Periods, Birth Control and HRT

Meghan says most painful, heavy periods come from estrogen that isn't being cleared, plus inflammation. Estrogen leaves through the bowels, so constipation lets it get reabsorbed. A sluggish liver slows clearance too. Inflammation raises prostaglandins, which drive cramping. Blood sugar dips spike cortisol, which suppresses progesterone and worsens PMS and cramps. Gut imbalances, endocrine disruptors, chronic stress and low magnesium, zinc, iron or iodine add to it. She describes a healthy period as one that comes every 26 to 32 days, lasts about 3 to 5 days, and has a moderate, red flow with no brown blood, clots or flooding and mild cramps at most. Other signs of imbalance she watches for are mid-cycle spotting, breast tenderness through the second half of the cycle and waking between 2 and 4am the week before a period. What to do:

• ■Get to 1 to 3 complete bowel movements a day. Her line: "You cannot fix your hormones without fixing your elimination."
• ■Eat liver-supportive foods like beets, dandelion greens, arugula, bitter greens, lemon and cruciferous vegetables.
• ■Keep blood sugar steady with regular meals, and don't skip meals.
• ■Swap plastics, synthetic fragrance and conventional personal care and cleaning products for cleaner versions.
• ■Move your lymph daily with walking, rebounding or dry brushing, and make room for rest during stressful seasons.
• ■For cramps, she uses castor oil packs and raspberry leaf tea.
• ■Track your cycle (basal body temperature, cervical mucus, phases) as a fifth vital sign, and ask for ferritin, which is often missed in menstruating women.

If you're on hormonal birth control and thinking about coming off, do it with a licensed practitioner. If your pain is severe or sudden, talk to your doctor. Her free Cycle Audit shows where your cycle health stands.

When you stop hormonal birth control, your body has to restart a hormonal system that may have been suppressed for years. Meghan says it usually does this with a liver that is behind on its work, depleted nutrients and disrupted gut bacteria. That is why post-pill symptoms tend to show up together:

• ■Acne, often cystic, along the jawline and chin
• ■Hair loss
• ■Irregular or missing periods
• ■Mood swings and anxiety
• ■Fatigue
• ■Bloating, weight changes and low libido

Synthetic hormones run through the same liver pathways that clear your own estrogen, so by the time you stop, the liver has a backlog. Hormonal contraception also depletes B6, folate, zinc, magnesium, selenium and CoQ10. It shifts the estrobolome too, which is the group of gut bacteria that clears estrogen. The brain-adrenal stress axis needs time to recalibrate as well. That can take a year or longer for women who started young or stayed on it for a decade or more. The pieces Meghan works on:

• ■Open the colon. If you aren't having 1 to 3 bowel movements a day, estrogen that should leave gets reabsorbed.
• ■Move the lymph. It carries away the inflammatory waste that builds up as synthetic hormone metabolites clear.
• ■Replenish the depleted nutrients before trying to support hormone production. In her words, "You cannot build progesterone without B6 and zinc."
• ■Support the liver through drainage work done in the correct order.
• ■Rebuild the estrobolome with targeted gut work. She finds a general probiotic falls short here.

She went through this herself. After more than 10 years on the pill and then a hormonal IUD, her skin broke out in cystic acne and her cycle took months to regulate. Her free Cycle Audit shows where your cycle stands right now.

When hormone therapy isn't helping, Meghan looks at whether the body can clear the hormones being added. She supports HRT and calls the right protocol life-restoring for many women. The liver breaks estrogen down, its byproducts get neutralized, and they leave bound to bile through the colon. When any of those steps stalls, estrogen builds up and recirculates and can drive the very symptoms HRT was meant to relieve. She compares it to pouring water into a clogged sink. Signs she sees in women on HRT:

• ■Breast tenderness that won't resolve
• ■Worsening anxiety, insomnia or mood swings
• ■Stubborn weight gain around the middle
• ■Bloating, headaches or breakthrough bleeding
• ■New melasma or jawline acne

Her steps:

• ■Keep working with your prescriber on the prescription itself
• ■Get to 1 to 3 complete bowel movements a day so estrogen has an exit
• ■Support the liver and bile flow once the colon is moving
• ■Lower the incoming load from plastics, synthetic fragrance and conventional personal care products
• ■Ask about what a prescription rarely checks: bile flow, gut health, methylation and toxic burden

Her line: "Get the prescription, and then build the system that can actually use it." Her free Hormone Health Scorecard shows where your hormones stand.