Dear Infertility _Season 5_Ep1_Healing Your Hormones with Alisa Vitti: Audio automatically transcribed by Sonix

Dear Infertility _Season 5_Ep1_Healing Your Hormones with Alisa Vitti: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kristyn Hodgdon:
Hi, I'm Kristyn Hodgdon, an IVF mom, proud women's health advocate, and co-founder of Rescripted. Welcome to Dear (In)fertility. This season join me along with a variety of women's health experts as we explore holistic approaches to our reproductive, hormonal, sexual, mental, and overall health and wellness. From the practice of cycle syncing to the importance of pelvic floor therapy, we'll address some of the many questions women have about their bodies and share practical tips for improving your day-to-day life. Now, let's dive in and work towards ending the shame and stigma surrounding women's bodies once and for all, from first period to last period.

Kristyn Hodgdon:
Hi, everyone, and welcome back to Dear (In)fertility. My name is Kristyn, I'm your host, and I'm so excited to be kicking off this season with Alisa Vitti. Hi, Alisa.

Alisa Vitti:
Hi. So happy to be here.

Kristyn Hodgdon:
So happy to have you. Alisa Vitti is a functional nutritionist, hormone expert, and the founder of FLO Living. She is widely recognized for her expertise in women's hormonal health and is the creator of the cycle-syncing method. Through her books, Women Code and In the Flo, her online programs and speaking engagements, Alisa empowers women to understand and optimize their hormonal health by aligning their lifestyle choices with their menstrual cycles. So welcome again. I'm personally thrilled to have you here, I'm fangirling a little bit because I have been following you for quite some time, and as someone with PCOS, I feel like, like the queen of helping people regulate their hormones and their cycles, just thrilled to be having this conversation.

Alisa Vitti:
I am so happy to, you know, and anywhere where women are talking about periods is where I want to be. So I'm glad to be here and helping how I can.

Kristyn Hodgdon:
Yeah. So we were chatting a little bit before we started recording, I was telling Alisa that after a long and arduous journey with IVF, I quit IVF and I'm on my own sort of holistic fertility journey, if you will. And so this season will be all about holistic approaches to fertility, with women's health experts discussing various topics. And I thought, who better to kick off the season than Alisa to just talk about where it all starts. It's like our hormones and our menstrual cycles, and it really is the fifth vital sign. And if your menstrual cycle is off, everything's off, right?

Alisa Vitti:
Yeah. At least, we look at it as if it's an important biomarker, right? It's ongoing feedback from your body throughout the month, whether that be in the form of symptoms that you may have during your luteal phase, or the color of your bleed, or how you feel during ovulation with skin and breast tenderness and libido and mood, all of these body responses that you can pay attention to as you're tracking your cycle are ways for you to stay connected to what is the status of my hormonal health today? Because it is definitely not a end of the month kind of thing. Like, did I make it at the end of the month? Is it all perfect? Your hormone and the ratios of your hormones, they're changing week over week throughout the four phases of the cycle, and each phase needs to be performing optimally so that the next phase can be interconnected. So I think we have to, first, inform us, get out of the mindset that we silo or put in the closet or only pull out of the drawer, so to speak, once in a while, how we're engaging with our hormones, engaging with our cycle, checking in on it. Hormonal health care really needs a whole makeover in terms of our perception, and it has to go from this occasional annual GYN visit or crisis management kind of perspective to everyday actions that you do to support hormone function. And that's certainly what we're all about at Flo Living and what we're working so hard to do, which is to really just make hormonal health care more accessible to women and giving them the sort of guidance and tools that they need to be able to make it very approachable and easy because it certainly can feel so overwhelming to try to even figure out where to start.

Kristyn Hodgdon:
Absolutely. It's so hard to know where to start. I think, I've been doing this for a long time and I feel like I know a lot about reproductive health and I'm very in tune with my body and I still have irregular cycles and I've been on and off birth control for the past 15 years and just in the past five years if I haven't, if I wasn't doing IVF, I was back on birth control because I had to be able to control when I got my period to start IVF again. And I'm so done with that cycle. And I think so many women are just stuck in that cycle. And if I am done having kids, I hope that's not the case, but if I am done having kids, I don't want to have to go back on birth control again just to get a normal period. I want my hormones to, it's like I'm finally ready to get to the root of the issue. And so I guess, I think I'd love to start with just what are some red flags that people can look out for when it comes to their hormonal health and their menstrual cycle?

Alisa Vitti:
First and foremost, you've got to just look at what's happening to your symptoms across the month. Are you having any PMS? If you have any PMS, that is your first red flag that your estrogen-progesterone ratio is not balanced optimally, right? The only reason why a woman has PMS is not because it's part of a biblical curse, it's not because you're destined to suffer as a woman. It comes from an imbalance ratio of estrogen to progesterone in the luteal phase, which is the 10 to 12 day phase leading up to your bleed. If you produce more estrogen and you don't break that down efficiently and you're producing insufficient levels of progesterone due to a lot of stress and micronutrient deficiency, which I'll talk about in a second, so many women are struggling with, then you have this imbalance ratio in the luteal phase, which 1,000,000% will kick off any and all stereotypical PMS symptoms. This should raise the red flag, the alarm bells. You should get real concerned about that, not just because your hormones are off today, but there was a really important study published now, probably 20 years ago called the Biocycle Study, and it really linked out for the first time that unaddressed PMS during your reproductive years increased dramatically the risk for you developing the big four diseases of inflammation postmenopausal. So that's diabetes, heart disease, cancer, and dementia. So here we are, cultural narrative perspective, joking about normalizing PMS in media, everywhere. Meanwhile, that's like your first line, like alarm saying, oh, things are not going the right way, please take action today so you can improve your health today and prevent all this inflammation in the future. And the reason why that is, is because of course, progesterone is one of those special hormones that is very anti-inflammatory in nature. And without sufficient levels of it, you start to accumulate inflammation when you're young and then of course that compounds as you get older. And this is why women with PCOS like yourself, like myself, when I was dealing with it before, you know, you're at greater risk even in your younger years for those inflammatory issues, right? And so it's just so important to take PMS seriously, I can't stress that enough. The second thing to look at, of course, is the color of your bleed. What color is it? Ten years ago this year or this season, this month, I made television history, feminist history, I was the first human being to go on national television to simulate the colors of menstrual blood, to help, to start the first ever conversation nationally about how we can use our monthly bleed as an at-home hormone test every month, right? Because it'll tell you if you're doing okay in terms of that estrogen-progesterone ratio as well. So if it's a nice fresh cranberry red color, you're good. If it's brown stained like prune juice on a napkin at the beginning or the end, that's typically indicative of low levels of progesterone. If you're trying to conceive, you're probably well aware of thisand know that it's an issue. If it's a dark and cloudy, excess estrogen, not great. And if it's light pink, insufficient estrogen also not great for your health. So it's, the color has to look the correct way as well. Then you've got to look at cycle length overall, right? Are you menstruating at a regular clip for you? There's a very, a nice deviation of what is normal. So anywhere between 27 and I would say 34 days, if you're less than 20, and again, the goal is that you are consistent every month. So if you're every 27 days like clockwork for you, great. For every 28 days, great. If you're every 29 days, it should not bounce around 27, one month, 30 for another month. It should be the same interval monthly. And you can have a slight deviation as to what that is. And then if it's sooner than every 27 days or later than every 34 days, then we're looking at other hormone issues as well. So those are like the first three big things to look at just around the cycle.

Kristyn Hodgdon:
Which I think might be eye opening for someone because it's like they never thought that the color of their menstrual blood or, we're not taught these things at a young age and.

Alisa Vitti:
No.

Kristyn Hodgdon:
You should be learning all of this in sex-ed, and, instead we're just taught pregnancy prevention.

Alisa Vitti:
Really, I think the narrative in sex-ed is that it's reinforcing a disconnect. And I remember for me, when, I don't remember so many things about childhood as clearly as a lot of people do. But I remember this crystal clear, the day we learned about menstruation I was in sixth grade and I did not know this was, I grew up with immigrant parents, so there was zero conversation. I was not, I didn't know about Judy Blume. Like even though that was, when I was growing up and those books were popular, had no exposure to the concept of menstruation until I went to school that day, and which is a remarkable thing to have had that level of innocence safeguarded. And I still appreciate that to that day because I formed all my own opinions as opposed to what I noticed in class. So there they dropped the knowledge about menstruation. Instantly, I was so excited, I mean, beyond excited. I was like, are you fucking kidding me? I get to have this thing every month. This is the best news I've ever gotten. I'm stoked and.

Kristyn Hodgdon:
Foreshadowing towards your future.

Alisa Vitti:
Well, just wait. So the same day, something else pretty, pretty funny happens. So then I looked around the room and all my friends, my girlfriends were like, you could just see how, like, upset they were. I was like, why is everybody feeling so differently than me? And I didn't, I just filed that away. But later I realized that it was because I had not been given any preconceived narrative around, oh, the curse is coming soon. I went into it and when I heard about it, I was just filled with excitement and enthusiasm and joy versus my friends who had probably already heard about it in cultural media or at home or whatever. They came into it with this sort of baggage that wasn't even necessarily theirs, but that they brought in from what they had been exposed to. So just to round out the story, later that day at recess, I grabbed my three best friends, Melissa, Katie and Kristen, and we sat on this wall on the side of the school. And I immediately formed the Period Club of which I was the president. And the Period Club had two main functions. Every day, we met at recess for the first five minutes to decide, it was an ongoing debate, of course I was right, who was going to get their period first in order? Because estrogen changes facial structure. And I could even see at that young age who was going to go through that process first. I was dead last by many years. And then the second function of the Period Club was to take regular bathroom breaks. Any time any one of us thought we might be getting it so that we could all go and help verify if in fact menstruation had happened. And it was the highlight of my sixth grade recess. And one could certainly argue that I have never stopped being the president of the Period Club.

Kristyn Hodgdon:
I would say, yes, you are the president. But that's, that's my goal as a mom of a girl and a boy, like to be open about it. And it's not a bad thing and it's a normal bodily function. And that's half the battle, is just like reducing the stigma to not you don't want to talk about it or talk about why, whether you're having an issue or whether your period might be irregular because you think like even your doctor might say, oh, no, you're fine.

Alisa Vitti:
There's all the gaslighting that goes on. But my daughter, who is eight, she and I have been having conversations about this and age and stage appropriate ways for many years now. Like most kids, she wanted to know where babies came from and when she was three and four. And and now that she's approaching those pituitary turning on years like 9, 10, 11 before menstruation begins, brain changes start to happen, much like what happens in perimenopause, starts at 35, but it takes 10 to 15 years for the brain and the pituitary gland to slowly increase FSH levels to the point where it shuts down ovulation so that it's not happening overnight. The same thing happens with puberty. It takes about the same amount of time as you start like around 9 in the brain and completes at 22. But I want her to be aware that there's going to come a time in her life where she goes from having this one biological clock, which she's aware of, that follows the sun, a circadian pattern. And we have learned about how to take care of our circadian rhythms with getting out into the sunshine every day, going to sleep at night, not exposing herself to screens, like these are things I talk to her about at 8 years old, right? Before that, I was talking to her about evaluating her poop every day, right? I want her to be looking at whatever biomarker she has available to her. So if she looks at her poop and she's a mom, it looks like dinosaur eggs. I say, okay, great, what can you do? What does that mean? I ask her questions so she can be self-directed. So she'll say, oh, it must mean I'm dehydrated. I need more water and maybe I need more vegetables. So she will say, can I have some more vegetables at dinner? And then we check the next day and we do a little check in and say, how did it come out today? It looks much better. So all of this is training her in skills so that when she starts bleeding, she will understand that it's her responsibility to be observing. As I've written about in my books, I want you to be in a sort of constant observation mode and compassionate reaction mode, right? So whatever your body is asking for, we do it with love and support. And then for everyone, I think the conversation should simply be to just be such an easy way to redo the sex-ed class is to go from thinking about menstruating or not to biological rhythm awareness, right? And this would apply across the life cycle for women. When you are a child, prepubescent, you are a single biological clock only person, you are circadian only. When you start menstruation and slightly before it starts, your infradian rhythm, the second biological clock that I wrote about for the first time in my book In the Flo, this turns on and this begins a process by which you have two of these clocks happening simultaneously. You have to care for both your circadian and your infradian clock, which is why I created the cycle syncing method and which is what is so helpful, and the missing link for women, whether they're dealing with fertility issues or PCOS or whatever it is, which we can dive into in a minute. And that's something that you must care for throughout your reproductive years. If you want to protect and enhance your fertility, protect and optimize your cycle, flow down hormonal aging as you go through perimenopause and set yourself up for postmenopausal health and well-being. And then when you are done menstruating after your last bleed, you go back to a single clock system, right? And you start caring for yourself that way. And so this is how I have positioned sex-ed so far to my daughter in the highest level of ways at age eight. So we've talked about the circadian clock, she knows about the infradian clock, have I gotten into all the nitty gritty about bleeding and cycle phases with her? Absolutely not. She's only eight, that would be too much too soon. But just so that she understands that there's this exciting thing that's going to happen to her, she's very excited about it. Someday I'm going to have the second clock turn on and I'm going to feel different things, I don't know what that's going to be like, but I'm really looking forward to it. I wanted to make sure that I could lay down a path of knowledge transference to her that would engender the same feeling of joy and enthusiasm that I had when I first heard about my cycle and I see that it is taking place for her, and I'm just so glad to be able to do that for her. And it's something that every mother can do for her children, and I think it's, we have to just do it. We can't wait for the cultural narrative to change permanently, and there's so, it's everywhere.

Kristyn Hodgdon:
I love that. I'm inspired, even for my son. We should normalize these things.

Alisa Vitti:
Yeah, of course.

Kristyn Hodgdon:
I think a lot of people want to know, myself included, how should you be caring for yourself throughout your menstrual cycle and the different phases? Because there are times where you need to be gentler with your body and times where it's okay to do that high intensity exercise. So can you explain some of the cycle syncing method to us?

Alisa Vitti:
Yeah. So when I, you know, I've been taking care of women for two decades at Flo Living and I was really excited back in 20, I want to say 2017, we started having like this mainstreaming of talking about menstruation in the media. It was like the theme of the wellness, themes of the year for a couple of years in a row, we had women who were showing themselves free bleeding on Instagram. We had a woman run the marathon in London without a tampon, and it was like historic stuff that was happening from where I sit, both as a women's health specialist and as a feminist, I was like this, is anybody noticing that this is historic level kind of stuff that's taking place? I certainly was. So I just thought, okay, great. Finally, now we're going to start to see a shift in the rates of PCOS and fibroids and endometriosis and infertility because we're getting the information out there, we're normalizing just talking about menstruation. But I wasn't seeing the rates of those conditions coming down, they were just getting worse. In fact, I think the new infertility rates for couples have gone from 1 in 10 to 1 in 8, it's just it's getting worse. And when I looked at that, I said, why is it that women are suffering so much more than men with 80% of women will have a hormonal issue in her lifetime? Let me just underscore that. Let's all like breathe and take that in. 80% of women will have a hormone issue at some point in her life. When you compare that to the male cohort, it is not even in the same galaxy of a percentage, right? So I said, why is that? I'm a systems thinker and I was like, okay, we all are exposed to the same endocrine disruptors, we're all exposed to the same sort of bad diet. What is it that we are overlooking at such a fundamental level in the female ecosystem? And that's when I started digging and I uncovered this second biological clock that no one's ever heard of called the Infradian Rhythm. And when I understood its impact on not just regulating our menstrual cycles, but on other key systems of the body, from our brain to our metabolic function to our stress response system, to our immune response system, I said, okay, we need a method to care for this rhythm, just like we now have a method to care for our circadian rhythm. We need one for this infradian rhythm. And that's when I created the cycle syncing method. And fundamentally it is where we synchronize calorie intake and food type with the phases of the cycle, where we sync workout type and intensity with the phases of the cycle and where we can also project plan to take advantage of what is happening in this infradian rhythmic way. And all of this, the goal of this is to reduce cortisol output, stabilize insulin production and blood glucose levels, optimize the breakdown of estrogen and support the production of all hormones throughout the cycle so that you can really protect these cyclical hormonal ratios that need to occur in each phase of the cycle. That's what it does for you in a very elegant way, where you don't have to titrate those levels each and every day in a maniacal kind of fashion, right? Because we women have enough to do as it is. So to understand what to do, you first just have to understand that there are four phases of the cycle follicular, ovulatory, luteal, and menstrual. And at a high level in the first half of the cycle, the follicular and the ovulatory phases, your metabolism is slower and your resting cortisol levels are lower. So as a result, you can and should eat fewer calories, because of the rising levels of estrogen we also want you to be eating lots more lightly steamed or raw fruits and vegetables so that you can help with estrogen elimination. And because of those lower resting levels of cortisol, you can also do and your, sort of, better blood sugar stability, you can also do more intense cardiovascular workouts at this time and you will not destabilize either insulin or cortisol as a result, which is important because when you do destabilize both insulin or cortisol, and/or cortisol, you end up disrupting progesterone production in the second half of the cycle. And you can also disrupt ovulation as a whole. So it's really important to dial it in correctly. Then in the second half of the cycle, metabolism speeds up. Studies show you need 279 more calories per day. Did you know? No one knew until I wrote about that in my book. And so then as a result, we encourage you to eat more calories proactively, bigger breakfasts, bigger lunches, cooked vegetables. Why? Transit time is slower in the gut, digestion is slower in the gut. So we need to make things easier to digest and so that we can absorb our nutrients better, you want to cook everything, you want to eat foods that are blood sugar-stabilizing, good macro combinations, good fats, and then also resting cortisol levels are higher. So you don't want to get up and just do it in the morning, from a workout point of view. You want to sleep a little bit longer in the mornings? Definitely. In the luteal phase, women in general need 20 minutes more sleep every day that compared to male-brain sleep recovery. Yeah, you should not be, if you're in a partnership with a man and you guys are going to get on some health kick together and you've inaccurately decided that you're going to try to get up with him at 5 a.m.. No, don't do that. Make sure it's 5:30 and he can get up by himself at 5:00. Good for his testosterone, bad for your cortisol and for your brain. Your brain is more densely networked than the male brain, more connective neural pathways. And it needs more, 20 minutes more sleep every night to go through its self-cleaning process to protect your health. And then in the luteal phase, you need a little bit more as well because of resting cortisol levels and you should not get up and do a workout first thing in the morning. If you do make sure it's not fasted. I mean, in general, you should not do it.

Kristyn Hodgdon:
That was going to be my next question because something that I've been doing wrong for a very long time is drinking my coffee, then working out, all fasted, and then eating breakfast, and as a result, like I wasn't waking up hungry and I actually was listening to a podcast you were on, I believe, and we were talking about the importance of breakfast. So can you go into that a little bit? Like, why is it so important for women to eat breakfast and be protein at breakfast and before you drink your coffee or before you work out?

Alisa Vitti:
I have so many things to say. It's like, where do I start?

Kristyn Hodgdon:
This is like the single most mind-blowing revelation to me. I'm like, oh, so I don't have to give up an entire food group. I just have to wake up and eat?

Alisa Vitti:
You have to wake up and eat, yeah. So because of the fact that we are optimized as females, our biology is optimized to extract nutrients more efficiently from our food than men. And because we have this infradian clock that changes our metabolic speed throughout the month and we have much more sensitive interplay between our hormones and ovulation, fasting during your reproductive years, especially intermittent fasting done at the extremes that, that are fantastic for men and postmenopausal women who both share a circadian only biological rhythm reality, are detrimental for women who have an active infradian rhythm and have the opposite effect. They will disrupt your ghrelin and leptin neurotransmitters, so you're going to start to wake up and all your hunger cues are going to be off. It's going to throw off your circadian clock, it's going to disrupt your infradian rhythm, it's going to disrupt ovulation, it's going to increase inflammation, like it is, can disrupt your thyroid. It will affect your cycle, it will decrease your fertility. It is not a good thing for you to do. And just from a 24 hour clock perspective, the way our blood sugar levels kind of function is what you do first thing in the morning, sets the tone for the rest of the day. So if you screw up your first am feeding, then the rest of the day you're chasing a blood sugar roller coaster of hypo and hyperglycemia because you'll be starving from a caloric point of view and a blood sugar point of view, then you're going to overeat and now you're hypoglycemic, and then you're going to crash, hypoglycemia. And women wonder, why is it that I feel anxious all day and foggy and tired, even if I'm not in the days leading up to my period, because we do not know how to eat properly. So the rule of thumb is at the very longest you would wait, which I think is too long, 90 minutes after you wake up, but really try not to push it more than an hour. If you can get up and eat a good macro breakfast for, a macro combo breakfast, some protein, some fats, some healthy carbohydrates, women also do not need to stay away from carbohydrates, whether you have PCOS or not, carbohydrates are not the enemy. Carbohydrates when done properly and in the proper spacing and quantity and type are very beneficial to keeping your blood sugar stable and giving you access to micronutrients that support progesterone production and everything else. That can look like, could look like a bowl of yogurt, goat yogurt for the A2 protein. I would, if you're going to do cow, make sure it's A2 only because any A1 dairy is going to open up the fissures in your small intestinal tract and create an autoimmune response, which is also bad from a fertility point of view. So A2 Dairy-only goat or A2 cow milk added. You can add in some whey protein to jack up the protein concentration in the yogurt, put a little bit of granola in there, measure your granola. The package says a third of a cup is a serving you better take out your little third of a cup scoop because you want to make sure that you're balancing those macros or if it's a smoothie, make it in a way that is not super glycemic impacting, so many of our smoothie recipes that I see people posting that look really good from an Instagram point of view are like sugar bombs, like the bananas and the, I don't know, too many things in the smoothies, right? So think berries that are low glycemic, think vegetables, think water, think protein, think fat, right? If you're going to do a smoothie and that would be good in the first half of the cycle, only. Then when you get to the second half of the cycle, you better get up and eat breakfast really quick, faster, 30, right away and sit down and have a couple of eggs, some sweet potatoes or some leftover chicken from dinner and some brown rice and some vegetables. Breakfast in the luteal phase should look like lunch or dinner, right? And not something like a sweet snack.

Kristyn Hodgdon:
... But I'm noticing now that I'm starting to wake up hungrier because.

Alisa Vitti:
That's a good sign. That means that your leptin and ghrelin are healing from taking better care of your circadian eating patterns. And then I would say coffee, just to talk about caffeine for a second, which I've written extensively about and am known to bring up the controversial topic because it's so important for women to know, especially from a fertility point of view. There are studies that show just having a cup of coffee a day can increase miscarriage rates in women who are trying to conceive. And if men are having more than three cups of coffee a day and their partners are trying to conceive, that also affects and increases their partner's miscarriage rates because they're drinking coffee, right? So caffeine is a drug that we have to approach it very cautiously. I've been caffeine-free now for 20 something years, and it's because, for a lot of women, actually 50% of the entire population has a variance in the cyp1a2 gene. And when you have this variation in that gene, it means that you don't metabolize caffeine quickly. You don't make the enzymes to break the caffeine down. Caffeine has a half life of anywhere from 6 to 12 hours, depending on how much of this enzyme your body makes. But if you have this gene variation, which half of the population does, you don't make any of this enzyme. And that means that the half life of caffeine now can go from 6 to 12 to 18 to 24 hours, which means you're not clearing it. And you can go on to the Mayo Clinic's website and look up caffeine toxicity, read through the list of symptoms and find yourself there. You will find, oh, gosh, these are the, this is how I feel every day. Not that you have necessarily anxiety that has no known cause. It could be that you have unidentified caffeine toxicity. And if you are actively going through a conception journey and you have had histories of miscarriages or struggles to conceive, I would actively encourage you to stop caffeine altogether, whether it's coffee, matcha, black tea, green tea. I wouldn't do any of it.

Kristyn Hodgdon:
Sign!

Alisa Vitti:
So but listen, when you have your, when you have, when you're properly taking care of your infradian rhythm from a metabolic and workout point of view, your energy levels.

Kristyn Hodgdon:
You'll wake up rested.

Alisa Vitti:
You do not, unless you're a cycle syncing currently, you don't know what you are capable of feeling like. You don't know how good you could feel, you don't know how symptom free you could be,you don't know how your period could start. You could be like, oh, whoa. It started? I didn't even feel it. You don't know how much energy you could have. It's night and day.

Kristyn Hodgdon:
Yeah, I was talking about this with someone because I have PCOS and Hashimoto's, and I was like, I don't know if the way I feel is just like my normal or if everyone's normal because I just don't know anything different. For the past couple of years at least. So speaking of that, something I want to ask is for someone like me, it's hard to even know what phase of my cycle I'm in. So for someone who might have an irregular period or some other ovulation disruption, how do you even begin on this journey? Is like, what small changes can you make to sync back up?

Alisa Vitti:
Yeah, so you cannot start cycle thinking if you don't have a cycle, right? And so that's what the first book, Woman Code, was dedicated to. The now very well loved and well tested Flo protocol, really looked at the, the first question I asked myself because I was patient zero is how do you recalibrate your endocrine function when it's not working, right? I was not ovulating, I was not menstruating. From the age of 12 to 22, I only had five bleeds, three of which were chemically induced with synthetic progesterone. It was a mess. I was over 200 pounds at five foot six, I was covered face, chest, and back in cystic acne. I was depressed, I was anxious, I could not get out of bed in the morning, I could not fall asleep at night. It was a mess and no one knew what was wrong with me. And when they finally did figure out what was wrong with me because I, while I was a student at Johns Hopkins, of course, what does a girl with all of these issues do on the weekend? Well she's in the medical library trying to figure out what could be going on. I found an article about the Stein Leventhal disease, which was the original name, of course, given by two men who discovered the disorder, was called for PCOS. And I took it to my gynecologist and said, you're right, this is what you have. We obviously did some testing. And I said, great, now what do we do? She said, there's nothing that we can do, there's no cure. It's going to get worse for the rest of your life, and you're probably never be able to have kids naturally, and all the other disease risks. But we can put you on the pill today. And then we got other medications for when these other symptoms start to happen. And this was the moment that changed my personal story and my professional life. And I just heard my body say, that's not your future. And I repeated that to her, and she was like, what do you mean? And what are you going to do? And I said, I'm going to go figure this out. And that was the basis of the Flo Protocol. And the Flo Protocol really takes us through this sequential path that is required to reboot your endocrine system as if your computer went on the Fritz, this is like the rebooting program. And so we start with blood sugar stabilization, we then move on to addressing the cortisol issue. Then in the third step, we address estrogen metabolism and the gut, which also includes taking out any and all endocrine disruptors, which are a huge problem for women who are dealing with irregular cycles and any other menstrual issue like endometriosis and fibroids and what have you. And then once your cycle comes back online, then you can begin cycle syncing to prevent any future relapses. I've been ovulating and menstruating now for the past 20 something years, right? Without a gap. And that's supposed to, supposedly not possible for someone with a PCOS diagnosis. And I was able to have my child at 37 naturally on the third try. And even if and I've worked with so many women who've had to use IVF because of some other issue, if you take care of your hormones properly, do the correct clean up work, get your cycle back, start cycle syncing and keep cycle syncing for many years, when it is your turn to make a baby and let's say you have to use ART, because it's okay if you do, you can do it once, one time and have the baby successfully as opposed to many. And you can do a mini IVF where you don't have to take, for example, women who have a regular, very healthy regular cycle where you are, you're ovulating and you can measure and test for that, you do not have to go through an IVF process where they shut off your cycle with birth control, you can opt out of that. You can do a mini IVF. You can take the least amount of stimulation medications. You can retrieve fewer eggs because that's important to know that as you go through the egg retrieval process, the more eggs you take out, the sooner you can start menopause on the other side of it. And any IVF doctor will tell you that, it's true, you should ask. And that is something that I think is important as you start to plan your IVF journey, if that's something you are going to be looking to use. Think about it like cooking, right? You can always add more salt to the pot, but it's harder to take it out, meaning you can start with a lighter approach. You can always get more aggressive with the stim, with the meds, with the prip, with the plan, right? But if you prepare your body properly, if you take six months to a year to clean up endocrine disruptors, to get off caffeine, to start using the cycle syncing method, to, to use any of the supplement. We have a dedicated supplement kit for women who have either had a history of being on birth control and are extremely micronutrient depleted, which can increase their risk for infertility issues, idiopathic infertility issues, for example, 93% of all idiopathic infertility has a vitamin D three deficiency.

Kristyn Hodgdon:
Wow.

Alisa Vitti:
93%. And guess what is depleted when you're taking birth control, among other things, right? So not to mention vitamin B6, which is important for progesterone production. Vitamin B5, which is regulates cortisol and the list goes on and on, to gut disruption. The pill, you've got to clean up from the pill and to prepare yourself for conception or an IVF cycle, the nurture kit is great for that as well, which you can access on our website. So, you know, you've got to do the right things. And then if you take the time to prepare, when you do have to use your ART, it can be more efficient, less medication can be required and you can be more successful more quickly, which of course is the goal. You don't have to avoid it. It doesn't have to be an either/or. It can be using all the tools in your arsenal so that you can just get it to the results faster.

Kristyn Hodgdon:
I love that because I'm in a place right now where I'm not like, we have two embryos left. I'm not completely discounting a transfer in the future, but I just know that my body isn't where I need it to be right now. And I get so frustrated when I think back. I was 27 years old, I came off ten years on the birth control pill, never got my cycle back, and was sent straight to a fertility doctor. Now I'm a big fan of ART, I have four-year-old twins from IVF, gave me the greatest gift in the world.

Alisa Vitti:
Nothing wrong with it.

Kristyn Hodgdon:
Nothing wrong with it, but I also think that I was maybe sent to the fertility clinic too soon. There was, there were no recommendations made for how I could actually holistically approach my cycles or, because it was, now that I think about it, very similar to you, acne, like completely broke out in acne after coming off the pill like cystic. And that was a struggle because then it never subsided because then I was just on all these fertility drugs and it was a really long and difficult journey because, I always say, I felt like I was like wearing my infertility on my face because it was like, oh, what changed?

Alisa Vitti:
You were wearing your hormonal imbalance. I've talked about this in many times. One of the places where I've shared my concerns about this is that the business of birth control documentary that Ricki Lake recently produced, where there have been no official studies done on this strategy that we have of placing 13 and 14 year old children on synthetic birth control to deal with mild PMS, cramps, acne, the things that happen as the body starts to come online with the cycle. And the only reason why these girls are having cramps and acne at 13 and 14 is because their pediatric diet has been rife with seed oils, artificial ingredients, A1 dairy, pesticides in their food and by the time, and too much sugar, and by the time they get, and gluten, by the time they get to puberty, they're already gut disrupted, endocrine disrupted. So of course, they're going to have to clean that up. And their cycle is not a curse, the symptoms are an opportunity. It's a loving phone call from your body saying, hey, people, the inputs are definitely not working. We can't do this amazing thing we want to do for you, please help. It's a call for help, but nobody's looking at it like that because of the cultural narrative and the toxic mythology around our cycles. Oh, it's the curse, this is what's to be expected, there's nothing to do. You're a victim, stay passive, take this medication and don't think about it. And don't think about it for ten years, don't think about it for 20 years when you come off and you don't get your cycle back and you want to have a baby, don't think about that either. Don't question that either, just go on more medication. And so the whole trajectory of that is not good. And by the way, it goes beyond the fertility conversation and it goes into perimenopause and menopause. And it's just that women are somehow so flawed in their functionality that they just need to be medicated throughout their life cycle. It is such, it's so laughable conceptually, because when I spent a whole chapter in In the Flo just outlining the ways in which Mother Nature or whatever it is, has designed the female physiology to be an extraordinary performer. So yes, it would have been great if you had been a young person right away understanding, hey, something's wrong with your hormones, you may have PCOS, here's what we're going to do to address your gut, your metabolism, your insulin sensitivity, your endocrine disruptive exposures, and to get your cycle back because you could have easily gotten your cycle back in your teen years and gone into your 20s with a regular ovulatory and cyclical lead.

Kristyn Hodgdon:
Yeah.

Alisa Vitti:
So that your first conception could have been natural. That's absolutely something that could have happened for you.

Kristyn Hodgdon:
Yeah, and I think that's why your work is so important and you know why I'm so passionate about what we do at Rescripted. Because women don't know what they don't know if, of course, if I could tell my 27 year old self now, I would have known the options that I had.

Alisa Vitti:
But that's what I love about what you're doing now for yourself, which is you're taking the pressure off of yourself and you're going to do the cleanup work that you could have done when you were younger. You're going to do that now. And in addition, it's gotten a little compounded, right, because you've been on a lot of medications that are micronutrient depleting. Your job is to really replenish and not to mention just the medication exposure, you, no big deal, 3D printed two small humans.

Kristyn Hodgdon:
Yes.

Alisa Vitti:
That's right. And you've been caring for them for the past four years and being sleep deprived. I'm a mother, I get, like the nutrient stores are very low and possibly contributing to the struggles that you're currently dealing with.

Kristyn Hodgdon:
Dimension stress and nervous system deregulation and all.

Alisa Vitti:
All the things, right? So you're going to a tackle that now, that's what I love about the balance supplements at Flo Living is it's really about making sure these are medical-grade therapeutically-dosed micronutrients to make sure that you can get your levels back to where your endocrine system needs just to do baseline functioning after many years of birth control, exposure, after many years of rounds of IVF, these are the things you really need to have in your system. And then as soon as you get your cycle back, you got to start cycle thinking. And if there are any endocrine disruptive things that you're still doing, if you haven't switched your makeup, go to Credo Beauty, make all the swaps. If you haven't switched your house cleaning products, go to Grove Collective or Seventh Generation or wherever you get out. And you know, no fragrances and none of this, all the things.

Kristyn Hodgdon:
I know my, somehow convinced my mother in law who loves candles to throw out all the candles.

Alisa Vitti:
No more candles. You can buy a diffuser and diffuse essential oils as long as they're organic in the house. But yeah, if you have, and even think about it for your children, right? If you have regular child care coming into the house, make sure that they're not washing their clothes and scented stuff because all that's going to transfer right into your baby's skin and that's the beginning of their endocrine disruption. So it's unfortunately a very difficult world right now for ovaries, for hormones in general, and not just for women, precocious puberty is on the rise in boys and girls. Autoimmune diseases are on the rise in children, neurological issues are on the rise. And so we know that these forever chemicals and endocrine disruptors are affecting everyone. So as a mother, you can only support what your little sphere of influence. But yeah, it's it's definitely adds to my stress levels and I'm sure everyone else is too have to be so vigilant about all these things. It shouldn't be so hard. These chemicals should just be banned. I know we were, we had our daughter in a French nursery school and I remember the moms from France were like, why are you American mom so nuts about gluten free this and organic that? And I sat them down just very lovingly and I said, listen, in your country, many of the chemicals that are allowed here are banned, you don't have to worry about it. And as you can see, it's a whole different reality. But over here, they're allowed. And yeah, we are a little nuts about it because, right, we should be vigilant on our children's behalf and our own behalf. So it's a little tough, there's a little work to do. But the good news is the payoff is absolutely a real thing that you can have. If you have PCOS, we've worked with women who've not menstruated for 19 years due to PCOS and being on and off birth control, who get their cycles back, who then go on to have children, women who have endometriosis who cannot function half the month due to the pain, no more pain. People who've had preoperative cysts on their ovaries, after three months of doing the protocol, no surgeries are needed. This is not something that is like a special thing that happens to some people, this can happen for every woman who changes her dietary inputs. Because then your endocrine system will start to change its hormonal outputs for your benefit. And that's how we get rid of symptoms. We don't get rid of symptoms by dealing with it in this whack a mole, take this gummy for that symptom, try this to deal with that issue. It's about addressing the entire functioning of your hormonal system as a whole.

Kristyn Hodgdon:
I'm realizing that I've been under-eating and overexercising for fertility at least. And I think a lot of women, just like diet culture as a whole, other rabbit hole that we could go into, just so many of us who have tried to stay slim and not gain weight, it's like we're actually depriving our body of essential nutrients and our body doesn't feel safe so that it's not menstruating. And.

Alisa Vitti:
That's right.

Kristyn Hodgdon:
But yeah, so having to let go of that a little bit is, is something I'm working on.

Alisa Vitti:
Here just so you have some perspective that you come by that honestly, women have been left out of medical fitness and nutrition research. And the extremely unscientific assumption that has been made all these decades is that, well, we're not studying women, actually, but they're just probably smaller versions of men and have slower metabolism, so whatever we find that works for the men, let's just say it should work for the women, except they have to restrict more calories and work out harder to compensate for being female. And this is the entire unscientific, extremely un, have I to add baseless foundation of the entire diet and fitness industry. And if you follow anything as a woman in your reproductive years that is not based on the cycle syncing method, then that will be at the expense of your hormonal health because you're not going to be eating enough calories in the right phase of the cycle, you're going to kick off a stress response, you're going to disrupt ovulation, menstruation, and have a whole other host of unnecessary symptoms, not to mention weight. Remember, I was obese and I lost 50 pounds without dieting at all because I learned how to work with my hormones. And then when I gained 50 pounds for my pregnancy, that came off as well, because she just balanced her hormones postpartum and you get right back to cycle syncing as soon as your cycle is back and you do the right things leading up to that. To supercharge your nutrition you don't like under eat postpartum for the first three months, you eat like an Olympic athlete postpartum for the first three months. If you do that, then the weight just comes off because that's what it's supposed to do. So we're working not, we have to work smarter. We have to, that's why the book is called In the Flo. There is a flow and a function to how your body works, and the more you align with that, the easier and better everything is and the results that you get.

Kristyn Hodgdon:
Absolutely. Women are not small men. Staci Sims, let's end on that.

Alisa Vitti:
Or as I like to say, the form of your self-care should follow the function of your biology, period.

Kristyn Hodgdon:
I love it. Well, thank you so much, Alisa. I could talk to you for hours, but I learned so much and I'm sure everyone else will too. Appreciate it. Where can everyone find you?

Alisa Vitti:
You can come to FloLiving.com if you're having any issues whatsoever. We are a hormonal health care platform to serve you with digital therapeutics and products to help you deal with these issues. You can find us on Instagram at FloLiving and @Alisa.Vitti And you can download the only official cycle syncing app at MyFloTracker.com. And the books, In the Flo and Women Code are on Amazon.

Kristyn Hodgdon:
Awesome. Thank you, Alisa.

Alisa Vitti:
Thank you.

Kristyn Hodgdon:
If this podcast means something to you, be sure to hit follow or subscribe. This helps you because you'll never miss an episode and it helps us because you'll never miss an episode. For everything you need to know about women's health and fertility, head to Rescripted.com or follow us on social at Fertility.Rescripted.

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