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Welcome to The Health & Wellness Practitioners Podcast! Dr. Danielle and other guest experts talk about everything from getting your practice started, developing your clinical skills, growing your practice YOUR way, and dealing with the real stuff life burnout and work/life balance. Whether you’ve been practicing for decades or just started your journey, you’ll find something here for you!
DR. DANIELLE: Okay. So welcome everyone. I had given you a little sneak peek that I would be here today in a group with Dr. Colleen Holland. We started a conversation in the group, I guess actually I started the conversation. I posted a question asking if anyone else is tracking their cycles - I said, cycle tracking. And I had mentioned that it was making a big impact on my energy levels. I've been doing it for five years now. And the words that I used were not what I was talking about exactly. So one thing led to another, you and I talked through messenger and I was like, let's just share more about this whole topic. So here we are. So let's just get started with you sharing a bit more about who you are and what you do, and then we'll take it from there.
MEET DR. COLLEEN HOWARD
DR. COLLEEN: Sure. So I've been in practice a little over 20 years, and I started right off the bat in perinatal and pediatric care. So I was working with the population that we associate with reproductive health and fertility. And what I noticed was that this population gets some of the worst care out there. And in particular, those who menstruate have a lot of challenges that go unanswered, and they're often gaslighted into thinking, oh, it's just normal. You're supposed to have cramps. You're supposed to feel moody. PMS is a part of being a woman. And that got very frustrating to see what so many of my clients were going through. And I also was able to observe some of the challenges, not only in getting pregnant for couples, but what happens during pregnancy, obviously those of us who work with pregnant couples, but postpartum too; not only seeing what happens to the mom, but also to the baby because of what could have been addressed before the idea of pregnancy even occurred.
So it was really very clear to me that I was being pulled in this direction to go further and further back into more preconceptive work. And I just started diving more heavily into more fertility work and also just trying to seek answers that were not available to most people, but that exist, meaning you go to the conventional practitioner and any menstrual cycle issue, you're going to receive one of three options. You're going to receive synthetic hormones, the pill, or the IUD or something like that, you will sometimes be given the option of antidepressants, and/or surgery. And so those are your three options as a fertile human being, especially a fertile woman in this world and that is not enough because there are so many other things that can help. So one, I wanted people to understand that there were more options and not only that, but there are many things that they could do with their own hands and their own mind to help their cycles because fertility should not be a curse. Fertility is a part of our health. It's a part of our lives. It's what makes the world around. As people who ovulate, menstruate, some of us gestate, and lactate, we serve humankind with a tremendous amount of reproductive labor. And so we are being done a great disservice when we have three options as our treatment choices when we're suffering, when our fertility is not robust and healthy.
So all of this was really occurring to me and I started looking for other options, I got trained in something called Arvigo therapy, which is external visceral work to improve reproductive and digestive health. And a lot of body workers train in this work. Many of your audience is probably familiar with it. It's really beautiful work and it addresses one thing that nothing else addresses and that is the circulation to the reproductive organs and the digestive organs of blood flow, lymph flow. All of that, all of which needs to be flowing well in order for those tissues to function well. And in our society and I'm sure you've probably had other guests you've talked about trauma, but where do women in particular hold a lot of trauma? Deep in our pelvis. And what that does is it creates some congestion and it creates lack of good circulation. And so that particular body work is so very powerful because it's so ridiculously simple and you can literally teach someone how to do some massage on themselves. And they won't be able to do all the work on themselves, but a practitioner can work with them from time to time. But they have the power to actually do quite a bit of the work on themselves to make improvements in their own cycles. And that work is miraculous. So that was one thing I was like, oh great. Why did I never learn this? I had to go somewhere and seek this out.
And then I learned about charting menstrual cycles. And most people hear about it these days because when you want to get pregnant, you try your cycles and you try to figure out where you are in order to time intercourse to make sure conception happens. And that's great. I love that people are being empowered with that knowledge. And there's yet even more information that you can get. You can actually very successfully utilize menstrual cycle charting to avoid pregnancy. And you can use it also to monitor your health, whether you're interested in pregnancy or not. Because like I said earlier, the menstrual cycle is a vital sign and we all have a right to have robust fertility and the fact that in conventional models that that's really largely ignored. Not only ignored, but suppressed regularly. There's a real disconnect in healthcare. So that's sort of where I've taken my career.
I no longer do body work but I have a functional medicine practice around reproductive health. Most of my clients are either people who have periods or menstrual cycles that are less than ideal and they want to feel better, and they want to cycle better and they want to stop suffering. There's so much suffering when it comes to menstrual cycles. And a lot of times work with couples who are trying to become pregnant and really the only other answers out there for them are heavy duty medications and ovulatory, stimulants, and IVF and those sorts of things. And some have been through that gamut you and it's been unsuccessful or they feel terrible about it and others haven't gone that direction yet. They want to try to give something else a try.
I think the thing that keeps me going is always finding more new information to help understand how we can help ourselves, how we can give ourselves permission to have good, healthy menstrual cycles. As the world just tells us, oh, it's your lot. You got a uterus, that's what you deal with. And if from a functional medicine perspective, a mens cycle chart is incredibly diagnostic and it takes literally minutes a day of observing cervical mucus each time you go to the bathroom, taking your BBT, your basal body temperature each morning before you get too active for the day. So if any of your audience members want resources, I have tons of free resources I can share with you on the basics of fertility awareness method and even some of the Arvigo work, the abdominal work.
CONVERSING WITH YOUR BODY THROUGH CYCLE TRACKING
DR. DANIELLE: We do have quite a few hands-on practitioners. There are a variety of health and wellness practitioners here in a group now. I would say that the majority are hands-on practitioners; chiropractors, massage therapists, some acupuncturists, physical therapists, public floor therapists. So the majority of us here are working with people hands on, and I think there's a lot of different directions we could go with the conversation. There's a lot that we could talk about. I'm glad that you shared more about how you're practicing now because, I don't know that there's ever been a time in my career - I've been in practice for, or this is my 14th year - where people are exploring options for their career more than they are now, because like it or not, technology is changing a lot of things. It's never going to replace a human placing an acupuncture needle or a massage therapist’s actual hands or a chiropractic adjustment. But what we do, I believe need to be open to is other models for our businesses, ways that we can integrate both our in-person services and our online services, ways that we can work with people who are not able to come to us physically. Again the technology, we're not necessarily always fans of social media or cell phone use. And there are amazing aspects of it as well that it brings to us as practitioners and gives us access to helping people that we wouldn't have otherwise been able to help. So we just got to look for the ways to embrace the technology and the positive aspects of it. While managing I think also the negative or less than ideal aspects of it as well.
So when I posted and asked about, is anyone else cycle tracking? The type of cycle tracking I was talking about for myself is the fertility awareness method, plus something else - and I don't know that there's a term for it. I learned from Kate Northrop in her membership program; she talks a lot about tracking your cycles, whether it's your menstrual cycle, the moon phases, paying attention to your energy levels on those days. And it's all on her planner as well. I also started to think maybe I kind of made my own spin on this whole thing because I am looking at the moon phases and my menstrual cycle. And I hadn't even really realized it, but the fertility awareness method I learned when I was in chiropractic school, I was experiencing infertility my first marriage, and so that was an option that someone referred me to, I don't even remember if it was a nurse, an OB, someone that taught fertility awareness method, I think maybe a nurse in the hospital. So I learned that when I was in my mid twenties and it was very eye opening because I was able to identify pretty quickly that my menstrual cycle was not healthy. It was coming every 28, 29 days, but there were other aspects of it that I was able to identify like, Ooh, this is not ideal. And now after having four pregnancies, three births, it's interesting; I look at my menstrual cycle as a vital sign. I hadn't really put it into those words, but it tells me so much about what's been going on with my body. What's been going on in my mind, even in my spirits. And it's an indicator of how much my health has improved actually, even though I don't necessarily look as healthy as I looked when I was 20 years younger. My menstrual cycle shows me a much different picture.
DR. COLLEEN: It's really nice to be able to see that on paper in front of you. I know a lot of people use apps too, which is great. If my clients want to use apps, that's totally fine. I do ask them when they're learning to start to transfer that data onto paper, because seeing it all in front of you in one chart is very, very helpful versus on a small screen, on a phone. But being able to see it, not only seeing what - it's like, you and your body are having a conversation. And I can tell someone one thing I can say you might want to lay off the gluten. You might want to consider that the dairy is contributing to your acne, or you might want to not go out and have those drinks with your friends each night after work. But if the chart shows that, oh, I didn't ovulate until day 20 and I had a short luteal phase, but leading up to ovulation I had four nights where I went out and had drinks; that's a very different conversation than me saying to someone you might want to reconsider, maybe your liver is having a hard time with that. This liver health is very connected to menstrual health. And so you have a conversation with your body that you can read like a book right in front of you. And then when you are making changes and you make notes on your chart, you make changes and you look at a new chart and you can see how those changes are actually affecting your body. And your body is telling you, Yay, this worked, look at this, this is working for us, or, there's something still going on we need to figure out.
MENSTRUAL WELLNESS IN WORK AND LIFE
DR. DANIELLE: Having practiced this as a practitioner or clinician for as long as you have, how do you now implement this into your own life and into your work?
DR. COLLEEN: Oh, gosh, I love this question Mostly because I get so excited about how this has changed my life for the better. So I am someone who had pretty significant polycystic ovarian syndrome from menarche really into at least my mid thirties, I'm 47 now. And now I regularly ovulate, but I might have ovulated two times, three times a year before that, which is not enough for optimal health. And I also suffer from endometriosis. And so I have been able to with my education, all the things I've researched and the things I implement, figure out ways to heal my own cycle. And so much of it is diet, lifestyle, supplements of course, but also relaxation, rest, prioritization of sleep, prioritization of what matters most to me, and not prioritizing a perceived ideal of what my practice should look like.
So making my practice work, and if it's working then changing it and oh, is that working? No, it's a little bit better, but it's not okay. Then I need to change it again. I've gone through that my whole career. And I've been able to see if I look back, I've probably been charting my cycles for 12 plus years. If I look back at my charts, you can see an incredible progression of health through those, even though I've struggled with a lot of health issues, and I've heard you mention on another podcast, connective tissue disorder EDS, I have that as well and mass cell activation syndrome. And so I have a lot of things that I've been working on in my life as a healthcare provider and my own health issues. And so a lot of this journey has taught me a tremendous amount about not only what I need to do to keep myself on this planet and doing whatever I can do while I'm here, but also helping people that otherwise wouldn't maybe have someone to work with who hasn't been through this, and hasn't got firsthand experience with what they're dealing with.
So I walk my talk, I often recommend things to people, and with rare exception I recommend everything I recommend is something I've at least tried. And I commit to it regularly. So even things like the self-care abdominal massage, like I always recommend people do that because I've seen what a difference it can make. I also do regular pelvic steaming because it does miraculous things for my cycle, my flow and my level of endometriosis pain. And I've gone from four days of H - E double hockey sticks down to maybe two hours of I might need two ibuprofen to get me through for anyone who suffers from endometriosis, that's an enormous improvement.
So I've learned so much and I've applied so much of what I've learned in my own life that I feel like maybe it puts me in a unique position to work with people who've gone through a lot of this. And so there's some gratitude for what I've been through in my life, because I've always known that I was supposed to be a healer. There was just no doubt in my mind. When I was in high school and even in college, I was trying to figure out I was pre-med, I didn't know anything else. I was like, I'm a healer, I'm going to be a doctor. And so it was during undergrad that I realized that I would not be the kind of doctor that I wanted to be if I had gone that route, I didn't know that I know about it today. I'm just so glad I listened to that inner voice. I have no idea how that happened, but I'm so grateful for it. I don't know if I would still be here in this body if I had gone that route.
So everything happens for a reason and my own struggles, my own everything that I've been through, it really inspires me to continue to learn. Not because I feel inadequate in my knowledge. I mean, everybody goes through that. But because I just, I know there's more out there and I really want to to understand as much as I can.
DR. DANIELLE: Well, thank you for sharing all of that. I don't know if you might have known this already. I've shared this on the podcast before that, before chiropractic school I considered a lot of different careers. I was working in a pharmacy though, and I was thinking about getting my master's in counseling or art therapy or dance therapy, all of which would've required me to move away from home or go to pharmacy school. And then, I don't know, I just kept getting the nudge really to go to chiropractic school. I didn't know anything about chiropractic, but I had narrowed it down to either pharmacy school or chiropractic school and wow, am I glad I chose chiropractic school? We could make the list of all the reasons why chiropractic school is so hard and we take on so much debt and all of the things, but I wouldn't change any of it to have gone through pharmacy school instead. Knowing what I know now. Right. But similar to your experience, I don't know really what led me down one route versus the other, but I'm very thankful that I chose the path that I did and that I listened to what otherwise seemed like a crazy idea to most people that knew me, especially my parents. We didn't have any healthcare providers, definitely no chiropractors in our family. And it was just kind of like an idea that it came up with, like I had studied more marketing and business and social work and it was like, own my own business and help people? Cool. Chiropractic can let me do that? Okay. So here we are now all these years later.
DR. COLLEEN: I haven't met a chiropractor that doesn't have some similar type of story. Like there's just this calling this, or most healthcare workers have some calling, but there's something about our profession that just, the round peg and the square hole or the square peg and the round hole, we're just different. We're just a different breed. And I feel like that inner voice that gets us to where we are is maybe we just pay more attention to that because like you, I had a ton of pushback from my family when I made that decision. I had a ton of pushback from my professors when I made that decision. And these were my mentors and people I thought really cared about me and what I wanted to do. And that was hard to stick to my course, you know?
DR. DANIELLE: Yes, I can relate. And especially now with our children being 19, 11, 7 and 4, one of them has aspirations for a career in a field that I'm like, no, you can't do that. No. I'm also balancing what you just said, right? Like supporting her no matter what she wants to do and trusting her journey and balancing those two things like wanting to protect her from this predatory industry and also letting her make her own choices as she's ready to do that.
DR. COLLEEN: And something to your point that I think you teach all the time is that we have no idea what a field will look like in 3, 5, 10 years from now, and so I have a similar sort of thing where I'm worried that my dear little one chosen career will not be lucrative enough for her to support herself. And but now I'm like, it's a lesson that I have to learn too, and I'm just letting go because I have no idea what she can do with this particular training that she's going to get and what she can do with it to make it her own. So that gives me a little bit of reassurance when I get into that fear model, you know?
MAXIMIZING YOUR BENEFITS FROM THE FERTILITY AWARENESS METHOD
DR. DANIELLE: I do. Yes. So for people that might be listening or watching who are familiar with fertility awareness method, for example, like they are already implementing this, do you have recommendations or suggestions, tips for them on how they could take what they're doing with tracking their cycle days and maybe their basal body temperature, their cervical mucus, how can they take that information and utilize it to up level their health? Or is there more that they could do with it so that it's not just pregnancy avoidance or a fertility method per se? How can they use it to help them with balancing their life and their work and avoiding or managing burnout?
DR. COLLEEN: Yeah. So burnout just comes from taking from an empty tank, and so our fertility - our health - our fertility, which is a big part of that during our cycling years, but even after we're done cycling, the amount of time we spend cycling and ovulating in a robust manner actually helps us post-menopausaly as well. So I don't want anyone to think that, oh, just from the time of 12, 13 until we're 50, that's the only time it's important, but that time is important and even has great effects after menopause as well. And we can cycle into our sixties and some people might be horrified by that thought. But let's just start with saying that ovulation is a very important process in our body.
I've heard you talk about how the masculine body is about quantity and the feminine is about quality, and we need both of those in our world, but let's just focus on the quality aspect of the feminine body. And so if you have a body that ovulates, it takes a great deal of energy to do that. We put a lot into ovulating each cycle because the potential to create a life is always there whether we want children or not want children, or maybe want them later. No matter what we choose, we put a lot into that. Not because just the potential child, but in doing that and creating that healthy egg, we actually create healthy levels of estrogen and healthy levels of progesterone for a body that has implications for our heart health, our brain health, our bone health, our mental health. And so regardless of the whole potential child thing, we need the right amount of hormones throughout our cycle and throughout our lives.
Estrogen is a growth hormone. It's often associated with feeling great and gregarious and energetic. And that's why during our fertile phase when our estrogen is as high as it's going to be throughout our cycle, we tend to be more outgoing and energetic and fertile, and I feel sexy. And not that we can't feel sexy all cycle along. Believe me, ladies, we can. But that's what it's most often correlated with - estrogen. And so estrogen is a growth hormone. It grows tissue, it grows the endometrial layer. It grows and matures the ovum and the follicle that holds the ovum in, in order to make more estrogen. And it has effects all throughout the body, on our hair and our skin and our bones and our heart, on and on.
And then once we ovulate, the estrogen is still in small levels, but it drops considerably. And what happens is that progesterone just takes off. And so if we have had a healthy follicular cycle, the part of our cycle the first half before we ovulate, then we're more likely to have a healthy, robust ludial phase, which is the second half between ovulation and the start of our next period. And so progesterone is beautiful in that it helps to balance the effects of estrogen. So we don't want growth to go unchecked; lots and lots of estrogen without progesterone to balance it can lead to things that we don't really want to have to think about. That's when we start to think about estrogen dominance on the very low end of the scale, we can feel really crappy. We can have terrible PMS, we can have subfertility, breast tenderness, nausea, mental health concerns, premenstrual dysphoria, you name it. But if we have enough to balance that out, we should glide right into our next period. The progesterone helps us to sleep better. It feeds ourselves just like estrogen does, but there's a balance between the two and our cells need both of them.
And so if we are not ovulating regularly, whether our cycles are healthy enough to produce a healthy egg and produce enough progesterone, or if we are, for whatever reason, taking some sort of menstrual suppression to keep ovulation from happening. Now, there are always a time and a place, I understand that people need birth control and fertility awareness method is not the right method for everyone at every point in their life. So this is not a guilt trip sort of statement, but when we do take something that suppresses our menstrual cycle, like the hormonal birth control pill, even the mini pill it still suppresses the ovulation. The Mirena IUD can suppress ovulation, and even the copper IUD to some extent can suppress ovulation.
We do that because we need to, for our choices to do that. But we need to know that you would be best to minimize the length of time that you do that because the balance of estrogen and progesterone throughout your cycling lifetime is very important for your longevity and how you feel. Just on a day to day basis, there are so many side effects to hormonal birth control. I don't know if I need to talk about them here, but so many that women suffer from and even low libido, depression, these things that sometimes women are not even told are related to the pill or the IUD.
So I'm getting a little off topic here, but I'm going to try to bring it back to what you asked about. Essentially what I wanted to say is that it is really important for us to ovulate and we are at our best and are ovulating. We are at our healthiest. If you are noticing on your charts that you are not ovulating every cycle, or that maybe you ovulate, but your luteal face after you ovulate, but before your next period is rather short, that's less than 11 days, less than 10, that's getting a little short. That means progesterone production is not as robust as it could be. If you feel really crummy during your luteal phase, the day leading up to your period, or if you have premenstrual spotting, all of these are signs that you need a little support, your body's struggling. And so whenever our body is one of the first things that's going to slack off on is fertility, because why would it in its mind, why would it bring a child into a body that's struggling? That's something that can be pushed off, it's got to work on making sure your heart's functioning, your lungs are functioning and all those vital organs. So while fertility is of vital sign, it's not as vital as the others when the body needs to prioritize. And so when you are noticing these things and, you know you need to work on your cycle - now was your question about how to use the cycle chart to schedule your life?
LEARNING FROM YOUR BODY TO BETTER YOUR LIFE
DR. DANIELLE: That could be the answer perhaps, right? How can we use our charts so that we - I think specifically, what's the relationship to the information that we gather and for our community managing preventing burnout.
DR. COLLEEN: Yeah. I think preventing burnout is just prioritizing your health. And honestly, I feel like the cycle chart is a way that you can do that. Just like you would, well, blood work is a different thing, but you can use the same sort of data from your blood work. Like if your cholesterol is getting very high and your triglycerides are high and your LDLs are high and your HDLs are low, then you might consider reducing carb intake, the refined carbs. And so you make decisions based on what you see there. And you can do some of the same things to you with your charts. So if you are scheduling people during a time in your cycle where you definitely feel your worst, that might not be the most conducive for you. That's just going to continue to pull from that empty tank. And so when you are able to chart and see, okay, when do I feel my best? Then you can schedule heavier on those days and really lighten your schedule when, or take off and take some downtime while you're healing while you're repairing, while you're making changes.
So it's a wonderful barometer to be able to be one, how can I schedule to make this work best for me? But two, what can I do to improve things so that I have more days where I feel well? And three, then is what I'm doing working? So you can see that in your chart too, like, okay, I gave up gluten and dairy and let's see what happens in my cycle charts. Now, usually people if someone has a sensitivity to those foods and they take them out, they will see a difference usually within the first cycle cycle, but definitely within three. There's a magic number three, when it comes to menstrual cycles, it usually takes three full cycles to see the full effect of something that you've started to improve your cycles. So I usually always say give it a good three month to know for sure that usually people start to see within the first month.
But even starting a new supplement, let's say you take some diindolylmethane, DIM, it's a common one for unopposed estrogen. It helps the liver to metabolize estrogen and, and get it out of the body. I'm not making recommendations because I don't know a particular person out there. I will say that you can go too fast on detoxifying if you're not aware of the other things. Like for instance, if you're not pooping every day, do not start detoxing with herbs and supplements because that is you have to start at the end and work backwards. So when it comes to any approach to improving health, you got to make sure the bowel is functioning well. So that's where all of the effort is focused on immediately is making sure those modes of elimination are working well before we start doing anything else to improve detoxification. And a lot of women these days do need help with estrogen metabolism. But if you just read about that and you start taking DIM or start taking calcium D-glucarate, or doing liver detoxes, you might be causing yourself a little more. That's the clinician in me. That's why jumping to that.
DR. DANIELLE: This is great. I could listen to you talk and it's amazing actually to hear you speak about these things. For me all things that I've been aware of for a long time, literally almost 20 years now. I also feel like I can never get enough of it. I just want to continue learning and some of the things that you've said, I've never heard them put in quite those perspectives before, so it's fun. For people that might want to learn more about your practice, where is the best place for them to connect with you?
DR. COLLEEN: Sure. My website is WombForGrowth.com. So it's a little play on words. They can just email me through there. They can learn more about my practice. I have some information on there. I want to also mention that if they're interested, especially if you're wanting to learn how to chart to avoid pregnancy, it's very important that you get a certified educator to teach you. If you have a perfect cycle and everything looks great, you can pick up a book like Taking Charge of Your Fertility and teach yourself how to chart and you may be able to do just fine. But if you have anything that's a little bit off of your cycles, if you're postpartum or if you're just coming off the pill, or you have PCOS or endometriosis, then I would highly highly recommend working with a professional who's been certified.
So there's an association called the Association for Fertility Awareness Professionals and that's just FertilityAwarenessProfessionals.org, and all of the listed educators, fertility awareness educators on there have gone through a two year training program and they are the secular association. So within fertility method, there's a secular branch that's full spectrum. So not only do we teach people how to chart for achieving or preventing, but also we walk them through more use of morning after pills and abortion. So we provide all of that support. There's no restriction to that. We're trained in all of that. Then there are also fertility and educators who are trained in the natural family planning model, which is based on more derived from the Catholic church. So you can have phenomenal instructors there too. Just pick whichever feels resonates with you. But the Association of Fertility Awareness Professionals is a great place to go to find someone. Most of us do work virtually, not everyone is a functional medicine doctor most are not. So that's something to keep in mind.
DR. DANIELLE: Yes. Thank you. Give your website one more time and I'll also make sure that we put it into the show notes later on the podcast.
DR. COLLEEN: Okay. Thanks. It's WombForGrowth.com.
DR. DANIELLE: Perfect. Dr. Colleen, thank you so much for being willing to do this with me. I think it was kind of a spontaneous idea I had when we were chatting privately outside of the Facebook group, and you said yes. So it worked out and here we are. I know that your time is valuable and I appreciate you making time to talk more about this.
DR. COLLEEN: My pleasure. Thank you.