If you’ve struggled with irregular periods, you might have noticed it can be a little tricky to figure out exactly what’s going on—and, therefore, exactly what you need to do to get your period back. 

In this episode, Lara discusses:

• the two most common explanations for irregular periods,
• how to tell them apart, and
• how hypothalamic amenorrhea is frequently misdiagnosed as PCOS. 

Links:

• Prof Jerilynn Prior's paper about hypothalamic suppression
• PCOS cannot be diagnosed by ultrasound
• Cyclic progesterone therapy for PCOS
• Lara's metabolism book

If you’ve been diagnosed with endometriosis, the big question is: What type of lesions?

In this episode, Lara challenges long-held assumptions to explore:

• the three types of endometriosis lesions, 
• emerging evidence that superficial lesions may not explain pain or other symptoms, 
• alternative explanations for pelvic pain and infertility, including pelvic congestion, immune dysfunction, and gut microbiome imbalance, and 
• an update on the bacterial contamination hypothesis.

Links:

• Could pelvic congestion syndrome explain your pelvic pain?
• Prevalence of endometriosis in asymptomatic women (1991 study)
• Surgical removal of superficial peritoneal endometriosis for managing women with chronic pelvic pain: time for a rethink? (2019 BJOG article)
• Bacterial contamination hypothesis (2018 paper)
• Fusobacterium infection facilitates the development of endometriosis (2023 paper)
• ANZCA 2024 Statement on pelvic pain and endometriosis 

Is your low blood sugar a symptom of insulin resistance or mild dysfunction of the autonomic nervous system?

In this episode, Lara returns to the topic of hypoglycemia to discuss:

• the difference between insulin resistance and dysautonomia,
• why unstable blood sugar does not automatically mean insulin resistance, and 
• her concerns about continuous glucose monitoring. 

Links:

• Dr Andrew Maxwell's presentation about dysautonomia, hypermobility, and mast cell activation.

Symptoms of hypoglycemia or low blood sugar include light-headedness, headaches, and anxiety. Hypoglycemia can even feel like panic attacks. 

In this episode, Lara discusses:

• why young women are more prone to hypoglycemia,
• the importance of the autonomic nervous system and a "blunted glucagon response," and 
• what you can do to feel better. 

Links:

• Prevalence of self-reported symptoms attributed to hypoglycaemia within a general female population of the UK
• Hypoglycemic symptoms in the absence of diabetes: Pilot evidence of clinical hypoglycemia in young women

Do you feel hungry all the time? Abnormally hungry? If so, it’s worth trying to figure out why. Potential drivers of abnormally high hunger include insulin resistance, gut and microbiome issues, low blood sugar, and food addiction—just to name a few.

In this episode, Lara explores food addiction and some of the controversy around the term. She also discusses the next best steps on the road to recovery. 

Links: 

• Lara's new book about metabolic health
• Poll: Addiction to highly processed food among older adults
• Dr. Jen Unwin's Resource page

For some women, stopping normal dairy products can relieve period symptoms. But why?

In this episode, Lara discusses:

• the inflammatory effects of A1 casein  
• how a mast cell histamine response can drive period problems such as premenstrual mood symptoms, heavy bleeding, and pain.

Links:

• Successful mast-cell-targeted treatment of chronic dyspareunia, vaginitis, and dysfunctional uterine bleeding
• Childhood asthma, allergies and risk of premenstrual disorders in young adulthood
• Casomorphins and gliadorphins have diverse systemic effects spanning gut, brain and internal organs

Did you know that what’s happening in your gut can affect your periods and hormones? 

In this episode, Lara discusses:

• small intestinal bacterial overgrowth (SIBO) and its role in IBS,
• how SIBO can drive or worsen endometriosis, insulin resistance, premenstrual mood symptoms, and the fibromyalgia of perimenopause, plus
• how to treat SIBO. 

Links:

• The curious link between estrogen, mast cells, and histamine
• Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome

Why do antihistamines cause weight gain? And how does hormonal birth control affect metabolism?

In this episode, Lara looks at:

• how common medications affect metabolism
• why birth control that is *androgenic* is more likely to cause weight gain, and
• whether natural progesterone is more likely to cause weight gain or weight loss.

Links:

• The histaminergic system as a target for the prevention of obesity and metabolic syndrome
• High H1-affinity antidepressants and risk of metabolic syndrome in bipolar disorder
• Natural treatment of menstrual migraines
• Weight change among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception
• Impact of micronized progesterone on body weight, body mass index, and glucose metabolism: a systematic review
• Cyclic progesterone therapy for PCOS

Are you a morning person or an evening person? And could that affect your ability to lose weight?

In this episode, Lara looks at chronotype, which is your individual disposition to be awake or asleep at certain times. And how that might affect your overall health and metabolism.

The supplement inositol is a superstar for treating polycystic ovary syndrome. It’s also been clinically trialled for weight loss, thyroid disease, anxiety, insomnia, and premenstrual mood symptoms. 

In this episode, Lara looks at:

• "what is inositol?" and how to get it from diet
• myo-inositol versus D-chiro-inositol, and 
• why it's all a little confusing.

One thing Lara forgot to mention is that to get results with inositol, you need to commit to it for at least three months. And if it works, you’ll probably want to stay on it for years. Luckily, inositol can be quite inexpensive, especially if you choose straight myo-inositol powder.

Links:

• Myo-inositol for insulin resistance, metabolic syndrome, polycystic ovary syndrome and gestational diabetes
• Inositol treatment for PCOS should be science-based and not arbitrary
• Cyclic progesterone therapy for PCOS