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The Mel Lawson Show
I'm Mel Lawson, mum of 3, Founder and CEO of Bare Biology (a UK supplement brand). Basically, we talk about life. From psychology and health to self-development and spirituality, and much more. We have experts, we have fascinating guests, and we talk in a very open and honest way. We share our vulnerabilities and hope to entertain and inspire you, maybe make you laugh, and possibly help you experience some ‘aha’ moments along the way.
The Mel Lawson Show
How To Love Your Time Of The Month | With Tanya Borowski | The Mel Lawson Show
This episode is a powerful reminder that the menstrual cycle is such a beautiful part of being a woman but it takes time to find its rhythm. Tanya Borowski is a Women’s Health Specialist and Educational Speaker and has so much wisdom to share.
I highly recommend listening to this if you have a teen daughter or your inner teen needs some love.
Download the slides mentioned here.
More from Tanya here.
This episode is sponsored by Melanie's family-owned UK supplement company Bare Biology.
Welcome back to another episode of the Mel Lawson Show, and I have the brilliant Tanya Brovsky back. Hopefully you've all heard the episode we did with her earlier in the series. If you haven't listened to it, I really recommend it because it gives a really good overview of Tanya and women's health. But in this episode this is the first of a series of episodes where we're going to go really deep into the menstrual cycle, menstrual health, particularly for teenagers and young women. So we're not doing perimenopause menopause even though we're in our 50s. We are all about the teenage girls. We both have teenage daughters. We are all about the teenage girls. We both have teenage daughters.
Speaker 1:We think that very strongly, think that teenage girls are not being looked after. In fact, they're being harmed. I would go so far as to say, with some of the advice that they're given, and yeah, we'll come on to that. Um, yeah, we'll come on to that. But basically we want to help everybody understand the menstrual cycle and learn to love it, and these are the sort of things that should be taught at school. Sadly they're not, but here we are.
Speaker 1:So tanya is a registered nutritional therapist and functional medicine practitioner, an amazing expert in all things women's health. I've learned so much from you about my own hormones, but my daughters, and hence why we're doing this series, because I was so inspired by um and so tanya also does a lot of education for other health practitioners and I came to one of the events and I was absolutely mind blown about the things I didn't know aged 51, about the menstrual cycle. For the people who are listening and not watching on YouTube, if you'd like to see the slides that Tanya refers to, we will put them in the show notes or you can watch on YouTube.
Speaker 2:So so here we go Amazing. So thank you so much for having me back and I'm really excited to be running this series with you and absolutely all, because it is an area that is not really being covered in depth. There's been a lot of chatter in social media and on TV programs around menopause and perimenopause, and that is an area that I am equally passionate about. But teen health, or tween health, and understanding the menstrual cycle and all the wonderful benefits that it really set out what our hormone, what what the hormone, the endocrine system, actually does. And I suppose I'd like to also lay out that and explain that this just doesn't happen. It doesn't just happen automatically. There are our end. Our hormone system is very much influenced by our environment. So and our environment is the food that we eat, the way that we've been brought up, the chemicals that we're exposed to and the relationships that we have in terms of our, in terms of our nervous system so all of these components impact our hormonal system and I'd like to. What I'd like to start by doing is beginning to engage the women that are listening, to get there and hopefully then encourage their daughters to actually then really understand sort of what the benefits of the of the menstrual cycle actually actually are.
Speaker 2:The first experience that our girls are introduced to hormones is under the banner of sex education at school, so everything is about reproduction. Now, interestingly enough, the menstrual cycle is ultimately about procreation, is about reproduction, so the purpose of the menstrual cycle is for the woman to be able to reproduce within that. Because this has then fallen under sex education within our, within every single school, and uh and and education setting. This doesn't, in my mind, and I don't know whether you'll agree, this doesn't necessarily frame what the other benefits of the menstrual cycle actually are. And so there is then an immediate response by the young girl of, I believe, fear, because everything is about, okay, what are your?
Speaker 2:You want to be able to be practicing safe sex, which, of course, that's what we're advocating, but it's also about prevent, about how to protect themselves from becoming pregnant, and I would like to we, with this series, would like to turn that on its head and actually facilitate young women to becoming more engaged and actually fall in love with this wonderful process that happens for 30, 40 decades of their life and actually understanding other than reproduction. Well, why else do we make? Do we produce these hormones oestrogen progesterone as long as we ovulate. Why else do we produce those? And that is hopefully by the end of this first session. Uh, everyone listening will be in awe of what your body and or your daughters or your cousins or your whoever's body, is going through this process, what actually it does each month yeah, totally agree.
Speaker 1:It just gets reduced to the initial, like this this is going to happen to you one day. You're going to pull down your knickers and there'll be blood in them, right, and I remember very well my eldest daughter that remember when that happened, we can all remember that. So you sort of prepare them for that shock. And then it's all about how do you basically collect that blood in a way that's not embarrassing and you know, and my girls at school they're at an all-girls school the poor they had a poor teacher stand on the stage they have in this theater and demonstrate the best way to put in a tampon, which is, you know, helpful. But then it's about how do you collect the blood and then how do you stop getting pregnant. And that's kind of where it stops.
Speaker 2:That's it, that's where it stops. Yeah, absolutely so.
Speaker 1:yeah, I'm all ears Okay.
Speaker 2:So there's a diagram, that there's an image here that many people are familiar with, which is an image of how the hormones ebb and flow within the menstrual cycle. So we and people may be quite most people are sort of familiar with this they probably have to learn it for their GCSE but actually what I'd like to do is step you through actually how this actually begins and why it actually begins, and also understand how the brain and the what this, what actually is, is occurring is that there is that, this dialogue. Uh, when periods begin, which in medicine, science, we call menarche, that is just the first day of when that bleed happens and from that, from that day forward, there is a beginning of a communication between the brain and the ovaries that they have to get to know each other. It doesn't just automatically and it absolutely doesn't automatically happen that there is this climbing growth of, of, or production, should I say of oestrogen, and then, in what we call the second half of the cycle, that we then have this huge production of progesterone. That takes time for that to happen. So we call this an ovulatory cycle, and that is the goal of optimal health having regular, what we call ovulatory cycle, and that is the goal of optimal health having regular, what we call ovulatory cycles, where we ovulate and we then produce lots of progesterone. That is the goal and that is now considered a vital sign of life. So you and I were talking a couple of days ago about this in terms of we can actually view this as a monthly report card, and we are wanting to encourage and nurture all of these young women to actually herald a celebration that this, that day, one that menarche has occurred, and actually aid that young woman, that teen, to understand, a what is happening and, b, the objective is to continue this dialogue between the brain and the ovaries so that it into a regular ovulatory cycle that I'm going to explain. And so there are.
Speaker 2:The health of a young woman is fundamentally based to be able to. We need to think about, as we want them to achieve, having these regular ovulatory cycles, and there are three key aspects. There is the ovarian health, which is where the tiny follicles are housed. There is we want the communication between the brain, so the hypothalamus and the ovaries to be healthy. We don't want there to be any danger signals. That, then, is sending a communication to the brain to say things aren't safe here, ie, things aren't safe to reproduce, because that is the ultimate goal. So we need to be thinking about these areas when we're talking about the health of achieving these ovulatory cycles.
Speaker 2:So the first component is we need to go back in time and we need to think about how those follicles actually occur in the ovaries. So, because it's these follicles that actually produce the oestrogen and then the progesterone. So did you know, mel, that actually and this is completely wild that every woman is born with about 2 million what are called primordial, so tiny weenie follicles? So they are born with all the follicles that they will ever have. So in utero you have got those follicles. Isn't that wild?
Speaker 1:It's wild, it's kind of a miracle, isn't?
Speaker 2:it. It is a miracle, yeah.
Speaker 1:Yeah, can I ask a really basic question? Yes, because when you say follicle, I think of a hair follicle.
Speaker 2:Ah, okay, so it's like a tiny, tiny little, just really basic. What is it? So? It's a tiny tiny formation of an egg. Okay so, it's like a tiny, tiny little, just really basic. What is it?
Speaker 1:So it's a tiny, tiny formation of an egg.
Speaker 2:Okay, so it's like a mini egg. It is like a mini egg, it is.
Speaker 1:Right, because I think people when they think follicles Very good, good, so it's like a tiny, tiny.
Speaker 2:So you're born with two, about two, million, two million, and they're called primordial follicles, and then by puberty you're already down to between 300,000, 500,000. So there's just this natural, what we call atresia, which is cell death. It's just a natural process.
Speaker 1:And that's it. You can't make any more. No, no, no, You're born with your, and then there's just this natural cell death.
Speaker 2:Yeah, so by the time we hit puberty and we're going to go because that's very important we're already down to about 500, about 500 000.
Speaker 2:okay so that's, right okay, so that's just the natural process. So that constitutes the, if you like, the ovarian reserve of the mini eggs, and these will just naturally diminish as we age and so within that, so if we think about those follicles, those 2 million follicles that we have when we are born, then it makes sense that actually the health of the mother, so when we're in utero, absolutely impacts the health and the, if you like, the integrity of those tiny primordial follicles, those baby eggs, those mini eggs. So this is what we call sort of tri-generational. So this is why there is a interesting data around that more and more women, girls, are being diagnosed with PCOS.
Speaker 2:Pcos, which we'll come on to. There is a significant impact by the environment that the mother has been exposed to in terms of their blood sugar levels, their androgen, their testosterone exposure, while then, and what impact that has on the babies that they're actually carrying. So there is such an importance and the nutrition of the mother. All of these components impact the baby follicles and this is then before the health of the woman that's actually the young woman that's actually carrying those. So it is a highly impactful environment, uh, that that that we are, that we are being exposed to wow I know it's so amazing.
Speaker 1:What so? Because when, obviously, when you're pregnant, I remember worrying about folic acid, omega-3, yep, generally, you know, avoiding things, alcohol, etc. But it never occurred to me to think about the health of my daughter's follicles yes, I know, so that isn't a really.
Speaker 2:I just think it's a fascinating concept and it is, and it is um, it's well, it's primal and it's called a primordial.
Speaker 2:They're called primordial follicles, so that's amazing, yeah so the kind of key nutrients that you've absolutely named the the top ones, but we also need to be thinking about zinc. Vitamin d is also really, really important um, in that, in that sort of preconception, is vitamin A. Vitamin A, retinoic acid is involved in numerous sort of cell signaling components as well, so iodine is also really important because well, for many, many reasons, but having optimal thyroid health is incredibly important in pregnancy. Selenium as well, and and selenium is a key antioxidant. So we think it's about, it's the body's way of and it's a component to many of our own built-in antioxidant system. So it's a really important what we call micronutrient. So we need it, in small amounts but regularly, to ensure that all of these processes happen without us even thinking about it.
Speaker 2:Okay, so the next sort of important stage with our teenagers is the onset of puberty, and that happens in stages, and at the end of puberty is menarche is the first stage of when a young woman will have a period, stage of when we were, of, when a young woman will have a period, um, and but there is a a separate process that happens before puberty begins, which is called andronarchy now, and this is basically the awakening of the adrenal glands and this is really fascinating. And now, because this actually begins to have the, the adrenals come online before the ovaries sort of kick in really, and the adrenals when they awaken, they produce a high level, or their their escalating level of androgens.
Speaker 1:You know what I'm going to ask you? Yeah, what's an androgen?
Speaker 2:Okay, so an androgen is more known as a male hormone. So you have DHEA, testosterone. These are male hormones and this is why, and these male hormones in women produce excess sebum, they can start to produce, which is why you start to see teenagers. But this actually adrenarche can happen from, actually from about seven, eight, nine, okay, and it maintains pardon me, it maintains through these levels of producing androgens, dhea, through to their peaks at around 20.
Speaker 2:But the key point to this is that the first sort of hormones to actually really awaken and come online are these male-like hormones, and so this is why, quite often, people start to be concerned that their daughter is starting to get acne or that they're starting to get maybe a little bit of. They start to develop a little bit of underarm hair, pubic hair, and it can start as early as sort of seven or eight, and it also affects their sweat glands. So you start to notice that there is a change in the way that they actually smell and andronarchy actually happens before puberty comes online. So we've got this sort of potent potential. Well, we've got this unopposed, if you like, male hormone milieu before any of the other, before estrogen comes online, which will come onto it, which is where menarche starts and estrogen helps to kind of dampen down and helps to quieten down the androgens, and that is one of the key reasons why you can start to see skin changes and in as, but just before puberty starts which I think is really, is really fascinating.
Speaker 2:So it is not the time to go charging off to the doctor and start thinking about certain skin creams.
Speaker 2:It's a, it's just a natural, a natural progression yeah yeah so just relax relax, all yeah, and it can be very unnerving when you've suddenly you start to notice, especially because this does happen, and I was surprised when I was researching this, that it does happen, quite. It does happen as young as seven or eight, but yeah, it is quite. That would be alarming, it would be alarming, but that's not. But you, yeah, it is, it's just, it is a natural, is a natural process. So puberty so we have something called um, you start to start to see starts happening around from eight up through to sort of through to 13. You start to then see breast buds occurring. Then you have pubarchy, which is you start to see more development of pubic hair, and then you have sort of the growth spurt and menarche, which is when the first day of when the menstrual cycle will start is can can begin as early as nine. That is young, but this is happening more and more these days up to 16. Okay, how old were you when?
Speaker 1:you started your period? I think I was 14. Yeah, I was 15.
Speaker 2:Yeah.
Speaker 1:Yeah, yeah, and my eldest daughter was 14 and my youngest is coming up to 14 and I think is coming up to starting.
Speaker 2:Yeah, yeah, so breast buds can start, as I've said, sort of around eight. That doesn't. So that doesn't mean that they are anywhere near menarche right, and and I can remember, and you can again, as parents we can be a bit concerned because we're well it's.
Speaker 2:It's a whole roller coaster, isn't it, of, oh, my god, my little girl yeah but having breast buds at eight doesn't mean I mean they could be another five years away from five, six years away from menarche. There is no. I think we're also in very much in danger of we have these ranges, but please, everyone that's listening, these are just guidelines and there are. And who wants to be average? You know who wants to be average at her pace and they absolutely, because women's mitochondria are so powerful, the that the it is very genetic. You do tend to follow suit as to sort of as to how your mother developed. So, yes, my daughter, I'm sure she'll thank me for saying this um, yes, developed sort of.
Speaker 2:Her menarche was a similar age, yeah, 15 I believe. Yeah, so, um, that's sort of that's how that's how things begin. So the growth spurt which, as the name would suggest, is when they start to change in you, you absolutely start to notice, um, a change in their height and she will attain really have full height, or about 98%, 99% by the time she's sort of 16. Okay, and this is completely driven by oestrogen, because oestrogen is the first hormone that comes on board. Okay, progesterone is a way off at the moment. So, with menarche, that first period, that is all driven by estrogen. There are also two other hormones. There's growth hormone, which we want, and a hormone called insulin growth factor.
Speaker 2:Now, this is really important because the combination of these three hormones is associated with a normal but temporary shift to mild insulin resistance and it's a way of conserving energy. And the other time in our lives when this happens is in pregnancy that we shift to this natural but temporary sort of insulin resistant state to be able to use our energy. So we quite commonly will see and this is a very much a danger zone with social media when, with this sort of temporary shift to insulin resistance, we start to see, just, maybe, a little bit of storage around the midriff, so they might start to see just a little bit of what they perceive to be belly fat that's stored around the middle. It's not, it's just a completely normal adaptation that is happening. Uh, that within a year, that will. That will move if we allow that menstrual cycle to mature. And I think that's a really important component, because we are just being bombarded with stick-thin girls at this age.
Speaker 1:I remember it so well Me too, Because I was like a little stick washboard stomach. And then suddenly I remember I was wearing a swimming costume and I thought, oh my god, I've got a belly.
Speaker 2:Me too I'm fat, were we in the same holiday? I was in a pizza.
Speaker 1:I was in Spain, so it's when we left Spain, and I remember it was a yellow swimming costume and I was, and then I I didn't go so far as having disordered eating, but I was basically then on a diet yeah, pretty much.
Speaker 2:It is a very it's. It's so wonderful that we can be really transparent and share this. I think it's so, it's so important because at that that age sort of 13, 14, 15, you're just on that cusp where you're still going on holiday with your parents and then you suddenly you're by that pool and you're so self-conscious and you just internalize all these things to yourself. And so this comes back to if this is taught in schools and education this is a normal and natural, it's transitory, it's a temporary shift. Then to be forewarned is to be forearmed.
Speaker 1:And as parents, we can explain that to our daughters, can't we? Yeah, because I'm sure my eldest will hate me for saying this, but it happened to her. She was tiny, you know sticky type body shape, and then changed and she was horrified and, did you know, swerved into the disordered eating for a bit. So, yeah, I think that is really Because I didn't know that. I mean, I remember saying to her oh, it's normal, you know, it's normal when your periods start, but I didn't understand that it is actually normal, I guess.
Speaker 2:Yeah, yeah, and there's a reason is the fact that we're, as the name suggests it's, a growth spurt, so we're producing a lot of growth hormone, and growth hormone actually inhibits in the action of insulin. So insulin's job is to facilitate taking sugar and actually transporting it into the cells where it can create energy. So in that growth spurt, as the name would suggest, we're producing lots of growth hormone and so it's sort of imagine it. It's like muscling insulin out of the way a bit, it's kicking it to the curb, so insulin can't then get hold of that.
Speaker 2:It's not quite like that, but it can't help to drive that sugar into the cell where it needs to be. So it sits in the bloodstream longer and it can convert into and that's what causes that temporary shift. But it's completely transitory. They don't need to go on a diet, they don't need to go on a low-carb diet. But having that information is really powerful. Yeah, and that's a golden piece of information and I think I also want to touch on this area here now and then I'll come back to it. But it is also this obsession with diagnosing, to being so quick to give, well, all of our population labels. Is it pcos? Is it insulin? Are you insulin resistant? Is it pcos? Is it endometriosis? It's like these girls are 15, 16. We need to allow this cycle to start maturing and get the get, the brain and the ovaries get. They need to get to know each other. It's a process, it's a maturation process. Like any friendship, it takes a little bit of while of getting to know each other and we need to allow that friendship to actually run.
Speaker 1:So, yeah, so, just again, relax. Or as my teenage son would say, lax it, lax it, yeah it, just as you were talking then I was kind of thinking of booting up a computer and you know, sometimes it takes a while to boot up and it's kind of doing that wheel of death thing.
Speaker 2:Exactly.
Speaker 1:That's exactly what's happening Don't jump into. Oh my God, it's broken, get it down, Get it fixed. Yeah, it's just booting up.
Speaker 2:It's booting up exactly which actually this slide actually shows. So how does it all start and what is the beginning of this relationship? So this is an image that, um, you've seen before and I think it's incredibly powerful. That shows when we start at a young age. We start by that first period is it's we produce. We're starting to produce a lot of estrogen and as we, as I will talk you through, we're not ovulating for quite a bit of for quite some time. So we and the only way that we can produce progesterone is when we ovulate. Okay, so I'm going to step you through that process.
Speaker 2:At the moment, so at the beginning of uh and this can be for the first couple of years while that wheel of death is occurring, while that, while they're getting to the brain, the ovaries are getting to know each other, there is this sort of escalating, climbing oestrogen that's happening and the sort of awakening of all of those follicles. So we've got this natural picture of lots of follicles vying for attention, vying to be sort of the chosen one, and we've also got this temporary insulin resistance and that could be very easily in some ill-informed, maybe, surgeries diagnosed as PCOS, which I'll kind of explain that. But I think, just hold that thought, but this sort of slide, just that actually we are in this sort of very sort of more escalating oestrogen picture of an oestrogen is about growth and proliferation. And we have the progesterone hasn't come, hasn't come on board yet. Can I ask a?
Speaker 1:quick question. Yes, so leading up to your menarche, the first time you bleed, you haven't been producing oestrogen.
Speaker 2:No.
Speaker 1:No.
Speaker 2:The oestrogen only comes from the ovaries.
Speaker 1:Okay, so then you're producing oestrogen Correct, quite a lot of oestrogen, it starts to.
Speaker 2:So it starts in the cells in the ovaries. So there are two cells, so there's the theca cells and the granulosa cells. And we start when the brain comes on board and starts to send messages to the ovaries, messenger messages to the ovaries. It sends, and those messengers are luteinizing hormone and follicle stimulating hormone. So the first message that is kind of shouted by the brain is follicle stimulating hormone and it does what it says on the tin. Those follicles are being stimulated and on that stimulation those cells in the ovaries produce oestrogen. Okay, but actually, and the very original building block for that is cholesterol. All of these sex hormones, all of these hormones, their building block is cholesterol. They all start as cholesterol, which is pretty amazing.
Speaker 1:That is amazing cholesterol.
Speaker 2:they all start as cholesterol, which is pretty amazing. Okay, so, let's, should we talk, should we talk through the process of how that actually happens, so the way that it happens? So follicle stimulating hormone there is this sort of the adrenals have come on board, as we've talked about adrenarchy. Then there's the awakening of the brain. It's like, okay, I'm sensing all is well, I'm getting enough nutrients, I've got enough calories coming in, I've got the right levels of vitamin D, I've got the right levels of zinc, I'm in a safe environment to reproduce. And so the brain sends, sends a message which is follicle stimulating hormone, and the follicles sense they have receptors for this, for this hormone, and they actually start to grow. They move through a process, they start to grow and develop and within that that and through that development process, they produce estradiol estrogen. So that's how estrogen begins to then come online. Okay, and so the brain is now on board and is the master controller. She's like the CEO, she's the CEO. So as long and I've read this is really important concept so as long and this is really important concept so as long as the brain, the CEO, is sensing that there's enough energy, there's enough calories around, that's consistent, that she's not underweight, that she's not overexercising, so she's using up too much energy and not enough energy is available to go through this process of the menstrual cycle, that she's getting enough sleep. If the circadian rhythm is off, then that's not a safe environment. So the brain is the CEO of the organization and she then sends that first message out, which is follicle stimulating hormone from the pituitary.
Speaker 2:So, as a consequence of all of these follicles now beginning to be recruited, they're kind of probably you know, you've got this, you've got this reserve of follicle, of these mini eggs, of these follicles, and each cycle probably between six and 10 start to develop with this FSH. They're kind of vying for position, they want to be the chosen one, right? So they're developing and when enough of those are starting to develop, fsh will then start to decline and one of them will become the dominant follicle and by this point is really now pumping out quite a lot of, quite a lot of oestrogen and this is now called a pre ovulatory or dominant or a dominant follicle, and this is, as I said, there is a lot of oestrogen that is now that is now being produced. So in a cycle, this of this will be occur around day 14. So day one is the first day of the bleed, so these follicles are now being produced. So you've now got around day 14, this peak of oestrogen, and that peak of oestrogen will trigger, will send what we call a negative feedback back to the brain to say We'll send what we call a negative feedback back to the brain to say, ok, we've got our peak of oestrogen and now we want another hormone, a releasing hormone. Now we have luteinizing hormone that actually triggers ovulation, and that is so.
Speaker 2:Ovulation is when that dominant follicle called the graphene follicle ruptures and the mature, the cargo inside is this beautiful mature egg that is released into the fallopian tube.
Speaker 2:And that happens about 10 to 12 hours after that luteinizing hormone peak. So again, the order is that you have these growing follicles that are really producing lots of oestrogen, you have this peak of oestradiol and when we reach that peak of oestradiol, it triggers the brain to say, okay, I now know what to do, I now need to release luteinizing hormone and we have ovulation. Okay, and this is also really interesting is that conception is only possible from around five days before ovulation. As soon as we've ovulated on the day of ovulation, that fertility window closes. So this could be taught in school as well, and I think the fear of it is that people is that young girls are not, are not then going to be relying on contraception. But actually understanding the cycle is is really, is really important sort of the five days leading up to ovulation and then the day of ovulation reflects the lifespan of, reflects that that sort of fertile window does that make sense?
Speaker 1:very good to know. Yes, so if I may, just so it can take to that point where the the brain gets, that we've got the message. Peak oestrogen release the luteinizing hormone.
Speaker 2:Hormone yeah.
Speaker 1:That doesn't happen after your first period.
Speaker 2:That can take several years. It can take a couple of years. You're absolutely right.
Speaker 1:So you may not be ovulating for the first couple of years.
Speaker 2:The first stage of the cycle where that oestrogen is really proliferative and it is actually called the proliferating correct for the first couple of years, the first stage of the cycle where that oestrogen is is really is proliferative and it is actually called the proliferative stage, is what we call the follicular stage. We now understand that because it's all about follicles. Okay, so, in as our periods and as our cycles are starting uh, this is why they're like a young it's very, very common for uh, young girls for their cycles to be 35, 45 days, because they're not and quite you know they're not going to be 28 days no, so again relax
Speaker 2:yeah, I mean it very rare. They won't be. No, they were, um, it will, they might. They might be 35 days, then there might be 45 days, then they, then they may ovulate and it may be to 29 days, 32 days. It is a, it's a process, it's a, it's a communication. So, absolutely, that's really great to bring that. It's not. Yeah, it doesn't immediately happen. Yeah, yeah, got it. So when we do actually start to ovulate, when the follicle ruptures, it transforms into this sort of yellowish body which is called the corpus luteum, and luteum is that comes from the Latin word yellow, so it's this yellow, this yellow body Corpus Latin for body there you go.
Speaker 2:I did Latin at school. Now I know why I spent all that time doing Latin at school.
Speaker 1:It is quite useful. It is quite helpful.
Speaker 2:And then we're producing progesterone. So that is the only way that we can produce progesterone is when we ovulate. Only way that we can produce progesterone is when we actually is, when we ovulate, and that progesterone its action is to, it modifies the cervical uh mucus so that it becomes and it also acts on the endometrium, which estrogen has been. All, as I've just mentioned, is very, is a prolific hormone. So all of that estrogen that has been produced has, if you like, pumped and plumped, if you like, that an endometrium lining ready for implantation. And progesterone helps to, um, helps that to become sort of thicker and more and more and more spongy, ready to receive if there is conception, ready to house that conception.
Speaker 2:But if pregnancy doesn't occur, then the corpus luteum degrades estrogen and progesterone gradually, both decrease. That progesterone and the endometrial lining will shed and that is the beginning of the menstrual cycle. And that progesterone helps to thin also the uterine lining, so it helps for a lighter bleed. So this is why in teens and actually in perimenopause, when we have less progesterone around, the bleeds are much heavier and you've got more flooding, because we don't have enough progesterone around to thin the bleed and to calm it down and that uterine lining is also full of mast cells which contain histamine and heparin, which actually also lead to that flooding and, uh, quite painful cramping periods, which are more common in teen health because they haven't got enough progesterone on board okay, so, and we'll talk about this in the second episode of some more problem yeah, periods and and things to worry about potentially or look into investigate.
Speaker 1:Yes, we'll go. Yeah, absolutely.
Speaker 2:But a heavy flooding.
Speaker 1:We've all been there, Absolutely. It happened to me wearing white trousers, which was nice, as a teenager. Nice, nice Is again not something to be concerned about too much in the beginning. Certainly not in the beginning, certainly not at the beginning.
Speaker 2:We need to get this. Yeah, it is not. If this is happening for two years, yeah, then absolutely, then we need to go, we need to take it to the next level. But really, this the and in my experience in clinic and in practitioners that I mentor, they are just seeing so many cases of young girls that are being put on the pill to shut all this down before any of this communication has had time to bed in. It is just not the right thing to do in my opinion. Yes, not the right thing to do in my opinion. Yes, and the progesterone component also allowing that communication to happen.
Speaker 2:So we want that progesterone to come on board to help lighten the flow, but also to help calm down the androgens that are big, that, if you like, are in ascendance from adrenarchy. So, yeah, we've got, if we go back to the beginning, we've got adrenarch, those adrenals coming online, producing those androgens, those male-like hormones which can be responsible for the kind of the acne and the skin changes. So getting our menstrual cycle to mature and to become ovulatory. Another purpose of that is because progesterone when we start to produce lots of regular amounts of progesterone for 11 days in that second half of the cycle it actually lowers. It's anti-androgenic. It helps to lower those androgens. It helps to calm down, tells the brain okay, calm down now, stop calm down those hormones.
Speaker 1:And once that progesterone has kicked in and calming those androgens, is that a permanent piece then? So if you, yes, unless the natural goes wrong. So then it's like this constant communication between lh and fsh.
Speaker 2:So some people who are listening may be practitioners or they're sort of more well versed that they. If that LH luteinizing hormone stays high, it will. The only what switches off that luteinizing hormone is when there's been ovulation and we start to produce lots of progesterone. Naturally then it will communicate back to the brain to say okay, you can calm yourself down now. Um, and in pcos, very, very commonly we see high levels of luteinizing hormone against follicle stimulating hormone and so because the woman, because the young woman, is not ovulating and so there isn't the progesterone to feed back to the brain. So it is all about communication, that's why Right?
Speaker 1:So, if you know you have the acne piece for example, again, there's a tendency to rush off to the doctor, understandably, because you know it's distressing, yes, of course, and embarrassing and all of those things that that that girls feel and boys obviously, um, but again, you know too many too quickly going on the pill, or you know raracatane or something else, um, again, if possible, just wait, because hopefully that will calm down and resolve itself naturally, ideally yes, so there's, uh, we will do a complete session on acne, but it's, it's really good, but it's all.
Speaker 2:It's all intertwined, so there's. I would I would say that there are two fundamental uh, there are two fundamental components to the way that we, the way that we want to think about that is everybody talks about acne being hormonal, which there is. There is that component, and the key to that is that we actually the hormonal component is, that is, that we want there to begin. We want there to begin, we want there to be a regular ebbing and flowing of all of our hormones. If we intervene very early on and actually stop that communication and stop the natural production of all of these hormones and their natural communication, then we are as soon as you come off the pill, then there is going to be a rebound because that communication starts up again and they've got to start again to, and so all of the that there will. There will be a rebound effect. Okay, so we want to be able to establish a natural and go through those teething pains, but at the same time, we want to be able to provide some remedial relief as to and make sure and this is where we we then want to ensure that everything, all of the other foundational components to health of the human being, are all in place and that we've we've we've ticked off that, that checklist, because those are all other contributory factors that can contribute to acne.
Speaker 2:So here we're thinking about optimal gut health, we're thinking about actual health of the skin and maybe bacteria that we're carrying on the skin itself. We're thinking about absolutely optimizing. It's really, really important to have good, sufficient levels of zinc A, because zinc is also an anti-androgen, so it helps to calm down that sebum production. So having good levels of zinc, having good levels of omega-3s, also helps to calm down the inflammatory pathway of acne. They work on the prostaglandins, which is what non-steroidal anti-inflammatories work on. And then we also want to be thinking about the gut microbiome. This is why a truly holistic approach is so much more serving the young girl than actually just applying the over-medicalized model, because we're not treating the whole person and we're not appreciating the whole person, so you're really only just sticking a sticking plaster if you go straight to that.
Speaker 2:Yeah, and actually also, roaccutane is a form of vitamin a and there is some really good treatment protocols using vitamin a. Um, if you see a very, if you see a well-versed, uh, nutritional therapist, they can talk you through using that in a in a safe way. Uh, in combination with probiotics as well, is a is a really good.
Speaker 1:So, yeah, lots of solutions yeah, and I know I've taken you off and we'll come back, that's okay. Onto the right piece, um, but I think if I were listening and I might not get to the episode where we talk more about what you can do. The zinc piece 30 milligrams of zinc.
Speaker 2:Which? What kind of zinc? So you can go with a zinc bisglycinate. That's a really nice form. 30 milligrams is sort of the most, is a good therapeutic dose that can make people feel quite nauseous. So take it with sort of the largest meal of the day, which tends to be dinner, because that's the meal that you've cooked for them and have it after your dinner.
Speaker 1:And have it after dinner or midway through?
Speaker 2:yeah, that's so it's great for those follicle, for follicle health it's. But in terms of what we're talking about, it's anti-androgenic, so it's helping to level off that kind of we've got that unopposed those androgens, so it helps just calm down that sebum as well. So it's, it's a it's a wonder nutrient. Yes, it's a top wonder nutrient for this, for this age group yeah, yeah, I give it to my teenagers.
Speaker 1:Yeah, not my tween yet, but yeah and it does, it's really good I mean it's also we'll come on to talk about.
Speaker 2:But for mood, all of these microminerals are needed to make our neurotransmitters to make serotonin. Vitamin D is needed as well to make melatonin to help them sleep. So if they're deficient in zinc, and sadly more so in girls, it's really, really depleted in vegan and vegetarian diets. Sorry, I, probably I am. Well. We're here to be controversial. I am really anti-vegan. Yeah, let's just say it. Uh, for young, for for they're just not. They can't. You can't get the nutrients that you need and you need these micro minerals, and it's a classic time when girls in particular, become vegan.
Speaker 1:Yes, often as a way to control their food intake and calorie intake very vicious under the guise of health or, you know, environmental reasons. Whatever it is which I absolutely condone.
Speaker 2:I think they're warriors.
Speaker 1:It's fantastic but it's not doing the health any favours, sadly not. Yeah, okay, so sorry, I know that people are shouting at the screen for that. So back on the piece.
Speaker 2:Yes, so now we've got. So now, where the goal is sort of this mature, we're wanting to get this beautiful mature regular cycle. And again, just to say, a regular cycle does not. It's very uncommon, up until sort of around 20, to be landing on a 28, 29 day cycle. It's much more common to be having 35, 32, up to 45 day cycle. That is very, very normal for this age group cycle. That is very, very normal for this age group.
Speaker 2:Okay, and so why do we? So? What are the other reasons why? Why do we produce all of this oestrogen and progesterone for three, four decades?
Speaker 2:So oestrogen is. We need it for bone health. We have receptors on our bones and we achieve peak bone mass at the age of 19. And that is directly correlated to the beginning of our menstrual cycles. All of this beautiful estrogen and we have these receptors on bones, we need it. We have oestrogen receptors in muscle, a plethora in the brain, which is why we have this recalibration in perimenopause that's been swamped with oestrogen receptors and suddenly there's an ebbing away of oestrogen. That's why that changes. But the brain has many, many receptors for oestrogen the heart, the mitochondria. The mitochondria is basically how we produce energy, our immune system. All of the cells of our immune system has a plethora of receptors for oestrogen and insulin sensitivity. So this is a really important component and progesterone the same. So progesterone is needed absolutely for bone health.
Speaker 2:Progesterone is also classified as a neuro the clues in the name so brain steroid. So it's like your brain is on steroids. It's when we ovulate. It provides calm, it's an anti-analytic. It has in the brain. It can convert to something called allopregnanolone, which has an affinity to the GABA receptor, which is what elicits calm and just sort of tranquility. So progesterone is we're thinking about about and I always describe progesterone as sort of estrogen is the diva hormone. She's your diva and progesterone is your calming, nurturing best friend. She's the one that's going to be making sure you get home from the nightclub, okay, and she's your. So they come in pairs. They need um, and then we also and yeah, progesterone is also uh, we need in again in the immune system. Progesterone also increases our metabolism. So our metabolism increases in the second half of the cycle, um, and we also produce a tiny little blip of testosterone just before ovulation which kind of gives us that drive and that ambition and also sex drive, which makes sense because you've got sex drive just before ovulation. So it is this beautiful symphony of naturally ebbing and flowing hormones which is what we're after.
Speaker 2:So these regulatory ovulatory cycles provides the health and resilience of the young woman. And when I talk about resilience, through my lens, we're talking about all of those systems. So having resilience is having a robust uh and yeah, having a robust immune system. It's having an active and stimulated brain and producing neurotransmitters. It's having uh, it's having an optimal metabolism. It's having all of those systems that I've just good cardiovascular system. Having those regulatory, regular ovulatory cycles supports the health and resilience of the young woman. And if we don't ovulate, we don't produce progesterone.
Speaker 2:We're going to do a whole session on the pill because it's a really it's as an important topic, but I just want to sort of segue into, if we look at this slide, everything that we've just spoken about. The top shows the, the fsh and the lh being produced by the brain and then the corresponding peaking of oestrogen, the ebbing away of oestrogen and the beautiful surge of progesterone when a woman is put on the pill. There is just this flat A, the oestrogen that is in the pill. There is one brand actually that there is an exception, but the oestrogen in the pill is not body identical oest estrogen. It is equine ethanol estrogen, so it is a synthetic form of estrogen. It is not body identical. It is so much stronger than the natural estrogen that we produce, so it is. It's more prolific, okay, and the progesterone is not progesterone, it's a progestin in all forms of contraception. It is not anything like the natural progesterone that I've just been talking to, and so its purpose is to.
Speaker 2:The purpose of the pill is to prevent that beautiful ovulatory cycle that I've just been banging on about. So, because its goal is to prevent pregnancy, so it prevents ovulation, and so that bleed that some women have on the pill is not an ovulatory bleed, it is not a menstrual bleed, it is a withdrawal bleed. It is just that the pill is for seven days. Quite commonly are the at the end of the cycle is our sugar pills, the seven days of sugar pills. So it is just, it is just a withdrawal bleed. It is not providing any of those beautiful health benefits that we've that we've just been talking about is not providing any of those beautiful health benefits that we've just been talking about, and there was a recent study in 2023, the Danish study that showed that the oral contraceptive pill use during adolescence seems to increase the risk of depression in later life.
Speaker 2:So that for me alone, in this milieu of everything else that our teens are having to deal with, there has been no generation where and I refute that they are classified as a snowflake generation. I really refute that statement there has been no generation where they have been exposed to so much fear mongering and their mental plasticity is still developing. So why on earth would we add in another potential risk factor? And this absolutely study absolutely categorically showed that this is not then reversible, whereas the element around bone health, which I'll just come on to next, it is more than they're still not. It's not categorically they're not categorically sure whether it impacts, uh, bone health in quite the same way, but absolutely it does link to a greater risk of depression in later life, um, due to the change in that neuroplasticity.
Speaker 2:If taking the oral contraceptive pill in adolescence and I wouldn't want to risk that- no, definitely not this study is 2013 um date and which um is talking about the impact of oral contraceptive uh, on bone metabolism, and it states in adolescent girls, the skeletal effect of the combined oral contraceptive is of great concern. Recent data suggests that the oral contraception may impede the development of peak bone mass, and remember that peak bone mass is very reliant on estrogen. We're shutting that off. We're replacing it with a synthetic form. So, again, for me, I really wouldn't want to risk that. Okay, there is a particular form of contraception which is the uh depo provera uh injection and that categorically and the royal osteoporosis society has proven, yeah, completely, so I um would say there is, there isn't yeah, but I mean just what you said earlier that the estrogen plays such an important role in laying down bone density.
Speaker 1:Yeah, it's just kind of basic logic isn, isn't it, that if you switch that off when they're 13, 14, and that you don't reach peak bone density until you're about 19, that's a good five years. Yes, and I think osteoporosis is a bit like heart health, I think, when you're young Totally. I mean, obviously no one tells you this either. That's a whole other thing we'll talk about when we talk about the pill.
Speaker 2:Yeah.
Speaker 1:They don't sit you down and go. And, by the way, here's all the risks, and you know you have to be happy with that before I can prescribe this to you. Yeah, Anyway, lost my train of thought there. I'm lacking progesterone.
Speaker 2:I think what you're saying is that if the we think we're infallible, that's it, yes, so you don't worry about and we are generally infallible, but you don't worry about it, or?
Speaker 1:your heart health when you're absolutely 14? No, but if you're diagnosed. I know a friend of mine who had a severe eating disorder when she was young and she was diagnosed with quite severe osteoporosis in her 30s. Yeah, and that's not uncommon it's not uncommon, um, and that's a very serious thing, and you don't want to be breaking a hip in your 60s. Let's say no, uh, because all the a lot of research shows that once you break a hip or something, you end up in hospital.
Speaker 2:Yes, and then the mortality rate you die very quickly after that. They're pretty tragic stats.
Speaker 1:You're absolutely right, so don't be thinking I'll be fine, don't need to worry about that now. That is something to really think about. It is yeah.
Speaker 2:And there is a nuance to this in terms of some of you are probably thinking well, you've just been talking about instilling fear.
Speaker 2:We don't want to be instilling fear.
Speaker 2:We want to be framing this with more knowledge, and so it is.
Speaker 2:Hopefully, what the listener is beginning now to understand is that it can take seven to 10 years for a young woman's menstrual cycle to reach that maturity, which is that's the key Having and trusting in your that, your body, that this has been happening since the beginning of time.
Speaker 2:And the reason that we've been having these cycles since the beginning of time and the reason that we've been having these cycles since the beginning of time is for all of those other benefits that that we've been, that we've been talking about. And so to actually who are we to intervene and put young women on the pill for, to regulate cycles or for acne at 12, 13, 14. We're really we have this has been happening for millennia. So we have this process occurring and we need to trust that the body does know what it's doing and that it has that ability to actually laid and the key to it is that we are. This beautiful image here is that every cycle, we are laying another piece on this path of creating a beautiful foundation for the optimal health and resilience of that young woman to transition through every single decade.
Speaker 2:And that's what the beauty of that menstrual cycle is doing.
Speaker 1:I love it when I heard you speak about this before you referred to and I don't know if it was you that coined this or someone else, but the pituitary gland is the conductor of the orchestra yes and when you're talking, I'm thinking of you know, if you could picture your, your hormones, as in an orchestra, that they're quite new and they're all learning their instruments exactly right, and they're all.
Speaker 1:You know the violin's a bit off and you know the saxophone is coming at the wrong time, exactly right. And 10 years later, they're the Royal Philharmonic Orchestra playing at the you know, royal Albert Hall, at the Royal Albert Hall. You've completely got it, my friend. So we want to be the Royal Philharmonic and not just basically go right, you saxophone, you're a bit shit. Well, I've only just started learning how to play, yeah, but you're shit. So we're just going to shut you down. Yes, exactly Off, you go Off, you go.
Speaker 2:Yeah.
Speaker 1:So they need to rehearse and practice and work with the conductor, and I think that's a really lovely way to think about it. It's beautiful it takes a while Totally, and I think that's a really lovely way to think about it. It's beautiful, it takes a while.
Speaker 2:You can nick it, you can have that. Yeah, it absolutely is. It's a really beautiful way to put it, mel. It is a communication, it's practice, it is, and it takes a while and some women and some young girls they may settle into a 29, 32-day cycle just within a year or six months, but it is. I think the message is we are all individuals and do talk to your mum. Talk to your mum about how it was for her, because very, very it is. There is a hereditary component, and talk about it amongst your friends. But don't compare yourself, your body shape, or it's not a competition, but it is about talking openly about your, about your experience, and talking to someone that you feel heard and in a safe space and that actually can explain this in a way that the penny drops for you. And arguably you know our NHS. They're too overworked, they don't. They've got 10 minutes, they can't.
Speaker 1:I mean, I don't know how long I've been talking and on the scale of you know, know they've got someone who's come in with a heart attack yeah, yeah. So it's like it's they're always dealing with the acute yeah issue. You know, yeah, so yeah, and I think also, when you were talking earlier about the whole process, I was thinking I was picturing my youngest daughter thinking all that stuff's going on inside her and she's oblivious. I mean, obviously she's aware of, you know, breast growing stuff, but isn't that amazing how clever our bodies are?
Speaker 2:I think that's really the kind of message that I'm trying to get across. Yeah, so clever. It's like we are amazing.
Speaker 2:This body is miraculous miraculous, it is miraculous and to that point actually, mel, is that this is a very energy demanding process. All of the processes in our body, all of everything from having this conversation, because we're using cellular energy. That is, metabolism, the process of creating cellular energy and then diverting that energy to the cell, to the tissue, to the system that requires it, and the menstrual cycle that going through the building of oestrogen and ovulation, is a very energy demanding process.
Speaker 1:So it's very nutrient depleting so girls going on diets yeah we can talk about that.
Speaker 2:It's a whole session. Yeah, yeah, perfect, all right. So I think that is.
Speaker 1:Hopefully we've sort of inspired you to fall in love with that and I think that, um, yeah, we can well I understand it now for the first time in my life. I'm sure, that's not true, I've sat through quite a few of your lectures now, but I really it's really clocked into my head now and I just think, yeah, the thing I'm taking away from this is patience, watch and wait, watch and wait. And please don't intervene, I think in life in general, just wait, yeah, just, and if you don't know what to do, just don't do anything and just wait.
Speaker 2:And talk to and we will be talking. We're going to be talking about what natural interventions you can take in the next episode to help with heavy flow and to help with mood and PMS mood we're going to be talking about that, but, yes, absolutely the first and to put those foundations back in place. And the first thing to do is to take a breath and to not name and shame and say, oh, it's my hormones I mean it's.
Speaker 2:That's kind of like shooting the messenger. It's actually these hormones are just reacting to the environment and they're just learning the ropes. So give them them time and they will pay you in spades, because that's what they're designed to do. Lovely Thank you.