Stephanie Fein MD [00:00:00]:
Hello, fabulous. It's Dr. Stephanie Fein here with weight loss for fertility. And we are talking about periods today because weight loss can be frustrating for women in general in so many ways. But today we're talking about one in particular, and that's that week of the month. And we can be doing all the things we know to do. Hunger scale, water, sleep, focusing on protein, and it may even feel like we're doing exactly the same thing week after week. But we look down at the scale and it's up two or four pounds and we burst into tears.
Stephanie Fein MD [00:00:41]:
And remember, this week can be more tender, so it makes sense. But also seeing the needle move in that direction can feel really defeating, even if we're feeling steady. So today we're going to talk about how to manage this time during weight loss. Now, first, many of us retain water or bloat during this time, and that doesn't feel great. And it can make the scale read high. But it is not a permanent problem in that the water will return from whence it came, like, usually within a few days. And we don't actually care about water weight again because it goes away. We care about fat weight.
Stephanie Fein MD [00:01:24]:
So not being surprised by water weight gain can go a long way. When we know to expect it, we won't think it's fat and get frustrated, which may affect our decisions. So that's such an important piece. What we're trying to do is get through the week and prevent sort of that effort idea like, oh, it's not working anyway, never mind, and then just overeat completely. There is a tendency to do that when we're not feeling. When we're feeling a little tender and when we're feeling like things aren't working. I'm putting that in air quotes, but there are reasons for that and we're going to talk about them. And this is one of them.
Stephanie Fein MD [00:02:05]:
One of them is that we can retain water. Water is not fat. It will go away. And that's important to know. And the second is that many of us have a lot of other symptoms as well. So bloat is one of them. It directly affects the scale, but all the other symptoms can affect how we're eating and feeling and what we're doing, and then can affect the scale. So we can have strong cravings.
Stephanie Fein MD [00:02:31]:
We can feel emotional. It's like just in and of itself, feel things a little more deeply, like cry a little more easily. But also, especially when we're going through fertility, we can be sad about the fact that the period's there at All. So there's lots of different emotions, reasons for emotions happening. And if we're prone to emotional eating, then that can affect our weight loss. And there's also, of course, physical pains for some of us, Some of us get that symptom. And if we're again not feeling well sometimes, if we're prone to fixing things with food, that would be another one of them. All of these things separately or together may potentially lead to overeating or the effort eating that I was just talking about.
Stephanie Fein MD [00:03:24]:
And then we really do gain fat. And that can feel defeating. So I'm here to help you. There's two parts to handling this time of the month during weight loss. The first is, and so often is in general, acceptance. Accept with love and understanding that this is part of being a menstruating human being. And I want there to be a caveat in here. It's very important.
Stephanie Fein MD [00:03:57]:
It's not about accepting severe symptoms. And endo comes to mind at this point. Endometriosis, if you're having to take days off for pain, go to the er, this sort of thing, that is too much pain, that's so much pain. And that would not be considered in the normal range. Now endo is a whole subject unto itself because often we'll think that we know that periods are painful, so this must be part of it, but it's not. And also it can be compounded because people telling you that it's okay when it's not. So it's a, It's a very tricky time here. I'm talking about.
Stephanie Fein MD [00:04:41]:
What I want to say is symptoms within a normal range. How do we know what the normal range is? That's challenging. So if you. We can talk to other women, but that may or may not be helpful. Some doctors may or may not know. I mean, so it is a. It's tricky. But if it's so severe that you have to be in bed or that you're going to the ER or anything even close to that, please get checked out.
Stephanie Fein MD [00:05:10]:
And if you're not getting answers that seem that make sense to you, then keep asking. Okay, so there's that kind of abdominal pain. There's. People can also get terrible migraines and if they're untreated, there's, There are treatments for the, for terrible, terrible migraines. If you get them with your periods, I'm telling you these sorts of things just cause I want you to get help. That's the stuff I'm talking about, like acceptance and love is fantastic, but won't Help a migraine. If medication would do a better job, we can accept that we have a body that gives us migraines that need treatment. But I want you to get the treatment and then we can just accept that that's something that happens and we'll sort of go into that a little bit.
Stephanie Fein MD [00:05:59]:
So that bottom line is I want you to get treatment if it's severe symptoms. And really the only way we know that is by asking and following up and learning. So I encourage you to do that. And people here, because we're on fertility journeys, are hooked up with specialists like, you know, OBGYNs and REIs. So often you're in the process of getting this stuff looked at, and that's awesome. I just want to encourage you to keep going and get answers you're happy with. And if you have any unanswered questions, please continue to ask. Okay, so there's an acceptance of a variability in our existence in a month, that we go through cycles.
Stephanie Fein MD [00:06:41]:
I think everyone does their seasons and everything, but I'm specifically talking right now about periods and that we accept with love and understanding that this is part of it, of life, of being a human. And so we're accepting that we have times when things are easier and times when things may be not as easy. That's a big deal for a lot of go getter fabulous women. Like, listen to this show. So when we're really bright, we're used to being able to accomplish things. Accepting that sometimes there we have physical limitations is really important. And we do that again with love and understanding. That may mean a mental health day, you know, or it could just mean doing being a little easier on ourselves, not beating ourselves up.
Stephanie Fein MD [00:07:37]:
The acceptance will look different probably each month and for each person. But this piece of understanding that we have. All humans have limitations and this may be one of them. It may not. It may be a limitation one time and not another time. But just accepting what our body's telling us, that's really the bottom line. You know, here we use the hunger scale. We're training ourselves to listen to our bodies.
Stephanie Fein MD [00:08:07]:
It's. It follows here too, listening to our bodies and being kind to them. So the second sort of part of that is being realistic about how our body, our heart and our mind really feels during a period. Really, it's just before the period comes, right before the bleeding starts premenstrually. That's the time when we usually have these symptoms. And what we want to do with this acceptance and being realistic about what's going on for us is we want to observe and be curious and if it makes sense to keeping a record, because then we can start to see patterns, we can start to be able to anticipate and that feels so much better. We get a teeny bit of control over something that's not in our control completely. And it's really helpful for how we go forward.
Stephanie Fein MD [00:09:04]:
So that was that first, under acceptance and being realistic, we're going to observe, be curious and potentially keep a record. That's a really important piece of this. The second is to have a plan and we're calling it a period protocol and we're going to base that period protocol that you're going to create. Right now we're just about to talk about it based on the acceptance and your observations that you are making. So a period protocol has three parts. The first part I'm calling scale strategies. So under scale strategies, actually I'll tell you all three parts. There's the scale strategies, cravings and enhanced self care.
Stephanie Fein MD [00:09:57]:
Those are the three parts of a period protocol. And you're creating this. So ideally you're sitting down and you're with your observations, you're writing down literally exactly what you're going to do. And under the scale strategies, some things to think about are whether you're going to get on the scale or not. So in general, I recommend getting on the scale once a week, same time, same day, while you're in weight loss, in maintenance, I can see getting on each day. That can work out really well. But while we're in weight loss, once a week is what I recommend. And during a period week, if you're, especially if you're in the beginning of the weight loss, you may not be sort of constitutionally ready to see the number go up.
Stephanie Fein MD [00:10:43]:
So you can decide that that week you're not going to get on. That's reasonable. But the second part of this is I would love for you to be able to manage your mind around the scale. And what I mean by that is what are you going to tell yourself if you see the number go up? Now, some of you are further into this journey and you're totally fine seeing the number go up, especially when you know that the actions you've been taking for the past week are right in line with what you want to do? So nothing's gone out of control, everything's been fine. But getting on the scale during your period you may be used to, at this point, seeing a couple pounds up, knowing it's water, it's not a problem. That is fantastic. That's such a wonderful place to be because we can watch our brain sort of freak out maybe, and we understand what's going on. I call it managing our mind.
Stephanie Fein MD [00:11:43]:
We may even get to the point where we don't freak out about it. We're like, oh, yeah, that makes sense. That's what I was expecting. Fantastic. But we want to get to the point where we can manage our mind when we step on the scale. And the way we do that is that we decide what we're going to think ahead of time. So we're going to get on the scale, and no matter what it says, we are going to think thoughts on purpose. And some of them may be something like, this is water weight, or, I'm expecting water weight this week.
Stephanie Fein MD [00:12:23]:
Another one is, my period is coming, let's see what it says next week. Or something like, oh, it always does this. Or I know I used my hunger scale well, so this can't be fat. All those if true, right? We have to believe those thoughts. So any thoughts we're thinking, we have to shift them and they have to be believable to us. We can't just think pretend thoughts like affirmations without belief behind them do not work. So the work here in terms of knowing what we're going to think ahead of time is choosing thoughts that are believable to you and that feel a heck of a lot better than omg, I can't do anything right. This doesn't work.
Stephanie Fein MD [00:13:13]:
I'm destined to forever, you know, be a certain weight. Those are not helpful, and they don't help us decide to continue to do the stuff that's been working. So we're going to either decide to get on the scale or not. If we get on the scale, we're going to decide what to think ahead of time. And then this is also a good time to look at the previous week and see how it went. This is part of the food date. The evaluation is, how was my hunger scale? Is there a place that I can improve? Is there something I know happened, and what am I going to do about it next time? So all that can be used as part of this, how we manage our mind around the scale. So that's the first part of the period protocol.
Stephanie Fein MD [00:14:06]:
How are we going to handle the scale? Second is cravings. And you will see similarities. I want you to be able to decide how you want to handle the cravings. I had a woman, she taught me this years and years and years ago. She was losing weight and she said, but every month I have a Very significant craving for chocolate. I've tried many things and the only thing that works for me is eating the chocolate. So I am okay with not losing weight that week. And it was so refreshing.
Stephanie Fein MD [00:14:45]:
I hadn't heard anyone say anything like that. And she was, that's exactly what happened. But because she knew that she had a plan for it, it wasn't like eating chocolate 24 7. She had a plan for how she was going to incorporate chocolate into her week. And she, because she thought it through that way, she was able to lose weight overall in the month because the other three weeks were not affected by that. It was really powerful. So the main thing about cravings, and some of us have big cravings and some of us don't have a lot of cravings or easily avoided cravings during periods. So if this is not you, amazing.
Stephanie Fein MD [00:15:27]:
Also it could be you one time and not the other times. So it's just something great to have a handle on to think about. So the ways that we can handle cravings are a couple. One is we can use it to practice allowing urges. That is one of the ways we handle cravings around here. And period cravings may feel like regular cravings to you. So this may be a perfect time to allow them. If you want a little brush up on allowing urges, that's episode 52.
Stephanie Fein MD [00:16:03]:
And another way to hand when you're deciding how to handle your cravings is eating the cravings. So in and like the woman I just told you about, you can do that in a bunch of different ways, including things like planned amounts, or you can try substitutions or you can just try using the hunger scale. And that would be a way to incorporate it. Eating it when you're hungry, stopping when you're satisfied as part of a meal. And that could be the way that you decide to handle the cravings. And as a side note too, the hunger scale may feel different during your period. That's good to discover and to know. You may get different signals from your body when during your period for a hunger scale.
Stephanie Fein MD [00:16:54]:
And that's another great thing to just observe. Then when we're working on the cravings, we can observe what worked, what didn't, and what we're going to do differently. That's like an evaluation. That's like a food date. You can use it just for the cravings and basically then tweak it over time so that this protocol becomes something that really supports you, you personally. And that's always what we're looking for. And as an example, I had one client who decided to have what she would likely crave because she craved certain things. She was going to have that in the house ahead of time so that she knew she had it because she found that when she went shopping for it in the height of her craving, that did not end well.
Stephanie Fein MD [00:17:45]:
So it was such a smart way of thinking about it. It was so perfect. I loved how she evaluated that. So she noticed that she did it. It did not work out well. So she is going to do it differently next time. Perfect. She may find that that works.
Stephanie Fein MD [00:18:00]:
The next hypothesis she has, and she may find that it doesn't. And then she'll come up with something else. That is exactly how we do it around here. We tweak until it works well for us, and that's how we're going to handle cravings. And then the third part of the period protocol is enhanced self care. This is a really important part. This is part of that accepting that we're menstruating humans on the planet. We're going to treat whatever pain we have as we want to, basically.
Stephanie Fein MD [00:18:31]:
If that's medications, if that's heating pads, if that's, you know, whatever that is, massage. But I do recommend treating the pain. I just don't want people going through pain if they don't have to. I encourage adjusting expectations for yourself during that week or the couple days. You know, there's a variable amount of days that that one is affected. But adjusting the expectations, maybe that's not the day that you, you know, run six miles or it's not the day that you work until 9pm There can be adjustments that you make. Knowing that this day isn't the best day to get this particular thing done and maybe giving yourself a little rest or allowance to go slower that day, it really matters because sometimes when we push ourselves in a time that isn't conducive to it, things take longer than they need to, longer than they would if we did it on the next day when we felt better. You may need more rest and you may want to like schedule that in.
Stephanie Fein MD [00:19:42]:
During those days you may need sleep. Things that would support your sleep, your routine, going to bed early, that sort of thing. And then hydration is always really important. And when we do it during our period, we can feel better. It will help us not retain as much water when it's. It's counterintuitive. But when we hydrate, we actually. It's actually a diuretic.
Stephanie Fein MD [00:20:07]:
It helps keep the fluids moving. We're going to be peeing out and that will help decrease the bloating as much as can be. It may not certainly take it away and you may still have it, but it's not going to add to it by not drinking water. You still will bloat. It won't solve that. So I highly recommend staying hydrated. That is the period protocol, my friends. I highly recommend it.
Stephanie Fein MD [00:20:35]:
You just whip that puppy out when you feel the period coming on and you'll know how to handle weight loss. And frankly, everything else will be easier when there's the understanding of this time, a couple days when we may need to adjust things a little bit. So we're going to accept that we're menstruating humans. We're going to be realistic about how our body, heart and mind feels during or really just before our period. We're going to allow for this. We're going to observe, be curious and keep a record if that's helpful. We're going to create a period protocol that's ways to think about the scale, what to do about cravings and how to beef up self care, water, sleep, rest, slow hugs, whatever you need. We're going to write down the period protocol and refer to it each month and we're going to experiment and refine it as we go.
Stephanie Fein MD [00:21:32]:
And then we're going to be so happy to have this going forward because not only are we losing weight now, but then we want to keep the weight off. And this is going to be helpful during maintenance as well. It'll give you the best chance of feeling good about your weight loss efforts during this week of the month. And that's what I want for you because I want you to be able to feel like you can keep going, that you can handle what happens in your life and lose weight and you won't be derailed or frustrated because you're expecting it and you have a plan for how to care for your sweet, sweet self. And then you can continue weight loss. No sabotage required. I am always around for you. If you have questions about this or anything, you can find me on Instagram, effaniefynmd or LinkedIn.
Stephanie Fein MD [00:22:26]:
Stephanie Finemdash. And if you want to lose weight with me with this care and planning, then you just come to stephaniefinemd.com and you click the lose weight with me button and we will be connected. I am sending you so much love until next week.
