November, 2024
While an abundance of scientific literature points to the dangers of nutritional deficiencies in females living in low and middle-income countries, a deteriorating situation of females in high-income countries is falling below the radar. More and more cases of nutritional deficiencies (often hidden) are the result of “first world” anomalies related to our food culture and its impact on reproductive health. Western societies are afflicted by unhealthy lifestyles: over-consumption of processed and refined foods, sugars, empty carbohydrates and dangerous fats. Poor food quality contributes to the epidemic of over and under-weight, fad or unhealthy diets, low access to quality food, reduced physical exercise, environmental toxins, chronic stress and health problems. A lack of awareness about the effects of a toxic food culture on menstrual cycles and on both male and female fertility (and not just overall health) is just the tip of the iceberg.
Menstrual problems are becoming more the norm than the exception. They present as “symptoms,” e.g. irregular cycles, disappearing cycles, long (over 35 days) or short cycles (less than 22-23 days), light or heavy bleeding, unexplained bleeding or staining, painful periods, PMS or PMDD (mood swings, depression, anxiety). Many of these problems mask or coincide with gastro-gut-microbiome issues, food sensitivities (wheat, dairy, gluten), chronic stress and use of medications- including hormonal birth control!
Nutritional deficiencies can be detected on routine blood tests and can translate into cycle and health problems such as low vitamin B12, iron-deficiency anemia, thyroid imbalance, insulin resistance and metabolic disorders like PCOS- all of which can disrupt the menstrual cycle, fertility and reproductive potential. When a woman learns to chart her fertility signs, these imbalances become visible, signaling that something is “off.”
Charting basal body temperature and cervical secretion changes during the menstrual cycle enables a person to identify nutritional imbalances which present as patterns: PMS, irregular cycles, absent or minimal fertility window, a lack of sync between temperature and secretions, consistently low temperatures (36.00 or lower); short luteal phases (under 10 days), to name a few.
While a fertility awareness chart can help connect the dots, the health provider may not because most physicians learn little about nutrition during their medical education nor are they familiar with fertility awareness (FA) as a charting tool. One might think it easy to diagnose and treat these problems, but in reality, most physicians are clueless.
In the best case scenario, a physician will order a blood test (total blood count or TBC), to check for possible, underlying causes, and then refer the patient to a functional practitioner, dietician or naturopath for assessment and counseling. In the typical scenario- both physician and patient miss the “dots” and instead opt for a solution of convenience. The patient leaves the clinic with a prescription for hormonal medications (some form of birth control pill) -to “regulate” and “fix” with a “fake” cycle. Unfortunately though, this does not solve the root of the problem. It only masks the deeper one. Physicians see period issues as the problem rather than a warning sign about something deeper. Common nutritional deficiencies should not be treated with hormones! Even when a blood test is done, and deficiencies are revealed, physicians typically dismiss or ignore the results because they do not seem “severe” or “extreme,” and it is apparently easier to write a prescription for hormonal birth control (HBC) than it is to refer the patient to a practitioner who specializes in nutrition and lifestyle modification. A more effective approach puts the responsibility on the patient so she can learn how to manage and balance her dietary needs through behavior change and nutrition education (including supplements).
The literature on the relationship between nutrition and healthy menstrual cycles is solid and it highlights how diet influences menstrual regularity, symptom management, and reproductive health. Research consistently shows that deficiencies in key nutrients can lead to menstrual irregularities: more severe PMS, worsened menstrual cramps, bloating, and mood swings, irregular staining and bleeding, infertility and more. A diet rich in essential nutrients supports hormone balance, improves menstrual health, and alleviates common symptoms.
Key Findings from the Literature:
1. Iron and Menstrual Health: Nearly 30% of reproductive age females experience iron deficiency. Studies emphasize the importance of iron, particularly in menstruating women, due to blood loss during periods. Iron deficiency is linked to anemia, fatigue, and heavy menstrual bleeding, which can lead to irregular cycles and fertility issues.
2. Calcium and Magnesium: Research shows that calcium and magnesium intake can reduce menstrual pain, cramps, and PMS symptoms. Magnesium, in particular, is noted for its role in relaxing muscles and stabilizing mood.
3. Omega-3 Fatty Acids: Literature highlights the anti-inflammatory properties of omega-3s in reducing menstrual pain and inflammation. Supplementation with omega-3s has been shown to decrease the intensity of dysmenorrhea (painful periods).
4. B Vitamins: B vitamins, especially B6, are linked to mood regulation and reducing PMS symptoms. Studies suggest that adequate intake of B6 and folate (B9) can alleviate irritability and depression associated with menstruation.
5. Vitamin D: Research has found that vitamin D deficiency is associated with menstrual irregularities and worsened PMS symptoms, suggesting that vitamin D supplementation can help regulate the menstrual cycle and improve mood.
6. Diet Quality and Cycle Regularity: Several studies link a balanced, nutrient-dense diet (rich in fruits, vegetables, whole grains, and healthy fats) with more regular menstrual cycles. In contrast, diets high in processed foods, refined sugars, and unhealthy fats are associated with hormonal imbalances, menstrual disorders and metabolic syndrome, like polycystic ovarian syndrome (PCOS).
7. Inflammation and Diet: Foods with anti-inflammatory properties (e.g., fruits, vegetables, omega-3s) are shown to help manage menstrual pain, while pro-inflammatory diets (high in processed foods and trans fats) exacerbate discomfort.
So, the literature is clear that good nutrition is essential for maintaining regular, healthy menstrual cycles and reducing menstrual discomfort. If more doctors and their patients were aware of this relationship, nutritional balance could be achieved earlier, sparring women years of “hidden symptoms” with HBC and sparring them the need to do IVF years later when they are ready to get pregnant.
If you know someone taking hormonal contraception for period/cycle problems, encourage them to do a blood test (three months after going off HBC) and review the results with a naturopath or functional medicine practitioner. The goal is not to “normalize” either high or low results on the range but to “optimize” the results for the specific individual. If you know someone who suffers from menstrual problems, gift them a valuable resource that will improve their menstrual cycle experience and quality of life.
Every woman has the power and potential to optimize her health, one cycle at a time…
References:
Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review, 2023
How can diet influence women’s reproductive health?, 2023
Female Fertility and the Nutritional Approach: The Most Essential Aspects, 2021
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