Abundance, Not Restriction: A Refreshing Take on Food and Pelvic Health

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Learn more about my guest here:

Instagram: https://www.instagram.com/alexisbrooksnutrition/

Tiktok: https://www.tiktok.com/@alexisbrooksnutrition

Website:  www.alexisbrooksnutrition.com/book-a-call

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Transcript

Lindsey: New and seasoned OTs are finding their calling in pelvic health. After all, what's more ADL than sex, peeing, and poop? But here's the question. What does it take to become a successful, fulfilled, and thriving OT in pelvic health? How do you go from beginner to seasoned and everything in between? Those are the questions, and this podcast will give you the answers.

We are inspired OTs. We are out of the box OTs. We are pelvic health OTs. I'm your host, Lindsay Vestal, and welcome to the OTs in Pelvic Health Podcast.

Lindsey: Alexis, thank you so much for being a guest on the OTs for Pelvic Health Podcast. I am so excited to roll up our sleeves on all things nutrition and women's health and hormonal health and all the things that I'm fascinated with. So thank you for being here. 

Alexis: Thank you for having me.

Lindsey: Yeah, I'd love to just kind of get us started with a really basic question because I'd love to learn a little bit more about you, which is what are some of the things that led you to specialize in hormonal health, particularly around menstrual cycles and pelvic conditions like endometriosis? 

Alexis: It definitely came from a personal experience. I was diagnosed with endometriosis in 2021. Always had an interesting relationship with my period, my menstrual cycle, I guess, as a whole, but didn't fully understand what that meant until, I guess, relatively recent, probably 2019, 2020 is when I really started studying the menstrual cycle and understanding like, oh, you know what, there's a name for what I'm experiencing. I likely have endometriosis, and that's when I dove deeper in all those things.

But in my research, I was able to see that there's so many other women who are experiencing the same things as me. And some of them had endo, others had PCOS, others maybe it was fibroids or something else. But it really struck me how many women were experiencing these things, these hormonal imbalances or like beyond hormonal imbalances, and how little information there was out there, how little support there was.

When I was in the thick of it, I just kept telling myself, like, once I figure this out, once I get to the other side, I'm going to tell everybody about it. So that's what really drove me into it. 

Lindsey: And so that's where we're at, right? Because we're talking that was four or five years ago, and now this is your life's work.

Alexis: I mean, you're making it happen. I am. And it's really exciting to think of that, because you're right, it has been a minute now since then. And I have moved to the other side where I would consider myself in remission. Like, I don't experience any of the symptoms that I was dealing with before. And I had a really long list.

I actually had a doctor who said, just because you have a laundry list of symptoms doesn't mean you have endometriosis. So I had a laundry list of symptoms, but I don't have them anymore. But I'm really happy to be able to serve women who are in the place that I used to be in, or a similar place.

Lindsey: Oh, yeah. I couldn't agree with you more. And I think that's incredible. Alexis, how would you describe the connection between nutrition and conditions like endo, right? Painful periods, pelvic pain, things that we know are common, but people just aren't talking about enough.

Alexis: Yeah, I feel like a lot of people don't even know there is a connection. A lot of people see these things as fully different entities, that there's my hormones, or maybe they're not even fully clear on what that means.

There's the food that I eat, and then I have this pain. They're not necessarily putting these connections together. But the reality is that nutrition is powerful for all things.

It is the raw material of what our body uses for our immune system, for our hormone production, for enzyme production, for brain health, gut health, all the things. So there's no way that wouldn't also connect these pieces too. So we can, because nutrition plays a role in that, it could actually work both ways.

So depending on what we're eating, what we're choosing, it could create more pain or more hormonal imbalance, or it could do the opposite. It can begin to help to balance things. It can help to improve our gut health, our immune system, reduce inflammation, which that's usually the underlying piece when it comes to pelvic pain or chronic pain in general.

Lindsey: Some of the advice that we hear most commonly out there, especially as regards to gut health, is to avoid certain foods. And whether that's the most common foods that people talk about, dairy, soy, et cetera, or maybe some of our clients have actually gone and gotten food tested. And so when it lights up like that for them on an allergy test, or they're avoiding the most common culprits out there, I feel like that's pretty common advice, but I think you have a very different take on that. And I find it really refreshing and I'd love if you could share it with us.

Alexis: Sure. Yeah.

So I feel like food sensitivity tests, they can be a helpful tool to kind of give us an idea of what's going on. But I think what they often miss is the underlying reason of why it's lighting up. So say all of a sudden we take a test and it shows that maybe eggs are there and tomatoes and strawberries or something like that.

And the advice would be like, okay, well, those things are irritating your gut. Those things are, you're sensitive to them, so remove them. So yes, that's true.

That could help in the short term, but it's not actually addressing the problem. You didn't just all of a sudden become sensitive to these foods. There's a reason why you did.

And usually what's going on is there's something going on with the permeability of your guts, like your intestinal lining. Maybe there's something wrong where those foods were able to slip through those foods. And also like larger particles are able to go into the bloodstream too early.

Food is eventually supposed to get it, or the nutrients I should say is eventually supposed to get into your bloodstream, but not when the food isn't fully digested. But when that happens, when it slips through our immune system activates because that's not normal, that's not supposed to happen. So then it is tagging those specific foods as a problem, as an invader.

And then we begin to react to those foods every single time. So if we remove those foods, like those foods won't be reactive anymore. But if we're not actually addressing what's going on with the gut health, we're going to keep on tagging more foods, and we're going to keep on removing more foods, and we're going to end up with a diet of five foods.

And our gut health is going to be worse off because the less diverse your diet is, the less diverse your gut bacteria is. So it's going to be a problem that just compounds on itself. So I don't recommend just stopping there, we'll say.

We take that test, you see those foods, but also think of like, okay, but what else can I do? Like maybe I'll remove those foods to feel a little bit better. But let me continue on this journey to fully heal from that.

Lindsey: What is next? I was so fascinated when I've heard you talk about this because it seems to be what people assume is going to be the thing that solves their problem, right? Oh, I just removed this.

And as you said, it's a slippery slope. Now all of a sudden, instead of just three foods, we're removing seven. And as you said so eloquently, like our diversity of nutrition really goes down.

So how else should our clients be looking at this?

Alexis: Yeah. So a lot of times it does mean also like feeling the gut. So if that is true, what's happening, like the leaky gut or intestinal permeability, sealing the gut.

So there are specific things. L-glutamine is one, bone broth, collagen. Those are some things that can help too.

I don't know if I mentioned Olivera, it's another one, zinc carnosine, but basically those are things that help to repair the gut. If there's an imbalance, like gut bacteria might mean that we're choosing a certain probiotic to help out with supporting that balance. It might also mean that we are adjusting lifestyle too.

So how we live our lives also impact our gut health too. So the outside environment impacts inside environment. So making sure that our sleep hygiene is good, making sure that our eating hygiene is good, which I think this isn't talked about a ton, but it's not always about what we're eating.

It's also how we're eating. So are we eating in a rush state? Are we eating while we're driving, while we're running out the door? Are we eating standing up? Do we have a designated space to eat, or do we have our desk where we're working at and doing something more stressful or active, and then just eating next to it? All of these things will impact our gut health too, because there's a gut-brain access where the brain and the gut are always speaking to each other. And if we're not in a restful state while we're eating, we're not even able to digest fully.

So those are some things that we can begin to do to support the gut.

Lindsey: I love that. That makes so much sense.

Even taking a step outside of just this one area of leaky gut and gut permeability, what are some other big nutrition myths that you see people with pelvic pain or other conditions having? 

Alexis:I think a lot of times, I guess this is a similar realm, but not specific to the gut, but a lot of times people think about removing. They think about removing more than adding. So they may see the list, maybe the list that you mentioned earlier.

It's the dairy. It's the gluten, maybe. We're thinking about what food is it that's causing this thing? Let me remove it out, instead of thinking about, well, what can I add that is anti-inflammatory? What can I begin to add to make my diet more diverse? Because pretty much, I don't think I've ever met anybody who couldn't use a little bit more diversity to their diet.

Everyone, even myself, we can always use that. It's something we have to keep in the forefront because it does require attention. What about we add some omega-rich foods like fatty fish, or maybe we take it as a supplement, or turmeric or ginger.

Those are really well-studied things to help to reduce inflammation, to help to relieve pain. Thinking about antioxidants, like what's the veggie department going like? A lot of times we can use a lot more veggies. I think that's the common myth of remove, remove, remove, versus creating a sense of abundance.

Lindsey: That's exactly the word I was thinking when you started talking about that. Just as someone who, I've had my own gut health issues, and definitely my clients. It's one of those things where definitely removal and limitations are some more guiding principles.

I don't know about you, but if I feel limited in anything, it affects my mental health. It affects my ability to really feel like I could fully participate and be engaged. I have to say, I just love hearing you talk about this because to think about it as actually it's our call to action to include more foods and to diversify, to really complete our nutritional profile, I feel like is really refreshing and just not talked about enough.

I love that approach.

Alexis: Thank you. We get to have our favorite foods.

That's another one too. People are like, let me remove all my favorite things I enjoy, but no, you can still enjoy a lot of the foods that you enjoy. Sometimes something may change about it, like the frequency, for example, or certain aspects of it, but I'm someone who likes to include as many foods as possible in the diet.

Lindsey: It makes so much sense. Alexis, with your years of working with clients, how do you really help clients understand the gut hormone pelvic floor connection? What are some simple go-to things that you do to help clients connect those dots?

Alexis: I would say oftentimes an easy way for people to understand it or to maybe visualize it is to connect it to a symptom that they're already experiencing. I feel like constipation is one that people can get, especially if they're constipated, but thinking about if we're constipated, we are going to strain.

If we're straining, that is going to affect the pelvic floor, our pelvic muscles. If we're constipated, that means that there's something going on with the gut. We have slow motility.

Things are not moving through the digestive tract as quickly as they're supposed to. Because of that, we can also recirculate hormones that are supposed to be excreted through the waste. Estrogen is one in particular.

It's one that, like a lot of things in our soul, but estrogen is one of them. If we are constipated, things are not moving out as quickly as they're supposed to. Estrogen will actually recirculate back into the bloodstream.

We can end up with estrogen dominance, higher levels of estrogen because our gut's not working well. That's one example of how it's the gut hormones and pelvic floor.

Lindsey: That's great.

I love that example of constipation, which is, I'm sure, something you see in a fair amount of your clients.

Alexis: Yeah. I feel like it's very, very common.

Some people, I do see people who have the opposite issue, but I feel like almost, I would say almost 100% people have some level of a gut issue, but constipation is probably the most common.

Lindsey: Yeah. I find that constipation is one of those things where, at least as a pelvic floor therapist, I don't have a ton of clients seeking out our services for exclusively that.

I almost feel like it's a newer symptoms like urinary incontinence or pelvic pain. Then as you start talking to them, they're like, oh no, I've had constipation for the last 20 years. My mom has it.

My sister has it. It ends up being more of something that they underestimate and just almost take for granted as a familial issue versus actually being a sign and symptom that they could use services like yours or pelvic health services. That's fascinating.

As a pelvic floor therapist, we certainly love to refer to nutritionists and integrative health coaches and people that can be part of our team. What are some of the, just thinking about your own client caseload, what are some cases where you would really, if as pelvic floor therapists were working with certain clients, what are certain ones that you would say, please consider sending them to someone like me so that we can really work as a team together? 

Alexis: I feel like there's quite a few, but for sure the digestive issues like having the chronic constipation or especially if people have been experiencing it for a really long time, there's usually, there's a lot that that person needs to tackle at the same time or they definitely need a team around them. I feel like we work so well together or the type of work that we do together that it's like, it almost feels like everything.

Menstrual irregularities, so whether they're missing cycles, not ovulating, they are having the pain. If it's been a long standing, I feel like that's, I would say that's even like a bigger indication of bringing more people on board for the team. I know my ideal situation would be, we were all in the same office together and we could seamlessly integrate or offer workshops together.

A client is there and they see two of us, they see pelvic floor therapists and nutritionists right afterwards. I just, I see that multidisciplinary environment being so conducive.

Alexis: Yes, it's true, We need that.

Lindsey: Are there any simple strategies that our listeners can share with our clients when they're considering their own hormonal imbalance?

Alexis: The simple strategies are more basic than probably we often think of them as. It's the foundations.

Our hormones are delicate. They're strong and they're delicate at the same time and they are impacted by everything. They're impacted by our environment.

Some simple things is making sure we're getting enough sleep. That really impacts our hormones and making sure that it's good quality sleep, like seven to nine hours. Also balancing blood sugars, that's another big foundation that I talk about really often.

That means that every single meal should be protein, fat, fiber, so that we're able to balance blood sugars, which is the catalyst of the rest of our hormones. If our blood sugars are going really high, getting really low and just all over the place every single day, we're having the midday crashes, we're having the feeling of anxiety, all these things that were going on with our blood sugars, that will actually affect the rest of the hormones downstream. It's going to affect your progesterone, your estrogen, your testosterone, your cortisol levels, all those things will be impacted.

I always come back to that as a foundation. I guess one last one would be something to build resilience slash release stress from the day. I don't talk about removing stress because that's like impossible, but what can we do every single day, even for a short time, that can at least allow us to release it or to be able to better manage it, build the resilience around it?

Lindsey: Oh, I think that's so important.

I love that you're taking the time to talk about that in your sessions with clients because sometimes I think as professionals, we're not sure if that's in our realm or someone else on the team is covering it when really just something is basic. I always say the best of the basics better, and you're absolutely right. Sleep really is such at the cornerstone of all of our clients' symptoms.

Even if in the very first session, we just focused on that. In my private practice, when I was in New York City, I really focused on pre and postnatal people and talk about the sleep deprivation. I would literally spend an entire hour session talking about strategies and setting themselves up for asking for help and for success around rituals, having the body recognized.

Now it's time to unwind and to relax and so. I think that's so spot on. I love that you addressed that.

Alexis: Yeah, I try to be as integrative as possible. I agree. I think there is definitely a line where it eventually gets out of my scope, but I know that those things I definitely can address to make sure that people are aware of it and they can start to focus on it.

Lindsey: Yeah. Do you mind sharing with us a simple case study of sorts where you helped someone specifically with endometriosis? I know that you do all chronic pelvic pain, but I think endo is especially passionate for you. Would you mind walking us through a case where you were able to help someone get through their symptoms? 

Alexis: Yeah, One person that comes to mind, she came to me, she had excision surgery maybe a year or two before she saw me, but she chronic pelvic pain. That didn't go away or it came back. She really didn't want to go on birth control.

She wanted to try something like a natural approach, but she's also unsure, would it work type thing. Also, her periods are really bad. They're heavy.

They're also really painful. She would not be able to do anything on her period. She would tell her husband the day before her period or the day of I'm out, she'd be in bed for a day or two.

Usually, if it happened to fall on a day where she was working, she'd have to call up work, that sort of thing. Within maybe three months, after three cycles or so of working together, she was out and about walking around in the city on day one of her period. We did some functional testing.

What we found is that her adrenals definitely needed some help. A lot of the work that we did together was the blood sugar balancing thing, taking care of her foundations, but then also making sure that she had enough minerals to be able to allow her adrenals to do their jobs, like the magnesium, potassium, foods, and then also adding it in supplement forms, like drops form was helpful for her. We found that she was estrogen dominant, so not making as much progesterone and she was making a lot of estrogen.

Also, she was recycling it back because she was someone who experienced constipation. We did work on her gut health. I remember we did remove gluten.

She found that that was something that triggered her specifically. Her bowel movements became more regular. We also did some targeted supplementation to help her out with her detoxification pathways, particularly for estrogen.

Periods got lighter, pain went down, was able to be out and about on her period, which was wild. She was like, I couldn't believe it. I was actually outside on my period, on day one.

That was a nice experience and being able to help her, support her through that.

Lindsey: That's beautiful. I think so much of what you said, we can imagine our clients, the clients that come to us are like, look, I want to do this as natural as possible, but skeptical as to whether or not this could work.

That's book volumes. Also really interesting because you talk about sort of that more abundance mindset when it comes to food, but you're also aware there are certain cases where at least removing gluten or one of the most common allergies does make a lot of sense to kind of give the body a break. That was fantastic.

On a slightly personal note, I read on your website that you love to travel. I'd love to hear, where's your most favorite place to go? Where are you imagining your next trip being?

Alexis: I actually have a trip next week.

Lindsey: Awesome.

Alexis: I'm going to Belize for a childhood wedding, 

Lindsey: A childhood friends wedding.

Alexis: Yeah, so that's actually going to happen about a week from now. I'm really excited about it. I have not packed yet. I tend to move a little bit, but that is something I'm really excited about.

Lindsey: That's amazing.

I'm sure Belize is going to be beautiful. Alexis, for anyone who is learning more and potentially sending their clients to you, where can our listeners find you?

Alexis: Yes, you can find me everywhere at Alexis Brooks Nutrition. That's my Instagram, my TikTok, Alexis Brooks Nutrition. Website is also alexisbrooksnutrition.com.

Lindsey: Perfect. I'll put all of that in our show notes so that anyone listening can easily reach out to you. I can't thank you enough for spending this time with us today and giving us just like a sneak peek into your approach.

I do find it incredibly refreshing and very motivating and very in line with the occupational therapy approach. Thanks for all the work that you do in the world. I'm excited to continue to follow your journey and all the clients that you help.

Alexis: Thank you. Thank you so much for having me. This was a great conversation.

Lindsey: Thanks for listening to another episode of OTs and Pelvic Health. If you haven't already, hop onto Facebook and join my group, OTs for Pelvic Health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week.

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