S1 E19: Estrogen Waves & The Ups and Downs of Healing


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Amanda: Hey, this is Amanda, women’s health dietitian.
Emily: And I’m Emily, nutritional therapy practitioner.
Amanda: And this is the Are You Menstrual? podcast where we help you navigate the confusing world of women’s hormones and teach you how to have healthy periods.
Emily: Each week we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology, and metabolic health.
Amanda: Our goal is to help you wade through conflicting health information and empower you on your healing journey.
Emily: We hope you enjoy it.

Amanda: In this episode, we are covering a topic that we get endless questions and DMs about and that’s the ups and downs of the healing journey and the symptoms that tend to pop up for people. And specifically, like what is causing this? Why are you dealing with acne? Why’s your period worse? Why are you gaining weight? And a lot of this has to do with shifts in a hormone called estrogen. And we call them estrogen waves.

So healing is not linear. I know we kind of all have a picture in our minds of what healing is going to look like when we embark on making nutrition and lifestyle and supplement changes. But oftentimes we can feel worse before we start to feel better. And I think this is totally normal, there’s definitely those few unicorns that feel better immediately and then they have no issues. But I think that’s definitely the minority. So being mindful of what’s actually happening, what’s causing this, I think it can really help. It’s definitely helped in the group coaching programs that we do. And women just, we always give them a sense of what to expect, like kind of mentally prepare yourself for this, because it’s all just a result of your body adjusting to its environment and rebalancing hormones and minerals. So a lot of times those negative symptoms that we’re worried about aren’t actually bad things.

Emily: And we’d like to put a name to this phenomenon, I guess you’d call it, which is why we call it estrogen waves, because it kind of helps to name something and then define it so that you feel a little bit better going through your healing journey knowing what’s occurring. So you are going to hear us use the term estrogen waves quite a few times in this episode. And we’ve even written about it before on the blog and on Instagram. But just to give it a more kind of coherent definition, estrogen waves are when our progesterone levels naturally increase, which is a good thing, and lead to a release of estrogen that has been stored up in our tissues. So the stored estrogen in our tissues is the thing that’s going to improve because we’re going to release that and allow the body to get rid of it naturally.

But you might be wondering, why does estrogen get stored in our tissues in the first place? So when our bodies are stressed and depleted, that’s when progesterone levels are going to decrease. And it is this decrease in progesterone that allows our estrogen to be stored in our tissues. So, so many of us are going to experience this because we’re dealing with stress and hormone imbalances and just all of these different things that make us depleted. And so that’s what happens when our progesterone levels go down. And so this is very common for women who will get their estrogen and their progesterone levels tested and both are low. And they say, well, I have low estrogen and I have low progesterone. So obviously I’m just kind of depleted all over the place. You can still see estrogen dominant symptoms even if you have low estrogen on a blood test because they’re stored in your tissues and not in the blood, if that makes sense. So this really affects a handful of women, any of us who are dealing with hormonal imbalances or excess stress. And so it’s a really good thing to keep in mind when you do start that healing journey.

Amanda: And we can even see this in our monthly cycles. You know the research shows us that during our follicular phase estrogen levels in the tissues, because you can actually measure estrogen in the tissues, are higher than during the luteal phase. And we know that, you know, estrogen is the hormone that’s increasing during that follicular phase, but we still have that big increase prior to ovulation. And then we have another smaller increase during the luteal phase. So it’s interesting that when progesterone is present, you know, once we ovulate, and we’re in that luteal phase, that’s when we have progesterone. And so when that is there, the tissue levels of estrogen are much lower than the follicular phase. So it’s interesting, I think you can also see this in pregnancy when you have that huge increase in progesterone, especially in the beginning, people tend to have more acne, nausea, not feeling as good, breast tenderness, like it’s almost like that estrogen wave that you experienced during healing, but it can happen in that first trimester as well.

So when we’re eating in a food, we’re rebalancing minerals, are working on reducing our stress but also making our bodies more resilient to stress by using things like adrenal cocktails, balancing our blood sugar, eating protein and carbs throughout the day… All of these things are going to reduce cortisol, that stress hormone, and when we reduce how much cortisol we’re making and how much energy we’re expending to respond to that that stress, then we’re naturally going to have that increase in progesterone as long as we are ovulating, right. We have to ovulate to make progesterone. And this typically leads to you feeling better at first. And then once you have that increase in progesterone, then you can have that kind of estrogen wave where your body’s like, okay, I have more progesterone, so we’re going to get rid of some of this estrogen that we have stored in our tissues. And you can get symptoms like painful periods, acne, and weight gain. 

Emily: And we totally get it, we understand that this makes it really difficult to know if something you’re doing is working. Like the lifestyle and the dietary changes, the stress-relieving activities, all of that, you might start second guessing, because it feels like you’re getting worse before you’re getting better. But that’s why we’re doing this episode. Because as confusing as it is and can be during a healing journey, we want you to understand that this is all part of the process. And it happens to a lot of women.

It’s important to remember that the last 100 days or three months impacts your current cycle. So let’s say you’ve been on a healing journey for a while but you, you’re, you’ve come up against a really just gnarly cycle, you’re getting all the period pain, you’re getting all the, you know, maybe heavy bleeding, maybe headaches, fatigue, whatever. And we’ll walk you through more specific symptoms in a bit. But let’s just say your period is totally back to what it was before you were on a protocol or before you are really prioritizing your health. It kind of plays with your mind, and it makes you think, oh, I must be doing this all wrong, this is obviously not what my body needs. You really need to give it time because what you may be experiencing is these estrogen waves, you really need to look at things in three month increments, which is why we always recommend giving yourself at least a six-month timeframe. And that’s the very minimum when making nutrition and lifestyle changes.

So you are playing the long game here. I know that six months sounds like an eternity. And for most women, it’s actually going to be even longer than six months, depending on how long you’ve been, kind of, depleted, and your minerals have been all over the place, and you’ve had these hormonal issues. While it may take even one to two years to see the progress you want, think about the fact that, like, that is such a small time in the grand scheme of things, right? One to two years is really a blink. Although we know it doesn’t always feel like it. But hang in there because you will see ups and downs within those, those couple of years, for sure. 

Amanda: And I think it’s more about you know, making changes slowly, making it so that everything is sustainable for you. And that’s why it can take one to two years. But imagine if at the end of a year…I would say for most people it’s like about a year, and they’ve kind of got it figured out where after a year they know how to feed themselves to feel their best, which is I feel like something a lot of people spend their whole lives trying to figure out. So they know how to feed themselves appropriately. They know what to do if something comes up. So if you do have maybe more PMS or some cramping, what do I take? What supplements should I prioritize? Is it something in my day to day that led to this? You just start to build this relationship with your body where you’re much more in tune and you know what’s going on. And rather than being reactive and being afraid of your symptoms, you take them on as communication. And that’s the whole point.

Next, we’re going to talk about how do we support our bodies during that healing journey when symptoms do pop up. Because it doesn’t mean you can’t do anything. But we want to start by saying that symptoms are not a bad thing. People get symptoms and they freak out. And we see this all the time. We see this in the women that we work with, we see it on in our community on social media, it’s, the first tendency is to immediately think something is very negative. But rather than viewing those symptoms as a negative thing and something you need to fix, we recommend looking at them as a form of communication. So your body’s just trying to let you know that something is off, or that it’s recalibrating and working on fixing something.

Emily: So here’s just a few things we recommend for supporting your body during the healing journey. And we’re gonna go through some very common symptoms that we see when people are embarking on that journey with the estrogen waves and the hormonal shifts and all of that. And the biggest one, especially one that I’ve dealt with a lot—you can ask Amanda—is fatigue. So just a general feeling of lethargy and not feeling your best, just kind of moving through your day without a ton of energy that you may be used to experiencing. And this is really chalked up to one thing, so if you are used to running on stress hormones and higher levels of cortisol than normal, if you are always in that go-go-go mindset, you are, you thrive off of adrenaline and off of drama and just like the daily rush…Once you start to implement the things that we teach, like, the really good diet or I don’t even like to say diet, but the foods that nourish your body, the nutrient-dense foods, the slowing down, the rest, the prioritizing the stress-relieving activities, maybe getting off your phone… Once you start doing all of these things and your body starts to figure out how to kind of get back into that balance, your cortisol will start to go down.

And if you’ve been addicted to cortisol for the last however many years of your life, what you’re gonna start seeing is that you feel just kind of fatigued. You feel these energy dips that you have not experienced really before, maybe, especially for some of you faster metabolizers that are just constantly on the go. I think a lot of us, even myself before I started the healing journey with Amanda, I was just constantly addicted to that adrenaline rush, like constantly on the go, always on my phone, not getting an adequate amount of sleep, all of that. And when I did low carb, like…you name it, I did it. I just felt awful when I started kind of prioritizing my health, because it was just like, oh, man, I’m just always, my body’s finally slowing down and I feel it, right. So this one’s a big one. And you probably will experience this. 

And what we have to say about how to support yourself is just to check in, make it like a daily check in. So ask yourself, are your basic needs being met? Did I eat enough today? Did I eat every three to four hours? Did I eat a protein-rich breakfast? Did I sleep enough last night? Did I sleep well last night? Am I making time for fun today? Did I do anything in the course of the day that made me happy, that made me feel alive, that I was excited about? And then lastly, am I doing any sort of therapeutic movement or exercise that’s making me feel better? So not necessarily intense or something that kind of makes you really, really exhausted. But just something calming, something good for your mental state. And just that feels good for your body.

Amanda: Or are you doing too much exercise, right? Or is it the, too intense of the type. And that’s kind of the other thing is you’re starting to slow down and have less cortisol, it’s like, your body’s going to try to repair itself, it’s going to try to rebalance. And sometimes we, when we get out of that high stress state, we realize I actually don’t tolerate my current exercise of choice that well. I see this a lot. And it’s, it doesn’t always mean that it’s forever. Oftentimes, it could just be for, you know, maybe it’s like that 6-12 month period that you’re working on things. But you can be kind of defeating the whole purpose of the healing journey if you’re doing like super intense exercise, it’s leaving you very fatigued. And so it’s, you know, how are you recovering from that exercise? Are you super sore all the time? Are you exhausted? Do you feel worse after you work out? You should feel better after you train, you should have more energy than you had when you went into that session. So all those things are going to have a huge impact and fatigue can come from so many different areas. And so it’s just kind of figuring out is this, like, a not eating enough fatigue, no sleeping fatigue? Or is this like a normal fatigue that’s part of the healing process? Am I not getting enough movement in? I think that’s, that’s like something I see a lot—people will stop working out. And I’m like, you don’t necessarily have to stop working out, you might just have to shift what you’re doing. Like you can still go for walks, still do strength training a couple days a week, do yoga, if you can tolerate all these things, of course, but it doesn’t have to be like an all or nothing. Fatigue can come from a lot of different areas.

And I think that acne can, too. And that’s probably, I would say that acne is like the top of the list with the ones that we get the most from people is, whether you’ve always struggled with acne or if it’s brand new for you, as you start to balance your minerals, support your hormones… A lot of what’s happening is that estrogen, we also tend to move iron and we start to use iron more efficiently. Because of course, you know, we’re recommending things like beef liver and sometimes cod liver oil for certain people. We’re trying to get more copper and vitamin A in, right. And even the adrenal cocktail, like that vitamin C and the potassium and the sodium are very powerful. And so even sometimes just adding those in, we’ll see people have reactions. And a lot of the time it’s because you’re getting that shift in estrogen and in cortisol. And so sometimes we see it from taking vitamin E. Sometimes people will, will say like try to add in vitamin E to see if that helps your skin. Sometimes when people start taking vitamin E, it’s very potent. It’s powerful, and it’s anti-estrogen. So it does a similar thing as progesterone, right? So it can lead to some of that estrogen, those estrogen waves as well. So sometimes people literally just need to take a break from the vitamin E or take less and they can see an improvement. Yeah, acne is definitely one of the most common ones that we see. And vitamin E could be contributor, constipation if you’re not having a regular bowel movement every day, and then of course making food changes.

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Hey, Amanda here, just giving you a quick break, hopefully a break for your brain in the middle of this podcast episode to remind you that if you haven’t gone through our free training, Optimizing Hormone Health Through Mineral Balance, we really do recommend starting there. And the main reason for that is because you’re going to hear us say things like mineral foundation, having a solid foundation, are you putting the foundations in place, especially as we get deeper and deeper into different hormonal topics and specific imbalances in the body. The mineral foundation is always going to be so essential. So if you haven’t watched the free training, you can find it in our show notes or you can go to hormonehealingrd.com and it’s going to be right on that front page there. But we really recommend starting there so that you can understand how is your current mineral status, how do you assess this, and how to get started with all that just so you can get as much as you possibly can out of the rest of the podcast episodes. But that’s it. I hope you enjoy the rest of this episode.

Emily: Yeah, I think too, it’s important to remember that your body, when you’re healing, you’re also, there’s a lot of natural detox going on there. So like your liver is working really hard to, you know, make sure it’s getting those hormones, those excess hormones out. And so an acne breakout or consistent breakouts over those course of the healing journey could just be like your body detoxing, and that just is a sign that your liver needs some extra support.

So things like we recommend castor oil packs, and that will help support digestion, bowel movements, and your liver. Again, as Amanda said, take a break from vitamin E, if you think that may be kind of causing worse symptoms—just kind of play with it. There’s nothing wrong with just stopping supplementation just to see how your body reacts when you’re not taking certain supplements. And then I also like to track my breakouts when they’re happening to see if it is related to a specific time in my cycle. Because that’s a big sign as well that like, hey, this is just when my body’s trying to regulate out and that’s when I’m getting breakouts. And so it’s not necessarily a horrible thing. It’s just again, like Amanda said, communication from your body that things are moving and shifting.

Amanda: Yeah, so we’ll, we’ll link our blog that we have on castor oil packs in the show notes. But again, acne can be from a lot of different areas. So it’s kind of like ruling things out and figuring out which one applies to you most. If you’re someone that started getting it after taking vitamin E, sometimes we, people just are like, I don’t want to deal with it, I’m just gonna stop taking the vitamin E, that’s fine. We have plenty of people that are like I’m gonna power through and I’m just gonna, like, get through this estrogen wave and hope that my skin improves. And oftentimes after a couple months, those people don’t have any issues. So you could go either way. 

Another common one that we see are on and off headaches, not necessarily very intense headaches, but kind of lingering headaches that women can experience, and this can definitely be from those estrogen waves. They, for sure it could be hormonal shifts that are happening. It can also be, are you, is your liver working better? Are you detoxing more? A lot of times people can start to see some gut shifts, right, we can have bacteria shifts based on the food that we’re eating. Especially if you made a lot of changes at once. We tend to see this where you could be having like a die off reaction, like, as your digestion starts to improve, your immune system starts to improve, you can actually start to get rid of overgrowth in your gut without even taking anything. And so you could be having some of those like liver detox die off type symptoms.

And the other big one I think of is blood sugar. Whenever I hear headaches, I think blood sugar. If you, it’s very common with low blood sugar, so if you are someone that is new to eating more regularly throughout the day, it could, maybe you need to make your meals a little bit more dense, meaning like more, like, animal protein in there, I would look at the balance of protein and carb. Are you getting enough protein in the meals or is it heavy on the carb and then that’s leading to highs and lows in your blood sugar throughout the day which could cause headaches.

Emily: And speaking of blood sugar, that’s where magnesium really helps with this one. If you are experiencing some headaches and you think blood sugar might be the culprit, starting to supplement with magnesium can really be beneficial. And if you’re new to magnesium, start with like a topical kind. Start with an Epsom salt bath, maybe some magnesium oil spray, and then work your way up. I am to the point where I’m doing the topical and the magnesium malate and then the magnesium glycinate in the evening. I just find that not only does it help with the insulin and blood sugar response for me, but it also aids in that necessary sleep and rest that we need when we’re healing. So magnesium is great all around.

If it is hormonal shifts, vitamin E can definitely help. Obviously we were just talking about maybe vitamin E is the culprit of things like acne, but in the case of things like headaches, vitamin E is very beneficial for people who struggle with that and you can actually start taking vitamin E the second you feel a headache coming on. And a lot of people do experience quite immediate relief from that. So just…

Amanda: Migraines too.

Emily: Yes, for sure. So just something to keep in your back pocket, if you are someone who begins struggling with headaches. And then of course rest and getting enough sleep, maybe prioritizing little cat naps during the day, which I know is not feasible for everybody, especially if you work. But just something to keep in mind, if you are tired, if you are fatigued, if that cortisol is going down, if you’re not getting enough sleep, you might start seeing more headaches and migraine type symptoms for sure.

Amanda: And then another common one is digestive changes, right? Whether that, sometimes it’s constipation, sometimes it’s someone experiencing looser stools, and which, no matter which one it is, you want to look at what food changes have you made, right. Our food has a very big impact, especially based on how much fiber it’s going to have in there. That’s like a really, really big one. So if you have any changes in your digestion, the first thing I would look at was like, did I make a ton of nutrition changes at once. This is again, why we always say, like, go slow, you know, don’t like change everything all at once. Because if you do, it could just be a phase like it could just be like a week where your gut is, like, okay, I’m completely changing my microbiome. So let me kind of catch up here. But if things persist, and you don’t see that improving, then you definitely want to look deeper.

Emily: Yeah, and just a word on loose stools, I don’t think it’s super important to worry about if it’s just every once in a while. But if you, like Amanda said, if you’re having persistent loose stools, that could be a sign that something’s off. But if you every once in a while, let’s say you experience diarrhea or loose stools, just ask yourself did I recently add in a food that I’m not used to eating that maybe my body has just not figured out? Like, oh, this is, this is new, I’m not sure you know, if I’m, if I’m capable of digesting this right now, because even like the most nourishing foods can cause this. And a big example, something I experience personally, every once in awhile is with dairy. So we have talked so much about how nutrient-dense and great dairy is for adding into your, your nutrient-dense foods and your, your diet. And for most people, it really can work. But for some of you who maybe have not been eating dairy for a long time, your body is maybe just not used to digesting it. And so you have to start slow, right. Don’t just start consuming dairy by drinking, you know, three to five glasses of milk a day, like start slow. Start with maybe hard cheeses or yogurt and then work your way up slowly.

Another thing that I really like to use…I’ve been eating dairy for a really long time now, and still every once in a while, it’s not every time, but every once in awhile, I’ll have a glass of milk and then I feel like it goes right through me pretty fast. Like, my body was not totally prepared for it or maybe I’m experiencing more stress than usual. So what I like to do is take… MITOLIFE has a supplement called Dairy Absorb, and you just take one, it’s a little tiny capsule that you take every time you eat or drink dairy. And it really helps. It’s just lactase, so it helps you to digest the lactose in the dairy. And so I just, if I’m going to drink a glass of milk, I take one with that every once in a while if I’m experiencing more stress, and that really helps me. So dairy is a big one that you might see digestive issues crop up. But again, just go slow, and maybe consider that lactose support.

Another one interestingly enough is raw carrots which stimulate bile. And this can support a bowel movement, but it can be kind of strong for some people as well, especially starting out and those with endometriosis. So if you are wanting to incorporate raw carrots, that’s great. We recommend starting with the raw carrot salad, which I believe Amanda, do we have a blog post on the raw carrot salad?

Amanda: I, I’m pretty sure we do. It’s mentioned in one of them. So I’ll make sure that I put it in the show notes.

Emily: That’s a really good recipe to start out with and just kind of eat maybe a couple tablespoons or a little bit more at a time and just kind of see how you feel afterwards. But I feel like a lot of raw vegetables can be harsh on digestion for some people. Carrots seem to be better for most people. But again, always just go slow if you’re experiencing constipation or loose stools.

Amanda: And another thing that’s really common with loose stools is it can show that you’re not tolerating how much magnesium you’re taking. It can be the type as well. But this, people often ask like how do I know if I’m taking too much magnesium since the amount is so dependent on the person. And getting loose stools is a sign that you took too much too fast. Usually I just say like you would want to stop the magnesium or go back down to that lower dose that you were taking for at least like a few days and wait for your stools to regulate and go up slower if you can. Sometimes even going back down to the low dose doesn’t help, and you need to stop the magnesium completely. And then you can start again. I would say, like, look at the type that you’re taking, are there any additives in it? What form of magnesium is it? Is it magnesium malate or magnesium glycinate? Is it magnesium bicarbonate? You know, magnesium citrate very commonly causes loose stools. So it could be the type. Like, I don’t do amazing with magnesium malate. But I could take a ton of magnesium glycinate. So sometimes it’s the type that you need to play with.

We can also get loose stools just from supplement changes and new supplements. So I would say if it’s not, say you’re having really consistent loose stools, it’s having an impact on your quality of life, that’s when, and you stopped the magnesium, that doesn’t do anything, I would stop all of your supplements. And I would also stop raw carrots. And then I would look at any dairy if you, if that’s a new food that for you. And then I would slowly add things back in one at a time because then that’s going to help you pinpoint like, where the heck did this come from, versus if we make a ton of changes at once, it’s really hard to see what’s causing it.

Emily: I think honestly, the moral of this episode is going to be go as slow as you possibly can with all of these supplements, because it’s so much better to start out slow, than to try to just add everything at once and to really dive in. And I know that, that’s tempting, because you just want to be all gung ho for your health—it’s so much harder to backtrack. Whenever, if you start experiencing a lot of these different symptoms and they’re completely unbearable, it’s almost like I don’t know what to take out. I don’t know what to start over. So if you take any word of wisdom from this episode, it’s that there are symptoms that are very normal in the healing journey. And the best way to combat this is to just go slow with all your supplements and all your changes.

So that said, on the flip side of the coin…constipation, okay. So if you are someone that’s experiencing constipation, you’re not having a bowel movement regularly, ask yourself, did I, drink enough water? Am I drinking enough liquids in general? And this can be, I would even say for hydration purposes, count all of your, your liquids—bone broth, adrenal elixirs, regular water, anything. Like, even if you’re eating fruit that counts, because these all have water in them. So it doesn’t necessarily just need to be plain water. But make sure that you are drinking enough liquids throughout the day. Are you eating less? So are the changes that you’re making in your diet causing you to maybe eat less than you normally would, because that can definitely stop motility or slow it down a little bit as well. Make sure that you’re still eating enough, that you’re getting in those calories, those proper macronutrient balances…all of that. You want to, you want to continue staying nourished and not eating less.

And then are you stressed while eating? This is going to be a big one for motility. Because our body does not prioritize digestion when we’re stressed. So if you are eating on the go or eating while you’re working or doing any number of things while you’re eating, that just might be a big recipe for disaster when it comes to constipation, especially if you already tend towards constipation. And this will be a lot of people with a sluggish thyroid. So definitely something I need to keep in mind. I cannot eat while stressed, because my digestion will go to complete crap if I do. But again, fiber is really important. And this is kind of individual because some people don’t do too great on a ton of fiber. But we do need to make sure that we’re getting at least some cooked veggies in. Most people need a little bit of fiber. So prioritizing the cooked veggies, making sure that you’re not eating too many raw veggies, because raw veggies can actually contribute to constipation.

Amanda: Yeah, and again, like, if it’s just at the beginning of making food changes, I would say it’s probably just an adjustment in your body. And I wouldn’t necessarily freak out. Because it can take time. I mean, our gut bacteria will completely change based on what we’re eating. And our gut bacteria helps us break down our food. So you can see those changes in the beginning. Raw carrots, obviously, we mentioned if you have loose

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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