ABOUT THIS EPISODE

Dr. Nicola Rinaldi has a PhD in biology from MIT. Since experiencing hypothalamic amenorrhea (missing periods) herself, Dr. Rinaldi has been on a mission to spread awareness of the condition and how to recover. In 2016 she published the book "No Period. Now What?" This book is a comprehensive resource that includes much of the medical and scientific research that underlies our current understanding of the triggers for amenorrhea, what steps to take for recovery, and treatments to use for recovery and pregnancy as needed. In addition, Dr. Rinaldi performed the largest survey to date of women who likewise experienced amenorrhea, and includes results from the survey answering many of the common questions women have, such as "How long will it take to recover?" "Will I be able to get pregnant?" and "Will I resume cycling after pregnancy?". Finally, the book includes Dr. Rinaldi's own story along with those of hundreds of other women, providing hope and reassurance to women following in their footsteps. Since publishing "No Period. Now What?" Dr. Rinaldi has been a guest on multiple podcasts, attended the ACSM and SCAN conferences, and presented the winning poster at the 2017 Female Athlete Conference.

In this episode we talk about how you can advocate for yourself when you’re suffering from amenorrhea (absence of a period) or Oligomenorrhea (irregular periods), how to know the difference between amenorrhea and PCOS, and what it takes, and how long it takes to get your period back, and how to check out your cervical mucus for a more intuitive way to track your ovulation. You can check out her website and popular blogs below and make sure to check out her book, No Period, Now What? For more details on all of the information we talked about in this episode!

Bleeped Content:

24:18: “I did a survey for my book of over 300 women who experiences HA… Over 82% of them lost 10 pounds or more in the last few years. That’s a significant weight loss for anybody.”

30:06: “[getting your period back] will happen more quickly if you’re able to go “all in” and eat more than 2500 or more calories per day…”

Navigating BodyLove IRL:

In this episode we talk about how to advocate for yourself at the doctor if you are experiences amenorrhea; especially if you are living in a larger body, or struggling with a ‘false’ PCOS diagnosis.

Listener Q/A

In this episode we answer:

  • How long does it take to get your period back?
  • Is soy really bad for hormonal health?
  • How do you actually “check” your cervical mucus?

Resources:

Nicola’s Most Popular Blogs:

English
United States

TRANSCRIPT

00:00:00welcome to episode 54 of the body Love Project podcast on Jesse Haggerty a registered dietitian intuitive eating counselor and personal trainer running a private practice out of Boston and your house
00:00:28under fueling for your body and your activity you can lose your nothing to do
00:00:38that was dr. Nicola Rinaldi a woman's health expert and author of no. Now what today were talking about her and no-nonsense approach to regulating hormones preserving fertility and recovering from hypothalamic amenorrhea which is a fancy way of saying when you lose your. As a result of under fueling and or over-exercising
00:01:04before we dive into the interview I have a couple of exciting announcements so first if you were a personal trainer group exercise instructor or yoga teacher I'd love to have you join my upcoming virtual Workshop series it's called nutrition and Body Image coaching skills for personal trainers this series is part self study and part live art workshops where you learned everything from how to talk to your client about nutrition and body image and how to screen for eating disorders and disordered eating and what to do next you can learn more at Jesse hagerty.com at Jessica Haggerty calm and click on the four trainers tab at the top of the page only taking 10 people in the score so if you want I not make sure it to do it soon
00:01:56and I'm also looking for an undergraduate or grad student to apply to my 2-year mentorship internship program I'm looking for someone with a special interest in media and communication and of course a passion for the body positive movement eating disorder Recovery Health at every size and weight inclusive Wellness the ideal candidate will be self-directed enthusiastic with strong writing and communication skills and a bonus is an entrepreneurial spirit and a knack for research you can apply online at Jesse hagerty.com jobs and this is a virtual position so you can do it from anywhere in the world
00:02:38unless I want to remind you that you can download my free intuitive eating audio guide which is a step by step on how you can get started with your own intuitive eating practice you can find that at Jesse hagerty.com and click on the banner at the top of the page just enter your name and email address and the guy will be delivered straight to your inbox One Last Thing Before we talked to Nicola as you probably know I usually blank out mention of Wheat and calorie count on his podcast especially when my gas are recounting there eating disorder history but in this episode nickel and I talked a lot about her research where she had some really specific finding around the negative effects of weight loss and calorie restriction that I found a really interesting just to remain consistent I did still blank these numbers out so there are no mention of numbers in the episode but I did include the non edited quotes in the show notes in case you're a clinician and want access to the information or you're just curious you can also find a lot of
00:03:38information in Nicholas book and then again that's called no. Now what and there is a link to that in the show notes as well now let's talk to you Nicola
00:03:50so Nicola can you tell me about what the term body love means to you or what comes to mind when you hear that term
00:04:02trains to hit our bodies you know comparing to the media you know whatever we see online and now we always finish all the advertising so I can fix this fix that so we focus on all the negative little things that we feel we shan't improved and pink of heating ourselves and hitting our bodies and it's just there's no reason for that I think so I think that body love is about letting go of those little imperfections realizing that everybody has little imperfections in their part of what makes us human and all and really focusing on all the cool things that we can do with our bodies instead of what they might look like that you know that doesn't meet the quote
00:05:02good idea and loving our bodies like we love our friends bodies you know I feel like we are friends and family members that I said things to myself after I look in the mirror that I would never in a million years say to anybody else
00:05:26anyone else since I think that reframing all of that and being as kind to ourselves and our relationship I really think kind and treating ourselves like we treat other people I think it's is a great way to love our bodies and we have four other people for ourselves to so important
00:06:08so ironically I think that I know a lot of the work that you do now is centered around taking care of your body and centered around taking care of your body in a different way than mainstream culture and diet culture tells us to because we always get the message has more and eat less and have more control over our body so can you talk a little bit about your personal and professional journey to doing the work that you are doing out around on amenorrhea and Women's Health it was stuff that I love to do volleyball and lifting weights cuz I wanted to be strong and play squash with my lab mates and bake
00:07:08and then I got sucked into the idea that I needed to protect my body I need you to know I had love handles that I should get rid of and I was starting to think about getting pregnant and I kept reading you at least wait to have an easier time getting pregnant and lose weight to have a healthy pregnancy and so I was like okay I'll do that for my calories and I lost a fair bit of weight in a short amount of time and you know I thought it was great I was like oh this is awesome you know I finally have the body I've always wanted and you know I never mind that the body I had before was perfectly good and Loud me to do everything I wanted to do
00:08:02and then I went off the pill to you don't start getting pregnant and I didn't get it. Cuz my body was like so here I was for the following the Mantra if you know lose weight exercise more be healthier and in my case it wasn't true and I think that's true for a lot of women that you know if a little bit of something is good then more is better and most is best and you know you're the healthiest when you're a teeny tiny and exercising all the time and that's really not how our bodies operate so anyway that's it. And that makes it really hard to get pregnant so I worked for I went to the doctors they told me
00:09:02do you know it's normal for it to take awhile for your period to come back and so you know come back and see us a little while and I didn't really know what was going on so I started doing some research and learning a little bit and eat a lot more and I did eventually get it. But I'd already kind of started down the path of fertility treatments now I had a couple of ultrasounds in a short. Of time and channel
00:10:02the idea that I would have to quote on quote on do all my work to you know get back to where I had been and it turned out good and we had a couple months out for insurance reasons and
00:10:26going on with your normal natural cycles and so you don't know if there's a problem or not and I was like why would I want to see on my own and I was very lucky to get pregnant on that very first ovulation and my son is now almost 12
00:10:50and then I started posting and learning more and sharing my research and many years until finally this to that light even more research and you know and all of that and it's like
00:11:29giant bug going to be like three different bugs to have it all in one place
00:11:44can you talk a little bit about that because as you were telling the story I you know I just felt you know this like such deep sense of concern that you know you go to doctor after doctor and did you know what this is, and right cuz I see this all the time to wear a lot of these things like under eating over-exercising he's like this order to eating and exercise patterns that you know kind of fly under the radar because you know you're only spending a few minutes with your doctor and I'm like throwing out just kind of that like quick advice if I can maybe try this or maybe try that doesn't usually stick when you know the underlying motivation for that is like so deep that you know having her doctor kind of Take 2 seconds to give you that recommendation usually isn't going to do a whole lot
00:12:42and that's if your doctor even says that because yeah
00:12:50so now you're eating and exercise aren't
00:12:54without the understanding that if you are under fueling for your body and your activity you can lose your period because of that it has nothing to do with your absolute body size you know it's about are you eating enough on a daily basis to fuel the you know he does every second you know from pumping blood fueling your your brain at your breathing your muscles working I mean the energy that we take in on a daily basis goes to so many things that we don't even really think about it I mean it's like that. There's so many things that our bodies are doing and then you know if you're exercising on top of that the exercise is something that we are body has no choice about like we do the exercise it has to pay that energy
00:13:54so then if we're not eating enough for that exercise plus everything else it has to be like what am I not going to do because I've done this exercise or because I'm not eating it because I don't have enough and so it'll do things like make you colder it doesn't want to spend the energy to warm you up so a lot of women who have and that's why because your body doesn't have enough energy to keep you warm until they're all in all sorts of things that your body can choose to do less of or to shut down at one of which is for your reproductive system that's a nice to have not a need to have you look fine or how much are you eating
00:14:54are you there other food groups that you're not eating you know how do you feel about getting a little bit of weight you know how does that make you feel because it's a very scary thing for a lot of people because of the way our society glorifies and very muscular you know like that that's sort of the idea that we're supposed to look like and is definitely privileges that you that you gain when you when you meet that at that body I deal and you know it can be very hard to be in a body that doesn't look like that and so it's very scary for people
00:15:38I think the doctors needs to realize that not everybody is meant to have it is meant to be in a teeny tiny body and not everybody is meant I mean it's really important to be fueling for what your body wants and what your body needs and what you want your body to do every day and know if somebody's not getting her period for doctors to support them in understanding that you know they might need to eat more and they might need to exercise less and if it does actually work to restore. If you do that so I think you're right it's like that is very often. Absolutely not getting at the underlying cause of the missing periods and in fact research these days it's showing that you know it probably
00:16:38does protect your bones to some degree but we should be gaining bone mass too many decades of our lives and the birth control pills don't seem to encourage
00:16:52I know that's so nice I guess how can people eat cuz I'm sure that there are people listening to this who have experienced this in the past or are experiencing this presently and how would you recommend someone really advocating for themselves if they're going to their doctor with this problem and I'll I'll kind of take this time to say underline what you said before of that you know this could happen to anyone and anybody size like you don't have to be quote-unquote underweight right to have this problem to have the hypothalamic amenorrhea you can be in anybody's eyes and like you said that energy deficit and the over exercise which are really geared like the the promotion of those types of things are geared towards people in larger bodies
00:17:52and so anyone in any size or anyone anybody size can be facing this how can they really advocate for themselves they're going to their doctor
00:18:05I think it's really important to look at some of the underlying research you know do some reading about female athlete Triad or relative energy deficiency in sport and you sort of have to know these things for yourself and tell your doctor look I think this is what's going on with me you know what are your thoughts on this because I think that it's just not on the radar screen of a lot of primary care physicians or even OBGYNs because they they just don't see it that much which
00:18:41I'm I'm suddenly immersed in this world so to me it's crazy but I've and he was like I only see me cuz I'm like that it's all around me I see it everywhere oh I oh I see what the hundred percent aware of the underlying causes and what might be going on so I think coming in and saying like your own Advocate and also not letting yourself I really don't think that's it I mean if they have if they have tests that they do that show that it's some other issue you know there are other things that can cause amenorrhea like if you had some kind of
00:19:41there are absolutely no reasoning for why this is not a problem I think it's really important to go insane you this is what this is what I think is going on with me and looking for support in that way yeah that makes so much sense and I think to Amy and I can only I don't watch other people go to the doctor so I can only speak for my own experiences going to the doctor but there's not usually a whole lot of conversation around or like right at least when I go see my primary care physician write about like how often you know getting my cycle or
00:20:41I like do I ever skip. Let me know it usually seems to be like a quick conversation and it could be really easy to gloss over that especially if you're just not someone who's comfortable talking about it like it's not I think women were like okay like I'm not going to make a big deal out of this until it really feels like a problem and so it could easily be that they're just not getting all of the information as well cuz I got like when you said that like once a year
00:21:20that's really interesting
00:21:30hormones tested that seems to be the most indicative of AJ it's typically either below normal or on the low side of normal that's really the only good market for AJ and unfortunately LH can be perfectly normal in about 30% of the women that do FHA so some other things that are contested is an answer comparing between DHA and PCOS polycystic ovarian syndrome that's another hormonal issues that can manifest with as amenorrhea and women are misdiagnosed with PCOS instead of typing because I cherish for diagnosis or
00:22:30ultrasound scan is done having a large number of follicles on the ovaries the technical definition is has recently been updated to 25 or more follicles between 2 and 9 mm on one ovary but a lot of doctors will take a look at this and then the third one is which is in excess of a typical male hormones
00:23:20so jacaman Fest in blood work or it can manifest with physical symptoms like male pattern hair growth and a lot of acne that doesn't easy to treat with absence of eyes are blood work that supports the diagnosis
00:23:53or does physical symptoms I really encourage people to look at it first before you know are you are you under eating are you exercising everyday or you're exercising a lot or alot of high very high intensity exercise have you lost weight in the past because I think that it seems that I'm beside you the survey for my book of over 300 women if you had experience HHA and I was actually really surprised when we analyze the data to find that 82% of them had lost pounds or more at some point in the last few years
00:24:39or you know any further stressor like you could be a psychological stress or continued under eating or you know increasing your mileage for running. Considered to be in that area so that's another factor that I would look at you know so all you really have to look at the big picture and not just go based on you know amenorrhea and less of an issue with that is that if you do in fact have HOA instead of PCOS prescription for what you should do to recover is basically the opposite you know you shouldn't manage your man cheating or exercise more right
00:25:36if you have have you want to eat more you probably want to exercise list certainly less high-intensity exercise intensity exercise can be sensed by our body is a stressor and that can help with shutting down the hypothalamus so that's why it's really important that you get that diagnosis piece correct no no I said it's so important to you because I know that well I know also like another dietitian Julie Duffy Dylan does a lot of work with PCOS as well and really helping people be able to like manage PCOS symptoms like from a non-diet perspective so it's not about you know like restriction or over exercising but yeah but I also know that like four people in people go to the doctor and that's the diagnosis they receive like it usually is just like
00:26:36General prescription of like like we were talking about before eat less exercise more and how problematic if for anyone really I think that's a problematic recommendation across the board but especially if you're already doing that right and you're now trying to do it even more and you're making the problem even worse
00:27:00but I would also say if you were really looking to advocate for yourself to read your book and then maybe some stuff and bring that to the doctor with you if you feel like you're you don't have the language to to Really advocating for yourself either
00:27:19Turkish very well supported with a scientific research so I went through and I read hundreds of medical papers when I was writing the book that's all digested in there and so yeah you can highlight sections and you can say to your doctor look very this reference and it's not just this is what I read on the web it's like the medical support for what I'm saying so yeah and I think it's really important what you said before about how the survey with all of the women who 82% of them have lost weight in the past year and again regardless of body size correct so weight loss at anybody size it is causing stress to the body and I think that we think okay we don't want someone who's you know teetering on like the underweight portion of the BMI to lose weight but like someone who's
00:28:18higher BMI range can lose weight that's not going to cause stress it's like it all causes stress is all affecting our system and our body regardless of size doesn't want to be in that deficit he said
00:28:37so I have some questions from listeners I don't know if you're up for answering right okay how long it does it actually take to get your period back so once you have the diagnosis or you realize that you're not getting your period anymore do you have a general time frame and I'm assuming it depends on how quickly you're able to kind of get back to a baseline number of daily calorie intake doubt daily energy intake and how much exercise do you have to actually pull back on
00:29:18so this is one of the questions that I asked in my survey and the median X recovery was 6 months so I've seen it happen as quickly as four to six weeks I've seen it so many factors that play into that and I think it's really important not to compare with other people because we each have a very unique journey to losing our. And we have a unique journey to regaining it everybody has a different amount of exercise they're doing different food they have to have overcome so 8 Note 6 months it is it is a general time frame that I date that I feel comfortable giving people
00:30:06it will probably happen more quickly if you are able to go quote on quote all in more quickly which is eating or more calories per day and said that's that's a guideline it's not like I don't want people to be like I must eat yes I really encourage people to learn to eat more by based on how your body is feeling but that can be hard when you're getting started in the process if you've been significantly actually look like so that that's why I give the numbers yeah and I think that's really important to because a lot of times on the podcast I will I purposely pull
00:31:06number Swig calories or or wait mentioned but I think that it is important to give that like you said a minimum like something that's like this is what it means to have enough cuz I think that sometimes our idea that is so skewed right and then they're using the calculation that they got for my fitness pal which I can say I'm shocked the force is not enough so I really hope that anybody who likes looking at that I like that you kind of throw that that number out there as like a minimum tame for and then like you said that work with you can start
00:32:06your way into an intuitive eating practice and if you wanted to work your way I always love recommend AV intuitive eating for work with an intuitive eating coach or do if there's a few online courses that I always recommend to people and then that's kind of a way where you got to find what like feels good for you but I like that you know if you are under fueling so much it's good to have an idea that like it that we usually what we consider enough is very skewed from the information we get out there
00:32:37share the research in my book that supports those numbers which is basically a scientist took people who were weight stable and looked at it but they were really eat each day and it was it wasn't self-reported it was everything was weighed and measured and and they looked at their metabolism so that's that is the amount or actually burning in a day and so that's the amount that you need in order to survive fully fuel your system so it's I mean it does sound crazy high but I think a lot of times people will eating weed
00:33:25definitely in the second piece of all in is cutting out high-intensity exercise exercise he is running a marathon and she's getting her. All the time so I think it's very different if you have menstrual cycles I'm particularly in room issue has amenorrhea so there was a study that I saw recently where they looked it normally cycling women
00:34:31are many women who are trying to recover
00:34:36intensity exercise and it's important to know that it's for the time being this is not a forever Thing by any means it's this is what you need to do for a short amount of time in order to and then overtime you can add back in that exercise and as long as you continue to fully fuel your body and the exercise you're doing it's not a problem at all like I said women who have recovered during Ironman triathlons and she's been eating regularly because
00:35:16exercise and so you know that makes such a huge difference when you're really eating enough to support the exercise that you're doing oh yeah definitely and I mean it just sounds like you really need to give your body a chance I must catch up right cuz if you're trying to catch up by eating enough and then on top of that you're training for a marathon it seems like near impossible to get enough in to really keep your energy balance like close to neutral to then be able to get your period back because like you said that's kind of the last you know one of the last things to go there's other things that happen when you're in the energy deficit and then your period goes so like your body does have to like make up for all of that like you said regulating body temperature and hair growth and all of that stuff
00:36:16before it's going to say okay now I feel safe having a reproductive cycle where I could possibly get pregnant pregnancy if that's what you're looking to do as well
00:36:35if at 6 months and like I was saying is I didn't ask the question in my survey about you know did you immediately change your exercise and eating habits or was it more gradual indefinitely they were faster results for those people who were able to immediately make the changes but everybody has to make a decision for themselves as to the best way for them personally to go about this you know it for some people it might be super scary to think about eating that much or completely cutting out there running and so in order for them to recover they might need to take smaller steps in might the whole process might take a little bit longer but that's okay you know it's okay for people to be like I'm going to try this first and see what happens and then you know it's that doesn't work then I'll go a little bit easier to take those extra steps once you seen the effects of the first few steps in like maybe I can take a month off and you're taking it in bite-size steps can often be
00:37:35I think it's women who want to get pregnant where we're going all-in right away it's like okay to me right now so I'm just really depends for each individual what was the most important to them and you know how they want to go about this I think that's really important to understand is you know everybody can make a plan for yourself and you know I only work with people on that and I know you did to coming up with a plan that's going to work because if if you if you're not ready to jump in then jumping in isn't going to it's not going to work it's it you know you have to be mentally ready I think that you know the mental part is huge in in all of this recovery and should have working with our minds to understand how some of the things we thought were healthy or maybe not so healthy or you know
00:38:33particularly around the body image and doing some of the work to feel comfortable in a body that might be getting bigger than it has been you know that's really challenging and so that can take some time and so you know there's there's so much that goes into all of this that you know I can give you a six-month median but it's so yeah I know and I think that's really important to highlight because this idea of going all-in for like you said if if if they have it if getting pregnant is kind of like the highest priority that it might be really easy for someone to say okay you know what I'm just going to do this and I don't care if I'm I'm afraid I don't care if there's like a lot of fear and anxiety around this but like I just really want to get pregnant but I tend to work with people who like pregnancy isn't their top priority as this all has to happen kind of like two steps
00:39:33one step back for a while we're everything happens really gradually and yeah there is so much fear around it and there's it takes a huge shift in your perception to be able to do something that sounds as simple as just eating more and exercising last night yep yeah so hopefully you can just kind of like hear your voice saying like eat eat more exercise okay another question that I got from someone on Instagram which was is soy actually harmful to female hormones I know that we've heard a lot about soy and estrogen
00:40:26this is an interesting question so one of the things that one can do to kind of give your body a push once you've been all in for a while or once you've restored Cycles if there long you can take soy isoflavones for like 5 or 6 days at the beginning of your cycle and that can encourage earlier ovulation or vegetarian pretty much all her life and she said she eats soy everyday and she was able to recover her Cycles so I think any major changes in foods can upset our bodies balance like I wouldn't suggest to somebody trying to going out to try and recover their Cycles be like
00:41:26I mean I think everything in moderation is really that that I haven't seen strong evidence that a couple times a week
00:41:48is she eating or drinking things in moderation your body can handle it so you know like I've seen like broccoli is bad for fertility eating like 2 pounds of broccoli everyday yeah it's probably not going to be so great for you know any of your system
00:42:10ice creams
00:42:42as far as particular food groups I really just encourage moderation I mean you know I haven't seen strong evidence that there is a particular type of food that's going to piss in your cycle return or eat this and it's going to make your cycle go away I just know I just don't think our bodies work like that they're pretty good at taking in what they need and getting rid of the stuff so yeah as much of a variety of food you can one thing that people have tended to do recently is that the low carb diets and there is some evidence that the low carbs can prevents the return of menstrual cycles because our hypothalamus does glucose and insulin and it needs those bumps over over the day to start
00:43:42add some of that back everything in moderation is good healthy way to eat for Recovery definitely carbs are necessary headlines of like this food is bad and good and you know even when some of the Articles have like a couple of Reno pieces of research sprinkled throughout them and their there they're always kind of dose dependent right so I probably wouldn't be that awesome for you if was the only thing you were eating but I don't know many people who are actually doing that right
00:44:42things that we know are harmful like cigarettes like while I would never recommend smoking never advocated for that but that also has a dose dependent affect have a cigarette here is very different than like smoking a pack a day now is that we know that cigarettes are toxic and the chemicals in them are toxic and yet our bodies are able to handle that Sugar I mean it's that ridiculous I'm sorry Heather that's good Touchstone yes okay so I have one more and I think the person who said the saying was a little bit and talk and I was kind of state
00:45:42difference between cervical mucus consistency and it was something that she read in your box
00:45:54right right right
00:45:56cervical mucus is really interesting it can actually give us a very good sense of where our body
00:46:05when you are deep in and mucus coming back is actually a great sign so there's an excellent book taking charge of your fertility that I highly recommend for detail and I think that's a really great resource to learn more about their menstrual cycles and how they work but so they're couple different ways that you can check out what your you might notice it when you go to the bathroom like after you wipe after you know each other after peeing or number to the bearing down kind of precious some of the mucus out of your vagina
00:47:05feel like it can feel a little bit sticky or more slippery or watery and the different ways that your body excrete stop mucus you learn about it I mean it's you know it's actually really cool like for me I noticed and I don't know is that much until I get close to ovulation and then I just feel generally much for wet down there and when I wipe it feels very slippery and I can take that you know I can take any cuz it comes out even on the toilet paper and kind of put it between my fingers and stretch it and you know if it if I'm getting very close to ovulation mucus and it really does look and feel like I White's it's amazing that is very friendly to sperm so our bodies are making this mucus so the sperm can survive
00:48:05meet up with the egg and then create an embryo so it's pretty much get pregnant right now if you want to get pregnant having sex for 5 days before ovulation can lead to pregnancy it's like right
00:48:32having sex before all the time
00:48:37pregnancy understanding your mucus patterns can be really helpful for that really well worth learning about how your menstrual cycle works and how that how that mucus all works and you know it it's it's really cool. I think so yeah and I think just being able to I guess I kind of like being comfortable just looking at it and it's not something that you have to like go searching for it like it's something that you all feel when you go to the bathroom and I think women in Psych screw that you know it's just
00:49:31get away from any of that shame around our body
00:49:36I know I agree and I think so you know it's it's funny because you know everything that's happening in the bathroom right like we're all doing pretty much in private at least here in the United States and I that's very true session with a client like I am going into a lot of these questions that can very intimate for the first time your meeting with someone like you know talking about how often it is that you typically like me with your best friend but I think so especially like we have to be able to have these conversations that we're getting the full picture
00:50:36doctor or you know anyone that's working of people especially you know might be coming to you with a problem like this and so I think that you're right it is really important but then just in general like the general public like there is still such a stigma around you know having a. I remember how embarrassed I was. When I was younger I don't like that was that's so sad I was so you know you're so conditioned to think that this is something that you should feel bad about her something that you should be embarrassed if it doesn't really feel like
00:51:27I said women should have daughters can do to encourage sharing monthly what happens monthly letting them see what it looks like I mean you know there's nothing to be ashamed of and you know if your daughter's get to see this is what is going to come out
00:51:57around all of it and I think even cuz I know one of the things that you talk about is that like primary amenorrhea which is why a young girl rate doesn't ever get it. Because you be there like you said if he was alive would like to search and just so you know girls were really active and I think a lot of times that she can almost exacerbate that right like there is all set like a sense of like okay I don't have to worry about getting my. So it almost feels like safe right to not have it where I was like if we took a little bit of that shame away that they might
00:52:57it might be highlighted as more of a problem that they can kind of nip in the butt earlier
00:53:05yeah I think it's
00:53:09Harry competitive athletes at a very young age you know I haven't worked with with that population and also I I don't really have any strong recommendations but I do feel like eating more would be helpful even even if they are helping with bone density in that kind of thing you know just as soon as we can I think it's really important exercise last week's people know our bodies need some rest so not okay
00:54:02I know we put so much pressure on ourselves
00:54:07thank you so much this is so informative and I definitely will encourage everyone listening to us even more information to check out your no. Now what and I'll post a link to that in the show notes find out more about you
00:54:28really helpful to understand you can also find me on Instagram and Twitter. Is struggling with this at your Facebook that you have so many awesome resources in there as well and thank you so much for the no you can't.
00:55:43thank you so much for listening if you would love this episode you might want to check out episode 27 with Shira Brenner and if you want to share this episode with a friend had to Jesse hagerty.com blp podcast serial see every episode along with its respective show notes and some images of my favorite quotes from each episode share them on Facebook Twitter or Instagram and make sure to tag me at the handle Jesse Haggerty Rd thanks so much for hanging up and I'll see you next week with a fresh episode

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