Hot flushes are most prevalent in African Americans and Caucasians. It is least prevalent in East-Asian people. It’s thought this is because of the soy-rich diet of those in places like Japan. But it is also because the ageing process is revered in East-Asia where it is not in Westernised countries such as America.

To support someone with hot flushes phytoestrogens such as sage are key. Sage is especially nice because it is also cooling and helps with hyperhidrosis (excessive sweating). Another herb worth considering is peppermint (Mentha piperita) for its cooling properties. 

Anxiety is worst in people who are approaching perimenopause and already burnt out from life’s demands. To abate this, phytoestrogens like black cohosh can help because it’s also a nervine.

But it can be complemented with other nervines like chamomile (Chamomilla recutita) and passionflower (Passiflora incarnata). I also like to give people suffering with anxiety herbs to help with burnout such as oat straw (Avena sativa) and perhaps even an adaptogen such as ashwagandha (Withania somnifera) because it relaxes and strengthens. 

I see lethargy as another symptom of burnout. Adaptogens are key here, as well as tonics. I particularly like nettle (Urtica dioica) in addition to the ashwagandha I’ve already mentioned. Eating a low glycemic load diet will also help with lethargy as it improves slow release of energy. This is vital for anyone surviving on coffee which will stress the adrenals further.

Weight gain is somewhat unavoidable and potentially beneficial as fat cells are where we make a lot of our oestrogen. But when it seems to be going on too fast, or too much, it’s important to try and work to stop that.

Weight-bearing exercises such as weight lifting is a great way to improve muscle bulk and metabolism, not to mention bone health. Eating a low glycemic diet will help stop the fat from depositing in the middle of the body, as will managing stress levels with relaxants (as mentioned in the anxiety section).

You can also work with herbs that help balance blood sugar levels, like cinnamon (Cinnamomum zeylanica).

If you’re struggling to get to sleep, it’s partly because it takes much longer to produce melatonin as we age. This means that we need longer in the dark than we used to before bed.

It’s crucial to have at least an hour away from all screens before bed in order to promote its production. But interestingly, working with chaste berry (Vitex agnus castus) can help with this at the right dose. 

Poverty, stressful life events and negative attitudes to ageing contribute to menopausal depression more than ethnicity. But it’s interesting to note that Chinese Americans have the least amount of depression in western society. Possibly because they still revere their older generations.

Gambian women are known to feel renewed and strengthened during the perimenopause as they are relieved from childbearing and become a respected elder.

Our western attitudes to ageing have a lot to answer for. But whilst I’d love those attitudes to change overnight, they won’t. In the meantime, we’re left with depressed perimenopausal populations.

Anti-depressants like St John’s wort (Hypericum perforatum) may help, but I don’t particularly like it. I actually much prefer lemon balm (Melissa officinalis) and orange blossom (Citrus auratium) as they are incredibly uplifting. It’s hard not to see the brighter side of life while taking those herbs.

Any and all of these herbs can be made into an infusion or decoction. For an infusion, just pour boiling water on top of a heaped teaspoon of herbs and let it infuse for 5 minutes before drinking. Drink that 3 times a day. But if you don’t have time for that you can get them as tinctures, an alcohol extract, and taken as drops each day. I’d recommend 2-5ml of a herb twice a day. Or 5ml three times a day if you go with a combination of herbs.

Finally, we want to note that due to the rise in popularity of herbs for women’s health, some of the popular species are now in danger. For example, this is true for black cohosh. Therefore, buy from reputable suppliers, and ideally places that source cultivated plants rather than wild-harvested to be sure that your medicines are sustainable. Read more about Endangered plants and women’s health: Fertility herbs at risk.

Physically

During menstruation the body is letting go of the un-fertilised egg and endometrial lining from the previous cycle. Whilst this is occurring, it is already starting to gear up for the next ovulation. The hypothalamus releases a hormone (GnRH) that tells the pituitary gland to release the follicle-stimulating hormone (FSH). 

This stimulates follicles (aka immature eggs) to start to mature in the ovary on one side of the womb (ovulation alternates sides each month). Those maturing eggs make oestrogen of their own and feed back to the hypothalamus to keep providing the support it is. 

During this phase you are losing blood, of varying quantities, and this can leave you feeling drained. So be mindful of this, take it slow and eat nourishing blood-building foods like raw cacao, red meat, red wine, dark leafy greens, molasses and apricots. Towards the end of this phase you might stop bleeding but it’s unlikely your cervical mucous will return till the next phase. Your waking body temperature will be relatively low during this phase. I used to find mine would drop on the morning my period came, I could actually use it as a heads-up that she was on her way that day. 

Emotionally

You may be feeling introspective, or hermit-like. If you can’t get this space and time to yourself, the outside world can get pretty tiring and annoying. Try to carve out as much me-time during your bleed as possible. Alternatively, you might be one of those people who, as soon as they bleed, feel relieved, and find their energy starts to build.

I was one of those people. If that’s you, still try to take it easy and slowly build yourself back up into out-going life. Try to rest just a touch longer, or spend the energy you have on yourself, rather than prioritising others. This is a good time for planning what you want to do in the coming month, and tuning into your emotions and intuition. 

Supportive herbs

This phase, if not supported correctly, can leave us in an energy deficit for the rest of the month. It’s a good idea to drink lots of nettle and raspberry leaf tea during this phase to build blood and tonify the womb. I actually put these two herbs in a drink I make called Aunt Flo. It’s a raw cacao drinking chocolate with those herbs combined within.

Physically

After a few days most of those follicles start to die off,  except the one that will go on to be the egg for that cycle. Once a peak surge of FSH is reached the pituitary gland releases luteinising hormone that triggers ovulation itself. You’ll notice your cervical mucous will start to change during this phase from non-existent to sticky or crumbly. Your waking temperature during this part of the cycle is relatively low. 

Emotionally

Your energy has built up since you bled and this is when you’ll start to want to go out and socialise again. It’s a good time to make plans, and communicate anything to your loved ones that you discovered during the menstrual or pre-menstrual phase. This is a time to plant seeds. It is also a highly creative time for many people, and this new burst of energy can be great if channelled well. However, for some they can be left feeling unfocused and ungrounded, so this is a good time for grounding and embodiment practises. 

Supportive herbs

It is a good idea to keep feeding and nourishing the body during this phase. It is a time of gentle blossoming of new ideas as energy rises. I think delicate flowers are beautiful during this phase such as rose bud tea. Helping us to open our hearts to the week ahead. 

Physically

The egg is released from the ovary and starts its journey down the fallopian tube. The body has the next 24-48 hours to fertilise that egg or pregnancy won’t occur that month. The egg leaves behind the capsule that it grew in; this is called the corpus luteum. The corpus luteum will release its own progesterone for the next few days in the hopes that pregnancy does occur.

This supports the endometrial lining for the next few days. You’ll find your cervical mucous is at its most abundant during this phase. Often it will get watery or even super elastic like egg white (which is called spinnbarkeit). Your temperature will suddenly rise by 0.2 degree centigrade and stay high like this till your next period. 

Emotionally

This is the peak of your energy for most people. It’s also when you’re feeling most sexy and sociable. Make the most of it by going out or booking in those important meetings. You will feel confident and be at your best for communication. Words will flow freely from your mouth. You’ll feel like you’ve had some of the luck potion, Felix Felicis, from Harry Potter! 

Supportive herbs

Usually people find ovulation to be the easiest part of the menstrual cycle. I personally find that the energy boost can make me a bit hyper. Taking ashwagandha helps me to just pace myself a bit better so I don’t accidentally over-work and burn myself out for the next phase. 

Physically

It takes a little while for the body to realise fertilisation hasn’t occurred, and as the corpurs luteum uses up its resources and disappears, progesterone takes a nosedive, initiating menstruation. During this phase you’ll find your energy dips, along with your immunity so tiredness and colds are more likely.

Your cervical mucous will go back to crumbly or sticky and perhaps you’ll have some dry days before the period begins again. But your waking body temperature remains high till then. 

Emotionally

It’s normal to feel easily irritated and moody during this time because your energy reaches a natural low point and balanced blood glucose levels are harder to maintain. Communication skills are at their lowest but your instincts are heightened. If there is a contradiction between your instincts and what you are able to do this causes friction and irritability, which you may not be very good at expressing in a considered way. It tends to all come tumbling out in moody, angry or tearful outbursts instead.

To be on the safe side, we usually pick a tiny, insignificant pet hate to lay into so we can express the feelings without actually making any real progress. It’s pretty impressive. I have found that if I’m able to actually have downtime to relax, lessen my workload and eat well, then my irritability and tearfulness just don’t occur.

I implore you to experiment with using this phase to transition into a time of self-reflection and solitude. It can also be a great time for more introverted work such as planning and taking stock of life – the perfect tasks for solitude, and the perfect preparation for the next phase of your menstrual cycle where you can tune into your intuition more. 

Supportive herbs

One herb that really encapsulates this phase of looking inwards and slowing down is passionflower (Passiflora incarnata). This herb helps you slip into that dream-like state that is just out of reach for so many people in the premenstrual phase. If you are able to let go of your responsibilities (even if it’s just for half a day) you’ll find there is a bliss-like state that you can grasp, passionflower will help you do this. 

By charting our cycles and knowing where we are in them at all times we can harness the strengths of every part of it. We can also avoid the bad sides too. A lot of our suffering with periods comes down to the indoctrination we’ve received in western culture that they’re a negative experience. But there is a wave of menstrual activists, such as myself, whose purpose is to turn that narrative up on its head. 

Viva la Menstrual Revolution!

After four years of having taken the contraceptive pill (microgynon 30 specifically) I was sick of the constant thrush/cystitis cycle I found myself in. I’d been getting informed and empowered about the amazing benefits of ovulation to mind and body and I wanted to experience it for myself.

When I was about 19 I was taught how to use the hormone-free fertility awareness method as a contraceptive by an NHS nurse. Little did I know how incredibly rare this service is!

Although my experience with the contraceptive pill was negative in the end, I had taken it for many years without issue before then.

While your contraceptive provider is there to help you, there is a chasm of difference between the side effects they think you need to know about and the ones that so often lead to people quitting their hormonal contraceptives. When I was researching the history of the contraceptive pill for my masters this became more obvious than ever (1).

The research papers which looked into the side effects of the contraceptive pill would list life-threatening illnesses such as blood clot risk. But the reasons why people would stop taking their contraceptives would range from hair loss to loss of libido. Hardly life-threatening, but incredibly important to the lives of those taking them.

As women and anyone with wombs get more informed and empowered about their bodies they’re less likely to put up with those life-changing side effects and are instead seeking out natural alternatives.

The most effective hormone-free contraceptive is the fertility awareness method. With an effectiveness rate of 99% when used correctly it works better than the most popular hormonal contraceptive with an effectiveness rate of 91%; the pill (2). 

The fertility awareness method works by teaching you how to read the signs of your body. If you keep track of two out of three things; your waking body temperature, cervical mucous and/or cervix position you will be able to tell when you’ve ovulated.

Because an egg only lasts up to 48hrs in the female reproductive system before dying you only have up to 48hrs where it can come into contact with sperm (3). However, because sperm lives for up to 10 days in fertile cervical mucous, if you’ve had sex in the 10 days beforehand, it’s possible you will get pregnant.

Having said that, this is a very conservative estimate, there is only a 5% chance sperm will survive more than 4.4 days and a 1% chance sperm will live more than 6.8 days in a fertile woman (4).

By knowing when you are producing the sort of cervical mucous which would keep sperm alive, versus the mucous which actually acts as a barrier to sperm you can know when to avoid and when to have sex. I learnt the method through an NHS registered FAM practitioner, but you can learn it through books and I teach it in my Periods 101 online course too. What’s nice about this method is that you can choose how cautious you wish to be.

When I was learning it, I continued to use a barrier method for six months and abstained during my fertile phase. Once I felt more comfortable then I dropped the barrier method during the non-fertile days with my long-term partner. At my most cautious I had three contraceptives in my defence system!

The first was FAM, the second was a condom, and the backup plan was the emergency contraceptive pill if a condom failed and I was near a fertile day. When the time came to try to conceive, I got pregnant on the very first month of trying (much to my husband’s surprise!). After over 10 years of using the method I don’t chart anymore, I just instinctively know when I’m ovulating.

Barrier methods vary in efficacy. A rate of 98% means that for every two out of 100 men having sex with a male condom will lead to pregnancy:

• Male condom is 98%
• Female condom is 95%
• Diaphragm and caps (when used in combination with a spermicide) have a 92–96% effectiveness (5)

The diaphragm and cap have really fallen out of popularity and aren’t completely side-effect free because the spermicides that make them so effective change the Ph of the vagina, can cause local irritation and can damage the epithelial cells too (6). If you want to use them, perhaps in combination with another method, you’ll need to request to have one fitted by your doctor/obgyn.

For me personally, there is another element to going hormone-free when it comes to contraceptives. When you become attuned to your body it becomes intolerant to artificial modification of your hormones. You notice how they change your mental state, your libido, your agility, your physical well-being and more.

I enjoy being on the natural rollercoaster of hormones now that I know how to work with them, rather than against them. My research into the history of the contraceptive pill looked at why people chose to use it in the first place.

The most common answer was to manage the regularity of their periods. Specifically that the irregular nature of their period was too much of an inconvenience. Why? Because most of the working world is constructed around male physiology which fluctuates less. It can also be extremely hectic, busy and high pressured and often doesn’t allow us time to rest, time to dream, or time to be.

One benefit coming from the pandemic is the flexibility of the working world now. I hope that women can spearhead a new cyclical way of working which sees the benefits of rest at the core of it and natural contraception use will most likely grow along with that.

1. Inoue K, Barratt A, Richters J. 2015. Does research into contraceptive method discontinuation address women’s own reasons? A critical review. Journal of Family Planning and Reproductive Health Care. 2015;41:292-299
2. Statista.com, 2019. Methods of contraception used by women in the United Kingdom (UK) in 2018. [online] Available at: https://www.statista.com/statistics/1063613/contraception-use-among-women-in-the-uk/ [Accessed 12 May 2022]
3. Knight, J. 2016. The Complete Guide to Fertility Awareness. Routledge: UK.
4. Ferreira-Poblete, A. 1997. The probability of conception on different days of the cycle with respect to ovulation: An overview. Advances in Contraception. 12, (2-3), p.83-95.
5. NHS.uk. 2022. Contraceptive diaphragm or cap. [online] Available at: <https://www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/> [Accessed 11 May 2022]
6. Bishop, K. 2022. It’s Your Power Portal: Take Control of Your Vaginal Health with Herbal and Holistic Care. Aeon publishing: London

Have you ever wondered why you have felt a particular way only for your period to arrive and you have an ‘ah ha’ moment and think “now it all makes sense!” Understanding our cycle is important for many reasons, keeping an eye on our overall health, tracking where you are in your menstrual cycle and having a bit more control to plan things when we are at best capacity to tackle them.

I like to use the seasons as an analogy for this because it is something so familiar to us it’s easier to remember than perhaps the more clinical descriptions. How we feel during our cycle directly correlates with the seasons too.

You might think – like I did when I first started learning about this – that it’s just oestrogen and progesterone that are the key players of your cycle. In fact, there are several hormones on the go, and I hope this gives you more of an idea about the intricate dance that plays out each month.

Our menstrual cycle is seen as something primarily for procreation, this is indeed a wonderful thing it does, but our bodies are more than that, we need all these moving parts to work regardless of whether or not a pregnancy happens. I hope in my work to shine a light on how damaging that narrative can be as it can hinder women receiving the help they need. 

Your menstrual cycle actually starts in your brain, the hypothalamus, it sends pulses of gonadotropin-releasing hormone (GnRH) to the pituitary gland, this then starts to release follicle stimulation hormone (FSH) and luteinising hormone (LH) which communicate to your ovaries and follicles.

The following is an overview, your cycle is pertinent to you, things might not completely align with a 28-day cycle, which is completely ok. A ‘normal’ cycle is anywhere from 22-35 days, and as long as you are roughly the same number of days each month by a day or two that is a happy menstrual cycle.

If it changes drastically say 24, 30, 25 days then this is indicative of something not being quite right with your cycle. It would be worth getting that checked out with your health care provider.

Your period is always day one of your next cycle, you want to make sure that it is in full flow, and you aren’t counting any spotting days that might happen before your period. Charting can be a wonderful way to get to know your menstrual cycle you can find out more about that on The Well Woman Project Blog.

The spring part of our cycle is where your hormones are climbing back up again after your period getting your body ready for ovulation. You might find your energy returning and just like spring you are ready to maybe put some brighter clothes on, and head back out in the world again.

You might find that your clarity comes back, you are feeling more confidant and just want to pick back up where you left off before your period. As spring sees life coming back again with all the buds and flowers, so too are you. Often people find they are full of ideas and creativity in this stage (sometimes a little too much and extra grounding is needed!).

The reason for this shift is that oestrogen is on the rise, and this is the action taker, mover, shaker and fiery hormone. Testosterone is also rising – this is thought to be a male hormone, it isn’t, it’s produced in all humans. It helps to maintain and build muscle, bone density and boost libido. We have several different types of oestrogen but our super-duper one is oestradiol and is only made in the ovaries.

FSH is also building at this point in your menstrual cycle, it does what is says on the tin, stimulates your follicles to get an egg ready and mature, as it stimulates the follicles, and an egg begins to form this lead follicle then produces oestrogen. Once the oestrogen has met its peak, FSH and LH take over once more to nudge the egg over the finish line and for it to be released.

It’s short and sweet this part of your cycle, very much like the summers can be in the UK! However, in terms of your menstrual cycle there is A LOT going on. ovulation is the peak of oestrogen and testosterone; you most likely feel your most confident, can spin all the plates and feel on top of your game.

Very much like summer, we are out and about, the days are longer we are wearing less, socialising more, its lighter so more things get done and the big blue skies lift us up and make it feel that much better.

If you have presentations, talks, or anything that requires you to be sharp as a tac this is the time to plan it into your diary! Your body is at the peak of its game so you might as well take advantage of that in other areas of your life! In the summer you walk with more swagger.

Ovulation seems a bit of a non-event to be honest as it only lasts a matter of a day or two, but it really is where it’s all at, it’s how we make hormones and if it isn’t happening for you that is a big problem for your whole health. This is where it all comes together, all the hard work your body has been doing to get you here, the dance of the hormones all weaves together and makes Ovulation the sensation it is.

When autumn kicks in the evenings draw darker and generally, we cling to the notion of the summer, we don’t want it to get colder and be indoors, we long for the lazy days of the summer months and want to keep going with that intensity which just isn’t possible, we must harvest and put things away until the next year.

Almost every woman I have worked with hates the autumn part of their cycle, everything about it is a struggle and the fight to keep on going rather than give into it is where most of us struggle. To be plain and simple our body just doesn’t have the capacity to keep functioning in the summer mode during autumn.

Summer is for summer and autumn is for autumn –when you think about it, you can’t do all the thing you did in summer in autumn and vice versa. Winding down in autumn, closely followed by a brief hibernation in winter, allow us to be fully rested making us have more energy for spring and summer.

I can’t stress enough how paring back on the expectation you have for yourself here is paramount, if we are trying to do all that we were capable of with a full tank why do we think we can do it when it’s half full or nearly empty?!

Immediately after ovulation in the second half of your cycle, FSH, oestrogen and testosterone fall away and LH and progesterone pick up, these are cooler, quieter and laid back hormones. As oestrogen peaks it stimulates the secretion of LH which together with  oestrogen and FSH make ovulation happen. LH take over in the second half, it also instructs the corpus luteum to formulate. The corpus luteum is the ONLY way we make progesterone, so it is very important ovulation happens because it sets off a chain of events that is vital to our health.

The corpus luteum is an extra endocrine gland grown every month, it supports a pregnancy until the placenta takes over, if no pregnancy it gets reabsorbed back into the body and a new one will form next month.

The dark depths of winter, curtains drawn, slouching on the couch watching TV, wanting all the carbs and feeling like we don’t want to talk to another soul. We are inside and don’t want to go out into the night again!

Resting is the key to this part of your cycle and not demanding too much from yourself, you are bleeding, this is a big deal, it depletes our body so we need to allow it to period in peace as much as we can. An early night, delegation and preparing ahead for your needs are ways you can help yourself during this time.

We aren’t meant to be roller blading no matter what the adverts suggest! However for many women this period is a time to tune into their intuition and move through emotions. Every season has its own needs and powers, they will become more apparent to you the more aware you are of them.

The quality of our period will be a culmination of many things diet, lifestyle, exercise, toxin overload (emotional and physical) stress, wellbeing and everything in between. Learning to understand your cycle helps you to understand your body as a whole. Periods that are very painful/heavy are NOT normal and could signify an underlying problem like endometriosis or edenomyosis.

Absent periods or cycles that go on for 35+ days are also not the norm this could be a sign of PCOS (polycystic ovarian syndrome) These conditions can take a long time to diagnose partly due to this normalisation of it being ok that periods are a nightmare, it’s always best to get this checked out.  

As an example of how a herbalist may approach one aspect of women’s health, lets look at how dysmenorrhoea can be rebalanced. 1 in 5 women have their daily life seriously affected by painful periods; asprin and paracetamol are go-to temporary fixes, as are contraceptive hormone treatments, but is there something more long-lasting and empowering that can be included to help?

Herbalists will approach any solutions holistically to understand the person, the pattern and the problem. There are specific therapeutic approaches utilising the best of vitalistic and scientific medicine to address the root and the branch of the problem incorporating the below treatment strategies:

Turmeric and ginger root excel at increasing blood flow through the uterus to ameliorate painful cramps. Turmeric and ginger work in multiple ways including inhibiting substance-P, associated with pain perception, as well as inhibiting the inflammatory enzyme COX-2. 

For a week before the period starts, drink hot ginger tea and a take a teaspoon a day of turmeric powder in food or a drink. Blood invigorating emmenagogue herbs such as yarrow, calendula, dang gui and dan shen are often employed by herbalists too.

The essential oils in fennel seeds are beneficial as uterine spasmolytic for pain relief. Drinking 2g of seeds in a tea every few hours throughout your period can help.

Chamomile flower has useful inflammation modulating properties and is easy to take as a tea or tincture as well. Rose flower tea has a long-tradition for easing menstrual cramps.

Herbalists will also use herbs such valerian root, cramp bark, wild yam root, cinnamon.

There are many respected women’s tonics to choose from ashwagandha, dang gui, black cohosh, and tribulus, but one stands out as especially useful, shatavari.  It also has impeccable sustainability credentials. So many ‘women’s herbs’, such as false unicorn, lady’s slipper and black cohosh, are endangered or threatened from over-harvesting in the wild. Shatavari offers an easy-to-grow, sustainable and life-affirming alternative.

Importantly, cook with plenty of herbs in each meal to enhance absorption and microbiome dialogue. Include linseeds, healthy oils and beetroots for the bowels. Aloe vera juice is a gentle liver and bowel regulator with added nourishing properties. In Ayurveda it is called ’the princess’ for its ability to transform inflamed skin and menstrual problems. Herbs such as dandelion root, artichoke, white peony, bupleurum and vervain are also useful here.

Typical vata symptoms of cold, aching, pain and digestive upset, can be soothed using a nourishing-warming diet, warm oil massage, topical heat with hot water bottles and towels, castor oil packs, rest and yoga poses such as the reclined thunderbolt (supta vajrasana).

As so much inflammation is driven by an excess of poor quality oils in the diet, its essential to minimise omega-6 and optimise omega-3. Foods that are rich in saturated and omega-3 fatty acids includes plant based fats such as coconut oil, hemp seed oil, extra virgin olive oil (uncooked) and avocados. Raw nuts (other than peanuts) and seeds contain oestrogen balancing plant sterols.

The endocrine system is often referred to as an orchestra working as a symphony; if out of tune for any reason then it may be implicated in menstrual cycle disruptions. This synergistic quality plays to the herbalist’s strength, as plant phytochemistry’s multi-dimensional nature is capable of influencing the major endocrine glands at the same time.

Apigenin, a flavone found in chamomile and green tea, inhibits aromatase to prevent excess testosterone and progesterone converting to oestrogen. The flavones found in citrus fruits, in particular lemons and lime peels, help here too. Vitex agnus-castus is renowned for interactions at a hormonal level and is used to indirectly enhance progesterone levels.

Foods play a major role in hormone balancing. The brassica family contain several powerful nutrients that help metabolise oestrogen by enhancing liver detoxification processes. Broccoli and kale sprouts are especially potent. The alliums, including garlic, onions, scallions, chives and leeks, are rich in sulphur-containing amino acids and the powerful flavone anti-oxidant quercetin. These compounds help the liver detoxify and reduce the production of oestrogen. A few grams a day of seaweed influences nutritional and hormonal pathways to help reduce a sluggish metabolism and feed the endocrine system.

Phytoestrogens are also important. Phytoestrogens are plant compounds with structural features similar to endogenous oestrogen. However, because they are weaker, they can act as partial agonists. Lentils are a good source of phytoestrogens. Two tablespoons daily of freshly-ground flaxseed delivers a high lignan content assisting a healthy oestrogen balance. Mushrooms (such as shitake and reishi) regulate aromatase, regulate oestrogen levels and may be used to manage various hormone related pathologies. Herbs such as oregano, thyme, rosemary, sage and turmeric promote the metabolism of hormones.

The vast experience gathered over the generations by midwives, nurses and physicians has resulted in very detailed knowledge of how to support women’s health with foods, plants and life-style. Integrating this traditional knowledge with the detailed understanding we have today of menstrual health, leads to access to evidence-based natural solutions.

Perhaps the natural way to minimise over-medicalisation is to support young girls into womanhood by educating them about how their life-style, dietary and medical interventions may impact their health. Furthermore women going through menopause should be educated similarly too. We need to give knowledge, not just so there is free-choice, but empowering options to choose from too.

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Oestrogen is a catabolic sex hormone that has a large array of roles and influences including reproduction, digestion, mood, fat-balance, fluid ratios, skin pigmentation, breaking down muscle mass that leads to an increase in body fat and aromatase. Testosterone, and to a slight degree progesterone, are anabolic sex hormones that promote lean body mass.

Aromatase is an enzyme that is found in oestrogen-producing cells located in the adrenal glands, ovaries, placenta, testicles, brain and fat tissue. Higher levels of aromatase in the body convert more testosterone and progesterone into oestrogen. With the increased prevalence of Environmental Endocrine Disruptors, we are exposed to multiple triggers for endocrine disruption.

Elevated aromatase activity and oestrogen dominance are some of the most common factors associated with breast, uterine and ovarian cancers in women. Prostate, colon and breast cancer in men are associated with oestrogen dominance. Other symptoms include PMS symptoms, cervical dysplasia, uterine fibroids, endometriosis, decreased libido, fatigue, fibrocystic breasts, headaches, infertility and weight gain.

Cruciferous veggies

Cruciferous vegetables such as broccoli, cauliflower Brussel sprouts and cabbage contain several powerful nutrients that help metabolise oestrogenic molecules. These nutrients include Indole-3 Acetate, Indole-3 Carbonyl and Diindolylmethane. These cruciferous veggies also contain sulfur containing nutrients such as Sulfurophane and Phenyl Isothiocyanates that enhance liver detoxification processes and destroy cancer cell formation.

Broccoli sprouts 50-100g/day are a good way to get this.

Healthy fat-rich foods

These are foods that are rich in saturated and omega-3 fatty acids. It includes plant based fats such as coconut oil, hemp seed oil, extra virgin olive oil and avocados. Raw nuts (other than peanuts) and seeds contain oestrogen balancing plant sterols. Organic poultry, wild-caught salmon, wild game and 100% grass-fed beef are the best animal-fats for healthy hormone function.

Allium family

The alliums include garlic, onions, scallions, chives and leeks. These are all rich in sulfur-containing amino acids and the powerful flavone anti-oxidant quercetin that both help the liver detoxify and reduce the production of oestrogen.

Flavone rich herbs

Dietary flavones and flavonones have been demonstrated to be the most potent aromatase-inhibitory flavonoids. The most powerful flavones include chrysin which is found in passionflower and apigenine which is found in chamomile.

Flavonones

These are found in citrus fruits and in particular lemons and limes. They are classically called citrus bioflavonoids and they include diosmin, hesperidin, rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin, nobiletin and quercetin.

Antioxidant-rich herbs

Herbs such as oregano, thyme, rosemary, sage and turmeric are loaded with volatile oils that promote liver detoxification. Turmeric has a potent ability to destroy oestrogen receptor positive cancer cells which are the most commonly found cells in breast, uterine, ovarian and prostate cancer.

Chlorophyll

One of the most powerful life-giving substances on the planet is chlorophyll. This is the pigment that gives green foods their color. Chlorophyll-rich foods have a very deep green color and they are extraordinarily useful in purifying the body of toxins.



Fermented foods

These contain organic acids, anti-oxidants, enzymes and probiotics that enhance gut function and eliminatory channels. Fermented veggies include sauerkraut, kimchi and fermented soy.

Lignans

Using 2 tablespoons of freshly-ground flaxseed everyday helps to establish a healthy oestrogen balance.

Herbal teas

Green tea and Licorice specifically balance oestrogen levels. 

Mushrooms

All mushrooms regulate aromatase and regulate oestrogen levels. Use shitake, maitake, button, cep.

Lentils

All lentils contain appreciable amounts of phyto-oestrogens that help to balance oestrogen-progesterone levels. Soy is well known for this but all pulses are helpful.

In Ayurveda, understanding your own personal health concerns is centred around recognising your ‘dosha’, or constitution. In some ways, your ‘dosha’ is a little like your ‘health star sign’. Understanding your dosha will help you to understand how your body works and, therefore, how you can help it. There are three core Ayurvedic ‘dosha’, Vata, Pitta and Kapha.

Put simply, everyone will have a little bit of all three, but there is often one that is more dominant than the other. Vata types are highly creative and a little like a whirlwind of ideas, Kapha types are your steady, strong grounded individuals’ that often hold everything together. Your Pitta types are fiery, passionate, competitive and determined. Already you can probably recognise which one you might be.

But, how does this relate back to the menstrual cycle? Interestingly, in Ayurveda, the menstrual cycle has its very own Vata, Kapha and Pitta stage. How can this help? If you can recognise which phase affects you most, there are differing strategies in terms of how you can support yourself.

Here is how the Ayurvedic menstrual cycle works:

• The Vata phase lasts from approximately day 1-5 (from the first day of bleeding)
• The Kapha phase lasts From the end of bleeding until ovulation (approx. days 4-14)
• The Pitta phase lasts from ovulation until your period starts (days 14-18)

And, here is how each phase is characterised with tips on what you can do to help:

Vata types

Vata is the force that regulates all downward movements in the body, pushing the menstruum down and out of the body. Vata, therefore predominates during the period itself. If your Vata is out of balance, it will manifest as digestive upset, constipation, pain on intercourse, fatigue, anxiety and/or insomnia indicating the need for some Vata balancing practices.

How do we balance Vata? This is a time to keep warm, rested and safe. Manage your diary so that you have some calm space during this time to recharge and keep life on your terms. This is an opportunity for an extended me-time. Calming, nourishing herbs that will strengthen and support your adrenal glands are key here. For example, liquorice and ashwagandha. Steer clear of anxiety inducing stimulants and create space for mindfulness and meditation.

Kapha types

Kapha types naturally nourish and strengthen others. They are your mother-earth. So, the Kapha stage of the cycle is all about building the endometrium (the mucous membrane that lines the inside of the uterus). Oestrogen is the hormone that builds and increases at this time. It is the phase of restoring strength to the body and preparing for conception.

If your Kapha is out of balance it will manifest as imbalances such as fluid retention, breast distension, weight gain, discharge, fatigue, back ache and general ‘heaviness’ may appear at this time. Kapha types also store not just energy, but memory and emotion. If you notice you feel teary and a little low, it could be an indicator of imbalanced Kapha.

How do we balance Kapha? This is a time so often filled with energy and vitality when you can rebuild your nutritive strength, take tonifying herbs and spread your wings. Building herbs that support oestrogen balance are key here. Oestrogen dominant conditions are characteristic of a Kapha imbalance. Shatavari is your primary herbal remedy alongside cleansing, decongesting herbs such as aloe vera.

Pitta types

Pitta types are naturally hot and fiery. Fire is transformative and this is stage where the body prepares itself for new life; the endometrium for implantation of the fertilized egg and the breasts for milk production. Essentially, Pitta fires our body in readiness for conception. It is the hormone progesterone that peaks during this phase.

Severe PMS is a classic sign of imbalanced pitta, due to hot pitta accumulating in the blood and liver. As the blood channels and menstruation are connected, there can be extra heat in the system, leading to skin irritations, headaches, diarrhoea, feelings of irritation and emotional overload. This is when Pitta types can really manifest as fire!

How do we balance Pitta? This is an important time to help the liver metabolise the high hormone levels; increase the amount of colourful vegetables, do your exercise and let your spirit soar. Use heat-clearing and liver-regulating solutions such as turmeric and classic greens like spirulina.