Book review, by Stephanie Jones.
I really enjoyed this informative book by experienced Naturopathic Doctor, Lara Briden. Lara runs a clinic in Sydney, Australia. She treats women with PCOS, PMS and endometriosis, women suffering from pelvic pain, and women with a range of other period problems.
This book has a big focus on natural treatments – lifestyle and dietary modifications, and herbal/vitamin/mineral supplementation. Lara also acknowledges that there are some instances where hormonal medications (e.g. contraceptive pills, IUD) or surgery, may be necessary.
Lara gives clear descriptions of how our menstrual cycle works – a good refresher for most women who might not have had any information on this since high school health classes!
For example: Did you know it takes 100 days for your follicles to mature and then eventually complete the process of ovulation?
So, the health of your body throughout that whole 100 days will influence:
• the health of the egg
• symptoms experienced at ovulation
• your menstrual bleed
• the health of the corpus luteum (the part of the follicle left after ovulation of the egg, which helps produce the healthy calming hormone progesterone)
Lara discusses how hormonal contraceptive pills work. She describes the different types of contraception and the pros and cons of taking them. She is clear that her preference is not to take any hormonal contraceptive. She believes that it is important for a woman to have a period, thinking of this as your monthly report card to show the overall health of the body.
Please note: For some of our patients here at Pelvic Health Physiotherapy, the best option for them to reduce pain and bleeding (working with their gynaecologist or GP), may be to take a hormonal contraceptive. This can help to reduce symptoms, and these women may well be advised to avoid periods altogether (via contraceptive hormone pill). Some of the suggestions for overall health in this book will however still be of help to these women.
At Pelvic Health Physiotherapy we often encourage our patients to use a tracking app or diary to monitor their symptoms, recognise patterns and show improvements with treatments. Improving your knowledge of your body’s anatomy and physiology is always really useful!
Lara believes that having a healthy menstrual cycle means ovulating, yet ovulation is suppressed on most contraceptive pills. The Mirena IUD is the lowest dose hormone option that will not stop ovulation completely, and for some it can prove to be very helpful. Lara explains how the normal hormonal fluctuations that occur throughout a cycle support mood, muscle and bone development, and general health. But, on a contraceptive pill you don’t have an actual bleed. If you are taking the pill, it is a drug withdrawal bleed that occurs because you stop the hormone and take a sugar pill. So, what you think of as ‘regular’ bleeds are just due to your scheduled sugar pill taking, and not due to a natural hormonal cycle in the body.
I found it interesting to read about the history of hormonal birth control for women and I was quite shocked to think about how young most of us are when we start taking these hormones. For myself I remember starting on the pill at high school to help improve my spotty skin and “regulate my periods” which were irregular (as is normal for teens when they are still establishing a regular cycle).
Knowing what I do now, I think I would think twice about taking the pill from a young age if there were no other medical reasons indicated. After all, it is a normal part of being a woman! A regular cycle with ovulation gives us an indication of the over-all health of our body’s hormone systems.
If you go through your cycle without any pain, have energy for regular exercise, you ovulate, you don’t notice big changes in mood (PMS) and your period bleed is right on time with minimal fuss (a few small cramps) – then you get an A+ on the period report card!
I believe this is important to consider in female athletes who are on the pill and think they have a ‘regular cycle’. Taking the pill could mask amenorrhea caused by an energy deficiency or RED-S (relative energy deficiency in sport). These women could be in an unhealthy hormonal state without realising it. I have heard of female athletes seeing it as badge of honour to train so hard that they lose their periods. This is shocking when you think of how unhealthy you would need to be for your body to decide to shut down one of its key body systems. It’s a bit like switching your phone to maximal power-saving mode and losing all the functionality of your phone!
Lara presents some great ideas, backed up with evidence and references. She is very honest about issues she discusses that don’t have studies to back up her ideas, where her advice is based on her own clinical experience.
I enjoyed reading about the common-sense lifestyle treatment strategies that we also use with our patients. Stress reduction, getting regular exercise and eating a healthy diet. Lara suggests some people may need to look at cutting out foods that can cause inflammation in the gastrointestinal system. In her clinical experience she has found dairy products, gluten and sugar to be common irritants, and that reducing these may be beneficial in some patients. At Pelvic Health Physiotherapy we would recommend anyone wishing to trial cutting out food groups do so in conjunction with a trained dietician.
I thoroughly recommend this book as an interesting read for any woman wishing to improve body literacy. It was great to understand a bit more about this natural cycle that repeats in the background throughout our reproductive life and reports back to us monthly!
Stephanie is an experienced pelvic health physiotherapist, and is also a qualified yoga and pilates teacher. She has a holistic, evidence-based approach to treatment. She is constantly looking to further her knowledge in an effort to do the best she can for all her patients. We feel very grateful to have her on our staff, working with us here at Pelvic Health Physiotherapy.