From Menstrual Cycle To Menopause: Understand Your Body’s Rhythm As A Female Entrepreneur

This is THE podcast episode to seek the truth about all things menstrual cycle, hormone balancing, kegels, and perimenopause. CJ chats with Chloe, a Women’s Health Specialist, Physiotherapist & Nutritionist, who shares her wealth of knowledge on parts of reproductive health that, frankly, we weren’t taught at school (but should have been). Prepare to understand your body on a deeper level.

Expect revelations that’ll leave you shook and takeaways you wish you’d learned sooner:

1. Reading your unique menstrual cycle, rather than applying the broad brush strokes that tell you how you’re “supposed to feel” in each phase.
2. The influence that high chronic stress can have on your menstrual cycle (stress being the third biggest factor to menstrual cycle disruption).
3. How to soothe the debilitating symptoms associated with conditions like PMDD, PCOS and Endometriosis as a business owner, like bladder control, pain, and improving sleep hygiene.
4. The difference between perimenopause and menopause and managing the symptoms as a leader and business owner who’s got a legacy to protect.
5. Kegels isn’t the only (or often the right) solution for a problematic pelvic floor: Chloe reveals what is.

Connect with Chloe on Instagram: https://www.instagram.com/chloestevensphysio/

Check out her podcast with Michelle Caroll: https://open.spotify.com/show/7CUj8KDAcMcKMbva4vxW40?si=af94b72552d8435e

You can also connect with me! Instagram & Threads: onherplate_ or onherplate.com.

Transcript

Welcome to the Energized Entrepreneur podcast. I'm CJ, your host founder of On Her Plate Educating
and Empowering female entrepreneurs to repave the foundation of their business with a nourishing diet
so they can match their energy with their growth rate. I am genuinely honored to be inside of your ears
right now. If you're listening to this, you must be a female entrepreneur looking for your permission slip
to hustle in a way that puts your health first. Well, great news. You found it. Let's power up this episode.
Hi, Chloe. Welcome to the Energized Entrepreneur podcast. How are you? I'm good. Thank you. How
are you? Yes, I'm very well. And I'm really, really excited to have you on because of your amazing
expertise in the area. We're going to talk about today the menstrual cycle Pro menopause, menopause,
pelvic floor health. We have a lot to cover today so I'm going to jump straight into it. Before we get to
your intro, your professional intro, I'm just going to do a couple of hot C questions to loosen everybody
up. And and for them to get to know you more on a personal level. So we'll jump straight in. What was
the latest podcast or TV series that you binged and loved? Um, I just listened to a podcast last week who
believe in magic, and it's about a charity or a fake charity, and it's about, um, the the mom and the
daughter who set up this charity. And basically it's about fabricated illness, disorder or disease. I don't
know what it's called. I think it's disorder. Um, and so I, one of my patients and I were talking about that
and, um, she put me on to that podcast, and I literally listened to it on my journey to London last week
and on my journey back and at the gym the other day, and it was really, really interesting. So it I'd
definitely recommend it. I think it's called Believe in Magic, but it's basically about how they set up this
charity and got lots of, um, traction from celebrities when in fact this, uh, little girl or teenager when she
was actually, uh, not ill, she had they had fabricated illness, disease or syndrome. Sorry. Oh my God.
Mhm. Yeah. Okay. That's that is, that's quite a good one. Okay. Great. If you could only eat one meal for
the rest of your life what would it be. Probably, yeah. Um. I love sea bass, sea bass and, like, oily fish on
my favorite foods. So it has to be something like, maybe like a sea bass risotto or some sort of, like
seafood. Uh, or like fish pasta, probably. Oh, I love a seafood linguine, actually. That's good. Okay.
Beach or mountain? Mountain rice. Favorite workday beverage? Okay. Um, I drink a lot of squash. I'm
not gonna lie. I don't really like tap water, so I do drink a lot of, um, like, oh, squash like a child. So,
yeah, I do love a peach squash. Actually, I do love a peach squash from time to time. So I agree with you
there. Yeah. Uh, lastly, what's your go to hype song for the gym? Um, Kendrick Lamar. Um, anything?
Kendrick Lamar. Nice. Great. Okay, great. That's your hot seat. Done. So that's. That's no side done. So
let's get more into the professional. Let's get into it now. So, uh, over to you. What you do. Why you do it
in a nutshell. Okay, so I am a women's health physiotherapist, um, which is basically a physiotherapist
that looks after anything to do with like gynecological or obstetric or pelvic health and in women. So we
mostly treat things like incontinence and prolapse, pelvic pain, pregnancy related musculoskeletal things.
Um, then we do do things with like endometriosis, um, and other pelvic pain conditions. So I work
Monday to Friday in the NHS doing that. Then I also run a small women's health consultancy where I
help small businesses to understand women's health related conditions and how they can implement
strategies to support women with those conditions. Whether it is like a coaching business, like a fitness
coaching business or a small business, how they can support women's health within their business. So I
would just, um, talk about exercise, uh, stress management strategies, nutrition strategies, because I'm
also a nutritionist and how that can help to support women in, uh, coaching businesses or workplaces.
Amazing. That's a lot. But so, so important which we're going to discuss today the the work that you do. I
think every topic that we'll talk about today is going to be big, but let's kick off with the menstrual cycle
because I feel like there's obviously many rabbit holes. But uh, specifically, how can your cycle influence
how you work negatively and positively? So I think the problem with the online space is if you read
things, you will expect that you should feel a certain way at different times of your cycle. For instance,
you should feel very energetic and productive around your follicular phase, and then when you are
ovulating and then in your luteal phase, you might feel unproductive and not be able to do as much work.
These are all really broad brush stroke claims, and we don't have any scientific data to back that up. So I
think what we have to be really mindful of is, yes, there may be trends where women will feel certain
things at different times of their cycle, but we cannot predict that as a guideline. There's no evidence to
back that up. Some women will have very extreme symptoms from their menstrual cycle, some will have
none at all. And so we can't ever give a broad brush stroke claim to say, or a guideline that you should
feel like this on X day and this will impact your work because of X. It just doesn't work like that. It's far
more nuanced. There's not a lot of research and each woman is very individual. So myself compared to
you will be completely different. But also my cycle this month compared to my cycle last month will be
completely different. And so it's very difficult to kind of give these sort of fixed things around how you
should feel around your menstrual cycle, because a we don't have the data be even if we had the data, it
would probably come back in a complete mix and melee of different results because we are so individual.
Plus the fact that our cycle is, is, um, influenced, I would say by many different things in our lives,
especially things like our, um, stress, uh, and our lifestyle. So potentially our diet can affect it. Our
exercise levels can definitely affect it positively and negatively, and also the amount of stress we have in
our lives, our sleep. All of these things can cause issues with our menstrual cycle, and thus it's very
difficult for us to say we should all feel like X on X day because women are completely unique. And as I
said from their different cycles, month to month are completely unique. Yeah. Totally agree. And the I
mean I see it obviously more with nutrition just because that's the field that I'm in. But there's a lot of
things like you should eat this during luteal phase and eat this during follicular phase. And sure, there are
some foods that can potentially help with bloating or the argument that suggests that you need to eat
differently in in each phase of your cycle. You know, we're forgetting the main thing that your diet
throughout the entire month influences the cycle. It's not a case of what you eat. Neutral phase will make
you feel better, and luteal phase. It's a case of you need to be looking at the entire month, not just
splitting it up per phase. Right. And definitely and I think that that's the issue. It's you know, it's actually
your in you have to zoom out and look at your entire lifestyle instead of looking at things even on a
month by month basis, you know, zooming out and looking at everything over like a good six year period
or six months to a year period to see what what is going on is, is better than kind of zoning in on a few
days of that month and trying to manipulate things. We do know that there are very slight changes in
metabolism, and I think this is something that comes up a lot in the online space. I see a lot of coaches
say things like, oh, when you are, when you have PMS or you're in your luteal phase, you burn 200 more
calories, um, than you did because your body temperature is slightly, slightly raised. If we look at the
actual hard data, it's about 30 to 100 calories for most women, and actually, you can't really know how
much extra you burn as an individual. So I think, again, we have to be really mindful of what we put out
there. We do know that perhaps some women are a little bit more insulin resistant in their luteal phase,
but we're really stepping into like minutia here. Most people aren't eating enough fruit and vegetables.
Most people aren't eating enough protein. Most people don't get enough sleep. Most people don't drink
enough water. Most people don't manage their stress very well. So then coming along and being like, let's
manipulate your macronutrients slightly and you're new to your phase is just such a waste of time
because most of us don't do enough of the right things and myself included. You know, I don't probably I
probably could eat a lot more variety of plants and probably could get a lot better sleep. So, you know,
we often we often look at the really sexy things like, let's manipulate this really sexy little tiny thing at
the top when we're not doing the fundamentals at the bottom, managing our stress, sleeping well, eating
well, exercising regularly, but not exercising too much. And I think it's it's just not sexy to give someone
really generic lifestyle advice. But that's what most people need. I'm so glad you said that, because, yeah,
I think it's the world of trends, right? We live in a world of trends, and so things do look more appealing
and sexy to do, and especially with hormone balancing, etc., etc. you know, people just zoom in on those
things and like you said, like not enough protein, not enough vegetables, not enough calories, just in
general. That's the main problem that I see in the women that I work with. You know, they're expending
a lot of energy, not just through exercise, but through the sheer stress that they're under and they're eating
so few calories for what their body actually needs, which, again, can influence the cycle in a big way.
And so I think, yeah, getting back down to those basics, it's not even like the basics of sexy. It's just the
basics of the basics for a reason, just most of those before you start to add things on. And even when you
do add things on, make sure that it's not from a random person on Instagram, Tik Tok, whatever. Go and
see a specialist. Go and do your own. Research your own knowledge and education. Because only then I
think you can feel truly empowered enough to make those changes that will actually work on top of the
basics that you've started. Now, I would say let's move on to actually, no, I do actually want to cover
because you mentioned stress. And obviously as a business owner, um, stress is just a natural, um,
element in your life. When you say stress affects the menstrual cycle, what do you mean by that? How?
How are our cycles being influenced by the stress that we are under? So if we think about things like
hypothalamic amenorrhea, which is where you lose your menstrual cycle, I think we talk about that a lot
in terms of chronic dieting and excessive exercise. So we know that people who are really nutrient
deficient or not eating enough or really under fueled are at risk of losing their cycle, as do we often talk
about the fact that people who massively over exercise are at risk of losing their cycle. Well, we don't
talk about a lot is the third factor that can be stressed. So really high chronic stress can lead to
irregularities and potentially hypothalamic amenorrhea, which is loss of your menstrual cycle for three
months or more. So what we know is that stress can really have a big influence on our menstrual cycle,
enough to make it irregular and even stop it, because it's our body's way of protecting us. It's our body
saying to us, you are not healthy enough to have a pregnancy right now. So I am going to block the
signals from your brain that stimulate the hormones from your pituitary gland to make you have a normal
cycle. So women don't ovulate and thus they don't have a menstrual cycle. And I think we as I said, we
often focus on excessive exercise and under fueling. But stress is another factor as well. A lot of women
who are going through periods of acute stress in their life, whether that's grief, whether that's, I don't
know, um, a divorce, whether that's whatever, running a business, they are at risk of losing their
menstrual cycle if they aren't managing stress effectively, because our body is basically saying you're not
healthy enough to have a pregnancy. So we're going to stop you from having a period. So, you know, I'm
always, I think stress management is a challenging thing to think about, especially when you run your
own business. Like I run my own business. It is stressful, right? But I think you have to find ways that
suit you. We're all so different. Um, I think the online space often really glamorizes exercise as a means
of, of, um, stress management. And actually, you know, exercise isn't an emotional crutch for your stress
management. In fact, you know, putting time into things that are like restful, um, or spending time with
the people that you love fostering good relationships, you know, self-care isn't just like bubble baths and
face masks. It's like really looking after yourself. Maybe hiring someone into your business to help you
out, taking some of the strain off yourself. You know, it's potentially spending time with people that
make you feel good and make you actually step away from your business. I think we often think, oh,
stress management is always exercise. And actually that isn't an emotional quote. I'm not saying exercise
isn't good, but also too much of it, as your only mechanism of managing stress is potentially problematic
as well, especially if you're verging on irregular cycles and hypothalamic amenorrhea. But also, you
know, I think about, I think finding things that you find make you feel calm and fill your cup back up is
really important and that can look different for everyone. Like for me, like I started taking Spanish
lessons. Like I don't need to take Spanish lessons, right? It's nothing to do with my life, but it's actually
been a really good thing for me to do something that is nothing to do with my business, nothing to do
with women's health, nothing to do with exercise. Because that is the three things that I do all the time,
you know? So I think having something that's completely separate, that the only reason you're doing it. Is
to reduce your stress or do something that is mindful and away from that is really important because we
weren't taught to deal with stress, right? Not in the most effective way. So I think naturally people tend to
be very reactive when it comes to stress, and they're almost more like coping mechanisms rather than
actual things that you do to stay healthy, to make you feel good. It's more like a stress management tactic
or I see this quite a lot with I mean, obviously I see it a lot with binge eating and comfort. Yeah, people
just naturally gravitate towards that as a way to manage their stress. But I also see it in, like you say,
women over exercising because they're doing like spin. They're doing Pilates, yoga here. I used to be one
of those people. I used to work out 4 or 5 times a week, and I really didn't need to. And actually it will
touch on this later. But that's how I got the the pelvic floor issues that I have now is because I was over
exercising way too much, on top of the fact that I was super stressed, on top of the fact that then I was
drinking a lot of wine to, again, reactive to the stress that I was under. So I feel like we get into our own
bubble. We think that we're dealing with it, but actually we're not. And I think that's great advice to do
something actively, not reactively. That is entirely different and away from what you do day to day, like
a real hobby. We don't really do hobbies anymore, but, um, but, you know, getting back into like,
painting or drawing or like outdoor sports, team sports. And I think that's so important to do rather than
just, oh, I'm going to do a spin class three times a week because I'm stressed out. I totally agree, and I
think, I think one thing that made me realize that my identity was so attached to those things was when
people ask me what my hobbies are, I'm like running and weightlifting. Well, yeah, they are my hobbies,
but right. But like actually is, you know, I do those to look after myself as well. Is there anything that I
actually do that is purely a hobby that isn't like, you know, some long term benefit to my to my health,
you know, and I think that's a really nice thing to do, actually doing something that has nothing to do
with anything else and just is on its own. If you, you know, you don't have to do it at all to look after
yourself. It's just part of something that you find really interesting or you really enjoy. Okay, great. So
now let's dig further into menstrual cycle disruption like PCOS, endometriosis and PMDD. Because
when it comes to working and, you know, to use that word hustling hard, these can really throw a painful
and disruptive spanner in the works. What common working habits and behaviors can exacerbate the
symptoms of these conditions. I mean, we mentioned stress, but are there any more? And on the flip side,
what's your advice for dealing with those difficult times throughout the month if they still need to show
up and get their work done? Because essentially, if you're a business owner, you know, it is hard to take
time away from your business when you've got so much going on. So what's your advice around this?
Um, if I start with endometriosis, the first thing I would say with endometriosis is, you know, stress can
heighten symptoms of all three things. But you know, this particularly around menstrual cycle symptoms,
stress can heighten like dysmorphia, which is like painful periods. Um, and I would say that the biggest
thing to try to manage when it comes to, um, endometriosis would be your management of pain, which
can be extremely challenging. You know, if you're in crippling pain, work can be severely affected by
that. And if you're trying to run a business and that's really, really challenging, what we teach a lot within
women's health, physio is like different. Pain management strategies with endometriosis. So I would say
if you know that you are having a really bad flare up, having tools in your toolkit that help you to manage
pain can be really important. We do. We do a lot of different things from like breathwork for to pelvic
floor structures to even like, um, we use things like, uh, pelvic floor wands or dilating as if women have,
like symptoms of vaginismus. But I think having those tools in your toolkit and that can be really helpful.
Um, that would be a way to kind of address pain management. And if we can get pain, you know, I'm not
saying that those things are going to erase pain, but they tend to make women able to be able to more
manage their symptoms. What we also know is that women with things like endo are far more likely to
have symptoms of like interstitial cystitis. We used to call it that. Now we call it painful bladder
syndrome. So frequently going to the toilet, going to the toilet and doing very small voids and having
pain when they go for a wee, uh, getting up frequently in the night, having a very irritable bladder. So
that can obviously cause problems with your work if you're constantly having to get up to go to the toilet,
especially if you're on meetings or on calls or whatever you do as a job. So managing bladder habits can
be a really big thing that we do within physiotherapy. So stopping just in case. Wees. Um, teaching
women to like do bladder retraining. So they're going to the toilet less frequently. Um, thinking about
reducing irritants, things like caffeine, alcohol, um, spicy foods, citrus, tomatoes, all of these things can
really irritate the bladder. So sometimes reducing those can be a bit of a low hanging fruit. For managing
bladder symptoms. Women who have endometriosis are three times more likely to have IBS, and so
thinking about different foods that are potentially irritants for you. If you do feel that you have IBS like
symptoms, what we do know is one of the best ways to manage IBS always comes back to meditation,
and I kind of feel like that gets a bit of an eye roll from some of my patients, like, oh, you're just telling
me to meditate. But actually there's so much data that supports like breathwork and meditation for pain
management and IBS management. So you know, it is scientifically supported. It's not me just being all
sandals and candles and wafting sage at you like that really does help. Um, so that might be something to
think about, to allow you to be able to get on with your day. Because especially if your bowel movements
are challenging, that can have a bit of an upset. And then we with endometriosis, we as physiotherapists
work a lot with sexual function. And you might not think, well that's not related to my work, but sexual
function is. Closely related to your relationships and when your relationships are in a good place, most
people tend to feel better and they are more productive and they work better. And they're not thinking
about, you know, problems at home when they're trying to manage their business. And so we as I said
before, we use a lot of different down training techniques to get the pelvic floor to relax, because that
tension in the pelvic floor from chronic endometriosis can cause a lot of like coccyx pain, which can be
problematic for sex, but also problematic for sitting all day. So there's loads that we can kind of do with
endometriosis. Um, if I talk about PMDD. So PMDD. There's not a lot of research. And I've recently
written a webinar about this for the coaches that I work with. Um, there's not tons of research around this,
and it's relatively, relatively new with regards to what we should be advising. And I've looked into the
nutrition management. If I'm honest, every time I look into the nutrition management of women's health
condition, regardless of whether it's your menstrual cycle, perimenopause, PCOS, endometriosis, PMDD,
it always comes back to the Mediterranean diet. Like, I literally just think if every woman started to eat a
more Mediterranean style diet, which we don't in the West End, like the UK specifically, we looked at
eating more wholegrain, more variety of fruits and veg, more oily fish, more, um, like, uh, olive oil. Um,
these sort of things can be really helpful for managing any sort of women's health conditions. So that is
one thing that comes up with PMDD. I don't know why there's balloons there. Um, I don't know why we
go. That's obviously. Yeah. About, um. So I would definitely say, like, thinking about that from a
management perspective. Again, with PMDD, a lot of things come back to like good sleep hygiene as
well. So sleep hygiene is not just about, you know, going to bed on time. Sleep hygiene really starts like
when you wake up in the morning, like instead of grabbing your phone straight away looking at sunlight
instead. So getting your phone out of your bedroom like you do not need your mobile phone in your
bedroom. If you say, oh, my alarm is on my phone, you can buy it. If you've got an iPhone, you can buy a
£5 alarm off Amazon. You do not need your phone in your room like it's just. Unless you are caring for
someone that needs to contact you potentially at night, I would say get your phone at your room. Other
things I would say is things like making sure your room is dark, wearing earplugs, um, potentially, um,
making sure it's cool, having a warm shower before bed so that your core temperature cools down
because your peripheries are warmer, so the blood flow changes. Um, these can all be really, really not
looking at your phone an hour before you go to bed. Not looking at screens an hour before you go to bed
can really help with sleep hygiene. And I think that has a massive impact for PMDD. Um. And then
when it comes to PCOS, I often get PCOS women to really think about the carbohydrates that they're
eating, like keeping good quality carbohydrates in your diet as a woman is going to give you energy and
you need that. And actually, you know, potentially what I will often say is like, uh, bunching your
carbohydrates around training or around a potential big task that you have to do at work. So say you had
to write a big proposal having high quality like, uh, low GI carbohydrates before, like so I'm talking like
whole grains, fruits and veg and then thinking about the fact that that's going to give you energy to do a
task or go and do some exercise can be really helpful. Um, then I think, you know, exercise is going to
help with all of those things. But what I would say, particularly with our endometriosis and our PMDD, I
am, you know, not blasé to the fact that it can be particularly challenging to want to exercise if you are
really crippled with your endometriosis symptoms, or your PMDD is so challenging that you don't even
want to get out of bed. I appreciate that those are really difficult things to deal with, but what you have to
think is that it doesn't have to be an hour in the gym. It can be five minutes of stretching at home, it can
be five minutes of walking around the block. I think we can be so dichotomous and we think if I'm not
doing X, then it's not worth doing Y, and that's really problematic. The thing I would say with PMDD is
if it is really severe, you need to go to your GP like, you know, there's no shame in having some help
with some, um, antidepressants. And in fact, you can cycle antidepressants with PMDD, so you can take
it for the two weeks of your luteal phase. You don't have to constantly be on an SSRI or any sort of
antidepressant. So I would definitely, if you are feeling like so low, like, what is the point in life, you
know, this sort of feeling that there's no amount of Mediterranean diet that's going to help you. You
really need to seek medical advice and I never want people to think that, you know, lifestyle doesn't
come alongside medicine because it does. Medicine has its place. And as much as Instagram gurus would
like you to think that they can fix everything, they can't, medicine is there for a reason and it's there to
support you. If you know your lifestyle factors are only going so far and you need more help. I love all of
that. What about the knowledge I. I love that there are clearly. Many options to to try out because I think,
like I do know some women who have gone to the GP and especially with symptoms of endo for
example, and not being turned away, but being dismissed with, you know, it's in your head, this is
normal. And so I think it's it's important to recognise that, you know, yes, it's a bit of a battle to get there,
but there are people that can help you. There are definitely options that are beyond, you know, whatever
extremes you're thinking of or thinking that it's you're powerless against it and you're helpless. Because I
think that's easy to feel when you feel as you do, the symptoms can, you know, as we know, it can be
really debilitating. So I mean, there's so many options that that, um, that you've just highlighted there that
you can try. Um, let's move on to something that you speak very passionately about, which is menopause
and perimenopause, because many women are leaving the workplace and even shutting down or zoning
down their businesses due to the symptoms of these. I also see many women who are in their late 30s
confusing perimenopause with menopause and panicking. So can you explain the two and why are
women finding the symptoms so harsh? Um, that they, you know, what do we need to do to ensure that
this stops happening so that they're taking the extreme workplace? Okay. Um, so perimenopause is the
gradual slowing down of your ovaries over time. So what will start to happen is the way a slow decline of
the production of estrogen from your ovaries, but that does doesn't switch off overnight. That will
gradually decline over a period of time. Now, from about 35 we can see declines in estrogen. Um, but
perimenopause generally doesn't happen for most women and for about 44 to 54 is that kind of
perimenopause range. There's a lot of like specific numbers online, and I think we have to be mindful
that it's more of a range. And again, there's no like fixed number. Now that as I said, your ovaries don't
just stop producing oestrogen overnight. But it's the gradual slowing down of your ovaries over a period
of time. And oestrogen is getting lower within your body. Now, what that means is you might start to
have irregular cycles, so you might start to have a 38 day cycle, or you might start to have a really short
cycle, or you might have a lot of really heavy bleeding. It's that irregularity of your cycle that is a bit of a
giveaway. And that's what we're tracking to say that you have gone through to menopause. Menopause is
one day in a woman's life when she has consecutively for 12 months had no period. So perimenopause is
a gradual slowing down. Menopause is one day in a woman's life where she's had no period for 12
months, and any time after that is post menopause. That doesn't mean you won't have symptoms after that
time. Women can have symptoms post menopause as well, right? Symptoms are for perimenopause are
massive. Like I could literally be here for 20 minutes explaining them all. But if you think about the fact
that oestrogen has an effect on every cell within your body as a woman, then you can think of the fact
that everything, every function, every part of your body can be affected by perimenopause or this or this
slowing down of oestrogen over time. I think some of the. Obvious ones are like nights a hot splashes.
That's such an obvious one, right? Um, but I think some of the most challenging ones that I see with
women in clinic are insomnia, brain fog, vaginal atrophy. So this is where oestrogen has a plumping
effect to our genitals. So it has a plumping effect in the vagina. When estrogen is depleted we start to get
things like vaginal dryness. When we have vaginal dryness, um, and a lack of reduced muscle, the
vaginal walls get thinner. Women are more likely to have thrush, UTIs, pro lapses, incontinence and I
think that's a really big one. Um, the other one that I see massively within my clinics, obviously is a
physiotherapist is joint pain. I always think one of the telltale signs I'll see of a woman who is in
perimenopause, but doesn't really know what's going on with her, is hand pain. Hand and foot pain, like
joints start to get achy and stiff and painful. And then there'll be some brain fog. There'll be a few maybe,
you know, a bit of anxiety. Most women get brushed away from the GPS, sometimes with anxiety and
when actually they're perimenopause symptoms. But as I said, you know, I could sit here and list all the
symptoms of perimenopause, but there are so many. Just know that oestrogen affects every cell in your
body. Thus, when you don't have oestrogen, your every cell in your body can be affected by that change.
Yeah, that makes sense. Yeah, and it is a big change. I guess that's why we see women. They do leave the
workforce earlier because these symptoms do kind of come out of nowhere. They can be quite severe, I
suppose the ones that you've mentioned, and especially if you're quite high up in your career, if you do
own your own business, that is a lot to take on when you're dealing with all of these things as well. Mhm.
Oh yeah. Definitely. I think I went to a business conference last with the week before last and there was
an amazing speaker and she was talking about this trend that she saw with women at the peak of their
career, leaving the workforce at that time, because it takes you a long time to establish your career. And
most women are at the peak of their career when these symptoms start. Right. And then what we when
she was really talking, she talks about all the other factors that I'd never really considered. Right. When
you're at the peak of your career, you've worked really hard to get there, but sometimes that's the time
when your parents might be ill and you have more caring responsibilities. Maybe your children are being
a bit more difficult because they're now teenagers, and you're thinking about that as well. Um, maybe
you're having all these perimenopause symptoms. A lot of marriages can break down around that time as
well. So there's so many other factors that push women to leave the workforce that are, yes, partly
contributed to by perimenopause symptoms. But everything in our life that can happen at that time as
well can be really changeable and really challenging. Um, and I think, you know, I think again, probably
comes back to that, like stress management and how you manage stress. And, and I know that's easier
said than done if you, you know, if you're a woman at the peak of your career, you're also caring for a
sick elderly parent or got care responsibilities for them. You've got a child ferrying them from here.
They're everywhere. Your marriage is breaking down. Like, I can't imagine how stressful that is and how
much that takes. But you know, and then couple that with all the symptoms of perimenopause, it must be
extremely challenging. But I think, you know, if you do have an employer, there should be most big
companies now have like menopause policies. So having a look at menopause policies would be really,
really important. I think if you are employed, you know, if you're not and you run your own business,
then of course that's going to always heighten your challenges. But also, you know, knowing that you do
have flexibility within your business. And I think we kind of as business owners, we think if we step
away from it for two minutes, it's all going to crash and burn. And that's not the case. If you've worked in
establish your business over a long time period. You know, one of the reasons that you probably went
self-employed or set up your own business was for more flexibility and freedom when life does life. And
so I would say, I would say, you know, use that to your advantage. And, and I know that's easier said
than done, But, you know, I also think that sometimes when we have a business, we treat it like our baby
and we are scared to relinquish any control. And and again, that can be problematic because I think there
are a lot of people who are better than us at other things. You know, I might be really good at women's
health, but I'm not particularly good at, I don't know, copywriting and maybe being brave and hiring
people into your business when you're at that point in your life. And especially we're talking about
women who are well established. Right? So that that would make me think that they probably do if they
are entrepreneurs and have their own business, have the potential to be able to hire people into their
business, relinquish some control and, um, get some support from others who might be better at you than
certain things that no one wants to hear that, but other people are better than us at lots of things, right?
Yeah. Yeah, definitely. And that's what they do in all companies, right? I know that if you're an
entrepreneur and you have your own business and it's just you or maybe you and maybe a VA or
something, but if you're that big and that establishes we're talking about, then you've got to think of
yourself as a brand, as a company, and the CEOs and founders of these bigger companies, they will
obviously hire out people to do the work that they're not good at. We all have strengths and weaknesses,
and I think that's a great point to, you know, to really think about that. I think one thing that we're
confirming with everything we're talking about is that that your your menstrual cycle and menopause,
perimenopause, everything we're speaking about is your body. And so it is your life. Right. So the going
back to the conversation at the start where we were discussing, you know, following trends just isn't good
enough because you're talking about your body as you age, your longevity, your health. And that is so, so
important. And it's way more important than just following a trend. You know, you need to understand
how your body works at a fundamental basis. Yeah. And I also think if you don't put your health first,
your, your, your business or your job will will suffer. Take taking taking two weeks out of your business
to put your health first and really look after yourself is much better than carrying on, carrying on,
carrying on until you completely burn out and then think, you know you don't have sufficient health to be
able to continue. So I always, I always, always think to my myself, you know, I'm not going through
perimenopause yet, but I always think to myself if I'm like, oh, should I go on that walk? Or I've really
got to do that thing? Or maybe I'll skip the gym because I've really got to do this piece of work. I always
say to my I always think to myself, well, actually, my health is way more important than anything that I
do or with my online business, go to the gym. That's the best investment that I can make or or, you know,
cook yourself that nice meal or go to your Spanish lesson. That's the best investment that I can make in
my business, because that puts me at my peak performance. And so I would say you have to kind of
check yourself. It's so easy to get caught up in. I've just got to do all of these things. But actually, are you
giving a good product or you're giving a good service? If you're so drained and you're not motivated and
you don't feel passionate for it anymore. Yeah, exactly. I always speak to the fact that your nutrition and
your food and this is just one example. Obviously, you've mentioned exercise and mindfulness as well as
a big one. But I'll talk about nutrition as that's what I do. The the nourishment needs to sit at the
foundational level. And then you build your business on top of that. Because if you're not having that
nourishment at the foundational level, everything you build on top of that from, you know, let's say you
invest in a website designer and you get an accountant and, you know, all of this kind of stuff. Yeah,
that's great to have. And it helps you make sales and it helps you make money. You need that. But you
could go on and on and on. And that not having that nourishment foundation is going to bite you in the
ass eventually, because you're not nourishing your body well enough to deal with all of those sales that
come through, all of those clients that you have to deal with all of those times that you have to show up
for your for your business and your audience, you know. Um, okay. Great. So we've obviously covered a
lot, but the last thing that I really wanted to cover was the pelvic floor, because it's such a misunderstood
area of the body, and most women aren't aware of just how many things they're experiencing that are
actually linked to their pelvis. You've touched on a few. So incontinence which can show up, as you
know, leaking when running, for example, chronic back or hip pain, vaginismus, so much more. There
are very few experts in this area I find, despite it being so problematic for women. Can you share the
essentials that women need to know about their pelvic floor health, and how to look after it in their day to
day lives? I know it's a rabbit hole, but, you know. Yeah. Um, yeah. So your pelvic floor kind of. I think
the most things that people think are wrong with it is a strength related issue. And the pelvic floor, Yes, it
needs to be strong, but that's one of a few things that it needs to be. So we have to be mindful of just
focusing on strength because that can be problematic in of itself. A perfect floor does need to be strong in
that. It needs to be able to control the sphincters. So shut the sphincters, help support your posture. And it
also needs to have endurance as well though. So it has to work pretty much all day without you even
thinking about it to stop you leaking, um, urine or feces. So it has to have endurance too. But it also
needs to have flexibility. It has to be able to move up and down, kind of like a trampoline. We don't want
it to just be very rigid and, um, non relaxing because it needs to be able to relax for lots of things. It
needs to be able to relax to in order for you to be able to go for a week, for you to have to open your
bowels, you need to be able to relax for you to have penetrative sex. It also needs to be able to relax in
childbirth to allow a baby through the birth canal. So I think we kind of have such an overemphasis on
strength that we don't realize that it needs flexibility, too. And the final thing that it needs is coordination.
So if I cough, sneeze, laugh, jump, run, it needs to be pulled in a coordinated fashion, switch on quickly
without me even really having to think about it like a reflex. So as I said, it needs four factors really
strength, coordination, endurance, and flexibility, not just strength. And I think if you were to just go
online and look at pelvic floor, you might end up in a bit of a problematic place because all you would be
focusing on the strength of your pelvic floor and you can, like any muscle in the body, overtrain your
pelvic floor. So I think there's kind of a spectrum of disorders and problems. And so one of the biggest
things that we see as women's health physios is incontinence. And there's different types of incontinence.
So there's stress incontinence which is where there's any increase in intra abdominal pressure which can
lead to leaking. So that would be your coughing or sneezing, your laughing, your running, your jumping.
And I'd say that's probably one of the most common forms of the most common form of incontinence.
The next is urging incontinence. And that is the sudden urge to need to go to the toilet, which you should
be able to control for about 15 minutes because your pelvic floor should have that endurance. But if it
doesn't, then you may leak on the way to the toilet or even before you get there. And then we have things
like overactive bladder. And this is where women will have a very irritable bladder, and they'll go to the
toilet extremely frequently, maybe every half an hour or so, or getting up frequently at night. And
sometimes this can be as a result of bladder irritability or something like painful bladder syndrome or
interstitial cystitis, but also can have an overlap with like a non relaxing pelvic floor as well. Then we
kind of have our like vaginal sort of issues. And that might be like a prolapse or a prolapse is where one
of the pelvic organs falls into the vagina and causes a heaviness or a dragging sensation, and this could
be as a result of a strength related issue. Or again, it can sometimes come from like an overactivity of the
pelvic floor, which leads to like a pushing down of one of those organs. And then we have like our bowel
symptoms, which may be, um, kind of a stress, um, uh, feces incontinence. So that might come from, um,
strength related issues around the sphincter of the bow. And so they, they would probably be our most
common pelvic floor dysfunctions. But then, as you said, we do have symptoms of non relaxing pelvic
floor is what we now call it. And that can kind of be on a spectrum as well. So some women might have
problems with having penetrative sex or have dyspareunia, which is painful sex because their pelvic floor
won't relax. But then we can even get women who have something called vaginismus, which is where
they can't have any sort of penetration, whether that be a finger, a tampon, um, a penis. They can't have
penis in vagina sex because basically the muscles just of the vagina kind of clamp down and don't let
anything enter. And that can cause a lot of problems in relationships. And so in that scenario, we have to
work on down training the pelvic floor, getting it to relax. Um, and so I think if you are worried that you
have any of those symptoms, which all of them can have a bit of an overlap, it is best to either virtually
speak to a women's health physio or, um, go and see one face to face. We don't always need to see people
face to face, and we can ask enough questions to kind of come to a conclusion of what we think might be
the problem when it comes to pelvic floor. But I think if you were just to ignore it or go on to Google,
you might end up doing the wrong thing for your pelvic floor when because it might not be the problem
that you are experiencing. So I think the biggest thing to remember with pelvic floor is it isn't just the a
question of it not being strong, and kegels or pelvic floor exercises definitely aren't going to work for
everyone. And there's lots of other things that we can do. And so I would say it's best to talk to someone
with knowledge. And I know you said expert, I just would call myself a specialist because I feel like
there's so many people with so much more knowledge than myself. Um, but I think, yeah, I think there
are, there's, um, quite a lot of pelvic health physios now. And I think if you are concerned that you have
any of those related issues, my advice would be look on the top, which is the pelvic obstetric,
gynaecological Physiotherapy Society. And they have a register of everyone that is affiliated or a
member of them. So that would be a good place to start if you are looking for that kind of physiotherapy
input. Oh, that's such great advice. I personally just feel very passionate about this area because I have a
problematic pelvic floor even before pregnancy, and my symptom was chronic back pain. And it wasn't
until I actually found a specialist that, you know, made me realize that's a pelvic floor. My particular
issue was a pelvic floor issue and overtrained pelvic floor, as you as you mentioned. And I genuinely
dread to think what would have happened if I'd just gone down the rabbit hole of Kegels, because it
would have my pelvic floor was already so overtrained. Like from what? And from a lot of stress and
anxiety. So it was just constantly like tensing up and as you say, like not given that time to relax. So, you
know, if I'd have gone down the Kegels rabbit hole and followed all of that advice without seeing a
specialist, then I probably would end up in a worse position than I was. Um, yeah. So that's such great
advice, so important. And again, you know, the internet, social media, we've just got to be aware of the
information that we're consuming. Right. And yeah. Um, find the truth. Um, yeah. Perfect. So great. So
to wrap things up, I've just got one last question before we can go through where people can find you. So
last question, what are three things the listeners can do from tomorrow to start improving the health of
their menstrual cycle? The menstrual cycle, I would say. Um, managing stress. Well, having outlets that
allow you to manage stress, I think we always just jump to supplements and nutrition and and exercise.
And of course, those things are really, really helpful in a lot of cases. But I think one of the biggest things
is looking after your mental health and your stress. So I think thinking of things that are completely
mindful for you and take you away from your business, or what you are doing can be really helpful for
your, um, menstrual cycle. We know that one of the big things that we see with changes in menstrual
cycle is, you know, under eating, over exercising. But I think the one that doesn't get looked at enough is
stress. And I think as this is about business owners, I would definitely recommend finding outlets to
manage your stress, which can help with your menstrual health. Most definitely. Um, the second thing I
would say is stop following trends when it comes to menstrual health. You know, cycle thinking, um,
changing your nutrition through different stages of your cycle and start looking at your own cycle and
being an expert in your own body. What my cycle is like compared to yours or compared to the listener's
is completely different. So taking advice on what works for my cycle is pretty superfluous and useless,
and keeping data on your own cycle is a much better way of looking after your menstrual health. Most
definitely. Um, and the the third thing I would say when it comes to menstrual health is really before you
start looking at the really small things that you can change. Be honest with yourself about the big things.
Are you really getting enough sleep? Are you really having a mediterranean leaning diet and eating
enough fiber and eating enough micronutrients? Are you really exercising sufficiently? Are you
undertrained? Are you overtrained looking at that and then also looking at if you're getting enough
nutrients in? More than anything, I would say I think most women are under fueled. That doesn't mean
that they're not eating enough calories. I just think sometimes people aren't eating a knife at the right
stuff. So before you think about individualizing or changing anything to try and help your cycle, like
supplementation or individualizing your training to your cycle, look at the big rocks first because they are
the fundamentals to menstrual health in my opinion. Amazing. Perfect advice. Awesome. Okay, finally,
where can people find you? How can they learn from you? Um, so I have, um, my Instagram account,
which is Chloe Stevens physio Stevens with a V. Um, and if you are just looking for general women's
health advice, I would definitely look there. If you are a business owner, small business owner, and you
have women in your business, or you are a coach or something along those lines, then I do provide like
consultancy to small businesses to help them to understand women's health conditions and how to
implement strategies which can support women within their workplace or within their business. So they
would be the main. The main ways to find me my website is Chloe Stephens Women's Health. Co.Uk. So
you can also go on my website and there's um, a contact form on there. Amazing. Thanks, Chloe. Thank
you so much for jumping on and just sharing your wealth of knowledge in this area. I think it'll be greatly
appreciated. My pleasure. Thank you for having me.