Shift Work's Impact on Menstrual Cycles

Speaker 1 0:00

I like to use the analogy of our smartphones and what happens when the battery goes low . So we all know that the phone will go into battery saving mode . And if you think about the body , that's the same way . So your smartphone will start dimming down a bit , turn off the Wi-Fi , turn off Bluetooth or turn off all these other these processes that use energy , and for your body , one of the processes is reproduction . So they just turn that off because you don't need it , it's not essential , you can live without it . So let's turn that off , save some energy so that we can stay alive , because your body's ultimate goal is survival .

Speaker 2 0:42

Shift work can be brutal , but it doesn't have to be . Welcome to a healthy shift . My name is Roger Sutherland , certified nutritionist , veteran law enforcement officer and 24-7 shift worker for almost four decades . Through this podcast , i aim to educate shift workers using evidence-based methods to not only survive the rigors of shift work but thrive . My goal is to empower shift workers to improve their health and well-being so they have more energy to do the things they love . Enjoy today's show .

Speaker 2 1:18

Shift work really does impact on us greatly biologically , but the female has a early warning detection system which lets them know that their body is in trouble . The infradium rhythm , or menstrual cycle , relies very heavily on a synchronized circadian rhythm in order to run properly . An irregular menstrual cycle is not uncommon in the female shift worker and loss of menstrual cycle or hypothalamic amenorrhea is also quite common . Today I have invited my good friend , rachel Lee , onto the podcast to discuss everything menstrual cycle so that you can have a better understanding of what it means to lose your menstrual cycle and the impact that that has on you biologically in the future . If you get anything out of this podcast , i would ask that you would please share it with your colleagues and also make sure that you rate it and review it . So now let's get on with the show and hear what Rachel's got to say all about this topic . How are you , rachel ?

Speaker 1 2:26

I am good , thank you . How are you ?

Speaker 2 2:28

I'm very well , thank you , and it's so good to have you sitting here in my lounge room , being able to do this face to face . How good is that .

Speaker 1 2:35

Yes , it's amazing

Menstrual Cycle Loss and Its Implications

Speaker 1 2:36

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Speaker 2 2:36

We studied together , we did MNU , mac Nutrition Uni , together and we've become quite good friends as a result of that , as a bit of a support unit through those horrendous exams , wasn't it ? Yes , we try not to remember the nightmares around that , martin , if you're listening to us , but anyway , through our conversations you're getting to know , because we're working on a few projects together at the moment , which is all very exciting . We can't talk about that , but let's talk about an area where you've become quite proficient in and you relay this information , and that's for females that have lost their menstrual cycle . Now you have a history in relation to actually having lost your menstrual cycle yourself And in relation to that , can you give us a bit of a history of yourself and what was that actually occurred ?

Speaker 1 3:23

Yes , so for me , losing my period was a result of under eating at the time . So this is actually going back around six years or so when I was in uni , and with many people who go to uni , they start taking greater charge of their life and they can start making decisions for themselves , which include food decisions , and for me at that time , i started exercising and then starting wanting to lean down a bit more , hoping that that would get me more friends or like better network , and that spiraled down into losing my period because I was just not eating enough on a chronic basis . Now I do want to preface this with saying that , with people who lose their period , there are a multitude of reasons that this can happen , but for me , it was a result of overtraining and under eating at the same time , and this is what's called hypothalamic amenorrhea , or HA to just make it simple .

Speaker 2 4:28

So it's HA . You've touched on that . There are a number of reasons why this can actually occur . You also was diagnosed as hypothalamic amenorrhea , which is losing your cycle . But what are the reasons broad-stroking ? What other reasons would there be that people would lose their cycle for ?

Speaker 1 4:44

Well , the most obvious reason , because you're pregnant . That's like the first reason , but there are also other conditions . The most common one would probably be PCOS , so polycystic ovarian syndrome , where people do get irregular or absent cycles . So that's the second most common reason . And there are a multitude of other reasons , like issues with the thyroid , which can disturb the menstrual cycle . So it is really important And I always put that out there that if you've lost your period , don't just jump straight into it that all it's HA or it's PCOS or whatever . Always get it checked out with your doctor , with your GP , to get those tests done and ensure that everything is ruled out .

Speaker 2 5:26

That's good advice too . So for people , they should really just go to their doctors and get a proper diagnosis in relation to why they've lost it . How long should you wait ?

Speaker 1 5:36

In general , if you haven't had a regular period for three months that's the general guideline You should really get it checked out just to make sure that nothing's gone wrong , because we'll all have that one month or two where we've been stressed out or things have changed or you're experiencing jet lag and that can throw your menstrual cycle off . So if it's not been there for three months , then that's worth checking out .

Speaker 2 6:01

Explain to us , then we've obviously got PCOS or there's other reasons why people would lose it . The hypothalamic amenorrhea , what is it ? It's quite dangerous to lose your cycle , isn't it ? For a number of reasons ? for biological reasons , like I would imagine , as a male , and obviously this is not an area that I fully understand and probably never ever will fully understand . But when you lose your cycle , as a male I would be thinking it's something to actually celebrate for a woman , not having to go through that every 28 days with sanitary napkins , etc , etc . And having to deal with the hormonal imbalances and things . So you don't celebrate losing a menstrual cycle .

Speaker 1 6:37

Well , that's what a lot of people do experience when they lose their period . So that was for me as well . well , kind of in that you feel like , oh , i don't need to go through this every month anymore , but it's until you realize the implications of that or the consequences of that , that it's like a wake up call to you saying that , oh my God , i really need to treat this , or else it can lead to a multitude of issues , both psychologically and physiologically .

Speaker 2 7:08

Losing a menstrual cycle . Does that mean that your body's in trouble ?

Speaker 1 7:11

Yes , so there are three main causes of HA First , being under eating , so underfueling for your needs . Second , being overtraining . And the third being stress . So , like chronic stress , i have heard stories where a parent or a very close relative has passed away and that's been just very traumatic and that stress has caused that person to lose their period for like months . So even your chronic stress can be a cause of that .

Speaker 2 7:41

And what would it be an indicator of ? Like , why would stress cause that ? I mean , obviously , when we think of stress , we think mentally , i'm having mental issues , i'm having problems , i'm not coping with this or I'm not coping with that . But stress presents in different ways , biologically , in our body as well , doesn't it ? So why would your body go ? oh , we're not having a menstrual cycle .

Speaker 1 8:01

Well , if you think of it , your body . Why we have a menstrual cycle is because to reproduce . But if your body isn't in a good state mentally or physiologically , then your body just goes like oh , let's turn this off because we don't want to add more stress to the body . Your body is stressed out enough , whether that be stress from underfueling yourself or over training or just experiencing mental stress , like chronic mental stress . So your body just goes like that's it , let's turn it off or let's wind it down . And that's where you might start to experience like longer cycle lengths or the bleeders like goes for a few days , things like that . So that can all be the lead up to having no menstrual cycle .

Speaker 2 8:48

The indication that you've lost your menstrual cycle is you don't have the bleed or it's a regular .

Speaker 1 8:52

Yeah , and I like to use the analogy of our smartphones . And what happens when the battery goes low . So we all know that the phone will go into battery saving mode , and if you think about the body , that's the same way . So your smartphone will start dimming down a bit , turn off the Wi-Fi , turn off Bluetooth or turn off all these other these processes that use energy , and for your body , one of the processes is reproduction . So they just turn that off because you don't need it , it's not essential , you can live without it . So let's turn that off , save some energy so that we can stay alive , because your body's ultimate goal is survival , and so that's what it will do . It will do everything that it can to keep you alive .

Speaker 2 9:36

If I've got a client or I've got a person , or there's someone that's listening that is doing one of these diets that they think they've got to do a 1200 calorie diet , or they've got to do an 800 calorie diet and they're under eating to burn off body fat , because this is a common problem for females in itself . So what we do is we get to the stage where we search for anything to lose our body fat because we feel that we need to be in a particular state of appearance for people . So what we actually tend to do is we go and we look for these diets that are very restrictive on calories . So if you're a female that's listening and you're on a diet and all of a sudden it starts to become either a regular or whatever , this is a warning sign . Is that correct ?

Speaker 1 11:11

Yes , that is a warning sign that you would want to look out for .

Speaker 2 11:14

Right , And when that actually occurs . it's not something to ignore , is it ?

Speaker 1 11:18

No , definitely not , which a lot of people unfortunately have , but that's a result of not being educated on it And there isn't really much out there on this kind of topic . There's been more and more in recent years , but back then , when I started promoting this type of content and like putting this content out there , there weren't many people talking about it And it kind of gives the false sense of that no one experiences it and it's just me or it's just normal , and what that leads to is people just hold it off and don't do anything about it , or they don't know that it's bad and just leave it . That's what leads to the damage , or longer term damage .

Speaker 2 11:58

So when I think about HA and we're gonna call it HA , hypothalamic Aminorim I would be thinking that this would be a common thing for athletes , because athletes they wanna look ripped , they wanna lean , but they're training their backsides off to achieve something like an Olympics , or they're training to get to stage , or they're training for a competition and they're under-reading and over-training . But we've gotta start thinking more broadly , don't we ?

Speaker 1 12:23

Yes , so this kind of concept did start with athletes , and it can be intentional and unintentional . So it could be intentional that they are trying to lose weight . It might not just be for aesthetics , but also for performance . So if you think of sprinters or cyclists , they are better off or they can go faster to a point if they are leaner because less weight , less resistance against the wind or whatever .

Speaker 1 12:49

And it can be intentional like that , or unintentional , that they're running so much that they just can't keep up , or they're running so much that their appetite is suppressed and they can't keep up with the fuel that they're taking in , or they're not educated on how to fuel themselves , so they could be going on hours of running without refueling . This can all lead to what we call low energy availability , which is just like underfueling . But in recent years , with all the diet trends that you've mentioned , it is becoming more and more common among , just like the general population whether they might be exercising or not exercising just like purely under eating and trying to stay leaner than what their body would like For people that are listening here .

Speaker 2 13:37

If you're a person that goes to the gym and you want to go to the gym and do endless hours of cardio because you feel like you need to lose three , four , five kilos or whatever it is that you feel like you need to lose by under-reading , under-fueling , it's okay to fuel the exercise that you're actually doing , and this is where it's important to see a dietitian or a nutritionist , isn't it , that can actually calculate because of the exercise that you're doing .

Speaker 2 14:01

This is what you need to fuel . You can still calculate a deficit , an energy deficit , for a person to lose body fat , but you still need to fuel that because of the complications . So the complications that come about by losing your actual cycle , when we lose our cycle , it's not something to ignore . So what sort of impact is this having on us biologically ? Because this is the important thing , because we know that people have anorexia . Anorexia nervosa is a classic example of a person who would lose their cycle due to hypothalamic anemia amenorrhea . What damage are we talking here , rachel , in relation to what it's doing to a person biologically ? If you could step us through that , what does it look like ?

Speaker 1 14:44

Yeah . So the first thing that people usually think of is , oh , i've just lost my period , but actually that's just the tip of the iceberg .

Hypothalamic Amenorrhea's Effects on Health

Speaker 1 14:52

And then the next thing people think of is bone mineral density . So in sport there was something called relative energy deficiency , in sport , reds , which is commonly known , as someone exercises too much or underfuels and then they lose their period And that affects their bone mineral density as one of the three kind of triads that are affected . And it affects our bone mineral density because estrogen , so the female sex hormone , isn't produced enough And estrogen plays a very important role in bone metabolism , so forming your bone .

Speaker 1 15:29

What that means is that , oh , you might still feel your bone there , but how dense is it inside ? How strong is it inside ? So if someone has very low bone mineral density , you can actually Google this . Just type bone mineral density and you can see the difference . If someone has low bone mineral density , where they have literally holes in their bones and it's very fragile , so this leaves people prone to fractures . So you might be seeing a 20 year old athlete that looks very fit and very healthy , but actually their mineral density is very low and they could get repeat fractures just doing their sport and it's because their bone is so fragile .

Speaker 1 16:11

So that's the second most commonly known impact . But actually it also affects things like cardiovascular health . So you might have a poor lipid profile where you have a high kind of bad cholesterol or just like high cholesterol in general , and it can obviously affect fertility , where it's harder to fall pregnant , obviously if you have a irregular or absent cycle . And even if you do fall pregnant , there is some evidence showing a high prevalence of miscarriage or pregnancy complications with those that have lost their period in the past from HA . In addition to that , it also affects our psychological health , just purely by being underfueled or under chronic stress . So there is a high prevalence of things like anxiety or depression among those with HA .

Speaker 2 17:02

So , without even realizing it , let's just go back over a few of those points . right Number one , we're talking bone-rineral density , and I would imagine that the longer that you go without your cycle , the worse your bones would actually get .

Speaker 1 17:13

Yes .

Speaker 2 17:14

Right , so your bones could end up looking like an aero bar Really .

Speaker 2 17:17

Yeah , yeah yeah , like you could have chocolate hard on the outside . So when we feel our bone it feels good , but internally it looks like an aero bar because it's full of bubbles , isn't it Like ? absolutely full of holes all the way through , which means that when it breaks if you do break it or you do yourself an injury then you're in a position where it's going to be extremely difficult to actually recover from that . Just on that point when you regain your cycle back , does that bone-rineral density improve again , or does it stay in a poor state ?

Speaker 1 17:45

I would say it mainly depends on what stage of life you're in , because this is so common among adolescents . That can be a long-lasting effect because you're growing up while you're in puberty and stuff and you've kind of disrupted that process . So if you lose your period during adolescence or puberty , that can have a much harder effect . It appears that bone-mineral density can come back , but in some cases it might not fully recover . So this is why it's really important to step in as early as possible and recover your menstrual cycle as soon as possible .

Speaker 2 18:20

Because the impact of that could literally be that lack of cycle , bone-mineral density deteriorates badly , because I would imagine the majority of people that are suffering from HA would be somewhere probably in the order of 14 , 15 years of age to up to 30 years of age . Would that be fair ?

Speaker 1 18:37

Yeah , if you look at the prevalence of disordered eating and eating disorders , it is most common around 16 , 17 years old , all the way to the end of university , because that's where most people are trying to find purpose in life , trying to gain control of their life . but also when they don't really have control of their life , some people will experience difficulty or challenges trying to find their identity and that's what leads to disordered eating , where the only thing that they can grasp on is food Or because of silo pressures , they feel that if they control their intake and lean down or look better , then they'll have more friends or have a better social life . So I would say it's around teens , late teens to mid-20s . But obviously this can happen to anyone of any age and I've had clients who have experienced this after their first child , like even when they're trying to lean down after they've had their first child and then they experience this and they have trouble having their second child . so it can definitely happen to anyone .

Speaker 2 19:45

When I think about that too , that would have a big impact , because people are very dissatisfied with their bodies after they've had their first child , and then they would die it down , do whatever they can to lose that baby fat , so to speak . They could put themselves in a severe deficit and cause themselves all sorts of problems around that . So What we've discussed is it's not only unique to athletes , it just is solely related to underfueling and stress , and the third one that you said was stress and over-exercising .

Speaker 1 20:14

Usually it would be a combination of two or more . They usually come hand-in-hand and like , if you think about it , if you're trying to lose weight because you're dissatisfied about yourself , that might lead to some stress and then that all adds in and you might be trying to exercise more to lose that fat . So we can all come in and like they might contribute on different levels for different people . Usually it's two or more factors .

Speaker 2 20:38

Okay now , the next thing that you spoke about was the lipid profiles . Just to explain to the layman that's listening to this ,

Health Impacts of Hypothalamic Amenorrhea

Speaker 2 20:44

your lipid profiles are extremely important because we have a triglyceride level , we have HDL cholesterol , which is our good cholesterol , and we have LDL cholesterol , which is our so-called bad cholesterol , and it's important that we have a really nice balance of both of those profiles . What does HA do to that profile ?

Speaker 1 21:05

So it can increase your so-called bad cholesterol , and I've seen that anecdotally and also in the research . it's high prevalence of cardiovascular events , and it's actually similar to what people experience at menopause . Estrogen levels decrease as well , and estrogen plays a very important role in ensuring that your arteries don't clog up , and so if you think about that , if they're clogging up , that's no good . When estrogen levels fall in HA , that also affects our cardiovascular health and our risk of cardiovascular events .

Speaker 2 21:40

Estrogen is playing a major role in keeping our arteries clear and because if we have almost zero estrogen which we're going to have with HA and also in menopause , which is common this is why our LDL cholesterol increases , which causes the plaque in our arteries , which ends up blocking our arteries , and this is why menopausal women are in the position where they will end up with having heart attacks , events or things like that , because that's the very reason And this is why people need to understand that losing your cycle at a young age can actually be building that plaque up which doesn't get cleared . It's a plaque that builds up and builds up and builds up . Now , the other thing that you spoke about so we've covered cardiovascular . Now the next one that we're talking about here , that you spoke about , was that it could be more difficult for people to fall pregnant afterwards . So it has an impact on that , but in what way ? why would it have an impact on that ? Does it affect the reproductive organs in a female ? In what way would it affect those ?

Speaker 1 22:36

Well , if you didn't have a period for prolonged a bleed for a prolonged period of time , your muscles in your uterus can also atrophy . Well , if you think about you're not using it , so then it kind of shuts down a bit , Yeah , and it can be harder to fall pregnant And if you've experienced HA before , it is also easier to experience it again . So if we look at even like bodybuilding , where people will try to lean down , compete and then they recover their body fat and then try to diet down again for another competition , usually what you see is that it doesn't take as long for them to lose their period , So like they lose their period quicker .

Speaker 2 23:21

I hope you're enjoying the show . If you are , please don't forget to rate and review once you've finished . This helps the shows reach enormously . And have you got my free e-book The Best Way to Eat on Night Shift ? Well , this is a comprehensive guide to the overnight fast , why we should fast and how to best go about it . I've even included a few recipes to help you . I've put a link to the e-book in the show notes .

Speaker 2 23:47

And are you really struggling with shift work and feel like you're just crawling from one shift to the next ? Well , I've got you . If you would like to work with me , I can coach you to thrive , not just survive , while undertaking the rigors of 24 , seven shift work . I also conduct in-house live health and wellbeing seminars where I will come to your workplace and deliver evidence based information to help your wellbeing team to reduce unplanned leave and increase productivity in your workplace . I've put the links in the show notes to everything mentioned . You can find me at ahealthyshiftcom or on Instagram at a underscore healthy , underscore shift . Now let's get back to the show . So it's almost like the body goes you . I know what's happening here , So I'll just prepare us for it and just go with it , exactly For survival .

Speaker 2 24:44

Now I've lost my cycle . I've lost it for three months And I'm now thinking this is not good . I need to go and see a doctor . What's a doctor going to do ? What's the conversation that a lady in today's day and age when they go to see a doctor ? What's the conversation that you should be having with your doctor ?

Speaker 1 25:01

Yes . So usually the first question that the doctor will ask is could you be pregnant ? And then , if you're not likely pregnant or there's no chance of that being the case , then they would take bloods or do some ultrascans to look at what could be the problem . But what I normally suggest is for people to tell the doctor what they think it might be . I've actually heard a doctor say before that one of the questions that he asks is that what do you think it might be ?

Speaker 1 25:32

Because that's so important , because you might have things running in your mind and the doctor is obviously not a mind reader , so they might be thinking in one completely different direction while you're thinking , oh , could it be HA ? So it's really important to speak up and say hey , actually I've been trying to lose weight for a bit and I've really been not eating much and exercising quite a lot . I read up on this , or I did some Googling , like everyone does , and I think it might be something like HA . What do you think ? And that can really prompt the doctor to refer out or consider that possibility and that can steer them in the right direction . Or maybe they might say , oh , no , it's not a case of that . So it's really helpful for the doctor and for the person who is seeing the doctor to speak up and tell the doctor what they think it might be .

Speaker 2 26:21

It's a process of elimination , isn't it for a doctor ? But if you go in telling him where to start or where you think would be a good place to start , let's face it , it's your body , you're in tune with it , you know . So the ideal thing for you to do is to go in and say this is what I think it would be , because otherwise he's going to start with everything else , which is going to be a massive inconvenience for you , because he's going to start like , maybe blood tests or ultrasounds for PCOS or have a look at all the other causes hormonally Could be looking at bloods for the hormones and things like that . So if you go in , you can avoid all of that . So , once it's been diagnosed , what's the next best thing ?

Speaker 2 26:56

if he says OK , this looks like it's HA because you are underfueling what you're doing ? You're doing a lot of cardio , you're doing a lot of running . You're clearly show me your diary you're not eating enough of what you're actually eating . So what's the next course of action , rachel , what should you be doing as a person that's just been told you got HA Because it's not a death sentence . So what should be the next thing that you should be doing ?

Speaker 1 27:15

Yeah , before we go on to , that I actually want to go back to when you see your doctor , Because sometimes , well , if you think about , your GP is seeing so many people they might not actually be aware of HA and that's why I've seen a lot of people misdiagnosed as PCOS .

Speaker 2 27:31

Yes .

Speaker 1 27:32

So if you do really think it's HA , don't be afraid to get a second opinion .

Speaker 2 27:37

This is what happened to you , didn't it ? Because we've had this conversation .

Speaker 1 27:40

Yes , so I was diagnosed as PCOS and they were like you're not underweight , you look fine , you look healthy . Yeah , it's just PCOS . You don't have to be underweight . That's another important thing . You don't have to be underweight . You could be classified as normal BMI and have HA , or even classified as overweight and have HA , so you can have HA at a range of body fats .

Speaker 2 28:07

That's a very , very important point , because you could literally be someone in a 110-kilo body underfueling yourself . People note that just because you look at someone that looks like they're underwritten and we've all seen them . you know , we can all go for a walk and we can look at a person , and we can see a person that we look at and we think , oh my God , you know , take them home and give them a bowl or pasta . They need something to eat . It could literally be someone who weighs 110-120 kilos , is in the obese range or morbidly obese range , and they're in a position where they are underfueling what they need as an energy requirement . So you can still suffer from HA And I would imagine , in thinking about it , it makes sense , doesn't it , that when someone is overweight to that extreme , that they would underfuel themselves to try and lose that body fat .

Speaker 1 28:56

Yeah , potentially , but then there might also be other things . when you're classified as obese , when you have obesity , that could affect your menstrual cycle as well , which is why I keep on saying , please get it checked out , get everything else eliminated , because there could be so many other reasons . It might be HA and something else . It might have nothing to do with HA . So , yeah , getting it checked out , being vocal about what you think it might be , what you'd like the doctors to check out , and not just be completely 100% sitting there oh yeah , i've lost my period and then just waiting for the doctor to say something .

Speaker 2 29:30

We want to go in with that knowledge , and I think this is important , because doctors are not . They shouldn't be treated as vet , where they've got to try and look at an animal and work out exactly what it is that's wrong . We've got a mouth , we've got ears , we can ask questions , we can say this is a situation so that a doctor has a place to start . So go in , give them the story . So then we've been diagnosed , we've got HA or what is suspected to be HA , which means that we're either stressed , we're under-reading , we're over-exercising . What should we be doing from there ?

Speaker 1 30:01

This can obviously be guided by your GP on what the next steps are and it would depend on your situation . So whether you want to be working with a nutritionist or qualified like dietitian to look at your diet , see how you're under-fueling , how you need to eat to recover your period and , in many cases , recover some body weight . So restore some body weight and some body fat . And , in terms of training , you might want to be working with a coach to check out if you are over-exercising or how you can scale down your exercise . So , as a general rule with HA , i would say no high-intensity exercise . So like hit classes , because they are a stress to the body and , as we've been talking about , ha is already a huge stress , so we don't want to be adding more stress .

Speaker 1 30:49

So , maybe working with a coach and also removing any cardio that you're doing , in most cases , people don't need to completely stop exercise . That's not to say that everyone should continue exercising . Some people , for other reasons or for because they've been just overexciting so much , they really do need to have a complete stop . So that's something to talk with with your coach , and then you also might want to bring in a psychologist to help you on the mental side . So if you're struggling with your obsessing over exercising , or you feel very anxious when you don't get to exercise , or you feel very anxious when you're trying to restore some body fat and eat more and you're finding that very hard , you're finding it very challenging to improve your relationship with your body or with food . That's where a psychologist can really step in and be a really good guide .

Speaker 2 31:46

I think that's really good advice to psychologists because I know even from my own experience , getting to the stage where you get down to really low body fat levels , it would be very easy , i would imagine , for a female to go oh it's only my cycle , it doesn't really matter , because I'm not looking to fall pregnant anyway , so it doesn't really matter .

Speaker 2 32:04

So the fact that I've lost my cycle doesn't matter , i'll still keep going because I want to be nice and lean and you know I won't have abs , etc , etc . So to start putting on weight to try and recover what you need to based on the reasons why you've explained it , i think this is a really good thing . To get a psychologist to help you to deal with , or a proper coach , not someone who's got no knowledge in it , but someone who's got body image , trained in body image or something like that to be able to explain to you the importance of putting this on and to help you to work through the process of putting a bit of fluff back on , to be really , really super important , not only for your body biologically but for your mental state as well , because we have to deal with that And I would imagine particularly with girls that do bodybuilding shows or athletes at very , very high levels . To have to put that weight back on must be traumatic .

Speaker 1 32:55

Yes , and that's why wording is also very important .

Speaker 1 32:58

To like , for example , just

Support and Informed Decision-Making in Health

Speaker 1 32:59

mentioned fluff , just then that could be like triggering , which is why I keep on saying restoring body fat , you're restoring health , and you might need to catch yourself out on it and like , oh no , okay , i'm restoring health , i'm restoring my body fat level so I can function properly .

Speaker 1 33:14

So the way you approach it is so important . That's where a psychologist can really help you in doing that reframing and helping you train up on that . And it's interesting because one of my DMs , a girl , was saying that , oh , but like , at the end of the day , it's really me facing the problem , so I really see how a psychologist could help because I need to do it . And then I was like , yeah , well , if you think about it , you can do all your study and all your learning by yourself , but when you have your classmates , when you have your teacher there beside you , you still have to do your homework . It's not like they're going to write it for you . By having that environment there or that support group around you , that can just make the whole process just still challenging , but a bit easier . It can guide you , yes .

Speaker 2 34:00

I liken this to even just coaching normal clients as a driving instructor . Like you can read how to drive a car , you can read it . You can say right , this is what you got to do , this is how you got to go about it . You know , you got to push this pedal , you've got to steer here , you've got to put your seatbelt on . You got to do this , you got to watch that , you've got to look in these mirrors , blah , blah , blah . But having a driving instructor there just to until it's ingrained in you the right way to go about things , it's nice to have that gentle reminder along the way until you are competent enough to go off on your own and actually do that , and you know when that situation gets to that stage . So I think having a site and there's no shame And I think the good thing about it is today when you see your doctor , particularly here in Australia , when you see your doctor , your doctor can give you a healthcare plan to recover from this So you can actually see a psychologist . For I think from memory don't quote me , but I think it's 12 sessions that you can , which are funded by Medicare , to go and see a psychologist just to help you to work through where you're at and what you're actually doing and how you're going . So this is the benefit .

Speaker 2 35:01

I want to talk about the energy balance thing as well . You and I are both MNU certified , so we're evidence based coaches . Sometimes it can be if people are a bit worried about their cycle because it's a little bit intermittent . It wouldn't hurt to come to a nutritionist such as ourselves to actually have a console to find out are you fueling yourself properly for what you're doing ? There's no shame in that , it's not . We tend to find that the people that fuel themselves properly lose weight better , don't they Once they're fueling themselves properly because they've got more intensity . So what I'm saying here is it can be really really good for a person just to have a consult with a nutritionist that can look at what you're doing for exercise , what you're actually eating , and make sure that you are eating it sufficiently , but by the same token , they're also can help you with a deficit so that you can still lose the body fat but you're not in a ridiculous deficit where you lose your cycle . You agree with that .

Speaker 1 35:57

Yeah , and I also think that a coach can be a very good person to tell you when your goals are unrealistic . Because , if you think about it , society is telling us all you need to be zero body fat or whatever to be accepted or be trendy or whatever . But that might not be healthy for you . It might be way too low for you to function properly mentally and also physically not just talking about your performance in the gym , but even cognitive performance going to work and being able to do well in what you love . So in some cases it might be going to a nutritionist just to check in and have a wake up call . Hey , this goal is going to run the risk of you underfueling and maintaining a body fat level that's way too low for your health And that might impact ABCD . Is that something that you would like to proceed with ? Because , as a nutritionist or even a psychologist , even now , doctors , it's all about an informed decision and it's not about us . It's more about us giving you the information and then helping you make an informed decision that will put you in the best place .

Speaker 1 37:11

So a lot of the time , people fear seeing a nutritionist because , oh my God , they're just going to tell me what to eat . I can't eat that , i can't do that , but at least for me , how I like to coach my clients , is that okay ? so these are the options that you're thinking about . Let's look at the pros and cons of each . This is the information . This is what I would suggest . At the end of the day , it's your decision . You can make it as long as you're informed about it . If we talk about , even in bodybuilding , there are risks with such an extreme sport . But if someone is informed of all these risks and they decide , yeah , that's something I want to do , i understand what the consequences might be . I think I've weighed them up and I want to go ahead . That's a fair choice .

Speaker 2 37:59

So it's important that a coach actually sits down and has that conversation with a client . So girls that are going into bodybuilding or in bodybuilding , you need to have that conversation with your coach . What's the impact of this ? Because it's an expectation on girls and men today . This is the goal to get to stage to be looking fantastic , but that comes at a cost too , and I think coaches have got a duty of care to their clients to actually say this is what you're going to go through and be prepared for it so that you are making that informed choice , like you've said , with the coach , nutritionist , etc . So someone that's actually certified in that area to make that informed decision , so that when this happens , you can't come back on and say , well , i had no idea .

Speaker 1 38:44

Yeah , and also having a recovery plan out of that .

Speaker 2 38:47

Right . That's the next thing I wanted to talk about , because we need to be very careful , don't we Like , as a coach or as a nutritionist , if someone came to me with HA or that had lost their cycle or for whatever reason ? once we had a diagnosis and we knew that it was like Joe , i'd be wanting to get someone out of that As a matter of urgency . Based on what you've told us about the impact that it has , we know it has an impact on our lipid profile . We know it has an impact on our reproduction . We know it has an impact on bone mineral density . These are all very , very important things which might be the reason why we're snippy or we don't have the patience for people . People are causing us problems and we don't have any tolerance . We need to recover out of this straightaway Now . Based on what you've learnt yourself , what's the best possible scenario ? Obviously , you see nutritionists right , but based on your experience working with people like this , what do you see is the best way to get out of this , to recover this cycle ?

Speaker 1 39:40

Yes , obviously this would depend on each person and their situation , And I would also add that in some cases , if someone is presenting with symptoms of an eating disorder , this would be outside the scope of a nutritionist and they would really have to see a specialist dietitian and have a specialist medical team to help them , which is why it's so important to again see your doctor .

Speaker 1 40:03

But if it's a matter of underfueling , then it's about setting in , potentially , a plan to ensure that you're eating enough .

Speaker 1 40:14

For example , I find that a lot of people will be in mint , fasting or they'll be skipping meals . So , first thing , the key or the core thing is having regular meals , having

Regular Meals and Restoring Body Fat

Speaker 1 40:26

three main meals a day , having snacks in between , and then , obviously , your dietitian or nutritionist will be able to guide you on how you can structure those meals or how much you want to have in those meals . But as a general rule , your main meals would want to include all the three main macronutrients , so like a starchy carb , a source of fat and also a source of protein , Because what I tend to find is that , okay , I'll have a meal , but I'll have cauliflower , rice and chicken breast and then just vegetables cooked in very minimal oil . So it's a very useful guideline to say that you need to have a starchy carb , a fat and a protein source in that main meal . So that's like a really broad-stroke kind of general guideline And then you can go deeper and see okay , for my training needs , what do I need to have there ?

Speaker 2 41:13

So it's not something that we particularly need to track our way out of . It's just something that we need to make sure , if you're a good coach , that you can say right , breakfast , we need to be making sure we're getting this . Lunch , we need to make sure we're getting this , we need to be making sure we're getting these meals to cover and our two snacks . And I notice in my time with you , even over the last few days , i notice you ensure that you will eat three main meals and you also snack twice a day , and that's obviously the impact that you're conditioned to doing that coming out of it , because I could skip , but I have to make sure that you're eating at the times that you're eating , and that's an observation that I've made just on being with you for the last few days that you like to have your breakfast , your lunch and your dinner and you like to do two snacks a day as well , because I would imagine , having gone through that would be quite scary . Yeah .

Speaker 1 42:03

Yes . So now I kind of consciously ensure that I'm eating enough , consciously ensure that I'm getting enough carbs , or like , if I've had a hard training session , that I go home make sure I'm fueled , make sure I have convenient snacks like protein bars or even like cereals or yogurt in the fridge that I can grab quickly . A really good habit that I've picked up And it's not just for HA , just for anyone , even shift workers to always have a snack or a protein bar in your bag , because then you don't have to be out , or like if I'm , for example , if I'm traveling and suddenly all the shops are closed or I just can't find something nearby , i'm hungry . I always have that , those calories and those nutrients there for me in case I need it .

Speaker 2 42:49

Because one of the biggest problems that shift workers do have is access to their own snacks and foods .

Speaker 2 42:55

And it's only a planning thing And , like you said and I think it's a really important point that you made you always make sure that you've got readily able to grab food So you can have yogurt and a cereal and you can have a protein powder or , on the go , grab yogurts and some fruit or something like that that you can always be fueling yourself instead of going so long without food , which causes us all sorts of grief .

Speaker 2 43:19

So we need to make sure that we've got those nutrients And people need to not be afraid of eating that way . It doesn't mean you're going to put on weight because you're eating three meals a day in two snacks , because this is ideal for our body . And what people need to understand about having those three meals in two snacks is you're fueling your body . So your body is up and about Hormonally , it's running really well And we are in a position where we move a lot more , so we actually burn more . So even though you might be having an extra meal , the fact that you're moving more might mean that you're actually you know calorie neutral . You know you're actually burning more . So this is what happens , and I think that's excellent .

Speaker 1 43:54

But if , like you , were trying to restore your menstrual cycle , then you would really want to be in a surplus , and that would help with being in a surplus , because another common thing that I observe is that people want to restore their period but not gain any weight or gain weight .

Speaker 1 44:11

But I want all of that to be muscle And that's not a realistic goal to have .

Speaker 1 44:16

And that's very important to know , because body fat is actually really important for us in that when we restore body fat , it helps with our leptin production . So leptin you can think of it as our satiety hormone , so it helps us feel full throughout the day , and this is why , when our body fat levels go low , we get a bit more hungry because those leptin levels drop , and so by restoring our body fat levels we can restore that leptin production , and leptin also plays a role in the whole process of initiating that menstrual cycle and keeping it regular . So this is why Restoring body fat is part of it , and when you restore weight , actually it's not just body fat . So if , for example , in recovering your period , you increase your body weight by , say , 10 kilograms , not all of it is going to be body fat , some of it's going to be muscle , some of it's going to be organ tissue , some of it's going to be water weight , and that's all very important for us to be healthy and functioning and live a very fulfilling life .

Speaker 2 45:23

So while we're an athlete and we're sprinting and we're down to absolutely wafer-thin body fat , lost the cycle , we're in a bad way we need to get that body fat back .

Speaker 2 45:32

So once we've competed or we've done whatever and this is what people shouldn't be afraid of they're grossly underweight at that point . And to put that weight back on now , someone might turn around and say I'm 10 kilos up from my competing weight , whether it be stage or whether it be running 100 meters or whatever , i'm 10 kilos up . But , like you rightly pointed out , we need to be very careful that we don't say I've put on 10 kilos of body fat , because that's not what we've done . We've actually probably put two or three kilos of water on because the glycogen's going back in . We've got a ready , available glycogen . We've got muscle that's building . We've got everything's all rippin' about and running . We've got a lot more food in our digestive tract , which is adding to weight as well . So it's important that people note that Don't think you've put 10 kilos of fat on . You might have put four or five , but you needed that .

Speaker 1 46:22

And you've restored it .

Speaker 2 46:23

And we've restored the fat , We've restored ourselves back to a healthy level of where we need to live comfortably for our body . It restores our cycle . It restores absolutely everything going along Hormonally . Everything goes back into tune nicely , like a finely tuned orchestra , Beautifully . Now I want to ask you this and I'm going to put you on the spot here a little bit because I just want to ask you this , because I know you have had discussions with a client who is a shift worker , who has lost her cycle . Now , this is quite common . Can you talk about that ?

Speaker 1 46:58

What I have seen is that there is that greater prevalence of menstrual dysfunction , which includes everything from having no cycle to having irregular cycles , among shift workers and especially among those that do night shifts , overnight shifts , and that might be a case of circadian misalignment . It might also be a case of just chronic stress , because those who work in shift work from what I've heard , it is very stressful And , if you think about it , just those that work in the hospitals or in all types of like the police or like firefighters or things like that those are very stressful environments , especially when something happens and like they have to be on high alert , and that can also impact the menstrual cycle . From just the chronic stress .

Speaker 2 47:47

So we talk about , you know , frontline healthcare workers , doctors and nurses , and we can talk about police , fire , paramedics , and doing night shift is stressful enough and we get circadian misalignment which causes us all sorts of grief . But the bottom line is , if you skip three cycles , this is a time to go and see your doctor , isn't it ? And have a chat so that they can identify what it is and not just say , oh , that shift work . because I know I've spoken to a number of females that have DM me and said , oh , i've lost my cycle and it's ever since I started shift work . And the idea now is , if you've gone basically three months , it all falls back to where we started here , doesn't it ? Have a conversation with your doctor so that , through the process of elimination , we can manage stress , make sure you're not over exercising and make sure that you are fueling yourself properly , which I think is just a fantastic way for us to wrap it up , and I think that was just amazing chat . Thank you so much , rachel . I really appreciate it .

Speaker 1 48:42

Thank you so much for inviting me on .

Speaker 2 48:44

I think it's fantastic . What are you happy to field questions from people ? if people would have messaged you .

Speaker 1 48:49

Yeah , yeah , they can certainly message me . So I have two Instagram accounts . One is so , that's my larger account , which is in Chinese . I do have an English account and I'm pulling my phone out because I kind of remember what the handle is It's RxR Nutrition . So on Instagram , so you can search me , follow me . I don't post very often , but I'm happy to take any questions or like , if you want to just consult , just pick my brain or get some advice , i'm happy to do that .

Speaker 2 49:19

So yeah , So if you go to RxR Nutrition , then you will see Rachel's Chinese account . So if you're a Chinese speaker and you're listening to this , then you can go across and you can communicate with Rachel in Chinese as well , which I can't do , but you can do , and that would be a good way for you to go across . And there's also where she doesn't post regularly on her RxR Nutrition . She certainly posts regularly on her Chinese one And you can go and have a look at all the cute emojis that are telling stories , which is an amazing account , just to go and have a look at and try and work out . But I'll tell you one thing whatever you do , don't use the Instagram translator to try and translate what it is she's saying , unless you're up for some comedy , because the comedy , the way it translates , it , does not translate properly . So , rachel , you've got your website as well , haven't you ?

Speaker 1 50:03

Yes , so that's rachaldashnutritioncom . Again , that is mostly in Chinese as well . If you want to ask any questions , feel free to DM me .

Speaker 2 50:12

Some of it does translate . It might be loosely translation , but there's quite a lot of stuff in there . Rachel , love you to death . I think it's fantastic You've been able to sit down and do this with me . It's been great . We've been wanting to do this for a while and now we've had the opportunity to do it , And I want to say thank you very much .

Speaker 1 50:27

Very , very welcome .

Speaker 2 50:27

And that's Rachel . Now , rachel is very , very knowledgeable in this area , so I would highly recommend that you something that she said today that resonates with you , or you do have concerns that you would like to sort of just ask her questions around it . It's a place where she's actually been , so it's something that she can put your mind at rest around those sort of things . Rachel's been working fairly heavily with me in the background around the shift work and the shift work book . She's got a really , really good handle on all of that sort of stuff as well . So please don't hesitate to reach out to Rachel in relation to if you're having any concerns around your menstrual cycle there , because she's extremely well read in that area .

Speaker 2 51:10

I hope you enjoyed that , and if you did enjoy it , then please don't forget rate and review the podcast , if you would

Podcast Review and Subscription Request

Speaker 2 51:17

please . I would love you if you could do that for us and make sure that you follow on so that you get those surprise bonus episodes that I've been dropping as well . Thank you for listening . If you enjoyed this episode , be sure to subscribe so you get notified whenever a new episode is released . It would also be ever so helpful if you could leave a rating and review on the app you're currently listening on . If you want to know more about me or work with me , you can go to ahealthyshiftcom . I'll catch you on the next one , music .