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The 4 pillars of Menstrual Health

(according to me, Gemma)

Over the years I’ve worked with hundreds of women, and in every case I’ve seen the same themes come up again and again and again – Pain, PMT, Perimenopause and Tiredness (I wish that last one began with a P as well!) 

I like to dig into those themes when I’m talking about periods and hormones, because they really do seem to affect so many women that come to me, often at the end of their tether, and getting a good understanding of these 4 pillars really helps to empower you with your own health and wellbeing, giving you the chance to take back control and be in the driver’s seat when it comes to your body.


Pain is your body’s way of telling you something ain’t right.

All too often we are told its normal, suck it up and take some medicine. But paracetemol doesn’t always do the trick and is not always the answer anyway, because our pain is trying to tell us something important and it’s our job to listen.

How do I know if my pain is normal?

Well, if you ARE reaching for over-the-counter pills each month, or desperately trying to get your GP to write a prescription for something stronger, then it’s not normal. 

Why am I in pain?

Pain indicates that something isn’t right and that there is an underlying problem that needs to be explored. It might be something like Endometriosis, Adenomyosis or fibroids. Pain can be brought on by stress or diet, or inflammation. The key is  to listen to what it is telling us so that we can get to the root of it.


What counts as PMT?

There is a full spectrum going on here – at one end is a kind of irritability that lasts a few days and at the other end is a full on nosedive into the abyss of PMDD (premenstrual dysphoric disorder) that can be bloody terrifying. Wherever you are on that spectrum, if it is disrupting your day-to-day living, then it needs some attention.

But it’s normal, right?

PMT, at all ends of the spectrum, has been normalised and is usually approached with seemingly harmless banter and eye-rolling, but that doesn’t mean it’s normal to be raging and crying or full of brain fog in the run up to our periods, and it doesn’t mean you have to put up with it and struggle. PMT is not ‘normal’, it is an indication that something is a little or a lot amiss.

So what’s going on?

Your emotional plunge is telling you something – we have been well-trained to try and ignore the so-called negative emotions, like anger, sadness, depression, grief, frustration, but they are all there to help point us in a better direction. Once we tune in a little, we can start to respond by getting our hormones in balance, re-assessing our needs and evaluating our external stresses as well as our nutrition. It sounds simple, and it is, but sometimes it is also really hard to make the changes we need to make because of things like jobs, family commitments, financial constraints and so on. That’s where I come in, because making lasting, effective changes often needs support, guidance and encouragement.


So I’m tired, but isn’t everybody?

We’re not meant to be so bloody tired all the time. We’re really not. If you’re struggling with brain fog, exhaustion, low energy or fatigue, then let’s take a look at that. Society would have us believe is that we should just get on with it and stop moaning, but pushing through and ignoring our tiredness leads to imbalanced hormones, fatigue and burnout. 

What’s my period got to do with tiredness?

When your body is gearing up to bleed and you keep asking more of it, then it goes into deficit. Constantly struggling against fatigue and exhaustion makes life ugly, and it knocks our periods and hormones out of whack. A vicious circle, yes, but one that can be broken.

Can’t I just take some sleeping pills?

Nice try. The thing is, the sleeping pills may help you to get a bit more sleep, but they won’t do the work of fully resting your body, or helping to rebalance your hormones (and I mean ALL your hormones, not just progesterone and oestrogen) so things won’t actually improve much.


What IS perimenopause, really?

The dictionary says that perimenopause is ‘the period of a woman’s life shortly before the occurrence of the menopause’. I prefer to think of it as puberty in reverse, a handover that takes place as we stop using our ovaries to ovulate and the adrenals pick up the slack. During ‘Peri’, our body is just adjusting to a new way of being, just like it does when we start our periods and become pregnant – and if you really listen to the narrative around it all, you could end up believing all of it is very dangerous to our health. 

Is it always a hideous affair?

The common symptoms that we hear about are hot flushes, dry vaginas, night sweats, brain fog and mood swings to name a few, so how do you navigate this without HRT? Is it possible? Yes it is! I believe a big part in that lies in our overall health. There is no denying now the evidence is there, our diet and lifestyles have a direct effect on our hormones and not always in a positive way.

How can I reduce perimenopausal symptoms?

It’s all about getting good information about your cycle and symptoms so that you can really understand your body. With that understanding in place, you’ll find it easy to make the right choices to help ease symptoms. It’s not a big list of things you can’t do, but rather a big list of ‘Ooo, this is going to make me feel better and it’s so easy’. It is a confusing time because we haven’t been taught any body literacy. Really supporting yourself through this time will serve yourself for the future. Taking hormones isn’t a panacea, but understanding your body like a pro gives you all you need to make informed choices. That matters to me greatly and is the core of why I do what I do with everyone I work with.