It is becoming more popular for women to want to test their AMH (anti-mullerian hormone) levels to predict their fertility. Most GP’s first point of call with any fertility issues is to test AMH and some IVF clinics are also likely to measure your AMH before you begin treatment.
However, AMH levels are not the be all and end all when it comes to fertility - in fact it doesn’t have any direct links to fertility or pregnancy outcomes at all. Let me first explain to you what AMH is and how it works in the body. 

AMH is not a score & it does not tell us how many eggs you have left

Clearing up AMH myths:

• AMH does not tell us the quality of your eggs

• AMH does not tell us what your chances of conceiving are

• AMH does not tell us how long until you go into menopaus

• AMH does not tell us how fertile you are

Anti-mullerian hormone is produced by the granulosa cells in the ovarian follicles. Ovarian follicles are where our eggs reside and become mature before ovulation. These follicles become bigger as the eggs mature and the AMH levels continue to rise as the follicles grow. The follicles stop producing AMH once the follicles reach a certain size. The AMH test is basically measuring the number of follicles that are growing. Women are born with millions of follicles, and they slowly decline as we age. Having a low AMH means there is a reduced amount of follicles growing, and therefore, a reduced amount of mature eggs available for conception - but again this does NOT mean a reduced chance of falling pregnant. Women with PCOS have a lot more follicles compared to those without PCOS. This means women with PCOS can have a very high AMH reading which can be deceptive - keep reading to learn why. 

You need one quality egg for conception. Although AMH levels measure the ovarian reserve, it does not measure the quality of the eggs, nor the chances of pregnancy. AMH levels do not give a complete picture of your fertility. It is more important to have amazing quality eggs for increased conception and healthy pregnancy outcomes rather than a high egg reserve. 

Why you shouldn’t rely on AMH levels for your fertility:

If you are on your fertility journey and are relying in your AMH levels to be the guide to tell you if you are “fertile” or not - this is not a good idea for the following reasons:

• If you have high levels of AMH this can give you false hope because it could be possible that the qualty of your eggs is not amazing and therefore may be hard to fall pregnant.

• If you have high levels of AMH and therefore don’t bother looking into your partners sperm health - this can also be a problem as we may not be seeing the full picture of your fertility as a couple.

• If you have low levels of AMH you may be causing yourself unnecessary stress because the low levels don’t actually link to fertility problems or birth outcomes.

Currently, there is no standardisation of AMH measurements and different laboratory tests have different cut off measurements. This means that some labs may say that you have normal levels, where other labs could say that your levels are low. This is just another reason why it is not a reliable tool for predicting fertility. 

What affects AMH:

There are many environmental factors that can impact AMH levels. Studies have shown that the use of hormonal contraception (>1year) can reduce AMH levels by 50%! This is a lot and very relevant to take into account if you have just come off hormonal contraception to get pregnant and have just got your AMH tested.  Your levels can also be impacted by factors such as the time of year that you get tested. Research has shown Vitamin D levels to influence AMH levels. Women who measured their AMH levels in winter were 18% lower compared to those who measured their levels in summer with higher Vitamin D. These are all factors that need to be considered when interpreting results. 

What we can do to help our fertility:

As we age our eggs are exposed to a range of environmental toxins which affects the health of our eggs, which makes sense as to why we are generally more fertile in our younger years. Women who smoke or have a higher body mass index have been indicated to have lower AMH levels and egg quality. Additionally, exposure to benzene and  formaldehyde, which are commonly found in everyday products, such as,  cosmetics and personal products have been associated with lower AMH levels and egg quality. Genetics, illnesses and stress can also influence our egg quality. However, this does not mean we can’t improve our egg health! Reducing our exposure to environmental toxins, improving our diets and managing our stress levels are all  ways to optimise our overall health, but especially our precious eggs. 

Our egg reserve is precious and vulnerable. This is just one of the many reasons why it is important to always look after our health, especially if you are wanting a baby in the future. Rather than focusing on your AMH levels, which don’t really give us a clear indication of your fertility AT ALL, let’s put our efforts into having quality eggs! It doesn’t matter if you are not planning on falling pregnant until 10 years down the track. We should be aiming to protect our eggs now.

If you have been told your AMH levels are low, please don’t freak out. Remember, quality over quantity!

Focus on these top most important factors for your fertility journey:

• Tracking your cycle with Tempdrop fertility tracker - use this link for 15% off 

• Monitoring your cervical mucus can provide further insights to your fertility and ovulation

• Investigate your hormonal balance - we need progesterone to help with conception and implantation - reach out to me if you need assistance with hormone testing - available worldwide.

• Assess sperm health & quality - reach out to me for help to access these tests

• Join my Natural Fertility course which covers all of the above + so much more in a supportive course

• Listen to my podcast on Spotify or Apple Podcasts for more fertility support!

References:

1. Marcelle I Cedars, Evaluation of Female Fertility—AMH and Ovarian Reserve Testing, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 6, June 2022, Pages 1510–1519, https://doi.org/10.1210/clinem/dgac039

2. Moolhuijsen, L. M. E., & Visser, J. A. (2020). Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function. The Journal of clinical endocrinology and metabolism, 105(11), 3361–3373. https://doi.org/10.1210/clinem/dgaa513

3. Moolhuijsen, L. M. E., & Visser, J. A. (2020). Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function. The Journal of clinical endocrinology and metabolism, 105(11), 3361–3373. https://doi.org/10.1210/clinem/dgaa513

4. https://www.europeanreview.org/wp/wp-content/uploads/5255-5260-1.pdf 

5. Plante, B. J., Cooper, G. S., Baird, D. D., & Steiner, A. Z. (2010). The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years. Menopause (New York, N.Y.), 17(3), 571–576. https://doi.org/10.1097/gme.0b013e3181c7deba

6. Li, H., Hart, J. E., Mahalingaiah, S., Nethery, R. C., James, P., Bertone-Johnson, E., Eliassen, A. H., & Laden, F. (2023). Environmental Exposures and Anti-Müllerian Hormone: A Mixture Analysis in the Nurses' Health Study II. Epidemiology (Cambridge, Mass.), 34(1), 150–161. https://doi.org/10.1097/EDE.0000000000001547

In the first episode, we discussed some of the reasons you might not be getting pregnant and this episode we dove into how to get pregnant with an irregular cycle.

As a naturopath with a passion for fertility, I've seen many clients face similar challenges on their journey to conception. One common issue is a lack of comprehensive hormone testing and ovulation tracking. Many couples rely on LH strip testing, which I don’t recommend but more on that in a future ep. 🌡️👶

The Important Role of Hormone Testing

Hormones play a crucial role in your ability to conceive. Hormone imbalances can disrupt ovulation, making it challenging to determine your fertile window. Comprehensive hormone testing can identify these imbalances and help create a targeted plan for conception. Hormone testing can also help conditions like PCOS (Polycystic Ovary Syndrome), thyroid imbalances and high androgens. Understanding these conditions can provide critical insights into your fertility health.

Understanding the Right Day to Test Hormones

Timing is everything when it comes to hormone testing. Testing on the wrong day of your menstrual cycle can lead to inaccurate results. It's essential to know the optimal days for testing different hormones to get a clear picture of your hormonal health.

Fertility Nutrient Testing and why nutrient status is essential

Nutrient status is essential for fertility. Testing your nutrient levels can ensure you are within optimal ranges for conception. Proper nutrition supports hormone balance and overall reproductive health. Plus, ensuring you have the right nutrients can improve your chances of:

• conception

• a healthy pregnancy

• aid in postpartum recovery.

I didn’t want to spoil the whole ep but please know there’s so much more for you to enjoy and to learn! 🌸💖

Make sure to check out the podcast on Spotify and Apple Podcasts.

don’t forget to Check out my socials

• Instagram: @ellennaturopath

• Facebook: @EllenLouiseNaturopath

• TikTok: @EllenNaturopath

If you haven’t seen, I have been in the motions of creating my fertility series on my Conscious Health & Life podcast. The first episode has been up for a few weeks now, Ep 24 Fertility series: Why am I not falling pregnant with Ellen Louise Naturopath, and we looked at topics like:

• trying to fall pregnant but it’s not happening

• ovulation window and fertility window tracking

• been given IVF or IUI as an option

• it’s not just women’s health but also men’s health when it comes to conception

• no one size fits all approach to fertility!

Why am I not falling pregnant?

The first episode tackles one of the most common questions typed into Google: "Why am I not falling pregnant?" Many women find themselves in this situation, feeling frustrated and unsure of where to turn. The only options offered to them are IVF and IUI. Before jumping to these conclusions, it's essential to explore other underlying factors that could be influencing fertility.

Ovulation and your fertility window

One of the most critical aspects of fertility that is often overlooked is the ovulation cycle and fertility window tracking. It's surprising how many people don't realise that they are only fertile for about 5-6 days each month! This small window is crucial for conception, and understanding how to track it accurately can make a significant difference.

Exploring other fertility options

Many clients I work with have been told that IVF or IUI are their only options, without a thorough investigation of other potential factors. Before beginning these options, there are several other avenues to explore. Lifestyle changes, dietary adjustments, and natural therapies can all play a significant role in enhancing fertility.

Sperm health in fertility

Fertility issues are not just a female concern! Fertility problems can be due to issues with sperm count, motility, or morphology. Unfortunately, sperm health is often only tested after a year of unsuccessful attempts to conceive. Early testing can save couples from months of emotional stress and disappointment.

The MTHFR Gene

Genetics are another crucial factor in fertility that is frequently overlooked. Many people are told that their fertility issues are genetic, yet genetic testing is rarely done early on. One of the most significant genetic factors affecting fertility is the MTHFR gene. This episode will explore the impact of the MTHFR gene on fertility, why it matters, and what can be done about it. Understanding your genetic makeup can provide valuable insights and guide effective treatments and interventions.

Stay tuned for more!

Fertility is something I am passionate about and I am so excited to kick off this podcast with you. If you have any questions, queries or stories; please forward them to my email hello@ellenlouisenaturopath.com or reach out on one of my socials!

• Instagram @ellennaturopath

• Facebook @EllenLouiseNaturopath

• TikTok @EllenNaturopath

If you’re due for a fertility catch up or want to 15 minute discovery call, select a time that suits you and book a meeting. I can’t wait to see you! 💖🌸🤰

Did you know that hormonal imbalances are one of the most common causes of acne?(1). Low progesterone particularly, can directly and indirectly contribute to acne development.

How can low progesterone cause acne? 

Progesterone is an important female hormone that is dominant in the second half of the menstrual cycle. It has a role in suppressing an enzyme called 5a reductase. This enzyme is needed to convert testosterone to DHT. DHT is another type of testosterone but has more potent effects.

DHT and testosterone are androgen hormones, and are what stimulates sebum and acne formation. DHT is 5-10 times more potent than testosterone (2).  If we have low levels of progesterone, it means more DHT is converted, which means more acne.

Low progesterone= 

Higher activity of 5a reductase= 

Increased DHT conversion= 

Increased sebum/acne production.

LOW PROGESTERONE & HIGH OESTROGEN

The female hormones progesterone and oestrogen counterbalance each other. They are like yin and yang and have different roles in the body.

When one is high the other is low.

If Progesterone levels are too low, this means that Oestrogen is too high.

High oestrogen is commonly seen in those with PCOS. PCOS is associated with high insulin. Imbalanced insulin levels can also increase the androgen hormones testosterone and DHT. Not only that, elevated insulin increases both the size and amount of sebum/acne production (3).

High insulin can also disrupt ovulation. We need to be able to ovulate in order to produce progesterone-creating a snowball effect on acne formation.

How do I know if I have low progesterone? 

The main reason for low progesterone is no ovulation. There are many reasons why you might not be ovulating- stress and undereating are two of the main reasons for no ovulation- read more here.

The best way to find out if you are ovulating is to track your basal body temperature.

Signs and Symptoms of Low Progesterone: 

• Mid-cycle spotting 

• Irregular cycles 

• A short luteal phase 

• Acne Breakouts 

• Anxiety/low mood/irritability

• Premenstrual Syndrome (PMS)

• Heavy or very light periods

• Recurrent miscarriages and trouble falling pregnant

• Poor sleep 

• Low libido

• Hair loss/thinning 

• Poor thyroid function

TESTING FOR PROGESTERONE:

If you have a feeling that you might be low in progesterone, it may be a good idea to get your levels checked! To interpret the test results correctly, it is important to test progesterone on day 21 of your cycle.

If you have irregular cycles, test 7 days AFTER ovulation. You can determine ovulation by tracking your basal body temperature.

Lymphatic Congestion For Acne:

Check out this FREE download to learn about lymphatic congestion for acne & how to clear it

Lymphatic Congestion Method Here

Preview Below:

Female hormones are complex and when they are imbalanced it can cause a magnitude of issues in the female system… It's not just the direct impact but how it can indirectly interfere with other mechanisms within the body. But… Not to worry, that's where I come into play!! I have treated hundreds of women to balance their hormones and helped them to get the most out of their lives and menstrual cycles. Your hormones are not something to be afraid of, we can use them to our advantage when they are in harmony.

Book in a FREE chat with me today!

References:

1. https://link.springer.com/article/10.1007/s40257-020-00542-y 

2.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015761/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131965 

First off!

Download this to learn about lymphatic congestion for acne & how to clear it

Now lets understand acne better:

Acne is one of the most common skin conditions worldwide (1). Historically, we did not have acne, and it is thought that the prevalence of acne development came with the integration of our western diets (1). 

Acne is an inflammatory condition and affects the areas of the skin that contain sebaceous glands (oil glands): face, back, and chest. 

Acne develops due to the 4 main factors, explained below. Hormonal imbalances and our diet are the two main things that drive these factors (1).

Contributing factors:

1. Excess sebum production (oil from glands on the skin) 

2. Inflammation pathways 

3. Bacterial imbalances

4. Increased production of keratin cells - Keratin is a substance that helps protect the skin from damage. Too much production can prevent dead skin cells from being cleared. This causes a blockage at the skin/hair follicles and reduces the skin's ability to regenerate new skin cells.

**m-TOR is an enzyme that is involved in signalling pathways within the body and is needed for our metabolism and building muscle.  

Excess sebum production is driven by elevated androgen hormones (such as testosterone) and insulin growth factor-1 hormone (IGF-1).

IGF-1 can activate an enzyme called m-TOR**.  mTOR, further stimulates sebum production, keratin, and inflammation,— all contributors to acne (1). 

Too much activation of m-TOR can be a sign of metabolic dysfunction. Excess m-TOR not only contributes to acne, but also other metabolic diseases such as insulin resistance and arthritis (2).

You don't need to all remember these names… but what you should remember is that our diets can directly impact these pathways. 

High sugar foods raise your insulin levels- high insulin increases IGF-1 and therefore the cascade pathway of acne developing (1).

Dairy foods can also contribute to acne via a similar pathway. The casein in dairy products can increase IGF-1. Additionally, dairy milk has a high insulin index which can cause blood sugar and insulin spikes (1,3). 

The IGF-1 from cows milk is identical to the IGF-1 in humans, so it acts the same inside the human body (3). IGF-1 can stimulate the synthesis of androgen hormones (3). Together, these factors make it very hard for the body to fight against acne development. 

Additionally, in some people, the A1-casein can cause irritation in the gut and initiate an inflammatory response (4,5). 

The Gut Skin Connection: 

Gut health is fundamental to treat in all conditions, but especially acne. There is a Gut/Skin bidirectional connection. You may have heard of ‘leaky gut’- if you have a leaky gut it is likely that you have ‘leaky skin’. Leaky gut can cause metabolites and toxins to enter our bloodstream and in turn, cause inflammation and an accumulation of toxins to leak into the skin (4). Just like our gut microbiota, our skin has a microbiota with ‘good’ and ‘bad’ bacteria. An imbalance between our good/bad bacteria can impair our immune system and contribute to inflammation (1,4). Studies have shown those with acne to have a lower gut diversity (4). An imbalance of ‘good’ bacteria can also drive our gut microbiota to produce metabolites that have been indicated to activate the mTOR signalling pathway mentioned above (1).

Poor detoxification pathways:

Another cause of acne is poor detoxification pathways. When our body’s elimination and detoxification process aren’t working properly, toxins can accumulate in our system and show up on our skin - because our skin is also an elimination pathway.

• Our liver is needed to help detoxify and excrete toxins. It is also needed to metabolise excess hormones that can contribute to acne eg testosterone & oestrogen. 

• Lymphatic congestion: Our lymphatic system can accumulate toxins and bacteria  beneath the skin. Movement is needed to help get our lymphatic system moving - exercises, massage and dry skin brushing are all great ways to get the lymph moving. 

• The Gut: Alongside the aforementioned roles our gut plays, our gut is also key for eliminating excess toxins. Yes that’s right - you actually poop out your oestrogen.

PCOS:

PCOS is a common hormonal condition that is characterised by high levels of androgens and insulin resistance, which are 2 main drivers of acne. Therefore, it is common for those with PCOS to have acne.

Remember: PCOS can be fixed !

Overall, there are different drivers that can contribute to acne. However, by taking a holistic approach and taking into account all the factors, treating the root cause and utilising targeted supplements and dietary changes, your recovery can go a long way.

REFERENCES:

1. https://link.springer.com/article/10.1007/s40257-020-00542-y 

2. https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-020-00396-1

3. https://onlinelibrary.wiley.com/doi/10.1111/j.1610-0387.2009.07019.x

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678709/

As a Naturopath, I believe in treating the root cause of a problem rather than just addressing the symptoms. This approach is particularly important when it comes to menstrual irregularities, such as anovulatory cycles.

Anovulatory cycles occur when a woman does not ovulate during her menstrual cycle. This can result in irregular or absent periods and difficulty conceiving. While there are several potential causes of anovulatory cycles, including hormonal imbalances, stress, and certain medications, it is important to address the underlying factors in order to restore regular ovulation and improve fertility.

If you have a regular period but are having trouble conceiving it is important to track your basal body temperature and not just relying on period tracking apps alone - read more here why.

Now let’s understand the reasons behind anovulatory cycles:

One common cause of anovulatory cycles is polycystic ovary syndrome (PCOS). This condition is characterised by insulin resistance, hormonal imbalances, and multiple cysts on the ovaries. I would approach PCOS treatment with a focus on dietary and lifestyle modifications to address insulin resistance and balance hormones. Read more about PCOS here.

A low glycemic index diet, high in fiber and healthy fats, can help to regulate insulin levels and improve fertility outcomes in women with PCOS. Supplements such as inositol and magnesium can also be beneficial in improving insulin sensitivity and reducing inflammation.

In addition to diet and supplements, stress reduction techniques such as yoga, meditation, and deep breathing can be helpful in regulating hormone levels and restoring regular ovulation. Acupuncture and herbal medicine may also be recommended to support the body's natural healing processes.

Stress is another significant factor that can contribute to anovulatory cycles. When the body is under chronic stress, it releases higher levels of cortisol, a hormone that can disrupt the delicate balance of reproductive hormones necessary for ovulation. This can lead to irregular menstrual cycles and even anovulatory cycles. I would recommend stress reduction techniques such as mindfulness practices, yoga, and deep breathing exercises to help regulate cortisol levels and promote relaxation. Additionally, I may recommend adaptogenic herbs such as ashwagandha and rhodiola, which can help to support the body's stress response system and promote hormone balance. By addressing stress levels, we can support healthy ovulation and improve overall reproductive health.

Another potential cause of anovulatory cycles is thyroid dysfunction. Hypothyroidism, or an underactive thyroid gland, can disrupt the balance of hormones involved in ovulation and menstruation. As a naturopath, I would focus on optimizing thyroid function through targeted nutritional supplementation, such as selenium and iodine, and lifestyle modifications such as stress reduction and regular exercise.
Listen to my podcast episode all about thyroid health here.

In summary, anovulatory cycles can have a variety of causes, and it is important to address the underlying factors in order to restore regular ovulation and improve fertility outcomes. As a Naturopath, I would approach treatment with a focus on dietary and lifestyle modifications, stress reduction techniques, targeted supplements, and other natural therapies to support the body's natural healing processes. By taking a holistic approach, we can improve overall health and wellness while addressing the specific concerns of anovulatory cycles.

Check out my Natural Fertility 4 week course

Always consult with your healthcare practitioner before starting any herbal medicine.

Warmest,

Ellen xx

When we think about women’s hormones, most of us think about oestrogen. However, progesterone is just as prominent and important as oestrogen. Progesterone is often the forgotten about hormone- but it is fundamental for healthy periods and your overall health. 

Progesterone's main role is to hold and nourish a pregnancy.

That is how it got its name Pro-Gestation.

However, Progesterone is not just important for pregnancy and fertility it also plays a role in: 

• Healthy and regular periods and cycles 

• Lightening your period

• Calming the nervous system 

• Reducing inflammation and regulating the immune system

• Stimulating muscle growth 

• Promoting sleep

• Preventing osteoporosis, heart disease and breast cancer.

Progesterone counterbalances Oestrogen.

When Oestrogen is high Progesterone is low and vice versa. 

For example: 

• Progesterone thins your uterine lining- Oestrogen thickens it 

• Progesterone boost your thyroid hormones - Oestrogen suppresses them

The MAIN way that we make Progesterone is with ovulation. 

If we are not ovulating, sadly we may miss out on all the benefits of progesterone because our bodies don’t make it. 

Those who are on the oral contraceptive pill, have PCOS, a missing period , or have anovulatory cycles will not be ovulating regularly. 

You can identify if you are ovulating by tracking your basal body temperature. Read how here.

Even if we are ovulating, there is a high chance that you could have low levels of Progesterone.

As well as healthy ovulation, we need a healthy luteal phase to optimise Progesterone production. The luteal phase is the 2 weeks after ovulation (approximately 10-14 days between ovulation and your period).  After ovulation, Progesterone prepares the uterus for an egg to be fertilised. If there is no fertilised egg your Progesterone levels drop which is what stimulates menstruation to begin. If there is a fertilised egg, Progesterone helps to maintain the uterine lining throughout the pregnancy.

Signs and symptoms of low progesterone: 

• Spotting in the luteal phase (premenstrual spotting) 

• Irregular cycles 

• A short or no luteal phase (there should be at least 11 days between ovulation and your period)

• Fertile mucus in the luteal phase (progesterone dries up fertile mucus)

• Acne breakouts

• Poor sleep

• Miscarriages

• Troubles falling pregnant

• Mood changes - anxiety, low mood, irritability.

Reasons why you may be low in progesterone: 

• High stress: Our stress hormone, cortisol, is produced via the same pathway as progesterone. When we are under stress (good or bad stress) our body needs more cortisol to cope. More cortisol production comes at the expense of less progesterone production.

• High Oestrogen: Having too much oestrogen causes an imbalance of hormones between progesterone and Oestrogen. Oestrogen should be the dominant hormone in the first half of the menstrual cycle and progesterone should be dominant in the second half of the cycle (luteal phase). They become imbalanced when one becomes dominant throughout the whole cycle. High oestrogen in the luteal phase is what can drive PCOS. It can also contribute to: 

• Weight Gain 

• PMS

• Irregular cycles

• Heavy and painful periods 

• Mood swings 

• Breast tenderness

• Sleep issues

• Low Cholesterol: Our bodies need cholesterol to produce progesterone! Read more about cholesterol and hormones here  

• Low thyroid function: Our thyroid is involved in hormone production. 

There are many ways we can tackle low progesterone. The best way to identify if you are lacking progesterone and ovulation is by tracking your basal body temperature. 

You then need to find out why you are not ovulating, is it because you are not eating enough? PCOS, hormonal imbalance, high stress, thyroid dysfunction, nutrient deficiencies? There are many factors that can interfere with our hormones, and getting to the root cause is fundamental to optimise your health. 

If you would like guidance to find your root cause and to reach your health goals I would love to chat. 

Whether you are wanting to fall pregnant or not, your fertility is important. The health of your reproductive cycle and your fertility can say a lot about your overall health- think of it like 5th vital sign!  

There are many factors that can impact your fertility, such as your lifestyle, environment, genetics and hormonal factors.  However, just because you are told you are infertile doesn’t mean you can’t reverse it and improve your fertility and overall health. Even if you are not worried about your fertility status, you should care about your overall health- keep reading to find out why fertility impacts your overall health. 

Approximately 10-15% of couples are affected by infertility. Yet, less than 50% of couples follow a preconception care plan and over 85% frequently follow behaviours that can affect fertility, such as alcohol consumption in the lead up to conceiving. If you are wanting to fall pregnant even if it is in a couple of years- start looking at your fertility status NOW. Even if you know you want to have babies in the future, but not anytime soon, your health should still be a number one priority! You don't have to wait until 3 months before thinking about preconception care. But 3 months is the recommended minimum.

Infertility is not necessarily a disease, rather a disruption of the body’s function or genetics, that are linked with other diseases and conditions such as nutrient deficiencies, hormonal imbalances and nervous system dysregulation. For example, it is common for women with PCOS to suffer from insulin resistance. Fixing underlying metabolic and hormonal imbalances through lifestyle improvements can go a long way at enhancing your fertility and overall health. For those women who have PCOS but aren't worried about fixing it because they don’t want to have babies- this is your sign that having a healthy menstrual cycle and fertility status is crucial for your overall health and longevity!! P.S PCOS is certainly treatable without the use of the oral contraceptive pill or metformin.

“Fertility is a reflection of your overall health”

Do you care about your health but you are not wanting to get pregnant? It is still highly important to be informed about your fertility status. This is because you can feel 100000% better when our menstrual cycle and hormones are in check.

When you are in tune with your body, you can avoid pregnancy naturally- without the side affects of hormonal birth control. In order to do this, you need to be aware of when your fertile window is. You can do this by tracking your basal body temperature.

PSA: period apps cannot accurately predict ovulation.

Your menstrual cycle doesn’t have to be a burden, when your hormones are in harmony, your cycle can be a wonderful thing. It has soooo many health benefits other than just the purpose of baby making! Ovulation, is the main event of your menstrual cycle and healthy ovulation is the foundation of fertility. Without ovulation our body is ‘robbed’ of our beneficial hormones oestrogen and progesterone. 

Benefits of each monthly surge of Progesterone:

Benefits of each monthly surge of Oestrogen:  

• Calms the nervous system 

• Reduces inflammation and regulates immune system 

• Promotes sleep  

• Supports thyroid hormones

• Protects against breast cancer

• Glowing skin  

• Stimulates libido

• Enhances insulin sensitivity 

• Regulates metabolism 

• Encourages muscle gains 

• Supports strong bones 

• Supports a healthy heart and brain

---

Fertility status is not only important for females and their menstrual cycle. The fertility status of males can say alot about their health too. Research has shown men with low testosterone levels and low quality semen to have higher chances of hypertension and heart disease. The rates of coronary heart disease is 60% higher in infertile men compared to other men. It has also been reported that one in ten infertile males have metabolic syndrome. These health conditions are not ideal for anyone, especially those who are wanting to have a baby. 

More than 50% of male infertility cases are of ‘unknown causes’ and many couples are told that it must just be genetic or it's just the way it is. However, this is not always the case, there can be underlying factors that can be improved through supplementation support and lifestyle/dietary changes. A semen analysis test can give you more insight to your overall predictor of fertility and help direct what areas of your sperm need support. Read more here.

If you would like more guidance on how to improve your fertility status or get it checked- please reach out.

I have created a step by step guide on how to optimise your fertility with easy, practical and proven implementations. If you would like to learn more, please click here. 

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276647/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355494/

Did you know that period apps can’t accurately predict ovulation? They are becoming more and more popular to help women and couples conceive or prevent pregnancy. However, although these apps are great for identifying patterns in your moods, symptom severity, and period bleed length/volume, they are not the best tool for predicting ovulation or your fertile window. 

A recent study reviewed all the current apps on the market and concluded that the overall quality was low. These apps were found to be a highly inaccurate and an unreliable source of predicting ovulation for both conception and avoidance purposes. The variability between the apps was extremely high.   

One of the main reasons these apps are unreliable, is because everybody is unique and not all bodies work like the ‘textbook’ says it should. A 28 day cycle is perceived as ‘normal’ and it is assumed that ovulation happens on day 14 (2 weeks after day one of our period). However, this is not always the case. A ‘normal’ cycle can be anywhere between 21-35 days, which means ovulation does not happen on day 14 for all- Not all period apps are clever enough to identify and predict this. 

“Approximately only 10% of women ovulate on day 14 ”

If we assume everyone ovulates on day 14, the chance of disappointment when you don’t conceive or the risk of unplanned pregnancy is high. Say you are trying to conceive, and you ovulate on day 19 of your cycle (which can be common), if you were to have sex on day 14 the chance of pregnancy is low. Your period app could predict that you ovulate on day 19- but it is still only guessing. Basal body temperature tracking is the best way to know when you ovulate.  

If your period is late, it means that you ovulated late. There are a number of reasons that can cause ovulation to be delayed.

having a period does not always mean that you have ovulated. 

Anovulatory cycles are quite common. It appears as a ‘normal’ cycle, but it is not actually a complete cycle. You still have a period bleed, however, you do not ovulate or make hormones, such as progesterone that are stimulated by ovulation. Period apps cannot predict these anovulatory cycles. To determine anovulatory cycles, you need to track your basal body temperature (BBT)- you will know if you have had an anovulatory cycle if your temperature does not go up when ovulation should occur. 

On a ‘typical’ cycle, having a period usually means that you ovulated 10-16 days prior. But, as human beings, life happens, and there are unpredictable events that can change the way our body functions. There are things in life that just pop up, unexpected, not even we can predict, let alone a period app! Things like stress (mental and physical), illness, environmental factors, medications, poor diet (under-eating), are all factors that can delay or prevent ovulation. 

My favourite fertility tracker that I use myself & what I recommend for my clients is “TempDrop”.

It tracks your cycle PROPERLY, by measuring and tracking you BBT to enhance your chances of pregnancy or to help avoid pregnancy .

For 10% off, use this link .

All in all, knowing when you ovulate is a great tool to understand your body and your period… but using an app is not always the best tool. The app trend is still a positive thing- it is a part of the movement that makes period talk less taboo. Having a period app makes them feel more ‘normal’. Get on the next trend and start tracking your BBT to get to know your body even more.

References:

https://www.jogc.com/article/S1701-2163(19)30882-5/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27529/#:~:text=The%20assumptions%20are%2C%20however%2C%20outdated,before%20the%20onset%20of%20menses.&text=This%20is%20true%20even%20for,next%20menses%20in%20only%2010%25.

At school we were taught all the things about how not to get pregnant…

As Coach Carr from Mean Girls says “Don't have sex, because you will get pregnant and die!”

Obviously this is humour, but I feel like this is the narrative many of us had to live by until we got to the stage when we actually do want to have a baby. Yes, we learnt all about safe sex, which is all extremely important. However, we were never taught what to do when we want to fall pregnant. Or what to do when we can’t fall pregnant. Or why you can’t fall pregnant. 

So… Let's learn the basic fundamentals of fertility, the reasons why you might not be falling pregnant, why we should consider preconception and where to go if you are feeling lost.

There are many reasons why you might not be falling pregnant. Let me give you the rundown on the things you should consider even before you start thinking about having a baby.

1. Preconception Care

Preconception is all about optimising mum and dad’s health before conceiving!

Evidence shows that the preconception period is crucial for optimising mum and bub’s short and long-term health. Yet, in Australia, only 50% of pregnancies are planned.

For a mother's egg to develop and mature, it takes approximately three months. However, the health of a woman's egg and its genetic material is actually determined by the grandmother! Although we cannot change our grandmother's health, we can optimise the health of our own eggs by starting a preconception plan at least three months before conceiving.

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Preconception is not just about taking a prenatal vitamin.

Preconception includes optimising both yours AND your partners, physical and mental health. It’s about changing your lifestyle choices to become the healthiest parents you can be before bub arrives.

Not only does preconception put you in a better position to transition into parenthood, it has been shown to reduce miscarriages, preterm birth, and abnormal birth weight; improve the growth and brain development of the baby, reduce neural tube defects, reduce the chances of the offspring becoming obese and developing metabolic diseases, as well as, reduce the risk of postnatal depression.

Stress is another crucial factor to consider preconception. When we are stressed, our bodies are not in a stable position to procreate. Stress can be a major factor that can interfere with fertility. Read more about stress and preconception here.

2. Timing

After preconception care is taken care of, the next question is, do you know when you are ovulating, and are you having sex on the right day? Did you know females are only fertile for approximately 5-6 days a month? If you don’t know when you are ovulating or when you are fertile, please read about basal body temperature tracking here.

3. Do you have a hormonal imbalance?

Hormonal imbalances are one of the main causes of infertility for females. This can mean that the body is producing too much or not enough hormones and can't regulate and respond to them properly. Our hormones need to be in harmony for regular and efficient menstrual cycles. Without a happy cycle, we cannot ovulate, and we need to ovulate to make a baby.

There are many factors that can contribute to hormonal imbalances: poor diet, including over or under-eating, stress, some medications, drug/alcohol use, environmental toxins, poor sleep, dysfunctional thyroid, and other pathological conditions. However, is possible to treat hormonal imbalances with lifestyle changes.

Signs and symptoms of hormonal imbalance:

• Absent or irregular periods.

• Heavy or painful periods.

• Spotting between periods.

• Increased hair growth on the face, neck, chest, and back.

• PMS

• Unexplained weight gain or weight loss.

PCOS and anovulation are the most common causes of infertility in women and are both driven by hormonal imbalances. 

• PCOS- is a common hormonal condition that results in anovulatory cycles (no ovulation). PCOS is characterised by excess androgens (male hormones). Although PCOS is the most common hormonal condition in women, it can be treated and ovulation can return. Read more about PCOS here. 

• Hypothalamic amenorrhea (HA)- this is a condition where a menstrual period is missing for more than six months. It is generally caused by under-eating, where your body decides it doesn’t have enough nutrients to reproduce, so it shuts down ovulation. 

• Conditions and nutrient deficiencies that affect the thyroid gland can also contribute to imbalances between your reproductive hormones. Not only that, the thyroid is vital for maintaining a healthy pregnancy!

4. Have you recently come off the oral contraceptive pill? 

The next thing to consider is - did you stop taking the pill because you decided to have a baby? If so, following a preconception plan is even MORE important. Why?..

• The pill can mask hormonal imbalances and hormonal conditions like PCOS and HA. How many of you were put on the pill to “regulate” your period? If that is the case, it is likely that your cycle is still irregular and you may need treatment for PCOS or HA.

• The pill depletes the body from so many crucial nutrients, which are in even more demand during pregnancy. Getting your levels back up to optimal before you start thinking about conceiving is so important. Think about it.. If your body is depleted, then your growing baby takes everything you’ve got, imagine how you will feel postpartum. You can see how postpartum depression is so prevalent....

• The pill fills your body with synthetic hormones. It can take time for your body to clear these out and kick back into gear to produce your own hormones. Your hormones can be out of balance for some time, and it can take time before your body is regulating and making enough hormones for consistent menstrual cycles and ovulation. 

• The pill can alter the vaginal and gut microbiome. The health of the mother's microbiome is extremely important for healthy outcomes for bub - the mother's microbiome determines bub's microbiome. During birth, a mother's microbiome is passed on to the baby. An optimal microbiome should set bub up a robust immune system. The first step for a healthy microbiome is looking after your gut health. Improving gut health has been linked to successful pregnancy outcomes in those who were subfertile. 

Fertility is not easy for some. Understanding what is involved in conceiving before you spend thousands of dollars on IVF treatment could help you go a long way. 

I have created a step-by-step guide on how to optimise your fertility with easy, practical and proven implementations. If you would like to learn more, please click here. 

References: 

https://pubmed.ncbi.nlm.nih.gov/23852908/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012023/ 

https://www.jstage.jst.go.jp/article/jcbn/67/1/67_20-53/_article/-char/ja/ 

https://doi.org/10.3889/oamjms.2020.4569 

https://www1.racgp.org.au/ajgp/2018/july/preconception-care 

DOI - 10.26479/2018.0402.18

Do you ever wonder why sometimes you are jumping out of bed to exercise and eating all the vegetables, and then the next week you can’t drag yourself out of bed and want to stay at home eating chocolate in bed?

Well… it’s actually a normal part of your menstrual cycle!

Your menstrual cycle is a series of monthly body changes that are controlled by fluctuating female hormones. The menstrual cycle does not just include the week of the period, in fact, our hormones are changing everyday throughout our monthly cycle. Unlike men, who’s hormone cycle is within 24 hours, women’s hormones change every single day and can be the reason why we feel different each day - we cycle on a 28 day hormone cycle.

The female hormones can change our energy, mood, weight, strength, motivation, appetite, confidence and sleep. 

A typical cycle is around 28 days. However, anywhere between 26-32 days is considered normal. If your cycle length is outside of this - I would urge you to consider getting hormone testing completed.

The menstrual cycle is divided into 4 phases. I like to compare the phases of the menstrual cycle to the cycles of the weather: Winter, Spring, Summer and Autumn. Both the menstrual cycle and the weather cycle have a lot of amazing common features. For example, hibernation, growth, releasing, or slowing down.

For some, getting your period 'sucks'. The mood swings that come with fluctuating hormones, and the monthly bleed and pain all seems to be inconvenient and annoying. But did you know, with the right knowledge, you can use the menstrual cycle to your advantage! Each phase/season has its own super power! It doesn't have to be a burden, in fact, it can be a tool to better your health and help you get the most out of life!

WHAT ARE THE PHASES OF THE MENSTRUAL CYCLE & HOW CAN WE USE EACH SEASON TO ITS FULL POTENTIAL?

WINTER- PHASE 1 (day 1-6)

The first day of your period bleed (menstruation) is considered day 1 of the menstrual cycle- your period phase is referred to as the Winter phase. During this phase our female hormones are at their lowest, you may feel less energised and more introverted- it is a time to lean into your feminine energy. 

WINTER DO’S 

• Pamper yourself 

• Journal

• Spend time to connect with yourself 

• Rest and Reflect 

• Yoga/Gentle exercise 

• Warm nourishing meals 

• Hot teas 

• Warm epsom salt baths

WINTER DONT’S

• Big social events 

• HITT workouts 

• Strenuous cardio

• Work late 

• Overcommit yourself 
  
  

SPRING - PHASE 2 (day 7-13)

Spring is a time when your hormones are on the rise! Spring is also known as the Follicular Phase, which comes straight after menstruation. Follicular means that the follicles of the female egg are maturing, in preparation to be fertilised at ovulation. The rise of oestrogen and testosterone calls for an increased mood, brain power, and energy levels!

SPRING DO’S 

• Creative projects 

• Problem solve and make decisions 

• Social events 

• Lighter meals - your appetite may naturally decrease during this phase. 

• Strength training and high intensity exercise

• Sexy time 

• Show your confidence 

SUMMER- PHASE 3 (day 14-16) 

Summer is ovulation! This is the main event of the menstrual cycle! Ovulation is time for procreation, where the egg awaits for fertilisation to occur. During this phase you get a big spike in testosterone and oestrogen levels! These hormones make you feel sexy, glowing, high energy and confident! Ovulation you should be feeling your best - an even heightened effect of the feelings during spring.

SUMMER DO’S 

• Indulge in more sex and self pleasure: this is the time your body is designed to procreate- naturally, your libido will increase. 

• Socialise

• Network 

• Go on a date 

• Try something new

• Higher intensity exercise and strength training

AUTUMN - PHASE 4 (day 17-28)

Autumn is known as the Luteal Phase, it comes after ovulation. Ovulation is how you make progesterone, our dominant hormone during this phase. Progesterone has a main function of maintaining and nourishing a healthy pregnancy. If fertilisation occurs during ovulation, the Autumn phase is designed to prepare your body to grow a baby. Progesterone is used in the body as a natrual anti-depressant, natural pain relief, can help you feel cool, calm and collected & have amazing sleeps. If no fertilisation occurs, the cycle starts again. 

AUTUMN DO’S 

• To do lists 

• Potter around the house

• Wind down and reflect. 

• Less social events 

• Pilates, walking and slow exercises. 

• Lean into your intuition 

AUTUMN DON’TS

• Be afraid to eat more - your metabolism and energy requirements increase during this phase

• Big work projects 

• Strenuous exercise

TO RECAP:

• Winter, is menstruation, day 1-6

• Spring, is preparing the follicles/eggs for ovulation, day 7-14

• Summer, is ovulation, day 14-16

• Autumn, is the fall of oestrogen and rise of progesterone, day 17-28

The days above are approximates - if you have a shorter or longer cycle - these phases will be shorter or longer as well.

It is important to remember, that just because in certain phases of our cycles we may feel less energised or not in a bubbly mood - doesn't mean that conditions like depression or chronic fatigue are normal. There are many factors that can contribute to our mood and energy. However, being aware of what phase  we are in our cycle, may help us to feel more in control. Knowing why we might feel a certain way can help us feel less alone.

If you want to know more about the menstrual cycle, learn the changes that happen within your body and take advantage of the benefits even more- Check out my e-book and podcast below.

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Want to learn MORE about your menstrual cycle?

Here is a podcast episode I recorded all about living in synch with your menstrual cycle:

Research shows how important it is for both men and women to follow a preconception plan for fertility. Following a preconception plan has been linked to a healthier pregnancy, healthier bub & less risk of postnatal depression (for males and females).

Many people assume that when couples are struggling to conceive that it is the female who is having issues.

Studies have shown that up to 50% of infertility cases are linked to male sperm health (1)

Yet, there is less awareness of the need for male preconception and it is far more common for women to think about preconception than men.

Sperm takes approximately 60-80 days to develop and mature, in order to be ready for fertilisation.

Egg fertilisation can only occur if the sperm is healthy enough

Sperm needs to develop into the right shape, and have the capabilities to “swim” efficiently.  You must also be able to have and keep an erection, produce enough sperm, and have adequate semen.

The semen needs to be the right consistency in order to to be able to carry the sperm to the egg. During the development process, the sperm is extremely vulnerable and any problems during these steps can inhibit pregnancy.

Environmental toxins, nutrient deficiencies, and lifestyle factors can all affect the outcome of the sperm and semen quality. Damage to the sperm DNA can increase the risk of miscarriage and lack of ability for fertilisation of an egg (3).

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The main driver of poor sperm health is oxidative stress (5).

Why is oxidative stress so bad?

Oxidative stress is driven by our environment and almost every lifestyle choice we make every single day. It needs to be addressed in basically every male living a "modern day life."

Why should I or my partner get their semen assessed? 

Over the last 40 years, the quality of semen has declined by 50-60% (1). This is mainly due to our modern day unhealthy lifestyles increasing oxidative stress, as explained above.  The most important test for male fertility is a semen analysis. Knowing the health of the sperm, particularly the sperm's DNA, can give you more insight to your overall predictor of fertility and help direct what areas of your sperm need support (5).

The reference ranges shown on semen analysis reports are typically at the lowest acceptable range and usually indicate that IVF is required. The reference ranges have been taken from a large 2010 study by the world health organisation (WHO) (6). If you are looking at the analysis for ‘natural’ fertility, you ideally would want your semen results to reach the median range from the study. See below.

How can I improve my semen quality?

Many people on their unexplained infertility journey get told that "this is just how it is" and “it must be genetic". This is not always the case and there are many ways to address fertility and increase sperm production and sperm health.

Several studies have indicated a healthy, balanced diet, that is rich in omega-3 fatty acids, antioxidants and vitamins/minerals can improve semen quality and pregnancy outcomes. Diets high in processed meats, dairy, caffeine, and refined sugars were associated with poor semen quality and pregnancy outcomes (2).

For healthy, happy sperm you need lots of:

• Zinc

• Choline

• CoQ10

• Vitamin D

• B6

• Selenium

• Omega 3’s

• Alpha Lipoic Acid

If you would like support on your fertility journey and would like to know how to further improve your fertility and sperm health, or undertake a semen analysis test, please reach out.

1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291266/ 

2. https://www.sciencedirect.com/science/article/pii/S2090598X18300068 

3. https://pubmed.ncbi.nlm.nih.gov/30448091/ 

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602871/

5. https://pubmed.ncbi.nlm.nih.gov/24745838/ 

6. https://academic.oup.com/humupd/article/16/3/231/639175?login=false 

Are you and your partner considering having a baby? Have you thought about your preconception plan? In Australia, it is estimated that only 50% of pregnancies are planned.

There is a substantial amount of evidence showing that the preconception period is crucial for optimising mum and bubs short and long term health.

Of the 50% of pregnancies that are planned, many do not consider stress levels as an element of preconception care that needs optimising. 

Why should stress management be included in preconception care? 

By nature, our body's main aim is to procreate - but we need the conditions to be stable in order for this to happen.  When we are stressed our “flight or fight” mode is activated. Back in “caveman”/palaeolithic times, flight or fight mode was designed to help us run away from a tiger or attacking tribe. It increases  our adrenaline, our blood rushes towards the muscles to enable us to run faster, and it shuts down all other systems, like the reproductive system, which are not needed for survival. In today’s world the tiger is that email from your boss, or that never ending to do list, or the deadline to your project. Even though we might not think that these modern day stressors are as bad as running from a tiger, the same system is activated. If you are constantly being chased by a tiger (or constantly stressed about things) your body will go into survival mode. This means less blood flow and nutrients are available for the ovaries and testes and therefore, less nutrients available for healthy sperm and egg production and especially a risk for no ovulation occurring. 

When we are in fight or flight mode, along with adrenaline, cortisol is also released. High cortisol can suppress the immune system, digestive system and reproductive system. Not only does cortisol impair the functioning of our reproductive system, cortisol and progesterone are produced via the same pathway. Progesterone is our pregnancy hormone. It is needed to support and maintain a healthy pregnancy. Chronic stress  tells the body to make more cortisol, this comes at the expense of progesterone production. Remember, if we are running from a tiger we do not need progesterone to survive, but we do need cortisol. 

Not only is stress management important for optimising female hormones, studies have shown men with higher levels of stress to have a lower sperm count and lower sperm quality compared to those with "normal" stress levels.

A reduction of testosterone levels were also seen in those with higher stress levels.

Like progesterone, testosterone is produced via the same pathway as cortisol. 

Chronic activation of your stress response can also induce inflammation throughout the body. This further puts your body in a state that is not ready to procreate. 

During the COVID-19 pandemic a significant increase of psychological distress was seen across the world. An online survey was conducted of 1031 women and approximately 50% of them saw changes to their menstrual cycle. This is some substantial evidence of how stress can impact the female reproductive system. 

Stress is inevitable, particularly in today’s busy society. However, there are strategies that we can implement to help cope with stress. Stress management  is just as important as eating healthy. 

Here are some practical ways to manage stress: 

• Taking time for hobbies such as reading, listening to music, playing sport or watching your favourite show or movie

• Allowing time for relaxation every day  such as yoga, deep breathing, massage or meditation

• Getting enough sleep!! Have a regular sleep routine, aim for 8 hrs a night 

• Journal your daily thoughts, goals and gratitude

• Exercise daily 

• Learning to say no to things and people that don’t serve you

• Getting out in nature and grounding yourself 

• Encourage healthy relationships with friends and family 

• Setting boundaries around work commitments 

• Avoid managing your stress through alcohol, smoking or drugs 

• Limit to one coffee a day

Although stress is hard to escape, being able to cope with everyday stressors and learning how to down regulate your stress response is a crucial part of preconception care and optimal pregnancy outcomes. It is likely that your stress levels will increase once you transition to becoming a parent. Therefore, having the foundations of stress management down pat sets you up for the best transition to the next phase of your life. 

If you would like support on your fertility journey, or would like to know how to further support your fertility, please reach out. 

1. https://www.sciencedirect.com/science/article/pii/S2090598X18300068#b0520 

2. https://www1.racgp.org.au/ajgp/2018/july/preconception-care 

3. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

4. https://www.frontiersin.org/articles/10.3389/fendo.2021.642755/full?sp_sn=twitter&spclid=071676D2-8BE5-492D-8F98-4EA8D299A7E6#h11

I see people in my clinic with chronic low iron every single day. It can be debilitating and can be very frustrating when it is so difficult to increase iron levels.

Many of you reading this, at some stage of your life, have probably been told that you are low in iron.

It is very common to be low in iron, especially for women. But what does iron actually do?

Iron is an essential mineral needed for many bodily functions. “Essential mineral” means that we must obtain it from our diet. Without it, oxygen cannot be transported around the body leading to many symptoms, including fatigue. Iron is needed for energy production, but also growth, cell and hormone production and function, and brain development. Although low iron is very common, excess iron is just as troublesome, and can risk damage to body tissues. Which is why it’s super important to have iron testing done before supplementing.  

Why Do We Need Iron:

Iron is needed to make haemoglobin, a protein that carries oxygen in the red blood cells from the lungs to all organs and cells of the body. 

Iron is required for enzyme reactions in the body to produce hormones, amino acids, collagen and neurotransmitters (chemical messengers that influence mood).

Energy production: A reduction of oxygen to our cells leads to reduced energy levels 

DNA synthesis

How to know if you are low in iron?

Low iron can lead to anaemia, a condition where your body cannot make enough red blood cells. Anaemia develops once all your iron stores are depleted. Ferritin is what stores your iron and transferrin is what carries iron throughout the body. All can be measured on a blood test. The optimal reference range for ferritin is 80-100mcg.  It’s very common for me to see people with ferritin levels of under 20.

Signs and symptoms of iron-deficiency; 

• Fatigue 

• Lack of concentration 

• Pale skin 

• Headaches

• Weakness/Dizziness 

• Shortness of breath 

• Hair loss/ brittle nails 

Sources of iron

Iron in food comes in 2 forms, haem Iron and non-haem iron. Haem iron is found in animal products and is best absorbed. Non-haem iron is absorbed less efficiently and is found in plant-based foods. Because of this, vegetarians and vegans are at a higher risk of developing low iron. 

Food Sources:

Haem Iron - Beef, lamb, kangaroo, chicken and fish; liver meat is an excellent source - eg chicken liver. 

Non-Haem Iron - Dried beans, lentils, legumes, wholegrains, green leafy vegetables, dried apricots, potato with the skin on.

There are certain factors that can either enhance or inhibit iron absorption. 

Iron blockers: 

• Tannins, found in teas, coffee, wine, cocoa, and whole grains

• Fibre can bind to iron

• Oxalic acid, found in spinach, chard, beans and nuts. 

• Phytates, found in seeds, nuts, legumes, soy 

• Calcium and Zinc compete with iron for absorption in the gut. 

• Poor gut health can impair absorption 

ENHANCERS OF IRON: 

• Consuming vitamin C rich foods at the same time as iron rich foods can improve absorption (same goes for supplements)

  • Kiwi fruit, capsicum, cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower), berries, citrus fruits (squeeze lemon over your meal). 

• Activating your nuts and seeds or rinsing and cooking your legumes well, reduces phytates

• Cooking spinach reduces oxalic acid

Can you have too much Iron? 

Excess iron can be just as troublesome as low iron. The gut highly regulates how much iron is absorbed. However, a common hereditary disorder, haemochromatosis, compromises the body’s ability to regulate iron stores.  

Over supplement use, and frequent blood transfusions can affect the body's regulatory system.  Inflammation of iron-rich tissues (liver, lymphatic system & spleen, GI tract, muscle) or use of oestrogens/oral contraceptives can also cause iron excess.

Signs and symptoms of excess iron: 

• Constipation

• Nause &/or vomiting 

• Abdominal pain

• Weakness/Fatigue: This symptom is common in both high and low iron.  It is so important to take an iron supplement under the supervision of a practitioner

• Weight loss

You can get haemachromatosis gene tested which is a very important one if you have a family history of the condition.

Supplementing with iron: 

Supplementing is usually necessary for iron deficiency and if you have been low in iron you were most likely told to get an iron supplement from the chemist. Sure, but were you told what type or how often?

Did you know that not all supplements are the same quality and many supplements are not tolerated well by the gut? Iron supplements come in many forms. Some forms have common side effects, such as constipation, nausea, and vomiting. 

Iron bis-glycinate is more gentle on the gut compared to iron contained in products such as Ferrograd or Maltofer. Iron bis-glycinate is generally better tolerated compared to other forms (3). This is because it is in a chelated form, meaning, the digestive system does not need to break it down. Instead, it is passed directly through the stomach and small intestines and absorbed more efficiently with less gut upsets. 

Our bodies can only absorb approximately 25 mg of iron per day. It is more effective to supplement every second day rather than every day (1,2). A supplement containing 25 mg of iron bis-glycinate is ideal. A bigger bonus if the supplement contains vitamin C too. It is also important to take away from blockers mentioned above, especially, coffee/tea and supplements like calcium and zinc. 

Having insight in what to look for in a supplement should help avoid unwanted gastrointestinal upsets.

If you suspect you may be low, or high in Iron and would like some guidance, please reach out. 

Always consult health care practitioner before supplementing.

References

1. https://pubmed.ncbi.nlm.nih.gov/29032957/ 

2. https://pubmed.ncbi.nlm.nih.gov/31413088/

3. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-13-71#:~:text=compared%20the%20tolerability%20of%20ferrous,received%20ferrous%20sulfate%20%5B20%5D.

Your period is like your monthly report card- it’s your body’s way of telling you if something is out of whack.  So what does it mean if your period is missing?? There could be many reasons for this, a common condition is Hypothalamic Amenorrhea (HA). 

Hypothalamus = gland in brain that send message for ovulation 

Amenorrhea = absent periods 

Having regular healthy periods are a sign of good health and healthy ovulation. Without ovulation you cannot make a baby, nor can you make all the beautiful hormones that benefit our mood, hair, metabolism, skin, bones and heart health. When your hormones are in balance and harmony, you can have, and you should have, healthy, comfortable and pain-free periods. 

Hypothalamic Amenorrhea (HA) is a condition where a woman's menstrual period is missing for more than six months.

For a diagnosis, all other medical conditions that could possibly explain the lack of period must be ruled out - it is kind of like a process of elimination. If you have recently stopped taking the oral contraceptive pill, this could be why your period is missing - this is different to HA. 

Remember, the pill shuts down ovulation. It is common to take a few months, post-pill, before your brain relearns how to communicate with the ovaries again, in order to ovulate and have a period. 

HA is usually a sign that the body is going into survival mode - The body doesn’t feel safe and doesn’t feel capable of ovulating and bringing new life into the world. The main purpose of the reproductive cycle is to reproduce, right? The reproductive organs differ from other organs, like our heart, lungs and brain that are crucial for our survival. Although the reproductive system is super important, it is not essential to survive. 

What causes HA? 

HA is usually caused by under eating, high stress, and overexercising. When we are not nourishing our bodies with enough food, the body is very clever, and preserves those calories and nutrients for more crucial organs. If we are putting ourselves under too much pressure and stress, the brain is thinking… “Now is not the right time to make a baby, the body doesn’t have the nutrients or mental capacity to support a growing baby” So what does it do? It shuts down ovulation to prevent pregnancy and will present with a missing period. 

• The body cannot differentiate  between “good stress” and “bad stress”. It is all “stress”. When we exercise at a high intensity it is putting the body under stress. This is not always a bad thing… However, even if you are not “over exercising”, high intensity exercise can still be a contributing stressor in HA cases. 

• You can exercise - as long as you eat enough!

What are the symptoms of Hypothalamic Amenorrhea?

The most obvious symptom of HA is a missing period. But there are other symptoms that are less obvious such as: 

• low libido

• increased bone loss

• mood changes

• low energy

• thinned uterine lining 

• most of these are due to low oestrogen

Some women with HA have polycystic ovaries, this does not always mean they have the syndrome PCOS. 

It is common for women to be misdiagnosed with PCOS when they have HA because of many similarities between the symptoms. It is important to understand why your period is missing, to get the right diagnosis, to direct the right treatment. 

HA treatment is generally to eat more food. Whereas, PCOS treatment can often involve managing testosterone and insulin levels. You can see why it is pretty important to get the right treatment? Read more on the different types of PCOS here.

Testing: 

If you lost your period to under eating which has caused HA, you likely will have one or more of the following signs:

• no withdrawal bleed from the pill

• low fasting insulin (less than 4 mIU/L or 25 pmol/L)

• low ratio of luteinising hormone (LH) compared to follicle-stimulating hormone (FSH)

So: Are you eating enough to get a period? 

If you were my patient, I would ask you “Do you feel like you are getting enough to eat? For example, yesterday - did you feel satisfied with your food?” 

You need to be eating a combination of fats, proteins AND carbs to have a balanced intake to support your hormones.

Remember: 

Going on hormonal birth control is not an effective treatment for HA because a bleed on the pill is not a real period.

If you are still confused as to why your period is missing, it is important to get the right support to help you to receive the correct diagnosis and treatment. 

If you’re scared by the idea of eating more, please reach out for help to discuss whether you may have an eating disorder. Eating disorders are common and are nothing to be ashamed of - approaching your eating with self-love and self-forgiveness, and know you’re not alone.

Please reach out to me for more help to get your menstrual cycle sorted.

Book a free assessment here

Polycystic ovarian syndrome (PCOS) is a common hormonal condition. The symptoms of PCOS are related to anovulatory cycles (no ovulation) and androgen excess (high levels of male hormones, such as testosterone). The main symptom of PCOS is irregular periods, due to the lack of ovulation. No ovulation can result in an overproduction of androgens which is what can drive other common symptoms, such as; excessive body hair, acne, weight gain (especially around the belly), and hair loss on the scalp. There are 4 types of PCOS, and insulin resistance PCOS is the most common type.

If you have PCOS it is likely that you are insulin resistant. Approx 80% of women with PCOS are (1).  

What is insulin resistance? 

Insulin is a hormone that regulates blood sugars - it helps your body utilise sugar for energy. Insulin is released by the body in response to glucose (sugar) - it takes the glucose out of the bloodstream and  into the cells to be used as energy. Our brains and muscles rely on glucose to function, so it is important that glucose is utilised properly.  Insulin is basically a messenger telling the cells to open a door to allow glucose to enter. Insulin resistance is a hormonal condition where you have too much insulin. Having too much insulin, or being resistant to insulin means that the cell doesn’t allow glucose in. This results in more sugar remaining in the bloodstream, as well as too much insulin circulating.

Too much insulin can disrupt ovulation and cause the ovaries to make testosterone instead of oestrogen - this is what drives insulin resistant PCOS. 

You can have normal blood sugars, and still have too much insulin. The best way to determine if you are insulin resistant is to do a blood test measuring insulin not glucose. High insulin is what can cause high androgens and high androgens is what drives PCOS symptoms. Insulin resistance can be caused by genetic, environmental and lifestyle factors. Too much sugar can induce insulin resistance. Being overweight can exacerbate insulin resistance. However, PCOS can occur in women of any weight. Many women who are insulin resistant are within healthy weight ranges. Nonetheless, being overweight can worsen insulin resistance, and women with PCOS are at a greater risk of being overweight. Excess weight can increase the hormones involved in PCOS. 

The good news is, insulin resistance can be reversed through lifestyle changes, particularly diet, and can improve the symptoms of PCOS. 

I like to think that food can serve as medicine for the treatment of insulin resistant PCOS. In fact, I predominantly treat my PCOS patients through food and dietary changes to manage blood sugar levels. Several studies have shown diet to be an effective method for managing insulin resistant PCOS (2,3,4). Additionally, nutritional therapy using inositol has been shown to have similar effects as metformin (5,6). Metformin is the first line medication therapy for those with insulin resistance in a mainstream medical model of treatment, however it has side effects that the natural supplement inositol does not (5,6).    

So how do we use the diet to manage insulin resistance and support PCOS? 

The main driver of insulin resistance is sugar. Carbohydrates are essentially sugar; however, this does not mean we have to completely avoid all carbs. Our bodies do need some carbohydrates to function. Carbohydrates are found in many healthy foods, such as vegetables. The main aim is to slow down the release of carbohydrate/sugar after consuming a meal. By slowing down the release of sugar, it prevents rapid spikes in your blood sugars. This means your insulin can keep up with the demand of the sugar that enters your bloodstream; and therefore, reduces the amount of sugars circulating. There are many ways we can help slow the release of sugar. We can also re-sensitise insulin and enhance its ability to utilise sugar as energy: 

• Avoid high sugar food and drinks; especially, sugary drinks, deserts, cakes and biscuits. If you have insulin resistance, unfortunately your hormones will struggle to handle any high sugar foods. These foods also tend to not satisfy our fullness cues, and can lead us to keep coming back for more. 
  

• Reduce carbohydrates and especially avoid refined carbohydrates; breads, pasta, pastry, cereals and any processed foods. Lowering carb intake can help manage insulin levels and blood sugars. As mentioned, our bodies still need some carbohydrates. I like to aim for 20% of the diet to be made up of complex carbohydrates, like a diverse range of seasonal vegetables. Getting the right balance of macronutrients is fundamental for managing PCOS. 
  

• Consuming adequate fat and protein at every meal is particularly important for managing blood sugar levels. Fat and protein help you to feel satisfied and full. They also allow for a slower release of sugars to improve insulin sensitivity. Fibre can also slow the release of sugars. An approximate guide for a macronutrient balanced diet for insulin resistant PCOS is  40% fat, 40% protein and 20% carbs. With my clients I aim for 5 tablespoons of healthy fats every day. Some of my favourite healthy fats to include into your diet: 

  • Wild caught fatty fish - Salmon, sardines, tuna

  • Eggs

  • Extra Virgin Olive Oil 

  • Coconut Oil

  • Avocado 

  • Ghee

  • Grass fed butter

  • Nuts and nut butters

  • Seeds - pumpkin, sesame, hemp, chia, flaxseed, sunflower

  • Seed butters - tahini 

• Add Cinnamon to your diet. Cinnamon has properties that can enhance insulin’s actions and increase insulin sensitivity (7). Studies have shown cinnamon to significantly reduce fasting insulin and insulin resistance in women with PCOS (8). Additionally, there has been some promising research to show cinnamon can help regulate menstrual cycles in PCOS women who have irregular periods (9). 

How to add cinnamon into your diet: 

• Add a sprinkle to your breakfast

• Sprinkle on your roast vegetables 

• Add to smoothies and baked goods 

• Have cinnamon tea. I love the Pukka brand licorice and cinnamon tea. Licorice also has effects on PCOS as it can lower testosterone in women.

Other lifestyle considerations to improve insulin sensitivity and PCOS: 

1. Exercise: Moving your muscles requires glucose and can manage insulin sensitivity (12). Exercise also supports healthy weight management which we have learnt is important for those with insulin resistance. 

2. Prioritise sleep! Quality sleep is a way of maintaining healthy insulin. Additionally, your circadian rhythm AKA body clock, has a role in regulating glucose,  energy expenditure and insulin sensitivity (13). To regulate your circadian rhythm it is important to have natural light exposure in the morning and dimmed light in the evening- turn off your devices an hour before bed. Having a regular bedtime routine and regulated eating patterns can also help (13). Read more about sleep hygiene to manage hormones here.

3. Consider supplements that support insulin sensitivity:

• Magnesium supplementation has been shown to improve insulin sensitivity. Additionally, low levels of magnesium have been associated with insulin resistance risk (10). 

• Myo-inositol: Inositol is a messenger for insulin and studies show supplementation can improve insulin sensitivity and reduce circulating insulin (11). 

Many people think that the only treatment for those with PCOS is to lose weight and go on metformin. However, as we have seen there are many natural treatments that actually work to treat insulin resistant PCOS. Although weight management can help improve insulin resistance, it is not the be all and end all. Supporting your diet to manage blood sugar levels is an effective treatment strategy for insulin resistant PCOS. If you would like to learn more about fixing your PCOS check out my online course ‘fix your PCOS’. 

References

1. https://www.ndss.com.au/about-diabetes/resources/find-a-resource/polycystic-ovary-syndrome-fact-sheet/#:~:text=Up%20to%2080%25%20of%20women,to%20manage%20blood%20glucose%20levels.  

2.  https://pubmed.ncbi.nlm.nih.gov/32621748/  

3.  https://pubmed.ncbi.nlm.nih.gov/34820542/ 

4.  https://doi.org/10.1210/clinem/dgaa425 

5. doi.10.1097/01.EBX.0000466599.33293.cf  

6.  https://pubmed.ncbi.nlm.nih.gov/30614282/ 

7. ​​ https://jpma.org.pk/PdfDownload/10230

8.  DOI: 10.1002/ptr.5970

9.  https://pubmed.ncbi.nlm.nih.gov/24813595/

10.   https://pubmed.ncbi.nlm.nih.gov/26404370/ 

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655679/

12. https://academic.oup.com/edrv/advance-article/doi/10.1210/endrev/bnab038/6420158?login=false#324896513 

13. https://pubmed.ncbi.nlm.nih.gov/30531917/