Pause. Please take a moment to consider the above question and try to answer it. It’s okay if you don’t know the exact answer—just make your best guess. Great! Now, how do you feel about carbs in general? Do you think they’re good or bad, and why? Lastly, what do you think women need to have a healthy period?
Thanks for doing this little exercise with me! I don’t expect you to send me your answers; I just wanted you to reflect on how much you know. Personally, as a woman, I couldn’t have answered that last question until well into my thirties—despite menstruating for nearly 20 years! And I’m not alone in this.
Women’s health has long been neglected in research, and menstruation is still surrounded by stigma in many cultures. And for many, it’s simply seen as a nuisance. But it doesn’t have to be that way. With certain diet and lifestyle shifts, many of us can experience comfortable, even awesome, periods. So, let’s talk about carbs!
Before diving into the details, let’s quickly refresh our knowledge about what triggers our period:
What Triggers Our Period, in a Nutshell
Our menstrual cycle is regulated by hormones, primarily from the hypothalamus and pituitary glands in the brain, as well as the ovaries.
The hypothalamus sends out GnRH (gonadotropin-releasing hormone) in pulses. The pituitary gland responds by producing FSH (follicle-stimulating hormone) and LH (luteinizing hormone).
The ovulation cycle. Image from https://smart.servier.com/
FSH and Estrogen
We start with low-frequency pulses from the hypothalamus, which prompt the pituitary to produce more FSH than LH. FSH stimulates the development of follicles in the ovaries. Each month, one follicle becomes dominant. FSH also encourages granulosa cells surrounding the follicle to produce aromatase, which leads to the production of estrogen. During the follicular phase (the first half of the cycle), estrogen levels rise.
LH and Progesterone
When the hypothalamus detects higher estrogen levels in a woman's body, it will start to pulse faster. The faster pulse will gradually increase LH production, lowering FSH, so that in time, with the pulse going faster and faster, LH will dominate FSH.
When the ovaries sense a high enough level of LH, ovulation can occur. The ovum inside the follicle gets released and will make its way to the fallopian tubes, where it can be fertilized by sperm. The granulosa cells that surrounded the ovum stay behind in the ovary; they become the corpus luteum, which starts to create progesterone.
Period
Estrogen helps build the uterine lining, creating a suitable environment for a potential fertilized egg. After ovulation, progesterone spikes. It maintains the uterine lining and basically holds off menstruation. Progesterone is produced for about 14 days. If the egg is not fertilized, it will stop after this time. This triggers the uterine lining to break down. As the lining is filled with blood vessels, it will come out all bloody: this is our menstrual blood.
So, What Do Carbs Have to Do With This?
The intelligence of our bodies is designed to keep us alive. When our body senses that we’re under threat, it will switch off processes irrelevant to our survival, and menstruation is one of them. Though it keeps our species alive, you can totally live without it.
When the hypothalamus notices that a person is eating hardly any carbs, or when they are eating carbs but not enough calories, it will interpret this as being under threat, that food is scarce, and we need to conserve our energy. The result is that systems irrelevant to our survival are shut down, and a woman may stop having her period. This is called Functional Hypothalamic Amenorrhea.
Some experts, like Lara Briden, say that the hypothalamus will shut down menstruation because, with insufficient food coming in (the source of our energy), there won’t be enough energy to make a baby. Growing a baby takes up about 75,000 calories. Whatever the hypothalamus's reasoning, eating too few carbs or calories can shut down your period. To be clear, taking in enough calories but low amounts of carbohydrates can still end your period.
Why Carbs?
Carbs are the body’s preferred energy source because they provide easily accessible glucose, which is quickly converted into ATP (our energy molecule). While the body can convert protein into glucose or use fat for energy (via ketones), these processes are less efficient. Carbohydrates are easy. That's why the body loves to be fed healthy carbs in sufficient amounts.
Of course, we also need proteins and fats! Cholesterol, for example, is essential for making estrogen, progesterone, and testosterone. Enzymes, which are made from protein, play a key role in hormone production. So without these nutrients, we would also be in trouble.
Low Carb Keto Diets
Keto diets, which are low in carbs, can be effective for certain conditions like epilepsy. However, many women on keto lose their periods. But some don't. And that is because we are all different, and some of us can handle a low carb diet better than others. Still, for most, the initial phase of adapting to the low carb diet will be a little stressful on the body.
A Fun Fact, and Then We'll Discuss Some More Details
Carbs could also be important for the fallopian tubes. After ovulation, our egg goes to one of our two fallopian tubes. Here, it can be fertilized by a sperm merging with our egg. Yes, merge! Sperm do not penetrate eggs! There is no penetration happening here! The sperm merges into the egg’s wall and then releases its DNA content into the egg.
The fallopian tubes are filled with fluid, which enables the sperm to move toward the egg and the egg to move toward the uterus. This fluid contains glucose. It helps nutrients to move, feeds the cilia (tiny hair-like structures in the tubes that also aid in the egg’s transportation), and provides a healthy environment for the egg and, once fertilized, the embryo.
There are many different kinds of carbs and some are healthier than others. Check my previous post to learn more about carbs, or reach out so we can check what the best diet is for you. Picture by: Laura Santos.
How Does the Low Carb, No Period Thing Work?
When we consume too few carbs or calories, the pulse with which the hypothalamus sends out GnRH becomes so low that the pituitary starts to decrease both FSH and LH. When tested, generally LH will be lower than FSH. Eventually, ovulation will no longer happen because hormone levels are so low that all the necessary processes just don't start.
Other hormones also get affected, which further deregulates the normal flow of things.
Lower Leptin Levels
Leptin, a hormone produced by fat cells, signals the hypothalamus about the body’s fat reserves. When we eat fewer carbs, the body may start using fat for energy, lowering leptin levels. This signals an energy shortage, prompting the body to conserve energy.
Lower T3: Triiodothyronine
The thyroid, the gland that controls our metabolic rate, also picks up on lower leptin levels. Its response to less leptin, or a general energy deficiency, is to lower the hormone T3, which assures a high metabolic rate. When its levels drop, the body burns fewer calories and preserves energy for functions essential to stay alive in this time of energy shortage.
But also, triiodothyronine is made from another thyroid hormone: T4. To turn T4 into T3, the thyroid uses an enzyme that needs carbs to be active. So, less carbs, less enzyme activity, less T4 turned into T3. Higher cortisol levels also restrict this conversion. And guess what low-carb diets can also do?
Increased Cortisol Levels
Because the body likes to rely on glucose for its energy production, when we stop eating carbs that provide ready-made, ready-to-use glucose, the body can perceive this as a stressor. When stressed, the body increases cortisol levels, which help mobilize those other energy sources like fat and protein to turn them into glucose and then: energy.
In short-term, stressful situations, cortisol can help us survive. However, when stress becomes chronic, cortisol, and adrenal glands tired from constantly making cortisol, start to create some problems. One of them is that our hormone production gets out of balance.
The production of progesterone will lessen, which can make estrogen levels too high compared to progesterone. This is called estrogen dominance, and it can cause or exacerbate issues like heavy periods or fibroids. Testosterone can be impacted as well, leading to issues like acne, hair loss, or moustaches for women. And high cortisol levels can also decrease GnRH.
So, stress—whether or not from eating too little (carbs)—can cause many other issues with your periods than just stopping them. Chronic high levels of cortisol can deregulate your sleep, immune system, blood pressure, mood, memory, and emotions, and can even break down your muscles!
Funny enough, cortisol is also behind many of our sweet cravings, aka: a desire for carbs.
Lower Insulin Levels
Low-carb diets typically reduce insulin production. While this can help manage blood sugar in conditions like type 2 diabetes, it can also lead to the body conserving more glucose, which in turn increases cortisol to maintain blood sugar levels.
When insulin signaling decreases, leptin production also drops, sending signals to the hypothalamus that energy is scarce. This creates a feedback loop, further shutting down non-essential functions like menstruation.
How Many Carbs and Calories Do You Need?
The amount of carbs and calories a person needs varies based on factors like activity level. Lara Briden suggests aiming for at least 2,500 calories a day, with around 200 grams coming from carbs. Most healthy diets include 45-65% of calories from carbs. Tracking your intake can provide insight into what you are actually eating, and apps like Chronometer can make this easy. To learn more about carbs in general you can read my previous post: http://www.seedsofhealth.net/2024/08/25/carbohydrates-why-do-we-need-them/
Period Problems? Reach Out!
If you’re experiencing period issues, feel free to contact me (http://www.seedsofhealth.net/book-a-nutrition-consultation/). Due to a lack of knowledge, we’ve accepted too many inconveniences that we should never have had to live with. Dietary changes can greatly affect your period, and I'd love to help you find better balance in your cycle.
Sources
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02874-y
https://link.springer.com/article/10.1007/s40618-023-02068-6
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.702802/full
https://www.mdpi.com/2072-6643/16/17/2967
https://www.ncbi.nlm.nih.gov/books/NBK538239
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5197987
Carbs & Healthy Period. Image by pch.vector on Freepik
Do Women Need to Eat Carbs to Have a Healthy Period?
Fruits benerally contain a good amount of carbs.
Carbohydrates: Why do we need them?
Watermelon slices. Image by rawpixel.com on Freepik.
Watermelon ~ Food as Medicine
Search
Dandelion seed image
The ovulation cycle. Image from https://smart.servier.com/
The ovulation cycle. Image from https://smart.servier.com/
Dandelion seed drawing
Do women need carbs for a healthy period blog post.
Dandelion seed drawing
Dandelion seed drawing
Do women need carbs for a healthy period blog post.
Dandelion seed image
Dandelion seed drawing
Do women need carbs for a healthy period blog post.
Dandelion seed drawing
Carbs affect menstruation. Breads. Image by Markus Winkler.
Tubers and a little girl. Image by Laura Santos.
Do women need to eat carbs for a healthy period blog?
There are many different kinds of carbs and some are healthier than others. Check my previous post to learn more about carbs, or reach out so we can check what the best diet is for you. Pictures by: Markus Winkler, Laura Santos.
Dandelion seed drawing
Dandelion seed image
Do women need carbs for a healthy period blog post.
Dandelion seed drawing
The effects of cortisol. Image by brgfx on Freepik
These are some of the short term effects of cortisol. Long term stress however can wreck havoc on your system. Image by brgfx on Freepik.
Dandelion seed drawing.
Do women need carbs for a healthy period blog post.
Dandelion seed drawing
Dandelion seed image
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672338
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985077
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738399
https://pubmed.ncbi.nlm.nih.gov/23107319