The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
Irregular menstrual cycles, energy availability and RED-S with Allison Yamamoto
Did you know that overtraining/undereating and and the exercise/food balance can impact your menstrual cycle, bone health, and mental health?
Especially for women who's body has just gone through an intense, and often traumatic, experience like pregnancy and giving birth this can really have a huge impact on your health.
You're seemingly doing "everything right" yet feel like you're struggling all the time and even your menstrual cycle can get messed up.
RED-S (Relative Energy Deficiency in Sport) is much more common in postpartum women than you might think and Allison Yamamoto has very kindly agreed to come onto my little show to talk about this.
We talk about the causes of RED-S.
How society's pressures on women can cause women to, unknowingly, be sabotaging their own health.
How a "I have to do everything" approach is actually holding you back and impacting your health.
How a workaholic lifestyle, which most postpartum women have (when's the last time YOU had a break?) leads to issues
And, of course, we discuss the solution!
Allison is absolutely amazing and I have no doubt you'll be very happy that you listened to this episode.
You can find her in all the usual places;
Her website
Instagram
And TikTok for you cool kids
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If you decide you want to do the rest of the program, after only 5 months of paying $10/£8 a month you now get FREE LIFE TIME ACCESS! That's $50 max spend, in case you were wondering.
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And, of course, you can always find us on our YouTube channel if you like your podcast in video form :)
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Email peter@healthypostnatalbody.com if you have any questions, comments or want to suggest a guest/topic
Playing us out this week; "Stay up high" by Thruline
Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, peter Lap. That, as always, will be me. This is a podcast for the 10th of November 2024, and the day before music. Obviously, I have a guest on right. Today I'm talking to Alison Yamamoto and we are talking Red S. What is hypothalamic amenorrhea? Basically this is ischemic aminorrhea, but basically this is when you're training or under or being undernourished, affects your menstrual cycle and all that type of stuff. This happens a lot with people who exercise a lot. Postpartum happens regularly and all that sort of stuff. So this is a really nice, important conversation and alison is exactly the person to talk about. So we're talking about what is it, what causes it, what the solution is and all that type of stuff. It's an absolutely wonderful chat. So, without further ado, here we go. What is red s and how does it affect someone?
Allison:Yeah, so RED-S stands for Relative Energy Deficiency in Sport, and it's something that is actually a condition that's quite common, although the terminology around it isn't widely known, and so there are even statistics that show that the actual prevalence of people that know about this issue or know to look out about this issue is really low compared to the amount of people that this actually goes, this happens to you, or who are experiencing this type of issue.
Allison:So, essentially, what it means is it's the same term as female athlete triad for those that might be familiar with that terminology, but the TLDR, which is like kind of like the.
Allison:The summary of what a red S is or reds, is that it essentially is an instance where you're in an energy deficit that is chronic, which is to say that you're not getting enough fuel or energy, taking in enough through food and nutrition to support your daily activity or your daily energy needs, and when that happens over a chronic period of time, that that is associated with various health risks that we don't often acknowledge fully.
Allison:And one thing that's really amazing about women specifically, and when they're experiencing this type of issue, is that we can use our menstrual cycles as a barometer to be able to determine whether or not this is something that we're experiencing at a pretty severe level, because in more severe and acute cases where someone is experiencing this issue, then it can impact our reproductive health, and it's diverting energy away from what our body is perceiving as secondary or the non-critical, absolute survival mechanisms of our body, such as reproductive health, and so, therefore, we might start missing cycles or experience cycle irregularities or not have a period altogether, and so that's one of the ways that we could catch whether or not we're having this, but it's essentially a syndrome that is causing other type of risks, such as decreased performance. It could be causing our muscles to actually not perform at our best, but even like catabolize, which can lead to other type of issues, such as digestive issues, it can compromise our immune functioning and there's all these other downstream impacts of us maintaining these chronic states where we're not getting enough energy.
Peter:Because there's a lot happening there. Is there a specific group that is more at risk of this than other groups are? Because it seems to me that certain people must be more vulnerable to this than other people.
Allison:Yeah, it's such an excellent question. So there's two general leading indicators, I would say that would make someone more at risk. The first is people who are exercising, especially in sports, where there are higher body standards or there's a pressure within that sport to be leaner, or where there's a pressure and an expectation that being leaner might lead to better outcomes, and so this might be endurance athletes, it might be dancers, it might be really any sport where there's a lot of pressure around body standards and or high levels of exercise, where it can be harder to meet those feeling needs. And then the other area that can be more prone to this type of issue is folks that are dieting or really focusing on clean eating or really optimized around their nutrition. They can be that kind of group or demographic of people can be more prone to experience this type of issue.
Allison:And I guess a third that I would also mention is that for a lot of us and I think this is especially true in women and very relevant for your audience is that when we experience transitional events in our life, such as going through pregnancy, going through the body changes if affiliated with pregnancy, becoming a new mother, or any of the other transitionary events such as graduating from college or starting a new job, those can. Getting a divorce, getting into a new relationship like those can all be instances where we're more vulnerable to fall into these types of patterns, and so it's definitely an area that is worth being more cognizant of, where we might be using our nutrition or our exercise to either manage through some of that stress, or to try to control the way that we're looking in certain ways, or to feel like we want to be really hyper-focused on our nutrition. For any of those reasons, those transitionary events can be triggers for this type of lifestyle changes that could lead to experiencing something like reds wow, there's a lot again.
Peter:There's an awful lot happening because, so, because so, the first thing that that came to mind, as soon as you mentioned athlete, I thought, okay, so we have gymnasts, right, because we know a lot of gymnasts, female gymnasts, um, really, you know, they miss out on their their first period, let alone they start so young, and that varies very much. A an intense um, there's an intense focus on on weight, um, or at least there was there, probably still is, but um on weight and physique and all that type of stuff. Rowers jump to mind as in for people that, like I've worked with, they always have to make a way to sit in a boat. Do you know what I mean? So, if you're constantly, it's all power to weight ratio, that's all these women and men care about. Right, you have to be as light as you can yet perform as hard as you can. And you know, half of the CrossFit world I know at least a lot of those women are because of the intensity that comes with that type of exercise, that type of at least elite level sport.
Peter:Right, as I always explain to my listeners, because I think it's useful for normal people, as in normal people who are not elite level athletes to be aware of. There's nothing healthy about being an elite level athlete. Right, it's all about pursuit of excellence and just winning whatever you can win at any cost, because if you don't, someone else will fall into that particular particular gap. But what you're saying and this is why I'm bringing this up it's actually really interesting. That is actually, if you get to that stage where you start missing periods and all that type of stuff, you're not actually functioning at an optimal level. You just think you are. Do you know what I mean? As in when you're talking about muscle function not actually being optimal, you're more tired. You're probably more exhausted because you're not fueling yourself enough. You're not actually performing as well as you can or as you should probably be, even if you're an athlete, let alone if you're a normal person and such as someone who's just given birth exactly.
Allison:That's exactly right. And the thing that I will say also is I think that oftentimes, because we will affiliate folks that are experiencing any sort of athleticism at that higher, more elite levels, we often might assume wrongfully so that this is something that doesn't happen to people that are we want to not even identify as an athlete because we're not competing at some high level or we're not doing some sort of specialized sport with specific events. And, of course, to your point, experiencing or participating in any of those modalities where there is that pressure and there is very high intensity, pressure on training and stuff, would increase your likelihood of experiencing this. But I have seen people across the spectrum, in terms of how often they're exercising, that have also experienced this type of issue, and so it's something that is, when we're talking about prevalence, happening across the spectrum, not just in those that are elite and to your point, I think that you put it excellently, which is that if you are experiencing this deficit to the point where it's impacting your menstrual cycle, then you are actually in a situation where your performance is being impacted negatively because a lot of your hormones are being suppressed that are helpful in encouraging bone health, that are helpful in encouraging appropriate repair in your muscle that are helpful in actually building muscle. And, in a really weird and ironic way, a lot of the hormonal profile you're experiencing while you're in this state where you're chronically under fueled, is because it's in survival, actually encouraging your body to maybe have higher fat storage in order to be able to work through that survival.
Allison:And it's saying we're just trying to keep the lights on, and it might even be, in very severe or worst cases, not only catabolizing some of the muscle that you or not even just you know, not repairing the muscles that you need to be able to function and perform at the highest level and to be able to build strong and supportive muscle, but it's also potentially catabolizing the muscle in your digestive tract that could be making you experiencing some of those digestive symptoms that are causing discomfort, and so there's kind of an array of spectrum of issues that could be occurring as a result.
Allison:But, to your point, even the performance is being impacted, and so that's everything from like cognitive functioning to, you know, elevating your actual cortisol levels, because if you are in a state of this, like chronic energy deficit, your body is experiencing that as a higher stress situation that is making you more prone to have higher cortisol and therefore, like more chron morbid, be more at risk with chronic stress. So it is really interesting how much of your physiology, but also your day-to-day experience, is pretty impacted by being in this energy deficit yeah, and I think a lot of that again fascinating a lot of that is.
Peter:I think a lot of my listeners will be familiar with that idea. Where you have more IBS, right, you have higher stress levels, and with stress comes forgetfulness. We spoke about before we went live how I'm always forgetting stuff brain fog, if you will, and it's interesting because a lot of these symptoms there seems to be a huge crossover with what we would say okay. So we have mental health issues, stress, anxiety, that huge issues that we almost class as normal I am. I am an anxious person, so to speak. I am a. I suffer from high levels of stress. Um, I don't sleep particularly well. That that type of thing that that we're are. I have ibs. I can't even eat. I don't know gluten anymore that type of thing that I have IBS, I can't eat. I don't know gluten anymore. I can't eat bread anymore without breaking out in hives, even though I don't have celiac disease.
Peter:A lot of my listeners will be thinking that's what they are like. I'm very lucky. Like I said before the thing, I'm a middle-aged white guy. I can eat whatever I want, right, because my life is as stress-free as it could possibly be. As I accidentally kicked Lola. For my listeners that's what the ground was. So a lot of women, especially women, will be very familiar with a whole array of these symptoms that you've mentioned, but they've never linked it to their food intake. And so is this a chicken and egg situation? Is this a you're not eating enough and therefore you have all these symptoms? Or you have all these symptoms and therefore you know you're not eating enough? Is it just one of those type of where do we start, other than with awareness of of the issue?
Allison:yeah, it's. That's a really interesting point, because one of the things that I see quite frequently that's that's fairly common is misinterpreting some of these symptoms to believe that there are food intolerances that then lead to more restrictive habits when it comes to food. That may be well-intended even, but it's not necessarily the case. And then that becomes a reinforcing thing where, oh, you started to believe that you were intolerant to this thing and then, by eliminating it, then, when you reintroduced it, you might actually have developed what you believe to be now discomfort around this thing. And I'm not saying that food intolerances don't exist, because they absolutely do. And there are definitely cases where, of course, if you're getting allergy tested for something, it's coming up as positive, and then I would absolutely adhere to those, that type of advice. And and there are instances and there are absolutely conditions where people might have so many allergies or so many intolerances when it comes to food that that actually is there's an eating disorder that is specified to that situation where there's so much restriction and potentially even fear or bad, bad memories or bad situations that have occurred in the past that have led to more restriction around food to the point of, like it being a circular, a kind of like a circular cycle where one is causing the other chicken and egg. Um. I would say that the majority of cases that I'm seeing are the instances where the beginning started with some sort of dieting, some sort of attempt at weight loss, some sort of food restriction or adhering to really rigid food restrictions or advice that was really demonizing certain types of food categories that then are leading to some of these symptoms that then might lead to some other rabbit hole of trying to go after food restrictions, and oftentimes the biggest mistakes I see people making when they're coming to me or when I'm working with them are focusing less on the very fundamental aspects around their nutrition, around their training that might be leading to these dips in energy or that might be leading to feeling really burnt out, versus then focusing the redirecting and focusing their energy on these minor little optimizations, because they might be trying to fix some of these issues that aren't really going to be helpful if we're not addressing the absolute fundamental building blocks.
Allison:I think I want to also circle back to one of the other things that you said that I really resonated with, which was this notion that we have normalized some of these things to the point where we either A believe well, I can push through it and I can endure this, and so therefore it's not a big enough issue for me to be able to address or prioritize, because maybe my doctor told me the labs were normal, or because maybe it's not such a big issue that I couldn't push through this workout.
Allison:Still, and that is one of the most disappointing areas where people aren't seeking support or aren't making some of these changes because we've so much normalized.
Allison:Well, discipline means pushing through anyways, and it means that if you aren't feeling your greatest, maybe, but everything is coming back normal, that you shouldn't seek help or you shouldn't make a change.
Allison:And then the other area I think that's really interesting is internalizing it, to believe that it is normal and thinking oh, I am just really high stress, I am really anxious, and a lot of the times, the people that are more prone to experience this type of issue are the people that are really high achievers. They're people who are really disciplined, they're people who tend to be more perfectionist or just set really high standards for themselves, and the interesting thing about that is that they're also the people who probably, at baseline, have higher stress because they're going after something, or because they're have a really loud inner critic, and so the fact that they could also be in a situation that's somewhat artificially increasing their stress levels even more because they're going through these diets that are increasing the cortisol levels within their human physiology is something that it's hard for potentially to differentiate between. Oh, this is actually more stress than I even myself need to be experiencing relative to if I made some changes that corrected for some of the energy availability that they may not realize that they're struggling with.
Peter:Yeah, there's a lot happening there. And again, as a white guy, I will make this all about myself for a little while. Um, rather than that, listen. But what I found? I used to have a proper job before this, right, a long, long time before I became a pt, like 15 or so years ago, I was a project manager, uh, and I'm quite old. So I was a project manager for quite a while and I used to wake up at half past four in the morning and I used to be in the office at roughly six o'clock in the morning, well before everybody else. And if I to be in the office at roughly six o'clock in the morning, well before everybody else, and if I showed up in the office at quarter past six, I was already. My engine was at 90, if you know what I mean. I was revving that. I idled at 70 mile an hour. But if I was 15 minutes late, even though I was there two hours before anybody else, I was already at 90, right, and that is when I started then.
Peter:Ok, but I also need to look after my health and therefore I also need to go to the gym, because that is the solution for me and I hope people can resonate with this. It was always doing more rather than doing less. It's always OK, I need to start. I'm clearly stressed. Well, exercise is good for that, so I'm going to go to the gym, I'm going to lift some heavy weights, and then you fall into that habit of okay, I do 12-hour days and I wake up really early and I'm always stressed, and then I have to go to the gym the whole time. I have a wife in the house, by the way, so she would like to see me every now and again as well and do stuff. So you have that on top of it. And then you're like okay, but I'm going to the gym, so I need to eat a certain way, otherwise there's no point going to the gym. So, before you know it, the protein shakes come out and you ate a bit more protein and you have just microwaved scrambled eggs for breakfast. Yes, people, breakfast, yes, people, that's the thing. Um, and your food. And only on a friday do you have like a takeaway which is has to be like a chicken kebab, because that way it's still higher protein.
Peter:And never at any stage did I consider taking a step back and slowing down and just and I'm not talking about like mindfulness and hugging the tree if anybody listens to this but just not being so incredibly worked up when nobody else around me was. Like I said, it was in the office two hours before anybody else was, including my boss. So why am I showing up at six o'clock every morning, stressed out of my head, and then then when, when nobody is actually expecting of me other than myself, and that's exactly what you're talking about? I used to train and I don't know names on the podcast, but I used to train female professional who was always, who had never, who was always stressed and arguing, arguing with her then fiance, in the car on the way to work. They used to share the car on the way to work and they were always arguing. Because she was always stressed, because she was always in a rush first thing in the morning and she never considered waking up 10 minutes earlier. It just didn't. It just didn't enter her head that waking up 10 minutes earlier to give herself a bit of extra time to have a shower, do you know what I mean?
Peter:Sometimes we can really not see the tree from the woods or the woods from the trees, or whatever the saying is. Like I said, I forget things and therefore it's quite useful for people to get an outside perspective from someone like yourself. They can just say wait a minute. What you're doing now is not actually optimizing your lifestyle in the way that you think it is, and it's actually causing more issues than it's solving. Doing more isn't necessarily the best way is my very long way of my too long didn't read there. And then it's solving. Doing more isn't necessarily the best way. It's my very long way of Too long didn't read that.
Allison:Yeah, I think that's also interesting because there to other people's credit as well there's so much confusing information that exists in the ether about nutrition and about exercise and what you have to do or you should do or what you need to do what you have to do or what you should do or what you need to do and sometimes that overwhelm in and of itself especially when you're balancing a family or a job or a myriad of other things that are going on in your life that it can feel hard to actually go layers and layers deeper to try to see exactly what is should I be doing, should I not be doing?
Allison:And if someone is really convincing that this certain thing leads to some outcome, whether it's like an aesthetic goal or like a body standard or some sort of fear-mongering based for health and wellness it's really really hard to differentiate fact from fiction, and it can also create a level of stress around nutrition or around exercise where it seems like there's a right and a wrong and it feels like there's things that we should be doing and that can add a lot of pressure, and unfortunately, it seems like in a lot of these instances the misinformation tends to be louder than the really credible and helpful information, which is what sometimes leads to this rabbit hole of people getting stuck in these cycles or these patterns or these lifestyles that they don't realize are not necessarily best for their own health or their nutrition or, you know, whatever their performance within their daily lives are that they're really trying to optimize for yes, because it's especially like what you said.
Peter:The first thing I get a fair few emails because of the podcast and all that type of stuff and the first thing that people tend to see is social media stuff. I think this is the way everybody's life now. My Instagram feed is now full of stuff that apparently I need to buy for my dogs and for my cats, but other than that, it's all buy this and it will make your life healthier better. There's a shortcut Buy structured water and you healthier better. There's a shortcut, you know Buy structured water and you'll feel better. Buy magnesium pills and you'll sleep better. Buy whatever else you need to buy and this is the answer to you know. There's an ad I saw on Instagram the other day saying you know, ibs is caused by blah, blah, blah and it's all brain retraining type stuff that they're saying. I saw on Instagram the other day saying you know, ibs is caused by blah, blah, blah and it's all brain retraining type stuff that they're saying will then cure your gluten intolerance and all that type of stuff. It's really weird, but my feed is a mess. It's essentially too long.
Peter:Didn't read that? Taking an actual look at things requires probably a bit of outside, a bit of outside help, without actually working with someone so you can have a look at what your own life and what your own situation is. Because of course, we can all give generic type information, as in yourself you'll say, okay, eat a bit more and you'll probably feel better, right. But if someone really wants to know what works for them or what their causes are, it's probably best if they work one-on-one with someone like yourself who can just say, uh, in your specific case, this is more likely to be the solution than just a generic buy more stuff, if that makes sense.
Allison:Yeah, absolutely, and I think that there's. I guess one of the really common issues that I see people making as an example of this would be when folks are really really focused on purely just calories in, calories out, and they're really thinking about nutrition and exercise as this math equation that they have to achieve on potentially like a daily basis or whatever it is, and sometimes that really overlooks the importance of one of the factors that I'll mention, which is energy availability. And this goes into understanding the timing that you're having certain meals, how you're having certain types of foods around your exercise, and so, to your point, it's like not even as simple as the advice of, just okay, now you need to like eat more, which I think is oftentimes not necessarily the full solution. And a lot of times the mistakes that I'm seeing are okay. They were trying to. You know, we're trying to do some sort of diet regimen or some sort of like time-based eating or whatever.
Allison:It is that we or maybe we just didn't realize the importance of trying to think about energy availability throughout the day and what that means around our workouts, and this could lead to the same type of challenges that people run into, which is trying to optimize their exercise instead of like around performance or around actually achieving their goals when it comes to their fitness, or whatever their goals might look like when it comes to their exercise, and instead they get into these programs that are causing them to burn out a little bit more, and that could be anything from doing high intensity cardio every single day and feeling like they need to do that every day in order to be able to earn their food, or to feel like they accomplished something, and I think that, being on that, I guess treadmill for if we're going to use a metaphor can be what's contributing to either overtraining or burning out, and also not even helpful for, or necessary potentially for, what their actual goals are when it comes to their fitness.
Allison:So I think that those are the types of myths that I can see people falling into that are really common when it comes to trying to interpret through or go through what they're potentially seeing to your point on social media yeah, and so so do you find most of this stuff for women especially, starts with a place of calorie restriction, or do you as in?
Peter:because nine out of ten? When I first started focusing on postpartum health, nine out of ten people came to me for weight loss, postpartum weight loss right, I need to get my body back and all that type of nonsense, and thank God we've moved away from that, at least I see it a lot less. Uh, but it took like 10 years or 15 years, however long it took, but it's it's. Do you? Do you find that that's where it starts, as in with? From a calorie restriction point of view? No, no matter which situation. Like you said, it doesn't just affect athletes and even people who work out. You can bring this upon yourself just by massively restricting your calorie intake. So is it just by calorie restriction that this brings up, or is it a? Do you find in some cases, people maintain their calorie intake at such a level but then forget how much more active they are?
Allison:it can definitely be both.
Allison:I would say, though, that in a lot of the cases where there's quote unquote calorie restriction, that sometimes it's not the case that the person thinks that they're in an extreme calorie deficit, but it could be something that's accumulating over time, and so if your body needs and I'm going to try to avoid numbers, because sometimes that can be triggering for people, but a lot of times women especially underestimate what they need just to support whatever it is that they're doing on a daily basis, let alone adding any sort of exercise on top of that and I think this is particularly true for a woman that are postpartum, actually, and what that can lead to is being in a calorie deficit, intentionally or not.
Allison:So there might not even be active restriction, but if you're focused on clean eating, or maybe you just don't think that you need that much, or maybe you feel like you're comparing yourself to the people around you and they may not be eating that much that we might be in a situation, especially in social media, where you're seeing other people and how much maybe they're eating and thinking that that's normal, where we've normalized an amount that someone could be eating that is below what they actually need to feel their best, to feel energized to actually maintain the muscles that they want to have, even if it's lean muscle, and if that continuously occurs day over day for a long period of time, then what we don't realize is that we're getting and falling into these patterns that are being reinforced day over day.
Allison:It's kind of like the same metaphor of how little habits can really build into bigger lifestyle decisions and maybe even your identity over time, where if you decide to maybe go for a run one day and then if you continue to do that day over day over day, eventually at one point are you a runner where you are running? And it's kind of a similar situation where those those little changes that we might make, we don't realize how much those can impact in bigger ways over time.
Allison:So a lot of it comes down to like a constant awareness type thing, as in trying to be aware of how you're feeling, trying to be aware of what you're doing on any given day and the actions you need to take around that without just, like you said, without just counting calories all the time and all that absolutely yeah, and there are ways to do that without being that methodical about it, meaning that without counting macros or without counting calories specifically, there are frameworks that you can use and general heuristics that you can follow that, in combination with understanding your own self individually, which is understanding how you respond to those things, how you feel around those things and this is something that I really value about the individualized approach that we take with people, is that there are nuances that will differ between people to people, as well as what their goals are, which I think is a really important factor to come into play.
Allison:That there are frameworks that we build around that, because my goal is not for every single woman to feel like they need to be thinking about food all the time and that they need to be stressing about it, and that they need to feel like they can and cannot do certain things with absolute rigidity, as much as being able to provide the tools that are actually in service of what it is they want to achieve and how they want to feel around their bodies and how they want to feel within their lives and how they're showing up day to day, and I think that the unfortunate thing is that there are two different camps, where people can be really interested in their health and not realize that they're falling into these patterns that aren't actually helpful for their health, and then the other extreme, which is that they might have, you know, no interest in their health and no awareness whatsoever, and so therefore they might be not thinking about it at all and falling into some of these patterns in the same way, and so I've seen both ends of the spectrum where they end up in a situation either out of being a little bit too optimized and a little bit too rigid, or, in the other extreme, being a little bit too I guess I'll use the word unintentional around how they're fueling around some of their activity levels that can make it really easy for people to fall into these patterns, even when they don't realize that they are yeah, and I suppose that second bit is really where a lot of postpartum women come in right, um, especially because what I see a lot and what I see a lot in, as in in my face-to-face pt side of things, is a lot of putting yourself last to the, which is very common for for mothers to do that for like decades.
Peter:So when you're talking a prolonged period of time, mothers are a prime example of this right, you put yourself at the bottom of the tree, so to speak, for for 12, 13, 14, 15, 16 years, or when the kids go leave to go to uni or or something like that. And I find for a lot of, of course, it comes with high stress, right, I don't know if anyone's most people listening to this will be postpartum. Already adding a baby to your life adds a certain level of stress, believe it or not? It it really really does. And then if you then don't get the chance or are not aware of how to nourish yourself, I suppose it becomes a bit trickier and it then becomes easy to fall into that second category where you are.
Peter:It's not that you're not necessarily not interested in your health, you just are not aware of it declining more than it maybe should, as age progressives. Do you know what I mean? So do you feel this? Do you? Because this just occurred to me? Do you? Then? Do you see this more now in slightly perimenopausal women, so women who are, say, 40, a lot of women give birth when they're 30 years old. So they've had, say, 10 years of raising kids and putting themselves at the bottom of the tree and then, from the age of 40 onwards, technically you know, perimenopause is starting a little bit and people could then women could then therefore well think that, hey, actually it's normal now that I'm going through this, with less sleep and more anxiety and my irregular period, I'm just going through the perimenopause. So that almost gets mixed up with red S.
Allison:It's definitely something I see happening across the age spectrums when it comes to women, and so that means that I see this happening with everyone from teenage girls all the way up through to perimenopause menopausal women as well, and I think that speaks a huge testament to a few things.
Allison:One is woman's health and where woman's health is at in terms of clarity and support, but then also the pressure that women experience at all these different ages to navigate their nutrition and their exercise and their fitness in a way that can be a lot of pressure across every single age group, and so it's definitely something that I see across the spectrum, and one of the things, to your point on prioritizing yourself that can be a huge disservice is either ignoring the signs that this could be an issue or not prioritizing your own support and health and getting resolution or some sort of of mechanism to change and address some of these factors, and I think it's something that, at least for me, because this was something that I experienced for many years before I ultimately created the programming that I did and work with a team that is specialized in this area to be able to help other women, it was something that I very much underestimated.
Allison:How many other things that it would change that weren't just helpful for me in my own selfish realm of how I'm going to feel day to day or what I'm going to do, or whether or not I can do this thing or that thing.
Allison:It was something that I realized was hugely impactful for how I was showing up for other people and how other people were experiencing some of the areas that I didn't realize were impacting people in ways that were significant for them, and so I think that it's something where I think it's kind of cliched, but also cliched for a reason, in that it's true that being able to seek support and prioritize addressing some of these types of underlying issues and actually investing in that as a solution is something that can not only change your own experience in life for in a non-trivial way, but also how you're relationally experiencing things with others and how they're experiencing their own relationship to you or how they might perceive your own stress levels or whatever else. It is, um that I definitely underestimated how much other people would have an impact from me having made those changes myself.
Peter:Yeah, because that's huge, isn't it? I remember seeing a thing from Andy Murray, the tennis player he had to have a hip operation. He had to have a hip replacement because he was constantly in pain and I did the whole thing about the pain cycle a while ago. Operation, he had to have a hip replacement and because he was constantly in pain and and I did the whole thing about the pain cycle a while ago, if you're always in pain, you're always uncomfortable, and if you're always uncomfortable, it affects your mood. If it affects your mood, it'll affect your kids, it'll affect your spouse, in fact, every, every relationship around you.
Peter:You might not necessarily be aware that it is, or you might think it's normal that it is, but I don't know anybody who, I don't know anybody who is constantly uncomfortable within themselves that has, let's say, optimal relationships with people, with people around them. Right, and that pain cycle is, is a real thing. These things don't get better by themselves. They don't really get better without some sort of outside, um, outside interference, or some outside interaction, um, and I can provide a tangible example if it's, if it's helpful, or sorry.
Allison:Did I interrupt you?
Allison:No, no, you're great, okay, uh, yeah, and I can provide a tangible example if it's helpful, because I was just working with this a client who's a woman that, when she came into our program, was experiencing irritability, and it wasn't even something that she named, actually, she was just like I'm just a really highly anxious, stressed person and that's just kind of how it is.
Allison:And it was funny because, after having worked with us for I think she's been with us now for three months and her partner said to her that he has noticed how much less irritable she is, how much more he's enjoying being in our presence and he feels less on edge around her and he's seeing her navigate situations in a way that has been really game-changing for him.
Allison:Everything to, like you know, some of the things that was specific to their dynamic was around, like some of the things around the household and doing some of the chores, and he was commenting on how she was approaching some of those situations so differently and becoming less on edge around some of the things that before would have been really really, really challenging and potentially even leading to tension or conflict between them that he commented, and she was mentioning that as one of the wins that she experienced, and I thought that that was such an interesting example of how that wasn't even something she had acknowledged as a goal she had even acknowledged as a focus coming in and yet was something that was clearly impacting her own partner in to the point that he brought it up as feedback, and so I think that that is really trying to provide a little bit more specificity in terms of what I mean when I say that this has the potential to impact those around you in ways that we might not even realize yeah, no, no, absolutely.
Peter:I think, and again it comes very much back to that thing which you spoke about earlier, where people almost they normalize being a certain, but they don't need to be that certain. They normalize being anxious or irritable or, like I said, when I had my really shitty job, idled, as bill burr would say, I idled at 70 mile an hour with regards to my anger towards or irritability towards other people outside my relationship. I was just someone in front of me, someone driving in front of me, slowing, going 50 mile an hour, where this could be going 60. That would already have me going.
Peter:This guy, you're not this guy, and it was nothing to do with that guy, nothing to do with the person in the car. It's all about me and all internal, but I just thought that that was just the way I was. Unfortunately, that then has, as you said, it has an impact on the people sitting in the car with you, when you're like nobody likes to sit next to an angry driver, right, and, and that is that is how all these things kind of become, when people say, oh, I'm just anxious, or, and then you go see the doctor and the doctor very kindly gives you some medicine and all that type of stuff. And if you don't address the root causes of these things, you might well be less anxious, but you still have red S because these things don't. I think this doesn't go away with medication, is what I'm saying.
Allison:Yeah, that's a really good point. So a lot of the times one challenge or risk that can happen is if somebody is experiencing this issue, then I've kind of usually seen one of two things happen, and one of them and this is assuming that they try to seek a doctor so a lot of people don't even try to seek anyone to support because they don't even realize that this is an issue, and that's probably the vast majority of people. But then let's say that somebody is experiencing mental disturbances in some way, then going to a doctor and being able to get support is really important and helpful. Because if, because of two things, one is a lot of the times I see doctors saying either it's normal because you don't exercise, which it's not and then the other thing is saying, oh, it's fine, we'll just give you birth control, which also does not adequately address the underlying issue, and so, although it can give the, as a result of taking birth control can potentially make somebody bleed, it's not actually addressing a lot of the other mechanisms that are going on that are causing the deficit, and it likely is not actually addressing a lot of the other mechanisms that are going on that are causing the deficit and it likely is not even addressing some of the hormonal issues that were being experienced as a result of the energy deficit, because it's not a real, quote-unquote, real period that you're actually getting on the birth control pill, and so this is one where the best treatment, the best, best, best treatment if you're experiencing this type of issue, is to fix the energy deficit, and any sort of hormonal intervention really is either a temporary fix or it's a bandaid on the problem, see, is going to the doctor and then just getting dismissed altogether and saying, oh, actually you're fine, because maybe we took a few more labs and we think it's fine, or oh, but you have a healthy lifestyle, you're clearly exercising, you clearly care about your nutrition, you're fine.
Allison:Dismissing it and then, therefore, sort of validating the voice in your head that's like oh, this isn't a problem, I shouldn't worry about this. I'm going to deprioritize this, and both of those were experiences I experienced firsthand. They're super common. They're things that people coming to us. It's almost like a through line of what people are experiencing, which is really really, really unfortunate, and I wish that that was something that we could change overnight, and unfortunately it's not. So if that is something that is happening for you, then please don't hesitate to reach out to me. I'd love to hear your story. I'd love to see how I can support or advocate in any way, but it is something that I see is really frequently happening for folks that are experiencing this type of issue yeah, especially.
Peter:I mean, everybody knows the story, but anybody vaguely familiar with women's health and, you know, includes all men who have a sister, a mother or a partner or a female partner.
Peter:You should really be aware of this.
Peter:The amount of women that go to a GP, which is their first port of call, and they bring something out and then get dismissed Whether the GP is male or female doesn't even seem to matter all that much.
Peter:It's just not unless the gp has some personal experience with it. They tend to be very, um, very dismissive of issues like this, or they say it's normal, which is kind of why I asked about the perimenopausal sort of link, because, of course, irregular periods and all that type of stuff is very much part of that, and the GP's initial response is very likely to be yeah, you're fine, even if you're not perimenopausal, even if you're just 42 or 38 or whatever, even if you just show up as a woman of a certain age. The response is usually it's the standard, this is normal for your age, rather than let's have a look to see what it could be. I don't know a single GP that would ask any woman hey, so who looks healthy, who looks fit, who exercises. Hey, so what are you eating? Are you eating enough on a daily basis? So what would you say? Are some of the things that you say okay, this is really where you want to start your recovery.
Allison:If you think that you have you, that you might have red ass yeah, so I would say that and, unfortunately, because a lot of women are the, in some instances where you're not on birth control, you have a menstrual cycle and you're getting that feedback loop and you know that you have some menstrual disturbances, then in that case, and you're experiencing those menstrual disturbances, because there are a few different reasons that you could be experiencing menstrual disturbances. If that's the primary indicator that you have, then I would recommend starting by reflecting on your lifestyle, because oftentimes it's fairly people who know will know. But to get some validation, it is helpful to go to an endocrinologist who can eliminate other potential reasons that you could be experiencing those hormonal imbalances. In parallel with that, if you think that you could be experiencing an issue with energy availability, then, and because of you're having those meals, how you're navigating macros, whether or not you feel like there's a lot of rigidity around food, or whether you feel like you're intentionally feeling around your workouts or your training sessions Really starting to tune in with yourself is one area where I like to start to be able to validate.
Allison:Are you feeling burnt out, especially in your workouts? Do you feel like sometimes you're having struggles making performance gains? Do you feel like you feel cold really often and being able to start to tune into yourself, to see what are the signs and symptoms that I'm observing in my own life. It could be elevated levels of stress. It could be feeling really fatigued fatigued or having really huge dips in energy where you feel like you're constantly going for that coffee.
Allison:It could be disrupted sleep, which I know for folks that are postpartum, can be a really hard thing to assess, because there's obviously other factors that are going into that, but starting to try to tune in to gain that awareness, and if these are patterns that you're starting to see in multiple different areas where it's sort of leading back to oh, I actually might not have tied together the fact that I'm experiencing unexplained digestive issues with perhaps some of the dips in energy that I'm experiencing throughout the day, or the really elevated stress levels, or the fact that I'm having a lot of frequent urination some of those factors tying them together can helpful in realizing oh, actually, maybe I should start to take action and then, at that point, I usually like to recommend focusing on energy availability, and there are a couple of different factors that go into that and and I alluded to some of them already here today so I would start there, or start by reaching out and you can speak to someone like myself, or even messaging me on Instagram, and I'm happy to have a conversation to help you navigate or to help you understand your situation a little bit better, or where you could get started as well.
Peter:Well, awesome, that sounds very excellent indeed. On that note, was there anything else you would? Because I think we covered a tremendous amount. Was there anything else you were like, oh Pete, I wanted to bring this up, or because I think we, like I said, we covered loads here.
Allison:I think we covered most of everything.
Allison:I would just like to say that one thing that can be really challenging during having this experience, and especially in women's health in general thing that can be really challenging during having this experience, and especially in women's health in general, is just how isolating it can feel and how hard it can be to feel like you're potentially getting dismissed by certain places where you're trying to get support or where you're feeling really confused or you feel like it shouldn't have to be so complicated, and so having a support system or a support network or a support program, like in the case of the one that I've built, can be really really valuable because you don't have to navigate on your own, and I really truly believe this so strongly for women especially and I really meant it when I said reach out, ask me questions or just shoot me a note.
Allison:I always love to hear from folks and and talk to people directly, and I think the best way to do that for me is on instagram, and so I'm on instagram at alice yamamoto and I'm sure we'll link my website and everything else in the show notes yeah, we will definitely definitely do that.
Peter:Lovely, thanks very much. I will not have been able to press stop record here and press stop record is exactly what I did. Thank you so much, alison, for coming on. That was absolutely, absolutely wonderful. She's a wonderful guest. I definitely recommend checking out the Ally Method website because you know this is it's a common. It's a common. It's.
Peter:This sort of issue is more common than than people are led to believe. We come across this a lot, especially with people who run a lot and all that sort of stuff. Crossfitters have this quite a bit and you know, when over training or under nourishment just under eating essentially right. When overtraining or undernourishment just under eating essentially right. When that starts to interfere with your menstrual cycle and all that sort of stuff, the solution is fairly straightforward if you have a bit of guidance, and Alanson is exactly the person to go and talk to about this type of stuff, and it's always nice when I get to talk to another expert who just really knows what they're talking about. I absolutely love that, peter at healthyplusnatalbodycom. By the way, if you're like, hey, pete, I want to come on, I've got nothing better to do for an hour once a week on a week, even Don't have to come on every week, right? If you want to take over, you're welcome to it, but it's um. Now, if you want to come on, right, and then peter at healthy postnatal bodycom, if you're listening and you're like, hey, I, I know somebody who would like to come on or someone that I would like you to interview or a subject I'd like you to cover again, just peter at healthypostnasalbodycom. That's the email. Or indeed, send us a text. The text works. I'm getting text messages in from people and all that sort of stuff, which is actually really really quite cool. Anyways, that's it done for yet another week.
Peter:Next week I have an interview with Emily Wilson. Week I have an interview with Emily Wilson and the week after I am talking to what is it? Emily Wilson and I are talking postpartum planning, by the way, and then it's Dr Jesse Haymeyer the week after. You know we're crushing it this month. It's absolutely amazing. Anyways, you take care of yourself. Here's a new bit of music. Bye now. Thank you, thank you do um, thank you, bye.