EP.138/ Strategies to Alleviate Premenstrual Endo Bloating Before Your Period
So last week I took you guys through the ways in which inflammation, gut health and hormone levels can increase bloating in the lead up to your period.
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This week I want to give you some tools to actually alleviate that bloating, now you know why it’s happening. I’m going to give you two types of tools, one set to deal with in the moment of bloating and another set for which are long-term strategies to help you to address the root cause.
So, let’s start with the tools you can use in the moment. Many of these tools I’m about to share are based on my training with world leading SIBO doctor, Dr Allison Siebecker. I’m using her doses, which are safe and effective and if you’d like a reference for these doses, they are actually available on her website, under handouts, in a handout called Symptomatic Relief Guide. So these doses are available publicly, you don’t need a prescription for them, but always consult your doctor before starting new supplements.
1. Number one is using a prokinetic. A prokinetic is either a pharmaceutical drug or natural supplement which improves gut motility in the small intestine, so it increases transit time in the small intestine and also stimulates the migrating motor complex in the small intestine, which is the wave like motion that clears bacteria from food out of the small intestine and into the large intestine. When the migrating motor complex is slowed, this is when we are at risk of developing SIBO and one study actually found that 100% of participants with endometriosis had gut motility dysfunction.
A prokinetic doesn’t stimulate a bowel movement by the way, so it’s not a laxative. It doesn’t get to work on your large intestine, but on your small intestine, so it’s essentially aiding you to digest and move your food into the large intestine, and to clear gas and bacteria out of the small intestine too.
To stimulate the migrating motor complex, we can use a prokinetic at night, but for bloating, you can take it during the day, and this will support healthy transit time of gas accumulating in the small intestine. This can be really helpful in the second half of our cycle, when progesterone is naturally causing things to slow down!
So the two natural supplements you could try are ginger and STW5, which is also known as iberogast. For ginger, there are many different prokinetic formulas and I’ve put some of the best ones in the show notes, and you would just take the label dose, twice a day, one to two hours after meals or as needed, just be sure not to exceed the recommended dose on the label or to exceed 2000mg of ginger per day.
STW5 is a tincture, and you would take 20 drops with meals as or as and when needed.
I do just want to caution here that some of the ginger formulations can cause ginger burn, which is like a hot burning sensation in the diaphragm area, so if you have acid reflux this may not be the best option for you. You can normally get rid of the feeling through drinking water, but some formulations are less ‘ginger burn’ causing and I’ve highlighted which ones in the show notes. Ginger, being a spice, can also irritate bladder symptoms if you have interstitial cystitis, so this is something to consider and normally, I find the formulas which cause less ginger burn, cause less bladder problems.
Secondly, because STW5 also contains alcohol, I find this to also irritate the bladder in people with interstitial cystitis, so just be cautious with these two and experiment until you find a formula that works for you.
Finally, if you experience pain with prokinetics, it’s normally due to motility actually starting to get to work, which can cause muscle contractions at first, but if the pain is severe or persistent, it may be that you have an obstruction or adhesions disrupting the motility flow and working against it. If that’s the case, stop using and see a visceral manipulation therapist who can access your gut for adhesions and obstructions.
2. Peppermint oil
Next up is peppermint oil. Peppermint oil is actually a smooth muscle relaxant and is great for abdominal pain, if you get pain with your bloating and generally, it’s really wonderful for pretty much all IBS symptoms. Recent research has shown its effectiveness in multiple symptoms of IBS, so this is a great option if you have IBS issues frequently with endo and in the lead up to your period.
So, you could of course try the tea, and some people do find that to be effective, but generally, peppermint oil tends to be stronger. If you wanted to go for tea, I would make sure it’s strong for it to work!
For capsules, you want enteric coated peppermint oil, which are capsules that have a coating on them which protects them from stomach acid, so that the peppermint is released lower down in the intestines where we want it.
You would just follow the label dose and take as needed, though you could take them every day during the second half of your cycle as the effects are stronger when taken consistently.
However, if you have acid reflux, peppermint may not be the best option for you as it can sometimes cause acid reflux. Another possible side effect is nausea. You could test yourself on one dose and see how you respond of course and take it from there, but if you’re prone to acid reflux or nausea, you might want to consider some of the others. If you do want to give peppermint a go, pills are less likely to cause acid reflux or nausea as opposed to peppermint tea or say, a tincture.
Lastly, peppermint oil can slightly slow down motility, so if you are noticing sluggish motility already due to progesterone in the second half of your cycle, either use one of the other options or if you really want to take peppermint oil, also take a prokinetic.
Oddly, if you have interstitial cystitis, it appears peppermint oil may help or it may actually irritate. There’s some research going on at the moment, specifically on peppermint oil for the treatment of interstitial cystitis, and some practitioners advise using the tea, etc. whereas I’ve heard others warn against it. Personally, applying topical peppermint oil helps with my interstitial cystitis pain, and this would be because it’s a smooth muscle relaxant, so it’s calming down any contractions and cramping, but if I drink the tea, I find it causes a burning feeling inside my bladder, so I think you’ll have to see how you respond personally, but I’m very curious to find out the outcome of this study!
3. Number three is activated charcoal. Activated charcoal absorbs gas, so is really helpful for any bloating which is being causing by gut issues during the second half of our cycle.
You can take activated charcoal in supplement or powder form, you would just mix the powder into water, as and when needed, but you do need to ensure that you’re taking it at least 30 minutes before a meal and an hour after a meal, because it doesn’t just absorb gas, it absorbs nutrients too! This would be the same for supplements. You don’t want to be spending money on lovely supplements for the charcoal to be absorbing it all!
You can take up to 1000mg per dose or just follow the label dose, and you can do so four times a day, spacing the doses out by at least two hours, just don’t exceed more than 4 grams of charcoal a day.
Lastly, charcoal can sometimes cause constipation, so of course, we don’t want to worsen that if you already struggling with sluggish bowels in the second half of your cycle. If you are, then you can take magnesium in addition, which I’ll share in the next point.
4. Magnesium
Whilst magnesium won’t directly help with your bloating, it is great for constipation, so if this is one of the root causes of your bloating in the second half of your cycle, magnesium is a good tool to aid with this.
Magnesium is also a nutrient that most of us are deficient in and gets used up with chronic stress and during menstruation, and when we’re low in magnesium it can worsen PMS, pain, and fatigue so this is a great supplement for endometriosis.
The best options for constipation would be citrate or oxide, and I personally prefer oxide for anyone with interstitial cystitis, as the magnesium citrate can be irritating to the bladder for some.
You can take between 500mg to 1000mg in the evening, at bedtime, and it’s best to start at a lower dose, like 500mg, to see how you react to it, as if you take too much you may get diarrhea. The aim is to have a bowel movement come the morning, so that’s the sign you want to know it’s working and normally, it takes about 2-3 days to get to work, so be patient. If you don’t have a bowel movement in this time, move up to a higher dose. Often, 1000mg is the dose most people find works for them, however, as I said, you can go higher, you just can’t exceed 2000mg and you need to ensure you’re increasing your dose slowly.
Finally, make sure you take your dose two hours after food because otherwise this can interfere with the effects.
Hopefully, by supporting your gut to keep to a healthy flow during the second half of your cycle, you’ll experience lessened bloating as waste and gas isn’t hanging around for so long.
5. Number five is abdominal massage and for the purposes of bloating you could use either the I Love You massage or Arvigo Therapy, both of these you can do at home by yourself. Additionally, these massages are great for constipation and sluggish motility, so if you’re noticing those to be an issue in the second half of your cycle, I would recommend trying one of these. They also put your body into the rest and digest state, so if you’re working on trying to calm your nervous system down so your pain decreases over time (which I’ve been talking about a lot recently over on Instagram), then these are a great addition to your routine. You don’t need to do both, one or the other is fine, however, if you want the added benefit of adhesion release and better periods and less endo pain, Arvigo Massage is the way to go.
The I Love You massage is a simple massage where you literally trace the letters ‘I’, ‘L’ and ‘U’ over your intestines repeatedly. There are free YouTube videos on how to do this and I’ve linked to one in the show notes.
With Arvigo Therapy, you first need to be taught how to do it on yourself by a practitioner. The sessions are usually pretty affordable and can be taught in about 30-45 minutes, after which you don’t need to pay for anyone more sessions, you can just start performing the massage on yourself. I’ve linked to a wonderful practitioner in the show notes and to the practitioner directory.
You can do these massages daily, and I personally recommend using them in the evenings before bed, which is when the migrating motor complex really gets to work and as these help to stimulate it, they’ll give your motility a nice boost overnight. Of course, if you’re feeling bloated in the moment and want some instant relief, if you feel like it’s not painful to do, you could perform these massages when needed. Both of them take just 10-15 minutes at the most, so they’re quick to do.
6. Number six is a slightly different one and that’s lymphatic drainage. We’re not addressing the bloating directly but more the water retention and fluid build-up in the body, which could in turn help to reduce the bloating, depending on whether your bloating is coming from water retention or from fermentation in the gut.
So the lymph system is a collection of vessels that run like a map across the body, under the skin and around organs. They are connected to lymph nodes which can be found in places like your armpits and groin, they’re the small shaped bumps you feel when you’re unwell.
The lymph vessels contain fluid that collects waste products, toxins, bacteria, viruses, etc. from around the body. These products are then delivered to the lymph nodes, which attack any pathogens (baddies), and this is usually when the swelling occurs if you have a really active infection - that’s why you’ll get raised bumps under your arms when you have a virus for example.
Once the most harmful pathogens have been killed off, these toxins, waste products and dead bacteria are sent to the liver and kidneys through the blood stream, where they’ll eventually be filtered out of the body.
What’s important to note here is that the lymph system cannot transport waste on its own - the fluid begins flowing with assistance from movement, such as massage or exercise and if we don’t assist it, it can stagnate, like a stream that’s become blocked.
Helping to get the lymph system moving will help to shift any build-up of excess fluid and water retention, and it can help to get rid of the excess LPS which may be circulating in our blood stream before menstruation and would certainly be adding to our inflammation levels.
There are multiple ways to get lymph fluid moving, but two lovely self-care methods you could try are dry brushing before your shower and then using a sort of lymphatic drainage paddle after your shower on your skin.
So before your shower, you would use a dry body brush and starting at your ankles, brush upwards in short bursts, going over them same area three to five times before moving to the next section of your leg. The brush strokes should be fairly firm, and short, so say from your ankle to mid-calf and then from mid-calf to your knee. You would work your way up your legs, bum, torso, all moving up towards your heart, and then you would go to your arms, starting at your wrists, and working your way up to your shoulders. The process should take about 5-7 minutes.
Then you can jump in the shower, and you can totally stop here if you like. A body brush is about £10, so it’s a nice and affordable option.
If you want to add another layer, you can get a lymphatic drainage body tool, which looks a bit like a paddle and is made of wood. I think it originates from the gua sha technique. You would essentially follow the exact same pattern you took with the body brush, but this time more lightly, it can be very gentle, and you would apply oil first, so you don’t pull your skin. I tend to use coconut oil and my paddle was £18 from Amazon. I’ve linked to it so you know the kind of thing you’re looking for.
Now of course, this process is most effective when done every day but honestly, I struggle to fit it in, so you could try a couple of times a week or whatever works for you!
7. Number seven is taking an anti-inflammatory supplement. Now as we discussed last week, I don’t think the swelling and bloating is purely down to inflammation alone, but it certainly plays a role as inflammation is building as progesterone lowers and prostaglandins are slowly being released in the uterus to prepare for menstruation from ovulation, providing you’re not pregnant. So as we have higher levels of prostaglandins already, having endo, it’ll most certainly be helpful to lower these.
Now to be clear, these are not root cause fixes, I’ll move onto those in a moment, these are to help you to start feeling better in the short-term, but I just want to remind you that anti-inflammatory supplementation is not enough to get chronic inflammation down, we need to get to the root causes, but they can certainly help!
So in terms of anti-inflammatories, you could use supplements like magnesium, ginger, curcumin or fish oil and all of these have their own unique benefits, so my recommendation is to go back and listen to my episodes on supplements, so episodes 130 and 131. Then you can pick one or two that are best suited to you, and when taken consistently, should really help with your period pain too!
So that’s the symptomatic relief part of the podcast, but now let’s move onto addressing these root causes. Now what I’m giving you is the simple first steps, not the whole protocol for each of these because that would just be a lot!
1. Number one is to start balancing your hormones, and one of the key ways we can do this is through ensuring we have balanced blood sugar levels, as having dysregulated blood sugar can cause elevated oestrogen levels and low progesterone. So this is really the key place I start with when balancing hormones with my clients.
And the process is pretty simple, though it takes some getting used to and practice, and it’s simply ensuring you have protein, fibre, healthy fats and complex carbohydrates with each meal. This is because if we just have a plate full of refined carbohydrates like white rice or white pasta, we’re going to get a surge of glucose in the blood (which is what carbs break down into in the gut) and that will elevate our blood sugar levels and that then creates a cascade of negative effects on our inflammation levels, hormones, and energy production. The same goes for a plate full of brown rice and starchy veg or just rice and veg – yes, these foods are healthy, but they’re also rich in carbohydrates with nothing to minimise the effects on our blood sugar.
First off, we need to choose complex carbohydrates in contrast to refined. Refined carbs break down quickly and easily in the gut, flooding the system with glucose very quickly. These are processed foods such as bread, pasta, fries, crisps, cakes and pizza. In contrast, complex carbohydrates break down over a period of time, providing the body with sustained glucose release, and these include vegetables, starchy root veggies like sweet potato and parsnips, fruits, beans and whole grains. Now whole grains really depend on the individual, for some people they break down slowly, for others, they break down quickly and cause a blood sugar surge, so it’s really about how you feel on them as an personally.
And we always want to pair these complex carbohydrates with protein and fat, because they help to slow down the release of glucose to the blood. Fibre also does the same, but providing you have enough vegetables, you should be getting fibre from there, as well as from foods like beans and whole grains.
In terms of ratio, to balance your blood sugar the ideal ratio is having 50% of your plate covered with low starchy veggies like broccoli and asparagus for example. 25% of your plate should be a protein source, and the final 25% is split between fat and complex carbohydrates. So we’re looking at about two tablespoons or two golf ball sizes portions of fat and a serving of more starchy complex carbohydrates like sweet potato, root veggies or quinoa.
Now depending on your activity levels, you may need more or less starchy carbs – this is very individual, so you need to adjust your serving to what feels best for you. If you’re still hungry after a meal, or finding yourself having blood sugar crashes, try increasing the protein or fat intake first, but if your carb content is very low, increase your carbs, whether that’s from low starchy veggies or in fact you find you just need a bit of extra starch from sweet potato, for example. In the show notes, I have linked to a great diagram demonstrating what this could look like.
But just to give you an idea, you might have half a plate full of a salad of rocket and spinach, tomatoes, cucumber, red onions, and asparagus, with a piece of salmon, then say half a small avocado and a serving of quinoa, adjusting the grain serving to the size you personally need.
So, this is where I would begin with balancing your hormones. If this feels triggering for you because it’s food related, addressing your gut health will also support your hormones, as well managing your stress levels with stress relief tactics and supporting your detoxification processes. All of my episodes on oestrogen dominance and hormone imbalances cover various areas to address when healing your hormones, so you can have a listen to those if you’d like a different option, or if you get to grips with blood sugar and want to move onto the next step.
And you could practice this over the course of a month and see what happens with your bloating. I do recommend that this is kept up going forward, not just for bloating but for keeping endo at bay, for healthy hormones, sustained energy, lowered inflammation and to prevent the onset of chronic diseases, which blood sugar dysregulation has been linked to.
If you want to learn more about blood sugar, I cover it in multiple episodes, and I’ve linked to them in the show notes, or you can read my book or take my course, when it comes out again in a few weeks. And of course, if you want a step-by-step protocol for balancing your hormones, my course includes that and you can get on the waiting list now, so you’ll be the first to hear when it launches. Again, the link is in my show notes.
2. Number two is to start repairing the gut. Now this is a more complex one and tends to take time, and of course if there’s a condition like SIBO, that will eventually need treating. But we can start with some small steps, that really, we use with everyone to see whether they respond to these changes, and these are the basic foundations of good gut health.
You can listen to my episode Understanding the Endo Belly Part 1 for full protocol of what we call ‘first line therapies’, which like I said are these foundational pieces, and you can implement them over the course of a few months, but to get you started, you can try one or two of these options here.
The first would be to eat 30 different plant foods a week. Your good microbiome needs an array of different plant foods, fibres, and nutrients in order to survive and thrive, and to actually ensure the health of your intestines. In fact, your good gut bacteria take certain plant fibres and turn them into key food for our intestinal cells, which helps to keep the gut wall strong. So eating an array of different plant foods will not only help to start creating a healthy microbiome, it’ll also help the process along of repairing leaky gut.
Now I know for those with IBS, when they think about eating more plant foods it can be scary, because the fibre can often aggravate symptoms, but this is different. This is literally about eating any type of plant food – so olive oil counts, coconut oil counts, spices count, fresh herbs count, seeds count and nuts and veggies and fruits, and wholegrains and beans! Yes there’s a lot of options and they all count. And it’s actually pretty easy to get in 30 different foods when you consider this wide array of ingredients you have to work with. You know between the elemental diets I’ve been on the low histamine bi phasic diet, and honestly, I don’t think there’s a diet more restrictive than this and especially in terms of fibre and carbohydrate content, it’s much more restrictive than the low FODMAP diet, and I was still able to reach 30 different plant foods. So basically, work with the foods you’re allowed to eat if you’re on a specialist diet, and if you’re stuck, work with a nutritionist or check out gut health blogs for recipe recommendations.
Secondly, if you can, I would also begin reducing your intake of sugar. Now I don’t mean fruit. I mean added sugar, like maple syrup, honey, caster sugar, coconut sugar, corn syrup, rice syrup, added fructose, that kind of thing. Sugar actually feeds an unhealthy microbiome and inflames the gut, and changes the composition of the gut microbiome, leading to leaky gut. And of course, we want to heal the gut lining and create a nice balance of healthy bacteria in the gut.
I know this is a big step for a lot of people, so it may just be that you start slowly. Maybe you start reducing the sugar you add to your coffee by a quarter of a teaspoon for the first week, and then move to half and so on. Or maybe you start snacking on dark chocolate with a lower sugar content than a standard milk chocolate bar in the afternoon. Whatever it is, choose a method that’s manageable and sustainable for you.
And again, I would implement this over a month, to observe the changes. You could start with adding the plant foods the first month, and then start lowering sugar the next, or you could do it all in one go, and you could combine these methods with the blood sugar balancing or you could implement them month by month separately. It’s really up to you.
Now again, these are just two of the strategies and there is generally more to be done with healing the gut, but you might notice that these bring you significant relief. If they don’t, then don’t panic, this is just the beginning and normally I don’t expect to see complete resolution with my clients at this stage. So what I recommend is that you have a listen to my Understanding The Endo Belly episode, which I’ve linked in the show notes, and you can continue to layer some extra first line therapies on top of these methods,.
If neither of these options that I’ve shared appeal to you because they’re food specific, then that episode will provide you with some other options, like chewing properly, mindful eating and stress management. Or if you want to dive deeper, my course walks you through a step-by-step gut healing protocol, so again, you can get on the waiting list for that if you’d like to.
3. Okay, so number three is all about lowering inflammation. And normally, in functional medicine, we would begin with food, as this is one of the quickest ways to lower inflammation.
Now there is a specific protocol for lowering inflammation with nutrition, which I would normally implement over a month with a client, but again, I am just giving you the foundations first to get started. If you want to dive deeper, you can listen to my episode with Dr Jessica Drummond, which I’ve linked in the show notes, I have countless articles on anti-inflammatory nutrition, and I’ve linked to one or two of those in the show notes as well, or you can read my book or sign up to the course for an exact step by step guide.
So to start, one of the most powerful things we can do nutritionally to lower inflammation is to eat an abundance of colourful fruit and vegetables a day.
Specifically, we’re aiming for eight servings of vegetables and two servings of fruit. Now I understand that for those of you with IBS, this might be hard on your stomach at first and it may take some time to build up to this amount of fibre, so start slowly. However, a SIBO diet or low FODMAP diet shouldn’t prevent you from getting in this amount of fruit and veg a day, you may not be able to get in a whole serving, which is 80g, because of the portion size limitations with the low FODMAP diet, but if you aim for variety, you should be able to get in eight different veggies. For example, 1 small red pepper, one medium carrot, one cup of cabbage, four sprouts, one cup of broccoli, 2 cups of spinach, 1 cup of spaghetti squash and half a cup of beetroot are all FODMAP friendly. That’s eight right there! And you’ve got some green, yellow, red, purple and orange in terms of colour, and that’s really key to lowering inflammation because the more different colours you have, the more variety of antioxidants you have, and it’s these wonderful plant nutrients that lower inflammation.
So you’re aiming for lots of different colours but with a nice emphasis on dark leafy greens, and working your way up to eight servings of veg and two servings of fruit. Again, do this slowly if you have stomach troubles on a regular basis and if you have gut health issues like SIBO or another condition, you may need to heal that first before you can tolerate that many servings of veg. But just get up to what you can tolerate and what makes you feel good.
And in the beginning, if your stomach is sensitive, start with well-cooked and pureed or mashed fruits and veggies. So for example, have a smoothie for breakfast, and a roasted veg salad for lunch, and a soup for dinner, for example. Basically, we’re trying to take some of the digestion work out of it for your stomach, so it can predominately focus on extracting those lovely nutrients.
So ideally, we’re working on adding more colour and more fruit and veg to start with, and practice that over the space of a month again, and see how your bloating and swelling does, and see how your PMS and period responds too. Now in the beginning, as your body adjusts to this added fibre, you may find yourself more bloated, and that’s why it’s important to build up slowly and to focus on well-cooked or broken-down foods, so your body gets used to it. For example, don’t go from two servings of veg a day to eight! Start with an extra serving for a few days or a week, and then move up to another serving. And of course, have those bloating relief remedies to hand as well to help you through and listen to your body. If you need to adjust or reduce the amount of veg you’re consuming, do so but don’t just assume you can’t eat veg, it may be about the serving size, how it’s cooked or the type of veg, so experiment!
Now if this feels triggering because it’s food related, another way to lower inflammation is by getting enough sleep. Sleep deprivation is one the key causes of inflammation, so instead of working on your food, you could start here. Now of course, if you have insomnia, sleep can be a difficult area to master and again, this is about taking it step by step and in stages, and there’s really a whole sleep hygiene protocol we could go through, depending on the type of insomnia you’re struggling with.
But let’s start with the basic step of giving yourself a nine-hour window to sleep. There is no argument, we all need at least seven and a half to eight hours sleep a night, without that, there are significant changes in our health, and it can make manging endo much more difficult because it can worsen pain, inflammation, and hormonal imbalances.
Now as someone who struggles with sleep, I want to say to you not to let this panic you, and really just to allow yourself to work on your sleep, with kindness, not beating yourself up if you’re not at eight hours yet.
Giving yourself a nine-hour window allows your body time to fall into a deep sleep and actually get eight hours of solid sleep, rather than seven hours or even less. And this nine-hour window shouldn’t include reading or scrolling or watching TV, this is literally lights out, eyes closed time and ideally, this nine-hour window should take place across the same period of time every night, so for example, from 10.30pm to 7.30am.
The reason we do this is because your body has an internal clock, and this clock lets it know when to release our waking hormone, cortisol, to wake us up, and when to release our sleep hormone, melatonin, to help us get to sleep. When we have erratic hours or inconsistent sleep patterns, the body doesn’t know when to produce these hormones, so we can find ourselves wide awake at 1am and super groggy at 9am. The body relies on rhythm to create its essential processes, and so it needs us to follow regular rhythms in order to function.
Now of course, there will be some nights when you just can’t sleep, or it’s a friend’s birthday, or your child is up sick all night, and that’s just life! So don’t beat yourself up about it, but on the whole, try to get this regular nine-hour window in. I understand if you have a baby, this is probably not possible, so come back to this when you have your nights back but otherwise, see if you can begin working on this slowly but gradually.
It will probably take some time to adjust, it’ll probably take moving around your schedule, and discipline and practice, but eventually your body should find its routine and start feeling sleepy around this time. The hardest bit for many, is us actually having the will power to put this in place and I can tell you, as someone who has a habit of working late, it is a daily practice, one I don’t always do so well at, but one I am always coming back to.
If your sleep issues are really extensive, then it to me sounds like your HPA axis is probably off. I’m going to do a podcast on this soon, but I also have a whole module on this and sleep hygiene in my course, so if you want more guidance and a roadmap for addressing this, you can of course join the waiting list.
So that’s our three strategies for beginning to address these root causes, and if we’re taking the first suggestions rather than the alternatives I’ve provided, it’ll look like:
· Eating protein, fat, fibre and complex carbs at every meal
· Eating 30 different types of plant foods a week
· Reducing sugar
· Eating 8 portions of colourful veggies and two portions of colourful fruits a day (or building up to that).
So that’s four steps, and you could work on one step a week, so by the end of the month you’re at all four, or you could work on one step per month, and observe where you are in four months. Choose to do it however you feel is best. And remember, that these are foundational steps, they may not totally resolve your PMS bloating, but they’re a step in the right direction and you can choose to keep going forward with some of the other strategies I’ve mentioned for continued improvement.
And just so you don’t drive yourself crazy, I want to remind you that it is natural for us to be a little more bloated and perhaps a tiny little puffier before our periods, but these symptoms shouldn’t be extensive and shouldn’t be affecting our daily lives. So, if you can get down to a place where these symptoms feel minimal and manageable, don’t drive yourself crazy trying to get a perfectly flat stomach the day before your period, as it might not be totally possible.
I really hope this episode has helped you and been informative! If you find it useful, please share it with others who might benefit and please do let me know and reach out on Instagram. I’d love to hear how you get on!
Remember to consult your doctor when making changes to your diet or supplement regime.
Show Notes
Dr Siebecker’s dosages
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
Prokinetics
Vita Aid Prokine
Pure Encapsulations Motil Pro (in my experience, I found this caused a lot of ginger burn)
Integrative Therapeutics Motility Activator (better for IC/ginger burn)
Enzyme Science GI Motility Complex (better for IC/ginger burn)
Priority One SIBO-MMC
Invivo Clinical Bio.Me.Kinetic (I find this to be better for IC/ginger burn)
Gut motility
https://pubmed.ncbi.nlm.nih.gov/9660426/
Peppermint oil
https://pubmed.ncbi.nlm.nih.gov/30654773/
I Love You Massage
https://www.youtube.com/watch?v=JTOkKVlBHzk
Arvigo Therapy
https://www.thisendolife.com/this-endolife-podcast-episodes/arvigo-massage-for-endometriosis
https://www.arvigotherapy.com/team-members
Lymphatic drainage tool
https://www.amazon.co.uk/gp/product/B07V7GJW1W/ref=ppx_yo_dt_b_asin_title_o06_s00?ie=UTF8&psc=1
Supplements
https://www.thisendolife.com/this-endolife-podcast-episodes/2021/4/17/supplements-shown-to-target-endometriosis
https://www.thisendolife.com/this-endolife-podcast-episodes/supplements-for-period-pain-menstrual-symptoms
Blood sugar
https://ameliafreer.com/2020/01/10/build-healthy-plate-from-scratch/
https://endometriosis.net/living/diet-sugar
https://www.thisendolife.com/this-endolife-podcast-episodes/reduce-fatigue-endometriosis-symptoms-and-oestrogen-dominance
Course waiting list
https://mailchi.mp/thisendolife.com/wait-list
First Line Therapies
https://www.thisendolife.com/this-endolife-podcast-episodes/-the-endometriosis-belly
Sugar and gut health
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284805/
Anti-inflammatory nutrition
https://endometriosis.net/living/diet-antioxidants
https://endometriosisnews.com/2020/07/23/primary-pillars-healing/
https://endometriosisnews.com/2020/08/13/nutritional-changes-endo/
https://endometriosisnews.com/2020/09/03/easy-meals-anti-inflammatory-diet/
https://endometriosisnews.com/2019/11/21/snack-healthy-suggestions/
https://www.thisendolife.com/this-endolife-podcast-episodes/outsmart-endometriosis-dr-jessica-drummond
Sleep
https://www.sciencedaily.com/releases/2018/10/181009135845.htm
https://endometriosisnews.com/2020/09/17/5-ways-sleep-deprivaton-affects-endometriosis/
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My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here.
If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website.
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My free guide ‘Managing Endometriosis Naturally’ is perfect for anyone just starting out on this journey of managing and reducing their symptoms. Download here.
My free Endometriosis Diet Grocery List is a pdf list that includes all the foods I buy on a monthly basis, categorised into easy sections. I share my personal endometriosis diet plan, free recipe resources, recommendations to help you get started with the endometriosis diet and nutrition tips. Download here.
My free “Endometriosis Symptom Tracker” could help you begin to understand the subtle patterns in your endometriosis symptoms. As always, this guide doesn’t replace your medical treatment and is not intended to treat or cure endometriosis, but provides you with options that helped me to live well with endometriosis. Download here.