Infertility affects millions of individuals worldwide and remains one of the most emotionally and medically challenging conditions in reproductive health.

At the recent Growth Asia Summit 2026 in Singapore, Dr Celia Ning, Senior Director of Scientific Affairs at Kerry, presented From Hormonal Chaos to Cycle Confidence: Creating the PMOS and Fertility Ecosystem.

Celia highlighted that female infertility is an increasingly significant health concern across the Asia‑Pacific (APAC) region, shaped by a unique combination of metabolic, environmental, immunological and demographic factors.

Among these, polycystic ovary syndrome (PCOS), most recently re-named a Polyendocrine Metabolic Ovarian Syndrome (PMOS), is one of the most prominent contributors, affecting an estimated 10–13% of reproductive‑aged women.

The key characteristics of PMOS and treatment strategies for female infertility and PMOS in APAC were presented.  Dr Ning emphasised that current PMOS treatments should combine:

• Lifestyle and nutrition interventions
• Pharmacological options
• Assisted reproductive technologies.

Although PCOS treatment approaches in APAC are broadly aligned with international guidelines, Dr Ning highlighted that variations in healthcare infrastructure and cultural influences can affect timely access to care and treatment uptake.

Combined with the region’s distinct metabolic profiles, evolving lifestyles, and varied environmental exposures, these factors may be contributing to the rising prevalence and impact of PMOS-related infertility across APAC.

However, a growing body of evidence shows that PCOS is fundamentally a metabolic endocrine condition with reproductive consequences, not the other way around.   Clinicians knew the name “polycystic ovary syndrome” was inaccurate and misrepresented the condition.

From 14 years of global collaboration between experts and those who lived with the condition, a consensus was published in May 2026 announcing that Polycystic Ovary Syndrome (PCOS) is now termed Polyendocrine Metabolic Ovarian Syndrome (PMOS)⁴.  According to Teede et al.⁴ transition to the new name will occur over a three-year period.

Why PMOS and not PCOS?

PMOS is primarily a metabolic endocrine disorder.  Research consistently shows that insulin resistance is present in up to 75% of women with PMOS, even at normal BMI, and nearly 95% of women with PMOS who have overweight or obesity⁵.

Insulin resistance drives excess androgen production, disrupted follicular development, anovulation and/or increased cardiometabolic risk.  This metabolic foundation is why many experts argue that the term “PCOS” under‑represents the true nature of the condition.

Polycystic ovaries are not required for diagnosis⁶.  Ultrasound findings are not necessary for diagnosis, not specific to PCOS and common in healthy adolescents and young adults.  The name “PCOS” overemphasises a feature that is neither universal nor central.

Furthermore, the metabolic risks extend far beyond fertility.  Women with PMOS have higher lifetime risks of type 2 diabetes, gestational diabetes, dyslipidaemia, hypertension, non‑alcoholic fatty liver disease and/or sleep apnoea^6,7.  These risks persist long after reproductive years, reinforcing the need for a metabolic‑focused terminology.

Why “PMOS” Better Reflects the Condition

The proposed term Polycystic Metabolic Ovary Syndrome (PMOS) highlights the⁴:

• metabolic drivers: insulin resistance, inflammation and adipose dysfunction are central mechanisms.
• ovarian consequences: anovulation, hyperandrogenism and infertility arise because of metabolic dysfunction.
• need for metabolic‑nutrition interventions: lifestyle and nutrition strategies are first‑line therapy because they target the root cause.
• lifelong nature of the condition: this is not just a fertility disorder—it is a chronic metabolic condition requiring long‑term management.

Why This Matters for Nutrition and Health Professionals

A metabolic‑focused name aligns with what research has shown for years:

• Diet quality, insulin sensitivity and body composition are central to symptom management.
• Women in Asia‑Pacific and South Asia show higher insulin resistance at lower BMI, making metabolic framing especially relevant.
• Nutritional interventions (e.g., low‑GI patterns, whole‑food diets, vitamin D optimisation, inositol supplementation) directly target the underlying physiology.
• A metabolic lens helps reduce stigma by shifting the narrative away from “cysts” and toward systemic health.

In Summary

The overarching aims of the group behind the PCOS name change are to build greater awareness, strengthen diagnostic accuracy, elevate the quality of care and patient experience and ultimately improve outcomes across all aspects of the condition⁴.

The renaming of PCOS to PMOS reflects a deeper understanding of the condition as a metabolic‑endocrine disorder with reproductive manifestations, rather than a purely ovarian syndrome.

For the more than 170 million women living with PMOS worldwide, the implications are tangible.  PMOS management demands an integrated, individualised approach — one that addresses the symptoms experienced by each woman living with PMOS.

Such an intricate journey is filled with moments of anticipation, joy and connection.  But it can also include challenges and health considerations that require thoughtful attention and care.

The link between a mother’s health and their infant’s wellbeing has created a strong consumer demand for products targeting conception, pregnancy and breastfeeding.

Of recent launches in the Women’s Supplements Market, 38% were related to pregnancy and/or fertility¹.

The fertility stage is oftentimes the gateway to family living.  Around 186 million individuals live with infertility worldwide, at times leading to feelings of guilt, fear and self-blame².

Support, whether from healthcare professionals, family and/or friends, is key to helping people navigate the complexities of the fertility journey with dignity, resilience and hope.

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS), affects an estimated 6 – 13% of women, with up to 70% of cases being undiagnosed.

Around 40% of all female fertility disorders are due to ovulatory disorders³, with 85% of these linked to PMOS⁴.

Considering PMOS causes one in three cases of female infertility and affects 6 – 13% of women of reproductive age, there’s demand for naturally derived, science-backed solutions to help promote fertility for those living with PMOS⁵.

However, it is evident from the research that one of the main factors that impact this condition is insulin resistance.

This insulin resistance has a direct effect on Myo-inositol (MI) to D-Chiro-Inositol (DCI) conversion, ultimately causing a DCI deficiency.

This deficiency can lead to hyperinsulinemia, i.e., high levels of insulin, which can cause an overstimulation of the ovary to produce testosterone. i.e., hyperandrogenism, which in turn causes anovulation.

In parallel to this, there is a MI deficiency in the ovary which leads to poor oocyte maturation.  This is because MI is involved oocyte maturation.

This together with anovulation can contribute to infertility associated with PMOS.

Biosynthesis of myoinositol (MI) occurs endogenously, primarily in the kidney, with a rate approaching 4g per day.  The conversion rate of MI to D-chiro-inositol (DCI) ranges from 3% to about 9%⁶.

In women suffering PMOS, they have a systemic deficiency of DCI^7,8.  Consequently, the level of DCI in tissues can decrease significantly.

On the contrary, the situation seems to be different in the ovary, where there is a deficiency of MI⁹.  Therefore, women experiencing PMOS have DCI deficiency at a systemic level and MI deficiency at the ovary level.

To tackle both deficiencies, varying combinations of MI and DCI have been researched.  For instance, a ratio 40:1 MI:DCI taken by healthy women resulted in better clinical results that the use of MI or DCI alone^10,11.

Interestingly, a clinical trial comparing the benefits of a MI:DCI ratio at 3.6:1 versus ratio 40:1 showed significantly better results in the MI:DCI 3.6:1 group with almost four times more live births than the 40:1 MI:DCI group¹².

Furthermore, a MI:DCI 3.6:1 ratio has multi-dimensional benefits to women with PMOS such as regularising menstrual cycles and improving insulin resistance, hormonal, glycaemic and lipid profiles, with considerable efficacy and tolerability^12-15.

Pregnancy

Pregnancy is a time of incredible change for women as their bodies prepare to nurture a new life.  A mother’s health becomes paramount as her well-being and that of her baby is intricately connected.

Emotional health is equally important during this time, as hormonal changes bring about a variety of feelings, from joy and excitement to anxiety and mood swings.

A strong support network is crucial to help expecting mothers navigate the changes and challenges with strength and confidence.

A well-balanced diet of good quality carbohydrates, proteins, specific fatty acids, vitamins and minerals is essential to support changes to the mother’s body and for optimal growth and development of the baby¹⁶.

It is also important that mothers are aware of the foods that must be avoided during pregnancy including unpasteurised dairy foods, soft cheeses, raw meat and fish and alcohol¹⁶.

Mothers’ diets have also been found to influence a baby’s health into adulthood, with good prenatal nutrition reducing the risk of heart disease, diabetes and high blood pressure in adulthood.

Interestingly, a study reported that up to 92% of pregnant women reported taking prenatal vitamins and/or other supplements¹⁷.

Some of the most popular supplements are folic acid, which is essential for preventing neural tube defects in the developing foetus and Docosahexaenoic acid (DHA), which is key for cognitive, eye and heart development.

Omega-3 DHA fatty acids are critical for the development of the baby’s brain and eyes, reduces the risk of preterm birth, supports maternal health and contributes to healthy birth weight.

Breastfeeding

From conception to their second birthday, babies’ first 1,000 days of life are a critical window for good nutrition and infant wellbeing.

During this time, a baby’s gut and immune system develop rapidly as they move from a protected environment to one exposed to many immune challenges.

Breastfeeding is a journey that fosters a unique bond between mother and baby.  Regarded as the gold standard of infant nutrition, it offers a host of extraordinary benefits for both mother and baby.

A nutrient-rich diet and good hydration is vital for breastfeeding mothers, especially for those who are exclusively breastfeeding as they generally need an extra 300 – 500kcal per day¹⁶.

However, it is important to understand that every mother’s situation is unique and breastfeeding comes with its own challenges, which means it isn’t always possible.

Acknowledging these challenges openly helps to create a more supportive environment that equips mothers with the tools they need to best care for themselves and their babies.

One of the main medical reasons for women stopping breastfeeding is mastitis.  According to the World Health Organisation (WHO), up to 30% of lactating women suffer from mastitis¹⁸.

Through extensive research, intake of a probiotic strain isolated from woman breastmilk, Lactobacillus fermentum CECT 5716, promoted breast health and comfort.

This, in turn, prevented premature cessation of breastfeeding due to pain, by reducing mastitis pain symptoms and the incidence or recurrence of mastitis^19-21.

Summary

Addressing fertility and health challenges for women requires a multifaceted approach that includes dietary and lifestyle modifications.

Emerging research underscores the powerful role of nutrition in managing the key drivers of PMOS.

Incorporating nutrient-rich foods, maintaining a balanced macronutrient intake and adopting sustainable dietary patterns can empower women to improve their fertility outcomes.

As science continues to advance, personalised nutrition strategies show promise for tailoring solutions to individual needs, offering hope for those navigating fertility challenges.

Supporting women on this journey is not just about dietary choices; it’s about fostering overall health and well-being for the future.

Women may be living longer, but the extra years are spent in poor health due to the disparity in women’s health research, data, care and investment.

The women’s health gap equates to 75 million years of life lost per year and can affect other areas of a woman’s life too- a woman will spend approximately nine years in poor health, negatively affecting her ability to be present and/or productive at home, in the workforce and in the community¹.

Addressing the gender health gap, while crucial for women, benefits everyone.

Investments in women’s health could add years to life and life to years, potentially boosting the global economy by 1 trillion USD annually by 2040¹.

In fact, for every $1 USD invested in women’s health, around $3 USD is projected in economic growth – a significant return on investment.

As more and more women prioritize their long-term wellbeing, they are seeking products that not only address immediate health concerns but support their quality of life at every stage.

Companies who empathise and understand women’s evolving health priorities are seen as more credible by these informed and empowered consumers.

The Hormonal Lifecycle

The hormone lifecycle represents a unique journey for every woman.  Beginning with menstruation and continuing into late age with menopause, it spans across a woman’s whole life.

Hormones are crucial for regulating various bodily processes, including appetite, metabolism, sleep cycles, reproductive cycles, sexual function, body temperature and mood.

Achieving the right hormone balance is essential for meeting women’s needs and maintaining their overall wellbeing.

50% of global female consumers state they are concerned about women’s health issues, such as menopause and hormonal imbalances, menstruation and fertility.

When it comes to health, 48% of women are prioritising hormonal balance².

Thanks to advances in medical research and more open dialogues, the link between hormonal imbalances in women and health problems such as mood swings, weight gain and reproductive issues is now more widely acknowledged.

Menstruation

The introduction of menstruation during adolescence is the beginning of the hormonal lifecycle and fertility.

Hormonal fluctuations of oestrogen, progesterone, luteinising hormone (LH) and follicle stimulating hormone (FSH) across an average of 28 days prepare the ovaries and uterus for pregnancy or menstruation.

The menstrual cycle (Figure 1) is divided into four phases: menstruation, the follicular phase, ovulation and the luteal phase.  Each phase has unique hormonal changes, physical symptoms, nutrient requirements and emotional states.

Figure 1. The Menstruation Cycle

For more information on nutritional and physical activity recommendations across the menstrual cycle see here.

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

PMOS is also the most common cause of female infertility.

Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS), is a common hormonal disturbance affecting an estimated 6-13% of women of reproductive age³ and up to 70% of cases are undiagnosed.

PMOS is a female-specific endocrine disorder related to a deficiency of inositol, a type of sugar made by the body which aids in balancing chemicals that control blood sugar and fertility and specifically a systemic deficiency in the D-chiro-inositol and ovarian deficiency in Myo-inositol.

Symptoms of PMOS can differ from person to person but often include irregular or absent menstrual cycles, excessive hair growth on hair or body, acne and weight gain.

Lifestyle interventions such as physical activity and a balanced diet can improve some symptoms of PMOS.

A combination of Myo-inositol and D-chiro-inositol (3.6:1) has been shown to support the hormonal and metabolic balance in a woman’s reproductive cycle, promoting fertility and wellbeing, showing excellent clinical results with increased pregnancy rates, decreased miscarriage rates and improved live birth rates^4-7.

Menopause

For far too long, menopause was a topic shrouded in stigma and largely ignored by both society and the medical community.  This silence forced countless women to navigate this transition alone, often without the support or resources they needed.

‘The menopause lifecycle’ is the period of time from peri to post menopause.

• Perimenopause is the transition to menopause, typically lasting 3-7 years where menstrual periods become irregular and symptom onset occurs.
• Post-menopause is the time after a woman has gone without a menstrual period for 12 consecutive months.  While symptoms typically last 4 years from their final period, women may spend up to 40% of their lifetime in their postmenopausal years ⁸.

Menopause describes the stage of a woman’s life when her menstrual periods stop permanently due most notably to a gradual decline in the hormone oestrogen.

Oestrogen is a hormone that regulate the growth, development and physiology of the human reproductive system and are also involved in the neuroendocrine, skeletal, adipogenesis and cardiovascular systems.

Oestrogen has a protective effect on bone density, as this hormone declines during and after menopause, there is an increased risk of osteoporosis.

It is therefore important that interventions such as high calcium diet and physical activity are part of a woman’s daily lifestyle habits to protect bone density and quality of life in later years.

Figure 2. The Mechanism of Action Behind Menopause Symptom Onset

With 1 billion women estimated to be experiencing menopause in 2025⁹ and 80% of these individuals experiencing symptoms¹⁰, menopause is more than just a women’s health issues: it’s a societal health issue with far-reaching impacts.

Given the more than 45 possible symptoms that can affect a woman’s physical, cognitive, mental and social wellbeing, there is an urgent need for effective and innovative solutions.

These advancements hold the potential to greatly enhance the quality of life for millions of women and their families worldwide.

The use of herbal, plant-based treatments for managing menopausal symptoms has gained popularity as many women seek natural alternatives, with 33% of consumers taking supplements to support their health through menopause.

As a traditional Ayurvedic ingredient, ashwagandha is a natural adaptogen that reduces the negative impacts of stress on the body by managing cortisol levels¹¹.

Ashwagandha supports cognitive health by alleviating stress, improving sleep quality, enhancing mood, amplifying energy levels and sharpening focus¹².

Research in this area has also shown that supplementation with ashwagandha has resulted in reduced invasive menopause symptoms, vascular dysfunction and bone turnover/resorption, as well as inflammation and oxidative stress associated with oestrogen deficiency in post-menopausal women¹³.

Phytoestrogens have also been found to have positive effects on menopause symptoms, reducing the frequency and intensity of hot flushes.  Phytoestrogens are plant-based compounds that mimic the effects of oestrogen in the body.

8-Prenylnaringenin (8-PN), one of the strongest known phytoestrogens, showed a 40% reduction in hot flashes and a 32% improvement in symptoms of nervousness, fatigue and excessive sweating, making it an effective solution for supporting menopausal and post-menopausal health.

Conclusion

Changes in hormones present unique female health challenges from menstruation to menopause, with almost 50% of women prioritising hormonal balance.

Menopause is one of the key stages in a woman’s hormonal lifecycle where significant changes occur, directly impacting an individual’s health.

Clinically supported, natural solutions that address symptom management present an opportunity for women to be supported throughout the hormonal lifecycle and for quality of life to be improved through dietary supplementation.

For more on women’s health, read our guide on the Unique Health and Nutritional Needs of Women.

Women’s Unique Nutritional Needs 

“When you consider the various stages of a woman’s life, adolescence, reproductive age, pregnancy, lactation, peri-menopause, menopause and post-menopause, it’s not surprising that each of these stages requires distinct nutrition to support overall wellbeing. 

For example, adolescent females have an increased requirement for calcium to build life-long bone density. A deficiency in calcium at this life stage can result in increased risk of osteoporosis post-menopause, when the protective effects of estrogen decline,” said Dr Lisa Ryan.

By understanding the specific nutritional requirements of each life stage, women can make informed choices about their own health.  

Nutrition and Fertility 

One in six women experience infertility.  Hormonal imbalances can disrupt a woman’s delicate reproductive process, leading to irregular cycles, failure to ovulate (anovulation), difficulty conceiving, or infertility. 

There are some unknown causes of infertility, but one in three cases of female infertility is caused by polycystic ovary syndrome (PCOS) – the most common hormonal disbalance affecting women.

What is Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

Polyendocrine Metabolic Ovarian Syndrome (PMOS)*, formerly known as Polycystic Ovary Syndrome (PCOS), is a common condition that affects how a woman’s ovaries work. 

Polycystic ovaries are bigger than healthy ovaries and have twice the number of follicles than healthy ovaries do. 

In PMOS ovulation doesn’t take place each month causing women to stop having periods or have irregular periods and can also cause fertility issues. 

It’s a complex, chronic condition associated with a range of endocrine and metabolic symptoms.

PMOS can have a profound impact on a woman’s health, fertility, self-esteem and body image, leading to emotional distress. It is not just a fertility issue but one affecting a woman’s overall health, including her mental wellbeing.  PMOS is leading cause of female infertility.

“The exact cause of PMOS is unknown.  It’s thought to be linked to abnormal hormone levels in the body, including high levels of insulin. 

PMOS is also related to a deficiency in inositol (a sugar made in the body and found in foods) and specifically a systemic deficiency in the D-chiro-inositol and ovarian deficiency in Myo-inositol. 

Women with PMOS need to ensure an adequate intake of inositol through their diet or consider taking a supplement,” said Dr Monica Maria Olivares. 

Monica added: “The benefits of inositol in PMOS are very well known there are more than 300 scientific publications about this topic, more than 50 clinical trials, and 20 metanalysis demonstrating the benefits of inositol on fertility, skin, cardiovascular disease, hyperandrogenism and hyperinsulinemia.”

Nutrition in Pregnancy and Breastfeeding 

The first 1,000 days of a child’s life – beginning with conception through the first two years of childhood – critically impact development and health throughout life.

Therefore, it is essential that women have the nutrition, care, and the support they need for the healthiest possible future for themselves and for their children.

Vitamin and mineral needs can vary greatly between pre-pregnancy, pregnancy, and lactation. 

A carefully chosen diet can meet recommendations for most nutrients, but the diets of pregnant and lactating women often fall short of many essential nutrients.  For example, many pregnant women under-consume: 

• • • folic acid (to help protect against neural tube defects);  
    • choline (for fetal brain and nervous system development);  
    • iron (for increased maternal and fetal blood volume); and  
    • calcium (for bone growth and reduced risk of maternal hypertension). 
    • Omega-3 (for fetal brain and eye maturation) 

During lactation, the mother is able to provide all of a child’s nutrient needs via breastfeeding.  For optimal health of the infant, the WHO recommends exclusive breastfeeding for the first six months. F

or the mother, this means that the required intake of many nutrients becomes even greater than during pregnancy – after all, the baby is still totally dependent on the mother for nutrition, but it is now bigger than it has ever been. 

As a result, it is essential for the mother to eat a balanced diet during this time to ensure both she and her baby are healthy.  For some nutrients, the mother’s body will ensure the breast milk contains enough for the baby even at the risk of depleting her own body’s reserves.

These are mostly nutrients that are absolutely essential for proper growth and development of the baby, such as protein, calcium, and zinc.  Inadequate intake by the mother could lead to higher risk of iron deficiency, anaemia, or loss of bone mineral density. 

Some mothers don’t get the support they need to sustain breastfeeding.  Mastitis is the leading medical cause of women ceasing breastfeeding with ~15% of women experiencing mastitis during breastfeeding.  The main symptom is pain.

What is Mastitis? 

Mastitis is an inflammation of breast tissue and is associated with an imbalance of the microbiota of the mammary gland.  The main symptom is pain, and the pain, heat and swelling can be very intense. 

Other symptoms include inflammation and obstruction of mammary ducts, and it can be associated with systemic symptoms like fever and tiredness.  Mastitis a very common problem during breastfeeding, affecting around 15% of women.  

Nutrition in Menopause 

Peri-menopause, pre-menopause, menopause, post-menopause.  The menopause isn’t a single event in a woman’s life, but something women experience over the course of a couple of decades. 

It’s a transformative phase, marking the end of a woman’s reproductive years. This natural transition brings about a myriad of changes, both physical and emotional.  

1 billion women worldwide will be experiencing menopause in 2025. 80% of them will have menopausal symptoms, symptoms that can severely impact their quality of life.   

What is Menopause? 

Menopause is the consequence of the reduction in the ovarian function as it’s a gradual decrease in the level of oestrogens in a woman’s system. 

Oestrogens regulate the growth development and physiology of the human reproductive system, but also are involved in neuroendocrine, skeletal, adipogenesis and cardiovascular system.

The low level of oestrogen during menopause reduces the activation of estrogen receptors and causes the symptoms associated with menopause.   

There are more than 30 different symptoms associated with the menopause.  Common symptoms include: 

• • • • hot flushes 
      • night sweats 
      • difficulty sleeping 
      • fatigue 
      • lack of energy 
      • low mood or anxiety 
      • problems with memory or concentration 
      • vaginal dryness and pain, itching or discomfort 
      • reduced sex drive (libido) 
      • discomfort during sex 
      • irregular periods 
      • headaches 
      • heart palpitations  
      • recurring UTIs 
      • loss of muscle 
      • weight gain, and 
      • joint aches and pains.

Women choose to manage their symptoms and look ahead to healthy ageing in many different ways – pharmaceutical treatments, herbal remedies, life-style changes and increasingly nutritional changes, like adding more phytoestrogens to their diet. 

Monica said: “Phytoestrogens are plant-based compounds that mimic the effects of oestrogen in the body.  They occur in different botanicals, for example in red clover, soybeans and hops, and have been shown in clinical studies to reduce the frequency and intensity of menopause symptoms without serious side effects, which is very important.

In fact, there are more than 1,500 scientific publications, 300 clinical trials, and 30 metanalysis demonstrating how phytoestrogens can help to address symptoms in menopause.” 

Lisa added: “There are also specific nutritional considerations for post-menopausal women.  For instance, many experience changes in taste perception and suffer from severe dry mouth.

Their food preferences may shift, and they may require different supplements or novel botanicals to support these changes. This presents opportunities for food and nutrition innovation specifically tailored to women’s health.” 

Conclusion 

There is a growing recognition of the unique health needs of women and a shift toward prioritising women’s wellbeing. 

That said, every woman is different, and their needs are distinct and unique throughout various stages of life.  Nutrition therefore needs to be personalised. 

New technology is making personalisation easier.  By tracking what happening in their bodies, women can better understand the symptoms they are experiencing, allowing them to make decisions about taking a specific diet or ingredient to meet their individual needs.  

“There is wealth of information available about how women can use nutrition to manage their physical and emotional wellbeing throughout their lives. What’s important is to seek out science-based information and products that have been tried and tested in clinical studies,” concluded Lisa.     

*This article was updated on July 31st 2026 to relect the new terminology for PMOS

Over the course of the menstrual cycle, those who menstruate have different calorie and nutrient requirements due to fluctuations in hormones.  These hormones not only influence your monthly cycle, but also your body temperature, metabolism, hunger and food cravings.

Cycle syncing is a concept that has gained increasing attention in recent years but has been around for centuries.  It’s the practice of aligning your lifestyle, nutrition, and self-care routines with the natural fluctuations of your menstrual cycle.

Understanding the phases of your cycle and the specific needs associated with each one, can help to better manage your symptoms and optimise your well-being.

Our needs evolve over the course of the menstrual cycle, and by being aware of these changes, you can take proactive steps to support your physical and emotional health.

Tracking your cycle is the first step for people who are menstruating, to be more informed about their bodies and what is normal for them.

Once you are informed about the changes in your body, you can make alterations to support your diet, tailor your exercise to suit your energy levels and make changes to support your mood and sleep.

The menstrual cycle is divided into four phases: menstruation, the follicular phase, ovulation, and the luteal phase. Each phase has unique hormonal changes, physical symptoms, nutrient requirements, and emotional states.

Click through the interactive infographic below to explore the nutritional and physical activity recommendations across the menstrual cycle:

The following information is summarised in the interactive infographic above.

Menstruation / Period (Typically days 1-7):

• • • Oestrogen levels will be low
    • You may experience fatigue and PMS symptoms, such as cramps.
    • Lower Energy

Nutrition Focus: Iron deficiency anaemia is very common for those who menstruate, therefore increasing your intake of food sources of iron is important to replenish this iron lost as well as to combat fatigue.

Increasing your iron intake is important as iron deficiency anaemia from blood loss is very common for those who menstruate.

Iron-rich foods include both animal (haem iron) sources, eg. liver and red meat, and plant based (non-haem iron) sources eg. leafy greens and legumes.

Incorporating magnesium-rich foods, such as nuts and seeds can relieve migraines and mood swings, and incorporating foods rich in omega 3 such as salmon, flax seeds, and avocado, can alleviate cramps.

*Top tip: Prioritise Essential Tasks. Focus on completing essential but less demanding tasks that don’t require intense concentration.

Follicular Phase (Typically days 1-13):

• • • Oestrogen levels start to rise
    • Energy levels increase and mood improves
    • You might feel more social and extroverted.

Nutrition Focus: As oestrogen levels increase, choose an overall healthy diet rich in fibre and micronutrients like whole grains, fruits, and vegetables to support hormonal balance and provide sustained energy, and focus on hydration.

Include sources of healthy fats such as avocados and fatty fish to enhance mood and cognitive function, and fermented foods such as yoghurt and kimchi for gut health

Exercise: This is a good time of the month to prioritise high intensity and strength training like group fitness classes.

*Top tip: Use this phase to plan and initiate important projects or tasks that require creativity and strategic thinking.

Schedule meetings, brainstorming sessions, and collaborative activities during this phase when your energy levels are higher.

Ovulation (Around Day 14):

• • • Oestrogen surges, and energy levels are at their peak
    • We feel our best, with heightened confidence and energy.

Nutrition Focus: Similarly to the follicular phase, during ovulation, focus on an overall healthy diet including nutrient-dense foods like eggs, lean proteins, and leafy greens that provide sustained energy to accommodate the surge in energy in the body.

These support the surge in energy. Additionally, hydration is crucial as the body’s temperature rises.

Exercise: This is the best time for high intensity and strength focused exercise like bootcamp and kickboxing, as you reach peak energy due to a rise in testosterone.

*Top tip: Tackle high-impact tasks, presentations, or negotiations when you’re at your most sociable and persuasive.

Attend corporate events, conferences, or networking functions to build relationships and expand your professional network.

Luteal Phase (Typically days 15-28):

• • • Oestrogen drops and progesterone increases, which can affect digestion and appetite causing cravings.
    • Breast tenderness, bloating, and mood swings.
    • Energy levels can dip and we can feel more introverted
    • Sleep disruption can be common which can affect irritability and performance.

Nutrition Focus: Make sure you are getting enough protein and healthy fats to sustain you during this phase to avoid reaching for high energy foods.

Prioritise complex carbohydrates and foods high in fibre like whole grains and sweet potatoes to stabilise blood sugar levels and support mood and energy levels.

Incorporate foods rich in vitamin B6 and magnesium, such as bananas and chickpeas, to help alleviate PMS symptoms such as bloating, and support emotional balance.

Increasing foods high in vitamin D and calcium can also benefit to reduce PMS symptoms.

Exercise Focus: Medium to light exercise and active recovery like yoga and walking are best for this time of the month.

*Top tip: Concentrate on detail-oriented tasks such as data analysis, report writing, and quality control.

Use time management techniques to stay organised and efficient, as mood swings and PMS symptoms can be more pronounced during this phase.

Your needs can significantly shift over the course of the menstrual cycle, and being attuned to these changes can be a game-changer in managing various symptoms.

By recognising the change of hormones and their effects on physical and emotional well-being during different phases of the cycle, we can implement strategies to feel happier and healthier.

Whether it’s adjusting dietary choices, exercise routines, or self-care practices, these small changes can have a huge positive impact.

By practicing cycle syncing methods, we can have a deeper sense of well-being and harmony throughout the entire menstrual cycle.

October 18^th is World Menopause Day.  It’s a day to come together an recognise the significance of menopause in the lives of women worldwide.  With the importance of Women’s Health across the life stages, we would like to share key insights from our women’s health webinar that explored the intricate relationship between menopause, health, and nutrition.

Menopause is an inherent and transformative phase in a woman’s life.  This natural transition brings about a myriad of changes, both physical and emotional.  Our webinar delved into the diverse aspects of menopause, shedding light on its impact on women’s overall well-being.

In the video from the webinar, our experts Dr Izaskun Monsalve and Dr Monica Maria Olivares discuss the science behind menopause and the opportunities to innovate.  More importantly, they explored the crucial roles that health and nutrition play in managing symptoms and promote long-term health.

Join us on this informative journey as we celebrate World Menopause Day by fostering awareness and encouraging informed choices.

Together, let’s embark on this journey towards better health and well-being for women globally.

Author: Wendy Sweet, PhD. Wendy Sweet is the founder of My Menopause Transformation and a member of Australasian Society of Lifestyle Medicine. Her own struggle with symptoms of menopause – including weight gain and feelings of stress – led Wendy to explore this life stage as part of her doctoral studies on women’s health and ageing through the University of Waikato’s Faculty of Health, Sport and Human Performance.

Nutritional solution to symptoms of menopause

Among the various pharmaceutical treatments and herbal remedies for symptoms of menopause, nutritional changes rarely get a mention. But nutritional adjustments offer a powerful solution for women struggling to make sense of this life stage.

Whilst there is a plethora of advice about managing symptoms of menopause in the medical and pharmaceutical paradigm, how many of us change our lifestyle to accommodate our transition through menopause?

Positioning the menopause transition in ageing research opened the door to a variety of symptom management possibilities using food as medicine, not only for myself, but now for the thousands of women who join me in my coaching community. There’s an element of surprise when this happens.

Research endorsing Mediterranean diet

However, metabolic and cardiac research consistently view the menopause transition and subsequent endocrine changes, with increased prevalence of metabolic syndrome, cardiovascular disease, obesity, osteoporosis and immune dysfunction. Looking at these clinical endpoints is therefore important, because it helps us to explore prevention opportunities that (mainly) sit within lifestyle medicine and ageing research.

‘Among the various aspects of health promotion and lifestyle adaptation to the menopause and postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life.’  (Silva, Opperman et al, 2021).

With the menopause transition increasingly viewed as a systemic inflammatory phase that enables later neurogenerative and cardiovascular disease (McCarthy & Raval, 2020; Furman, Campesi et al, 2019), all roads in women’s midlife health and ageing research lead to the Mediterranean Dietary approach.

Inflammation & symptoms of menopause

Part of this approach is ensuring that women have the appropriate nutrients that fight inflammatory changes, which are known to commence in peri-menopause. For example, if women constantly feel hot and sweaty, this is a sign that their temperature regulation is out of balance. As such, the body activates sweating by moving heat to the surface of the skin. Heat generation is compromised as women move through menopause because blood vessels lose some elasticity. This is called vascular stiffness.

To reduce the effect of vascular stiffness, foods high in nitrates help. Dietary nitrate has been demonstrated to have a range of beneficial vascular effects, including reducing blood pressure, inhibiting platelet clumping and clotting, and preserving or improving endothelial dysfunction, and enhancing exercise performance in healthy individuals. (Lidder & Webb, 2012).

Adjusting nutritional choices as women move through menopause is a major modifiable risk factor that women have control over, especially for preventing heart disease, weight gain and osteoporosis – the main conditions that beset western women as they age. Whilst there is much confusion about dietary choices these days (eg, Keto, Paleo), many of these are high in saturated fat and protein. However, as women move through menopause into post-menopause, a high saturated-fat diet isn’t recommended, especially with regard to managing cardiac and metabolic health. (Silva et al, 2021).

Lifestyle and disease-prevention approaches

When it comes to looking ahead to a potentially healthy ageing, I’m a great advocate of using our menopause transition to begin to try new approaches. The lifestyle and disease-prevention science specific to women allows a framework from which to make these adjustments.

Most advice follows learnings from cardiovascular research as well as ageing and longevity research including:

• Small to moderate amounts of fermented dairy foods (low fat cheese and yoghurt)
• Protein sourced from plants, nuts, seeds, legumes, fish and salmon
• Fats from unsaturated plant sources or alternative sources of Omega-3 fatty acids and olive oil
• Low glycemic index carbohydrates from whole-grains and starch vegetables
• A minimum of five servings of fruits and vegetables per day (and up to 10) but not sugar-sweetened beverages

(Silva, Oppermann et al, 2021).

Menopause as natural process

The phenomenon of menopause brings numerous physiological changes in the body and whilst every woman’s experience is unique, positioning this transition that all women go through in ageing and inflammatory science offers a move away from the traditional view that menopause is a sickness to be ‘treated’.

Exploring cross-cultural studies that show substantial geographical and ethnic variation in the experience of menopause, as well as health and ageing studies, allows for a broadening of the menopause management paradigm. Furthermore, adding aspects of the Mediterranean dietary approach to menopause symptom and weight management, also helps to answer the call from Hickey et al (2022) for menopause to be normalised in ways that recognise this stage of life as a natural process ‘that challenges stigma around ageing in women’. (Hickey et al, 2022, p.3)

References:

Hickey M., Hunter MS., Santoro N., & Ussher J. (2022). Normalising menopause. BMJ. 377:e069369. doi: 10.1136/bmj-2021-069369. PMID: 35705221.

Lidder S., & Webb A. (2013). Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway. Br J Clin Pharmacol. 75(3):677-96. doi: 10.1111/j.1365-2125.2012.04420.x.

McCarthy M, Raval AP. (2020). The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation, 17(1):317. doi: 10.1186/s12974-020-01998-9. PMID: 33097048; PMCID: PMC7585188.

Preedy V. & Watson. R. (2020). The Mediterranean Diet: An evidence-based approach. 2^nd Ed. Elselvier Academic Press: London, UK

Silva, T., Oppermann, K, Reis, F. & Spritzer, P. (2021). Nutrition in Menopausal Women: A Narrative Review. Nutrients, 13, 2149, 1-14.

What they found was that breastfed infants, formula-fed infants, and even the mothers all had adequate iodine levels, which is good news for all mothers and children from iodine sufficient geographies.

Iodine is a mineral that is essential for cognitive development of infants and children, but it is also important for growth and development in adolescents and adults due to its importance in synthesis of thyroid hormones. Adding iodine to table salt in the United States significantly reduced the prevalence of iodine deficiency, but dietary guidance focused on reducing salt intake has raised concern that iodine intakes may fall below recommended levels again.

Want to know more about nutrition for infants and mothers? Read our blog Setting the Course for Lifelong Health: Nutrition for Mother and Baby

Geography can also impact whether or not we consume enough iodine, especially for geographies where there is no iodine supplementation program (like salt in the US) in place. Iodine is taken up from the soil by crops, but some geographies do not have much iodine in the soil. This means that people in those areas may be more likely to have low iodine intakes.

For areas with sufficient iodine, though, the study shows promising results:

1. Whether they are breastfed or formula-fed, infants will receive enough iodine in iodine sufficient geographies
2. Postpartum mothers seem to have adequate iodine status in iodine sufficient geographies

Want to know more about iodine for specific countries? Head to this page from the World Health Organization.

Read the study abstract here.