Hypothalamic Amenorrhea and How To Exercise

I get asked this question A LOT. Especially since Sarah Wilson kindly posted my story on her blog. I think, inherently, we are all a little voyeuristic. A little pervy. Wanting to know the intricate details of other peoples’ lives. Or perhaps we just want a little guidance or confirmation that we are doing the right thing. Either way, I have decided to share how I approached exercise as I was healing from hypothalamic amenorrhea.

Peeping Toms in Tokyo, 1951. Image via pinterest by sahua d

First, know this: hypothalamic amenorrhea (also referred to as the Female Athlete Triad) is often a result of over-exercising and/or under-eating, which leads to an overall negative energy balance for an extended period of time. The body senses that you are, essentially, starving and says “Righteo, no energy for reproduction, then” and bids farewell to your monthly lady holiday.

So, taking this into account, you can see that exercise is perhaps contraindicated in the treatment of hypothalamic amenorrhea. Right? Right! 

Chronic exercise = no good. BUT movement = good!

Prior to actually deciding to do something about my infertile situation, this is what my exercise looked like: 

• Monday: Body Attack (1hr) followed by Body Pump (1hr). I might have walked ~1/2 -1hr too
• Tuesday: Maybe a walk, maybe a weights session (maybe both), maybe a cardio session
• Wednesday: Body Attack (1hr)
• Thursday: Body Step (1hr), ½-1hr walk
• Friday: Body Attack (1hr), weights (1hr)
• Saturday: Body Step (1hr) – every second Saturday
• Sunday: Body Step (1hr)

Holy crap. I am exhausted just looking at all of that! So much time wasted in the gym! Granted, it was my job, which made it more “legitimate”, I suppose, albeit no less damaging to my health and fertility.

I realised that this was unsustainable and would leave me in my infertile state if I were to continue. 

Yes, thank you for your wisdom, Albert. For a while, I was insane. I thought I could just throw herbs and vitamins at the situation and it would sort itself out. But, after spending thousands of dollars (literally), I realised this approach was no bueno. So here is what I did…

I progressed quite gradually, and it helped that it coincided with my dietetics placement, so I had an excuse to no longer teach a lot of my classes.

Stage 1

• Monday: Body Pump
• Tuesday: Walk
• Wednesday: Weights (functional training 1hr)
• Thursday: Yoga
• Friday: Weights (functional training 1hr)
• Saturday: Body Step (every 2^nd weekend)
• Sunday: Body Step

 A considerable change, but probably not enough. Cue stage 2.

Stage 2

• Monday: Body Pump
• Tuesday: Walk/yoga
• Wednesday: Weights (8 minutes – YES, you read right EIGHT minutes – 8 sets of 3 clean and presses; sets 1 min apart)
• Thursday: Walk/yoga
• Friday: Walk/yoga, maybe a Tabata session (4mins of cardio)
• Saturday: REST
• Sunday: REST

Although it was tough (mentally), I stuck to this routine for quite some time (until my period returned), gradually adding in more yoga (vinyasa/yin/hatha NOT bikram/ashtanga) and taking out the Body Pump. As I have previously mentioned, I found the yoga incredibly beneficial to the healing process as it allowed me to focus more on my body’s ability, rather than its aesthetics.

So, now that my cycle is getting back on track, how do I exercise? Well, it depends. I try and get outside as much as possible for a gentle walk/hike, as I now live in the nature-lover’s playground:

Image by Lake Wanaka Tourism

But if it is raining outside, and I feel really good, and my stress levels are low, my week might look like this:

• Monday: Weights (1hr - 10 min mobility warm up, 30 min weights, 20 min stretch/yoga)
• Tuesday: 1hr yoga
• Wednesday: Body Pump
• Thursday: Tabata
• Friday: 1hr yoga
• Saturday: Hopefully the rain has stopped by now and I can go for a hike!
• Sunday: Rest

Note: I do at least 30 minutes of yoga every day in the morning. It grounds me and sets me up for an awesome day.

Now please note, this was MY journey. This gives you a general idea of what worked for me. It may or may not work for you. Listen to your body. If you have exercise/stress/lack of food-induced amenorrhea, then you probably need to pull right back on the exercise to start with, then take baby steps along the way, depending on how everything is tracking along.

If this is all too overwhelming for you, I get it. My hubby (who is a PT and peak performance coach) helped keep me on track. Everyone needs someone. Feel free to shoot me through an email via my website if you would like to book a consultation for some more structured, personalised guidance that will help you get your sexy back.

Final note – as always, be kind to yourself. x

How I got the body I've always wanted

This past weekend, I turned 30. Officially in the dirty thirties now. And I feel great. Fantastic, in fact.

My awesome hubby took me on a helicopter flight for my b'day!

It has been 1 year since I wrote my postabout putting on weight to restore my fertility. It has been 3 years since I lost my period due to under-eating, over-exercising, taking the birth control pill and being a stressed-out, maniacal perfectionist. It has been an interesting 30-year journey of progressing from someone who was constantly trying to change her body to meet some unrealistic ideal, to someone who actually loves the skin she is in. And I am not just saying that. For the first time in my life, I actually really love my body.

I have been wanting to write this post for a while, but putting it off. Not sure why. I guess we all have a fear of being judged in a negative light. So I ask you to please, if you have nothing nice to say, then say nothing at all. OK here goes...

For reference purposes, here is my before and after pic to show my progress. Please excuse the hair in both shots – one was scraggly beach hair and the other sweaty post-workout hair. But it’s not about the hair (although it is thicker and more lustrous nowadays). Let’s take an objective view here, simply looking at the change in body shape.

On the left, you will see “Check out my 8-pack, you think I'm healthy and fit , but my fertility is in the shitter” Kate. I showed this to a friend the other day and she said “Oh wow! What were you training for?”. Nothing. I was training for my illusive “dream body”. Pfft.

On the right, you will see “Check out my boobs, I look healthy and feminine and my internal state reflects this” Kate. There are just two things that I do not like about this pic – 

1)My lack of tan (although I have that many layers on here in Wanaka that a tan would not even get noticed) and 

2)The selfie pose. I hate bathroom-half-naked selfies. It makes you look like such a wanker. I apologise. I am doing this for reference purposes, not to show off or entice more Instagram followers.

OK, so aside from having boobs (seriously, I’m still obsessed with them), what is so great about my new body? Probably best if I list out the reasons, as I tend to do. As always, feel free to just read the bolded text to get a general gist:

1. I have unbelievable energy. I used to have to take regular naps throughout the day, just to make it through. Now, I can soldier through, completely sans-caffeine. Funny what happens when you start to eat enough
2. The whites of my eyes are crystal clear. They used to be constantly bloodshot and my vision was blurry. I relied on ClearEyes, and I wasn’t even getting stoned!
3. My skin is clear and wrinkle free. Previously, it would look kind of dry and lackluster
4. My nails are thick and strong. For the first time in my life, my nails are not snapping off as soon as a little bit of white appears. I used to have vertical ridges (signs of adrenal fatigue) and horizontal ridges (signs of thyroid issues). These ridges are almost non-existent now
5. My gray hairs have disappeared. Now this one I find quite odd, and did not think it possible. I used to have quite a few gray hairs, and my hairdresser can vouch for this – she kindly pointed out a patch of grays on my head that I would have otherwise been unaware of. Thanks Leigh. Those grays – all gone! Bizarre, right?
6. My cycle is getting back on track. Thank God, because that’s the whole reason I headed down this road. It’s not perfect – about 40 day cycles, but compared to the nothingness of about 6mths ago, this is a pretty significant improvement
7. I can do crazy yoga shit. Seriously – handstands and backbends and balances and all sorts of awesome stuff. I am loving it! I would never have gone down the yoga path if I wasn’t forced to sort out my stress and pull back on the chronic cardio that I was doing
8. I am so much more in tune with my body now. I listen to how it feels and I respond with understanding and respect, rather than saying “Harden up! It’ll be worth it”, because more often than not, it won’t be worth it.
9. My hubby thinks I am sexy and tells me this all the time. I know what you are thinking – he has to say that. Maybe, but he could just say nothing at all. I asked him if he preferred me the way I used to be and he said “Honestly, you were almost too skinny for me”. Interesting. I find the male response to this whole thing very intriguing. Any males out there who want to chime in on this, please do – obviously not telling me I’m sexy (unless you want to), but just commenting on the whole female body thang.
10. I am now in the position to be a positive role model for other females, both young and old. My previous body was unrealistic and unattainable for most. It took a lot of hard training and strict eating, and wasn’t even healthy. I was practically a male! No boobs, no period, no hips. Sounds pretty masculine to me!

So how did I do it? How did I go from hating my body at 57kg (172cm tall, 'cos I know you were wondering) to loving it at around 62-64kg (not exactly sure what my weight is – I broke up with the scales a while ago)? Well, it wasn’t easy. I didn’t just suddenly wake up and go “Hurrah! I am woman, hear me roar!”. These are the things that were invaluable to complete body image backflip:

1. Support. Lots and lots of it. From loved ones, and from you folks through the interwebs – thank you!
2. The knowledge that I might be helping others in a similar situation – this was a massive driver! I truly hope I can help others, even if it is just one person
3. The realisation that menstruation is a sign of fertility. Fertility is a sign of health. Body fat is needed for menstruation. Ergo body fat is healthy.
4. Self-love. I know this sounds really woo-woo, but it truly helped me understand the underlying thoughts I had about my body and how to change them. Gabrielle Bernstein’s May Cause Miracles, and Louise Hay’s You Can Heal Your Life are invaluable resources. Get them both. NOW!
5. Yoga. Yes, I am well and truly a hippy now. I even have crystals throughout my house. Candles too. But back to yoga. Aside from being able to bend and balance my way into poses that I was once only dreamed of doing, yoga taught me how to focus on my body’s ability, rather than it’s aesthetics.
6. The realisation that those who really matter in your life could not give a flying fuck (sorry - I was overdue for a swear word) if you are a size 8 or a size 14

Image via care2.com

This is my body. In your eyes, it may not be perfect. I have cellulite. I have stretch marks (in fact, I had cellulite and stretch marks before putting on weight). I don’t have abs. Or a thigh gap. But in my eyes, what I see and how I feel, for the first time in my life, I am completely and unashamedly happy. This is 100% me. I am not a replica of someone else, nor am I trying to be. I am confident and I am healthy, and I hope that I have sparked the desire in you to love, accept and appreciate your body exactly as it is. xx

Are you eating enough?

It is rare that I will get a client who is eating too much food. Often, it’s the other way around. Which makes sense, given what we have been taught about weight loss. It’s simple, really: 

“Eat less. Exercise more”.

Hmm. OK. My job (in terms of weight loss clients) really should be obsolete then, right? If it really were as simple as eating less and exercising more, most of my clients would be Kate-Moss-thin. But they aren’t. Some have just a little bit of stubborn fat that they would like to lose (for aesthetic reasons), others have more that they need to lose (for health reasons). All are exercising their butts off. Too much, in my opinion. All are not eating enough.

So simple, yet so easily forgotten. 

I was taught at university that if an overweight person comes to me and their food record shows they are consuming fewer calories than they are burning, then they must have been lying, because they should be losing weight. How f-ing arrogant of us to assume this. It truly breaks my heart to see people who are literally broken from trying so hard to lose weight using the traditional “eat less, exercise more” dogma”.

I agree. Ridiculous indeed.

So why is fat loss so hard?

Well, it is complicated, and I am the first person to admit that I do not have all the answers. As I mentioned, if weight loss were easy, we would not have an obesity epidemic that is running out of control.

What I do know is that when you consume too few calories, shit is going to hit the fan. Let’s back up a little for some weekly science….

Your resting metabolic rate (RMR) is an estimate for how many calories you would burn if you lay in bed all day (sans hanky panky). Your RMR represents the minimum amount of energy required to keep your body functioning – your heart beating, your lungs breathing, your reproductive system functioning, your thyroid gland humming along nicely, controlling your metabolism and body temperature. Let’s put this into practice and see what some numbers look like:

To calculate your RMR, you can use something called the “Schofield Equation”. While this equation does have some flaws, it provides a pretty decent estimate.

For me (and any other female in the 18-30 age group), the following equation would be used to get my RMR:

{(0.062 x weight (kgs)) + 2.036} x 1000 = 5,942kJ per day (divide by 4.28 to convert to calories)

So my minimum calories that I should consume, based on me staying in bed all day is 1388. MINIMUM! This is not taking into account any sort of exercise, folks.

Let’s say I decide that I am going to walk a little each day. My estimated energy requirements then go up to 2,082kcals per day! Just to do a little wandering here and there.

What is really concerning to me is that I have clients consuming around 1300-1500 kcals per day who are training at high intensity, for long durations, every day of the week. A rest day for them would involve a slow run, rather than a fast one. And this is not just females, it’s the fellas too.

What’s the problem with eating too few calories?

Image by Sara Thurley via Pinterest

When you have insufficient calories on board to fuel basic bodily functions, those functions will slow down. Your brain will recognise this lack of fuel and signal to the thyroid gland (in your neck) that energy needs to be conserved and to slow everything down.

Your thyroid gland controls all of your metabolic processes and your body temperature. If it slows down production of thyroid hormones, your metabolism will slow down, your heart rate will drop and you may struggle to keep warm. What happens when your metabolism slows down, people? You guessed it! Weight loss resistance!  If you are, essentially, starving, do you really think your body is going to give up its fat stores easily? Or do you think it is going to hold on to every last morsel to feed your vital organs (and to keep you warm). (PS have you checked out the Thyroid Sessions yet? They are awesome!)

If this wasn’t bad enough, your adrenals are probably going to kick into gear to help you survive (especially if you are doing high intensity exercise and don’t have enough carbs in your diet). This means cortisol is going to ramp up and give you a nice little pooch around your tummy that you can’t shift, no matter how many crunches you do (as a side note, crunches are not the best exercise for a lean mid-section, so just stop it).

In my opinion, troubles with weight loss are the least of your worries if you are chronically under-eating and over-exercising. I have spoken (at length) about how this can lead to Hypothalamic Amenorrhea (click the labels below this post to read more about this topic), but what about the other consequences, not just impacting the ladies:

• Compromised bone density
• Brain fog and inability to focus
• Decreased performance (in all forms of exercise, including the bedroom)
• Vitamin and mineral deficiency
• Low energy
• Increased risk of heart problems
• Poor memory
• Skin breakouts
• Hair loss
• Cracked and brittle nails 

Not pretty, right? Moral to the story – eat more and eat well! Or, exercise less. You choose. But don’t do nothing, or you could end up in some ugly (literally and figuratively) places. It might be useful to track your daily food and exercise, using something like “My Fitness Pal” to get a better picture of whether you need a slap in the face with a juicy steak.

Thanks, Ryan. Much appreciated. 

Ancient Genes vs Modern World - an event you must attend!

When I first moved to New Zealand, I decided that I was going to make a concerted effort to connect with like-minded practitioners. I wanted to be part of a strong community of health folk. What I didn’t know was how amazing my new-found health-nerd friends would be. Actually, I tell a lie. I had an inkling of their awesomeness. 

Sometimes (often) my images have no relevance to the topic.
I thought this one was pretty cool, though, don't you? 
It's a lizard made out of lime!
Image by Harry Chapin Food Bank via Pinterest

We started off our little NZ adventure in Christchurch. There was a chance, after all, that we would be living there eventually. This also happened to be the home town of one very well known, and very respected, nutritionist by the name of Jamie Scott (who also goes by the name of “That Paleo Guy”).

So I thought I would send him an email. I didn’t expect a response, but I hoped for one. I got one. Almost immediately – welcoming me to the country and an expression of interest to catch up! This was beyond exciting. But wait! There’s more – Jamie’s lady-friend happens to be an amazing doctor (yes – GP, MD whatever you want to call it – she is legit) who is a firm believer in using principles of evolutionary medicine and ancestral health to guide the prevention and management of chronic disease. "She", by the way, is Anastasia Boulais. These crazy cats are so passionate about ancestral health that they started up the very first Ancestral Health Society of New Zealand (AHSNZ), which you can read more about HERE. I am so proud to be involved in this remarkable organization with so many other incredible, like-minded people.

Here's a (relevant) pic of the happy couple (on the right)
with the folks from the Whole 9

After our little tiki-tour around NZ, I had the pleasure of meeting these two inspiring people and, I can tell you, they are freakin’ amazing. Not just because of their knowledge and dedication to spreading the word about ancestral health, but because of how unbelievably kind, considerate and inclusive they are.

Anywho…enough blabbering and butt-kissing. Even more exciting news – AHSNZ is holding its first conference at the end of June (the 29^th, to be exact). The following little blurb is 100% plagiarized from the AHSNZ website:

“Ancient Genes vs. Modern World” explores some of the key mismatches that exist between our physiology, having evolved over millions of years, and the novelty of a modern world that has rapidly changed over the last few decades”

Here’s a little breakdown of what you will be learning about on the day (again, plagiarism is at play):

• “Food for Thought: Nutrition and Brain Health” 
Dr Mikki Williden, PhD.  Senior Lecturer and Researcher, AUT. Auckland
• “Are Health Professionals Too Focused on Health?”
 Brad Norris, Director, Synergy Health. Christchurch
• “Ancestral Health in General Practice: Art, Science or Quackery?”
 Dr Pam Olver, General Practitioner. Wellington
• “The Ancestral Woman in a Modern World: Strong, Sexy and Fertile.”
 Kate Callaghan, Nutritionist. Wanaka (THAT’S ME!!!)
• “I See Weak People: The Under-Appreciated Role of Muscle in Health and Disease”
Jamie Scott, Health Researcher, Synergy Health. Christchurch
• “Sunlight: Friend or Foe? Skin Cancer Controversies”
 Dr Anastasia Boulais, Medical Practitioner. Christchurch
• “Stress in the Modern World”
Aaron Callaghan, Peak Performance Coach. Wanaka (AKA Kate’s hubby)
• “Urban Design and Health: The Spaces in Between”
James Murphy, Nutritionist, Synergy Health. Christchurch
• “Ancestral Principles in Managing Autoimmune Disease”
Julianne Taylor, Nutritionist. Auckland
• EXPERT PANEL: Anti-Fragile in Christchurch: Individual Health Strategies in a Changing City

Exciting right? This conference is the first of its kind in the southern hemisphere – you don’t want to miss it! Plus, you can come and hang out with me. Isn’t that worth the trip in itself (insert winky-face emoticon)?! Oh, and its not just for practitioners and/or Kiwi's. All welcome!

If you’re interested (which you should be) go and save your seat now – tix are only NZ$49 (meaning they are even cheaper for those of you across the ditch). Now THAT is a bargain to be hearing from some of the top experts in the ancestral health community. Hope to see you there!