The All In Podcast

Episode 37 - Helpful things in HA recovery

• Florence Gillet • Season 3 • Episode 37

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In this episode, Nicola and Florence chat about helpful things for your recovery journey, including useful thermometers and cycle tracking apps, vaginal cups and reusable underwear, books, podcasts and mental health apps.

To find out more visit www.noperiod.info/resources
and www.beyondbodyimage.com/resources

To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre
To join the NPNW English support group, please visit noperiod.info/support
To join the French support group, please visit noperiod.info/communaute
To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media
No Period, Now What? on Instagram in English
No Period, Now What? on Instagram in French
Beyond Body Image on Facebook
Beyond Body Image on Instagram

Email us  via allin@noperiodnowwhat.com

If you enjoyed this podcast and found it helpful, please drop us a rating and a review to help more people find it. 

Original Music by the Andy Shulman Band "Lost & Found" available on Spotify. 

To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre.
Get the German version "Keine periode - was jetzt?" at noperiod.info/buch.

To join our support groups, please visit noperiod.info/support
for English, noperiod.info/communaute for French, and noperiod.info/community for German.

To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media:
Instagram:
@noperiodnowwhat in English
@jenaiplusmesregles_livre in French
@keineperiodewasjetzt in German

...

Welcome to All In, a straight shooting, science based podcast about periods, fertility, and nurturing health outside of unrealistic beauty expectations. We will mostly, but not exclusively, focus on hypothalamic amenorrhea, HA, a component of relative energy deficiency in sport, formerly known as the female athlete triad. I'm Dr. Nicola Sykes, scientist and author of the book No Period, Now What? I specialize in helping people understand how their eating, exercise, and lifestyle habits are keeping them from hormonal health and their best life. My work focuses on regaining periods, improving fertility, and breaking free of the rules underlying diet culture. My name is Florence Gillet. I'm a certified eating psychology coach, a former HA patient, and an advocate of health at every size and body neutrality. I help people let go of their obsession with size and appearance to regain self confidence, finally appreciate their bodies, and live an overall fuller, more joyful life. Every two weeks, the All In podcast brings you real recovery stories, expert insights, and new scientific research on HA, hormonal health and fertility, with an unmissable touch of body respect and women's empowerment. Just a reminder that this podcast represents the opinions of the hosts and their guests. This content should not be taken as medical advice, it's for informational purposes only. And because each person is unique, please consult your primary care practitioner for any medical questions. Music by the Andy Shulman Band, available on Spotify.

Florence:

Hi, Nicola. How are you today?

Nicola:

I'm a little tired. I sort of forgot that we had planned to record this morning when I was on a flight to California. So, that didn't work out. So now it's 1. 30 in the morning for me, although I'm in California, so it's really only 11. 30, 10. 30. I have no idea.

Florence:

For those of you listening to us, if you don't know this, Nicola is a night owl and I'm not. So, I'm very lucky where I am, it's only 10. 30 in the morning. So, for once, I actually look very fresh because usually it's late my time and early Nicola's time, but in California, we could do it the other way around. So we're very happy to record again, another mini episode for summer. And today we want to talk about helpful things to support you in your recovery. What did you have in mind, Nicola, with this?

Nicola:

so I think there are some major categories of things that we can talk about. You know, I think one of the really important things once you're further into recovery is learning how to track your ovulation, you know, whether you wanted to get pregnant or not. So I have some recommendations for different options that you can use for that. From things you can buy to apps. And maybe a book and so those are, those are the, I think the things that I would talk about. And then you have for us.

Florence:

Yes. I, I'm thinking of whatever can support the unlearning process and the relearning process around how we perceive ourselves around diet culture, really rejecting all the fat phobic narrative out there. It takes time but I want to recommend a few ways that you can help yourselves doing that.

Nicola:

Fabulous. Where do you think we should start?

Florence:

So I think we should start with the cycle tracking. I'm interested to know what you would recommend.

Nicola:

Okay. So I do have a page on Amazon where I've listed a bunch of things. So that's at no period dot info slash resources. There are a bunch of different categories of items. So there's things to help with temperature tracking, supplements, and then books that I suggest. So, you know, you can do a lot with cycle tracking and you can do a little. So the very minimalist approach is basically just taking your temperature. So you can use any thermometer that you have lying around the house as long as it reads to 0. 1 degrees. A digital thermometer, I mean, Okay. That's pretty much what they all are these days. I've recently actually had a couple of people talk, tell me that they're taking the temperature under their arm or in the ear and those do not seem to work as well. So you do want to be taking your temperature either orally or vaginally. I've never done vaginal myself. I usually do oral. Some people might choose vaginal. Apparently that works. I don't know that for sure. But so you can just do a regular old thermometer. You can get a lot more fancy than that. There are a couple of different wearable devices that you can get these days. So there's the temp drop. There's the Ava bracelet. I think even some of the Apple watches now or Fitbits are starting to do temperature tracking and cycle tracking as well. So I did test an Ava watch for about six months, and it was absolutely fascinating to me because it tracks not only your basal body temperature by taking your skin temperature, sort of as an average throughout the night. Again, you can't really use your skin temperature for BBT tracking as a one off reading, but what these wearables do an overnight reading. So you can use it for that. It also measures your heart rates and your breathing rates and those sort of elevate a little bit as you're getting towards ovulation and then go up more after ovulation, which is something I had no idea about, but it was very clear you know, you could see the change, like, about the same time that my egg white cervical mucus started, so about 3 to 5 days before ovulation, I would start getting these small changes in my breathing rates and my heart rate. And then after ovulation, you know, it would be confirmed both by the increase in temperature, breathing rate and heart rate. Those those wearables can be about 2 to 300 dollars. So it really depends on your budget and maybe it's easier just to pop something on every night than it maybe is to remember to take your temperature every morning. So, depending on how good you are remembering things, one of those wearables might be better for you. And also, I think if you're looking to conceive, we're sometimes willing to spend a little bit more money on that than if we're just tracking for a cycle tracking purposes. And it's also a little bit more important to know when you're ovulating for sure, when you're trying to conceive especially if you've been having issues. So those are a couple of things I would recommend for temperature tracking, then there's the ovulation predictor sticks. So, measuring the luteinizing hormone, the LH surge, which happens about 24 to 36 hours before you ovulate. So, I've had people be like, well, my temperature went up 3 days ago and I don't have LH surge. I'm like. No, no, no. You would expect it, like, you missed it. It's too late. So chapter five in the book goes through the whole cycle and what's happening there's another chapter that's either 17 or 18, depending on which version of the book you have, that's sort of more about the individual steps of tracking. So really make sure that you understand for yourself exactly what's happening in your cycle. So that when you take an ovulation predictive stick, you know what you're doing and why you're doing it. So there are the sort of cheapy sticks that you can get. I have those on the resources page. They just have the 2 lines, you pee on them or in a cup and then dip the stick in. The 2 lines will be equally as dark when your LH is surging, meaning you'll ovulate in 24 to 36 hours, something like that. It's a window because ovulation generally happens 36 hours after the LH surge starts. But we don't always catch it when it starts. So when you're not doing a timed trigger, you only have a rough estimate of when you're going to opulate. You can also get more detailed with that. There are now some sticks that you can buy or kits that you can buy that allow you to measure more hormones. So there's the Mira that I believe lets you measure LH estradiol and progesterone. So you can see the progesterone go up after you've ovulated. it's actually a metabolite of estrogen and metabolite of progesterone it's not the same readings as you would get if you were doing a blood test. And then there's the Inito monitor and that measures LH, FSH, estradiol and the progesterone metabolite. So those give you even more detail. Which is sometimes good and sometimes bad, there's pluses and minus to these, each of them has a forum where you can post your chart. You can look at other people's charts. You can sort of compare within a chart as to what you will see probably an estradiol surge before you ovulate, you'll see an LH surge, but your LH levels might be different from what you get on the blood test, FSH, same thing So you can't use the absolute numbers to compare with the blood results, but they can be useful again, probably more worthwhile if you are trying to get pregnant and, then it's more important that you know when you're about to ovulate so that you can appropriately time intercourse for pregnancy. Again, we talk about that in the book and the day before and day of ovulation are probably the best times to have sex if you're looking to get pregnant or times to avoid sex, if you're not looking to get pregnant and not using any kind of birth control. There are also apps that are helpful. So I still use good old fertility friend, the app itself is called FF, which makes it a little hard to find. But, you know, that used to be just a website back in the day when I was trying to get pregnant and then obviously they developed an app. It's a little clunky. It's not the best app in the world, but it does a nice job of tracking and giving you, the cover line, which is the line that delineates pre ovulatory from post ovulatory temperatures. Some of them don't do well with non standard cycle lengths. I feel like fertility friend does much better with that. So that's one reason that I do recommend it to people that have had HA.

Florence:

Yeah.

Nicola:

Others that I know people like are Kindara and Flo and I think Kindara also comes with a wearable that you can sync with the app so there's there's some different options there.

Florence:

We want to stay away from the apps that are too calendar based, right? And that's usually the case with many of the fertility tracking apps is that they just base when your ovulation will come on the day of the calendar. If your period comes on that date and 14 days later, it's going to say, it looks like you're ovulating, which. In our case, it could very much be that we're ovulating a week later, right? Especially in recovery. Be mindful of the names we've given here because they're less calendar based and they are actually using the information you put in the app as their main way to predict when your ovulation is going to happen, which is more what we look for than the calendar based one.

Nicola:

Yes, and they also expect that you have a 14 day Luteal phase. I mean, I think that's true of all the apps. Some of them will learn that your Luteal phase is 7 days or 10 days or what have you. Some of them won't. So the ones that are more able to take the information that you give it and quickly adjust things, I think are better than those that sometimes, you know, sometimes it takes five or six cycles before, before it adjusts. And that's just annoying. Knowing when to expect your period is really helpful. For example, I have not been tracking recently and I got on, I thought maybe I might get my period this weekend. I got on the plane, went to the bathroom was like, ah, crap.

Florence:

Why does it always come at the times we have to travel? Why?

Nicola:

And so trying to put in a menstrual cup in an airplane bathroom is not the most fun thing in the world.

Florence:

I am just having an image right now. This is very wrong.

Nicola:

Anyway, but that brings up another point. I'm trying to be more environmentally conscious these days. And so, I have been using a menstrual cup for a number of years now. I really like it. I mean, there are different fits. There's a website called, I think it's something like findmycup. com. Something like that. And so you can just go on it and take a little survey. You know, how many kids have you had? It asks you a bunch of various other questions and then it will offer you some suggestions for cups to get. Cause there are a lot of different brands. But I like it because I put the cup in, in the morning and even on my heavy days, I think there's only been one day where I leaked and that was because I put it in, in the morning and then I kept it in until, Oh, 11 o'clock at night. And I played ice hockey at the end of the day. So,

Florence:

I'm not sure that's recommended just so listeners know you do have to care for it every few hours, but yeah,

Nicola:

Usually I just, I put it in the morning and take it out at night. I have found that I can get a little bit of a yeast infection if I just keep it in like the entire time I have my period. So I find that it's like, I just take it out and then I wear another type of reusable washable pad for overnight. Throwing away pads and tampons, I mean, it's, you know, these, it's just,

Florence:

I also find that it's a lot less comfortable than wearing the vaginal cup. And I have very heavy periods, so there's no way I can go the whole day with not removing the cup and rinsing it and then putting it back. But what I do is the combo of a vaginal cup with a reusable period underwear, and I've done that for years. The first ones I bought were from Thinx

Nicola:

Yes, I have some of those too.

Florence:

I still have them and they must be now five or six years old. If you really take good care of it, which is, they do advise that after you wear them, you want to rinse them with cold water, really remove the blood that's in there. And then wash it. Not using softener. And if you do that, you can really keep them a very long time. I've had different other brands. There's a brand locally that I use that I like in Dubai. It's called My Sahara. You need to find obviously the brand that you like, but I find that the combination of the fabric rather than this plastic feeling against your genitals, because it's quite a soft part of your skin,

Nicola:

Mm hmm.

Florence:

Wearing fabric rather than plastic. And then also the cup. It does take a bit of time to get used to how to insert it, how to remove it. You can sometimes panic the first few times and then it makes it even more difficult to remove because if your muscles are really tense, then you find it difficult, but it's really worth looking into it and learning how to use it. And even if you feel like all I can muster right now is maybe, you know, the period underwear, I can assure you, it's way better. And I've had lots of friends, with young girls, who started menstruating, they don't even want to wear the pads, right? Because they only started using period underwear, they're like, well, it's just so much more comfortable. And another trick that I had learned from my friend at my Sahara is maybe use a pad over the period underwear to go to school. So they can fill the pad first, throw one pad and then keep the period underwear. And that means they don't have to change period underwear during the day at school, which is much more complicated because you can't rinse. So you can't, you know, which I find is cool. And if you do that, I mean, you will reduce considerably the amount of pads that you use. There's period underwear for nighttime. If you bleed a lot, you know that there's these shorts that you can feel really confident sleeping in. I feel like to me, comfort wise, there's no comparison for sure. So it started like you for me was ecological concerns, but then I feel like now I don't want to wear a pad anymore and I don't buy them anymore. I'm like, Oh, thank you. That's great. Anything else?

Nicola:

Yeah. There's a book by Lisa Hendrickson-Jack who we will hopefully have on the podcast soon. I've been on her podcast a few times called the fifth vital sign. So that goes quite in depth into tracking the menstrual cycle, as well as why a menstrual cycle is important. There is a chapter on HA that I don't love, it focuses a little bit too much on like you have to be a certain amount of body fat, things that I don't necessarily agree with. So just skip that chapter, you know, read it for the cycle tracking. There's also Taking Charge of Your Fertility. That's the book that I used to learn about cycle tracking when I was trying to get pregnant. That's a bit of an older book, but I think still has a lot of useful information in it. That one's much more focused on pregnancy, and has a lot of other stuff in it besides just the cycle tracking. I think they both do, but those are some books that I recommend for pregnancy, learning more about tracking your cycle because obviously there's a lot more, you know, I have a chapter in the book about it. You can get way more in depth than that. Do you need to? Maybe not, but, it's nice to have resources to go to if you want to learn a bit more.

Florence:

Absolutely. Since we're on books, there's definitely books that I would recommend to support the mental part of recovery. One of them is Anti Diet by Christy Harrison. Christy Harrison also has a great podcast called Food Psych, which she's been running for years and years and years. And she's really one of the pioneers of health at every size, anti diet approach. She is trained as a registered dietitian. So she has the knowledge that a registered dietitian typically has, but then she decided to really take the other approach, not giving diets anymore and really encouraging more of an intuitive eating approach. I'm thinking of a book that I find is great when it comes to understanding stress and how we can feel better as females specifically is burnout by the Nagoski sisters. I think it's Amelia and Emily. I find that it was really well written and it talks about specifically why women keep burning out and how we can deal with completing the stress response because usually we get stressed and then we stay in the stress response. And that's really where the chronic health issues happen. So they're really talking very intelligently about it. They're researchers, right? So they say it much better than I am, but they're talking about the fact that you need to complete that cycle and then go back to a kind of rest and relaxation response in order for your body to recover. And that's something that we don't do anymore. So we stay constantly in chronic stress, but it's really written for women. Which I find is much more understanding also of the pressures we encounter on a daily basis as women of all the things we're supposed to do and we're supposed to manage. And another one that I found was really interesting when I was recovering in terms of more identity building outside of the eating disorder or disordered eating is Untamed. I know you, you liked that book too

Nicola:

Oh, yes.

Florence:

when it came out. That's more of a kind of biography, but I felt like it was also really interesting to read and understanding how much we've been in a way, conditioned to be a little bit in a kind of golden cage, right? As women, we have to look a certain way. We have to abide by the rules of society, but then are we really actually living the lives that we want to live? So that's Glennon Doyle, who wrote Untamed that I would really recommend.

Nicola:

Glennon also has a podcast. Yes. Called we can do hard things. I've been listening to that a little bit recently. Actually just had a guest on, Dr. Richard. I'm forgetting his last name, but he has a psychotherapeutic method called internal family systems. And he actually started it based on his work with, People with bulimia. I've learned some things from it. I've come across some parts of myself that are things that are residual from childhood that I've been wondering about for years and never managed to dig into until now. So, they have a great podcast with him and then also just learning more about that too. I think is useful.

Florence:

it's really a mental health podcast in general, and I think the name of the author you mentioned is Richard Schwartz, right?

Nicola:

Yes. Yes. Yes. Thank you.

Florence:

Podcasts I'm thinking of Real Health Radio, which is a really great podcast around all the issues of undereating and over exercising. Chris Sandel is obviously a great practitioner and a little bit of a spoiler alert. He's coming in the podcast soon in our podcast. I was looking for the name of, Virgie Tovar's podcast, which she's not doing anymore, but I thought it was really good. It's called Rebel Eaters Club. That's a great one too.

Nicola:

And her book Is You Have the Right to Remain Fat. Well, one of her books.

Florence:

Yes. Yes. And then I wanted to recommend, one that is hilarious. But really, really well done as well, dismantling diet culture and systemic fat phobia is called Fad camp. And it's an Irish comedian and her friend. So it's interesting because it's also a man and a woman, so they come at it from different angles and they take one theme per episode and dismantle random diets and random routines and crazy programs that we used to have more particularly, I guess in the UK TV, but they really dismantle a lot of it and they're really funny together. So it's a nice way to listen to stuff and unlearn, but also not be too much in the seriousness of eating disorder recovery, if that makes sense.

Nicola:

Nice.

Florence:

And one more app that I would like to recommend is for mindfulness practice. I know we agree on this. It would be great if in recovery, everyone could spend even a minute or two per day doing something that is making them mindful. For some of us, it might be, random stuff. It might be painting or washing the dishes you can do being mindful. But I find that deep breathing, guided meditation, anything that will help calm down your nervous system will help in your recovery. And the app that I recommend is available in different languages and it's free. It's called Insight Timer and you can search for different themes. So a lot of my clients also, I recommend that they look into self compassion practices, which we've had on a previous episode, a whole discussion over with Helle Laursen. So I invite you to go and listen to that episode if you haven't. But really, even if it's just deep breathing or listening to calm music or focusing on one thing at a time, doing mindfulness practices, it will really make a difference in your recovery as well. So that's a lot of things, Nicola.

Nicola:

There's a lot of things. And I mean, there are so many more books that we could discuss. I think, you have a list on your website at beyond body image. com. I have a bunch of books that I recommend on my resources page. So yeah, lots of things to read. And a lot of them have associated podcasts as well.

Florence:

Yes. So go check those out. I list also social media accounts. I list associations that do pro bono work towards awareness on disordered eating and eating disorders. So there's definitely a lot out there. It's a bit of extra work to put into, but it can really be helpful in recovery. Thanks for that, Nicola. We will have quite a bit of notes on this episode just to send you to all the names and the apps and the trackers and all of that. And I know Nicola, you have most of that stuff on your Amazon page, right?

Nicola:

No period dot info slash resources.

Florence:

There you go. That's going to be in the notes as well. Got to make sure of that. All right. Well, see you soon.

Nicola:

Yep. Bye.

One thing that always strikes me is how different each person's all in journey is. As I often say, there are many paths to HA and many paths out of it. Your journey is unique. That is so true. If you need more support on your journey, you should definitely start with NoPeriodNowWhat, which you can get at noperiod. info. com. And Florence and I both work with people on different aspects of period recovery and so much more. If you'd like more personalized advice and attention, you can go to noperiod. info slash appointments to schedule a time to speak with me on fixing issues underlying missing periods, blood work, diagnosis, and lots more. or beyondbodyimage. com to work with me on the fear of weight gain and making peace with food exercise in your body. I also take care of the new French version of No Period Now What through the Instagram account je underscore livre. We also have joined clients and online support groups so you can access both our domains of expertise and get the physical and mental help you deserve to put an end to disordered eating once and for all. If you enjoyed this podcast and found it helpful, please subscribe and drop us a review to help more people find it. Also, join our online recovery community at noperiod. info slash support in English and noperiod. info slash communique in French and let us know how All In is going for you. All In is not just about period recovery, it's about getting your life back. See you in two weeks!