150. Is Your Diet Too Clean for Your Hormones to Function?

What if the way you are eating — the way that feels disciplined, clean, and healthy — is actually the reason your hormones are struggling? This is one of the most overlooked and least discussed causes of cycle disruption. Not junk food. Not poor choices. But eating patterns that are simply too restrictive to support a healthy hormonal system.

In this episode of Cycle Wisdom, Dr. Monica Minjeur walks through exactly how under-eating and very low fat diets disrupt the hormonal cascade — starting with cholesterol, moving through the hypothalamus, and ending with lost ovulation and missing periods. Through Alicia's story, a 29-year-old who ate whole foods, exercised regularly, and had not had a period in over a year, you will see how the picture of health can mask a profound hormonal crisis.

You will learn:

• Why cholesterol is the direct precursor to every sex hormone in the body — and what happens when dietary fat is too low to support production
• How the hypothalamus monitors energy availability and suppresses ovulation long before periods disappear entirely
• What nutritional restoration actually looks like — and why increasing dietary fat and calories often improves hormones without significant weight gain

If your cycles are irregular and your diet is very clean, this episode may hold the answer you have been missing. Learn more or schedule a free discovery call at radiantclinic.com

Transcript

Speaker 0:02

What if the way you are eating, the way that feels disciplined and clean and healthy, is actually the reason your hormones are struggling? Today, we're talking about one of the most overlooked and least discussed causes of cycle disruption. Not junk food, not poor dietary choices, but eating patterns that are simply too restrictive to support a healthy hormonal system. I'm Dr. Monica Minjeur, the host of Cycle Wisdom, where we help women and couples restore hormonal balance and reclaim their wellbeing through personalized healthcare grounded in clinical excellence. So let's start off with a story about a patient of mine who I'll call Alicia. Now, she came to us stating she had a very clean diet, whole foods, no processed food, very low fat, very high in vegetables and fiber. She exercised very regularly. She enjoyed running, and externally she looked like the picture of health. However, she and her mom sought out evaluation because her mom was afraid that she had stopped having her periods, and she felt like her body was failing her without reason. In fact, I remember her saying to me, "How can I be eating so healthy and exercising so well and still have my body fail?" After a year of having these irregular cycles, they decided to seek help from our clinic. Now, we started off, as always, with looking for what was going on with her cycles. Now, unfortunately, she had not had a period in over a year at this point in time, so we started off with a full lab evaluation, including her hormones and nutritional assessment. This told the clear story instantly. Her estrogen levels were so low that they were in the menopausal range. Her estrogen was 12. Typically, anything less than 25 is problematic for menopause, and Alicia was only 29. Her progesterone was barely detectable, which was aligning with what we were seeing with the fact she had not been ovulating, and she had significantly low caloric intake when we evaluated what was going on from a dietary fat intake versus the amount of exercise she was doing. Now, clinically, she was technically not underweight by her body mass index, but it was below the threshold her hormone system needed. Now, these cases can be incredibly difficult to correct because we want to restore the hormonal balance, but we also need to restore the underlying driver that is leading to this dysfunctional hormone pattern. So we started Alicia off with starting to slowly increase her dietary fat and overall caloric intake, and this is one of the most important interventions. We also discussed decreasing the intensity of her exercise, and although this was the most challenging thing for her, it was absolutely necessary for her long-term healing. And then while we were awaiting those lifestyle changes to make a difference, we helped to support her with bioidentical hormones to make sure estrogen levels stayed high enough that we weren't going to be having problems with bone density or other dysfunctions from that chronic estrogen deficiencies. It took quite a while, but her cycle finally returned after about five months, and it took another seven months to start seeing that her cycle was happening consistently and regularly Now, this is going to be a big difference from what we normally would term as hypothalamic amenorrhea. The big picture here is a, is a systemic dysfunction known as orthorexia. Orthorexia is an obsessive focus on eating correctly. Now, this exists on a spectrum, so many women who don't meet clinical criteria for this can still be eating in ways that harm their hormonal health. And part of the trouble with this is that oftentimes women will latch onto one particular theory within medical systems or within healthcare in general and think, "This is the one thing I need to do." So for example, many women were told low-fat, low-calorie diet, that is the healthiest thing you can do for heart health. However, if you take it too far, the body doesn't have what it needs in order to produce enough of your other hormones. So primary to understanding is that cholesterol is the very top of the pyramid when it comes to hormone production. It is the direct precursor to every single sex hormone in our body. Estrogen, progesterone, testosterone, DHEA, cortisol, all of it starts with cholesterol. If we don't have enough adequate dietary fat from cholesterol, the body cannot produce these hormones in sufficient quantities, and your system will bottom out. Your hypothalamus, which is in your brain, is part of what helps to regulate that hormonal function, and it is exquisitely sensitive to energy availability. So if you don't have enough calories, if you don't have enough fat, this signals scarcity, and it down regulates your body's response to reproduction. It's basically your body's way of saying, "Not enough calories, therefore not enough energy to be able to support a baby." This is distinctly different from hypothalamic amenorrhea, which we have talked about in the past, which can lead to complete loss of your cycles, but it can live on the same spectrum, and it's far more common and far less recognized. In fact, for Alicia, looking back, before her cycles stopped altogether, she started to notice that cycles were spacing out a bit more. She had lost track of knowing that ovulation was even happening, and initially she told herself, "Well, if my cycles are still regular and they're still happening, my diet isn't affecting my hormones. I must be doing something right." Unfortunately, what she didn't realize was that losing her ovulation was quietly disrupting the quality of her hormones before the periods stopped altogether. Another common myth that we oftentimes address in our clinic is that eating more is going to cause weight gain. And for many women in this pattern, increasing calories and fat intake improves hormone function without having significant weight gain. Now, in some cases, you're going to need to gain a little bit of weight in order to get those cycles back, but I would argue that even that little bit of weight gain is going to be much more healthy in the long run because having a healthy balance of estrogen long-term prevents decline of things like bone density, decline of cognitive function, decline of problems as far as menopausal symptoms like irritability and hot flashes when you're in your 20s or 30s. And so we always have to look here and balance what does it mean to be healthy, to have a healthy weight, healthy diet, healthy exercise habits, and it should never, ever, ever come at the expense of losing ovulation and your menstrual cycle altogether. So let's go back for a second to the hypothalamus. So the hypothalamus, as I mentioned, is located in our brain, and it monitors that energy availability. What it does is it helps to adjust a hormone called gonadotropin-releasing hormone, and that gonadotropin-releasing hormone is important for signaling your body to release hormones like luteinizing hormone and follicle-stimulating hormone, which are helping to improve ovulation. If you don't have enough caloric intake, it suppresses that gonadotropin-releasing hormone, which then decreases the LH and FSH signaling, which can oftentimes delay or completely make ovulation go away. This can occur without any loss of body weight. In fact, many women don't notice a change in their weight at all, but if they are not getting adequate caloric or fat intake, the hypothalamus can respond significantly to that output, not just to your weight. So this is why it's so important that we assess dietary patterns as a part of every hormonal workup we do in our practice, not just looking at the scale, your BMI, or a particular number. Again, if we look back to this, dietary fat is not the enemy. Now, we don't want people eating just high saturated fat diets all day, but on the other hand, very low fat diets directly limit the hormonal building blocks that your body needs. Again, we don't have enough dietary fat, therefore we don't have enough cholesterol, therefore the entire steroid synthesis pathway of estrogen and progesterone and testosterone and all of our adrenal hormones falls apart. So women that are eating these extremely low fat diets, even if they're considering to be nutritionally clean, oftentimes have measurably lower sex hormone levels. And so when we check these levels, they can sometimes appear to be in menopausal range The other piece that plays a role here is the cortisol and progesterone connection. Now, most people know that cortisol is one of our stress hormones, and it oftentimes will elevate in times of stress. But stress is not just a psychological event. Stress can also be from things like chronically undereating. That places additional stress on your body, which then increases cortisol. Your body can then read this caloric restriction from the elevated cortisol and say, "Hey, there's a physiologic threat that's going on here." That elevated cortisol then competes with progesterone at the receptors, and it preferentially will send pregnenolone, which is the precursor to progesterone, over towards producing more cortisol instead. So we've talked about this in the past with cortisol steal, where your body will always try and prioritize cortisol production if it's needed, which then diverts energy away from your other hormone production. The problem here is this results oftentimes in low progesterone in your luteal phase, even if ovulation is still occurring. So the same mechanism that drives these luteal phase defects in women who have high stress also operates the same if we have restrictive eating or if our eating is not matching our caloric needs based on the amount of exercise that we're doing. The most common dietary patterns we see that are associated with cycle disruption are very low-fat diets or very low-calorie approaches. Oftentimes, women will say that they're following these patterns because they're trying to have a clean diet or they're going through a detox. Other times that I've seen this cause problems are when women do an extreme elimination diet. So think about something like Whole30, or sometimes I've seen even more extreme, where they only are eating 10 foods at a time. When we see that you're removing multiple food groups all at the same time, we can be at risk for losing what's happening from a standpoint of ovulation downstream because of the impacts of not getting enough fat, cholesterol, and then hormone synthesis in general. The other piece that I find is if women are doing aggressive intermittent fasting, especially in women that have high exercise or activity levels or in women who are already struggling with insulin resistance. Intermittent fasting has good health benefits for a number of reasons, but hormone support is not one of them. We also oftentimes find that if you are following a high-fiber, high-volume diet without adequate caloric intake, we can still struggle with this. So there are a lot of diets that can appear to be clean or that look like they're good for some reason or another, but they just do not have the hormonal support, and that's where things fall apart So how do we restore this? What does nutritional restoration look like while we're working on the hormones in the background? We always focus first on ways that we can increase your dietary fat. Now, I am not advocating to go and eat seven hamburgers a day. However, we do focus on where are the good quality fats that are present that we can add that in. I'm a big fan of things like avocado, olive oil, nuts. If you can tolerate it, going to full fat dairy, animal proteins, any place that we can add in some adequate dietary fat into your diet to help get that good caloric intake so it can convert that fat to cholesterol and then help to support those hormones in the background. We also need to make sure that we're having overall good caloric balance relative to your activity level. So in some cases, we talk about just the need to increase your caloric intake. I oftentimes with my patients sit through and calculate their basal metabolic rate, which helps them to understand at a bare minimum, this is the amount of calories you need, and then if you're going to be exercising at a particular level, the caloric intake needs to increase accordingly. If we're not able to get that much calories, then we absolutely must reduce the exercise intensity until we can see a restoration of the ovulation function. As a part of this caloric intake, we also want to make sure that we're supporting adequate protein. Proteins help to support not only hormone production and liver detoxification, but they also help to support muscle building. When we have more muscles, metabolism stays more stable. We are less likely to add additional fat weight, and we are typically able to have better tolerance longer term for that exercise that you maybe wanna try and get back to. The other big issue we have here is that for many women, there is significant rules around what happens with eating. So we oftentimes will talk about the anxiety that comes when it comes to eating more foods, eating more fat, changing what your body is actually taking in. We talk about reducing the cognitive rules and the noise around eating, and oftentimes have you working with a dietician or a nutritionist alongside that medical care when the pattern is hard to break. Again, we really focus throughout this time on restoring the hormones so that we are not causing long-term risk, and ideally making sure that we have good ovulation, good menstrual cycles happening, but really focusing long-term on how do we fix these disordered eating patterns in such a way that helps you to feel confident about what you need and supports that hormonal health for the long run. So some of the most commonly asked questions we get are, "I'm not underweight." And oftentimes we see family members bringing in, you know, a daughter or a sister, and they're saying, "Look, she seems to be a normal weight. She seems really active and healthy, and she runs track and she's in great shape and she works with her trainer. Could her diet really be affecting her hormones? I think there's something else going on." And again, this is where we talk through, yes, the hormone system responds to how much energy is available, not just your body weight. And again, many women we find have a completely normal body mass index, but they may be eating in ways that signal scarcity to your hypothalamus, which then again blocks that gonadotropin-releasing hormone and thus blocks the ovulation function. This is particularly common when exercise is heavy or frequent, or in women who are maintaining a very low fat intake. The other big concern we get is, "Well, I've been eating this way for years. How much weight do I have to gain or how much changes do I have to make before I'm going to notice a difference?" And this is a very nuanced conversation, and it's very specific and unique for each individual woman. But for many women, even a couple of pounds difference on your weight can make a difference. And in many cases, we don't have to gain weight, we just have to improve the overall balance of that caloric intake to include some healthy fats in ways that sometimes you don't have to gain the weight at all. Now, depending upon how long you've been eating, this can take quite some time to make a difference. Many women can see cycle changes within even a couple of months of meaningful dietary modifications if their cycles hadn't already disappeared. However, it can take months or even years to fully restore this function, especially if you've already gotten to the point of where the periods just aren't happening altogether Another common question we get is, "Well, I've tried eating more before and it didn't help. W- maybe there's something else going on." And unfortunately, that is the reality in some cases. Sometimes we can have multiple things that are causing this hormonal dysfunction, and that's why it's so important to be working with somebody who understands the nuances that multiple layers can be playing a role here. So addressing any eating dysfunction, addressing any exercise excess, but also making sure that we're looking for additional hormonal drivers that could be playing a role. Things like thyroid dysfunction, elevated prolactin, PCOS, which is now called PMOS, or other causes. Oftentimes, there can be multiple contributing factors, and diet, exercise, caloric intake is just one of the most actionable steps that can be obvious. But it absolutely is crucial to have a complete evaluation to identify what else might be present. Imagine if healthy eating could be redefined to include the nutrients that actually build and sustain hormones. Things like getting adequate fat, calories, and cholesterol in order to sustain those hormones rather than just being told to avoid certain food groups altogether. Imagine if every woman who was struggling with cycle irregularities was educated on what she actually needed rather than just being put on birth control or given a Band-Aid approach or just told, "You must be stressed." Every woman deserves this education to understand that with adequate dietary and exercise balance, it is impossible to improve your cycle health and restore your confidence in your cycles

Speaker 2 19:29

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