Charting Through Severe PMDD (Episode 443)

Full Transcript: Episode 443

Lisa: Welcome to the Fertility Friday Podcast, your source for information about the fertility awareness method and all things fertility. I’m your host Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Workbook. I’m a certified fertility awareness educator and holistic reproductive health practitioner with over 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormone health, and optimizing the menstrual cycle without hormones. I have been consistently outspoken about hormonal birth control over the past two decades and its impact on fertility and overall health, because you have the right to know how your body works and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and I host live coaching programs to help you achieve optimal fertility in health, because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys and a brand new baby girl. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with me today.

I’m sharing another brand new episode in my Fertility Awareness Mastery Mentorship Practitioner Series. In today’s episode I’m sharing my interview with Katie Ewen, and in today’s interview we delve into PMDD, which in many ways is an exacerbated and much more severe form of PMS. It has come up a couple of times on previous podcast episodes and I’ll be sure to link those episodes in the show notes page. Today’s episode we go really deep into Katie’s experience with PMDD and how charting her cycle and going through the FAMM process has shifted that for her. So a really powerful story that I’m excited to share with you today.

So before we jump into today’s episode, let me share a little bit about Katie. Katie Ewen, also known as Reflex East, is a reflexologist based in East London, England. She has been supporting people with their fertility and reproductive challenges with the calming power of reflexology in her private practice for three years. At the start of 2022, Katie joined Lisa as part of the FAMM program. Having had her own mental health struggles exacerbated by PMDD, Katie has personally found the FAMM protocols invaluable. Katie firmly believes that anyone who has a period or struggles to know how to relax should have the tools she can offer easily available to them, and is excited to offer fertility awareness to support her clients on a deeper level. So without further ado, let’s go ahead and jump into my interview with Katie.

And I’m excited to be here today with Katie. Katie is a member obviously of this year’s FAMM program, and at this point we are almost officially done. We have about a month left or so before the program is done, and so we’ve had quite a few months together to get to know each other, and I’m really excited to have you on the show. Welcome to the show, Katie.

Katie: Hi, thank you, and I’m really excited to be here also.

Lisa: Yeah, yeah. And I’m also looking forward to talking about this topic today. We’re going to be talking about PMDD. It’s a topic that I haven’t highlighted so much on the podcast, and I think it’s in part because of how I — I was just like I was saying to you in the pre-chat — no, the big secret as far as I’m concerned is that PMDD is like PMS’s angry cousin or something. It’s a more extreme version of PMS. But I feel like we’re often presented with PMDD as if it’s a completely different issue in and of itself, which I find to be very strange. But when you get into the cycle charting, you can clearly see that if someone has PMDD, it’s associated with low progesterone. Like it’s quite obvious.

Katie: It was very clear in my charts, that was for sure.

Lisa: Well, before we dive into all of that, let me give you an opportunity to share a little bit about your story to kind of bring us to this point. So my favorite question to ask is: when did you get your first period? Share a little bit about what that was like, if you’ve used hormonal contraceptives before, and then kind of leading into obviously your experience with PMDD, but also what led you to want to use fertility awareness in your practice as well.

Katie: So hello, I am Katie, and I am a reproductive reflexologist and now a fertility awareness practitioner. And my first period — it’s hard to remember now — I think I was like 11 or 12. It was really like pretty non-eventful. I remember like talking to my mum about it, and she gave me some pads and things. So I was terrified of tampons for a long time, and yeah, it was pretty non-eventful.

And then I’ve never consistently — I say consistently — taken hormonal contraceptives. Like I’m a lesbian, so I just sleep with women, so I don’t need hormonal contraception in that respect. But I did take it for a week to avoid having a period on holiday, which just made me feel sick, and then stopped taking it and got the period anyway. So that is my only experience of hormonal contraception.

And then I guess just moving through, my periods, once they did settle down into a regular rhythm and things — the thing that kind of started to become more apparent — and I tracked my cycle in a very basic sense for quite a long time of just using an app and being like putting in when my period starts. Like that was as far as it went for many, many years.

But I did start to notice this sort of pattern of like I’d always historically been very anxious. I didn’t really know what was going on, had these periods of time where I just wouldn’t be able to cope at all. And the anxiety would always be revolving around something quite different, but the way it would present would be very, very similar. And it took many, many years to get that diagnosed as OCD.

So then what I started to notice was my cycles — about 10 days before my period, almost without fail, I’d be starting to feel really like I wasn’t able to cope. I’d be having a lot of intrusive thoughts about all sorts of really horrible things, or thinking about like I don’t know if I want to be with my partner anymore, or like thinking I was going to cause harm to people and things. And these things are very typical of OCD. And that would become loud — so loud — 10 days before my period, like without fail.

Then once I’d look at that and be like, that 10-day mark — like, oh God, here we go. I don’t know what’s gonna happen now. But like to the point where when I’ve been in relationships, I would break up with people on a monthly basis because the anxiety was so intense that the only way to feel like I could stop it would be like, well, the thing I’m thinking about is the relationship, so then I’d end it. And then I’d get my period, then a few days later be like, what have I done, oh my God. And then like either try and sort things out, or if I hadn’t broken things off, trying to repair the damage kind of thing. And then you’d be like, yay, great, everything’s fine. And then the cycle starts again. And it was just so exhausting and so difficult.

Because my obsessions would revolve around all sorts of different things, and because it wasn’t identified as OCD for so long — because the way I have OCD is sometimes referred to as pure OCD, which isn’t a name I really like, because the name sort of suggests you don’t have compulsions. But what it really means is your compulsions are all very internalized rather than outward, like checking things or washing your hands, which is a very stereotypical thing that we’d think about with OCD. But mine would be sort of like internal monitoring of my thoughts and bodily sensations. So for many years I thought waves of anxiety were gut feelings. So I’d have a wave of anxiety and be like, oh, it must be true. Really difficult stuff.

So then, yeah, realizing the collision with my cycle — it would just be completely destructive and debilitating. Like it came out of — like I said, Dance School — and came out of dance school for a time and like really disruptive with work and all aspects of my life.

And then once you kind of started — I saw the link between my cycle and what was going on with my mental health. But it wasn’t like — I just thought, because it was so known to me, that it was like 10 days before, this is what’s going to happen. I just kind of thought that was it.

And then had a lot of therapy, so like the gold standard treatment for OCD is called exposure response prevention therapy. So that’s been life-changing. That’s really, really helped.

But then coming into the FAMM program — did not appreciate what I would learn about myself in there. And yeah, it’s very clear on the charts when there’s a progesterone issue. And I think my first chart, the luteal phase was something like seven days. And it was like, well, that explains a lot.

Lisa: I just want to interject, and for anyone who’s still kind of like, what is OCD — obsessive-compulsive disorder — just in case someone isn’t making that connection. And it’s really interesting the way you describe — I just want to kind of jump back to how you said pure OCD. Because I mean, I know next to nothing about OCD other than the basic things that anyone who’s heard that term would kind of think of. And so what you said was really interesting — you said that you didn’t have those kind of outward expressions of it, which would be more typical if you have heard of it, because you do think of the repeated washing of hands.

Katie: Yeah, exactly.

Lisa: I remember one of my jobs in high school, I worked at one of the fast food chains, and a woman would come in and she would never take off her — she’d have these white gloves and she would never take them off. And she wouldn’t let us even touch anything. Like if we were filling her coffee, we had to bring the coffee to her. So those are the kinds of things that I think of. But what you’re describing is very interesting — obviously very, very difficult — but having these thoughts, these intrusive thoughts that won’t stop. And I’m not sure if you want to talk a little bit more about that, because there may be listeners who’ve experienced similar things.

Katie: Yeah, absolutely. So I think something that’s really important to note — so obsessive-compulsive disorder: you have the obsession, which for a lot of people is some type of intrusive thought. And everyone gets intrusive thoughts. Like it’s part of being a human. And the intrusive thoughts typically come up about things that you either care about the most or you find the most abhorrent, the most appalling, things that you’re completely disgusted by. So they really go for things that are going to have some kind of emotional reaction.

So common things that people might experience intrusive thoughts about might be about causing harm to people, or like children — their own children, perhaps. Like if you’re a new mother, I know a lot of people have talked to me about experiencing those types of intrusive thoughts. Like I said, mine were a lot around sex and relationships in various different capacities. It can also really pinpoint things that are really important to you or you care about the most. So if you’re raised in a religious setting, then it could make you feel like you don’t care about your religion and things. So these are the types of intrusive thoughts that come up. You just need to look up different types of OCD to see a huge long list of different things.

And then compulsions is something that people will perform in order to kind of reassure themselves or to stop harm coming to other people. And they can be what start as seeming like rational. So for instance, someone who’s scared of — so in COVID, for instance, someone might start washing their hands once, twice, three times, and there’s a specific way, and then it comes and comes and it spirals. Because when do you know your hands are truly clean kind of thing? If you can’t see dirt on your hands, then it can easily spiral if you’re struggling in that way.

And once you start to get very heightened and your anxiety levels are very high, then the rational part of your brain isn’t really engaged in the same way. So yeah, for me, my compulsions have rarely been those kind of typical outward expressions of OCD — of orderliness or tidiness or cleanliness, checking things like turning light switches on and off. That’s not really how my OCD has presented. But mine has been a much more internal experience.

So if I had a thought about my partner — being like, oh, am I sure about this relationship? — I would go over and go over that question and try to find an answer to it. And something I’ve learned about me as well is my intrusive thoughts get really loud when I feel very vulnerable. So maybe I’ve actually had a really lovely time with my partner and I feel quite vulnerable in that, and then suddenly it’s like bam — you’re not sure about this. And then the anxiety peaks. You try to perform compulsions to calm those anxieties, but actually by engaging with it, you’re just making it so much worse.

And I’ve literally got written up on my wall, like a guide to OCD, and it’s like: treat it as OCD even if it feels uncertain too. And that can feel so jarring. And then you have to be quite strict with yourself of like — now I can quite often identify my intrusive thoughts and just be like, that’s not actually me. And then you go, I see you and I’m not engaging with you. And you have to kind of put a bit of a hard stop on them to begin with.

But the exposure response prevention therapy — what you then have to do is sort of face your obsession in whatever capacity that is. So for me, the way I was exposing myself would be saying these things out loud. For someone who had contamination OCD, it would be like getting their hands dirty and washing them once until the dirt was off and then being like, that is all you’re doing — you’re not going to engage in the compulsive behavior.

So what that does is it raises the anxiety levels, and you kind of have to sit in the anxiety without engaging in the compulsion. So for me, the intrusive thought — I’d be saying like, I don’t want to be with my partner, I don’t want to be with my partner, just saying it, saying it, saying it. And the anxiety would be so much, it would almost feel like I’d been hit by a bus. It was that intense.

And with time — and I did this with a therapist, I wouldn’t necessarily recommend doing this on your own — over time, you kind of see like, oh, these are just thoughts. And the anxiety levels come down and down and down, and you kind of learn to see the intrusive thoughts for what they are — they are just intrusive thoughts. And then be able to not engage with them in the same way and put it down and hopefully live your life in a much better way.

Because it is debilitating at times. Like with this constant internal checking, it can be constant and then so time-consuming. And then days can go past. And for me, when it’s been its worst, I get completely derealized, and it’s like I can’t even think about three seconds’ time, let alone what I’m gonna eat before lunch. It’s a really disorienting and scary experience. It can be really, really scary to feel like that in your body and feel like you’re not in control of your mind.

But with the therapy, it’s really massively helped me to be able to differentiate what’s what. And having that ongoing support has been so important for me. But yeah, it’s definitely far more well-managed now. But there was a point in my life where it was like every two to three months, just be like, I’m not coping. And then put the cycles in with that, and it would just be really difficult, really, really difficult.

Lisa: Well, thank you for sharing that with us and helping to really contextualize what it is and what that experience is like. And although obviously for you this can get to that severe level, I really think about what you said earlier, which is that we all have intrusive thoughts. Because we do. So just to kind of put that out there — we all have these kind of weird thoughts of just unsettling, and it’s like, where did that come from? And why?

So just to put that out there for anybody else who maybe hasn’t experienced it to the level that you have but who has experienced the random — and one example that came to mind when you were sharing about new mothers is postpartum depression, because that’s one of the characteristics of it: having these thoughts of wanting to harm your child or harm yourself, or all those kinds of things. So I think this is a really interesting conversation to kind of bring some of these challenges to light, to normalize — not the way that we deal with the thoughts, but normalize the experience.

Katie: Yeah, yeah.

Lisa: And then that kind of thing — if it’s getting to be something that you can’t manage, to really normalize reaching out for support. Because that would —

Katie: Yeah, 100%. Really — although it can feel very — I would imagine — like who has thoughts like this? Who could I tell? Like I feel like it could feel very isolating. But there’s obviously — you’re not the only one.

No, 100%. I think that was one of the things that I found really reassuring was once I started to kind of speak about it a bit more — with friends and then in other places — and now I feel quite comfortable talking about intrusive thoughts, where it’s just like it is such a common experience. But because intrusive thoughts are intrusive and often about really abhorrent things or taboo subjects, we don’t talk about them. But they’re so unbelievably common.

And yeah, I think that’s the thing of being able to get normalized — having these horrible thoughts every once in a while. It’s part of being human. It’s then how you react to them. And if you’re really struggling with these intrusive thoughts and the reaction to them is interfering with your life, then that’s the point that it’s so helpful to reach out, because then you can help to reframe them and see them in a different way and just know that it’s a normal part of the human experience. And it’s okay to have them, and it’s okay to have them and be like, I see you, bye — and then not engage with them.

Lisa: Yeah, that’s what you said — you’re like, that’s not me. So it’s kind of like, yeah.

But let’s chat a little bit about how your cycle made it so much worse. Because I feel like that is the piece that for a lot of listeners are going to be like, wow, who would have thought? Or they might be making those connections in their own life, where you have some sort of underlying challenge that worsens with the cycle.

So back to what you said — I will share my screen — because you had mentioned that your first cycle was seven — you had a seven-day luteal. So the luteal phase then, between ovulation and your period — so mid-cycle, that period of time, the second half of the cycle — should be about 12 to 14 days. So ironically, when we had our first conversation, I feel like I was quite clear on the fact that you had an issue with progesterone. And when I was looking at the whole picture, there was a lot of very specific things that were huge flags to me that were all fixable. Because I was like, I don’t know if you’re getting enough protein for your activity level. I don’t remember if we had a conversation about eating meat, but there was a lot of things in particular that were kind of like, yeah, we can — I don’t know about the whole picture, but we can certainly improve this whole PMS thing.

Katie: Yeah, definitely. It’s so funny looking at this now. It’s just like, wow, seven days. And I think that is — so not that I was charting in this way before I came into the program — but I feel like that’s so typical of what must have been happening before. Because that 10-day mark before my period was so clear of like, now everything goes downhill.

And yeah, in terms of the experience, just everything intensifies. And like I said, the intrusive thoughts are a very normal part of being human. And in that first part of my cycle, it’d kind of be like, ah, whatever. Like, more in recent years when I’ve had some therapy — in the past it definitely got worse in those 10 days, but it wasn’t so easy to be like, eh, whatever. But in the last sort of three to five years, the follicular part of my cycle would just kind of be quite good, quite happy, a bit more energy, just generally feeling a lot more settled in myself.

And then that 10-day mark, it was just like — I often refer to PMS as “period doom” — this impending sense of doom. And the world’s gonna end. And that’s what it feels like — just this sudden switch of, oh God, just nothing’s quite right. And then suddenly feeling very unsure of myself. And then with that kind of anxiety creeping in, it’s so much easier to buy into the intrusive thoughts, and then they just snowball and go and go and go to the point where it’s just like — you basically feel like you’re having a panic attack for the vast majority of the time you’re awake.

And I think that’s what it would do — it would just really intensify any kind of experience to the point where you’d be willing your period to come, just to be like, I know this is going to be the thing that’s gonna just let it all release. And as soon as my period would come, it would just be this huge sense of relief of, oh, okay, it is my period. And then two to three days I’m gonna start to feel more normal again. And be so grateful for that coming. But then also very concerned about — almost feeling desperate to make the most of every day that you feel all right, because you know it’s going to go downhill again.

And I think when I came into the program and the things that you discussed — yeah, we talked quite a lot about food and protein and basically eating more overall. And I found that quite a tricky thing. I have a background as a professional dancer, so there’s sort of a history of disordered eating. I wouldn’t say a full-blown eating disorder by any means, but discomfort around eating more than a certain amount. And I was vegetarian for like three years or something, and introduced meat maybe six months before the program.

And yeah, just upping that protein intake significantly — oh my goodness — within, I think even one cycle, the luteal phase extended a bit. And then by cycle three or four, I had a 13-day luteal phase or something, which might have been a bit longer than that.

Lisa: Yeah, so they did extend. I’ve definitely got one — must have been the one after, so cycle five in the program — where I had a 13-day luteal. And believe me, that is huge. So for anyone who follows charting information — because I have to address this question — is it possible for the luteal phase to vary? Because if you read Taking Charge of Your Fertility and other classic fertility awareness information, it clearly states that the luteal phase is a lot less variable, which is true. And for most women who have a normal, healthy cycle, the luteal phase doesn’t vary that much — it might vary between one to two days per cycle. But what I see in my practice is that it can actually vary a bit if it’s too short.

So in your case, because seven days is not ever okay —

Katie: I can tell you it didn’t feel okay either.

Lisa: It’s not okay. And so that would mean that we have a variation from seven days to 13 days, which is five days. But think about what that means hormonally — that’s five more days of sufficient progesterone.

Katie: Yeah, because as we went through the program and I got more comfortable with fertility awareness in itself, I started to chart more of my emotional kind of ups and downs. And I wish that I’d had more of that earlier on, because there was a cycle quite early on, after introducing some of the supplement protocols — I think the protein, adjusting activity levels a bit — had no PMS. And I was so confused by it, because it’s so known for me to feel like that. And I was like, I’m due on and — looking at my chart — I did ovulate, and I am at the point in my cycle where ordinarily I’d be really finding things more difficult. And I was just so confused by it, but also like, oh wow, these changes have already made an impact.

And I think having that cycle where I experienced that for the first time in my life — of not feeling like the world was about to end — and seeing the changes in my body, which really were pretty minuscule, of having put on a bit of weight, being like, well, if putting on a little bit of weight means I can feel like this, then cool, fine.

And actually, at the start of last month — September — had a really bad episode of OCD, which I haven’t had in about 18 months. So it kind of came as a bit of a shock to me, to be like, oh wow, we’re back here. My cycle was really impacted by that.

When I get very stressed out, and in these episodes, my appetite does just disappear. I lost quite a lot of weight very quickly. And for the first time in my life as well, of being very much wanting to put that weight back on — whereas other times when I had those episodes, particularly at dance school, it was encouraged to stay at that weight. And now I’m like, no, no, no, let’s get it back on, because I felt great then. I want to feel like that again.

So that’s been a really positive mindset shift that I did not anticipate coming from this. And obviously it makes total sense that if we’re coming in as practitioners to learn this ourselves — but I really didn’t expect to have this experience from the program. And it’s just really shifted my perspective on all sorts of different things as well.

Lisa: It’s so fascinating to hear your experience. I’ve got a few — I’ve thought about all these different points I want to ask you about. So I’ll try to remember them all.

The first one was — because you said you had this first cycle in your life basically where you didn’t have PMS. So maybe just take us through again — because basically your experience of PMS symptoms was what I would call PMDD, coupled with OCD, right? Like being a snowball of things together. But essentially many women who experience PMDD experience something similar, where — because I don’t have the definition in front of me — but basically the debilitating part has to be there. So with PMDD, it means that it’s debilitating and it’s impacting your life in a negative way, or having a hard time working or functioning. That’s when it crosses over into the PMDD territory.

And so this is one of the interesting things about cycle charting and kind of putting it together — because instead of just looking at this issue by itself, now we’re placing it in the cycle and looking at the whole picture, how it works together.

Now that you have that experience of having a cycle without that — tell me what you think about that. Because before, I would imagine — because it’s not always the same thing with the PMDD — but I work with many clients who’ve had similar things, whether it’s pain and they’ve never had a cycle without pain, or something like that. And they don’t — you don’t even think it’s possible. Like this is something you’ve been dealing with your whole life. So what do you make of that? And what kind of impact does that make on you yourself, and also how you plan to incorporate this with your clients?

Katie: Well, I think having experienced that — well, actually, going back a bit — I remember when you said to me, I don’t know if it was in a one-to-one or a hot seat situation, but when you said about like, but it could change. And you could feel even better than you do now. Like you think you feel okay now? You could feel even better. And I just remember being like, what? I honestly felt like someone had blown the top of my head off. I was just like, just couldn’t get my head around that. Like it could actually change. Which is kind of silly, considering I work with people supporting them with their periods and see things change for them, that I couldn’t apply that to myself.

So then when I did experience that, I was just so shocked again, and in a really positive way. But just like, oh wow, it’s possible. I think — it’s kind of frustrating because I wish I’d recorded more during that cycle of what was going on, what were the things I was doing. And I’ve got the general gist, but something I’m still really trying to work out is my activity levels and kind of how that impacts my luteal phase. I still haven’t quite nailed that. But I know that when I get a lot of protein into my diet, I feel so much better — like every aspect. And I was hardly eating anything, very carbohydrate-heavy in my diet before. Not a bad diet at all, but just wanting to tweak the balance of things.

And that’s something I’ve really taken in with clients as I’ve worked with case studies now — the amount of people that come in and their diet’s all right, but it’s a case of just shifting the balance of things. And that can be the thing that makes a really big difference. And that’s quite a good, easy way to get your head around things — it’s just shifting the amount of what’s on your plate of different things.

And yeah, working with clients and having had my own experience of learning and charting and knowing that, one, it can take a bit of time to get your head around the charting elements — so far everyone that I’ve taught has got it way quicker than I ever did. But I think it reassures them to be like, I learned this, it took a bit of time, we’ll go at your speed. And that’s been a really helpful tool.

And then, yes, I’ve had my own experience of like, I’ve used these protocols and they’ve made a massive difference to me. I think it’s really helpful to clients to see that you’re a human as well, and you’ve worked through elements of this, and you’re still working on other elements. But these are the tools I’ve used, and now I’m giving them to you. And I think that’s been really powerful and really impactful — to have very practical things and very clear protocols of how to treat clients and work with clients. And yeah, it’s just been such a brilliant addition to how I’ve been working with people so far.

Lisa: Well, in your experience, it really speaks to something important, which is: obviously there’s an issue there, and doing this approach doesn’t remove the issue. It’s something you’ll always be dealing with. However, with all of the therapy and treatments and protocols that you did in your own life, the whole — what are you eating? Why is this being exacerbated by your cycle? — that question wasn’t being addressed.

And so in the program — for anyone who’s kind of like, why do they keep talking about protein? — it’s not just because we like meat or whatever. It’s because there are certain foundations that we have to put in place in order to make hormones, in order to have a healthy cycle, in order to balance our hormones as cycling women, so that it doesn’t throw us into all kinds of problems.

And so part of what we’re doing is going to that basic foundation and using the cycle as a starting point, balancing those hormones, and seeing what happens. And often what happens when we do that is we feel a lot better in other areas of our life. So when I was approaching this with you, Katie — as I’m sure you approach it with clients — I wasn’t actually saying I’m going to fix your PMDD. Even though that’s kind of what we’re hoping for, right? What I was saying was, whoa, this cycle — we need to organize this a little bit better. Let’s organize your luteal phase so that it’s not seven days, and support your hormone production a little bit. And then see what happens.

Katie: Yeah, completely. And getting those foundations in place is just so important. And so the large proportion of my work so far has been as a reflexologist. It’s a holistic therapy, and we perform it all on the feet. There’s different parts of the feet that correspond to the body, and by working on the feet we can have an impact throughout. But the thing that I firmly believe is the powerful thing in reflexology is the relaxation element, and helping people to manage their stress and bring them down from that really heightened level to a much more calm and regulated state.

And I think relaxation, stress management, being part of those foundational elements — they’re things that we often know, but because we’re like, I kind of know I should relax more, I need to sleep better — it’s so easy to dismiss them. And yet they’re the things that underpin everything. And I think that’s been a really great part of the program, looking at the foundational factors and really addressing each individual aspect. And then seeing it — and it’s so exciting when you see it in the chart, like things change, and you’re just like, it’s happening. I just think getting those foundations in place is unbelievably important.

Lisa: Something I also think is important to point out is that what we did — it’s not magic. So it’s not like you ate a little bit more protein and all of a sudden your cycle was totally perfect and everything was great. And I know that you had ups and downs, because you mentioned you also had a resurgence of the OCD symptoms. And you were able to recover and obviously take what you had learned and incorporate all those things. But just to kind of put out there that with cycle charting, with this interesting process that we go through in FAMM, and what you may have noticed with some of your clients, is that we can get to this really great place that’s a lot better than where you started. But it doesn’t always happen in a straight line. It’s not magic, and it doesn’t happen in an instant. It typically takes a few cycles of effort and work. And it’s not the easy — like I feel like it sounds easy. We could talk about, do this and this and this, and it’s like, yeah, but it’s not.

Katie: Not at all. So the last cycle I had — the previous one — so it was kind of like the back end of August, September time, where I had a really awful episode. And my cycle was all over the place then. I’m usually about a 27, 28-day cycle, and it went down to 25, and I had bleeding on like day 22, 23. And I’ve never experienced kind of bleeding before my period.

So yeah, with the resurgence of having an episode, my cycle was impacted. And I’ve ovulated late this month, and I’m expecting my mood to kind of dip a bit and have a cycle that’s more typical of what’s historic. But I’ve not been as good on the supplements, my diet’s been a bit off since — like trying to get back on track. And it’s just like, I now know what does work for me. And it’s taking those things and slowly having implemented them again.

And that was something that you said to me — take it bit by bit. Like, maybe for charting just now, you just focus on one aspect rather than trying to do it all. And that felt so reassuring to me, just to be like, okay, I can drop this for a time, and I’ll do the bits that I know are going to really help me right now. So sticking with basal body temperature, because that really helps to confirm ovulation, and then picking it back up and getting more back into the rest of it bit by bit, as I started to feel better in myself.

And just having the permission to be like, okay, you can drop some of it for a time and then come back to it as you start to feel better. And I guess because I wasn’t using it for birth control or trying to conceive or anything, there wasn’t that added pressure. I was able to just completely drop it. So for context in that respect. But that’s been something that’s been helpful, to know that I can then offer that to clients as well — if everything gets too much for a time, we can drop the charting and just focus on getting those foundations back, because they’re going to be the thing that really help you to feel more like yourself again.

Lisa: Yeah, I know. I just like to point out the pattern because it sets the expectation. Because we’re human beings. I think what I want to see is that we’ll do something and it works for a while, and then we kind of stop doing it a little bit. And I sometimes wonder if we’re subconsciously — did it really work? Was it really that — but it’s a very natural kind of thing that happens. And I feel like it’s like that with a lot of things. I could list a bunch of different things. Like if you have certain medication that you take, and eventually you’re like, you’ve been on it for so long, is it really working? Yeah. Oh, it was working. Yeah, let’s go back.

But as you continue to — what I love about the charting aspect is that now you’re in an ongoing conversation essentially with your body. Whereas before, it was just one way. Your body was giving you symptoms, and you were ignoring them because you didn’t necessarily have the tools to be able to respond. But now you’re in an actual ongoing discussion. And the longer that you do this and the more that you pay attention, you’ll get to a place that’s more symbiotic, which is the goal obviously.

So share with us — for any practitioners who are listening who are thinking about this whole FAMM process and what it would be like to implement it and bring it into their practice — maybe share a little bit about your experience incorporating it. How does one incorporate the chart into reflexology?

Katie: So I did some training last year of reproductive reflexology, and there are different protocols of the types of treatment we would do depending on where you are on your cycle. And the course was brilliant in lots of ways. However, we spent half a day on basal body temperature and cervical mucus, and I just felt like I was not confident enough to then go and teach people how to use this. Because I was like, we got sort of five or six examples of what a chart might look like.

And I guess that’s part of the program — so much of it is bringing in your charts and clients’ charts and seeing real life charts, because they don’t look like what the textbooks tell you. So what this has really given me is the confidence to then go and teach people this method for whatever their desired uses, and then be able to really tailor the treatment to exactly where they are in their cycle, rather than kind of be like, do you think you’ve ovulated? Oh, I don’t know. So it’s made it really specific.

And then also, I came to the course looking for more information. I feel like I had the basics of fertility-related information, but the clients were coming to me and I was just like, oh, I just need more. And I remember looking at the website and seeing kind of an outline of the syllabus, and I was like, this is it. This is what I need. And I think I signed up really late — it was just before Christmas and we started in January. So it was quite a snap decision, but the best decision I made last year, 100%.

Because I just have this wealth of knowledge now, and this ability to teach people exactly where they are in their cycle and for them to understand exactly what’s going on. And there’s no assuming anymore. Like I just assumed I ovulated on day 14 because that’s where everything told me. And actually, that first chart — it was day 20 or something. Just because I had a 28-day cycle, it was far from what I thought it was. And I’ve got the data now to back that up.

And there’s just so much information in this course that will undoubtedly enrich how you support your clients in every area of your work. I just think it’s been invaluable. And so well thought out — every assignment, I totally understood why we were doing it. Because I’ve done courses before where I’m like, they’re just doing written work so they can tick off part of the certificate. Whereas everything followed on from the next thing, and you just feel so equipped and so supported to then go forward with your clients.

And yeah, it’s been the best thing I’ve done this year, 100%. Because it’s just given me so much confidence. I literally had a consultation on Sunday, and the form that they fill out for reflexology — there are at least two or three things I picked out that I wouldn’t have been able to, had I not done this course, just from a brief consultation form. So yeah, it’s been invaluable in so many respects.

Lisa: Oh, that’s amazing, Katie. That’s such a lovely, glowing — just do it. Just do it. If you’re thinking about it, just do it.

But I mean, I appreciate that. And that’s the point — it’s real. It’s what people really experience. And instead of having a bunch of hypothetical, curated — we do have some case studies — but instead of having a whole bunch of curated case studies, we have endless real client examples, which is necessary. Because what’s the use of having these perfect-looking charts when what you’re seeing is real humans, with the challenges that arise? And as a practitioner, you’re typically getting people who are having a challenge — that’s why they’re seeking support. So you’re more likely to see charts that are more difficult from that perspective.

So tell us a little bit about what you do, where you are in the world. I’m sure everyone has detected your accent or the difference between my accent, depending on where they’re listening.

Katie: So a lot of the work that I’m doing at the moment is reflexology. I’m based in East London in the UK. So mostly in East London, I also do Fridays in South London. So there’s different places that you can come and find me. But I will be doing another intake of fertility awareness clients, but not until the spring of next year. And that’s all online, so then I can work with anyone. So that’s been a really nice thing to then add to what I can offer, is this online element.

Lisa: Yeah. I mean, you can find me online — on Instagram is where I’m most active. So Reflex East — like the tag.

Katie: Hence — reflexology meets East London. Yeah, that’s me, I guess.

Lisa: And you have a website?

Katie: Yeah, website is reflexeast.com.

Lisa: Awesome. Well, I’ll make sure to link all the places so you can find Katie. If you’re lucky enough to live in East London — and yeah, I mean, thank you for being here. I’m really excited to share this episode. I feel like we really touched on some things that I’ve never brought up on the podcast before. So I feel like this episode is going to be really eye-opening for everybody. Thank you for helping me.

Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/443. I hope that you enjoyed today’s episode with Katie. I mean, what a powerful story and experience. I certainly learned quite a bit today about OCD and the different ways it can present, and also how it can be exacerbated by hormonal issues, menstrual cycle challenges, and PMDD.

And it’s really interesting when you look at the menstrual cycle as a vital sign. Instead of chasing individual symptoms, simply working on the basic steps required to balance hormones and to optimize menstrual cycle health — it’s really amazing what other symptoms can improve and level out. As I was saying to Katie — can’t remember if it was on or off air — when we started to jump into this program together and taking her through what I call the FAMM process and chart analysis, I wasn’t trying to improve her OCD. I was trying to improve her cycle, normalize her hormones so that we could address the very, very, very stark, quite obvious issue with progesterone production. And so that was the focus, really — to balance the cycle.

So it’s really fascinating to then see what comes out of that. And in Katie’s experience, it was very dramatic, with a significant improvement in her mental health and how the OCD intermixes with the PMDD. And I’ve seen similar results in different ways with other clients — again, focusing on the menstrual cycle, balancing hormones, and supporting general health in that way, seeing how that spills over into other areas of your life.

And so the same FAMM process that I took Katie through, she has learned through the program to take her own clients through. And that’s essentially one of the huge pieces of the mentorship program — which is to help you to understand how to not only support your clients to chart their cycle so that you can correctly interpret what’s happening hormonally, but also to provide them with the tools to balance the hormones in the cycle, normalize the menstrual cycle, and start to see those improvements. Which is a really fun process — very empowering to see how much the menstrual cycle can be improved by following these steps and really focusing on these aspects of health.

So like I said, I hope you enjoyed today’s episode with Katie. I just want to thank you again, Katie, for coming on the show and sharing your experience. It was such a great opportunity to shed light on OCD and similar conditions and just normalize some of the challenges that we all go through. Perhaps in Katie’s case it’s to a greater extent, in terms of her experience with OCD, but I feel like there’s so much of her story that many of us struggle with in a general sense, that may not necessarily get to the same level.

So I feel like it’s really helpful and important to talk about these things. And also, for many of you listening, it can be a surprise to hear how something like OCD can be connected to the cycle — and how at certain times of the cycle it could ramp up or ramp down. This is not something that is new or surprising to me, because I’ve been in this field for so long and I’ve heard so many similar stories. But I feel like it also sheds light on that aspect. It really anchors our conversation with a huge reminder that the menstrual cycle is a vital sign. And when the cycle is off, it makes everything else worse. So it’s really helpful to be able to have the tools to bring that cycle into line for our overall health, and especially as reproductive-age women.

So with that said, I hope you have a wonderful week, weekend, whenever you’re tuning into the show. And of course, as always, until next time — be well and happy charting.