Disordered eating and female health issues go hand-in-hand. That’s another one of the reasons I’m so passionate about integrating intuitive eating and a health-at-every-size perspective into my functional medicine work. Intuitive eating supports the body’s natural ability to self regulate, which is the core foundation for holistic healthcare. For women especially, supporting a foundation for health is extremely important not only for sensitive issues like fertility, but for supporting health and vitality throughout life. Hormonal balance affects every other system in the body.

But something I’ve noticed in both my personal and professional life is that most women struggle with symptoms related to hormonal imbalances (painful periods, fatigue, weight changes, irregular cycles) but they don’t seem to want to talk about it very much. Female health has been a really taboo subject throughout history, making it really difficult for us girls to get the high-quality healthcare we deserve. The problem is, when most women share these symptoms with their healthcare providers, they rarely get any answers. Instead, if they aren’t actively trying to get pregnant, all they get is a prescription for the pill. Most of the women I work with don’t want to use hormonal contraceptives, and so the go on suffering in silence until they can get some answers.

But part of the reason so many women are left in the dark is because most healthcare providers wrongly assume that their patients already have a firm foundation of wellbeing. In the traditional medical world, “health” is understood to mean “the absence of disease.” But there’s so much more to the story than that. Disease processes start on a biochemical level long before they actually manifest with strong enough (and measurable enough) symptoms to meet the diagnostic criteria for disease. But when symptoms are intercepted early enough, many diseases can be prevented. Cue: functional medicine. Even better, when healthcare providers work closely with their well patients on supporting a healthful and balanced lifestyle, as functional medicine doctors do, they can prevent dysfunction from manifesting. Dysfunction leads to disease, but supporting the way the body was originally designed to function prevents breakdown of the system. That’s call preventative medicine.

Building a Foundation for Health

Even though they don’t typically come to my office with specific complaints, I give my healthy patients treatment plans. Okay, so they’re not really treatment plans–more like prevention plans, intended to support a foundation for health. We talk at length about nutrition, exercise, sleep, stress, mental/emotional wellbeing, relationships, and other lifestyle factors. We make a plan to gently correct areas that are falling out of balance (like pulling all-nighters, over-reliance on caffeine and other stimulants, or skipping meals) and make a self-care plan designed to promote health rather than treat disease–but we do that too, as necessary.

Part of building a foundation also means making sure that the body has access to the nutrients in needs to function well. I never really sat down to think about it until I started studying medicine, but micronutrients are what enable our bodily systems at the biochemical level. The first and foremost consideration is fueling those systems, which is why eating enough calories, carbs, protein, and fat is so important. But our systems also use vitamins and minerals to make hormones, enzymes, and new cells. Due to the unique needs of the female body, the course of modern life, and the way our food is produced, we have a harder time replenishing certain nutrients after they’re depleted, or even getting enough of them in the first place.

In the Midwest, where I live, for example, fish isn’t a common grocery staple. I’m far from the coast, so fresh fish–rich in minerals and health oils–is expensive, usually frozen (icky), and because I didn’t grow up seeing my parents prepare it, I find it’s a hassle to cook. So, I don’t eat much fish, and consequently need to get those nutrients elsewhere. My job is also indoors, and because of the position of my city in relation to the sun most of the year (plus the risk of skin cancer), I need to supplement with vitamin D. As someone who enjoys outdoor running, and who hates sunscreen (texture issues), you’d think I’d have enough. But when I had my levels tested, I was at 27 ng/mL — way too low. So, I supplement.

Low levels of vitamin D and omega-3’s aren’t unique just to me, or to where I live, though. Public health research has shown that most menstruating women don’t get enough of other nutrients, too. So, I usually recommend a few supplements to my patients as a baseline, on top of some really important lifestyle considerations, all to maintain functional health.

Lifestyle Foundations

1. Nutrition

Eating enough calories is essential for healthy hormone balance. Within that, it’s also important that women receive adequate sources of protein, complex carbohydrates, and fat, too. I say complex carbohydrates because they typically contain fiber, and take longer to metabolize, which helps keep blood sugar stable. Fun foods are absolutely important, but I just like to make sure my patients are getting enough of everything that they need. Getting enough calories is number one, and getting enough color is number two. Plant foods offer great sources of macronutrients, but they also are the most concentrated sources of micronutrients–vitamins and minerals that we need to keep our bodies functioning optimally. The best sources are the ones designed for our nourishment…food.

2. Exercise

There’s a saying in the chiropractic world that goes like this: “Movement is life.” I love that saying, because it’s so true! One of the hallmarks of living things is movement. When we aren’t moving our bodies, we get stiff and store, and navigating throughout life becomes uncomfortable and painful. Moving our bodies not only is implicit to living our lives, but it keeps us healthy and strong so that we can feel our best. Due to modern pressures from diet culture, many people have a distorted view of how much exercise they really need, though. It’s especially important for women of childbearing years that we don’t overdo it in the gym. I typically recommend no more than 30 minutes of moderate intensity exercise per day (in addition to walking breaks and the natural movements of life).

3. Sleep

Sleep is extremely important, but even more underrated. I remember when I was a teenager, my health teacher told us that adolescents needed 7-9 hours per night, and adults needed at least 6. Most of the adults in my life at that time probably only got 6 hours per night, but I’ve since learned that the human body needs way, way, more than that. (Okay, maybe not way more, but ideally at least 30% more.) Sleep deprivation drives cortisol levels way up, which leads to allostatic overload (also known as “adrenal fatigue”) along with all kinds of other issues. And yes…it wreaks havoc on hormones. Unfortunately, many people struggle with insomnia, restless sleep, or other sleep problems, so we address those too.

4. Emotional Health/Relationships

Emotional health is getting more attention these days, and for good reason. A strong sense of community is essential for being able to cope with life’s daily stressors in healthy ways. They say it takes a village to raise a child, but I’d even go on to say that it takes a village to sustain adults. We need people in our lives, whether that means close family bonds, dear friendships, a strong church community, or other sources of social support. We can’t do this life alone, and we were never designed to. I’m quick to recommend counseling to my patients, because frankly, I think we all could benefit from it. But with anxiety and depression rates skyrocketing, social/emotional support is essential.

5. Fulfillment

This might sound like a new one, but I don’t think that a person is healthy unless they have a sense of motivation and drive in life. In other words, I find that humans function best in the world when they understand who they are, why they’re here, and are able to find pleasure in their lives. I always encourage my patients to engage in pursuits that they enjoy, whether at work, in hobbies, or even just a few minutes of reflection each day. When a sense of fulfillment in life is lacking, again, cortisol spikes, hormones become dysregulated, and health problems result. The mind-body connection is powerful.

6. Supplements

Once the broader foundation has been laid (lifestyle considerations), it’s time to talk about supplements. Supplements are #2 because pills can never compensate for imbalances in the things described earlier. Foundational nutritional supplements are like adding water to a bucket drip by drip while there’s a giant hole at the bottom, where water is gushing out. They’re effective, but the effects are more subtle, and the benefits are completely outweighed if a person’s lifestyle is out of balance.

I use supplements all the time in practice to correct hormonal imbalances, treat disease, and manage chronic conditions. But I also give them to my healthy patients to support optimal function. These are the ones I find most women require in order to maintain their sense of wellbeing.

• Vitamin D3: Epidemiological research has shown that most people in America are clinically deficient in vitamin D. Most adults receive optimal benefit from supplementing with 4,000 IU daily of vitamin D3, taken with food.
• Magnesium Glycinate: Magnesium supports hormonal balance by acting at the pituitary gland, where thyroid, adrenal, and sex hormones are produced. Magnesium also helps reduce headaches, bloating and muscle tension, which are major symptoms of PMS. Compared to other forms of magnesium, this form is most easily absorbed.
• Cod Liver Oil: In addition to aiding the absorption of vitamin D, cod liver oil is one of the best sources of omega-3 fatty acids, including EPA and DHA. Not only are these fatty acids essential for egg quality (a fertility concern), but they are necessary for neurological health and brain function. They also serve as precursors for hormone production. Without the building blocks, our bodies can’t make the messengers they need!
• B complex: B-vitamins act as cofactors for metabolic reactions. Everything from blood sugar control, to reproductive hormones, to thyroid function (and much more) requires B vitamins. These vitamins act like a key, activating necessary biological processes that we require to survive. When B vitamins are depleted, bodily systems literally shut down, and hormonally-regulated cycles (like fertility) are among the first to go.
• Probiotic: Gut health is an especially important consideration in fertility because our microbiome actually produces hormones, too! The “good bacteria” in our bodies also help metabolize hormones after they’re “used” so that we can clean out the dysfunctional molecules from our blood stream (i.e. detoxification). Gut imbalances lead to all kinds of health problems, and our hormones are no exception. A daily probiotic (combined with regular consumption of fermented foods) is one of the best ways to support gut health.

To sum things up…

Cultivating a healthy lifestyle really requires a holistic view. The diet/wellness industry likes to boil health down to just diet and exercise, but it’s so much more complex than that. Taking a vitamin pill can’t compensate for a strong sense of community and fulfillment in life, getting enough sleep, or an eating plan characterized by joy and freedom. For more tips like this, check out my Healthy Habits e-Book, or check out my services page to learn about working with me in a more personalized way.