PCOS & FHA: 1 Year Update

*Disclaimer: I'm not a doctor. What has worked for me won't necessarily work for you and you should always, ALWAYS take the advice and recommendations of your medical professional.*

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Well, it's been just about a year since I was diagnosed with PCOS and FHA (functional hypothalamic amenorrhea). You can read much, much more detail about my initial diagnostic progress, actions taken, and my progress thus far in these two posts:

Dealing with PCOS & FHA: My Experience 

Dealing with PCOS & FHA Part 2: Carbs, Stress, and Weight Gain

I've hesitated on writing a new update because, well...things are pretty great! At my last endocrinologist appointment all of my bloodwork was normal (including my testosterone), my periods have been mostly regular, and everything has felt surprisingly normal. 

Since July, there have been a few tweaks made to my training and my nutrition that have been a sort of litmus test to see how things have come along. The past year has been one giant experiment: how would my body react? would my hormone levels stay normal? what works for me? what doesn't work for me? My coaches, Anthony and Annie at Complete Human Performance, have been absolutely incredible with helping me through this entire process and providing amazing guidance. It truly has been a big collaborative process and I can't thank them enough for helping me through this tough year. With that being said, let's play catch up. 

Training:

Training has involved a lot of playing with different types and styles of programming, working around some nagging things that are really a result of old injuries, my hypermobility, and the fun stuff that comes along with having autoimmunity issues. I've spent the majority of the year training submaximally and building up a lot of volume. A LOT. OF. VOLUME. Particularly for things like my squats (sets of 20, anyone?) I've also spent a lot of time working various sticking points in all of my lifts and  just steadily building over time. I haven't really competed since my meet in March, minus a literally last minute decision to help fill a weight class at a strongman show which I treated as a training day. 

I have most of my competition plans for 2018 laid out and am currently starting a 3 month powerlifting meet prep and starting to push the intensity of training. A large component of being able to do this is learning how to work around my cycle. Since my period has started coming back with regularity, it has decided that I now have a 17-21 day cycle (why, tho?!) so I really only get about one to one and half weeks of normal non PMS/non cycle hormonal levels. The biggest implication of this with my training is that I get very extreme joint laxity before and on my cycle, which means I have to be extremely mindful of positioning, technique, and various other factors when I'm training. I don't tend to experience any extreme variations in strength or abilities around my cycle, but I do monitor it closely to make sure I train accordingly.

Nutrition:

This has been the area that has experienced the greatest change over the past year. Last year, I dieted very hard and made some really great progress physique-wise and then once my body had enough, it really had enough. As I have alluded to in previous posts, I put on a decent bit of weight (around 15lbs or so), which is a bit more than I typically try to put on in an off-season.  It has been incredibly difficult, both mentally and physically, to watch this unfold but it has also been incredibly rewarding.

The most beneficial thing I have done for my body, my sanity, and managing these issues has been: not losing weight. Seriously. I spent almost the entire year not dieting and in fact, spent most of the year bringing my calories way up and keeping them there. If you're dealing with FHA, the one piece of advice I would give is: STOP DIETING. Stop. Stahp. Stop it. There are exceptions to this, of course (and your doctor knows better than I do), but bringing food up and maintaining it there has worked absolute wonders for me and several other women I know. 

After implementing the carb cycling I discussed in part 2, my period returned to normal, as did my hormones, and my physique began to normalize out a bit after a few months. I still carb cycle between my rest days and training days but I've gradually added in a little more carbs on rest days and that seems to be working quite well.

I've been able to begin actually dieting for my season next year with a very slow and steady approach and I'm eating about 600 calories more than I did when I was dieting last year. My coach has only lowered my calories once or twice throughout the past 2 months and I'm continuing to see progress. I'm steadily losing weight in a way that doesn't feel brutally hard, isn't impacting my cycle, and isn't impacting my performance. Honestly, it's been...easy. THAT is what spending a year of not dieting and really trusting the process will do. It wasn't easy, especially mentally, but it was absolutely worth it. 

Mindset:

Stress management still continues to be the most difficult thing for me to implement. It's easy for me to get overwhelmed, spread myself too thin, and get caught up in all of the things I am doing. The difference now is that I am more aware of when this is starting to occur and I do my best to mitigate it. I've made some really big decisions to help with this and while they are scary, they're more than necessary. I've also really thrown myself into things aside from just training and competing. This year has been an incredibly year of growth and quite honestly, I don't think it would have gone that way if I hadn't had really great people in my corner to support me directing my efforts to other things. Managing my expectations regarding my body and training continues to be a huge component of making this entire process manageable. 

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And that's where I am at! I have another follow up in January to make sure my hormone levels stay normal while I'm dieting and training hard. I'll continue to make updates as things change as well. 

Onward and upwards. Always. 

The Problem With Empowerment

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Empowerment: a word that has garnered so much attention and use in the past few years that it is almost played out. Naturally, I want to ramble on about. Before I move on, let me be perfectly clear, I am ALL ABOUT “empowering” women….I just have issues with how we (the collective we) do it.

Let’s start with the word - empowerment.  Empowerment is defined as authority or power given to someone to do something. More colloquially, most of us define empowerment as the process of garnering confidence, strength, and fortitude to do things and feeling secure in the doing of those things. These definitions are perfectly adequate and do, indeed, serve their purpose. BUT….is that really what we mean when we say we want to “empower” people? We want to GIVE them power? We want them to garner power from another source? Are we supposed to lead people to some magical fountain of empowerment so they can drink from it and then BAM, they’re confident, secure, and strong?

Personally, I don’t love that idea. I don’t want to give anyone power because power isn’t mine to give. I think most people would agree that, when we say we want to empower people, we aren’t talking about an exchange of confidence forces. We want people to stand up and fight for themselves and do so with confidence. We want people to stand in their own power. It may seem like I’m being petty with linguistics here, but language matters. And more importantly, how that language is used and how those ideas come into fruition, matter. They matter a great deal.

At times, it seems that things written in the name of empowerment have taken on a rather less than “empowering” tone. There is a lot of “empowerment” that is done by shoving one group down so that another group may rise. Lately, it seems as if empowerment has really come to mean “making one better than someone else” and that’s just bullshit. That is not helping others stand in their power. That is not “empowering”.

NOPE.

NOPE.

In my own realm, I’ve seen this illustrated most strongly (ha!) when it comes to the idea of strength versus aesthetics. The idea that women who get into sports like powerlifting, strongman, etc. that are judged on strength are somehow above, better than, or just frankly more fucking feministy, than women who choose sports that are judged on aesthetics. Don’t get me wrong, I think lifting is about the most power-building (literally) thing that women can engage in - but do we really need to shove other women down to make that point? Furthermore, does the commentary on what women wear, what we look like,  and how we adorn ourselves actually serve to further the goal of helping women stand in their power?

Whether I am reading an article about bikini competitors or reading an article about women powerlifters, I feel as though I’m being told how to present my body. Look, I get it. A sport which is predicated on being on stage half naked IS inherently a bit more about how you present your body - that’s the sport. That’s, by definition, what someone signed up for. And you know what? More power to them. Insinuating that those individuals are somehow less, and women who compete on a platform are somehow better, is just exercising the same comparative bullshit that most women who lift have come to hate. I think intention is important here as well - is someone posting things on social media as a way to garner attention to take people’s money and provide  a, shitty at best and dangerous at worse, service to them? Are they posting as a exercise in confidence? Are they trying to share their story? Are they trying to criticize others? All of these things matter. And quite frankly, you as the consumer get to chose what you consume. You can unfollow, you can ignore, you can scroll on past. You can change the conversation and show that there is not one “right” way to fitness by sharing your own story and selfies, if that is something you chose to do.

It seems as if the borderline constant comparative banter and judgement occurs as a knee jerk reaction. There is a recoiling from and rebelling against what, for most women, was sold to them as they only way to do “fitness”.  Most women have been told that in order to be “fit” you must exercise a certain way, eat a certain way, post on social media a certain way, and if you don’t...well then, you aren’t fit. More importantly, the “cooking breakfast in your underwear” (credit for that illustrative phrase to Dani Overcash) model of fitness was sold to them as the only way to attain worth. The idea that one has to display themselves in a particular way or only do particular activities in order to check the box of “fit” is, indeed, totally fucking useless.

Can we not, though?

Can we not, though?

On the flip side, I don’t think making sweeping condemnations or generalizations about the intention of groups of women, and somehow framing those condemnations in a “well, clearly we are better” way, is useful. I know I am very guilty of thinking of that way and saying those things - and honestly, I still find myself doing that from time to time.  I don't want others to make sweeping generalizations about me, so why would I not extend that same courtesy?

We, the collective we, have to move past this. Instead, we can embrace that there is the radical notion that maybe, perhaps, some women may chose to present their bodies in a certain way and pursue certain activities because *gasp* they like them! And those activities make them feel good! And those things aid them in standing in their power. (Note: I’m not here to entertain a debate about whether one can have power if they conform, intentionally or unintentionally, to the “male gaze” or societal standards. That’s a different topic for a different time).

So what do we do? How do we help women stand in their power? We accept. We raise each other up. We refuse to settle for the tired trope of strength vs. aesthetics, because at this point, it’s just fucking lazy. We stop the comparative bullshit and the shoving of people into boxes. We stop judging women solely on how they choose to present their physical bodies. We  stand in our power. We help women to stand in their power.  We do better, because we deserve better.

Dealing with PCOS & FHA Part 2: Carbs, Stress, and Weight Gain

Disclaimer stuff: I’m not a doctor, endocrinologist, dietitian, etc. and am just sharing my own experience and what has been working for me. What has worked for me may not, and probably will not, work for you. Everyone and every body is different. Please always, always consult with your healthcare professional before making significant changes.

As I mentioned in part 1, I spent most of the winter feeling pretty miserable. After getting a diagnosis of PCOS and FHA, I tried taking metformin but due to my lack of more severe insulin resistance, it made me extremely ill. My endocrinologist told me to experiment with my diet and training and other lifestyle factors to see if those would bring some relief and we'd check everything out 3 months later.

I spent hours and hours researching different things regarding PCOS AND FHA and ended up mostly angry and disappointed. After searching every corner of the internet, I came up with some strategies that I wanted to try with my diet and lifestyle factors. The majority of these strategies centered around carb timing and cycle, weight management, stress reduction, and managing expectations.

Changes I've Made to Help Heal My PCOS & FHA:

Carb cycling: Managing carbohydrate load and consuming adequate amounts of carbohydrates at the right times is important for any athlete, but it is especially important for female athletes with PCOS and FHA. The process of carb cycling involves consuming different amounts of carbohydrates throughout the week in some regular pattern (typically based in training days and rest days). The principles behind carb cycling for PCOS are based on how carbohydrate intake influences insulin - the mechanics of which are far outside of the scope of this post but this gives a great overview.

My endocrinologist had agreed that cutting out carbs or going low carb all the time was not in my best interest so I needed to find a way to keep my carbs for training (when I needed them) and keep them down during other times.

 I worked together with my diet coach and we decided to try a pretty aggressive style of carb and calorie cycling. I basically eat high carbs and calories, just above my usual maintenance level, on my training days (4 days per week) and then eat low carb and low calorie on my rest days (3 days per week). Overall, my weekly average caloric consumption ends up being right around my current maintenance caloric level.

Thus far, this strategy has helped me feel extremely good in the gym, helped me drop my testosterone levels quite a bit, and my physique has responded positively as well.

Weight management: Last year was spent pushing my body, hard. When you push hard, you need to recover even harder and that part was something I couldn't get quite right towards the end of my season. I absolutely planned to put some weight on in my off season and then maintain that for a bit and then cut down at the start of my next season. Well, that next season will turn out to be next year and at this point, there isn't any dieting down to be done in my very near future. The mental stuff associated with that will be touched on later, but it is safe to say that keeping my bodyweight stable has been key to regaining my cycle and bringing my hormones back to appropriate levels.

Stress reduction: This has by far been both extremely difficult and extremely beneficial. When things started going awry, my stress levels were sky high - and not all of it was "bad" stress! My business was getting busy, my client load was increasing, I was working another job, I was training extremely hard, and all of that good stuff. However, I was not giving myself adequate time to recover and bring stress levels down. I spent the first part of the year really focusing on bringing stress levels down. I now take a day off and don't answer emails, train, do anything strenuous, etc. I take time to journal, read, meditate, or do something non work related every day. I try to get enough sleep in whatever form it make take. I build time for all of this into my day (or my color coded planner, rather) because they are non-negotiable.

Managing my expectations: When I first received my PCOS and FHA diagnosis, I was angry. "How could my body do this to me?!" was something that I often asked myself. After some reflection, I realized that that mindset was not productive at all.  My body didn't "do this" to me - I did this to me. I fucked up. And because I messed up, I can also fix the situation (the beauty of being 100% responsible for your shit means you have the power to change things!). I decided to view this as a great opportunity for growth in areas besides competing. My coach, Annie, actually mentioned this to me when we were discussing my situation and it really made me excited to grow as a person, a coach, and an athlete.

Managing expectations about my physique and performance has been (and continues to be) a learning process. I'm not always comfortable in my body and its current form and there are plenty of days where I wish I was leaner or that I could work towards that goal, but the reality is that it isn't that time yet. The time for that challenge will come, but it isn't now. Plus, I sort of enjoy having big(ger) shoulders and a wider back and actually having some hamstrings and a booty! This topic will get a dedicated post of its own, but suffice it to say, I've learned (and continue to learn daily) how to let go of certain expectations and see the big picture.

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And that’s where I am. My testosterone levels dropped about 40 points, all of my other hormones are normalized, and as far as my endocrinologist is concerned, I’m in a really good spot. I go back for another follow up in about 3 months to see if things are still in a good place and then I will go from there.

 This entire experience and process has been  a difficult, frustrating, and incredible learning experience. Am I uncomfortable at times? YES.  Absolutely yes. But I know that I need to be in that space for my health and for improvement over the long term. Is it easy? NO. It's tear inducing, frustrating, and overwhelming at times. But that's okay. Because it's necessary. I’m really looking forward to continuing to experiment and find what works best for me.  I truly can’t wait to see how this entire experience continues to impacts my life, body, and performance.