Ep. 194: Crafting your Women's Health Dream Team, with Chiara Estes

When it comes to women's health, why could you possibly need more than an OBGYN?? Well, there are a few reasons! In today's episode, I sit down with Registered Dietitian and Woven friend, Chiara Estes (no relation), to discuss the importance of your own personal "dream team" when addressing your reproductive health as a whole. We even talk through several mutual clients and how our different specialties worked together to provide demonstrable change for them. This episode was FUN and I think you'll enjoy the behind-the-scenes look at women's health from a broader, more empowering perspective.

NOTE: This episode is appropriate for all audiences.

GUEST BIO: Chiara Estes is a faithful Catholic, wife, mama, and Registered Dietitian who is passionate about fertility awareness and women's health.

OTHER HELPFUL EPISODES:

Ep. 57: Why & How Gut Health Affects Fertility, with Chiara Estes, R.D.

Ep. 113: Inflammation's Impact on Women's Health & Fertility, with Chiara Estes, R.D.

Ep. 2: BASICS - Fertility Method of Choice: Creighton

Transcript

Caitlin (00:25)
Welcome back to the Woven Well podcast. I will often tell women that they can craft their dream team to help them on their women's health journey, regardless of their goal. So if you're trying to regulate your periods and improve your health or trying to conceive after years of infertility, you will really benefit from having a team of cheerleaders and supporters who are focused on your success and thriving. One person can't usually do everything or at least not do everything well.

So you may have a fertility educator like myself, you may have a gynecologist and a counselor and a registered dietitian, each offering something worthwhile and unique that works together to help you toward your goal of health. Well, after working in this space for more than eight years, I've made a lot of relationships with some pretty fantastic people in all of those categories. And it really is a joy to get to celebrate the wins in the lives of women who we support. So...

Today I've invited a lovely colleague and fellow cheerleader of women, Chiara Estes, to join me to talk about how our services, when combined, have served women so well in the past. So we're going to talk about some specific cases that we've shared over the years. And I don't know, I'm just, really excited about it. So Chiara, welcome back to the show.

Chiara Estes (01:41)
Hello, I'm so happy to be back to talk about this important topic.

Caitlin (01:45)
Me too. Now you've been on the show before talking about things like gut health and inflammation because you are registered dietitian and so we'll make sure to link those episodes in the show notes. But today we're going to talk about how we have worked together to serve women. And personally, I love it when one of my clients reaches out to you because I know that they're going to have great support and I know that they're going to have a better experience with Creighton, honestly, a better experience with cycle charting and working towards women's health when they have that nutritional component too. It's really a game changer.

Chiara Estes (02:19)
Yeah, and I could say the same thing, right? Like I always get, I'll have the applications that come in and obviously I don't only accept clients who are Napro and Creighton trained, but when I get an application, I do ask like, do you chart your cycle in any way? And when they write Creighton there, I'm like, yes. Mostly because then I know that that deep understanding of their cycle is already there. And so then I know when I do talk to them while,

I don't have, I'm not claiming to be an FCP and have like that deep knowledge, but I do know because I chart it personally for what, eight or nine years now. And from what I've learned from many of the FCPs like yourself, that they're going to come into the sessions with this depth of knowledge about their cycle. And so then I know like, if I ask them, what is your cervical mucus like? It's not, it's going to be an actual answer, an actual answer that has a lot of detail. Like I know they're going to say detail or they don't even have to tell me honestly, because I can just look at their chart too. So it does, I know that the depth of knowledge about their cycle is there. And then just the convenience of, okay, well I know they can just show me their charts and I can see what's going on without having to ask too too many questions and that's not always the case with every single client that I have.

Caitlin (03:42)
Yeah, that's such a good point because I will talk to women sometimes who are kind of feeling out whether or not Creighton is right for them. And they'll say, well, I already chart my cervical mucus when what it really is, is they have an app and it says, do you see mucus? Yes or no, you know, or something really basic like that. But there is so much more to it that you can learn. And, you know, like you're saying with your personal experience, you could actually just look at their chart and already know a lot of information, which is very helpful. And I feel the same way when somebody comes to me and they're either already working with you or I recommend you and they reach out to you and start working with you because gosh, nutrition is the foundation for so much of our health and wellness. And most of us know very little about it. I think about the education I got about nutrition and diet and what to eat as a kid and it was minimal. It was really minimal. Like maybe eat fewer sweets and that's maybe it. But we don't learn about how what we eat actually impacts our ability to think well, feel well, live well. And so much of what you do is focused on serving women in the reproductive years. And of course, that's who I'm serving as well.

⁓ And so you know the importance of reproductive hormones and really nourishing those ways to do that and how nutrition can impact it specifically, which is super valuable. And like I said, your experience working with Creighton yourself and working with so many Creighton clients over the years is I also know when I do refer someone to you. know that they're in very capable hands and they're going to feel comfortable too. It's one less place where they have to go and explain, I'm doing this thing. It's called the Creighton model system. It looks at cervical mucus and have somebody look at them like, I've never heard of that before. You have heard of it. You know about it and you actually can utilize it as they're working with you as a registered dietitian. So there's a lot of benefits there.

But we have worked with several clients recently that I mean, I was thrilled when they reached out to you, but then to see the results of the teamwork here, working with both of us at the same time, I've just been like blown away with how beneficial it is. And I really would love a lot of more of my clients to do this. So I thought maybe we could talk about some of those specific situations.

But we have a mutual client that she had been charting with me for a while. She charted with me for a couple of years and then took some time off to have a few children and then began working with me again. And just looking at her chart initially, we saw a lot of hormonal issues. We were seeing limited mucus, which means there's not a lot of cervical mucus showing up on the chart. Not much of that peak type mucus or really like high quality, great mucus that we associate with a really fertile time and high estrogen. And I recommended that she reach out to you and start working with you. And within, I don't remember, you may remember maybe it was two months, something like that. She came back to me and her chart was totally transformed. I mean it looked like night and day. So I would love us to start there and talk about that situation a little bit.

Chiara Estes (06:51)
Yeah, and she was a fun client to work with in that she was very into health to begin with. I would say her depth of knowledge about nutrition is probably above average. She was one of those women who was very into fitness, very into nutrition. And so she's like, I don't understand. I'm doing all of the things that everybody tells me is healthy. I eat clean. I love to run. And she didn't understand why this wasn't adding up to having healthy hormones too. And so she is a type of woman that is more common than you think, the type of woman who is from the outside doing everything right. But then in her case, working out and running was something that was very important to her.

And so those women who are very active, when I see something like limited mucus on a chart limited mucus is a reflection of low hormones, it makes me wonder, are we really compensating enough for this amount of activity? And so then, you you could be eating all of the clean things. You could be eating all of the vegetables. You could be exercising. But at the end of the day, if your body is saying, I am not getting enough back in return to do all these things, it's going to start shutting off the unnecessary things. And then unfortunately, our reproductive hormones is one of those.

And so a lot of what we did with her, because the running and the exercise was very important to her for her mental health, then she just enjoyed it. you know, if something is important to a client, it's important to me too. I just, I don't want to tell somebody, stop running. Well, you could do that if it's something that's important to her. didn't want to say to stop. And so then it became, well, we need to figure out how much we need to be eating in order to be adequately compensating for this running, because she was having symptoms the days that she was running that were very different than the symptoms of days that she was not running. So it was telling me it's the level of activity that is the underlying stressor here, or I guess not the activity itself, but not adequately compensating for it energy-wise. And so we really pushed the amount of calories.

Caitlin (09:12)
Yeah, think you doubled it.

Chiara Estes (09:13)
Doubled it probably usually I will have them do a food vlog so I can kind of get an idea of what their baseline is And then go from there because unless we know what your baseline energy is. It's all an estimation But once we know that I can say, okay. Yeah, you're definitely not eating enough for the amount of working out that you're doing and the lifestyle. Like she had two young kids too. And so that's a different lifestyle in and of itself because of the stress and energy that comes along with taking care of two young kiddos on top of being an active person.

Caitlin (09:49)
Absolutely. And I so appreciate how individualized your approach is. And that I think it matches so well with the Creighton version of cycle charting, because we're looking at all the details. A lot of times we want to think about cycles in really generic terms, you know, like, my cycles are regular or quote unquote irregular, you know, those kinds of things. It's like, no, each cycle is different and unique. And you take that approach as well and you're looking at the individual hormones, but you're also looking at the individual person. And so I really appreciate the fact that when she came in to work with you, you didn't say, well, you need to cut out the running. You know, I mean, you said, no, I hear you. That's really valuable to you. It matters for your mental health. We're going to keep that, but we do need to adjust for this activity that you have and it transformed her chart. I mean she came back in a few months later, I don't remember exactly how many, but it was like it came to life. I just think about like a garden suddenly growing and there was beautiful cervical mucus and it came right when we expected it to. Some of those symptoms that you were talking about that would come and go when she would be running

We weren't noticing those as much and I was asking her, know, how do you feel? she's like, I feel great. I feel energized. I feel just really good. And, you know, we could see that something was off in the chart and we could even narrow it down to, okay, it's affecting the reproductive hormones, but we couldn't know on our own that it was going to be the need for more calorie intake or things like that.

And you may have done more than just double our calories. It could have also been specific to protein and fats and those kinds of things. But I really just appreciate that take on it and being able to take it to the next level and really address that underlying need. So we had a second client as well that we've worked with. And this one was a little bit different. The second client, she discovered through working with a napro technology physician, so someone trained in restorative reproductive medicine, that she had insulin resistance. So she partnered with you to get insulin resistance support specifically, like focus on her blood sugar or glucose and insulin. And she was really curious about what to eat, very motivated by that aspect of things and how to make lifestyle changes and then we're using her chart to actually see how those changes are going to play out. So for a little bit of context for people who may not be as familiar with this but insulin resistance can often actually show up on a Creighton chart. A lot of underlying health issues can show up on a Creighton chart. It doesn't have to be reproductive specific. There are others that show up as well. So someone with insulin resistance or glucose issues of any kind, maybe more likely to have longer cycles ovulate later within the cycle, often past cycle day 16. it could also be that they have an abundant cervical mucus. So they have it more than just during that window of fertility when the estrogen is rising and you would expect to see cervical mucus. So maybe in the time after her period leading up to that, or even after ovulation through the rest of her cycle, she may be seeing this extra cervical mucus. And it's coming from the fact that insulin is playing such an aggressive role on the ovaries themselves. The ovaries that don't quite have as much protection from that excess insulin as other parts of the body do. And so, the ovaries which are responsible for reproductive hormones are then kind of kicking it into high gear and you're seeing a bunch of this extra cervical mucus show up. So as she's working with you to treat those underlying health issues, we're looking at the chart to see how effective that is and you know what improvements or struggles she's experiencing. What was your experience with her like?

Chiara Estes (13:55)
hers was interesting. She was very open to also adding in other forms of testing via stool testing, which was actually very, it turned out to be very insightful for her blood sugars and insulin issues. And then she was also very open to wearing a continuous glucose monitor so it could really fine tune.

where are the actual problems during the day? Because when there are insulin and blood sugar issues, it's generally not the entire day that's the problem. There's usually a specific time of day or a specific meal or specific circumstances that tend to cause more issues than others. And so with her, we ended up running a GI map stool test and...

One of the things that came back was a low amount of a good bacteria that is actually tied to insulin resistance and type 2 diabetes. People who have low amounts of this one are more predisposed to insulin resistance and blood sugar issues. And so we did some gut support to help balance that out a bit better. And so that likely helped.

Caitlin (14:49)
Hmm.

Chiara Estes (15:02)
⁓ But then also looking at her CGM data, we were able to see which meals had the biggest issue. And what was interesting with her was her blood sugars were very responsive to her emotions during the workday. So it was like lunchtime was the problem time because not necessarily 100 % because of what she was eating. While we obviously work with that, you know, like let's lower the carbohydrates or switch the types of carbohydrates we're choosing to ones that you tolerate better blood sugar wise. But then also really focusing on her behaviors around lunchtime so that she was entering into lunch more calm, less anxious because her blood sugars did really seem to react to her emotions very strongly. And so once we addressed her meals and her guts, and her emotions during the day, not that we can control the stress around us, but we can control how we respond to it. And if you know that you don't respond well to stress or your body responds dramatically, but sugar-wise to stress, then you can really focus on that.

I believe she started ovulating much earlier than before, right?

Caitlin (16:09)
Yeah, absolutely. I mean, you can you could tell the change on her chart as well. And that's what I so appreciate people so appreciate about people working with you is that I know that you care just as much about their mind and their soul as much as their food and their body, you know, that you really are looking at them as a full person and wanting to care and nourish for that full person. So

fact that it wasn't just about the food that she ate, but the way in which she ate the food, know, the calm around her and her mindset and the settling of her spirit and those kind of things too. I mean that that matters. That's important and I am a big fan of medicine and physicians and the modern options that we have out there. I'm very grateful to live in the time that we live, but at the same time we don't always want just medications and surgery as the only options. When you have something like insulin resistance or something like low hormones, it's great to have those, but also obviously just working with a registered dietitian who is knowledgeable about how the body works and how to fuel it and nourish it can make such a difference and maybe prevent them from having to be on more medications than they need to or undergoing a surgery or anything else.

I really value what you do and I'm really grateful for the opportunity to team up with you on some of these client cases.

Chiara Estes (17:38)
Yes, me too.

Caitlin (17:39)
Well, thanks so much for being with us, Kira, and sharing all of this. I'll make sure to have the previous episodes that you had with us linked in the show notes ⁓ as well so others can get connected with you too.

Chiara Estes (17:51)
Great, thank you so much for having me.

Caitlin (17:52)
Listeners, I hope this has been an insightful episode to help you see how beneficial it can be to have a team helping you. And in my kind of dream scenario, it would be a team that knows one another and we're like minded and we know how to actually work together for your good. But we are your cheerleaders. I want you to know, I think I can speak for myself and for Chiara. We want to see you successful. We want to see you feeling healthy.

⁓ And it is a joy and an honor to get to be a part of your team. So as always, thanks for listening as we continue to explore together what it means to be Woven Well.