Worried post menopause lady - bleed and hormone disruption on keto!

(Emma) #1

Hi all,

Week 6 of keto and a first timer. After surviving keto flu, I started to really see and feel the benefits. I’ve lost 5 kilos, continuing well with my strength training and seeing signicant fat loss from my stomach and under the rib cage, the classic mid-line obesity from menopause transition. I’m eating plenty of healthy fats, fibre, clean protein sources and drinking electrolytes. My macros are good, eating 35g net carbs daily.

I am 2 years post menopause, long term user of bio-identicle progesterone daily and a little Testosterone.
I do not use Oestrogen HRT as I’m highly sensitive to it.

2 weeks ago, I started cramping, getting breast tenderness, frequent full bladder and urination, hot flushes, brain fog, low mood, tearfulness. Then, I bled, for 3 days!

I called the menopause nurse as UK NHS protocol usually requires a uterine scan for any post menopausal bleed to rule out Uterrine cancer. However, guidelines have changed and they now only scan if you meet certain risk factors … I do not, as I don’t take Oestrogen and I am using protective Progesterone so I’m not being sent for a scan, the menopause nurse isn’t worried and neither was I… it’s clearly caused by the Keto diet and I have read it disrupts oestrogen in particular but should “settle” down.

However… I am now worried. My symptoms are starting again… just 10 days after the bleed. I’m experiencing symptoms of both increased AND decreased Oestrogen.

I do not want to bleed again, I have menopaused! I also do not want these awful symptoms which I put up with for 10 years of peri-menopause. The impact on my mood is also really worrying me… I’m tearful and anxious.

When we burn fat quickly, our oestrogen levels drop as we have less oestrogen receptive fat cells.
However, it’s also widely claimed that Keto increases Oestrogen. Which is it??

I’ve also read some extremely worrying research which says very low carb diets like Keto also affect Thyroid function and women have reported hair loss on keto.

I have of course increased dairy, which is oestrogenic but that should not have such a dramatic affect!

I would really appreciate it if someone with proper medical knowledge could weigh in here with advice and ideally, reassurance.

I really want keto to work for me but I will not sacrifice the hormone balance I have begun to enjoy 2 years since I menopaused and I cannot feel like this or bleed again.

If it doesn’t change immenently I will have to stop keto.

No diet should send a menopausal woman backwards!!

Thank you all.

(Bean) #2

If you’ve lost weight, your fat may have released some of the estrogen and other hormones it was storing. I’m not a medical person, but I suspect this would happen if you shed fat using any diet. I had this in a much less dramatic way this last summer.

And yes, dairy may be something of a factor.

ETA- My thyroid is fine- I’m Hashis. What the studies say is T3 is lower on keto, but what it doesn’t say is that is harmful. There are some protective benefits actually. I’ve been keto/ then carnivore for years (ETA- 20+ years low carb keto, last two largely carnivore) and feel great in that regard. Again, any diet or major lifestyle change may cause hair loss. I haven’t personally.

You can always back off and ease into it a little. Add a few more carbs for a few weeks to let your body adjust and use less of your body fat?

ETA- My thyroid replacement meds have decreased on carnivore.

#3

Deal with a private HRT clinic, the UK is literally the worst place on the planet when you need any sort of HRT, doesn’t matter if it’s Testosterone, Estrogen, Thyroid, they equally destroy it all at the level of malpractice, in the case of Women, outside of the UK, menopause it literally an option at this point. You shouldn’t be having to deal with this.

It’s often disputed (here) but many have had negative hormonal effects from longer term keto, when you’re first starting it’s pretty normal, and you usually rebound from it. Your sex hormones go a little stupid, a lot of women will lose a lot more hair than normal, but it usually self corrects. But longer term lowers Testosterone and Thyroid hormones for a lot of people. I’ve been on both those side, but on TRT and Thyroid so I’m covered there.

Seriously look into a private doc to get you right. There’s a ton of different forms of estrogen for when women are hyper sensitive to a certain one, but I highly doubt anything is avail if you stick with gov’t hack doctors. I’m in a ton of forums with biohackers, alternative health, hormone replacement, thyroid problems and the never ending theme for all the people in the UK that get themselves right, is they go private.

(Edith) #4

I agree with @beannoise that it could be a result of your rapid fat loss, but I am also not a doctor. I can weigh in on the hair loss, though, via my own experience.

Any time you have a radical shift in diet, your hair goes into the rest phase and then after a few months, it will start to fall out as the new hairs start to grow in. That is because the change in diet was stressful to your body and hair is considered a luxury for your body. Most of the times a shift in diet means a decrease in calories, so your body doesn’t want to put energy into hair growth.

I’ve been low carb/keto for eight years now. I had problems on and off with thinning hair for the first six years of it. I was including a lot of intermittent fasting and my long term caloric intake was quite low. When I first went into menopause, it was the worst. I lost a fair bit of hair and it actually seemed to stop growing. About 1 1/2 years ago, I got into strength training and as a result, I realized I was eating too few calories and especially not eating enough protein. Whereas, I had been mostly eating two meals a day, I upped my intake to three meals a day and increased my protein intake to 1 gram per pound of body weight. Oh, my goodness, my hair is now thicker than it has been in years, maybe even since before keto!

Protein intake if very important for healthy hair and even bone health for that matter. So, I guess the moral of this story, is to make sure you are still getting a lot of protein, especially since you strength train, and you may avoid the hair loss problem or at least minimize it.

(Cathy) #5

I am guessing you are 53. I would think that diet or no diet change, you can have a spontaneous recurrence of a menstrual cycle. It happened to me around your age (if I am correct about your age). I did have an ultrasound and everything was fine.

For years after, I would occasionally get ‘symptoms’ of an impending menses’ but no further symptoms. Menopause is unpredictable. You are not ‘suppose’ to have periods once they have stopped for a year but clearly it happens.

If you are really concerned, perhaps push for further investigation. The weight loss may be cause for adjustment of your HRT. Just be a squeaky wheel. That is how things get done. If you don’t get the answer you want, keep at them.

(Emma) #6

Thank you so much for responding and confirming what I have read and heard from other women that keto does impact the balance of your sex hormones initially, particularly Oestrogen, for all the reasons you’ve all mentioned. The reassurance that it does ‘settle down’ is what I was looking for and definitely now have.

I did see a private womens hormone specialist throughout peri and now post menopause, not an NHS one, and she got me on the right HRT, including Testosterone. I’ve been really well and stable with very few menopause symptoms on progesterone and testosterone (taken for years), and since menopausing 2 years ago, right up until 5 weeks into keto!

My menopause specialist, from one of the top private clinics in London, tried me on every type and dose of oestrogen once she felt I may benefit from it, but my body cannot take it, I very quickly become over oestrogenised. I’ve balanced very well without it, and I think the very fact I’m responding like this to a probable rise in oestrogen or indeed an erratic pattern of oestrogen brought on by keto proves the point that I don’t do well with it!

It’s the NHS menopause nurse who decides if a scan is needed though and she’s happy that currently it’s highly likely to be the diet causing disruption and I am not at risk of cervical cancer which is all they want to check with a scan. If it happens again, I’ll call her as she directed but neither of us are worried and she said it should all even out!

Luckily my hair has not been impacted yet, I think I was simply catastophising a few days ago when I posted this as I have been so stable since menopausing and was imagining all sorts being affected if I continued!

I so appreciate your response, thank you!

(Emma) #7

Thanks so much Cathy,

Yes I am 53. Two years post menopause and yes, I totally agree, there are plenty of women who have the odd bleed post menopause for various reasons. I have certainly had phantom period symptoms on and off but it’s only right after beginning keto that it’s resulted in a bleed.
I think given the plethora of information and anecdotal evidence that keto initially affects hormone regulation and the amount of oestrogen receptive fat cells I’m burning away, it seems almost certain it’s the diet. If it looks like a duck, sounds like a duck and walks like a duck… as we say in England!
I feel reassured now that it’s temporary… I’m also feeling far less hormonal than I did a few days ago (I’ve reduced dairy to mitigate oestrogenic effects), so less panicky!
I eat plenty of protein and have increased fibre to support flushing oestrogen from the body.

I really appreciate your reply and support!

(Emma) #9

Thank you Virginia,

That’s really helpful and encouraging!

My hair has not yet been affected, and hopefully it won’t be, but your advice is really reassuring.

I’m getting plenty of protein :muscle:t3:

(Emma) #10

Thanks so much!

I have lost a lot of fat in a short space of time so I get the hypothesis. It’s reassuring to know it’s pretty normal for this kind of disruption!

My hair is thus far unaffected and my Thyroid seems to be fine but I was just concerned with the obvious effect on the sex hormones that the diet could cause other endocrine problems.

Great to hear keto offers protective effects in this regard!

I really appreciate your response!

#11

No prob! If you ever want to get stuff tested that your doc doesn’t want to do, look into Eval, he’s geared towards the bodybuilding world, but tests anybody. He’s opened a bunch of clinics but he has a bus that travels usually to gyms and can test almost anything you want, and he’s priced good.

https://evalbloodanalysis.com/

He was talking not too long ago (He’s a co-host on a Podcast) about making the London area places regular stops for testing now.

Good Luck!