Hormone management is a new trend, especially on social media. Useful or unhealthy? A conversation with the gynecologist Dorothee Struck.
BRIGITTE: Cycles and menstruation used to be taboo topics, today women actively tackle their “destiny”. Actually good, right?
dr Dorothee Struck: Absolutely. I think it’s great that younger women in particular are dealing with their bodies and dealing with them consciously. But many are now overshooting the mark.
What do you mean?
More and more women are assuming that they really have to coach themselves into a 28-day standard cycle, like the one that comes with the pill from the pharmaceutical pack. Patients keep coming to me who think they can’t get pregnant because their cycle is irregular, sometimes 28 and sometimes 30 days. It’s completely healthy. That’s why I would first like to find out what a normal cycle actually is. It is much more individual than many people think and I learned during my studies.
So what is normal when it comes to menstrual cycles?
Everything between 28 and 42 days in length, as soon as it is reasonably regular in itself, i.e. with deviations of three or four days. Add to that the fact that women lose an average of three days of cycle length in their lifetime. Very few women menstruate like clockwork every 28 days.
What’s the problem with women assuming this false normality?
It creates pressure and can undermine their self-esteem: I already don’t look the way women should ideally look, have thin hair, a nose that is too thick or thighs that are too wide, and then my cycle breaks down and gives me another one Reason for feeling imperfect, not okay, not normal. And we already have more than enough of that.
More and more offers are promising women exactly this self-optimization: a regular menstrual cycle without symptoms.
This is a completely unregulated market, which I find very problematic. Because the cycle is one of the things that our body has been successfully regulating itself for thousands of years. He cannot be coached. This micromanagement doesn’t work, and because it doesn’t work, it often creates stress, which in turn affects the cycle.
What do you mean by micromanagement?
Take the idea of cycle-based nutrition, which has been spreading for two or three years, especially on social media. This means eating certain things in the first half of the cycle and others in the second half. Seed cycling is a big trend. It’s about seeds and nuts full of unsaturated fatty acids, which I have absolutely nothing against, but whoever offers this to treat, for example, luteal insufficiency – a dysfunction of the ovaries in which not enough of the hormone progesterone is produced – has the cycle not understood.
Then the diet has no influence?
Yes, you can have a very positive effect on certain diseases, including menstrual cycle problems. If there is a lack of magnesium, the muscles, for example, cramp more quickly. So if you eat magnesium-rich vegetables and little sugar in the second half of your cycle, which, like alcohol, is a magnesium robber, your menstruation will be less crampy.
Polyunsaturated fatty acids, such as those found in linseed oil, also have an influence because they provide building blocks for certain tissue hormones, the prostaglandins. But the second half of the cycle always results from the first and after ovulation there is little that can be influenced. In addition, egg cells undergo a pre-maturation process of several months. The expectation that you can cure the menstrual cycle in the short term with nutrition or the right mindset is wrong. There are diseases where this is not enough.
Do women come to your practice who have tried exactly that?
Yes, and more and more often. Just a few weeks ago, I had a 42-year-old fertility patient who, in four years, had spent more than $10,000 on menstrual cycle coaching, an online hormone university, and moderately useful general nutrition tips. She had not even been to the gynecologist to have the basics clarified, such as the hormone status, an ultrasound examination and the individual history such as chlamydia infections. The man, 16 years his senior, had not been examined either, although the health insurance company even covers this for both partners. In the end it turned out that he had zero motile sperm.
But are all offers so dubious?
No, there are also good and well-founded ones, for example from trained consultants in the field of natural family planning. There are also women who have moved beyond having their own disease, such as polycystic ovary syndrome PCOS, where you can really do a lot with nutrition, and are now sharing this experience with others as self-help. The problem, however, is that anyone can call themselves a cycle mentor or hormone coach. To make money with it, it is enough to be good at marketing and social media.
How do I recognize a serious offer?
The greater the promise of salvation, the more careful one should be. And if someone offers coaching for PCOS, the question arises as to the entry criteria, for example whether it is described somewhere how this disease is diagnosed in the first place. There is a lot of self-diagnosis going on at the moment and this of course also opens the door to problems, because if the diagnosis does not fit, the coaching cannot help either.
A lot of things in this area are very feminist. According to the motto: We not only take our lives into our own hands, but also our cycle.
But feminism doesn’t mean that what doesn’t fit is made to fit. That almost has something clichéd masculine about it again. Empowerment is knowledge of the cycle and also an understanding that our body is a self-regulating system. But when women say we’re fighting for the right to have the cycle we want, then I have to answer: take the pill.
When knowing about the body turns into wanting to control it, it tips over.
Exactly. It’s a tightrope walk, of course, but for me, deep and healthy knowledge leads above all to awe: the body is a marvel and totally awesome. If I treat him well, he regulates himself. Respecting this is lost more and more.
This autonomy of the body obviously scares some women.
Yes, I see that too. The need for control has greatly increased. When I started in gynecology in the mid-1990s, that wasn’t an issue. Today women want to control their cycle, their fertility, their desire to have children. But there are things that are beyond our control. This is bitter for one or the other, but it is also good and relieving. Because trusting your body so little and having the feeling that you have to do everything for it is really exhausting.
dr Dorothee Struck is a gynecologist, naturopathic doctor and hypnotherapist in Kiel. Among other things, she has specialized in the desire to have children and also offers online hypnosis programs (Frauengesundheit-kiel.de).