Latest / The Brilliant Fertility Podcast / Episode 078: What Your Period Pain is Trying to Tell You

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Episode 078: What Your Period Pain is Trying to Tell You · The Brilliant Fertility Podcast

• 0:04
  SPEAKER_00: Welcome to the Brilliant Fertility Podcast.
• 0:07
  SPEAKER_00: I'm your host, Dr.
• 0:08
  SPEAKER_00: Katie Rose, and this podcast exists to help illuminate the path ahead of you.
• 0:14
  SPEAKER_00: With expert interviews, clinical pearls, and real client success stories, my intention is to bring you hope for what's possible on this journey, and to give you tools and resources to navigate the ups and downs on the road before you.
• 0:28
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• 0:34
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• 0:35
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• 0:38
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• 0:42
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• 0:44
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• 0:47
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• 0:52
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• 0:57
  SPEAKER_00: And I'm so grateful for you for being here.
• 1:15
  SPEAKER_00: I almost couldn't believe that we didn't have an episode dedicated to this yet.
• 1:20
  SPEAKER_00: And this episode is all about period pain.
• 1:25
  SPEAKER_00: This is something that about 84% of people with uteruses have reported.
• 1:34
  SPEAKER_00: And it's really wild to me how normalized period pain is, especially given that it is a vital sign.
• 1:43
  SPEAKER_00: It's giving us information about something that's happening within our body.
• 1:48
  SPEAKER_00: And maybe it's just like my current state of feminine rage, but I'm I'm mad that this hasn't been more acknowledged.
• 2:00
  SPEAKER_00: And um, if you're watching on YouTube this time around, you might be noticing like I'm I'm seated differently.
• 2:06
  SPEAKER_00: I'm actually sitting on the floor today.
• 2:09
  SPEAKER_00: And that's because when I was on a retreat in Mexico last month, we had our our daily circle on the floor.
• 2:22
  SPEAKER_00: Like we could shift around however we needed to.
• 2:26
  SPEAKER_00: But what was really interesting, I promise, I'm going somewhere with this, is my period started while I was on the retreat.
• 2:33
  SPEAKER_00: I was kind of dreading that because I tracked my cycles, I knew it was going to be happening.
• 2:38
  SPEAKER_00: I was like, damn it, of course, I'm gonna be in Mexico and this is this is gonna start.
• 2:43
  SPEAKER_00: And I was really dreading it because historically, my periods are moderately painful, and and that's a huge improvement over where they were 15, 20 years ago.
• 3:01
  SPEAKER_00: Huge improvement.
• 3:02
  SPEAKER_00: So like I wasn't complaining per se, but here's where it gets really interesting, to me at least, if you're a nerd about periods, and if you're listening to this podcast, you probably have one.
• 3:14
  SPEAKER_00: And my trade started, it started a day early.
• 3:18
  SPEAKER_00: There's a whole other story behind that, but started a day early, and it wasn't the least bit painful the entire time.
• 3:30
  SPEAKER_00: Like I I had I the only awareness that I had was, you know, I had to had to take care of the feminine hygiene aspect of it.
• 3:42
  SPEAKER_00: And that was so interesting to me that you know, it really had me thinking more about period pain, not that I don't already think about it on almost a daily basis, because it's part of what I ask all of my patients and clients about, but also just, you know, living in a cycling body and being aware of what phase of the cycle I'm in and what's approaching, and having more dread for my periods has been an interesting experience.
• 4:17
  SPEAKER_00: So, like I realized that I have some of my own work to do around that, and also having the experience of having a completely painless period, which like I could not, in recollection, pull up a memory of any time in my menstruating life when I could remember having a completely painless period.
• 4:43
  SPEAKER_00: Well, part of my story around periods was just not having one for a long time.
• 4:49
  SPEAKER_00: And so when I did get my period back, I was excited.
• 4:53
  SPEAKER_00: Like I was so grateful that my body was obviously doing something that it was supposed to be doing, that I have focused less on the pain aspect of it.
• 5:07
  SPEAKER_00: And so that's information that I am now like getting very curious about.
• 5:13
  SPEAKER_00: But it also reminded me that we got to have a conversation about what does it mean when we're experiencing a lot of pain?
• 5:21
  SPEAKER_00: What does it mean in terms of underlying factors and also what is it telling us about potential blocks to fertility?
• 5:32
  SPEAKER_00: So let's dive into that because I've been really marinating on this and reviewing the information that we do have, which, oh, like along with so many other things in women's health care, this is such an understudied topic.
• 5:52
  SPEAKER_00: It's it's pretty demoralizing.
• 5:56
  SPEAKER_00: And that's all I'm gonna say about that today.
• 6:00
  SPEAKER_00: And then I'm gonna go do some tapping about that so that I can deal with my own emotions around it without projecting them onto everybody else.
• 6:12
  SPEAKER_00: But what do what do we know about period pain?
• 6:16
  SPEAKER_00: Well, we do know that about 50% of people who have painful periods will be diagnosed with endometriosis or when they investigate for endometriosis, will be found to have endometriosis.
• 6:30
  SPEAKER_00: So there's that little tidbit.
• 6:32
  SPEAKER_00: But what about the other 50%?
• 6:34
  SPEAKER_00: And at what point do we need to actually pursue that investigation?
• 6:40
  SPEAKER_00: Would the percentage be higher if more people were getting accurately diagnosed for endometriosis?
• 6:47
  SPEAKER_00: Are there other things that are being missed in the medical world that we can be working on so that people can have more comfortable cycles?
• 6:58
  SPEAKER_00: And I was also just um remembering that someone shared an Instagram account with me that was um, I can't remember their name, but they were they were sharing how they they really enjoy being on their period.
• 7:16
  SPEAKER_00: Like there is an intuitive wisdom that comes through during that time.
• 7:20
  SPEAKER_00: They're really able to honor what their body is letting go of, and and they they really honor everything about their menstrual cycle.
• 7:38
  SPEAKER_00: And so I'm just being really real with you guys about that because I think there's a perception out there that because I've been practicing naturopathic medicine for so long, that I must have it all figured out for myself, that I must have this really perfect situation, and everything is just glorious behind the scenes and in front of the camera.
• 8:06
  SPEAKER_00: And like, no, like we're all just human, we're all just dealing with our own stuff as well.
• 8:13
  SPEAKER_00: But with with periods themselves, like in my practice asking about periods all the time, I have absolutely observed some patterns and some areas where I've seen immense improvement for people who have really suffered through their periods.
• 8:35
  SPEAKER_00: So, first I want to talk about like what are the major red flags?
• 8:39
  SPEAKER_00: Like, what are the symptoms or signs that someone might be experiencing?
• 8:43
  SPEAKER_00: Say, like this needs to be investigated further.
• 8:48
  SPEAKER_00: And then we'll talk about some underlying factors that contribute to menstrual cycle pain, what I've seen the biggest differences in in my practice with relieving pain, but also as part of improving the vitality of the cycle, improving fertility outcomes as well.
• 9:07
  SPEAKER_00: And then where we can fill in some gaps.
• 9:12
  SPEAKER_00: So, what are the big red flags?
• 9:19
  SPEAKER_00: This is obviously going to be a little bit subjective because so many of the women that I work with have developed quite a high pain tolerance.
• 9:30
  SPEAKER_00: And that's heartbreaking to know.
• 9:33
  SPEAKER_00: But when I ask people about their period pain and they feel like, oh, you know, like I can get through it, I can get to work.
• 9:40
  SPEAKER_00: I'm like, well, what is what does that mean?
• 9:42
  SPEAKER_00: Like, what would it mean for you not to have pain?
• 9:44
  SPEAKER_00: And they're like, oh, I don't even know.
• 9:46
  SPEAKER_00: I've never experienced that.
• 9:48
  SPEAKER_00: Well, that's a red flag.
• 9:51
  SPEAKER_00: And I know I just said 10 minutes ago that I couldn't remember ever not having a painful period.
• 9:58
  SPEAKER_00: But I mean, there was a time when I'd be like, this close to feeling like I was gonna pass out in class, or you know, almost did pass out in the uh checkout of a grocery store one time.
• 10:14
  SPEAKER_00: And um, so ask asking the questions of like, have you ever felt like you were going to pass out because the pain was so intense?
• 10:24
  SPEAKER_00: Have you ever actually passed out?
• 10:26
  SPEAKER_00: Have you vomited because the pain is so intense?
• 10:30
  SPEAKER_00: Do you do you does that happen every single cycle?
• 10:35
  SPEAKER_00: Um, do you take medication for it?
• 10:38
  SPEAKER_00: And if so, does that medication help?
• 10:41
  SPEAKER_00: Does it cut the pain completely or does it just take the edge off?
• 10:47
  SPEAKER_00: What other things are you observing when your period is painful?
• 10:51
  SPEAKER_00: Are you having really heavy flow?
• 10:55
  SPEAKER_00: Does that flow include clots?
• 10:58
  SPEAKER_00: If it is really heavy, how heavy are we talking?
• 11:01
  SPEAKER_00: And this is where like I get very granular with my patients about like how many tampons are you using per day?
• 11:07
  SPEAKER_00: What size tampons?
• 11:09
  SPEAKER_00: Is it a light or is it an extra heavy?
• 11:11
  SPEAKER_00: If you're using a cup, how many times do you have to empty your cup?
• 11:15
  SPEAKER_00: How many milliliters does that cup hold?
• 11:18
  SPEAKER_00: Because that's an element that I've realized women, people who have periods aren't familiar with what is a normal experience.
• 11:30
  SPEAKER_00: And we have just normalized so many of the truly not normal period symptoms, like extreme heavy flow, extreme pain, having to call out of work or having to push through extreme pain because you can't call out of work.
• 11:53
  SPEAKER_00: None of that is normal.
• 11:56
  SPEAKER_00: And we can't keep normalizing this.
• 11:59
  SPEAKER_00: It's exhausting, it's certainly not helping, and it's not going to contribute to a better fertility outcome either, to not address it and to have so many women who come to me and say that they've told their doctor what they're experiencing, and the only suggestion they are given is to get on birth control.
• 12:28
  SPEAKER_00: Now, I'm not totally opposed to birth control, but most of the people seeing me want to have a baby.
• 12:35
  SPEAKER_00: So the ones who have been recommended birth control under the circumstance of they know that they want to try to conceive within the next year is absolutely ludicrous.
• 12:46
  SPEAKER_00: And for the people who aren't sure when they might want to start their family or if they want to start a family, we still have to give all the risks, benefits, side effects, and other options.
• 12:58
  SPEAKER_00: And it's the other option piece that we're really failing people on.
• 13:04
  SPEAKER_00: So other option-wise, for me here in Arizona, um, I do refer out for endometriosis workups pretty frequently.
• 13:16
  SPEAKER_00: And, you know, we are in a in a situation where getting a good endometriosis workup feels like a bit of pulling teeth.
• 13:29
  SPEAKER_00: I only know of a few providers in our state who I really trust to be able to accurately detect endometriosis and safely remove it.
• 13:41
  SPEAKER_00: But it has to be a conversation.
• 13:44
  SPEAKER_00: We cannot just keep blowing off a lifetime of painful periods or painful and heavy periods just because it's just part of being a woman, just part of having a uterus.
• 13:58
  SPEAKER_00: No, that I'm sorry, we cannot take that anymore.
• 14:03
  SPEAKER_00: I will not tolerate it.
• 14:13
  SPEAKER_00: Gosh, maybe it's even possible to have a painless period, even if you have been someone who has historically always had some level of menstrual pain.
• 14:26
  SPEAKER_00: So now that we've gotten some of the red flags out of the way, that's not everything I would also add to that list.
• 14:32
  SPEAKER_00: Pain with bowel movements, especially while you're on your period.
• 14:37
  SPEAKER_00: Pain with intercourse, and that can be any time of the cycle, but also worse on your period.
• 14:43
  SPEAKER_00: Um, other symptoms that might get worse around your period.
• 14:47
  SPEAKER_00: So um digestive pain or even pain that feels like we listen, if you're like trying to take a really deep breath in and that feels painful.
• 15:00
  SPEAKER_00: Um, there's some referral pain patterns with endometriosis where depending on where the deposit is, it might refer to the shoulder blade.
• 15:08
  SPEAKER_00: And so if you have any aches, pains, bloat symptoms that all get worse around your period, those are more red flags to talk to your doctor about.
• 15:24
  SPEAKER_00: Um and then the the bleeding level, if we were to actually measure out like what's normal, normal blood loss during a complete menstrual cycle.
• 15:34
  SPEAKER_00: So for that three to five days of bleeding would be between 20 and 80 milliliters.
• 15:42
  SPEAKER_00: Now, five milliliters is one teaspoon.
• 15:47
  SPEAKER_00: So if you have a menstrual cup and you're uh unloading that three, four times per day for a few days of your cycle, it's probably too heavy.
• 16:02
  SPEAKER_00: Now I have to cap that with this is not medical advice, this is for educational and informational purposes only.
• 16:13
  SPEAKER_00: But if if your experience is that your periods are extremely heavy, if you're noticing that you're likely bleeding more than 80 milliliters per cycle, then it's absolutely worth talking about that with your doctor.
• 16:30
  SPEAKER_00: And if they don't think that's a problem, but your gut instinct says it is, then it is time for a second opinion.
• 16:40
  SPEAKER_00: All right, let's talk about what some underlying factors are that can contribute to period pain.
• 16:46
  SPEAKER_00: I'm gonna list them off and then I'm gonna go through each one a little bit here too.
• 16:51
  SPEAKER_00: So number one, inflammation.
• 16:56
  SPEAKER_00: Number two, microbiome disruption.
• 17:03
  SPEAKER_00: Number three, chronic stress, and number four, pelvic floor tension.
• 17:11
  SPEAKER_00: These are outside of endometriosis, and endometriosis likely carries all four.
• 17:17
  SPEAKER_00: We just need there they're entire dedicated podcasts to endometriosis because it is a systemic condition.
• 17:25
  SPEAKER_00: It's is not just a condition of the reproductive organs.
• 17:28
  SPEAKER_00: So I'll I'll pull back from the endo conversation so that we can talk about general period pain.
• 17:38
  SPEAKER_00: But yeah, we we need to get everyone with endo better help, that's for sure.
• 17:46
  SPEAKER_00: So let's talk about those little individual factors.
• 17:49
  SPEAKER_00: Now, if we I kind of want to work backwards on this.
• 17:53
  SPEAKER_00: So I want to start with pelvic floor, actually.
• 17:57
  SPEAKER_00: Um as I realized that I went on this retreat and we're we're sitting on the ground every day for hours every day.
• 18:09
  SPEAKER_00: Eight, you know, five, five to eight hours every day that we're sitting in in circle.
• 18:14
  SPEAKER_00: Um and I think the that most of us who work in scenarios where we have to be in a typical office chair, we forget how important our pelvic floor is.
• 18:33
  SPEAKER_00: Even me who works in this arena forgets about her own pelvic floor.
• 18:40
  SPEAKER_00: So getting up and and moving your body and moving around or sitting in positions that are how human bodies evolved, you know, it's only been a few hundred years that we've been sitting in office chairs.
• 18:59
  SPEAKER_00: Um how did we move?
• 19:02
  SPEAKER_00: How did we relate to meetings before that?
• 19:06
  SPEAKER_00: Uh what was our body positioning like and what was happening in the pelvic floor with that evolution?
• 19:16
  SPEAKER_00: So sitting on the floor, I noticed like, okay, not only am I closer to the ground, which feels really nice for my nervous system, I can actually feel things kind of open up differently, which is very interesting.
• 19:34
  SPEAKER_00: I noticed that my voice actually even has a little bit more depth.
• 19:40
  SPEAKER_00: So I don't know if that comes through on the podcast, but this is just what I noticed for myself.
• 19:45
  SPEAKER_00: Um, I noticed that I I'm actually bleeding right now that I don't presently have pain.
• 19:54
  SPEAKER_00: And so I'm just getting very curious for myself how the body positioning makes a difference.
• 20:02
  SPEAKER_00: But in general, the pelvic floor is such an interesting structure.
• 20:07
  SPEAKER_00: For any of you who are local to Tucson, you can actually um come check out our open house in a couple weeks.
• 20:15
  SPEAKER_00: It's on Saturday, February 21st.
• 20:18
  SPEAKER_00: We are having some guest speakers, and one of those speakers is Chinetta Body of Soma Moon Wellness.
• 20:25
  SPEAKER_00: She's actually going to be talking about the importance of our pelvic floor health.
• 20:29
  SPEAKER_00: Um, I got her on the books straight away when I got back from Mexico.
• 20:34
  SPEAKER_00: And anyway, so if you're in Tucson locally, I will link the open house in uh in the show notes.
• 20:43
  SPEAKER_00: But you can come come check that out with us.
• 20:47
  SPEAKER_00: It'd be so fun to actually meet some of our listeners in person um beyond some of our patients who I know are listeners.
• 20:54
  SPEAKER_00: But how do we identify if we have pelvic floor tension?
• 20:59
  SPEAKER_00: This may not be a super straightforward process if you just never really noticed your pelvic floor.
• 21:09
  SPEAKER_00: But again, some red flags that number one, period pain.
• 21:13
  SPEAKER_00: Number two, pain with intercourse.
• 21:16
  SPEAKER_00: Number three, issues with incontinence.
• 21:23
  SPEAKER_00: Number four would be pain in the hips, the low back.
• 21:29
  SPEAKER_00: And the fifth one is kind of correlated with one of our other markers or our underlying factors with period pain is chronic stress.
• 21:38
  SPEAKER_00: The pelvic floor is an area where we can absolutely carry stress.
• 21:45
  SPEAKER_00: And how we relate to that, if we're not paying attention to it, means that it just becomes this unconscious pattern, this unconscious holding pattern that I think we Because it's such a powerful and vulnerable area, it is more prone to carrying that stress as well.
• 22:10
  SPEAKER_00: So, what do we do about that?
• 22:12
  SPEAKER_00: I'm just gonna give you a couple little things that you can focus on today.
• 22:17
  SPEAKER_00: And then when we have more in-depth conversations about the pelvic floor itself, that will be more concrete action around it.
• 22:27
  SPEAKER_00: But number one, as I've been brushing up on the pelvic floor relationship to our nervous system and to other structures in the body, it's so interesting because the pelvic floor is one of only three muscle groups that lie horizontal.
• 22:48
  SPEAKER_00: Right.
• 22:48
  SPEAKER_00: So our vocal cords, our diaphragm, and our pelvic floor are the only three muscle groups that lie horizontal.
• 22:58
  SPEAKER_00: Think about all the other muscles in your body.
• 23:00
  SPEAKER_00: They're, you know, running along your arm, running along your abdomen, running along your legs, running along your neck, running, you know, across the back of your shoulder.
• 23:13
  SPEAKER_00: And so these groups work differently and they all have an opening in them, right?
• 23:22
  SPEAKER_00: So when we have tension around these muscles, those openings are affected, and presumably the other structures are structures around them.
• 23:30
  SPEAKER_00: So when we think about um when we're really stressed and our breathing changes, right?
• 23:36
  SPEAKER_00: Our diaphragm has a different type of action.
• 23:42
  SPEAKER_00: If you think about like your breathing kind of short and light, and there's tension there, and it really takes some consciousness to slow the breath or deepen the breath.
• 24:03
  SPEAKER_00: So one piece of acknowledging the pelvic floor is breathing, giving attention to the diaphragm, but also imagining that you could breathe into the pelvic floor.
• 24:18
  SPEAKER_00: And this is not so much a conversation about pelvic floor strength, not keggles.
• 24:23
  SPEAKER_00: This is more about allowing for complete relaxation so that you aren't carrying that chronic tension in the pelvic floor that then contributes to menstrual pain.
• 24:39
  SPEAKER_00: So breathing into the pelvic floor, imagining that all those little muscles in the pelvic floor could fully and completely relax.
• 24:48
  SPEAKER_00: And if you're in a safe space now to do that, where you can just pause and ask, what would it feel like to fully and completely relax my pelvic floor?
• 25:03
  SPEAKER_00: Don't worry, you're not gonna pee yourself.
• 25:06
  SPEAKER_00: You have sphincters for that.
• 25:07
  SPEAKER_00: That's a that's a different muscle group.
• 25:10
  SPEAKER_00: You're welcome for that imagery.
• 25:14
  SPEAKER_00: But even just asking that question allows for your body to go, huh?
• 25:19
  SPEAKER_00: I wonder what that would feel like.
• 25:21
  SPEAKER_00: Maybe I'm already doing that a little bit.
• 25:26
  SPEAKER_00: So breathing into the pelvic floor, imagining asking what it would feel like to fully and completely relax.
• 25:34
  SPEAKER_00: And I wonder what you're already noticing.
• 25:36
  SPEAKER_00: And I wonder what you might notice if you ask that several times a day while you're on your period.
• 25:43
  SPEAKER_00: How might that change your experience of having a period?
• 25:47
  SPEAKER_00: It has been game-changing for me.
• 25:52
  SPEAKER_00: The other little tip is that our our vocal core is also very connected to our nervous system, which is also very connected to our pelvic floor.
• 26:06
  SPEAKER_00: And when um when we activate the vocal cords in a way that provides like a deep resonant frequency, that can also contribute to relaxation of the pelvic floor.
• 26:23
  SPEAKER_00: So a low humming, like a or the oh type of sound, can actually help your pelvic floor relax too.
• 26:37
  SPEAKER_00: And it also feels good, it's it's activating that vagus nerve as it passes by the vocal cords.
• 26:44
  SPEAKER_00: So it's it's just a nice kind of yummy experience for the nervous system as well.
• 26:49
  SPEAKER_00: And I invite you to pause and do that.
• 26:51
  SPEAKER_00: If you're in the car alone, just pause, pause the podcast for a second, do like three nice oh just feel how that sits in the body.
• 27:07
  SPEAKER_00: And uh if you're like, oh my god, I'm totally weirded out.
• 27:10
  SPEAKER_00: I couldn't just like own to myself, well, I promise it feels good.
• 27:20
  SPEAKER_00: I want to address the chronic stress piece because I think we're all living with a bit of it, and the people who say they aren't have maybe adapted to that stress in such a way that maybe they're bullshitting us.
• 27:45
  SPEAKER_00: I don't know.
• 27:47
  SPEAKER_00: Um, if you are if you are truly not experiencing any stress, um, I would love to know more about that experience.
• 27:55
  SPEAKER_00: Please send me a DM.
• 27:58
  SPEAKER_00: And I think for the vast majority of us, it is really about figuring out how do we build the resilience to stress, the capacity to stress, the capacity to be fully human, fully embodied, fully integrated, feeling safe to be in our bodies in a dumpster fire world, and not let that stress sit in our bodies in a way that creates pain.
• 28:30
  SPEAKER_00: And so, what does that mean?
• 28:32
  SPEAKER_00: That means using all of these tools that I've harped about for so long.
• 28:38
  SPEAKER_00: Journaling, emotional freedom technique, somatics, all of these tools change our relationship to stress, build our capacity to live this life, and to tend to not carry it, right?
• 28:57
  SPEAKER_00: So in the traditional Chinese medicine system, the uterus is considered an extraordinary organ.
• 29:05
  SPEAKER_00: It's not a yin organ, it's not a yang organ.
• 29:09
  SPEAKER_00: The way our kidneys, our um all of our solid organs, our yin organs, all of our hollow organs, like the bladder, the intestine, our yang organs, the uterus, we think of okay, well, it's kind of hollow.
• 29:24
  SPEAKER_00: Like, why isn't a yang organ?
• 29:26
  SPEAKER_00: Well, it's it's yin and it's yang, it has it has both elements integrated into its energies, and it has the capacity to store any emotion, any trauma.
• 29:40
  SPEAKER_00: And so when we talk about chronic stress in relationship to menstrual pain, I believe there is a strong element of how we hold on to emotions, how we hold on to trauma as well.
• 29:55
  SPEAKER_00: And so I also think with um this experience that I had in Mexico, where we we did a lot of just really beautiful healing work and the cacao ceremony that we had on the first day, that was just so powerful.
• 30:16
  SPEAKER_00: And um, as the cacao healer facilitator Lupita was you know circling the group and spent some time really meditating over each woman.
• 30:30
  SPEAKER_00: Um, she also did a little like energy clearing work, and it it was within like minutes of her doing that that my period started.
• 30:41
  SPEAKER_00: And so that was just wild to me.
• 30:43
  SPEAKER_00: Like I know that there were some elements of healing and release that happened that day as well.
• 30:52
  SPEAKER_00: That I can't deny.
• 30:53
  SPEAKER_00: Like that just that's the truth in my body, and having guided many women now through trauma release processes, through EFT tapping, through timeline technique, through hypnosis, acupuncture is another tool that can be really gently used to help process trauma.
• 31:18
  SPEAKER_00: I've seen an immense difference in how these women experience menstrual pain or not.
• 31:27
  SPEAKER_00: Those who previously had extreme pain were usually able to get them to a place where um their periods are very manageable.
• 31:38
  SPEAKER_00: And those who had kind of mediocre periods were able to get to a place where they have very little to no pain.
• 31:48
  SPEAKER_00: And for the ones where you've been working at it for a while and there's still pain, those those are the ones that I strongly suspect that there's likely endometriosis occurring.
• 32:02
  SPEAKER_00: But that's just a little um little piece about the uterus and pain and trauma and stress.
• 32:10
  SPEAKER_00: It's it's all connected.
• 32:12
  SPEAKER_00: And it doesn't mean that you have to live with it forever, and it doesn't mean that you have to talk in circles about what's stressing you out or the trauma that happened, because please know that there are very wonderful, amazing tools that you can use to work through that with um maybe less pain.
• 32:41
  SPEAKER_00: Oh, being human.
• 32:43
  SPEAKER_00: It's wild.
• 32:45
  SPEAKER_00: We we are very much what they think spiritual beings having a human experience.
• 32:53
  SPEAKER_00: Then sometimes I wonder what we have signed up for, but I don't know that I would change it for the world.
• 33:04
  SPEAKER_00: All right, let's dive into a couple of the physical factors.
• 33:07
  SPEAKER_00: Um, the microbiome.
• 33:10
  SPEAKER_00: And we have to acknowledge that the uterus is not a sterile environment, the endometrial lining is not sterile, and we also need a lot more research on this.
• 33:24
  SPEAKER_00: But we could have such a range of experience within the microbiome, ranging from everything is pretty well balanced to an infection.
• 33:36
  SPEAKER_00: And so on the infection side of things, we could have, you know, a more severe infection like pelvic inflammatory disease that usually comes with extreme pain, bleeding, purulent discharge, odor.
• 33:52
  SPEAKER_00: That's like an emergency situation that needs immediate attention.
• 33:56
  SPEAKER_00: And then there's like a chronic endometritis piece, which is like a chronic inflammatory process that can be caused by um a less overt infection, and that can be detected through endometrial biopsy.
• 34:17
  SPEAKER_00: There is often a picture that comes along with chronic endometritis that includes bleeding outside of one's menstrual cycle.
• 34:26
  SPEAKER_00: So bleeding with intercourse, bleeding around ovulation, and just like a different type of pain that my patients have expressed when endometritis has been confirmed.
• 34:41
  SPEAKER_00: And that's something that is usually treated with antibiotics.
• 34:45
  SPEAKER_00: I usually will pair that with some herbs and probiotics, as well as acupuncture, um, sometimes microcurrent, if that's an option.
• 34:58
  SPEAKER_00: And um, and then we have just like microbiome imbalance, which is pretty tricky to investigate without spending a little bit of money or doing something evasive.
• 35:12
  SPEAKER_00: Um so we always have to ask the question with testing of will the results from this test change anything that we're doing?
• 35:22
  SPEAKER_00: So if we were to investigate the uterine microbiome further by running, say, a fertility fertilisus test, which is an option that allows you to collect menstrual blood and send it off for testing the microbiome as well as a vaginal swab, that might give us information that would lead us towards a different treatment plan.
• 35:48
  SPEAKER_00: There are some companies that have vaginal swab alone tests.
• 35:55
  SPEAKER_00: The research is pretty out on whether or not that can actually tell us about the uter microbiome and whether you know treating based on a vaginal swab would actually have much of a difference in um period pain or fertility outcomes, unless there's like a specific scenario like the presence of urea plasma or mycoplasma, which you can sometimes pick up on a vaginal swab or a urine test.
• 36:27
  SPEAKER_00: So please know that if you if you've had chronic pain and you have also experienced infertility, uh, investigating the uterine and vaginal microbiome could be a key to uncovering a path towards easier periods and fertility.
• 36:46
  SPEAKER_00: They're not perfect tests.
• 36:49
  SPEAKER_00: And sometimes it's frustrating to, you know, we've actually had like split testing done on occasion where we have the same person run two different swabs with two different companies and give two different results.
• 37:02
  SPEAKER_00: And it's like, damn, well, what are we doing here?
• 37:06
  SPEAKER_00: So I think we have to be really discerning about who we run these tests in, how we treat based off of them, what the symptoms are, what are the pros and cons of the treatment?
• 37:22
  SPEAKER_00: And if if the treatment wouldn't be harmful in the first place and could only be beneficial, then could we just start with that?
• 37:33
  SPEAKER_00: So, examples of like using certain probiotic strains, using certain herbs at different phases of the cycle to support the microbiome.
• 37:43
  SPEAKER_00: Uh, those are where I usually will start with these patients, unless we have a lot of red flags, which we talked about at the beginning.
• 37:55
  SPEAKER_00: Um, so just to recap where we've been so far, we've covered the pelvic floor relationship, we've covered chronic stress and trauma and the microbiome.
• 38:13
  SPEAKER_00: Lastly, inflammation.
• 38:15
  SPEAKER_00: And it's like such a broad term that can encompass a lot of you know the uncomfortable experiences that we have in our body.
• 38:28
  SPEAKER_00: So I want to just give like a little bit of overview of you know, what are what do we mean when we say inflammation, right?
• 38:38
  SPEAKER_00: There are inflammatory cytokines and prostaglandins that are released around um the time of the start of the period, and the prostaglandins are at play because they're helping to break down the uterine lining.
• 38:53
  SPEAKER_00: If we have a lot of prostaglandins, that can contribute to more period pain.
• 38:58
  SPEAKER_00: It can contribute to the really fun period poops, which are saying you're not weird if you experience like an increased frequency, urgency, looseness of bowel movement around your period.
• 39:12
  SPEAKER_00: Like, let's just remove the stigma around that.
• 39:15
  SPEAKER_00: But that is associated with increased prostaglandin formation.
• 39:18
  SPEAKER_00: So it's like we need the prostaglandins, we need some presence of them to help break down the uterine lining so you can release the lining, shed the lining, but we don't want too much of them.
• 39:29
  SPEAKER_00: We don't want an overflow of them to the experience that it increases pain or having to run to the bathroom five times that first day of your cycle.
• 39:41
  SPEAKER_00: And then inflammatory cytokines are chemicals that are released by our white blood cells in relation to an immune system response.
• 39:51
  SPEAKER_00: And so our immune system, our nervous system, and our inflammatory responses are all kind of intertwined.
• 39:59
  SPEAKER_00: And how we start to sift through that is by listening to the body and starting to get curious around what it's communicating.
• 40:10
  SPEAKER_00: And you know, some people may have an inflammatory response to a food, some people may have an inflammatory response to an environment, like you know, chemicals.
• 40:22
  SPEAKER_00: Some people have responses that are emotional that then result in an inflammatory response from the body.
• 40:32
  SPEAKER_00: And it does take some intention to piece through that.
• 40:37
  SPEAKER_00: I don't expect that, you know, we're gonna get to all of the answers overnight.
• 40:43
  SPEAKER_00: And, you know, unfortunately, I've seen people lean on things like food allergy testing to give them all of the answers they hoped for around inflammation.
• 40:55
  SPEAKER_00: And that, you know, it in my 13 years of experience, like that's probably not going to be what gives the answers that we're hoping for.
• 41:07
  SPEAKER_00: We have to look at inflammation from a physical, emotional, and spiritual context.
• 41:14
  SPEAKER_00: And yes, there are some lifestyle factors that we can probably get a little bit um more balanced around.
• 41:26
  SPEAKER_00: Um looking at sugar, alcohol, uh, highly processed foods, but we we can't just take those in a vacuum.
• 41:36
  SPEAKER_00: And I've I've really I've changed so much of how I advocate around these for these, you know, foods and products over the last 13 years.
• 41:47
  SPEAKER_00: That there was a time when I would tell people, just like, don't eat sugar, don't eat processed carbs, don't drink alcohol, and like, oh, young baby Dr.
• 41:57
  SPEAKER_00: Katie, you had such good intentions, but not a full understanding of the human psyche.
• 42:04
  SPEAKER_00: And maybe we never will have that full understanding of the human psyche, but you now know that when we just restrict and restrict and restrict, that doesn't necessarily get to the root of, well, why do we reach for those things in the first place?
• 42:20
  SPEAKER_00: Why do we reach for the foods, the substances that can perpetuate inflammation?
• 42:26
  SPEAKER_00: Well, there's a need being met.
• 42:28
  SPEAKER_00: And even just our body displaying pain is a communication of some needs that are probably being unmet.
• 42:38
  SPEAKER_00: So I use inflammation as an opportunity to get a better understanding of the body, not as a sign that we just need to restrict all the things that bring us joy.
• 42:50
  SPEAKER_00: But food does make a difference.
• 42:53
  SPEAKER_00: Lifestyle absolutely makes a difference.
• 42:56
  SPEAKER_00: And we have to understand if we are reaching for foods and substances that can create or perpetuate inflammation, that there's probably a reason, and we need to understand that reason as well.
• 43:10
  SPEAKER_00: But while we're working on that, we can look at what do we need to add more of?
• 43:16
  SPEAKER_00: Well, we certainly need more fiber.
• 43:19
  SPEAKER_00: We usually need more color in the diet.
• 43:23
  SPEAKER_00: So, what does that mean?
• 43:24
  SPEAKER_00: That means we're getting at least five fruits and vegetables, but ideally, like half your meal, each meal is plants.
• 43:38
  SPEAKER_00: And when it comes to fiber, um, I usually have people aim for about 30 grams per day, which the average American, the last study I read was getting around 12 to 15 grams a day.
• 43:54
  SPEAKER_00: So not even half of what we need.
• 43:57
  SPEAKER_00: And one of the things that fiber Helps to do is make sure that we are clearing out the toxins from our body.
• 44:05
  SPEAKER_00: So soluble fibers in particular help to ensure that all of the hormone byproducts and toxic byproducts that our liver has been so diligently working on filtering or detoxifying for us.
• 44:22
  SPEAKER_00: Our kidneys are the filters.
• 44:23
  SPEAKER_00: Our liver has our phase one and phase two detoxification.
• 44:27
  SPEAKER_00: The liver has been working on those.
• 44:29
  SPEAKER_00: Those substances end up in our bile as we are releasing bile from the gallbladder into the small intestine.
• 44:38
  SPEAKER_00: We are sending those conjugated byproducts to be released from the body.
• 44:44
  SPEAKER_00: And if we're not getting a fiber and if we're not pooping regularly, then those substances are just going to get reabsorbed in the colon and our body has to deal with them all over again.
• 44:55
  SPEAKER_00: And that can contribute to more inflammation as well.
• 44:59
  SPEAKER_00: So get your fiber in beans, lentils, leafy greens, squash, avocado, berries, um, well, psyllium, husk in your water.
• 45:13
  SPEAKER_00: If you need a boost to your fiber production, talk to your doctor about adding any supplements for fiber or any substances like psyllium that would add to your fiber.
• 45:24
  SPEAKER_00: Make sure that those are safe for you in your situation.
• 45:29
  SPEAKER_00: But there's just so much good evidence for how good fiber is for us.
• 45:35
  SPEAKER_00: And I'd be super curious to know like, you know, if period pain has been like a 10 and you spend just a couple days before your period, like really bringing some awareness to your pelvic floor, really acknowledging how your body is handling stress, getting your fiber in, pooping regularly.
• 46:00
  SPEAKER_00: Fiber also contributes happily to your microbiome.
• 46:05
  SPEAKER_00: What happens to your period pain?
• 46:08
  SPEAKER_00: Do you get down to an eight?
• 46:11
  SPEAKER_00: Can each cycle build upon the next cycle to the point where you get to a much easier cycle?
• 46:19
  SPEAKER_00: Ah, is it possible to have a painless cycle?
• 46:22
  SPEAKER_00: I can now affirm that yes, that is possible.
• 46:26
  SPEAKER_00: Even for me, who, you know, was thinking like maybe it's just a lost cog, maybe this is just what I have to deal with for the rest of my life because it's such an improvement over what it was for so long.
• 46:38
  SPEAKER_00: Um, there is there's hope yet.
• 46:41
  SPEAKER_00: And I hope that this gives you some tools and some insights into what might be happening in your body, what your your womb wants to communicate through pain.
• 46:53
  SPEAKER_00: And if you desire further insight or support into this, I'm here for you.
• 47:01
  SPEAKER_00: Um, I will link the discovery call in the show notes if it feels um like your soul has that little tug to dive into this together.
• 47:12
  SPEAKER_00: Um, but I'm also gonna list some resources that I wish I'd had as a teenager.
• 47:19
  SPEAKER_00: And and I wish that all people with periods had as a resource as soon as possible.
• 47:26
  SPEAKER_00: One is called the Period Repair Manual.
• 47:29
  SPEAKER_00: Um, this was by Dr.
• 47:31
  SPEAKER_00: Laura Bryden, who at the Nashrapa, I believe in Australia.
• 47:34
  SPEAKER_00: I hope I'm getting that right.
• 47:37
  SPEAKER_00: Um, that was a great read.
• 47:39
  SPEAKER_00: And um, and I am also gonna link some wellness and it's my friend Janetta seeking at our open house.
• 47:48
  SPEAKER_00: And you know, she specializes in pelvic floor health and breath work and somatic and yoga for pelvic floor health.
• 47:57
  SPEAKER_00: And and I hope that this is just a really lovely invitation to getting curious around what your body is telling you, and that if you've struggled with painful periods, that this is the start of the resolution and a new partnership with your womb that you can maybe even look forward to.
• 48:22
  SPEAKER_00: All right, sending you so much love as always, and it would mean so much to me if you took a moment to pause, send a rating in for the podcast that helps us get in front of more people.
• 48:36
  SPEAKER_00: And gosh, imagine how nice the world would be if just in general, so many more women had painless periods.
• 48:47
  SPEAKER_00: I think we need a matriarchy for that.
• 48:50
  SPEAKER_00: That's a different conversation.
• 48:53
  SPEAKER_00: All right, always, always, always so much love to all of you.