Seeing blood spots in your underwear when your period ended days ago can feel puzzling and concerning. Known as intermenstrual bleeding, spotting between periods and ovulation is not normally cause for alarm. But in some cases, it can indicate an underlying vaginal infection needs treatment.
The most common culprits of bleeding between cycles are bacterial vaginosis (BV), yeast infections, and sexually transmitted diseases like chlamydia and gonorrhea. Here’s an overview of how these infections lead to spotting:
Bacterial Vaginosis – Caused by an overgrowth of bad bacteria, BV leads to vaginal inflammation and thinning of the lining. This makes the walls more prone to bleeding. A fishy odor is a hallmark of BV.
Yeast Infections – Candida fungus irritates the vaginal tissue, causing itchiness and redness. Scratching can disrupt the sensitive lining enough to cause minor bleeding. Yeast infections produce thick, white discharge.
Chlamydia and Gonorrhea – STDs like these infect the cervix, which can become friable and bleed easily. Pain during sex is also common with chlamydia and gonorrhea.
Trichomoniasis – This STD invades the vagina, creating an environment prone to spotting and bleeding. A smelly, greenish-yellow discharge occurs with trichomoniasis.
Rising oestrogen levels approaching ovulation create an environment in the vagina that promotes the growth of bad bacteria and yeast. The hormonal changes make women more susceptible to infections during this time of the cycle.
While usually not severe, vaginal infections should always be treated properly. The first step is to test for any infections. My preferred options are at a local sexual health clinic, making sure that also include a test for BV, or I can order the Vaginal Ecologix test for you, and you can gain a comprehensive picture of your vaginal microbiome and identify specific infections.
In most cases, vaginal infection-related bleeding is short-lived once treated. But if you ever experience heavy, persistent bleeding between cycles, seek medical care promptly.
So don’t ignore sporadic spotting. It may be your body’s signalling an underlying infection needing attention. With proper treatment, you can restore healthy vaginal flora, tissue, and pH balance.
For some women, reaching the menopause can be one of life’s milestones, but when it will happen is a big unknown. Now a blood test can help predict when a woman’s last menstrual period is likely to be.
The test, called MenoCheck, can’t give a firm date, but it can tell women who are over 47 if they are likely to stop having periods within the next year. It would be most useful for those considering being sterilised or having surgery for painful or heavy periods, says Nanette Santoro at the University of Colorado Medical School in Aurora. “They may be wondering how much longer they have to put up with this.”
The average age at which menopause occurs is 51, but in most cases, it can happen any time from a person’s forties to early sixties. Periods usually become more infrequent before stopping for good. They stop because the ovaries run out of functioning eggs, which leads to lower levels of anti-Mullerian hormone – a chemical made by eggs – in blood.
Previous tests haven’t been able to measure the very low levels of anti-Mullerian hormone present in the year or two before menopause. But MenoCheck, which has been on sale for about a year, is more sensitive. To see how well it does, Santoro’s team used it on blood samples taken at yearly intervals from about 1500 women taking part in a different menopause study. Santoro is a consultant for MenoCheck’s manufacturer Ansh Labs.
The team found that those over 47 whose anti-Mullerian hormone level was below a certain cut-off had a 67 per cent chance of having their last period within the next year, and an 82 per cent chance of having it within two.
Most women wouldn’t need to take the test to know that they are nearing the menopause, says Esther Eisenberg at the US’s National Institutes of Health.
Yet without it, women can only be advised that if their periods have started to become irregular, they are likely to stop completely within four years, says Santoro.
Reversal of severe chronic acne and premenstrual symptoms including uncontrollable anger, anger and mood swings, affecting work and family relationships.
Overview
Acne is most prevalent in teenage years, and when it continues into adulthood it can cause can cause much ongoing distress. In addition to permanent scarring and disfigurement, acne has long-lasting psychosocial effects that affect quality of life.
Acne often presents in rhythm with menstrual cycles, particularly before the onset of menstruation in combination premenstrual syndrome (PMS), indicating hormonal involvement.
There are many natural approaches to consider that have been shown to be effective for helping women resolve their acne and PMS, but are not always understood by primary healthcare practitioners where topical drugs, antibiotics or the pill are the current medical treatments.
Introduction
BA was 33 years old and working as a solicitor when she came to see me saying:
She said:
“Since the age of 13 I have been suffering from what I think is cystic acne. At that age, once every 6 months or so, I would get one massive spot on my face. As the years have progressed, this has become much more frequent and appear to be more prevalent on my cheeks and jawline. Now, about 10 days before my period, massive cysts develop under my skin. Sometimes they are solid and other times they pop. It causes me severe anxiety and has had had an affect on my mood, social life and confidence.
I’ve been taking antibiotics every other month for the last 4-5 years but they’re not helping.
I also find that 7-10 days before my period I go completely bonkers – my mood, tolerance and anger levels are beyond my control. I feel out of control and unable to deal with my emotions rationally. As soon as my period starts, I have a sense of relief. This is having a negative impact on my husband and my children. I am struggling with my relationships.”
Health history
Cystic acne started a 13
She was prescribed Lymacyline (a tetracyline antibiotic), Clamidamice (an antibiotic which is given to treat serious bacterial infections), Roaccutane (a vitamin A derivative with multiple side effects), and Yazmin (a contraceptive pill). None of these were effective and her acne was getting progressively worse.
20: began a stressful career and started feeling anxiety, low patience, irritability, feeling angry, emotional and tearful. She had bouts of severe mood swings and uncontrollable anger.
Her periods were very heavy in the first 2 days and then flow was normal.
Painful periods
Ovulation was painful
She experience bloating after carbohydrates.
Nutrition history
BA’s diet was high in sugar and carbohydrates, and she frequently had sugar cravings, especially on her period.
Her nutrition was was low on protein and water
She ate dairy 2-3 times a month.
Significant test results
MARKER
LEVEL
INTERPRETATION
Vitamin D
Severe deficiency
Low immune function Oestrogen too high
Creatinine
Low
Impaired methylation and liver detoxification of oestrogen
Bilirubin
High
Impaired liver function
Ferritin
High
Inflammation
Haemoglobin
Low
Iron deficiency
HbA1c
High
Insulin resistance / pre-diabetes
Root cause analysis
Acne
Acne is mediated by high testosterone levels, stimulated by insulin resistance/spikes mediated by high sugar/starch intake, and dairy via Insulin Growth factor.
PMS
BA’s oestrogen was too high as evidenced by heavy bleeding and ovulation pain.
Excess oestrogen symptoms additionally include premenstrual anxiety, acne and mood swings.
I recommended a low carbohydrate, moderate protein, high fat nutrition plan which was rich in fish and eggs, with a high level of vegetables and beneficial fats, and personalised to BA’s requirements.
Avoidance of all cow’s dairy foods.
BA was asked to follow my 7 food rules as closely as possible.
LIFESTYLE
BA was recommended to use pumpkin seed oil as a cleanser twice a day, applying a teaspoon of the oil to her face and removing with a damp microfibre cloth. After cleansing I recommended she apply vitamin B3 serum.
SUPPLEMENTS
Vitamin D: calibrated dose of emulsified vitamin D drops
Drink 1.5 litres of water a day with additional vitamin C, sulphur and potassium.
NAC as a liver booster
Iron supplementation
Niacinamide to calm acne lesion inflammation
Minerals and vitamins: including high dose B vitamins, and zinc, selenium, molybdenum, copper, manganese, chromium and boron
Active DIM to increase oestrogen detoxification
Saw palmetto complex to reduce testosterone levels
SYMPTOM TRACKING
Symptom
Score out of 6
Initial score
Acne There are massive cysts on her face for 10 days before her period and she can still feel them after period. They are painful when sleeps and wears glasses. She won’t go out if has cysts on her face.
5
Number of cysts
6
Mood disturbance Premenstrual anger, explosive irritability and crying.
6
Results – follow-up 1 (+4 weeks)
No acne – for the first time since she was 13 (and now is 33 years old)
Irritability drastically reduced, only had a few moments of feeling annoyed
No period pain
No flooding, normal menstrual flow.
No pain with ovulation
She struggled a bit with the required nutritional changes, especially with adding vegetables to every meal, but has now made it part of her usual diet.
SYMPTOM TRACKING
Symptom
Score out of 6
Initial score
Score after 4 weeks
Acne
5
0
Number of cysts
6
0
Mood disturbance
6
2
I’m really happy with what Sandra has done for me. My skin and mood have completely transformed, to the point where I am so happy.
BA
My review
I was delighted with the quick response that BA had to the protocol, and particularly with how happy and confident she became in her life.
Acne and PMS are so incredibly responsive to focused nutritional interventions, and BA ‘s experience is a perfect example of how having the know-how to balance hormones leads to such a positive results.
Reversal of chronic and severe daily premenstrual anxiety and depression that started in childhood in a 33 year old woman.
Overview
Many women experience premenstrual anxiety and depression in a moderate or severe form. Typically these are hormonal imbalances which are driven by nutrient deficiency and/or excess, which when resolved can lead to calm, uneventful, natural cycles.
Introduction
OT was 33 years when she got in touch with me seeking help for her long-standing daily anxiety and depression, which became much worse before her period. She felt low 80% of the time and even worse in the week before her period, where she would have an emotional meltdown. She had tried all kinds of approaches to manage her low moods including counselling, anti-depressants and hormonal birth control, none of which were successful.
She said:
“I have suffered with anxiety and low grade depression for as long as I can remember although I only realised that there was a name for how I felt when I was in my late teens. Whilst at college, I hit my lowest point and had some counselling but I think i only had a few sessions. The counselling did not work for me as it felt very “standardised” rather than looking to help me work through my own personal issues. I struggled with my mental health all through university but managed to distract myself with friends and work.
Recently I made positive changes to my diet, but I still suffer with anxiety and depression. I started taking sertraline as I again hit rock bottom. I stopped taking sertraline around 8-12 months ago as I was having bad side effects including severe night sweats. My anxiety and depression is also heightened a week leading up to my period and I am now looking for a more natural way to manage my symptoms as I hate how I feel most of the time. This state of being can be so frustrating at times as I know that I am very fortunate in my life but my mood is always low.
I believe my menstrual cycle has an effect as I have a few days around the time I am ovulating where I feel “normal” or better than I usually do.”
Health history
Gynaelogical:
regular cycles every 28-29 days
severe premenstrual anxiety, irritability, crying spells, mood swings, depression and lethargy
premenstrual food cravings, fatigue, headaches and breast tenderness
periods are light
periods last 2-3 days,
feels much better once period has ended for the next 3-4 days
then mood goes back to baseline, low but functional
mood better around ovulation
vaginal dryness
Digestive:
stomach upset by greasy foods
cravings for fat and meat before her period
Nutrition history
High carbohydrate breakfast e.g. apple and cinnamon porridge with oat milk
Low on protein
Low on vegetables
Low on fat
Has 3 meals a day but they are quite small
Test results
Vitamin D deficiency
Vitamin B12 deficiency
Folate deficiency
Low iron
Omega 6 too high
Omega 3 too low
Blood sugar too high
Root cause analysis
OT’s mood was low in general, which indicates a deficiency of serotonin and dopamine, and this was confirmed by a neurotransmitter questionnaire.
Depressive, anxious syndromes can be caused by nutritional deficiencies from poor diet, including
5HTP derived from animal protein which creates serotonin
tyrosine derived from animal protein which creates dopamine.
magnesium
calcium
Additionally, it was very clear that her low mood was cyclical, improving at ovulation when oestrogen is higher, and crashing premenstrually. It was also clear that her oestrogen was too low in general and progesterone was too high premenstrually, as evidenced by
light periods
short periods – 2-3 days
breast tenderness
vaginal dryness
Factors contributing to low oestrogen in OT included
inadequate fat intake: steroid hormones such as oestrogen (and vitamin D) are made from cholesterol which is derived from dietary fat, which she could not digest and absorb
inadequate B vitamins which prevents the synthesis of oestrogen from testosterone
Protocol
NUTRITION
I recommended a low carbohydrate, moderate protein, high fat nutrition plan which was rich in fish and eggs, with a high level of vegetables and beneficial fats, and personalised to OT’s requirements.
OT was asked to follow my 7 food rules as closely as possible.
SUPPLEMENTS
Vitamin D: calibrated dose of emulsified vitamin D drops
Gynovite: a multivitamin with high doses of B vitamins targeted for low oestrogen
5HTP to increase serotonin
L-tyrosine to increase dopamine
Body balance oil to increase fat intake
LIFESTYLE
I recommended that OT purchase a Seasonal Affective Disorder lamp and expose her eyes the bright light every morning. Bright light therapy has shown to help with winter blues, regulating energy in the daytime and the sleep cycle at night.
SYMPTOM TRACKING
Symptom
Score out of 6
Initial score
Daily depression
4
Daily anxiety
4
Depression before period
6
Anxiety before period
3-4
Meat cravings before period
5
Craving for fat before period
5
Results – follow-up 1 (+4 weeks)
4 weeks later OT, for the first time, did not have the usual pre-menstrual emotional meltdown of breaking down and crying, and was feeling emotionally well during the month.
She did have 2 short depressive episodes, but said that at the same time her workload was excessively stressful.
Her anxiety had improved slightly, and she was still finding it difficult to fall asleep.
Her skin had improved a lot.
Pre-menstrual fat and meat cravings had reduced.
She was enjoying eating more vegetables and protein, she wasn’t hungry between meals and most significantly she wasn’t having any mid-morning cravings for food.
The Gynovite supplement caused digestive issues so I switched it to Optivite PMT.
SYMPTOM TRACKING
Symptom
Score out of 6
Initial score
Score after 4 weeks
Daily depression
4
2
Daily anxiety
4
3
Depression before period
6
2
Anxiety before period
3-4
3
Meat cravings before period
5
2
Craving for fat before period
5
2
Results – follow-up 2 (+8 weeks)
4 weeks later and all of OT’s symptoms had resolved.
Again she had no breakdown before her period and her day-to-day emotional life was absolutely fine.
She had a couple of anxious moments related to work stress, but that was all.
All her cravings had gone. She was still having a little anxiety before sleep and I adjusted her protocol to help with that.
She was finding it difficult to stomach the oil so I switched the oil to capsules instead.
SYMPTOM TRACKING
Symptom
Score out of 6
Initial score
Score after 4 weeks
Score after 8 weeks
Daily depression
4
2
0
Daily anxiety
4
3
1
Depression before period
6
2
0
Anxiety before period
3-4
3
0
Meat cravings before period
5
2
0
Craving for fat before period
5
2
0
OT’s review
“Within weeks of starting my supplement plan, I noticed a significant positive shift in my mental health and I am confident that this will continue going forward.
I can honestly say that with Sandra’s help, my life has changed for the better.”
I have struggled with anxiety and depression for as long as I can remember. Having tried everything from counselling, antidepressants and even Reiki, I was beginning to feel as though I would have to live with my anxiety and depression forever.
I made contact with Sandra following a recommendation from a friend and I am so glad I did. During the initial call, Sandra made me feel at ease straight away.
Within weeks of starting my supplement plan, I noticed a significant positive shift in my mental health and I am confident that this will continue going forward. I can honestly say that with Sandra’s help, my life has changed for the better.
Thank you Sandra!
My review
Despite the fact that I see significant improvements in client’s health every day in my work, it still sometimes takes my breath away when I see the power of functional medicine in action.
I always expect to see results within 4 weeks, and OT’s progress was no different. She was committed to the process right from the start and did an incredible job of following her plan.
As she said to me, and I agreed – “I wish I could have done this years ago, and I dread to think what my life would have been like if I hadn’t done this work with you”. It saddens me to think of all the women that are suffering through their cycles and not getting the help they need, and I am so pleased to have seen OT recover so quickly.
To prove the efficacy of oral vitamin B1 administration for the treatment of primary dysmenorrhoea, a randomised, double-blind, placebo-controlled study was carried out on 556 girls aged 12-21 yr, having moderate to very severe spasmodic dysmenorrhoea.
Thiamine hydrochloride (vitamin B1) was given in a dose of 100 mg orally, daily for 90 days.
The combined final results of both the ‘active treatment first’ group and the ‘placebo first’ group, after 90 days of vitamin B1 administration, were
87 per cent completely cured,
8 per cent relieved (pain almost nil to reduced)
5 per cent showed no effect whatsoever.
The results remained the same two months later as well when no drug was administered. Unlike all the current treatments which are suppression-oriented, this curative treatment directly treats the cause, is free from side effects, is inexpensive and easy to administer.
Floating around the internet in recent weeks was an announcement from Argentinian researchers who, quite by accident, found that sterile women’s health products were anything but sterile.
It turns out that cotton grown from genetically modified cotton seeds and sprayed with glyphosate (RoundUp and other herbicides) across the growth cycle, retain, and likely leach, glyphosate from the products that the cotton is spun into. It should not be a surprise that those cotton-based products retain the chemicals from which they were grown or processed, but it was. Not because the idea is far-fetched, it isn’t. Indeed, it is biologically more likely that these chemicals are retained than it is that they somehow would magically disappear post processing. What was surprising is that we never thought about this before.
When we consider that 89% of cotton crops are now genetically modified to be glyphosate tolerant, the implications of glyphosate transfer from what are considered sterile medical and hygiene products directly into the bloodstream of the users should give us pause. Heck, it should have given us pause many years ago, but it didn’t and wouldn’t yet if it were not for some accidental finding in a lab studying something else entirely. This accident speaks volumes about how thoroughly we test, or rather, do not test, many of the products we have on the market. It is precisely this lack of testing and lack of understanding that leads to the preponderance of chronic health conditions from which so many in the Western world suffer.
Glyphosate and Women’s Health
If we look at women’s health in particular, I cannot help but wondering if glyphosate leaching tampons have something to do with the increase in menstrual related problems like fibroids, endometriosis, PCOS, and others. The female vagina and cervix are remarkably efficient vehicles for drug absorption. The vaginal epithelium provides a vast surface area that is richly vascularized and highly innervated. Drugs and other chemicals absorbed via this route directly enter the bloodstream and avoid detoxification via the liver, meaning lower dosages are required to reach the same effect as an orally ingested medication. Small concentrations, therefore, could induce large effects. And small, regular exposures to glyphosate is likely what we get from tampon use.
Connecting women, science and spirit, the Gynelogic Sunday Supplement delivers a bi-monthly dose of news, views and reviews, as seen through my lady lens.
