How Overtraining and Under-Eating Cause Hypothalamic Amenorrhea (Episode 577)

Full Transcript: Episode 577

Lisa: Today I’m sharing a brand new episode in my FAM Practitioner series. I’m sharing my interview with Dr. Ashley Burton. And she’s sharing her experience using birth control, coming off the pill, her experience with HA, and how it changed her cycles from periods in her life where she wasn’t having cycles at all to periods in her life where she was having incredibly long irregular cycles, but certainly due to under-eating, overexercising, and all the things that come with that. Ashley is going to share how she was able to overcome these challenges and restore normal cycling.

Dr. Ashley Burton is a chiropractor and holistic nutritionist specializing in fertility, nutrition, and women’s health. She holds a bachelor of science in biomedical sciences from the University of Guelph, a doctor of chiropractic medicine from the Canadian Memorial Chiropractic College, and a diploma in natural nutrition from the Canadian School of Natural Nutrition. With a focus on prenatal, postpartum, and core rehabilitation, Ashley combines evidence-based care with a deep understanding of the mind-body connection. Drawing from her personal experience with hormonal health challenges, she empowers women to optimize their well-being through movement, nutrition, and education. So without further ado, let’s jump into today’s episode.

And I’m really excited to be here today with Dr. Ashley Burton. Welcome to the show, Dr. Ashley.

Dr. Ashley: Thank you for having me, Lisa. It’s a pleasure.

Lisa: Well, always fun to do these episodes. So before we started recording, I was just saying, of course, as I always say, how much I love doing these episodes. It always gives me an opportunity to spend a little bit more time with you. At the time that we’re recording this, we’ve been in the program now for several months. You’re already well into your practicum. And so really excited to chat with you today. And I’d love to start by asking you my all-time favorite question, which is how old were you when you had your first period? And kind of let us know how things went from there. And I’d also invite you to share a little bit about your area of specialization and all of that good stuff.

Dr. Ashley: Okay. I knew your specialty question, so I had to think about this because I actually can’t pinpoint exactly when I had my first menstrual cycle start. I think it was actually between grade 8 and grade nine. And I feel like I started late compared to a lot of my friends. So other than the surprise of having it happen for the first time, I remember being very underwhelmed because I was like, “This is it.” I thought there would be a lot of pain. I thought there would be a lot of blood. So my periods were very, very relaxed, non-painful, and very light. But with that said, once I started cycling, I started very late. They were very few and far between. Like I don’t think I actually had to cycle every month. I know that’s probably typical for girls who are just starting, but it was not on my radar all of the time. So it maybe would have happened once every two or three months. And it was a big deal for me because I am the oldest of two. So I have a younger sister and my mom had a hysterectomy when she was pretty young. So we didn’t have her to model kind of what that looked like for us as we were growing up. So please interrupt with questions along the way because this could be like a long story here.

Lisa: Well, I have one question only because you asked — because you mentioned you got your period a bit late. How old were you when it started?

Dr. Ashley: I guess well, when you’re in grade eight or grade nine, you’re like 13 or 14. Yeah. So I feel like that. And I remember one of my best friends in grade school, she got it and we were in grade six. So I feel like that was a little bit late for me there. So I guess it must have been 13 or 14. And thinking back to kind of my early adolescence, I had lost some weight. So the history is I have a history of a little bit of touch of hypothalamic amenorrhea and a history of disordered eating. Not that I had a full-blown disorder, but definitely hyperfixations on things, hyperfixation on weight. I was a little bit overweight as a child and figured out very quickly how to manipulate some food items to remedy that. So I lost some weight when I was younger from exercise and dieting — let’s just say it — quite young, probably around 13. So around the time I was supposed to get my menstrual cycle. So maybe that was one of the reasons why it was late. So fast forward a little bit and my cycles were, like I said, very few and far between. They were very light. They were non-painful until I went on the birth control pill. I believe I went on the birth control pill around 17 or 18. And I did it mostly because of facial acne and I had a boyfriend at the time and we wanted to be very careful. My mom had me when she was 17 and there was a whole big thing of like I must make it past this milestone. So that is how we navigated that. And that was the first time I actually had menstrual pain — when I was on the birth control pill. So I had to go through a couple to find the right one. I remember being like doubled over in the bus on the way home from university in pain. And in fact that was the first time that I had an anxiety attack when I first went on birth control. And of course, I was exercising a lot, probably under-eating at some points in there, depending on what my focus was for fitness and exercise, but obviously didn’t know because of it being masked by the pill. And I was on the pill from the age of 17, 18 till about 25. And when I came off the birth control pill, I actually didn’t have a cycle for about 5 to 6 months. I felt kind of broken. I was like, “Uh-oh, what’s going on here?” And at that point, I had gone through university, chiropractic college, and I was just starting my holistic nutrition program with the Canadian School of Natural Nutrition. And a lot of my teachers were giving me ideas of what it could be. They were like, “Oh, make sure you’re eating organic. Make sure you’re drinking non-chlorinated water. Make sure you’re getting enough sleep and manage your stress and all this stuff.” And we got a touch of fertility awareness in that program, but not enough for me to kind of like welcome it with open arms. So I got my period back and again instead of being kind of the normal range, it was about every 50 or 60 days I would get a period.

Lisa: So I started listening to your podcasts. I started tracking my cycle very loosely using my DIY charts of just tracking temperature and looking for cervical mucus. And then our wedding came around and I decided that I wanted to get nice and lean and shredded for the wedding. So I put myself on a little bit of a cut diet, and I was still working out heavy. And I actually saw through my charts my cycle start to diminish and diminish and diminish.

Dr. Ashley: And I went 3 months without having a cycle, 3 months without seeing cervical mucus, and I saw my temperatures dip down into the 35°C range. So I knew what I was doing because I was watching it happen in real time, but I had a short-term goal, and I was determined to get there. So I actually went the whole way. And on my wedding day, I was sitting next to my husband and I thought, “Oh gosh, I’m sitting next to the person I love and I can’t ovulate.” That is just the most devastating situation because you’re sitting next to the person you just married and you’re like, “We want to have babies but I actually can’t ovulate.” So I knew that I’d have to gain the weight back. And that’s what I did. I gained all the weight back and then I went into hard period recovery after that. I used your book, The Fifth Vital Sign, as a wonderful resource. I used No Period, Now What as a resource and I really got myself back on track there. But it took me a while to get my periods down from being 50 days to 35 days to now kind of 30 days with practice and a lot of mental gymnastics.

Lisa: Well, you just took us through a lot. So thank you for sharing all of that. I think the first thing I’ll say is that it definitely takes a lot of effort and determination to restore your period. So I feel like that’s huge. So maybe we can start there and share with us what of everything that you did, what you feel like was the most impactful in terms of bringing your period back initially.

Dr. Ashley: Well, I think initially I had to gain the weight back. That was the biggest thing because coming from a very strong nutrition background, I have always eaten organ meats. I have always eaten healthy in terms of whole foods and I do a lot of my own cooking. And so it wasn’t the fact that I wasn’t getting those nutrients in. It was the fact that I was consistently underfeeding and overexercising. So it was really that balance of reducing exercise and just eating more food. So I actually gained all the weight back. I had lost 10 lbs and then gained it back and that brought my period back and it brought my libido back. I was able to sleep without having hot sweats because that’s what happens when your estrogen starts tanking and you have an imbalance with the estrogen and progesterone. And I just felt a little bit more balanced and level. So ultimately, I think it was just gaining the weight back. Some women — I’m going to put myself in that category — have just a lower threshold for stress. And I think that knowing that about yourself is very important because then you can learn how to buffer it, right? Or how to keep your stress below that threshold. So it was really a mindset shift, being okay with gaining the weight back, and it went into making sure that I got rid of the clothes that didn’t fit me anymore. Like I’m not putting myself into an extra small sports bra ever again. Making hard set rules for myself. So if you can have hard set rules for yourself to kind of derail off of the natural and healthy track, you can also give yourself nice hard rules to get back on track. And so I took a step back from a lot of weightlifting. I took a step back from cardio at the time. I was fasting. So I stopped fasting. That was a big one — to make sure you get all your calories in, because it is really hard to get all of your calories in, especially if you’re an active woman and you’re skipping breakfast or not eating till 1:00 p.m. Very hard. And the other thing that I thought really helped was, and it was really hard for me to give this up, was actually cold dipping. So it was something I was doing with my husband and our friends, and it was a way to connect and have community and do hardcore things with my husband that I thought was cool. But at the end of the day, it’s just more stress buffering up against my threshold. And of course, it releases cortisol. It requires more thermic energy from food to raise your body temperature back up. So that’s extra calories that you’re burning that you might not be refueling. And then if you’re doing it through your whole cycle, you get to your luteal phase where your body temperature is meant to rise. It’s meant to keep your uterus warm like a little incubator. And then I’m going in literally sitting in a pond with ice in it. So a lot of those things, but I think the main thing was the energy balance and maintaining a minimum amount of body fat to be able to cycle.

Lisa: Yeah, there’s so much there that you did and I’m glad that you even mentioned the amount of weight because obviously that’s a huge part of this issue in general with losing your period due to HA, right? Under nutrition, over exercise, because there’s a huge fear around how much am I going to have to gain. So just to put it out there, there’s no magical number. In your case, Ashley, you kind of knew because you had been cycling and then you specifically lost some weight to achieve the goals that you had for your wedding. So in your case you kind of had an idea around how much that was and in your case it was about 10 lbs. I think that that’s useful to think about because in some cases it’s not as much weight as you think you have to gain. But for some women it’s more and it could be more related to how stressed their body is and how their stress hormones are. It’s not just an equation of gain this much weight and get your period back. It could be like reducing the stress in all of these different areas plus gaining some weight plus having a long enough period of consistency of food availability that your body starts to trust that it’s going to be there. I think the cold plunging is an interesting piece as well because a lot of the practices — I call out the kind of male influencer stuff — a lot of the practices that you were doing, that’s what is on trend right now, right? To fast, to do the weightlifting, to build that muscle mass. And there’s a lot of research about fasting. Fasting is a concept. There’s a lot of research showing potential benefits for longevity. So it’s not like you can argue that there’s no benefits in general, but what is the goal, right? Like if you’re trying to achieve menstrual cycle health — yeah. So anyways, when you did get it back, your cycles still weren’t optimal initially. So you were still having periods in the 50-day range, still having delayed ovulation. Do you want to talk a little bit about that aspect of it? Because it’s not in your case, it wasn’t just about getting it back and then the journey was over. That was almost kind of the beginning of the journey to then get to optimal cycling.

Dr. Ashley: Yeah. So getting the period back was easy. It was just like eat the food. And at the time we were kind of around the house because of our honeymoon and our wedding. And so it was easy to just eat food because we had great caterers. We had our honeymoon and we were staying in like wonderful places and we’re just eating a lot of food. So that was good. And it took me maybe a week to see my temperature start to go up and see the reappearance of cervical mucus. So it was very quick for me to have that back, which was nice. But after that first cycle, the cycles were long. And I’m trying to remember at that point what I was doing physically. And I can’t remember. And it’s hard too because I have a very physical job. I’m a chiropractor. I jump on people literally all day and move them all day. So there’s not like a time where I’m sitting down for more than like 15 minutes. So it’s a lot of physical exercise and that is a constant in my life. So what I really had to do was kind of change the other things around that. And it wasn’t until I honestly stopped cold dipping that my period started to get more in that 35-day range. So I really had to stop. It was last year I had to stop cold dipping and I stopped doing cardio and I was only weightlifting with the goal of gaining muscle because with that you also gain some body fat. It’s inevitable. And I was super okay with that because I just had the goal of spending the winter doing one workout a day — just a heavy weightlifting program — and then I would walk the dog and then that was that. So I was actually able to put on weight quickly for the first time, like muscle, because I had always tried to do that before but I was under-eating. So of course that wasn’t achievable. And with that I was actually tracking my macros. So I was tracking the food I was eating, purposely eating at a calorie surplus and hitting a protein target to make sure I was gaining weight at a sustainable rate that would obviously build muscle but then not build too much body fat. And that is exactly what I did. And the amount of calories that you have to eat if you’re active and want to do that is a lot. So that is one reason why I frequently post a lot of what I eat on my Instagram page to just show women how much you do have to eat to sustain your activity levels.

Lisa: Yeah. And for some women whose activity level is really really high, the amount that they have to eat feels unreasonable. And so this is typically why for success there, it’s the approach that you mentioned — there had to be a bit of a like kind of reevaluation and reduction in the activity itself plus also eating more. There was something that you said earlier in the conversation just around the age of 13 — that you felt like you were a little bit overweight and so you had already started to kind of manipulate your eating and things like that. And what I wanted to ask you about that was where did that come from? I mean, obviously there’s the general culture that we live in, which it’s completely insane and unreasonable. I feel like it’s impossible to be a young woman without having any of those impacts. Just generally, I’m just curious because I’ve talked to many women and sometimes there’s like — was there someone in your family or was weight a thing anywhere with your friend circle or was it media or were you in dance or gymnastics? What do you think was the influence for this?

Dr. Ashley: I think so. I grew up in a house of three girls. So my mom was mostly like a single parent and my younger sister lived with us. And I guess weight was always an issue because I have a lot of family members who are overweight. My dad’s side of the family is First Nations. There’s lots of diabetes. There’s lots of obesity and lots of unhealthy lifestyle habits there. Smoking, drinking, etc. And I think I always grew up around — it was me and my sister. Everyone called her Skinny Minnie and then there was Ashley, right? So I was a little bit overweight and we had some childhood trauma. It was probably like comfort food and eating for comfort and not having mindfulness with eating, but also maybe not having the best options available at the time being a young girl as well. So I was aware that I was bigger than my sister and kind of fitting in with the category of what my dad’s side of the family looked like at the time, and I didn’t want that, I guess. So my sister started gymnastics and I wanted to dance. I have always loved dancing. At the time, the programs that were funded for First Nations kids in Timmins, Ontario were only sports and dance was an art and not a sport. So instead of dance, I got thrown into kickboxing. And I hated it at first, but then I loved it. I loved it so much because I saw my body transform. I saw my body get stronger. I was able to do push-ups. So it was really really great for my confidence. And it started — I don’t think that started my body image issues but my body image awareness. It was definitely kind of being around women who were very hyperfocused on their weight, grandmas, aunts, always on a diet, and then being around my little sister with the nicknames. So I think it’s just you have to be very careful when you have girls and what you say around them, and even if you have boys because boys struggle with this, too.

Lisa: Well, I really appreciate you sharing that. I mean, I ask because it’s just how my brain works. When I hear you say that, I think to myself, well, I know it’s a very common thing. But at 13 to be kind of aware and to be actively kind of manipulating food — that’s why I asked. I’m thinking because I think other women kind of need to hear that as well. It’s easy to think that’s just how it always was or it was just natural to me — for anyone who’s listening who never really thought about where those ideas might have come from if you had a similar experience. And then you had also shared a little bit about your pill experience. So you were on the pill for several years, 17, 18 to 25. And then you mentioned that you felt like the pill had potentially masked some of the issues — like potentially if you were under-eating or overexercising, you wouldn’t have known because your pill period was coming regularly. And you mentioned that you came off the pill and it took almost half a year for your cycles to return and then when they did they were kind of on this trajectory. So knowing now what you know compared to what you knew then, do you want to just share a little bit about that experience?

Dr. Ashley: Yeah, 100%. And I think the problem — I’m always going to say the problems are institutions, right? The way that the curriculum is taught. And that’s why I love this program so much — because it gives you everything all at once and that’s the type of learner I am. In school obviously I learned how energy balance works. We learned a bit of nutrition. We learned about the female athlete triad, but no one put them together in an actual course. And that is so frustrating because they exist separately in my mind and they exist separately when they test us that way as well. Does that make sense?

Lisa: It does. Yeah. Because I mean from someone on the outside looking in, nutrition school seems to breed a lot of nutritionists that potentially have certain disordered eating patterns — of course, because you’re so hyperfocused on eating the quote unquote perfect food or the right food. And then I kind of — yeah, it’s such an interesting thing. And I just remember from my own experience that there’s clearly from my opinion and from the menstrual cycle as a whole, there’s not one diet for all stages of life. So I think this is one of the biggest challenges because sometimes if I’m getting pushback on some of the things that I’m talking about, it’s like, well, I didn’t say that what I’m talking about is for every possible stage of life. If you’re dealing with certain specific health issues, you might have to modify your diet for those. But if you’re a woman of reproductive age and you’re looking to optimize hormones and get your cycles to the point that they’re optimal for fertility and just to reduce all the issues that come with hormone imbalance, then there is a different way to approach that. And it kind of doesn’t matter what it says in the textbook if your period isn’t coming.

Dr. Ashley: Yes, 100%. And I think to answer your question there — the nutrition part of it, it’s only a part of it, right? You have to tackle the stress part. You have to tackle the other foundational lifestyle things like sleep, like stress. Through that whole journey, I went through so many different things. I got into crystals. I got my Reiki certification. I was journaling. There’s so many other things to reduce that stress level, right? Because we know that there’s different types of HA. HA can happen from just stress alone, over exercise, under-eating, or a combo of those. And I really do think that you have to be multifaceted with that. But I think it’s about timing as well. Like when I got off the pill and I hadn’t had my period for about five or six months there, I don’t know that I was in the same mindset as I was when I really went into period recovery. My mindset was a bit different. It’s kind of like the pregnancy intention score. Like how bad do you want your period? I don’t think I wanted it that bad back then because I was like, well it’ll come when it comes. I’m just going to keep doing what I’m doing without realizing that some of the things are probably hindering the return of that cycle.

Lisa: Yeah, absolutely. I mean, from a practitioner’s perspective, if someone is saying that they want to restore normal menstrual function, that they want to get their period back, their motivation has to be high enough to actually do the work because it’s very difficult. It might be easy on paper to say, okay, eat more, exercise less. But as you said, you use the words mental gymnastics. It’s a whole thing to kind of rethink what you’ve been doing and be okay with the weight gain and be okay with the changes in your body and the changes in your eating patterns. It’s just not an easy thing. So definitely if you have a client who’s actively trying to have a baby or planning for that in the future, it’s a different conversation — often a little bit easier because maybe it’s not even for you. You’re making the change so that you can have a baby, right? So it’s 100% even easier.

Dr. Ashley: Yeah. Like even now it’s getting to summertime and I’m thinking I have friends who are like getting ready for bikinis. I’m like you don’t need to get ready but I’m like oh I want to join you like I want to do these exercises and start tracking again and really get on track with like being super fit for the summer but I’m like oh no no that’s not going to help me because we’re going to start trying to conceive in August and I need to keep all the weight on this body that I can.

Lisa: So let’s shift gears and talk a little bit. You mentioned some of the very personal reasons why menstrual cycle charting became kind of at the forefront for you personally to kind of understand what had been happening in your own body, but also the implications for what it could do for your clients. So maybe share with us a little bit about that — your decision to kind of move into this area and why you wanted to do that and what some of the implications are now that you’re in the thick of it with your clients.

Dr. Ashley: So I realized that when I started tracking my cycle, when I was doing my DIY charts, it became much more than just tracking my cycle. At that time I just had literally like a spreadsheet with columns and rows and I would write down my temperature and I would write down if I saw cervical mucus or not. No other details than that. And I had other columns and I was tracking if I worked out that day, if I had a bowel movement that day, if I slept well that day. So it became kind of just like a journal. And I started to see patterns in that journal. And I thought, okay, well, this is more than just menstrual cycle tracking. This has to do with my nutrition, my weight, how many calories I’m getting, how much exercise energy I’m outputting. And kind of after being exposed to some of your books and your podcast, I was like, okay, this is really what I’m going to use as my barometer of what is healthy for me instead of looking out on Instagram to see what the other girls are doing. Like, this is where I need to focus and it actually keeps me balanced in terms of making decisions for me versus having fear of missing out watching others do their thing. So I think it’s good because it gives you perspective. And through my experiences with everything that happened, I had so much perspective. And even after the termination and after the hemorrhage I worked out the next day. I worked out the next day after both of those events because I had this rigid thought process in my mind that I had to work out. I had to pretend like everything was normal, that nothing happened, even though I was exhausted and my body went through this crazy event. So looking back and seeing those charts, I look back and I wish I had shown myself more compassion. So really, it’s like nutrition driven by fertility. That’s kind of my goal with learning this for myself, learning this to teach my patients and my clients. I have a lot of young women who sit on my table, young athletes who lose their period when they’re in a hard hockey training program, who lose their period when their volleyball season is on. And I use those as opportunities to make sure that they’re eating enough, that they’re cycling, that they know that their period is important. Because they’re at the bottom of the spectrum. And when I look at the top of my spectrum, I see older, frail, osteoporotic women on my table who either had like six babies in a row and were constantly breastfeeding and have low bone mineral density because they never worked on replenishing — or patients who had fertility problems who now have osteoporosis. So I see both ends and I see the value in educating both of those populations and me being right in the middle of that working on my fertility and having been in the place of the younger girl who I wish I had someone like myself to tell me, Ashley, eat more. Stop running so much. I wish that for myself, right? And so I really see the opportunity that I have in providing my patients and my clients with that. So now I have a full-time chiropractic practice and I never shut up while my patient’s on the table. They get an ear full of nutrition, of everything I’ve learned on podcasts that I listen to, on the research I do for my own podcast, about recipes and cooking and why everyone should eat liver. And then I have a little bit of a home practice where I do one-on-one consulting with clients who want to prep and nourish for conception or who are pregnant and want to enhance that.

Lisa: I really appreciate your perspective on that. It’s a blessing when you have the opportunity in your professional career to actually kind of see beyond just what’s happening at this particular age group. To have the ability to be working with a variety of different ages — I mean obviously with chiropractic they have similar issues but you’re seeing it across the age spectrum to see how this can turn out. Because it’s a broken record over here at Fertility Friday headquarters that the menstrual cycle is a vital sign and it has a ring to it, it sounds kind of catchy or whatever, but that’s not what this is. It’s literally that’s what it is and that’s the message. So I really like that you just shared what you’ve seen — to see like this is where it can end up if you ignore your vital sign for all these years. And the example of the woman who’s had many children but didn’t necessarily have the information about replenishing those nutrients because there’s just nothing more nutrient intensive than growing people. When you grow tiny humans in your body, there’s nothing more nutrient intensive than that. And also the potential implications of really exercising to the max but again undernourishing your body. And it all shows up in your menstrual cycle. So I love that for you, you’ve found this for yourself and also for your clients because what I always say is that the menstrual cycle cuts through all this stuff. But can I share — we were having an interesting conversation in class and you were sharing how you were kind of looking at your chart this one month recently and you were like, oh my gosh, I must be pregnant because you had the longest luteal phase that you’d ever had. Maybe share a little bit about that.

Dr. Ashley: Yeah, it was funny. I actually made an Instagram story about it as well this past weekend and I got a lot of comments on it. So I guess my cycle — two cycles previous to this one — I had my longest luteal phase I had ever had. It was 13 days and by day 11 I was panicking and I said to my husband, like, we got pregnant, I don’t know what happened, but we got pregnant. And he’s like, there’s no way, look at your chart. He knows how to read my chart. In fact he asked me, what’s your temperature today, have you had three temperatures in a row? Right? Because that’s like date night. So I compared that chart to my last chart and my last chart was my luteal phase was 10 days long and the difference was the activity that I was doing. So the cycle where I had a 13-day luteal phase — that was almost immediately after my last dental surgery. So I was giving myself permission to kind of relax a little bit. And it’s funny that I say that because when I say it out loud, it sounds so simple. I gave myself permission to not go crazy. It was hard. There were days where I wanted to do more than one thing and I wanted to maybe go for a run and weightlift, but I had literally just had two dental surgeries in the last two months and come off of antibiotics and I was like, my body needs a break. So I only did one exercise a day for that whole cycle and it was beautiful. Like the temperature shift was magnificent. It was obvious. My luteal phase was 13 days. I thought I was pregnant. And then I got my period. I was like, wow, that was a nice luteal phase. And then this last cycle, it started to get nice out here on Vancouver Island. So I was trail running and working out and running my core rehab program and sometimes doing like three exercises a day. And my luteal phase was short. So you see all these little exercise emojis and then a really short luteal phase. So I have proof of that, right? And you can’t work on what you can’t see. So having that was like a really big eye-opening factor for me.

Lisa: So I mean I love that you’re doing this and going through this. As someone who this has been a part of my life for decades, this is kind of like my hope — this is like my contribution — this is what I want to share. It’s not about having a perfect cycle. That’s not the goal because I don’t think a perfect cycle is real. I don’t think it exists. The goal is for you to get into this conversation with your body and understand your limitations and understand how what you’re doing is impacting things so that you can make different choices. So for example, we’ve had practitioners who are prepping to run a marathon. And so if that’s what you’re doing, you should be aware that that also isn’t a great time to be simultaneously trying to get pregnant. And you’re going to see that in your cycle because you’re going to see how that training impacts your hormone levels in a variety of different ways. And so that awareness is really what we’re going for. And the more that you do this, Ashley, the more that you then know what your limits are. There’s something that comes up sometimes when I have these conversations — I’ve had disagreements with people about luteal phase length, right? Because there’s some people out there, even maybe someone who’s listening, who’s like, well no, 10 days is totally fine. That’s normal for me. My luteal phase has always been 10 days and that’s normal for me, Lisa. So I don’t care what you’re saying. And my kind of response is that this is why we need training. Whatever you experience in your own body in your own silo isn’t necessarily normal. We have to find out what those normal parameters are and identify if what you’re experiencing is in those normal parameters. And until you actually start seeing multiple clients outside of yourself, you might think whatever you want to think, but I’ve had clients with 15-day luteal phases all the time. So I’ve come to the conclusion that anything under 12 days I wouldn’t say is normal. Even if people disagree with me, that’s okay. Because for my clients who do have shorter luteal phases, if they make certain changes, like in your case, Ash, they do tend to see the shift. And even if something’s been normal for you, it doesn’t mean that it’s actually optimal.

Dr. Ashley: Yeah. And I would have been one of those people who disagreed with you because for years I saw luteal phases that were like nine or 10 days. So for me to see a 13-day luteal phase, I was like, whoa, it’s possible.

Lisa: And I mean, I think if you’re a practitioner and you’ve only seen your own cycles, then the danger is that you’re going to normalize that in your clients. And because you don’t necessarily even think it’s possible for you to have a 14-day luteal phase. So I’m glad that we’re having this conversation. And again, this is really fascinating. And thank you for sharing that as well. It was just such a fun conversation because I’ve had it many times with clients before where you literally are seeing this thing for the first time — that years and years of charting you’ve never seen before — because you made some of these changes. And it’s really through that process that you start to really understand. We can talk about the vital sign piece and you can understand it theoretically, but when you apply it into your own life and then you start seeing it in your clients’ cycles and things and you start to see what’s possible, I feel like it really shifts your perspective on things. So, you know, as we start wrapping up, you’ve been in the mentorship for a while. I would love to hear just some of your thoughts. If someone’s listening and they’re thinking about joining, they’re thinking about whether or not this might be helpful in their practice, what would you want them to know?

Dr. Ashley: I would want them to know that the value is absolutely there. I don’t know if you remember — I messaged you before the program and I had FOMO like every time I heard a commercial for it on your podcast. So I reached out and I said, hey, like I have a bunch of knowledge, will there be enough value in here for me? And without a doubt you said yes. And the program has exceeded my expectations of the value that I would have expected to get out of it anyways. So not just from our live sessions — I wish I could be there in person more for them — but the access to the portal. So I am constantly learning. My husband will walk into the kitchen while I’m meal prepping, “Are you listening to Lisa again?” I’m like, yep, yep. So there are so many options for learning and opportunities for learning, whether it’s visually with the books and the references and handouts or audio with the videos. But then the client work and being able to bring the client work to class and have your eyes on it, have Amy’s eyes on it and everyone else’s — it is invaluable. So I really appreciate it and it’s been like a really really awesome opportunity to be a participant in this program.

Lisa: Well, thank you so much. That’s amazing to hear. And I thought of a question for you — as you bring this into your client work, I mean, you’re still in the midst of the program, so we’ll have to hear from you later on, a few years down the road once you’ve fully applied it. But now that you are kind of aware of what this is about, what are the implications for you with your clients? Like what can you do now that you couldn’t necessarily have done before?

Dr. Ashley: Well, for chiropractic clients, I think I’m able to — my questions are just different. Like the way I ask them questions, I’m already kind of like an unconventional chiropractor in terms of what I do with patients because I do focus on core rehab and stuff like that. So not only am I asking on my intake about core trauma to assess their core dysfunction if they’ve had like a C-section, vaginal births, and all this stuff, but I’m also asking deeper questions of like replenishment and nourishment. And my intake questions are, are you still cycling? Is your menstrual cycle normal, healthy? Where is that at? Because I typically ask that anyway because if someone’s not cycling then I know the amount of force I have to modulate to push through their bones if someone has osteoporosis or something like that. In terms of nutrition clients, I just have more resources for them and I have more confidence with my recommendations because I know that you’ve done a ton of research and put together like ironclad resources that I trust and value. And between your books and Lily’s books and all the content out there, there’s just so much information to sift through. I think it gives me a much more mainstream confidence to apply everything I’ve learned with my clients and patients.

Lisa: Oh, that’s amazing. Thank you so much for sharing that. And as we bring our call to a close today, I would love for you to share a little bit more about you, where you are in the world. You mentioned that you’re a fellow Canadian in BC. So for anyone who happens to be local and is listening, and also anything interesting that you have on the horizon.

Dr. Ashley: Yeah, sure. So yes, I’m located on Vancouver Island. I come mid-island and I cater chiropractic — I work a lot of places on the island, but I do also work from home. And then obviously the nutrition component is virtual, so I can reach anyone anywhere. But I do focus on women’s health in my chiropractic practice. I see women prenatal while they’re pregnant, postpartum, and I see infants as well. So I do infant care and obviously my nutrition practice is mostly around nutrition and replenishing and building nutrient stores to have successful pregnancy, conception, and postpartum. I have an Instagram page, Dr. Ashley Burton, and then my website is drashleyburton.com. My podcast is the Dr. Ashley Burton Podcast where I talk about a lot of nerdy things related to chiropractic and nutrition. And then I don’t have anything crazy going on right now, but I did release a nutrition fertility cookbook back in November. So that’s available on Amazon and the PDF is on my website as well. So right now I’m just working on my offerings for when we’re done the practicum program and I have more free time — because we all need more free time — to allow some nutrition clients into my programs.

Lisa: Amazing. Well, we will make sure to link to all of those places. Thank you so much for being here today, Ashley. This was a lot of fun.

Dr. Ashley: Thanks for having me, Lisa.

Lisa: Thank you for listening. If you enjoyed today’s episode and you’re wanting to share it with a friend or you’re wanting to grab any of the links that we talked about, head over to fertilityfriday.com/577. I hope that you enjoyed today’s episode with Ashley. It was such a great reminder that the menstrual cycle is truly a vital sign and it is always giving us feedback about what’s happening in our lives. And really and truly, what’s interesting about what we call the HA spectrum. In Real Food for Fertility, Lily and I really defined this concept of the HA spectrum because there are some women who have what we would call full-blown HA where they don’t have a cycle at all. And there were periods of time where Ashley experienced that. But there’s other periods of time where she did have a cycle, but because of the tendency to exercise a lot and not necessarily eat enough, her cycles continued to be irregular. And so in that situation, do you technically have HA? Well, not technically. You don’t meet the definition of full-blown HA because she was still cycling, but she still has those tendencies. And so this is a really important distinction to make and a really important piece of the puzzle to understand that women can still be on this spectrum of under-eating and overexercise and still be cycling, albeit the cycle will be showing signs that this is happening. And this is why we always want to be paying attention to the menstrual cycle as the vital sign that it is. So with that said, I hope that you have a wonderful weekend whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.