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.

PCOS, also known as Polycystic Ovarian Syndrome is a complex condition that can significantly affect a woman’s quality of life. One of the biggest ways it does this is by impacting on a women’s ability to conceive and maintain a pregnancy, but it can also impact a woman’s self-esteem by making it difficult to lose weight, it causes acne and hair issues, such as too much hair where a woman doesn’t want it to be, and potentially thinning of scalp hair.

Of course, there is more to it than that, but those are the major things that women report as the issues they’re most upset by.

In this article and podcast I will discuss the lack of awareness and poor understanding surrounding PCOS, how it is often misunderstood and why its name has a role in this. I discuss the common, and not so common signs and symptoms of PCOS and talk about the driving factors that can cause PCOS to develop. I talk about how PCOS is often diagnosed and discuss some of the key ways PCOS can be addressed naturally.

You can listen to this article on the podcast links below, or in the embedded player.

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Understanding PCOS

Lack of awareness

Sadly, but not unexpectedly there is a lack of awareness and understanding of PCOS, with many people who have not been diagnosed not aware of the condition at all, but also women who have been diagnosed, and some health practitioners as well, not properly understanding the condition. A big part of this lack of awareness is the lack of research into the condition, but also I believe it is part of the bigger picture of gender bias in medicine, and many conditions that are specific to women do not have the attention they deserve, perhaps the exception being breast cancer. One of the other things that doesn’t help this lack of awareness and understanding is the name of the condition itself – polycystic ovarian syndrome.

The name makes a few false implications which cause overall confusion – so here are a few points I want you to know:

1. The condition doesn’t originate in ovaries and the condition is not all about ovaries either, after menopause, the condition can persist. It is more of a metabolic condition, with systemic high androgens and insulin resistance being the core drivers.
2. A PCOS ovary doesn’t actually have ‘cysts’, rather what you can see on ultrasound is immature follicles. Follicles are the little sacks that your oocyte, or eggs sit in waiting for the hormones from the brain to tell it to mature and then ovulate. The issue is these follicles in PCOS is they aren’t developing properly, so if we got them to develop fully these so-called cysts would be a baby (if met with a sperm).

A new name?

Many physicians and researchers have proposed a name change for PCOS, however, that was being proposed in 2013 and it’s 2020, so who knows when that will happen. I agree the condition does need a name change, as I feel PCOS is not a good representation. One of the names suggested which I like is ‘metabolic reproductive syndrome’, however other names suggested were Poly-follicular ovarian syndrome with metabolic dysfunction and/or hyperandrogenic manifestations (PFOS-MD and/or -HM).

The list of potential signs and symptoms is long for PCOS, which explains why there are so many women out there that don’t know why they have the symptoms they do.

PCOS Symptoms

Most common symptoms of PCOS include:

• Irregular periods or absent periods
• Acne
• Weight gain
• Excessive hair growth, also known as hirsutism. This can vary in locations and intensity and it will also be different dependant on your nationality.

Less well known, but still common symptoms:

• Anxiety and/or depression
• Fatigue
• Brain fog
• Skin tags
• dark patches on the skin
• low libido
• Sleep disturbances and snoring (Sleep apnoea can also be more common due to the higher level of androgens. Poor sleep can worsen PCOS by worsening insulin resistance.)

And more than that, there are other complications, especially regarding fertility and baby’s health. The higher levels of androgens can increase the risk of miscarriage and are also linked with some increased risk for baby such as higher birth weight. Women with PCOS also tend to have difficulty with breastfeeding and a higher risk of diabetes after birth.

Thankfully, many of these risks are modifiable by correcting the underlying causes of PCOS, which I will discuss later.

Causes of PCOS – How does the switch get turned on

There are different ways PCOS can express, and for these different subtypes, there are different causes.

The main cause is insulin resistance, which causes the male hormones androgens to become high. Insulin, when it is too high, can trigger more production of testosterone, but it can also lower the amount of SHBG (sex hormone-binding globulin) which means our bodies can’t bind up the excessive testosterone as well, and so more is circulating our body, causing the symptoms of PCOS such as acne and hair issues. Insulin excess also affects our FSH : LH ratio which is important for ovulation, and high testosterone stops our follicles from maturing completely, so this means woman’s ability to ovulate is affected, and if that is affected their chances of conceiving is reduced, and oestrogen and progesterone balance is also affected.

There are different types of androgens, such as testosterone, DHEA and androstenedione, and depending on which one is elevated we can get an idea of what is driving your PCOS. For instance, if DHEA is high, we know that stress is a big driver.

It is also possible to have PCOS without insulin resistance and this is typically due to inflammation. this is a much rarer subtype, but certainly something to consider.

Something else to consider is your gut health can play a role in both hormone balance and metabolism. Your gut bacteria are responsible for so many things in the body, and if you’ve listened to my previous podcasts or read some of my other blog posts you’ll know that your microbiome is of vital importance in improving health. How does it affect PCOS? Well, if your microbiome is out of balance it can affect your metabolism, which can worsen insulin resistance. And an out of balance microbiome can also cause hormone problems, by allowing more of your ‘bad’ hormone metabolites to cycle back through the body.

Why do you have a PCOS ‘switch’ in the first place?

We know there is a genetic component to it, and there is some possibility that your genetic likelihood can be influenced by exposure to endocrine-disrupting chemicals in past generations, substances that are passed through generations. So effectively, what chemicals and diet your Grandmother was exposed to will impact your risk for PCOS.

This transgenerational effect has been demonstrated in animal studies when mice were fed an obesogenic diet and were given substances that mimic a high androgen state to bring about a metabolic state of PCOS, and it was found that their subsequent generations also expressed this condition.

It was also found that women with PCOS had levels of chemicals in their system that were not in use anymore and was found to have been passed through in utero from their mothers and grandmothers.

These chemicals are increasing the activity of the androgens and also acting as obesogens, contributing to the weight gain and insulin resistance.

Diagnosis issues

So how common is PCOS? The prevalence is about 8-13%, effectively 1 in 10 women. But it is a condition that is it is both over-diagnosed in young girls, and under-diagnosed in older women.

One of the issues in getting diagnosed is that there isn’t one specific diagnostic criteria, so you can get mixed messages.

Three main diagnostic criteria exist- the National Institutes of Health, the Rotterdam criteria and the Androgen Excess Society criteria.

All of the criteria require all other possible endocrine disorders to be excluded.

My criteria of choice is the Rotterdam diagnostic criteria. It requires a female to have two of these three criteria:

1. Irregular periods
2. Clinical and/or biochemical hyperandrogenism
3. “Polycystic ovaries”

Many young girls are being prematurely diagnosed with PCOS. But it is normal for young girls to present with some symptoms of PCOS and this often resolves in a few years without intervention. It can take 3-6 years for a menstrual cycle to regulate itself, however if there is early intervention this can prolong this process, and it is thought that the most common recommendation given at this time – the oral contraceptive pill (OCP) can worsen insulin resistance, which perpetuates the condition.

What are the other causes that need to be excluded?

This could be conditions such as Cushing’s, Adrenal tumours or congenital adrenal hyperplasia. Screening would include blood tests for TSH, prolactin, FSH and anything else your practitioner feels warranted based on your signs and symptoms.

PCOS and Teens

Getting back to teenage girls and their periods, it’s not uncommon for girls to have irregular periods when they’re young, and this will usually regulate itself within 6 years. My personal preference in clinic is to not interfere with hormones in young girls but to allow their bodies to regulate themselves. If hormones are interfered with too early, then it will typically delay the regulation until later. This is relevant to not just herbs, but especially to things such as hormonal contraceptives.

A common understanding is that women with PCOS literally have cysts on their ovaries. But this isn’t the case, as the name implies. the polycystic ovarian appearance that some (but important to note, not all) women have on ultrasound is actually a higher count of immature eggs within their follicles. These eggs aren’t getting the signal from the brain to mature further, triggering ovulation and release.

If you can remember the diagnostic criteria, the presence of 2 of the 3 criteria is what it takes to get diagnosed, so if a woman has irregular periods and signs of high androgens, she can have PCOS without the presences of any ‘cysts’ on her ovaries at all.

A more positive perspective.

One of the perspectives I have heard before about PCOS which I love is that this is an evolutionary trait which in years gone by was protective. if you consider that being pregnant and giving birth was a life-threatening thing at worst, and a depleting event at best, it can make sense why a condition like PCOS which can reduce one’s fertility may be protective in tough times. Insulin resistance is beneficial in times of scarcity as it allows you to store more of the energy from foods, which in famine times if beneficial. In times of plenty such as now, this, unfortunately, works against us. In a time without contraception, women may have gone from one baby to the next without a break, which can be quite a high level of stress and depletion. So, for women with PCOS who have longer times between ovulation, and so fewer opportunities to conceive, this could be considered a positive thing. Nowadays this might not be much comfort especially if you’re wanting to conceive, but I believe anytime you can view your health from more a positive light it is beneficial, so ladies with PCOS you might like to shift your frame of thinking to more of an ‘I’m a survivor’ mindset.  

Other considerations for PCOS

Sleep

Sleep disturbances are reported to be twice as likely for women with PCOS. Studies show found that women with PCOS are more likely to report difficulty falling asleep, to have restless sleep occasionally and often feel severely tired. Sleep problems also occurred in women with PCOS who were in the normal weight range.

It’s still unclear how PCOS affects sleep but we know that the metabolic impacts of the condition play a big role. The hormones melatonin and cortisol are responsible for our sleep cycles to a large degree and these are strongly influenced by insulin resistance and elevated testosterone, as well as the stress placed on the body if obese.

Sleep apnoea is also often reported in women with PCOS, more often in those who are overweight. In those people who are considered to be ‘severely obese’, (BMI >40kg/m2) the prevalence of sleep apnoea in both men and women can be as high as 92%.

The mental health impacts of PCOS which is an increase of anxiety and depression have a bidirectional association with poor sleep quality and insomnia.

Weight loss and exercise is one of the best ways to improve sleep quality in women with PCOS, and if needed there are herbal medicines which can be of support.

Nutrients such as magnesium and calcium and the amino acid l-theanine can also be supportive to calm the nervous system and promote relaxation and sleep.

PCOS and Mental Health

Women with PCOS have higher rates of anxiety and depression. PCOS can be a very distressing condition for many women and this varies from person to person, with some of the highest reported contributors to the anxiety and depression is the impact to fertility, the impact on physical appearance and self-esteem such as weight issues, hirsutism and acne, and also the frustration about the lack of a clear cut solution, and a lack of awareness and understanding of the condition. There was a study that found that women with PCOS were physically active reported less depression and anxiety than those who were inactive. So, while I love to use herbal medicines to support mood and the nervous system, I do frequently recommend exercise to support mood in women with PCOS.

Potential pregnancy risks

There are a few things to consider when trying to conceive, as women with PCOS have an increased risk of some complications during pregnancy. The good news is that if PCOS has been treated, these risks return to almost the same levels as women who do not have PCOS. The risks include an increased likelihood of developing gestational diabetes, pregnancy-induced hypertension and preterm birth, and an increased risk of neonatal complications.

The increase in birth weight of babies born to women with PCOS also suggests an increased likelihood of c-section deliveries.

The treatment used in the study I mentioned before was anti-androgenic therapy, which means correcting hormonal balance before conceiving will improve pregnancy outcomes.

one small study looked at the incidence of gestational diabetes in women with PCOS and found the prevalence was 30.2%, and that these women had impaired blood sugar levels after having their babies. What we can take from this is that PCOS can have a long term impact on glucose metabolism, and again it highlights how important it is to try and take steps to improve your hormones and blood sugar level balance before conceiving.

I recommend that all couples do a preconception care program before conceiving, which at a minimum entails taking a high quality preconception care nutrient complex for 3-4 months before conceiving but if there are hormonal imbalances its important to work on this with a practitioner before trying to conceive.

Complications with breastfeeding

A lesser-known complication with PCOS is that it can cause some difficulties with breastfeeding and milk supply – however, this can also be supported by working on hormones before pregnancy, and with the support of a lactation consultant after birth. Thankfully not all women with PCOS experience difficulties breastfeeding and the information that says it is potentially problematic is only based on small studies. In the research that we do have available, the breastfeeding difficulties were only experienced in the first 3 months and seemed to regulate after that time.

Breastfeeding requires the hormones prolactin and oxytocin to work properly, but we also need adequate progesterone during pregnancy for the breast tissue to develop properly. Insulin resistance and high androgens can affect hormones in all these aspects.

How to manage PCOS

There are so many options for treating PCOS, and as it usually the case with naturopathic remedies, you get the best results when you are treated holistically. This means considering various things like what exactly is happening with your PCOS subtype.

The information I am giving you is a starting point to take to your practitioner to discuss whether it is right for you and to give you hope that there are so many possibilities to help.

while there have not been studies finding some remedies that tend to be universally helpful for most PCOS sub-types, and one of that does seem to be of great benefit is the amino acid Inositol. Taking 2g twice a day is my recommended dose for this.

Diet and lifestyle changes are great for treating insulin resistance, and while it’s tricky to find research specifically for this in PCOS we know it helps address the cause.

I recommend 150 minutes of exercise a week, which can be split into small blocks of exercise such as 30 minutes 5 times a week, or larger chunks such as 50 minutes three times a week. Eating a low GI/GL diet is also very important to address insulin resistance, and having a diet rich in antioxidants and low in inflammatory foods is also very helpful.

If you are overweight and have PCOS, then aiming to lose 5-10% of your body weight is a fantastic goal, and this amount seems to be the magic number that improves fertility rates and reduces risks for diabetes. Losing weight ideally would be done through a combination of diet and exercise.

Nutrients such as magnesium, b vitamins, particularly activated B vitamins, vitamin D and chromium can also be helpful.

Omega-3 fatty acids such as fish oil or algae oil can also help with some of the components of PCOS such as high cholesterol and inflammation.

Other herbs that I would consider is Berberine containing herbs such as Phelledendron which helps with improving insulin resistance and regulates blood lipid levels. There is also evidence showing that Black Cohosh can be helpful alongside other PCOS treatment.

The combination of Peony and Licorice has been looked at in Chinese medicine studies, and this is still a good inclusion in treatment, depending on the individual. Bulgarian Tribulus can also be helpful to regulate ovulation.

Spearmint can be helpful to reduce excessive androgens. I like this when used in a tea and is why I included it in one of my tea blends that supports skin health, to address this aspect.

Supporting gut health is also very important, as a poor microbiome can impair metabolism and worsen inflammation. So eating a diet rich in vegetables with lots of diversity is fantastic for improving the flora diversity in the gut, but it can also be helpful to take probiotics or prebiotics, so discuss this with your practitioner to make sure you’ve got the right type for you.

References

Bahri Khomami, M., Boyle, J. A., Tay, C. T., Vanky, E., Teede, H. J., Joham, A. E., & Moran, L. J. (2018). Polycystic ovary syndrome and adverse pregnancy outcomes: Current state of knowledge, challenges and potential implications for practice. Clinical Endocrinology, 88(6), 761-769. https://doi.org/10.1111/cen.13579

Bahri Khomami, M, Joham, AE, Boyle, JA, et al. Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression. Obesity Reviews. 2019; 20: 659– 674. https://doi.org/10.1111/obr.12829

Fernandez, R. C., Moore, V. M., Van Ryswyk, E. M., Varcoe, T. J., Rodgers, R. J., March, W. A., Moran, L. J., Avery, J. C., McEvoy, R. D., & Davies, M. J. (2018). Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and science of sleep, 10, 45–64. https://doi.org/10.2147/NSS.S127475

Guerrero-Bosagna C, Weeks S, Skinner MK (2014) Identification of Genomic Features in Environmentally Induced Epigenetic Transgenerational Inherited Sperm Epimutations. PLOS ONE 9(6): e100194. https://doi.org/10.1371/journal.pone.0100194

Guo Z, Qiu H, Wang L, et al. Association of serum organochlorine pesticides concentrations with reproductive hormone levels and polycystic ovary syndrome in a Chinese population. Chemosphere. 2017 Mar;171:595-600. DOI: 10.1016/j.chemosphere.2016.12.127.

Holton, S., Papanikolaou, V., Hammarberg, K., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., McBain, J., Sinnott, V., & Fisher, J. (2018). Fertility management experiences of women with polycystic ovary syndrome in Australia. European Journal of Contraception and Reproductive Health Care, 23(4), 282-287. https://doi.org/10.1080/13625187.2018.1483020

Mo L, Mansfield DR, Joham A, et al. Sleep disturbances in women with and without polycystic ovary syndrome in an Australian national cohort [published online December 26, 2018]. Clin Endocrinol (Oxf). doi:10.1111/cen.13922

Rosenwaks, Z. (2017). Polycystic ovary syndrome, an enigmatic syndrome begging for a name change. Fertility and Sterility, 108(5), 748–749. https://doi.org/10.1016/j.fertnstert.2017.09.030

The post A Holistic Guide to PCOS appeared first on Alison Mitchell Naturopath.

Do you have a New Year’s resolution?

Is it to get more energy, to have balanced moods, or to control your weight?

Maybe I can help. Read on, my friend.

Cooking your own food is one of the best things that you can do to improve your own health, for so many reasons:

• You cut out packaged food, which means you will be reducing the amount of additives such as sugar, salt and preservatives
• Cooking your own food means that you retain more of the important vitamins and minerals, such as vitamin B group and vitamin C which normally would be lost in processing and deteriorate on the shelf during storage
• You generally get a bigger variety and serve of vegetables
• You’ll be able to take control of your own portion size

If you can get comfortable at cooking your own meals, you will make the biggest and most long lasting changes you’ll ever make that will benefit your health.

‘I’m not a good cook’, I hear you say. You’re probably rolling your eyes, audibly groaning and about to close this window. But wait! I implore you – read on!

I get it, if you’re not a whiz in the kitchen, cooking for yourself can be overwhelming, boring and stressful.

Thankfully, it doesn’t have to be this way – the better you get at cooking, the more you come to enjoy it.

That’s why I made this ebook and meal plan – to help with one of the biggest hurdles of health, the struggle of cooking for yourself – this was created for the kitchen beginner.

In my clinical experience I realised that one of the key barriers to people improving their health was their diet, and one of the biggest barriers to improving their diet? The ability and enjoyment of cooking.

‘What can be done about this’, thinks I. ‘I need to provide people with the tools to learn how to cook, but there’s so much more they need to know with this!’

So I got to work and created a 3 week meal plan and nutrition guide designed to help people who struggle to know what to do in the kitchen, but it’s also going to be great for those people who want to know how to eat well, how to eat mindfully, and how to plan their own meals. If you’re a good cook, you’ll still enjoy this ebook and meal plan.

Something you might not know about cooking is that it actually helps to improve digestion – did you know that digestion begins in the mind? This is called the cephalic phase -here is when we start to think about food, anticipate food, and that’s when we start to make all of our digestive acids and enzyme. If we have good production of acids and enzymes this means the better we will be able to better digest our food and therefore the less bloating and digestive symptoms we will have.

This meal plan has been built around the concept of whole food. Whole food essentially means that food in itself has been minimally altered by processing and so it retains the more nutritional goodness.

While one the biggest things that you can do to improve your health is to start cooking for yourself, there’s so many barriers today – one of which is the lack of confidence in the kitchen. In my meal plan and ebook I have threaded throughout tips on how to cook so that you will finish this guide with more confidence to keep navigating the kitchen, as well as making your own meal plan.

There’s so many other things in this meal plans such as a guide to mindful eating and knowing how to balance your nutrients throughout the day.

This ebook and meal plan has been 3 years in the making (most of the delay comes from having had two kids in the process of writing it) but it’s also because I’ve put a lot of love and effort into it – writing the content, creating and testing the recipes, balancing the meals and menus nutritionally as well as designing a shopping list to go with the meal plan.

But ultimately what I want is for you to find it easy to follow, and simple to implement. What I want is for you to have to do minimum effort for maximum gain.

So if your goal is to lose weight, or to get more energy, or to feel better in yourself, then I strongly suggest checking out this meal plan.

For those with food intolerances, you can make substitutions if you need to be dairy free or wheat free, but currently this meal plan is not designed around avoiding food intolerances or allergies. It’s also not suitable for vegetarians or vegans (but I do have something in the works for for you guys).

All you need to do is follow this link and purchase the meal plan.

And because I love you so much I’m going to give you a discount for January – just enter the code newyears at the checkout and you’ll get 25% off (that’s a pretty awesome discount!)

Happy Healthy New Years!

CLICK HERE to buy the Kitchen Novice Meal Plan and eBook – valued at $24.95 (use code newyears in January ’19 to get 25% off)

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Improving your diet doesn’t mean you have to deprive yourself of your favourite foods. I think that instead of thinking about removing ‘bad’ foods from your diet, it’s easier to first try to add in healthy foods – lots of vegies and other wholefoods. By adding in good foods, you are filling yourself up with fibre and nutrients so you feel fuller, but you’re also increasing your stores of nutrients that if you are low in, can make you crave unhealthy foods.

One of the ways that you can start to add in more healthy foods in some clever substitions. Brittnay from The Nut Butter Hub has shared some methods for swapping in some healthy foods for less healthy recipes.

Ingenious Ways to Make Your Favourite Food Healthy

Educating yourself is crucial when it comes to eating well. Rather than denying yourself or overindulging just a few tweaks here and there won’t have you missing out on anything. Turn these ideas and behaviours into habits to ensure you lead the healthiest lifestyle possible (while still enjoying it)!

Healthy Fried Rice, That Still Tastes like Rice

Rice can be good in moderation however, if you find that when you cook it there is enough for the whole village (and you managed it eat it all) it might be time to find an alternative. 

Enter cauliflower rice.

All you need to do is roughly chop your cauliflower and throw in a food processor for a minute.  You will find that the texture is very similar to rice. Use this ‘faux’ rice can be used in any dish where you would have normally used white rice and it tastes just the same. One of our favourites is cauliflower fried rice, the family didn’t even blink an eyelid when I served this one up!

Make Your Own Chocolate Bars

If you find you a get a hankering for chocolate, try making it yourself. There is a huge difference between cocoa and cacao, so just by making the conscious decision to understand what is in your food, will significantly improve your health.

Cacao powder is packed with nutrients and tastes just as yummy as cocoa. We love making our own truffles, it only takes a few simple ingredients such as coconut oil, cacao powder and sea salt.

Don’t Step Away from The Hot Chips

The next time you want fries try baking them instead of deep frying them in litres of oil. When at home try tossing your sweet potato wedges in a bag with olive oil and semolina. This coating with ensure you get a crispy oven chip every time. You can also try using a healthy oil like coconut to help reduce your cholesterol levels.

Can’t Give Up Mac and Cheese?

Processed pasta is not a good thing to eat on a regular basis. Get rid of boxed mac and cheese and make some at home. You can make a velvety cheese-based sauce with added butternut pumpkin. This sweet taste on mac and cheese is sure to be satisfying, and the added pumpkin will provide lots of nutrients and fibre.

Take it a step further and replace your high carb noodles with a plant-based pasta made out of chickpeas or legumes. The texture may be a little grainier than regular pasta but it tastes almost the same.  

DIY Pizza

You have two good options when it comes to pizza. You can make a pizza bread crust with cauliflower, but if is the classic pizza dough is that you crave? Then why not make it from scratch at home and just switch out what’s on top of the pizza instead?

If you want add a real kick to your pizza, try smoking your veggies. Putting the veggies in a propane meat smoker will ensure you don’t have to load up on cheese or fatty meats to add flavour. Try using eggplant or mushroom as they hold a lot of flavour and texture.

We Scream for Healthy Ice Cream

Everyone loves ice cream and since more and more people are cutting out dairy, alternatives should be very readily available in your local grocery store. But if you would like to make your own ice cream then trying banana nice cream is very fast and easy.

To make banana nice cream all you need to do is freeze 3 to 4 bananas and blend in your blender. The result is a healthy version of ice cream. Use your favourite toppings such as nuts and dark chocolate to make this even more of a special treat.

Totally Tasty Pudding

Chocolate pudding is great for when you want something decadent and sweet for dessert. Usually this milk-based chocolate treat can get you into some calorie trouble.

Try cutting out some of the calories by using an avocado base instead of cream. Yes that’s right, you can make your pudding with avocados. You want to blend some cacao powder, non-dairy milk, avocado, and sweetener in your heavy-duty blender. Let the mixture chill in your fridge a few hours. The result is creamy chocolate which is also really food for you.

Now you know how to make a few small tweaks to some yummy dishes! You just need to put it into practice and create some new habits. You will find that these habits will quickly evolve and soon you will be coming up with some tasty tricks and alternative all on your own.

Brittnay is an Australian who lived in London for the past two years.  She managed to squeeze in 21 trips to Europe & Africa in that time. She is passionate about her health and her family, and you will find her healthy and delicious recipes on The Nut Butter Hub.

The post Ingenious Ways to Make Junk Food Healthy appeared first on Alison Mitchell Naturopath.

Eat Right For Your Shape is a beautiful and easy to read, Ayurvedic food and lifestyle guide by Supercharged Food author Lee Holmes. I have spent a lot of time pouring over this book, and have cooked several recipes from it – loving every one. My favourites so far are the Green Bean Subji and Sweet Potato Hash. Below you will find my review and details on how to win a copy of this book for yourself.

“Even if you only follow Ayurvedic recipes one day a week, see this as a positive change.”

Lee recommends implementing changes at your own pace which is a suggestion I agree with – whenever faced with the idea of a radical diet overhaul I immediately think of all the foods I can’t have, then proceed to stick my head in the sand. Instead of coming at these diet principles from the approach of what you can’t have, think about it more like something that you can do in bits and pieces to suit you.

Lee makes it easy for you to get an idea of your Dosha (constitution/body type) and then choose the right recipes for you with colour coded symbols and helpful summaries. To start with, there is a quiz where you can find your dosha, and then a chapter describing the characteristics of each dosha so you can get to know it, and then a handy graph listing the best foods to eat for each type for easy reference. Not only that, there are meal plans as well.

The meals are also split into seasons and tagged for their appropriate dosha, with suggestions given on how to adjust the recipe for other doshas. I think that one of Lee’s aims is not to provide you a strict list of meals to eat (although there is meal plan for each dosha included), but rather to provide you with guide of what foods will boost your health, and then encourages you to incorporate this as much as is possible for you.

There is also a section explaining intermittent fasting – you might know this as the 5:2 diet – and the practice of this in a traditional Ayurvedic diet. While commonly recommended as a tool for weight loss, Lee also recommends this method of eating as a way to give your digestive system a ‘rest’.

One of the things I love about the way Lee writes is how laid back she is – she suggests just taking on as much as you would like to from her recommendations, and if you have a moment of eating some less health promoting foods, to absolutely NOT feel guilty about it.

But wait, there’s more.

Not only do you get a beautiful guide to eating for your dosha, recipes and meal plans, there’s also a section on incorporating Ayurvedic lifestyle techniques, including yoga, mindful eating and breathing techniques. This book is much more than a recipe book, it is a complete Ayurvedic lifestyle guide. And while there are several Ayurvedic books already published, many could be considered overwhelming, and I am yet to find one quite as pretty as this.

In case you missed it, check out my interview with Lee where we chatted about her trip to India which inspired her recipes for this book and how her eating style has changed over the years. We also chatted about intermittent fasting, some Ayurvedic principles and Lee explains Doshas and how we can balance our health by eating to suit our type.

Eat Right for Your Shape GIVEAWAY

Want to win a copy of Eat Right for Your Shape? Just comment below in 25 words and tell me what your favorite food memory is.

Share the Facebook or Instagram post for extra brownie points.

Competition guidelines

Competition ends Saturday 21st May 2016.

Winners will be announced in my newsletter on Monday 23nd May 2016

Only open to Australian residents.

The winning entry must be subscribed to my newsletter.

The post Book Review – Eat Right for your Shape by Lee Holmes + a GIVEAWAY! appeared first on Alison Mitchell Naturopath.

I recently had the pleasure of interviewing the beautiful and inspiring Lee Holmes. Lee has created several amazing recipe books and her blog has always been a source of inspiration for my dinners. I am so keen to share her new book – Eat Right for Your Shape – with you, it is filled with delightful recipes and a beautiful and easy to read guide of Ayurvedic lifestyle practices.

In this podcast Lee talks about her trip to India which inspired her recipes for this book and how her eating style has changed over the years. We also chat about intermittent fasting, some ayurvedic principles and Lee explains how we can balance our health by eating to suit our dosha.

Watch the video here:

Or just listen to the audio:

About Lee

Lee Holmes holds an Advanced Certificate in Food and Nutrition and is a certified holistic health coach (IIN), yoga teacher, wholefoods chef and bestselling author of the Supercharged Food series, which includes Eat Your Way To Good Health; Eat Yourself Beautiful; Eat Clean, Green and Vegetarian; Heal Your Gut; and Supercharged Food for Kids.

She is a columnist for Wellbeing Magazine and Lifestyle Food Channel’s Healthy Eating Expert, and her articles have appeared in leading Australian newspapers and journals, as well as The Times and The Daily Express in the UK and The Huffington Post in the US.

Find Lee at her award-winning blog, superchargedfood.com

You can also connect with Lee on her social media channels here:

Facebook

Instagram

Twitter

Google Plus

You can purchase this book here, along with any other of Lee’s books.

The post Interview with Lee Holmes – Podcast #21 appeared first on Alison Mitchell Naturopath.

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~Serves 2~

Ingredients

• ½ cauliflower
• ¼ bunch kale (the flat leaf or the curly is fine), finely chopped.
• Handful mint and basil leaves, finely chopped.
• Salt and pepper
• 1 pinch dried chilli flakes
• 1 tsp cumin powder
• 2 salmon fillets

Method

In a food processor, blitz the cauliflower until it turns into a coarse breadcrumb like consistency.

Get out two frying pans, one on medium high and the other on medium heat. Add some olive oil to both pans.

In the medium high heat pan add the salmon fillets (first season them with salt and pepper) skin side down.

In the medium heat pan, tip in the cauliflower. Stir through until it starts to soften then add the kale. Season with salt and pepper and add the dried chilli and cumin. Cover with a lid.

After about 4-5 minutes or the skin is crisp, turn the salmon over.

Cook the salmon for another 3-4 minutes or until cooked to your liking.

Remove the lid from the cauliflower, then add the mint and basil and cook for another minute, then take off the heat.

Serve the cauliflower scramble into bowls and place the salmon fillet on top. Garnish with some cracked pepper and torn up basil leaves.

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Health & Wellbeing Podcast #10 with guest Lisa Costa Bir

In this episode Lisa and I discuss how to reduce emotional and mindless eating to help control your weight by to reducing overeating.

Dieting doesn’t work long term so to reach a healthy weight you need to address your habits and maintain realistic healthy eating behaviours – it’s what you can stick to that will have the biggest impact.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

Lisa is a Naturopath, lecturer and writer as as well as an Ayurvedic Lifestyle Consultant. Lisa has an interest in treating thyroid and adrenal health. Her practice is in Caringbah in South Sydney.

You can connect with Lisa via Facebook, Instagram or on her website http://lisacostabirnaturopath.com.au/

Podcast Breakdown

1.04 About Lisa

2.15 Changing behaviour and habits around eatings, vs. low carb/low fat diets. Some tips for good eating behaviours to help us eat mindfully and avoid overeating

6.28 The Mindless Margin

7.30 How to eat less and not notice, e.g. by tweaking plate and cup sizes

10.00 The placement of your glass affects wine consumption

10.30 More things that affect mindless eating: glass shape, type of wine, eating at the table, chewing

12.35 Get the family involved

13.00 Eating out: cafe/restaurant serves

17.28 More tips to avoid overeating

18.20 Keeping yourself accountable

20.50 Some reasons why dieting doesn’t work

25.00 Emotional, boredom, comfort and reward eating

29.00 Food addiction

38.00 Guilty eating and eating when stressed

38.34 Dealing with stress and the importance of having a support team

42.04 Exercise and NEAT (non-exercise-activity-thermogenesis)

44.10 “Ideal” weight and body image, healthy vs. skinny

45.08 What you do on the weekends matters

48.00 Sleep for weight management

49.42 Lack of sleep in new mothers is a factor in weight gain after birth

50.45 Thyroid function and other hormone imbalances affecting weight Read more HERE and HERE

51.55 How to get in contact

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The post How to Lose Weight Without Changing your Diet (much) appeared first on Alison Mitchell Naturopath.

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Health & Wellbeing Podcast #8

Laura Burton from Burton Health is back and this time we’re talking about menopause. We discuss the symptoms and stages of menopause, helpful foods and nutrients for soothing menopausal symptoms and reducing the conditions associated with this time.

Apologies the sound quality isn’t the best in this episode (especially at the start, it does get better after a few minutes!) but I wanted to share the video anyway and not let the quest for perfection get in the way of me delivering this information to you.

Laura is a clinical naturopath practicing in St Leonards and Dural. Her key areas of interest are female hormone disorders, digestive health, stress & adrenal fatigue. Through her clinical experience Laura has identified the prevalence of stress in our everyday lives and sees it as the most common cause or exacerbating factor of her patients health conditions. Laura believes that we need to get back to basics and work on our ability to release and manage stress in order to prevent and treat disease.

Last year Laura set herself the mission to reach beyond the walls of her clinics and send her de-stress message out to Australian and New Zealand households through the Burton Health Tea Club. Each month she sends love letters and tea packages to her members to inject joy and excitement into their days and to remind them to slow down, relax and reconnect while sipping on a cup of organic herbal tea.

You can connect with Laura via her website www.burtonhealth.com.au, on Facebook, Twitter or on Instagram.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

If you’ve got something nice to say about the podcasts please leave a review, but I’m also keen for any feedback if you want to comment below!

Menopause – Podcast #9

Podcast Breakdown

0:00 Intro, and what we’ve been getting up to
1:59 How Laura became interested in helping women with menopause
3:49 The common feeling of being alone in your symptoms when going through menopause
4:29 Symptoms of menopause
6:28 Understanding the different stages of menopause and knowing what stage you’re in: Pre/Peri-menopause, Post-menopause
7:44 Menstrual migraines in menopause
8:20 Surgically induced menopause
9:04 Chemically induced menopause
9:15 How long does menopause last for?
10:03 Is it menopause or PMS?
10:46 Hot flushes
12:56 Helpful foods and nutrients for menopause, as well as a few lifestyle tips
17:55 Bone health, osteoporosis and osteopenia.  (Book mentioned was Strong Women, Strong Bones)
19:24 Weight gain in menopause
21:57 Inflammation often increased in menopausal women, leading to more aches and pains
23:23 Soy
26:00 Xeno-oestrogens, and is high or low oestrogen the problem?
28:56 Q1: Could the role of the liver be explained and what are the benefits of supporting liver function in menopause?
29:41 Oestrogen forms and metabolism
32:45 Keeping inflammation under control
33:30 Common retail menopause supplements: Red clover, Black cohosh, Wild Yam cream.
39:24 Our favourite menopause herbs

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Mahatma Gandhi once said that we should “chew your drink and drink your food”.  Even if chewing your food more was the only thing you introduced into your routine, you’d be pleasantly surprised the benefits your health and wellbeing would reap.

If you catch yourself inhaling food and swallowing food chunks the size of golfballs, it’s probably a good idea to slow down a bit, cut a small portion, and chew.

Digestion starts in the brain and the mouth, and if things aren’t going well here then it’s likely they won’t go too well further on down the digestive tract either. Chewing your food properly is one of the best ways to positively influence your digestive system, your dental health and your weight.

• Each time you chew you are sending a message to your brain that you are eating, and the more this occurs the more your brain responds by both producing more enzymes and acids to digest your food, but also by producing hormones that tell you that you are full. Not chewing properly can mean you’re often hungry after you’ve eaten.
• Chewing more means it’s less likely that you will eat mindlessly. By forcing yourself to slow down you will be less likely to overeat, and you’ll also allow your body to send through the message that you’re full (which is often a slow to come message) before you’ve overstuffed yourself.
• Chewing your food well means less damage on the oesophagus – if you’re swallowing whole chunks of food it can damage the delicate tissue in this area. By chewing properly you’re also lubricating the food with saliva, making its journey down to the stomach an easier passage.
• Saliva contains several enzymes that kickstart the digestive process. Fat digestion begins with saliva, and there are also enzymes that break down starches into sugar. You can experiment on this by chewing a plain cracker for a long period – it will transform from a savoury snack into sweet!
• The more you chew your food the more surface area you are creating, which means the digestive acids and enzymes will have an easier time breaking your food down even further.
• If your food is not chewed properly this acts a food source for the unfriendly bacteria in your digestive tract, allowing them to grow and crowd out your good bugs.
• Chewing is important for your teeth. It helps to keep your jaw and gum muscles strong, and the saliva produced is also important in controlling the bacteria in your mouth.

You should aim to chew each mouthful 25 times, or at least until it becomes a paste. For soups and drinks you don’t have to worry about the 25 count, but do give it a few chews to ensure the enzymes are working and to stretch out those jaw muscles.

This can be a hard thing to remember to do, so I often suggest to my patients to set a reminder in their phones to go off before their regular meal times “Remember to Chew!” and if possible to avoid eating while in a hurry, because this will mean you’re more likely to gobble down your meals.

Give chewing more a go, and let me know if you notice a difference!

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