very much, empathetic towards the women that come in who are having these conditions who they might have seen a practitioner who said, Oh yeah, that’s just normal, that’s just what happens in women. And they’ve been constantly told it’s normal, it’s okay, everything’s fine. It’s all in your head. And then when they can come in and sit down and I can go. I’ve been there and I know that there’s things we can do to treat it and no it’s not all in your head. It’s really quite a lovely process and quite a nice journey to be able to go through with women.

Alison Mitchell 13:39 I think a lot of the time when people feel heard, they feel acknowledged that they’re not crazy about it, that this is such a big relief for them in many ways. Oh, I’m not making this up so I know a lot of my patients say that and I know that some of yours do too. And like you were saying like sometimes other practitioners might say yeah that’s just part of having periods but sometimes it can be because things evolve and we know that certain things aren’t normal anymore, but our parents practitioners might have told them that their stuff was normal. Until then, our parents have told us here, that’s just normal, that’s what I had. That’s what my sister had that’s what your sisters had all of that sort of thing and so you just come to expect it and so it’s just breaking that cycle and, you know, takes one person to say, Hang on, we can actually do something about that. And that’s what I love about what we do as well as we’re with we’re popping that bubble we’re saying: You don’t have to have people sex and didn’t have painful periods, and you shouldn’t even notice your digestive system, they should just be like, La-La-La Everything feels wonderful. Yeah, absolutely. But it is a journey isn’t it.

Brooke Blair 14:54 absolutely is. I’m trying to think how many it’s probably been 11 or 12 years but I’ve been working through all of this stuff and we’re still going. And that’s being educated and knowing that there’s things that we can do to help. That’s, you know, other women don’t have that education and they haven’t been told that there’s things they can do so it’s gonna take a lot longer for those women.

Alison Mitchell 15:21 I definitely see that with naturopathy because it’s not as conventionally well known, it’s not as accepted, and what sort of avenues you can work on with with diet is not that well known, so I might have like someone that’s never really even realized they can work on them for something until you know they listen to a podcast or they read an article and they’re like, I wish I had known that earlier.

Brooke Blair 15:48 Absolutely. So I hope that this podcast goes out and people listen and go, oh hang on a second, I can go and get help, amazing.

Alison Mitchell 15:57 Yes. And, you know, I know that some of the things that you and I are working on together, it’s, it can be a little bit off putting when you hear that like it’s actually a bit of hard work that you have to do for a little while.

Brooke Blair 16:13 It is.

Alison Mitchell 16:13 *Nodding vigorously. But it’s worth it because it doesn’t last forever. And so, like, a month of hard work. Compared to years of pain and discomfort is so much better.

Brooke Blair 16:28 Yeah, it’s worth it, that’s for sure.

Alison Mitchell 16:32 So, I guess we could talk about how you and I came to me. Well I guess I should we say that because we might have actually spoken about this in some previous podcast but I’ll say it again anyway. I was pregnant with Lara with my second baby, and I had had a caesarean section with my first baby, and it was a bit of one of those situations where you’re not completely sure what happens, like I was very much adamant that I was going to have a natural birth but then all of a sudden, something like, like there was a non reassuring heartbeat, and my obstetrician had said to me previously I’m not sure about the shape of your pelvis, and I was very unsure what she meant by that. So she was basing that on like some internal examinations and I was like, like what does that even mean and so I was adamant. I was going to have a really great natural birth for my second baby. And so, I’m just, I’m very grateful that Ash is healthy and I recovered fine but I also had some really bad abdominal separation following him, and I had heard some great things about about you, about Brooke, about helping with abdominal separation or, because I had only heard that you know you just shouldn’t do sit ups. Okay. Bring it on, never get up out of bed. And so this was two and a half years that was two and a half years was no it was probably two years that I had had this abdominal separation for and it was. I mean, it was fairly severe, wasn’t it like five fingers. At that point is that moderate or severe or moderate,

Brooke Blair 18:32 moderate, I’m trying to think back to the integrity of your abdominal wall as well.

Alison Mitchell 18:37 thats a long way back for you to remember. anyway I thought I put on a bit of weight but now I just had like my abdominal muscles were just so weak, and then I had all this back pain because of that. So all of these sorts of things that started to fall into place like my back pain. The abdominal separation and then I also just wanted to make sure that everything was in tip top shape ready to have a natural birth. And I think it was like, probably our third appointment, where it was a natural person you’re like, oh, I should thinking about doing a community for women’s health, with one of the Chelsea from Mummy Movement. And I was like, Y’all be involved in that I love spreading awareness and then it just blossomed from there.

Brooke Blair 19:31 And I think I said let me tell you all about my horrible periods.

Alison Mitchell 19:34 I think there might have been a couple of people that, because you were like what did what do you treat with naturopathy and I was like, I do lots of children’s health. Lots of women’s health, and you were like “hmm.. hmmm… I might send some of my bed wetting children to you and period pain people and then yeah it just grew didn’t it.

Brooke Blair 20:02 It did, and now we have this very good communication and lots of clients that we share together which is amazing,

Alison Mitchell 20:07 and it just it just gets that next level of results really doesn’t it.

Brooke Blair 20:13 Absolutely, absolutely.

Alison Mitchell 20:15 And I think for me, I’ve always, I’ve always had that awareness, pure hypertonicity so pelvic floor problems can worsen Endo, because it creates this local inflammation that worsens pain, but I also didn’t have anyone that I could refer to, because you women’s physio is a few and far between.

Brooke Blair 20:38 Yeah, it’s a growing field which is amazing. There’s actually a lot more of us than what most people know about and it’s funny going to courses and you meet and you go oh hang on, you work in the mountains, I’m like not that far away from you. And then there’s about six people who work in the mountains and you oh wow okay there’s a lot of you in the mountains im just down here. There’s actually a lot of women’s health physios, it’s just that, a lot of us work in musculoskeletal physio practices so it’s not necessarily a world that people know so much about. Whereas if you are either a sole practitioner like I currently am, who has a business name that sounds like women’s health, or who specifically says Women’s Health physio as the main point of call. That tends to be how people are finding us a little bit easier, but there is actually a lot more now, which is amazing.

Alison Mitchell 21:32 That’s so good.

Brooke Blair 21:33 Yeah, yeah.

Alison Mitchell 21:36 first before you I only knew of one, and then you showed me a few more and then all of a sudden you do start to see it when, when you’re looking around for referrals for people. Oh, it’s a lot more.

Brooke Blair 21:49 Yeah, which is nice because there’s so many women who have so many concerns and just like a naturopath I’m sure everyone does things slightly differently in women’s health physio, everyone does things slightly differently. So, what works for one person might not work for the other and a different type of treatment might be what that person needs that maybe this other person couldn’t give you. So it’s always nice that there’s lots of people out there lots of different opinions and ways of doing things and ways of looking at the body that helps women to be able to get their best results which is nice.

Alison Mitchell 22:24 Yeah, that’s lovely. So I guess we could, you know, move on from that to talk a bit more about how much Naturopathy and physio work well together. So I think the probably the one of the things we could start with our favorite thing to refer for which is period pain.

Brooke Blair 22:41 Yes, personal experience of course we’re going to refer for that.

Alison Mitchell 22:48 So you and I both have a strong history of period pain. And so mine has settled down a lot with a little bit of time and using herbal medicine and possibly even having kids as well that might have something to do with it too but we’ve both got that passion for it and also that level of empathy for our patients that have it too. But there’s a really strong correlation between like having the stuff going on internally, like you said before at a cellular level hormonalIy as well as having the physical, the muscular component to. So, working on one side of those without addressing the other is going to be not as complete as could be. And this is actually applies to everything else that we’ll be talking about. So, you can’t do as good a job without doing both sides of it.

Brooke Blair 23:43 Exactly, you just get that extra bit better so that you get that extra little bit so you can get to 100% Rather than just sitting in being happy at 90%. If you know both working together, then you can get such better results and it’s amazing to see.

Alison Mitchell 23:58 Exactly. So, in terms of how I as a naturopath go about addressing period pain. I’m looking at, like there’s a few different aspects of what causes period pain and so when I’m working, I’m looking at people from a more energetic constitutional level as well when it comes to pescribing herbs which I mean might sound a little bit strange, but I do find that it gets the best results so you’re looking at like a person is hotter or colder. And so if you’ve got a lot of cold. For instance, like, there would be stagnation and dark red blood and clots, and they feel better for applying heat and so we use herbs that are going to be warming and stimulating. And then if they’re very hot person to then there’s usually that bright red blood, and they feel better for having a cold bath or a cold shower or buying an ice pack, and like there’s various other things that you look at in like the tongue, their skin and their hair, or like, assessing where they are at a constitutional level, but using herbs that are specific to that, as well as thinking about what are their hormones doing and what is their immune system doing because with things like endo with endometriosis, it’s very immune driven condition, so you need to think about what’s causing your immune system to go shonky in the first place, like is it a bit of a bug that’s hiding around, or is it something that you’re eating that your body is reacting to, and then it’s also things like is there a nutritional deficiency, that’s causing your body to be more immune driven, or is it an deficiency that’s causing you to become tighter and more crampy. So those are some of the areas that I look at with period pain.

Brooke Blair 25:48 Okay, I sort of way that as women tell physios we, that’s why I love working with you because you can work with things that are causing some of the pain. And then I can treat some of the byproducts of that pain, so a lot of women, particularly with endo sometimes with polycystic ovaries or just women who do have incredibly painful periods. I’m more so looking at the musculoskeletal system and the neural system to work out what’s happening more so at a pelvic floor level, but more recently we’ve sort of been looking all the way up basically to your neck and all the way down to your toes to work out if there’s something that may have set off some of the pain. So, for girls who have endo/ polycystic ovaries, some of them will be coming in not just because they get pain with their periods, but because they’re now starting to experience sexual pain, or they’re getting difficulty using tampons or different things like that that they starting to notice that isn’t normal. They shouldn’t be having where previously they were able to use tampons just fine. Or they’ve had sex pain free, but something has triggered this pain to start up. And so we’re starting to look at why is that happening, is it because they’ve had these pain because of that inflammation that you were talking about, for such a long time that the body has just started to go into a protective cramping type state trying to protect all of the organs and protect everything vaginally and saying no I don’t want anything inserted here because it could cause me pain. In some women, I see they could have had an injury so they may have had completely fine periods, they may have always had endo but not had any symptoms of Endo, but their periods were fine, and then all of a sudden they’ve had an incident where they’ve fallen and they’ve hit their tailbone, or their hip or they’ve whacked their knee, and all of a sudden they’ve started to get painful periods crampy sensations the pain with sex. Sometimes even leakage, and those sorts of things are very different for them and so yes we know there’s probably going to be findings in a pelvic floor level but also elsewhere throughout their body we might need to see what’s happened at their knee, we might need to see why their tailbone is sore and work out that perspective rather than just going straight to treat vaginally.

Alison Mitchell 28:08 Exactly because the body is a unit. And one thing is going to be like causing another area to shift and your body will always try and compensate, and just keep compensating compensating until it’s current anymore and then it’s like, ouch!

Brooke Blair 28:23 what’s happening here. Yeah, so it’s nice to be able to see and unravel all of those sides of things I had a lady in the other day, and I think she was in her 50s and she was having period troubles, and no one had ever brought up the idea that potentially there could be something hormonally or systemically like Endo, or something like that, but she has had painful periods and vaginal pain for the last 40 odd years. And so I sat down and I took her history with her for an hour, and we took it all the way back to as a child, she’d had eczema vaginally, and she had, I think she had constipation and gut issues as a child, and then all of a sudden she got her periods and they were really painful and then she woke up one day with vulvodynia and that’s never gone away. And even just sitting with her and going back through her whole history and her going wow no one’s ever sat with me and gone all the way back to my childhood to work out that actually, these things have been happening since I was very young, before I got my periods. So she’s another person, I’m going to get to come and see you to work out what’s happening at a gut level because she was close. Yep. Yep, exactly. Yeah, it’s lovely to be able to work on those sides of things and work out where the pain is coming from rather than going yeah cool you’ve got Period Pain what next. Yeah.

Alison Mitchell 29:49 Oh my goodness, I can’t believe that it was going on for that long, but this is this is often what happens in this realm of vaginal pain period pain but also digestive pain is because you don’t, you don’t get people asking you about these things and, often, if it’s something vulnerable, you to be too nervous to bring it up. So like what situation and will you be and so going to the doctor directly about that where that will get asked. Apart from an appointment, like a women’s physio or a naturopathic appointment or potentially even the gyno but often they’re very focused on a specific issue in conventional appointments, and so it doesn’t get brought up unless you specifically do so it is important to talk about these things. And I know that I mean, I probably ask the weirdest questions when I do my naturopathic screening I’m like, do you like talk about poo a lot people say I’ve never had a conversation about my poo as in depth.

Brooke Blair 30:49 Likewise, love a poo chat.

Alison Mitchell 30:53 And, Yeah. And do you give any vulval pain, any vaginal pain if you get pain during intercourse like all of those sorts of things that people like, what, why are you asking me that

Brooke Blair 31:04 some women say, yeah, no one’s asked me that before and, but actually yes I do have these issues and it’s until you raise that conversation, they’re not going to be forthright with it and say, Actually my vagina hurts all the time. That’s just not something that a lot of people feel comfortable saying yes, and there is such a stigma around it. We just love popping. So, I think that’s just such an important area that people need to know that you don’t have to put up with

Alison Mitchell 31:36 sex should not hurt

Brooke Blair 31:38 No exactly and if somebody tells you it’s all in your head it’s not and you need to see somebody else.

Alison Mitchell 31:44 Yeah, exactly what some other areas that we love to trade together so I love working with urinary conditions. So, chronic UTI’s, and a bladder pain as well so when people are constantly getting symptoms that are not not related to an actual infection which is one of those things. It’s just like so much mind boggling for so many people but they just came back negative and why am I still getting the pain, what’s actually causing that.

Brooke Blair 32:21 Yeah so that’s definitely something that we work together on which is lovely. I see that quite a lot, a lot of women come in and they say, because if oftentimes if they’re getting symptoms like that like UTI is a lot of them are leaking as well. So they might come into the session because their GP referred them for incontinence, but then when you sit down and chat to them will actually I’ve got pain when I pass urine and I go to the toilet and I empty my bladder but even though I know I’m empty it still feels like I need to go or I never get the sensation that I’m completely empty, or things like that pain with bladder feeling all of those symptoms that you shouldn’t be aware of that. A lot of women do actually notice can be coming from something anatomically, so I treat a lot of women who they sometimes have overactive pelvic floors like we just spoke about. And it’s because of that over activity that all the nerves in that area are quite overstimulated causing bladder pain sensations. Also not allowing the bladder to fill completely or empty completely. So I go through about 20 Questions about when you sit on the toilet does your flow start straight away does it stop start does it go off in a funny direction do you feel empty, all of those sorts of questions because if that’s what your body has always been doing, you don’t know if that’s wrong or right, you don’t know if there’s an issue there.

Alison Mitchell 33:44 You’d just think it’s a funny Quirk.

Brooke Blair 33:46 Yeah, exactly, exactly. And so I’ve had women who say Oh yeah no every time I sit down I have to wait 10 seconds before my urine starts to come out and I have to really think about it, that’s not what should be happening. And so, if then they have issues with what’s happening around their urethra where the urine comes out and around their pelvic floor they might not be able to completely bladder empty, which will put them at risk of having UTI over and over again because they’re not allowing that urine to exit their body. But also, if they are constantly having an irritated bladder, whether that’s from infection or not, and they’re leaking, then they’re definitely going to be getting more at risk of having irritation infection, things like that so it’s definitely something to try and work out, why is that happening.

Alison Mitchell 34:34 And the way that I would be working with these people is using mostly herbs that work on improving the mucous membrane health of the vagina and the urethra and all of that so nutrients that work on that sorry and then herbes that work on reducing spasm of the fine, finer muscles in there and then soothing bladder herbs so we’ve got one of my favorite of all time is Crataeva because it’s just this nice most beautiful bladder tonic, but it’s so soothing. And so that’s like my staple with chronic bladder conditions of all forms, really loving Kava relaxing the muscles down there too. And that’s also really useful in treating UTI as too. And then probably leads us on to the next topic which is prolapse.

Brooke Blair 35:23 Yes, I love prolapse, I don’t love it when it happens to women, but I love trading. So I think there’s a big misconception about prolapse, in that it only happens to older women. And it means that everything is falling out of you and it’s the worst thing in the world and all you can do for a surgery. So when I have women coming in who’ve been told that they have a prolapse or who think that they have a prolapse, it’s all doom and gloom and it’s the worst thing that could possibly happen to them, and prolapse isn’t something like that, most women. I think the stat is that 75% of women will experience some level of prolapse across their lifetime. And what we’re coming to realize is that prolapse, to some extent might actually just be normal because we are upright mammals, and our pelvis and our pelvic organs are at the very base of us, and they don’t have bony support underneath them, they only have muscular support. So over time there is going to be some degree of movement that happens purely because of gravity and because of how we move around. All other animals are basically on all fours, so they’ve got the whole abdominal wall but all of their organs or the pelvis that their organs are supported by, But we don’t have that support structure. So, most women that I assess there will be some degree of prolapse that I go okay, I’m not really going to call this prolapse because it’s just the natural movement that’s happening in your body, and everyone will have some normal amount of movement, some women move not at all and some women are quite mobile in their tissues, and they are going to be the women that are more at risk of prolapse, whether it means that things have dropped internally one centimeter three centimeter five centimeters. It’s one of those things that it’s quite scary for women, to hear the term prolapse and to get the symptoms of prolapse, which are things like heaviness or vaginal discomfort or feeling like you’ve got a dislodged tampon internally but you don’t have a tampon in. I also have lots of women who start to experience sexual pain if they have a uterine prolapses. So that’s one of the really lovely things to be able to treat, is being able to work on either pelvic floor strengthening or using pessaries which are pelvic floor support devices to help support the organs, and to get rid of those symptoms and change how women are functioning so that they can feel symptom free and comfortable.

Alison Mitchell 37:49 Definitely I feel like there’s, there’s various levels of it and sometimes people are not sure whether what they’re feeling is normal or not. It’s good to also just get it assessed to like to give you that peace of mind for someone like yourself to say, actually, where you’re at right now is fairly normal for your stage of life or for everything else that’s going on. Yeah. And then, how can we work on it naturopathically Well I actually really liked working alongside acupuncture too but I look at this from structural integrity of this muscle cells themselves. So things like nutrients that help with connective tissue strength collagen strength, and then using herbes they’re have lifting actions, and reducing inflammation and then also some hormonal support too so, working on a that oestrogen level in a very gentle way. And then using herbs that help with improving digestive function because we want to be reducing any sort of pressure from their digestive system that might also be affecting it too. Which I guess is another segue into digestive digestive stuff so one of the main things that I would probably be sending people to you for in regards to digestive stuff is constipation so when I feel like there is just a poor nerve signal going on or people are deciding, they’re just not getting that urge to go to the toilet because they’ve been constipated for such a long time. So do you want to talk a bit about that.

Brooke Blair 39:27 Yeah, I love treating poo conditions, could talk about poo all day long. So when women come into me for any sort of bowel conditions more often than not it is constipation related, but oftentimes I also do treat fecal incontinence which no one really loves to talk about but it’s actually really, really common and can be caused by constipation. So, in terms of treating something like fecal incontinence, which I’ll talk about first and then talk about constipation because that’s quite commonly related. So people experiencing fecal incontinence, I think the studies, wanting for one in four men and one in five women will experience fecal incontinence in their lifetime. Oftentimes, it can be post childbirth. After third or fourth degree tears, or after nerve injuries. It can come on with things like back conditions and back pain as well. And so a lot of it comes from the muscles at the back passage not functioning optimally, meaning that people aren’t able to hold on to this tool for as long as possible and can become fecal incontinence. A lot of the time, the women that I say for this, it’s because their bowel motion isn’t where it should be. So whether it’s too soft, so it’s like your type five six or seven on a Bristol stool chart, it’s just far too soft and the body’s not made to hold on to a bowel motion like that. So working with you and giving women techniques of how to bulk up their bowel motion can be quite helpful. Then from the constipation side of things. If they come in with fecal incontinence, we need to make sure there’s no constipation there, otherwise we need to treat that first and not worried about the fecal incontinence, because what people don’t realize is, in your rectum, if you’ve got a really big firm hard bowel motion sitting there, your body’s not going to be able to push that out without extra assistance. And so what the body does is it sends this mucus layer to try and help to lubricate the rectal walls to help pass about motion. And if your body doesn’t feel like it can pass it, you just won’t feel that there’s all this mucus there and it will leak out of the rectum, like it’s a fecal incontinence, where it’s really just your body tried to help you to pass this bowel motion. So we need to try and work out. Is it true fecal incontinence or is it that there’s an underlying constipation there. Then in terms of constipation a couple of the things that I see quite commonly is women feeling like I know that I have the sensation that I need to go to the bathroom, but I just don’t feel like I can empty myself, or I feel like something gets stuck. And so from that regard, if we talk about what their bowel motion type is like, sometimes it’s a perfect bowel motion and we’re going okay we don’t need to change your bowel motion type at all, we need to change either the sensation of you going to the toilet, or what’s happening. Anatomically, so really frequently I see rectal prolapses so we call them Rectoceles, not where the bowel is dropping out at the back passage but where the bowel creates a pocket more towards the vagina, and it allows bowel motion to get caught in there, so that women pass a bowel motion but then they just feel like something’s getting stuck, and they can’t quite get it out, and they’re always gassy and uncomfortable, and they might need to go to the bathroom six or seven times in a day but they still just never feel empty. So that’s something that I really love treating because doing a good poo is actually life changing. And if you sit down on the toilet, you do a great poo and you feel empty it’s a wonderful sensation. So that can definitely be something that I work with, but then also making sure that women know what the sensation of bowel emptying should feel like. And when they should emptying, empty their bowels. So working a little bit more with their nervous system to change that up. But yeah, sometimes it’s anatomical work sometimes women don’t actually relax their pelvic floor to empty their bowels they tighten it, instead, which makes it far more difficult to empty their bowels and it’s not that there’s an issue with the bowel motion, it’s just that they’re not relaxing and we can change that also.

Alison Mitchell And I think that with the rectocele, the way that I treat that is very similar to the prolapse stuff, but also yeah like getting all, there’s so many things that can be going wrong with digestive health, and natural remedies, it’s one of my main things that I treat your digestive health, for women’s health and digestive health, so it’s very very satisfying things to treat.

Brooke Blair 44:20 Yeah absolutely people, I have women who all of a sudden they can relax their, their pelvic floor muscles and all of a sudden they do this amazing pool and I say when that happens, I want you to message me because it’s going to be the best day of your life, and they go oh my gosh I didn’t realize that I could do like that and feel this good and it’s, it’s wonderful when you get a lot of neurotransmitter release when you’re actually doing a nice big poo.

Alison Mitchell 44:40 So if you haven’t been able to do for a long time, then you’re not going to get those neurotransmitters, but then it works the other way is if you’ve got constant, diarrhea, you kind of be running low on those. So having that perfect balance makes you happy lately.

Brooke Blair 45:05 Good poos are good.

Alison Mitchell 45:10 Did you want to talk about anything else.

Brooke Blair No, I think we’ve covered off a lot of it.

Alison Mitchell 1:54 My kids are going insane so I should probably wrap up now. like there’s, so many ways that we can work well together. I just so happy to be able to share this information to people and whether they do decide to see both of us or even do some of it, I just want people to know what is available to them. So I’m just so grateful that you and other women’s physios are around and thank you so much for sharing all of your amazing information today already

Brooke Blair 45:54 thank you and thank you for helping me to work on my body. At some point we’ll have to talk about everything that’s amazing that’s happening in my body at the moment which will be wonderful. Alison Mitchell So we’ve got a little bit of a teaser there and then we can follow that up later once we’ve we’ve got you towards the end of your health journey too. perfect. Alright, well thank you everyone so much for listening. Bye! Brooke Blair Bye

Alison Mitchell 46:40 Thank you so much for listening. I hope you’ve enjoyed today’s episode. Please join me over at the Guts and Girl Bit’s Instagram page and share any other words of wisdom that you would like to contribute as well. Guts and Girl bits now has a collection of eight courses that you can view online. The primary course available at the moment is Natural menopause support, which provides information on supporting yourself through the latest symptoms of menopause and easing through this transitional life. You can find the collection of E courses at gutsandgirlbits.teachable.com And they will also find a course of understanding underactive thyroid and coming up soon will be a courses called cyclical woman. Navigating the teenage years, children’s health, nourishing the mother, and more. If you’ve enjoyed today, please leave a review and share this episode to help spread the word. Thank you.  

The post Brooke’s journey with endometriosis plus how women’s physiotherapy works with naturopathy appeared first on Alison Mitchell Naturopath.

Hi Ladies, the e-course is here!

Laura and I have been busy creating content over the last couple of years, and now the course is finally ready! A few years ago Laura and I were recording a podcast episode about menopause, and we discovered that we both have a shared passion for helping women in this time of our lives and we worked out that this is one of the most common things we treat. It didn’t take long for us to realise that we wanted to find a way to reach more women, to remove the stigma surrounding Menopause and to give women confidence to transition this period of life. And so the idea for Natural Menopause Support was born.

We started with two podcast episodes, and then we created an Instagram page, and then a Facebook group, and now it has culminated in a beautiful e-course.

We have condensed our experience of working with women going through their menopause years into a series of digestible videos and worksheets that you can use to take control of menopause.

Here’s some of the things my patients have said about their improvements of menopausal symptoms just this month:

“I can’t remember the last time I had a hot flush”…

“My husband is grateful… and I feel like we have regained our relationship”…

“I don’t feel like a crazy person anymore!”

Supporting women’s health is something that Laura and I are very passionate about and making menopause a better experience for women is our mission.

You shouldn’t be made to feel like you are doomed to suffer in menopause, or to feel like you have no control over your symptoms.
There is an uprising of women taking control over their health and not being disempowered by gender bias in medicine. This is what we embrace, and want to share with women.

What does the e-course involve?

At the core of the course is a series of videos that break down the common symptoms that women experiencing during menopause. You will understand what is happening, and learn what you can do about it – naturally. We want the information to be things you can do wherever you are in the world, so we’ve put a focus on lifestyle support, diet tips (don’t worry, it’s not sapping all the fun) and teaching you how to use herbs to support yourself. If you have an interest in herbal medicine you’ll enjoy this, as we have lots of bonus content on how to incorporate herbal medicine into your life.

Who is this e-course for?

• Women who are 35 years and above
• If you have concerns about your transition through menopause (such as if you’ve seen family members struggle and want to make your journey smoother)
• If you are interested in improving your bone health, heart health and brain health
• If you are interested in learning about herbal medicine, specifically with a focus on women’s health and emotional health
• If you are stressed, frazzled and tired
• If you are already in your menopause journey and struggling with symptoms
• If you want to empower yourself to know more about the changes happening in your body and make your own choices
• If you are in need of some diet support and inspiration

Early bird discount ends 20/11/20 – use code nmsearlybird

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