Women's Fertility & Lifestyle Debate: Dangers Of Not Having A Period! Fasting Can Backfire For Women
On The Diary Of A CEO, Steven Bartlett and experts in women's health explore the complexities of menstrual cycles, hormonal conditions, and fertility. The discussion covers how various factors can disrupt hormonal communication, the importance of tracking menstrual cycles, and the relationship between conditions like PCOS and endometriosis with fertility. The experts also address pregnancy loss and the significant physical and emotional effects of hormonal changes.
The conversation extends to perimenopause and menopause, including common symptoms and treatment options like hormone replacement therapy. The experts examine how lifestyle factors such as chronic stress and inflammation affect women's hormonal health, and discuss workplace policies that impact women during key life transitions. Throughout the episode, they emphasize the importance of early detection and proper medical attention for menstrual health issues.
This is a preview of the Shortform summary of the Oct 16, 2025 episode of the The Diary Of A CEO with Steven Bartlett
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1-Page Summary
Menstrual Cycle Health and Hormonal Conditions
Stacy Sims and Natalie Crawford discuss the complexity of menstrual cycles and how various factors can disrupt hormonal communication. Crawford emphasizes that irregular cycles may indicate conditions like PCOS or endometriosis, particularly common among female athletes. They stress that severe menstrual pain shouldn't be dismissed as normal, as it could signal serious conditions requiring medical attention.
Tracking menstrual cycles is crucial for identifying concerning patterns early. As Liv's story demonstrates, dismissive treatment of severe menstrual pain can lead to delayed diagnoses of conditions like endometriosis, which Crawford describes as an inflammatory condition causing scarring and organ adhesion.
Fertility, Pregnancy, and Pregnancy Loss
The experts explain how fertility significantly declines with age, especially after the mid-30s. Natalie Crawford notes that egg freezing, optimally done in the late 20s or early 30s, can help preserve fertility for those delaying childbearing. Conditions like PCOS and endometriosis can complicate fertility, as Mary Claire Haver shares from her personal experience with PCOS.
Pregnancy loss, while common, remains stigmatized. Crawford and Haver discuss how miscarriage can cause significant physical and emotional turmoil due to hormonal changes. They emphasize the importance of investigating contributing factors in recurrent pregnancy loss, including conditions like celiac disease and lifestyle factors such as chronic stress.
Perimenopause, Menopause, and Hormone Replacement Therapy
Vonda Wright and Mary Claire Haver explain that perimenopause symptoms can begin as early as age 35, including sleep disruptions, mental health challenges, and cognitive difficulties. Wright describes using a combination of hormones and lifestyle changes for management, while Haver discusses the benefits of low-dose estrogen during perimenopause.
Menopause, occurring at an average age of 51-52, varies widely among individuals. Haver explains that hormone therapy can effectively manage symptoms and reduce health risks. Despite its benefits, only 4% of eligible women in the U.S. use FDA-approved hormone therapy, largely due to stigma and lack of education.
Lifestyle Factors and Their Impact on Women's Health
The experts emphasize how chronic inflammation and [restricted term] resistance affect women's hormonal health. Crawford points out that chronic stress impacts fertility, while Haver explains how metabolic dysfunction relates to conditions like PCOS. They advocate for tailoring lifestyle habits to different phases of the menstrual cycle for optimal health and performance.
The discussion concludes with workplace considerations, noting how traditional work structures often fail to accommodate women during key life transitions. The speakers highlight more progressive policies in places like New Zealand, which offers menstrual and menopause leave to support women's health needs.
1-Page Summary
Additional Materials
Actionables
- You can create a menstrual cycle dashboard using a simple spreadsheet to track your cycle patterns and symptoms. Start by logging the start and end dates of your period, any irregularities, and symptoms like pain or mood changes. Over time, this data can reveal patterns or changes that may warrant a discussion with a healthcare provider.
- Develop a personal fertility timeline by researching your family's fertility history and assessing your own reproductive goals. This timeline can include age milestones and potential interventions like egg freezing, helping you make informed decisions about family planning and discussions with a fertility specialist.
- Advocate for workplace flexibility by drafting a proposal for menstrual and menopause accommodations, similar to New Zealand's leave policies. Present this to your HR department or management team, highlighting the potential benefits for employee well-being and productivity, and suggesting trial periods for policies like flexible hours or remote work during symptomatic phases.
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Menstrual Cycle Health and Hormonal Conditions
Experts in the field of women's health emphasize the importance of menstrual cycle awareness and understanding the potential indications of hormonal conditions such as PCOS and endometriosis.
Women's Menstrual Cycles: Complex, Dynamic, and Variable
Hormonal Communication in Menstrual Cycles Can Be Disrupted by Various Factors
Stacy Sims discusses the historical acceptance of amenorrheic women in sports, an incorrect association with a more male-like and therefore acceptable condition. Natalie Crawford and Sims imply that an understanding of hormones and their variation is critical, noting a complexity that can make diagnosis challenging. Additionally, lifestyle factors can affect menstrual regularity, as Steven Bartlett describes his partner's more regular menstrual cycle after a diet change.
Progesterone builds a lush endometrial lining affecting glycogen storage, explaining different exercise responses depending on ovulation. Sims stresses reviewing stressors in the allostatic load when menstrual cycles falter, suggesting diet or recovery adjustments. Estrogen, responsible for growing the uterine lining, can indicate hormonal balance by menstrual flow, with lighter bleeds suggesting less exposure.
Irregular Cycles May Indicate Pcos, Endometriosis, or Hormonal Issues
Crawford argues that consistent menstrual cycles are normal, and irregularities may signal underlying conditions such as PCOS, endometriosis, or hormonal imbalances. Stacy Sims points out that PCOS is more common among successful female athletes and that careful management of training and nutrition can help avoid oral contraceptives, which might affect performance. Crawford underlines the importance of menstruation for non-contraceptive-using women of reproductive age, linking the absence of periods to detrimental bone and brain health due to low estrogen levels.
Menstrual Pain Shouldn't Be Dismissed As "Normal"
Severe Menstrual Pain May Indicate Endometriosis
Crawford indicates that 50% of patients with unexplained infertility may have endometriosis, a condition difficult to diagnose. She argues for addressing the root causes of menstrual pain, rather than treating symptoms with birth control pills. Excruciating menstrual pain could point to endometriosis, adenomyosis, or uterine fibroids.
Liv's journey illustrates the commonality of dismissive treatment towards severe menstrual pain, leading to delayed diagnoses. Endometriosis is an inflammatory condition where cells similar to the endometrial lining implant and cause inflammation elsewhere in the body, leading to scarring and organ adhesion. Despite treatments that offer symptomatic relief, the disease is not reversible and has severe impacts on mental health and fertility. Sims reports that cold w ...
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Menstrual Cycle Health and Hormonal Conditions
Additional Materials
Clarifications
- In the past, there was a misconception that amenorrhea (absence of menstruation) in female athletes was a sign of a more "male-like" condition, implying increased athletic prowess. This incorrect belief led to the acceptance of amenorrhea in sports, as it was mistakenly associated with a more desirable athletic performance profile. This historical perspective highlights a misunderstanding of the female body's hormonal health and the impact of intense physical training on menstrual cycles. This association has been debunked, emphasizing the importance of understanding and addressing menstrual irregularities in female athletes for their overall health and well-being.
- Allostatic load is the cumulative wear and tear on the body as it adapts to stressors. In the context of menstrual cycle health, high allostatic load from chronic stress can disrupt hormonal balance. This disruption can lead to irregular menstrual cycles and impact overall reproductive health. Managing stress through lifestyle adjustments can help reduce allostatic load and support a healthier menstrual cycle.
- Glycogen is a form of stored glucose used for energy during physical activity. During the menstrual cycle, changes in hormone levels, particularly progesterone, can affect glycogen storage in muscles. This fluctuation can impact how the body responds to exercise, with variations in glycogen levels potentially influencing performance and recovery. The body's utilization of glycogen can differ based on the phase of the menstrual cycle, potentially affecting energy levels and exercise capacity.
- Lighter bleeds during menstruation can indicate lower exposure to estrogen, which plays a crucial role in building the uterine lining. Hormonal balance can be inferred from the volume and consistency of menstrual flow. Understanding the relationship between estrogen levels and menstrual bleeding patterns is essential for assessing overall hormonal health. Changes in menstrual flow can provide insights into potential hormonal imbalances or irregularities.
- Female athletes, especially those who engage in intense training, may be at a higher risk of developing Polycystic Ovary Syndrome (PCOS) due to the impact of exercise on hormone levels. PCOS is more prevalent among successful female athletes compared to the general population, possibly due to the influence of rigorous training on hormonal balance. Managing training intensity and nutrition carefully can help female athletes with PCOS avoid certain medications that may impact their performance. Understanding the relationship between exercise, hormonal health, and conditions like PCOS is crucial for supporting the well-being of female athletes.
- Oral contraceptives can impact athletic performance in female athletes due to potential side effects like changes in energy levels, hydration status, and nutrient absorption. The hormonal alterations caused by oral contraceptives may affect factors such as muscle recovery, strength gains, and endurance capacity during training and competition. Athletes and coaches need to consider individual responses to oral contraceptives and adjust training and nutrition plans accordingly to optimize performance. Monitoring performance metrics and consulting healthcare providers can help female athletes manage any performance-related effects of oral contraceptives effectively.
- The absence of periods in women of reproductive age can lead to low estrogen levels, which are crucial for maintaining bone density and brain health. Estrogen plays a significant role in bone formation and maintenance, and its deficiency due to irregular or absent menstrual cycles can increase the risk of osteoporosis and cognitive issues. Monitoring menstrual regularity is important as it can serve as an indicator of hormonal balance and overall health status. Hormonal imbalances resulting from irregular periods can have implications beyond reproductive health, affecting various systems in the body, including bone and brain health.
- Endometriosis, adenomyosis, and uterine fibroids are conditions that can cause severe menstrual pain in women. Endometriosis involves tissue similar to the uterine lining growing outside the uterus, leading to inflammation and scarring. Adenomyosis is when the tissue that lines the uterus grows into the muscular wall, causing pain and heavy periods. Uterine fibroids are non-cancerous growths in the uterus that can result in painful periods and heavy bleeding.
- In endometriosis, organ adhesion occurs when endometrial-like tissue grows outside the uterus ...
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Fertility, Pregnancy, and Pregnancy Loss
Steven Bartlett and experts like Mary Claire Haver and Natalie Crawford explore the complexities surrounding fertility, the increasing challenges of conception with age, and the often stigmatized topic of pregnancy loss.
Fertility Declines With Age, Especially After Mid-30s, Due to Fewer, Lower-Quality Eggs
Women experience a significant decline in the quantity and quality of their eggs as they age, particularly after their mid-30s, affecting their ability to conceive.
Egg Freezing Preserves Fertility for Those Delaying Childbearing
Given the challenges associated with aging eggs, technology such as egg freezing offers an opportunity to preserve fertility. Bartlett’s discussion with his girlfriend about whether to freeze their eggs, and the experiences of women over 35, underline the importance of planning for the future. Natalie Crawford notes that the optimal time for egg freezing is in the late 20s or early 30s due to better egg quality. Crawford also refers to the increase in egg freezing when insurance covers the costs, demonstrating the significance of access and financial resources in fertility decisions.
Infertility Linked To PCOS or Endometriosis
Conditions like PCOS and endometriosis are linked to infertility and warrant careful consideration when planning for a family. Crawford highlights insufficient research and funding for such conditions, and Haver shares her challenging journey to conception due to PCOS. Surgery for endometriosis and the use of birth control for PCOS management are interventions that influence fertility. With endometriosis and PCOS, individuals may need to confront fertility and conception decisions earlier than expected.
Pregnancy Loss and Miscarriage: Common but Stigmatized
Pregnancy loss, whether referred to as miscarriage or by another term, is a frequent but often hidden and emotionally challenging experience.
Pregnancy Loss: Profound Physical and Emotional Impacts, Needing Empathy and Support
Crawford and Haver bring attention to the deep emotional effects of pregnancy loss, an experience t ...
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Fertility, Pregnancy, and Pregnancy Loss
Additional Materials
Actionables
- You can create a personal fertility timeline to plan for potential egg freezing or fertility treatments by charting your age against fertility milestones and medical recommendations. Start by researching the average age-related fertility changes and consult with a healthcare provider to personalize this timeline based on your health, family history, and any known conditions like PCOS or endometriosis. Use a digital calendar or a dedicated app to set reminders for check-ups and important decision points.
- Develop a support network for pregnancy loss by connecting with others who have experienced similar challenges. Use social media platforms or community forums to find local or online support groups where you can share experiences and coping strategies. This network can provide emotional support and practical advice, helping to break the stigma and isolation often associated with pregnancy loss.
- Engage in citizen science by tracking an ...
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Perimenopause, Menopause, and Hormone Replacement Therapy
Steven Bartlett brings up menopause, sparking a discussion on the importance of understanding hormones to manage menopause symptoms and health risks.
Perimenopause: Hormonal Changes Impacting Health
Vonda Wright and Mary Claire Haver share insights into perimenopause, emphasizing that symptoms can start as early as age 35, even with regular menstrual cycles.
Perimenopause Symptoms Often Dismissed: Mood Changes, Sleep Disruptions, Cognitive Difficulties
Mary Claire Haver discusses symptoms like sleep disruptions, mental health challenges, and cognitive changes that women often face during perimenopause, which can be alarming to high-functioning individuals. Wright remarks on symptoms such as heart palpitations, night sweats, and brain fog. The cognitive difficulties during perimenopause are concerning for women as they may forget simple things, such as where their keys are, or struggle to recall names. Natalie Crawford is on low-dose estrogen to alleviate the effects of perimenopause, even though she is still cycling regularly.
Hormonal Interventions May Mitigate Adverse Health Effects During Perimenopause
Haver suggests using low doses of estrogen in perimenopause seems beneficial against certain mental health conditions, potentially more so than increasing SSRIs. Wright herself chose to use a combination of [restricted term], progesterone, and [restricted term], paired with lifestyle changes for optimal health.
Menopause: Cessation of Periods, Varies by Individual
Defined as one year after the final menstrual period, the average age of menopause is 51 to 52, when the ovaries fail and cease to produce eggs and hormones.
Hormone Therapy Manages Menopause Symptoms and Reduces Health Risks, With Individual Considerations
Haver describes menopause as varying widely among individuals, highlighting the necessity for a broader understanding of women's health that encompasses the years beyond reproductive capability. She illustrates the personal significance of deciding to start menopause hormone therapy and discusses the mental health benefits of using hormone therapy early in perimenopause. Hormone therapy options include various forms, such as estrogen, progestogens, [restricted term], and different delivery systems.
Haver is on a hormone therapy regimen that includes a patch and oral [restricted term], oral micronized progesterone, and a [restricted term] gel that is FDA approved for men. Post-menopause, women stabilize hormonally, which may explai ...
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Perimenopause, Menopause, and Hormone Replacement Therapy
Additional Materials
Clarifications
- Perimenopause can begin in a woman's mid-30s, even while she is still having regular menstrual cycles. During this phase, hormonal fluctuations can lead to various symptoms like mood changes, sleep disturbances, and cognitive challenges, which may impact daily life and overall well-being. It's important to recognize these early signs to seek appropriate management and support as perimenopause progresses. Early awareness and understanding of perimenopause symptoms can help women navigate this transitional phase with better knowledge and care.
- During perimenopause, women may experience symptoms like heart palpitations, which are sensations of a rapid or irregular heartbeat. Brain fog is a term used to describe cognitive difficulties such as memory lapses, difficulty concentrating, and mental confusion. These symptoms can be distressing for women as they may impact daily functioning and quality of life. It's important for women experiencing these symptoms to seek support from healthcare providers for proper management and guidance.
- In perimenopause, low-dose estrogen therapy can help alleviate symptoms like hot flashes, mood swings, and cognitive issues. This approach aims to balance hormone levels that fluctuate during this transitional phase. Hormonal interventions in perimenopause are tailored to individual needs and may include estrogen, progesterone, and [restricted term] to address specific symptoms and health concerns. Consulting a healthcare provider is crucial to determine the most suitable hormonal intervention based on a person's symptoms and medical history.
- In the context of managing mental health conditions during perimenopause, the comparison between low doses of estrogen and SSRIs suggests that estrogen therapy may offer benefits in alleviating certain symptoms like mood changes and cognitive difficulties. This comparison highlights the potential role of hormone interventions, particularly estrogen, in addressing mental health challenges that women may experience during the menopausal transition. The discussion implies that for some women, low-dose estrogen therapy could be a viable alternative or complementary approach to traditional antidepressants like SSRIs. The emphasis is on exploring hormone-based interventions as a potential option for managing mental health symptoms during perimenopause.
- In perimenopause, hormone therapy can involve a combination of [restricted term], progesterone, and [restricted term] to help manage symptoms. [restricted term] is a form of estrogen that can address various menopausal symptoms. Progesterone is often used alongside estrogen to protect the uterus lining. [restricted term] may be included to help with libido and overall well-being.
- Menopause typically occurs around the age of 51 to 52, marking the end of a woman's menstrual cycles. It is a natural biological process that signifies the ovaries are no longer releasing eggs and producing certain hormones. This transition can bring about various symptoms due to hormonal changes in the body. Menopause is officially recognized after a woman has gone without a menstrual period for 12 consecutive months.
- Menopause varies widely among individuals in terms of timing, symptoms, and experiences. This variability highlights the importance of a comprehensive understanding of women's health that goes beyond just reproductive aspects. Recognizing these differences is crucial for providing personalized care and support tailored to each woman's unique menopausal journey. Understanding and addressing these individual variations can lead to more effective management of menopausal symptoms and overall well-being.
- Hormone therapy during menopause involves supplementing the body with hormones like estrogen, progesterone, and sometimes [restricted term] to alleviate symptoms like hot flashes, mood swings, and vaginal dryness. This therapy can also help reduce the risk of osteoporosis and improve overall quality of life for some women experiencing severe menopausal symptoms. It is essential to discuss the potential benefits and risks of hormone therapy with a healthcare provider to determine the most suitable treatment approach based on individual health needs and risks. Hormone therapy is not without potential risks, such as an increased risk of blood clots, stroke, and breast cancer, so it is crucial to weigh the benefits against these risks when considering this treatment option.
- Menopausal hormone therapy is considered the gold standard for treating symptomatic vasomotor symptoms like hot flashes and night sweats during menopause. It involves the use of hormones like estrogen and progestogens to alleviate these symptoms effectively. This therapy is widely recognized as the most effective treatment for managing menopausal symptoms, providing relief and improving quality of life for many women. The term "gold standard" signifies that it is the most reliable and effective treatment option available for this specific purpose.
- Stigma and ignorance surrounding menopause and hormone replacement therapy can lead to inadequate care and support for women experiencing menopausal symptoms. This stigma c ...
Counterarguments
- While low-dose estrogen may alleviate perimenopause effects for some, it may not be suitable for all women due to individual health risks or contraindications.
- Hormone therapy, though beneficial for many, carries potential risks and side effects that must be carefully weighed against the benefits.
- The assertion that hormonal interventions may be more beneficial than SSRIs for mental health conditions during perimenopause could be oversimplified, as mental health treatment is highly individualized and SSRIs may be more appropriate for certain individuals.
- The claim that hormone therapy is the gold standard for treating vasomotor symptoms may not acknowledge the full range of non-hormonal treatments that can also be effective and preferred by some women.
- The statistic that only 4% of eligible women in the U.S. use FDA-approved hormone therapy could be misleading without understanding the reasons behind this figure, such as personal choice, alternative therapies, or lack of symptoms.
- The idea that most doctors' offices do not provide adequate care for perimenopause might not account for the variability in healthcare quality and ...
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Lifestyle Factors and Their Impact on Women's Health
Significant discussion by various speakers sheds light on the key lifestyle factors that play a role in women's health, specifically their hormonal, reproductive, and overall well-being. The conversations reveal the intricate connections between these factors and the importance of considering women's unique physiological needs.
Nutrition, Exercise, and Stress: Key To Hormonal, Reproductive, and Overall Health
Chronic Inflammation, [restricted term] Resistance Affect Egg Quality, Fertility, Menopause Transition
Mary Claire Haver, Natalie Crawford, and others discuss the crucial role of [restricted term] resistance and chronic inflammation in women's hormonal health. Crawford points out that chronic stress impacts natural fertility and the success of IVF treatments. Haver notes that metabolic dysfunction, often seen in conditions like PCOS, is a symptom of the body's response to high [restricted term] levels. She also explains the importance of exercise for health and as a proactive measure to avoid health issues later in life. Additionally, Haver mentions that PCOS and endometriosis can accelerate the detrimental effects of chronic inflammation and [restricted term] resistance, highlighting the importance of engaging in anti-inflammatory diets and managing stress levels.
Lifestyle mechanisms that improve hormonal health often target these two factors, enhancing systemic health. [restricted term] resistance can lead to higher blood glucose levels and, consequently, perpetuate a cycle of hormonal imbalance. The panel underscores how lifestyle factors, including proper nutrition and exercise, can influence the severity of [restricted term] resistance-related conditions like PCOS and its accompanying symptoms.
Tailor Lifestyle to Menstrual Cycle for Optimal Performance and Well-Being
The discussion reflects on the need for women to tailor their lifestyle habits, such as diet and exercise, to different phases of their menstrual cycle to optimize health and performance. Sims comments on the inaccuracies caused by wearable devices that fail to track physiological changes accurately, especially during the luteal phase. This might cause women to doubt their capabilities due to misinterpreted data. She advocates for the comparison of physiological data across identical phases of consecutive menstrual cycles. The speakers also emphasize the importance of considering the menstrual cycle as more than a reproductive function; it affects all parts of female physiology, underscoring the need for lifestyle modifications tailored to menstrual patterns to optimize health.
Workplaces Often Fail to Accommodate Women During Key Life Transitions
The speakers pr ...
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Lifestyle Factors and Their Impact on Women's Health
Additional Materials
Actionables
- You can track your menstrual cycle using a journal to identify patterns related to your health and productivity. Start by noting daily energy levels, mood, appetite, and any physical symptoms. Over time, you may notice trends that correlate with different phases of your cycle, allowing you to adjust your diet, exercise, and work schedule to optimize well-being and efficiency.
- Create a personalized "cycle-syncing" fitness plan that aligns with the different phases of your menstrual cycle. For instance, focus on high-intensity workouts during the follicular phase when energy levels might be higher, and switch to gentle yoga or walking during the luteal phase when you might feel more fatigued. This approach can help manage inflammation and [restricted term] resistance by tailoring exercise to your body's natural rhythm.
- Advocate for your health at work by drafting a proposal for menstrual and menopause accommodations, using ...
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