The Menstrual Cycle & Body Literacy

The concept of body literacy comes from menstrual advocacy. The term refers to understanding the intricacies of the menstrual cycle in order to make fully-informed decisions about one’s health. It is a process of observing, learning, and understanding. For many people who menstruate, the only information we have been given in early life about our cycles is that they occur roughly once a month and last about a week. The conversation then rarely goes beyond some basic information on hygiene and perhaps pain management. Becoming body literate aims to change that by supporting developing a real understanding of the entire cycle and thinking beyond the bleed.

Cycle Basics

Learning the intricacies of your cycle is fascinating and something I highly recommend. Today, however, I’ll start with a basic overview.

Many of us think of our menstrual cycles as just the time when we actually menstruate. In reality, our menstrual cycles include the bleed and everything in between. The 28-day cycle is also an average, not a rule, with healthy cycles typically lasting anywhere from 21 to 35 days (Weschler, 2015). Cycles consist of two distinct major phases - the follicular phase which includes menstruation and the days leading up to ovulation and the luteal phase which includes ovulation and the days leading up to menstruation. These two main phases are broken into smaller phases so we then have the follicular phase, the ovulation phase, the luteal phase, and the menstrual phase.

These phases correspond to the thickening and shedding of the uterus’ lining, shifts in hormones and our basal body temperature (our temperature when we are fully at rest), and more.

Health and the Cycle

Different symptoms might also pop up during the cycle. Some of these are normal, like shifts in our energy levels, while others, like severe cramping, are not. A distinction should be made between "normal” and “common” period issues. For example, while severe cramping (dysmenorrhea) or skipping/missing periods (oligomenorrhea/amenorrhea) are unfortunately common issues, neither are normal and both should be addressed with support (Dawood, 1985; Practice Committee of the American Society for Reproductive Medicine, 2004). These cycle issues are also not just cycle related. Everything in the body is interconnected.

Why I Ask Clients About their Cycles

For those who menstruate, our cycles can give valuable insight into our overall health. You may have even noticed your cycle being affected by stress, travel, illness, exercise, or other factors. Some even argue that it be included as a basic vital sign along with heart rate, respiration, blood pressure, and body temperature (Hendrickson-Jack, 2019). There are a number of ways to identify exactly where we are in our cycles that I will share more about in the future, but, at the very least, I recommend that menstruating clients track the dates that they bleed each month. This basic information about how consistent their periods are, how long they are, how much they bleed, how many days between them there are, and any symptoms or challenges can be a gauge of overall health and potentially indicate underlying issues. If you struggle with your period, we’ll look to address root causes while also finding ways to mitigate symptoms in the meantime with lifestyle changes. I can also support you in finding specialists for testing, diagnosis, and treatment if needed. If you’re on hormonal birth control and not experiencing natural cycles we can still examine how that is going for you and support your relationship to your body.

How Can You Start Tracking?

I recommend clients start simple. The apps Clue and MyFlo are two that I use. You can also just mark on your calendar. You can start with just inputting the dates that you bleed. Over time, you can start adding in other indicators to get a deeper understanding of your cycle.

References:

Dawood, M. Y. (1985). Dysmenorrhea. The Journal of reproductive medicine, 30(3), 154-167.

Hendrickson-Jack, L. (2019). The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility. Fertility Friday Publishing Inc.

Practice Committee of the American Society for Reproductive Medicine. (2004). Current evaluation of amenorrhea. Fertility and sterility, 82, 33-39.

Weschler, T., MPH. (2015). Taking charge of your fertility: The definitive guide to natural birth control, pregnancy achievement, and reproductive health. New York, NY: William Morrow, an imprint of HarperCollins.

Intuitive Eating 101

Intuitive Eating (IE) is a core part of my philosophy. It was created by two dietitians, Evelyn Tribole and Elyse Resch (2012). It is a non-diet approach to eating and nutrition that focuses on tapping into ones own intuition and creating health practices and behavior that are sustainable over the long term.

IE consists of ten steps and principles. I meet clients where they are in terms of their relationship to food and dieting and support them through the steps towards becoming true intuitive eaters.

The 10 Principles of Intuitive Eating

1. Reject the Diet Mentality - Diets set us up for failure. Reject diet culture and its focus on weight and quick-fixes.

2. Honor your Hunger - Hunger is a normal biological function not a weakness or a problem. Keep your body fueled adequately. When we get to the point of ravenous hunger, as is common on restrictive diets, our ability to eat mindfully and intentionally disappears. We build trust in our body by keeping it fed.

3. Make Peace With Food - Give yourself unconditional permission to eat. Dieting leads to restricting and binging. Making peace with food allows us to stop feeling deprived which stops uncontrollable cravings and the binge-restrict cycle.

4. Challenge the Food Police - Learn to think about foods differently. Stop labeling foods as “good” or “bad.” No one food can make you healthy and no one food can make you unhealthy.

5. Feel Your Fullness - Trust that you are giving your body what it needs. Listen for body cues that tell you you are no longer hungry. It is ok to stop eating midway through an official meal because you are full just as it is ok to have a snack after another meal because you are still hungry. How much food we need on any day or at any meal will fluctuate depending on a number of factors and it is impossible to plan for that perfectly. Learning to listen to body cues takes that pressure off.

6. Discover the Satisfaction Factor - See food as more than fuel but as a source of pleasure and community. Eating things you enjoy in comfortable settings leads to greater feelings of satisfaction and enjoyment. We can also be full not not satisfied. Discover what you need to feel truly nourished after a meal and incorporate it into your life.

7. Cope with you Feelings with Kindness - Find ways to comfort and nurture yourself and process emotions in a healthy and productive way. Emotional eating is completely normal and ok but it becomes a problem when it is not helping or when it is the only tool we have.

8. Respect your Body - Embrace your unique body’s shape and size. Appreciate body diversity. Acknowledge that weight is not an indicator of health on its own.

9. Movement: Feel the Difference - Focus on how movement feels in your body rather than on calorie-burning or muscle sculpting. Find activities and routines that you enjoy and that fit your lifestyle.

10. Honor Your Health: Gentle Nutrition - Make food choices that are both tasty and supportive of long-term health. Focus on a way of eating that you can maintain consistently over time rather than on a crash diet. As with exercise, think about how certain foods make you feel rather than focusing on what you should or shouldn’t eat. Realize that one meal or one day of eating will not dramatically affect your health positively or negatively. Instead, think about the big picture.

The Science of Intuitive Eating

Coupled with a health at every size approach, intuitive eating principles have been shown to contribute to lasting behavior change while traditional diets do not (Bacon, Stern, Van Loan, & Keim, 2005).

IE supports positive physical and mental health outcomes including lowered risk for both obesity* and eating disorders (Saunders, Nichols-Lopez, & Frazier, 2018).

IE has been associated with less disordered eating, more positive body image, and greater emotional functioning (Bruce & Ricciardelli, 2016).

People trained to learn self-regulate their eating by relying on their hunger and satiety signals rather than external cues (like meal plans) experienced significant improvements in blood sugar control, insulin sensitivity, and HbA1c. (Ciampolini, Lovell-Smith, & Sifone, 2010).

Why I’m Passionate About Intuitive Eating

Since discovering IE, I have become a passionate advocate. As someone with a history of disordered eating, I know how scary and uncertain the concept of giving yourself unconditional permission to eat can seem. But as someone how has been practicing it for nearly a decade, I can also tell you it works. It is a foundational principle for me because I have both read the science and lived it. Because I’ve struggled with eating, I also can appreciate how these principles might be easy to comprehend but difficult to put into practice. As a coach, I help you tune out the noise and take things step by step.

IE allows us to develop healthy, sustainable relationships with food and exercise. My goal for all my clients is that they leave their time with me feeling knowledgeable and empowered about their own bodies and the choices they make for it. I believe small changes over a long time are more important than big changes that don’t last. I believe that there is a way that you can eat that benefits your health as well as the health of the environment and the food system that also makes room for food as fun, pleasure, and enjoyment.

On Accessibility

Though I am passionate about IE, I recognize that incorporating it fully may not be possible for everyone depending on their financial status, access to the foods they would like to eat, and other factors. I use the Food Access Hierarchy developed and outlined here by Patrilie Hernandez to inform my work with clients.

References:

Bacon, Linda, Judith S. Stern, Marta D. Van Loan, and Nancy L. Keim. "Size acceptance and intuitive eating improve health for obese, female chronic dieters." Journal of the American Dietetic Association 105, no. 6 (2005): 929-936.

Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454-472.

Ciampolini, M., Lovell-Smith, D., & Sifone, M. (2010). Sustained self-regulation of energy intake. Loss of weight in overweight subjects. Maintenance of weight in normal-weight subjects. Nutrition & metabolism, 7(1), 4.

Hernandez, P. (2020, July 04). Food Access and Intuitive Eating: Barriers to Successful Implementation. Retrieved July 09, 2020, from https://www.embodylib.com/blog/food-access-and-intuitive-eating-barriers-to-application

Saunders, J. F., Nichols-Lopez, K. A., & Frazier, L. D. (2018). Psychometric properties of the intuitive eating scale-2 (IES-2) in a culturally diverse Hispanic American sample. Eating behaviors, 28, 1-7.

Tribole, E., & Resch, E. (2012). Intuitive eating. Macmillan.

What’s Health Coaching?

Hello everyone!

Though I have a short answer to this question in my FAQs, I thought it would be good to elaborate with a blog post since health coaching is a relatively new and quickly-changing field that most people aren’t familiar with.

Coaches are educators, support systems, and mentors for individuals working towards health-related goals. You can think of them just as you would an athletic coach. A good coach is someone who can identify an athlete’s strengths and weakness, help them set realistic goals, brainstorm an action plan to reach those goals, think creatively about solutions to issues that arise, and work proactively on preventing injury and burnout.

Health coaches take this approach and apply it to general health. We can receive training through private health coaching schools and increasingly through universities, including Emory, Vanderbilt, the University of Minnesota, and Duke. Coaches can work independently, as I currently do, or directly in conjunction with other healthcare providers in clinical settings.

Coaches work specifically in the realm of lifestyle medicine, an application of environmental, behavioral, medical, and motivational principles to manage lifestyle-related health problems (Egger, Binns, & Rossner, 2009). We focus on the aspects of health that we can affect through behavior. Coaches do not replace the work one is doing with their physician or other medical professional but rather support it. For example, you may have been advised by your doctor to “eat better” or “exercise more” but been unsure what that looks like or how to make that happen within the context of your life. In this way, coaches also support physicians who are often pressed for time and only able to see patients for 10-15 minute appointments. Your doctor can help identify issues and make diagnoses and treatment plans, and your coach can take the extra time to help you with the factors you can control through lifestyle changes.

These factors include what can help improve your diet, how to find an exercise routine that is enjoyable and effective, and how to do both within the constraints of your budget and schedule. With so much health information available, it can be easy to know what to do for better health in theory but coaching can help address the how questions and turn general theory into individualized practice (Frates, 2018). Health coaches also support clients in taking the lead in designing their own health plans rather than simply giving instructions (Gorman, 2013).

I was drawn to health coaching as a way to combine several educational experiences, including health coach training, a master’s where I studied social issues around health, food, illness, and quality of life, yoga teacher training, and my practical training as a cook specialized in culinary medicine and sustainability. After serving as an unofficial health coach for numerous friends, I am excited to now be able to offer that type of guidance and support to clients.

References:

Egger, G. J., Binns, A. F., & Rossner, S. R. (2009). The emergence of “lifestyle medicine” as a structured approach for management of chronic disease. Medical Journal of Australia, 190(3), 143-145.

Frates, B. (2018). Health Coaching: Changing the Delivery of Health Care. Alternative and Complementary Therapies, 24(6), 250-252.

Gorman, B. (2013). Health coaching: holistically empowering change. Global advances in health and medicine, 2(3), 90.