Abnormal Uterine Bleeding in Perimenopause (Episode 482)

Full Transcript: Episode 482

Lisa: I’m excited to share today’s episode with you. Today I’m sharing another episode in the FAMM practitioner series, and I’m sharing my interview with Lilliana. We get into a really interesting topic. Lilliana personally experienced some significant challenges to her cycle while she was a member of the FAMM program, and in today’s episode she shares how following the FAMM process helped her to overcome it.

Before we jump in, I’ll just share a little bit about Lilliana. Lilliana is a massage therapist and abdominal therapy practitioner who helps women suffering from physical pain and discomfort in their bodies. Lilliana is also a womb awareness coach and loves to help women feel empowered through an intimate connection to the belly and womb by creating a connection to their inner knowing and moving from a place of feeling stuck to a place of clarity and radiance. Without further ado, let’s go ahead and jump into today’s episode with Lilliana.

Well, I’m really excited to be here today with Lilliana. Lilliana is a member of my inaugural FAMM program, and we’re recording this just about a month or so after our program officially ended. I’m really thrilled to have you on the show. You had a really compelling experience mid-class that we helped you to sort out. I’m really excited to talk about that. Welcome to the show, Lilliana.

Lilliana: Thank you, Lisa. I’m excited to be here.

Lisa: Well, thank you for coming on the show. One of the things I love about doing these podcasts is that I get to basically start most of them by asking how old were you when you had your first period and how did you manage your fertility and things like that. I would love for you to just kind of walk us through a few of the things that led you ultimately to join the FAMM program this year.

Lilliana: I started menarche around 12 and I had painful periods, irregular periods. It was interesting—I was never prescribed hormonal contraceptives or anything like that for those symptoms. I wasn’t on the pill very long. I started the pill around 16, and I think I stopped taking it around 19. I took it on and off. It wasn’t something that I did consistently, and then I just used condoms after that. Not a lot of history with hormonal contraceptives.

Fast forward, I had kids and two C-sections. That really sort of brought me back into bringing some awareness into my body. I think that for a lot of years, I sort of navigated just not really paying attention to my cycles. I didn’t know when I ovulated. I wasn’t very aware of how my cycle worked at all. It was really interesting. I was able to have kids easily, but labor was always an issue, so I had two C-sections.

I think it was after my son was about four years old, I was having some pain in my scar. I decided to see someone who does abdominal therapy, and it was pretty amazing. After a few treatments with this practitioner, my symptoms went away. My symptoms were like feeling tightness and numbness and tingling, and I would always sometimes feel like a random pain on my left side. It was kind of scary—it was really random. I was always wondering, gosh, what is that? When I would go to the doctor, they didn’t really offer anything other than pain medication.

After I saw this practitioner and my symptoms resolved, I was like, wow, I really have to learn more about this. That’s when I started really paying attention to my cycles a little bit more, although I wasn’t charting yet. I wasn’t doing anything like that, but I started to learn more about abdominal therapy and actually decided to take the training. I went to massage school, I took the training, and it was in the training that I heard about fertility awareness. I saw your book there too. I think one of the instructors had been on your podcast. I listened to the podcast, and from then I just started listening to you all the time and just really learning how what I was offering with abdominal therapy weaved into everything you were talking about.

When you were offering the mentorship program, I was like, oh gosh, I’ve got to hop on this. Just because in my area, what I like to do is I treat my clients and I help them through period pain with endometriosis, and abdominal therapy does help a lot. However, I was finding that there were some pieces that were missing, and I would refer to a naturopathic doctor. I would refer out to chiropractors, but I knew that fertility awareness was a key important piece to what I was offering, and there was nobody around in my area that was offering it.

I decided that I wanted to learn it myself, and at that time I was still cycling. I felt that it would be something good for me to learn about myself, and it was a big learning experience. I’m still cycling but I’m definitely in that perimenopausal phase moving into menopause. That’s what drew me to your program. I just felt that if I’m going to offer abdominal therapy, there has to be this other piece there. If I can’t offer it by referring them, then I felt like this would be a good thing for me to offer to my clients. It has been amazing just to learn all of the important aspects of not just learning about your cycle, but learning about lifestyle choices and how hormonal contraceptives affect your cycle—just so many things.

Lisa: Well, I always feel like I always say this, but you just took us through, I don’t know, like 30 years of your life. It’s quite a bit there. I think there’s a few interesting pieces of your story—one, that you for the most part avoided hormonal contraception, and also that just at the particular stage of life that you’re in right now in the perimenopausal phase, I feel like that really came out.

I remember when we had our first in-class hot seat sessions. In the FAMM program, I feel like for fertility awareness, it is important for the practitioners who are learning to also be going through the process. I mean, that’s how I learned. It’s kind of why it’s a mentorship program—it’s kind of like this where we’re all participating in our learning. But what was interesting about it is that you weren’t necessarily cycling at that point. Maybe share with us a little bit about what was happening with your cycles. Was it kind of like, did it happen in the middle of the class, or what were your cycles like leading up to the class and all that?

Lilliana: Right, yeah. I’m 49 now. I think around 47 or so, I was really noticing a shift in my cycle. It had been happening a little bit before that, around maybe 45, but around 47, I was going through some months where I wasn’t cycling and then it would come back. It was really becoming irregular again. It was interesting—my cycles were regular when I started menarche, and then they regulated after kids. It was pretty interesting that that happened, and then I started having these irregular cycles again in my later 40s.

I think I had gone maybe almost three months without cycling, and it was almost sort of in the beginning of the program right around April that I started cycling again. I was like, oh, I guess I am still cycling. Because when you go three months without cycling, you thought, oh, well, maybe that’s the last time, I don’t know. I ended up cycling again, and then it wouldn’t stop.

That was an interesting experience, and I’m so grateful that it happened during the program because like you said, we were also charting ourselves and learning how to chart. This was the first time I was actually learning how to chart the symptothermal method. Basically, what I would do before was just use an app and look at the app—the app literally would tell me when I was going to have my period again. I would always be looking at my app to see when I was going to cycle again. I was so disconnected from my body, it’s just really interesting.

I think that my story is not that uncommon—women don’t, I think if women have very regular cycles, they know like oh it’s always on the 28th or whatever. But for me, because I always had this tendency towards irregular cycles, I wasn’t always aware. I would have symptoms—breast tenderness and bloating when I was young. Then those symptoms sort of subsided, even the pain. As I got older, the symptoms were less clear, and so getting my period was not as predictable.

When I started cycling during the program, I thought okay, so I started charting my cycle, and then I started really getting concerned when a month later, I thought, gosh, I’m still bleeding. I wonder when this is going to stop because it wasn’t usual, it wasn’t a typical thing. I had had a lot of bleeding before—I think in my late 30s after my second child, I wanted to use contraceptives again, so I had the copper IUD put in, and I bled so much with that. I had it in for like six months and I would have like three week bleeds. After that, I was like, oh, I don’t want to do this anymore, so I had it taken out.

After this, bleeding for a month, I thought this isn’t normal, this isn’t usual. I started just trying to educate myself about perimenopause, and I did seek out a naturopathic doctor who prescribed some herbal tinctures. It was interesting because the herbal tinctures actually did work at first. I took a yarrow tincture and I took a vitex tincture, and within I want to say like 48 hours, the bleeding had stopped.

The other interesting thing about this bleed was that it wasn’t just heavy bleeding—it was bleeding with clots, with large clots. It was pretty concerning. When I took the tinctures and they subsided, and I went down to almost like spotting after 48 hours, I thought oh gosh, this is great, it’s over now. I kind of slowed down on the tincture protocol and then it just slowly started back up. I think within a week I started bleeding heavy again.

The naturopathic doctor had actually recommended that I do a metabolic panel and just get some blood work done, so I had that done. I also went to see my primary doctor. When those lab tests came back, it showed that I had low iron, so then the primary just prescribed iron medication. I think that’s when I was starting to talk to you about it. I think that’s when we had our first hot seat session, and you were starting to talk to me about diet. That’s when a lot of stuff clicked.

I had been learning it in the program, but then when I started really actually looking at my dietary intake, I started to really pay attention to what you were saying about the importance of protein and how it makes hormone and looking at what might be the cause of what’s happening.

My history is that I was vegetarian from the time I was 16 and I was vegan for three years. At that time, as a vegetarian vegan teenager, I wasn’t eating all the best stuff—it was pasta and things like that. Then after children, I was really conscious about eating really good balanced meals, not a lot of sugars and carbs. I was trying to limit those and also eating organic food. But it was really interesting that I didn’t make the connection between a potential nutritional deficiency and what was happening to me in this transitional phase in my life. It was interesting that you kind of pointed that out for me.

Lisa: Yeah, I mean, even before we started recording, we were talking about it and you, I think you said something like, if I had only bled for a month, I would have thought that it was fine. I was almost jumping up and down in the background like, no, bleeding for a month is never fine.

Right, so what I find—I mean, there’s a lot of different pieces to your story, but in retrospect now it may have crossed your mind—I mean, so just for the record, and I’ve said this in class as well, abnormal uterine bleeding, we always need to be paying attention to that. Outside of your regular period bleed, if you are bleeding like mid-cycle bleeding that is continuing, or if you literally, like in your case, bleeding for over a month straight, it is—and I recommend to all of my clients—to go to your doctor. Bleeding is something, I mean, just to be on the safe side. My first recommendation is always to go to your doctor and to request testing.

I think you may have pointed out one of the unfortunate aspects of this, and this might have even been before we were recording, is that when you are in that age range, in that premenopause age range, and you do kind of look up what to expect from that experience at that time of life, you are told that bleeding is normal. Just for the record, no one should be bleeding for a month—like stop, everyone write this down, right? This is why it’s really helpful to understand the menstrual cycle, understand what are normal parameters, what are not. Even if you are going through the premenopause years, that does not mean that everything goes. There’s still like an optimal situation.

I think it’s helpful to know that it can happen and it’s quite common. But if we look at the menstrual cycle as a vital sign, it does mean that there’s something wrong. But the point that I’m making is you should go to a doctor, you should get screened, you should get an ultrasound. You want to rule out serious medical conditions that can cause abnormal uterine bleeding. It’s always the important thing to do.

But what’s interesting about your situation is that I was probably the first one to actually ask you if you were eating enough food to sustain yourself physically and look at some of those potential underlying factors. Not just to take for granted that a woman in her 40s might just bleed out of control even though it’s really common, but to actually look at what could be contributing to this for you.

Lilliana: Right, yeah, absolutely. I mean, I went to—so after I went to see the naturopathic doctor, I went to my primary, then I went to my OB-GYN. Essentially, I did have some exams done. I had a sonohysterogram done, and I also had an endometrial biopsy. I did have some testing done just to rule out some things because literally, we mentioned sort of what was happening in the beginning, but I literally bled for months.

I ended up bleeding—I think when I was put on—so I went to see the OB-GYN, and I was put on progesterone, synthetic progesterone, so that slowed down the bleeding. But it didn’t stop the bleeding, so I ended up bleeding till essentially like August.

Lisa: Like April to August?

Lilliana: Yeah.

Lisa: Well, and so let’s contextualize this. When you say you were bleeding, did you have to—how do you collect your bleeding? That’s usually how I ask it. Do you wear pads or tampons?

Lilliana: Yep. In the beginning, that first month, I was using menstrual pads and I was having to change my pad like every other hour. Every other hour. It was heavy. It was really heavy. And this was for a month straight.

Lisa: Yes. Then I wonder why you had low iron.

Lilliana: Yeah, yeah, right. And I was tired. It was really interesting. I was really, really tired. Then when I started the tincture protocol, it slowed down a little bit.

Lisa: And was the tincture protocol before the progesterone?

Lilliana: Yes. I did the tinctures before, and then when I went to see the OB-GYN, we had plans to have the exams done, but in the meantime I was put on synthetic progesterone—medroxyprogesterone, 10 milligrams, three times a day. I was to taper that off as the bleeding subsided, and it took literally until August for the bleeding to subside.

I took the progesterone and then it started—it’s really interesting because, yeah, it started in April. May, I was like gosh, something’s going on. Went to see the naturopath. Then in June, I had blood work done, and then in June I also got the prescription for the synthetic progesterone. Then it wasn’t until July that I got my exams done, and everything came back normal. I did have uterine fibroids, so they did find that, but she couldn’t tell me that that was what was causing the bleeding, right? There was no—it was diagnosed as abnormal bleeding, but they couldn’t tell me why I was bleeding like that.

Once my lab work came back for the biopsy and things like that, I was still bleeding a little bit. This was July, and she said, here are your options. We don’t know why you’re bleeding, but we can give you a hormonal IUD or you can have an endometrial ablation done. She described it as a very simple procedure and that helps a lot of women and that this happens during perimenopause and this is how you can basically take care of it.

I just went home. I decided I wanted to think about it, and so I didn’t schedule it. It was really interesting because I just kept on with sort of really focusing on my diet and the supplements, and beginning of August I stopped bleeding.

Lisa: Well, so let’s talk a little bit about—so I remember we had a conversation, it was kind of one of those like emergency, like we need to talk because it was, I think it was around the time that you basically had to make this decision about the surgery.

From my perspective, as a member of this program, essentially I’ve created over the years kind of like an assessment protocol—what we called it in the class. Not only did I teach you how to take clients through this protocol, I took all of you through it as well. Essentially, what’s interesting about the cycle is that my aim is that we look at it in a different way. Instead of chasing symptoms and like oh my goodness we have this symptom and this symptom, we kind of remember that the menstrual cycle is a sign of overall health, and so we kind of need to focus on the foundations of overall health.

One of the things that stood out to me right away—and so this is something to be aware of for women who are in this age category—I mean, I’m approaching it, I’m turning 39 this year, and so it’s right up my alley as I enter into it. But there’s a few things we’ve talked about this in class—women who are in this perimenopausal age, it’s a very interesting age. Like me, myself, I have young children and aging parents, obviously like a thriving career, and so there’s a lot of individuals vying for my time and energy. I find that a lot of women in this age group have similar challenges.

It’s also a time where our body changes. I feel like there’s a lot of habits that we can develop in our early 20s and we can even maintain many of those into our 30s, but I’ve found just from monitoring the menstrual cycle that it does seem like this period of time in our 40s, late 40s, early 50s, we can’t get away with as much as we used to. There’s certainly more effort, I would say, that we have to put forth to maintain a good hormonal balance.

I think that the important part or piece that I brought to your story is just I’m not working from an assumption that your body doesn’t work. I’m working from an assumption that your body does work and we just need to figure out what needs to happen in order to get it to function. That’s not to minimize any potential health issues, and this is why it’s always really important to get thoroughly investigated by your medical doctor because we have to make sure that we’re looking at all of these options.

But one of the things that was most apparent to me in your case, based on not even necessarily the fact that you were vegetarian—I mean, in a way that’s kind of neither here nor there—but it was when I literally had you track your protein and we discovered how much protein you were actually eating. If memory serves me correct, it was something like 30 grams a day.

Lilliana: Yeah, it was pretty low.

Lisa: So any of the nutritionists who are listening are like, wow! But for the non-nutritionists who are listening, I mean, an adult woman, generally speaking, the ideal range falls somewhere between 80 and 120. And that’s just to maintain your hormone production. If you exercise, if you’re active and you do a variety of different activities, then we may even need to raise that a little bit more.

From my perspective, I can’t really make any decisions about anything until we rectify some of these basic foundational factors and then see what happens to the cycle. We had a number of conversations about that. So maybe share with us what it was like to kind of have that put right there after being a lifetime vegetarian and how you decided to address that information.

Lilliana: Yeah, so around the time that I was going to school for massage and taking the abdominal therapy trainings, I was noticing that my body needed more. I started eating a little bit differently. I was eating more fish and I started eating eggs, which is something that I didn’t do as a vegetarian. So I became from vegan, I became lacto-vegetarian, and I was pretty much lacto-vegetarian for, I don’t know, 25 years or so, for a while. Then just noticing that my body needed more because I was very busy with my kids and work and school and trainings and all of that.

I started incorporating that into my diet more, but I didn’t really realize how much I needed to really keep my body so that I wasn’t running low. Going through the program with you and just really seeing the numbers, it just really made me realize, oh, this is why I’ve felt tired a lot for a lot of years. Actually, when I was raising my kids, I thought I had chronic fatigue syndrome. It was really interesting. I thought, well geez, maybe if I juice more or if I do smoothies or take supplements.

I did start taking some supplements. I wasn’t a vitamin person. I really sort of stayed away from medication and vitamins and things like that, but I did notice that if I took vitamin C and vitamin D, I felt a little bit more energetic. But I didn’t realize how bad the situation was until I started really looking, scrutinizing and looking at the numbers and seeing how deficient my daily intake was, and why I was having these deficiencies and why I struggled to have regular periods—which is really interesting, like that’s a sign that something’s wrong in the first place, especially when you’re young, right?

Just what I experienced through this perimenopausal journey was definitely an eye-opener as to how important it is to really address nutrient deficiencies in a way that addresses it not just with more supplements. That was another thing that felt very clear—that it’s not about taking protein shakes and living off protein shakes or taking more supplements and more vitamins. It was more about really looking at what are the most nutrient-dense foods and how can you incorporate that into your diet.

It’s been hard because I can’t go from being vegetarian to eating a hamburger or steak, but I’ve started slowly with like having broth and having just some meat in my vegetarian tacos—now I make them with chicken. Yeah, just adding little by little, just adding it into my diet in a way that my body could handle it at first, in a way that I could also enjoy the food, and also be at peace with my own philosophy around why I became vegetarian in the first place. All of those things I had to work out for myself and make decisions based on what I really felt was most important. I just prioritized those things and it just made a huge difference.

Lisa: Well, so I want to get into what happened, but I just feel the urge to ask because of course there are vegetarians and vegans who tune into the podcast. Some are not too happy with the topics that are discussed because given what I do, it’s kind of specific. The majority of my clients are of reproductive age. Obviously not all are trying to have babies right now—like in your case, your goal was to not bleed out. It wasn’t to conceive at this stage of your life. But at the same time, I’m working with women of reproductive age, some of whom don’t want to get pregnant now but may have a future orientation, some of whom obviously are actively trying to conceive. But generally speaking, women who chart their cycles want to have a healthy cycle and they want to feel good and they want to have optimal hormone health.

My wheelhouse is supporting women of reproductive age to have optimal cycles, and what I found is it tends to be easier for better or for worse when meat is incorporated. It doesn’t mean that it can’t be done. Obviously there’s plenty of contingency plans and plenty of things. But the bottom line is that in your case, I think the initial focus was like, let’s just get in protein and see what happens. Because it’s kind of like if that’s what the problem is, then we should see some improvement. So maybe share with us, actually tell us a little bit about—because you had mentioned your philosophy, like how you had to kind of have that conversation. Do you want to talk a little bit about your initial reasons for becoming a vegetarian and if that shifted throughout and kind of where you’re at now?

Lilliana: Yeah, that’s interesting. So I became vegan as a teenager. It was something that I felt really strongly about, as far as from the perspective of activism. A lot was coming out about animal cruelty at that time. In looking at all of that and really looking at actually, we don’t really need to eat meat—so it was more of that where I felt like it was a philosophical thing that I didn’t want to eat meat. It was also part of my spiritual connection where I felt like I didn’t want to partake in eating meat. I just felt really good about that.

Fast forward to having kids. My daughter started having digestive issues. My kids actually—I raised them vegetarian mostly, but I didn’t restrict their diets. I mean, they could eat meat. But my daughter really started showing symptoms of really chronic digestive issues, and I kept looking here and there. Everywhere I looked, I couldn’t just figure out what was going on with her. Then I found out about the GAPS diet. The GAPS diet really helped her.

My mind started shifting around the fact that yes, it is good not to consume too much meat and to support this industry, but at the same time, here I am, I have this child who’s suffering, and the one thing that is helping her is bone broth and the diet. It really, really helped me shift my perspective around what the body really needs and what, you know, I started looking at, okay, what did my ancestors eat? It was primarily a lot of meat and starchy grains and things like that. That’s when things started to shift for me.

But now, it was interesting because I was open to then making meals with meat, but I didn’t partake of them for a long time. It was only when I started feeling depleted, like I said, when I started getting really busy that I said, okay, let me incorporate some eggs and fish. I was doing a little bit of broth at that time, but very, very little.

Yeah, it’s just become this thing where I understand that there’s a way where you really feel strongly about eating a certain way, and that should be honored, right, that that’s okay. But then also look at your body and what your goals are. If you’re having infertility issues and you’re struggling with deficiencies, you can try different things, but you really have to look at what is the priority. If you’re really wanting to conceive, then really looking at what all your options are.

I don’t know, it’s a difficult topic honestly. It really is because I think when I was young, you probably wouldn’t be able to convince me to change my diet, right? It was only when my child was suffering that I started opening up towards incorporating meat and broth and things like that. It really is a very sort of deep question to ask yourself. I think that when you’re faced with a deficiency or some abnormality in your cycle, I think that sometimes that can sort of put you in a place where you might consider eating meat, might consider shifting your philosophy, your perspective. But I think that has to come from within.

Lisa: Yeah. It’s an interesting question. It’s very tricky. I think that everyone has to kind of make that final decision for themselves honestly.

As you were sharing that, I mean, the conversations that we have, I wasn’t sitting there saying, and now you need to eat meat. I feel like I was focusing on protein, and so we were talking about protein sources. I think you kind of touched on it, but correct me if I’m misinterpreting—but I mean, when you’re trying to get from like a regular kind of 30 grams of protein to like a hundred, that’s a big difference. That’s more than three times what you were consuming. Initially, like how do you do that? Well, we talk about protein shakes, we talk about adding, right? Because I’m trying to find ways to help you to do it within your paradigm. I’m never the one to tell people what to do in that sense. I make recommendations and I work with people. I think it sounds like you came to that conclusion yourself because it was kind of like, I personally don’t want to live off of protein powder. So how am I going to do this?

Lilliana: Yes, yeah. And I’m glad you bring that up because there are—that you look at all of your options and one of your options could be just bringing in things like more supplements and protein powder. That can work, right? I mean, that can help people. For me, I just felt like it was more, a lot for me to get my protein source from whole foods. That’s what aligned for me. But I think that if going, using another avenue and doing the protein shakes, if that gives you similar results, I think that that’s okay too. I think it, again like you said, you choose what feels most aligned for you.

So yeah, that’s what I did. I just decided to incorporate more meat into my diet slowly like I said, and I disguise it a lot. I’m really good at doing that because I’ve had to disguise, you know, beets and things for my kids in foods. So I’m really good at disguising it in like a stew or a soup or in tacos and things like that. It’s worked out for me, and I feel good about it. I feel good about my choice.

Lisa: Well, I mean, thank you for sharing that with us. I feel like it’s really tricky when you’re kind of like, these are really life-altering kind of things that happened. I mean, in your case, you had a very strong belief in something and then you were faced with a situation that made you just have to look at it again and re-evaluate all of that. I think that happens a lot. We’re talking about the food aspect. It can happen a lot in all kinds of different areas of life. There’s something about charting your menstrual cycles, I find, that just really brings you to what do I need to do for my body, because you can kind of see exactly what’s happening.

So let’s go back to the cycle. You had this, you actually were in that kind of premenopause phase potentially, and then, right? Because you mentioned that you had like three months without a period. Of course I’m sitting there wondering, like could this have had something to do with the diet. When we’re in that age range, we automatically want to ascribe all of those things to, oh it’s because of premenopause. But as you can imagine, I wouldn’t necessarily jump to that because there are women who continue to have ovulatory menstrual cycles into their 50s. The average age of menopause is somewhere between 45 and 50, and some women continue to bleed until they’re like 55.

So with that in mind, if you’re having these disrupted cycles, even if you’re like 45 or 49, I would still be there just wondering, because it’s one thing if you’re having these natural disruptions and all the foundational factors are in place—and that’s another if they’re not. But anyway, in your case, you had the cycle, the long cycle, that you know, you went a period of time, then you had this like bleeding and bleeding and bleeding for months.

So tell us a little bit about what happened there. And I feel like, sorry, one of the things that came to my mind as well when you shared your story was that you went to your naturopath and they gave you yarrow. You said—in the text, one of the things I always say in class, I’m like, herbs work. Like they do work. They work so well that they can like mask what potentially is the causal factor. But so you did basically everything. You made a huge shift with your protein intake and you were like, you basically did everything. So tell us what happened.

Lilliana: Yeah, so I kept—so once I was put on the progesterone, I continued taking yarrow. I continued taking supplements and the protein shakes, and I started, you know, I had shifted my diet. I was doing all the things. I was doing everything possible to get my body back to balance essentially.

Yeah, definitely once I started taking the progesterone and everything else, things were slowing down. So that first part of that whole experience, I was bleeding very, very heavy. But then once I was on the progesterone and the other herbal supplements—I was also taking nettles tea, I was also taking herbal blends with cinnamon and rose petals and things like that that are known to reduce bleeding—so all of those things I was taking simultaneously while I was increasing my nutrient intake and also doing the synthetic progesterone.

So pretty much for that last phase of the bleeding, it was pretty much spotting mostly. It was light bleeding and spotting. It wasn’t like heavy, heavy, heavy the whole time. Otherwise, I don’t think I’d be sitting here literally, because when I thought, you know, when I wouldn’t stop bleeding in the middle of all this, I was like, gosh, am I dying? You know, it was pretty wild.

So yeah, I think that all of those things, and even after I stopped—so I went down to two pills a day of the synthetic progesterone after the bleeding subsided. I believe I did that, it was something like three weeks or something like that, I tapered down. Then I tapered again to one pill a week, and I did that for a good couple weeks. Then I continued taking the herbal. So I continued taking the yarrow, I continued with the shakes and the supplements and the protein intake.

I continue to do the food part and the supplements. I’m no longer taking the yarrow tinctures and the herbals. But it’s really interesting. So then in October, so beginning of this month, I had another cycle. And it was interesting because I thought, oh gosh, here we go again. I was a little bit concerned, but it was a normal cycle. I had two days of heavy bleeding, and then it tapered off and no bleeding.

Lisa: Wow.

Lilliana: So yeah, it was interesting.

Lisa: That’s huge.

Lilliana: Yeah.

Lisa: That’s huge. I think it’s interesting when you talk about it because, you know, when you talk, it was like the herbal tinctures work, but they slowed it and then it kind of started coming back. I just think it’s such a wonderful reminder that maybe even just to trust our bodies and to really take these abnormal menstrual symptoms to be a sign of something deeper. I feel like that’s the whole point.

But I’m thrilled that you were able to stop the flood, essentially, because I know there were many moments in there where I’m sure you were questioning if it’s even possible for it to stop.

Lilliana: Yeah, absolutely. And I’m glad you bring up the trusting piece. That’s where the fertility awareness comes in really strongly, because when you know what’s normal for a cycle and you know how to use the tools to get to a normal cycle, if you’re struggling with something abnormal, then there’s this trust. And like, I’m doing all these things, like I’m gonna fix this, you know, I’m gonna figure out a way to fix this. Like my doctor doesn’t even know why I’m bleeding, right? So I’ve got to figure out how to get myself back into balance.

It was really also just having a deep sense of trust in my own body—in that it could heal itself and that my hormone levels, if I was having low progesterone for whatever reason, right, nutrient deficiencies, then I could bring that back. That I didn’t have to have my uterus scraped or having an IUD with who knows what sort of side effects. I wasn’t really wanting to do those things. I really wanted to heal my body naturally.

Really having that trust in my own body and its own wisdom, I think that’s one of the most profound things that your program brings to women—is that when you have this connection, this intimate connection with your body and your cycles, then you can trust when something goes awry that you can find a way. You can use all the tools necessary to find a way to bring yourself back into balance. Without excluding all of the things, right, like you said, if something is off, you go see your primary, you go see a practitioner. But also listening to your own inner intuition and making decisions based on that, not based on fear.

One of the things that really is a scary thing is how many women get hysterectomies. That was one of the things that I was like, I don’t want to get on that train. I really want to avoid everything possible to not have that happen to me. I know that it happens to women and it’s necessary, but I just felt like I just want to try everything possible to avoid it. Trusting in your body is one of the key things, because I think that we make a lot of decisions—women make decisions again because we’re not aware of our bodies. We’re not aware, we’re not connected to our cycles. We make decisions based on fear, unfortunately.

Lisa: Well, one of the things we were talking about before we hit record was just how common is this? How many women experience this? I haven’t done a survey of women in this age group, but I happen to know that it’s quite common. That’s why it’s listed as one of the common symptoms, quote unquote, of premenopause or perimenopause.

I feel like it’s not always exactly this, your experience and all those things, but I feel like your story is a really important reminder of—we have to, like, instead of assuming perimenopause or premenopause, so those years typically defined as like the kind of 10-year period before your last one, instead of assuming that it’s going to be this horrible time where everything’s going to go awry and assuming that that’s how you’re supposed to live your life during that time, I feel like it’s time for a different perspective on that. Every woman doesn’t go through horrific premenopause. If we can kind of look at the cycle as a vital sign, if you are experiencing some really severe symptoms, that’s a sign. You may need to seek a team approach—so what I always talk about. We all need our doctors for diagnostics and medical support, but you may also need to seek outside of that for hormonal support, nutritional support, cycle support, things like that to really get yourself supported.

Of course, that’s the whole point that you took the program to be able to incorporate into your practice. So maybe share a little bit then before we go today. I know we focused on your own personal experience, but in the program, you’re also working with your practicum clients and things like that. So maybe share a little bit about how this experience has changed the way you look at the cycle and will benefit your practice.

Lilliana: Yeah, absolutely. So for me, again, I think I mentioned, it was that key missing piece in helping the women in my practice. So yeah, I’m bringing this in. I’m so excited to bring it in. The clients that I’m practicing with right now, I’m so excited because we are seeing, it’s kind of like you’re finding clues as to okay, why is this a little off, why are my temperatures low, you know, that sort of thing. It’s really exciting.

I think the women really get excited about it also, that they’re learning about their bodies, they’re learning what it means when your temperature shifts, right, and how to check your cervical mucus and why that’s important. So for me, I just think that, and also when looking at, like you said, a vital sign, looking at things that are off and we’re not sure why. For me, it’s just going to add that missing piece for the women that I really want to help kind of get their bodies back into balance.

Lisa: Well, so for someone who has been looking at the FAMM program, women’s health professional, and is kind of wondering like, what’s this all about? What, if anything, would you want them to know from your experience in the program?

Lilliana: Yeah, I believe that fertility awareness is something that is so needed out there. I think that there needs to be more people offering this to women, teaching them how to chart their cycles, teaching them how to learn how to bring their bodies back into balance. I think it’s so key. It’s complementary to, yeah, just so many things, right? Like people going through infertility, and if you’re going through a process like IVF, like it can help all of those things.

Yeah, if you’re really looking to help your clients learn about their bodies and their cycles, this is a comprehensive program. I mean, I’ve learned so much, and I love the way that you just really allow space for questions and you really bring things out clearly for us. And just the library of research is just amazing. You’ve got like, we’ve got so many articles in the program just based on the research that you’ve looked at, and it’s just—you can’t deny this stuff when you look at all that research. You can’t deny everything that you’re offering.

So it’s just a really invaluable program, and I really, I just definitely highly recommend it for anyone working with women, working with women struggling with infertility, and even with women in perimenopause, right? Like women who are going through what I went through—it can be very helpful. I really feel like young women just really need this, and so just the more people who can share it, I think will have less women suffering with all the side effects, right? All the things that we suffer with.

Lisa: Well, thank you so much. Your words are very kind. I’m thrilled that not only did you obviously enjoy the program and will be able to utilize it in your practice, but also that you had this very personal experience. I feel like this is one of the reasons why it’s important to chart and to participate, even though you weren’t really having cycles in the traditional sense, like it still benefited you a great deal.

I feel like this work is highly personal, but there’s still a separation, right? Even if you had a client that was in a similar age range that has a similar story, she’s not you. So, you know what I mean? Like there’s still that, still necessary to address that in a professional manner. But I’m just thrilled to share, to have the opportunity to share your experience because it’s a very powerful and personal testimony to just that connection between the overall health and your cycle.

So it’s great to be able to highlight that and to give hope to women who find themselves in the premenopause phase who are basically being told that their only options are surgery. Sometimes that may be the case, but obviously that’s not always the case. So thank you.

But before we wrap up, I’d love for you to just take a moment and share a little bit about you, what you do, where people can find you, your website, the socials, all the places.

Lilliana: Yeah. So I practice abdominal therapy in New Hampshire, and my website is LillianaRivera.com. You can find me there. Yeah, I also help coach women in womb awareness coaching. So again, I’m going to weave the fertility awareness into all of that. So yeah, you can find me there and find all my information on my website.

Lisa: Awesome. Well, I’ll make sure to link all of the places on the show notes page. So thank you so much for being here. This was a wonderful interview and I’m just thrilled that we were able to share this with the audience.

Lilliana: Thank you, Lisa.

Lisa: 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/482. I hope that you enjoyed today’s episode with Lilliana. I feel that her experience is such a powerful one. It really shows from the outside in the power of not only using the menstrual cycle as a vital sign, but utilizing the FAMM process to really break down and understand what’s happening in the menstrual cycle.

When we look at the menstrual cycle as a vital sign, then whenever we are seeing issues and problems that are consistent and continue to happen, cycle after cycle or month after month, they really do give us a ton of information about what’s happening health-wise. When we learn to work with that, then it allows us to gain much deeper insights about what’s happening in our bodies, and this is the perfect example of that.

So I want to thank you for tuning in to today’s show. I hope you have a wonderful week, weekend, whenever you are listening, and of course as always, until next time, be well and happy charting.