How to Balance PCOS, Exercise & Hormones [Podcast]

PCOS Diva

“Every body is a good body, and we have to honor this body that we have. No one ever got anywhere, no one ever got happy, hating it into change. Embrace the body that you have and make it the best body it can be.” – Dr. Brooke

Women with PCOS are prone to adrenal fatigue and hormone shifts, making exercise a tricky, though very necessary, thing. I asked Dr. Brooke, a well-known expert on metabolic nutrition, fat loss resistance and fitness to help us navigate the delicate balance between our hormones and exercise. During our conversation, we discuss what your symptoms are trying to tell you about your work-out and how you can best tailor your exercise to your ever-changing hormones (whether due to menopause, PCOS, thyroid issues, or stress).

Listen as we talk about:

• If you love intense training (marathons, CrossFit, etc.), how can you avoid exhaustion and adrenal issues?
• What testing should we consider for adrenal issues?
• What are your ACES (appetite cravings, energy & sleep) telling you?
• Have you reached metabolic adaptation or stagnation?

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A full transcript follows.

A licensed Naturopathic Doctor (ND), Dr. Brooke attended Seattle, Washington’s Bastyr University, where she earned a Doctorate in Naturopathic Medicine and Masters in Acupuncture and Chinese Herbal Medicine.

Dr. Brooke takes a balanced approach to health, using both conventional and alternative therapies. Metabolic nutrition, fat loss resistance, and fitness remain her area of focus and in her Manhattan clinic she primarily treats women with Hashimoto’s Hypothyroidism and PCOS – as well as other female hormone imbalances.

With these women she works to reset their hormones, their heads, and their habits, so they can finally feel at home in their bodies. Learn more about Dr. Brooke on her website, and connect with her on Facebook and Twitter.

Full Transcript:

Amy Medling: Hello and welcome to the PCOSDiva podcast. My name is Amy Medling. I’m a certified health coach and the founder of PCOSDiva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health and happiness. If you haven’t already, make sure you check out PCOSDiva.com because there I offer tons of great free information about PCOS and how to develop your PCOS diet and lifestyle plan so you can begin to thrive like a diva. Look for me on iTunes, Facebook and Instagram as well.

Today I have the privilege of talking to Dr. Brooke Kalanick and I actually discovered Dr. Brooke on a fantastic blog, I don’t know if you’ve heard of it, it’s called Girls Gone Strong. I invited her to come on the podcast to kind of talk about how to train if you have PCOS. I know I’ve talked a lot about different exercise modalities like yoga and we’ve done some pieces on high-intensity interval training and really how to exercise to avoid adrenal fatigue. I’m hearing from a lot of women that are wondering, “Well you know what, I love running, I love training for marathons, I really like working out hard, Crossfit type exercises. How do I avoid exhaustion and adrenal issues if that’s how I want to work out?”

Dr. Brooke, I’m hoping that you can give us some advice on how to kind of customize our workout program so we can avoid aggravating our PCOS symptoms, so welcome.

Dr. Brooke: Thank you. Yeah, thank you for having me. It is a tricky balance, partly … You and I were just talking off-air that most of us with … I have PCOS myself so this is something really close to my heart. Part of the issue with women with PCOS is we don’t just have PCOS, we have a lot of other things going on and it’s very common to not only have some sort of dysregulation with your female hormones and the hormone insulin, but to also have issues with adrenal stress issues, thyroid issues, inflammation. There’s the whole usually symphony of stuff that’s going on with us and so it’s very rare that I ever see a woman who just simply is dealing with PCOS. They’re out there, but most women ask a lot of questions and some are struggling are trying to balance that and kind of synthesize all that they’ve learned for themselves and all that they hear about PCOS and try to help that work with how they should be working out and eating when they most often have some other hormone issues.

Of course we can do some testing to look at adrenal issues, thyroid issues, blood work for thyroid. I really like the saliva testing for looking at a cortisol rhythm throughout the day. You can learn a lot by just your symptoms. I think if women are on the line now going, “Well I don’t know if I have … I know I have PCOS but I don’t know if I have any of these other issues.” There are a lot of questions you could just answer and I do on my website have a free quiz that you can kind of walk through different hormones and take a look and they’re all laid out individually so if you just want to know if you have a thyroid problem you can look at that. Betterbydrbrooke.com is my website and those quizzes are free, you can kind of just take a look and walk through some symptoms of adrenal issues, whether they’re low or high, low thyroid issues, Hashimoto’s, all those sorts of things that are very, very common to have when you have PCOS.

Amy Medling: I just want to give everyone kind of an overview of your background too because you are a naturopathic doctor. You got your degree from Bastyr University and you have a clinic in Manhattan where you focus on treating women with Hashimoto’s hypothyroidism and PCOS as well as other female hormonal imbalances and you’re really an expert on metabolic nutrition, fat loss resistance and fitness is kind of your area of focus. That’s why I’m so thrilled that you are on our podcast today to talk about those topics.

I guess, what I wanted to ask you is, in addition to the testing to kind of figure out what type of PCOS you’re dealing with, finding out if you have a thyroid condition or if you have cortisol issues, do you think that there’s kind of different types of exercise that are better for these different phenotypes of PCOS? I know I am more of that thin phenotype but I also have a lot of adrenal issues. I find … It was funny, I remember being in college and running all the time and that was kind of my form of exercise and still could … At that time I was dealing with a lot of insulin resistance, basically because my diet was awful, and I couldn’t lose weight.

When I got a shin splint and had to walk, the weight started dropping off. It just didn’t really make a lot of sense to me. I remember later in my 20s and 30s I started taking up lifting and doing more heavy lifting and that really helped my PCOS symptoms, building that muscle. I’ve kind of learned from trial and error that I can’t do a lot of running, I do a lot of walking, or I rebound. I really like resistance training like Pure Barre or using exercise bands instead of like the heavy weights because I find that I bulk up too much with heavy weights. Maybe you could … I’m wondering if the best way to approach this is maybe look at sort of these different phenotypes of PCOS and maybe talk about the best types of exercise for us.

Dr. Brooke: Yeah. I work with a lot of women with PCOS that want to lose weight so there’s that whole thing, and then there’s other women who maybe are not looking to lose weight but they’re trying to improve their body composition just by being stronger or they’re just trying to be healthy and active or they’re just trying to help use exercise to be healthy and manage their PCOS symptoms, or they’re like some of the people you mentioned in the intro that there are just certain kinds of exercises that they really love to do and it may be flaring up their symptoms.

There is a categorization, I guess, going around of PCOS of there’s lean type and heavy type, and I just don’t love that because I think we kind of associate heavy with bad and lean with good, and I feel like a lot of us have a lot of body image stuff that goes on and we don’t really need that label, it’s one more thing to contend with. I like to keep it a little less personal and a little more about the biochemistry.

What’s going on with PCOS women and when they look so different. This is such a huge problem because you hear women that go into their doctor saying, “I really think I might be dealing with this …” or their personal trainer and that person says to them, “Well you don’t look like you have PCOS, so I’m not even going to bother looking past that.” Hopefully this is changing. I think more and more experts are talking about the range and hopefully we’ll have a new categorization and a different way to think about PCOS than the way we do now, which is I think it’s very limiting.

When we think of women that are all dealing with some form of insulin resistance, we have to remember that that’s not a black and white thing. There is a degree of insulin resistance and a degree of insulin sensitivity for women to women, throughout the day and tissue to tissue. Most of the time we’re thinking about are you resistant? Are your muscle cells resistant to the message of insulin? Are your fat cells resistant to the message of insulin? Some of the insulins that hormone helps whatever we eat, nutrients, get into our muscle cells for use or into our fat cells for storage.

When a woman doesn’t have a difficult time losing weight or they don’t tend to put on a lot of body fat, I tend to think of them, and this is sort of my own framework, if they’re having more trouble getting fuel into a fat cell, but they have a pretty easy time getting it into a muscle cell, so they’re using things a little bit better and they’re able to take things in, use them and not store as much fat. Whereas the other type of woman that’s dealing with more body fat, they’re more resistant at the muscle level and they’re accepting, basically more sensitive, at the fat level so they’re easy for them to put on fat and not as easy for them to utilize fuel that they eat in their muscles. They deal with more fatigue and less exercise intolerance, especially if it’s simple … Just looking at the insulin resistance piece of that.

Just remembering that the sensitivity or resistance that we have to this hormone can be a little bit different sort of throughout our body and that’s one of the reasons that it looks so different on different women. The women that tend to take in nutrients easier into their muscles and not as well into their fat, they tend to also be the ones with more adrenal stress issues, so more of that adrenal fatigue, dealing with lower cortisol, lower blood sugar problems, whereas women that put on body fat easier, they tend to deal with more higher cortisol issues.

That, again, is kind of a generalization because we can have a whole range of adrenal stress and cortisol issues throughout our lives. There’s going to be a time where we might be much more wiped out and lower cortisol. There might be just a time of day where currently we’re doing okay and we have a big dip in the afternoon. There’s a lot of variation with our stress hormones and our insulin resistance, even within just one woman having PCOS.

Then there’s the whole thyroid conversation, but just dealing with those things we have to really honor these two hormones, insulin and cortisol, I think first and foremost. One, because you do need a blood test to check your thyroid so there’s part of that we just have to get a little more help with and a little more information. With insulin and cortisol, I love these hormones because they’re major, master hormones. They have an effect on how your estrogen, your progesterone and your thyroid and everything else works. If they’re not in balance you’re going to have a really hard time sorting out estrogen dominance or low progesterone. We really have to honor them first.

The other thing that’s really great about these two is that you have a fair amount of control over them. We have a lot of control over what we eat and when we eat and how we decide to handle stress and how much we decide to put emphasis on sleep and stress management. We have a lot of say in how these go. We also have this beautiful thing that happens all day long which these hormones are talking to us. They’re giving us feedback constantly about how they’re doing and do they like what you’re doing. Do they like your lack of sleep? Do they like the fact that you’re eating the foods you might be sensitive to. Do they like the fact that you are over-carbing for your unique metabolism or under eating fiber.

These signals, I use the acronym ACES all the time, so appetite cravings, energy and sleep. If you’re having issues with appetite cravings or energy between meals, that tends to mean you’re dealing more with issues with lower blood sugar and lower cortisol problems. When we eat something and have appetite cravings, energy changes after we eat, that can mean that we have sort of overshot our insulin capacity and that can be hugely helped by fine-tuning our carb intake, maybe sometimes a little more lean protein, a little more vegetables, and then sleep. If we’re having an easy time going to sleep or staying asleep, that is a huge indicator that our adrenals are not happy if either one of those things are happening. A higher cortisol at bedtime can sometimes make it hard for people to fall asleep and sometimes difficulty staying asleep throughout the night can mean lower cortisol and lower blood sugar problems.

Those are some ways for you to kind of just know like right now, what type of PCOS might I have and do I maybe also have some of these other issues. When it comes to trying to train, so if you’re somebody that wants to work out, whether you enjoy it or you’re trying to lose weight, what we’ve always done is like we’ll just go do more, just go start doing some more stuff and eating less. For us, with the hormone intricacies that are already slightly off, it’s very easy for us to take the stress of exercise and drive ourselves into the ground further.

Honoring of the insulin and cortisol, so I said to honor those above the other hormones because you get information about them, you have more say in what’s going on and you can tell really quickly in real time from one day to the next, like am I making an impact on those hormones? Also, when it comes to the two of them, deal with cortisol first because if we are dealing with high cortisol or low cortisol as far as our stress response, it’s going to be really hard to not push that gas pedal one way or the other with exercise. For those of us that love high intensity training or sprint work, that’s going to be something we have to do some of but not too much when we have a high cortisol problem, when we’re kind of running on stress. When we’re wiped out we really don’t tolerate that well at all so these are any type of metabolic conditioning, sprint work.

Then when we think about cardio we’ve got … Walking is sort of I call the great cortisol normalizer, so whether you know where you know where your cortisol is, you should be able to walk a lot and have that for the most part. We do have some people that don’t even tolerate that well and we get into some issues with autoimmunity and thyroid. When we’re just dealing with stress, walking is great. It takes a lot of time and some women don’t like that aspect of it, but it is something you can do and trust you’re not going to push the scale in a negative way regardless of where your hormones are at and it’s another great way to utilize your muscle mass to improve your insulin sensitivity because it’s just sort of slow, gentle, doesn’t tweak the stress response too much.

Many women don’t … They kind of shy away from the weights and they go towards lots of cardio because it’s just kind of always what we’ve been told to do and it’s easy. Most people, even if you don’t have a gym membership, you can go running, so the trouble with those, especially when it comes to weight loss, is that longer distance cardio, so when we’re talking like that cruising along for 45 minutes to an hour jogging or on a stairmaster, it will raise cortisol, all exercise will, exercise removes stress, but if we’re going for weight loss or fat loss, we get this cortisol rise but we don’t trigger that kind of magic fat burning combo of cortisol plus growth hormone, and testosterone, more so growth hormone for women.

We spend a lot of time and effort, we can kind of push our adrenals in a negative way but we don’t get that kind of magic hormone groove to really dip into fat loss. If you’re a PCOS woman like me who struggles with the burning fat piece of it, that’s really frustrating. Not only am I making my metabolism a little less effective, I spent time and energy and didn’t get very far. That’s kind of a lot of stuff when it comes to insulin and cortisol and exercise. Is there any part of that you want me to expand on or any more specific question to kind of dig into that a little deeper?

Amy Medling: I think you are just really showing us that it isn’t an issue of calories in, calories out. You take in 500 calories and then you see the little calorie meter go up on the treadmill that, “Okay, I’ve just burned 500 calories so now I just erased the doughnut that I just ate.” I mean, it just doesn’t work that way.

Dr. Brooke: Yeah. We’ve always been told that. We’ve kind of … I think we’re moving away from that and especially … At the end of the day, yeah, you’ve got to burn more than you take in. How do you get there isn’t as simple as well let’s subtract from here and add more time on the treadmill. We don’t work so much like a math equation. The real kind of magic of it is can you create that caloric deficit by balancing your hormones for two reasons: One, you’ve already got a hormone problem. You’re not just the average woman with … Well I don’t know if there is an average woman with no hormone problems anymore, but when you’ve got PCOS we have at least one hormone issue, likely you are also dealing with low progesterone, estrogen dominance, high or low cortisol and possibly a thyroid issue.

Many of you are dealing with oxidative stress and inflammation, food sensitivities, lots of GI disruption. There’s all sorts of … Sometimes there’s high prolactin in the mix, which really will impact insulin even further. You’ve got all this hormone stuff going on so you have to create as much balance within that as you can if you’re going to get results. Yeah, it’s never just one thing. When you look at all of those things, then we deal with something called metabolic adaptation or stagnation. It’s basically when you are putting in the effort and you’re putting in time at the gym and you’re not getting the same result, or you’re cutting calories and you’re not getting the expected result. You shave off 500 calories, either because you didn’t eat them or you thought you worked them off, and the math doesn’t work in reality.

This is thermogenesis and this is just your body’s way of getting really good at sort of, getting wise to our shenanigans when we start to do this thing. That happens to everyone. If any of us can think back to even in our earlier days we did a certain diet and at some point it just was less effective. Eventually your body kind of gets used to it. That adaptation, we’ve already got all the compromises in our metabolism and places where our metabolism already is not efficient and you’re sort of already at adaptation and stagnation so you really when you just think of it as calories, the math does not work out in our favor because we’ve got all these other shifts that are going on inside and your body is really stuck.

One of the things to think about, I think if you’re a woman with PCOS that’s looking to lose weight, the diet I think is probably the most important thing, just because it’s something we do several times a day, it can have really far-reaching consequences. It’s hard to just go back and put in time, like we said, on the elliptical and think, “Well, that’ll cancel that out.” Dialing that in and really honoring the fact that we have this carbohydrate sensitivity whereas someone who’s that leaner type that doesn’t put on as much body fat, they need to eat some carbohydrate but honor the fact that they have insulin resistance. Someone like me does better on a little bit more plant based fat, lots of lean proteins and very little carbohydrate.

We all have that spectrum where I help women try to find what is your unique carb tolerance, I call it, so it goes past this idea, “Well you have PCOS, you should be low-carb.” We all have, depending on your training as well and your stress levels, some adjustments we need to make within there.

When you look at that whole thing, dialing that in first and then like you said at the beginning, we tend to shy away from weight training and that is the most important thing for women to do, whether it’s lighter or heavier, for not only like aging and bone density but that is your sort of reserve of insulin sensitivity is your muscle mass. We have to remember too, with exercise there are these different types of proteins in muscles called glut transporters and when we exercise we actually don’t need insulin to get glucose into the cell. These little receptors rise up to the surface and take in the sugar and the fat without needing insulin. Whether you’re insulin resistant or not, exercise will always help you lower your blood sugar.

Then it’s just a question of: Are you someone who just needs to walk? Are you someone who needs to do some sort of old school standard body weight, or bodybuilding kind of training where it’s like 8 reps, or are you someone who can do a little bit more of like heavier weights and a little bit less reps and work with your cardio. Exercise to me is like one of the best pieces of medicine we can give for someone with PCOS.

Amy Medling: I love how you talked about finding your unique carb tolerance. In my programs I talk about it in a way of that PCOS is like this big science experiment and you have to kind of experiment with how many carbs, the types of carbs, to kind of get the right combination for you and that might change week by week, like you said, by your stress levels and such. In the article that you wrote you had this great quote, and I don’t know if I’m going to be able to find it. “Test yourself before you wreck yourself.” You talk about that in terms of exercise too and, again, it’s like this experimentation and you have to figure out what works best for your body by really getting in tune and listening to the signals and the messages that you give us.

Maybe you could talk a little bit about that idea about testing yourself before you wreck yourself. I think that’s probably what those, the women that are really wanting to train harder, what they need to hear, the message they need to hear.

Dr. Brooke: You’ve probably got information on your side about that. I definitely have finding your unique carb tolerance all over my website so looking through some of those and take the time to figure that out. Don’t also think that all that stuff with food sensitivities and wheat issues and dairy issues. Those are really big deals for women with PCOS and not every woman with PCOS is going to have an issue with certain, like those bigger culprits, but it’s really common, either because of the sensitivity or because those foods actually create some unique insulin responses so there’s a protein, there’s something called amylopectin in wheat and that is, some of it is just cause of a bigger insulin response and a lot more inflammation. Sometimes it’s not so much that you have celiac or gluten issues but digging in a little bit, because you may just have an exaggerated insulin response to wheat-based things.

Same thing with dairy. It behaves a little bit more like a sugar for most women, yet we’re taught eat low-fat Greek yogurt, eat low-fat cottage cheese, those are really great kinds of protein sources, and they don’t always work so well for women with PCOS. When it comes to like checking yourself and testing yourself, if you have a food that you’re questioning, the easiest thing to do with stuff like that is just take it out for a month. That might seem like a long time, but pay attention and check yourself and test yourself a little bit and see if you do better. Maybe it’s not something you can never have but maybe choosing that as one of your main foods that you have a couple of times a day or at least several times a week maybe won’t work for you as well as something else might.

When it comes to exercise, we’ve got, I think, a couple camps of people. There’s one, the women who really love to exercise, but they realize that it’s flaring their symptoms or making their PCOS worse somehow. If we’ve got someone who, like you mentioned, a marathon trainer, somebody who really loves to run a lot or train for those big events, or you’ve got someone like who’s doing a lot of CrossFit, which can just be very metabolically demanding, it’s a lot of high-intensity training. If you find that that changes your sleep, changes your appetite, changes your cravings or you’re not getting the expected results, then look to the stress of that and maybe think about adding more standard weight training, more walking and dialing down either the miles or dialing down the intensity of the workout and see if you do better.

We were talking before the show, Amy, as well that I put together finally a guide to managing your training and adjusting your training for your hormones so I’ve got all this in one spot here finally again at my website, betterbydrbrooke.com. You know when you’re doing something and you feel like you’re hitting your head against the wall, we have to listen to stuff. So anything that you love. I talk to a lot of people who, not so much the marathon runners, but I do talk to a lot of women who love things like CrossFit or they love just doing high-intensity training, and then they’re feeling achy, they’re feeling tired, they’re feeling sore and they’re just not recovering as well and they’re definitely not getting the results that they want.

We always have to remember what worked for us before may not work for us now. Like you said, time marches on, things change throughout our cycle. There might be a type of training that you do better on the first two weeks of your cycle and you have to dial it down the second two weeks because you’re dealing with adrenal fatigue and more progesterone and those more intense or longer-duration workouts affect your sleep more profoundly, let’s say, the week before your period, when you really need some resources to make progesterone. Most women with PCOS don’t have as healthy of ovulation all the time and make as much progesterone from our ovaries.

Just listen to the results that you’re getting, listening to the appetite cravings, energy and sleep and trying to just honor the fact that your body is really trying … I think we spend so much time hating our bodies and being frustrated that we have this hormone issue or that. I’ve had PCOS since I was in my teens, this is not new. It’s still annoying sometimes, but we spend so much time being upset and fighting against that. Our bodies are not trying to be so terrible. They are trying, really, to keep us going, so when they are talking it’s nice if we listen. This is why I always say, “Be your best friend.” If your best friend was saying, “Oh my gosh, I am so exhausted. My cravings are off the chart. My PMS is terrible. I’m having such a hard time falling asleep. I feel achy and tired every time I train. Do you think I should go to the gym and just really have a crazy hard work out for an hour?” You know your best friend would be like, “No. No you absolutely should not do that. You should probably take care of yourself, get some rest, maybe even get some help, but definitely today is not the day for you to push yourself.”

We are to have that own voice in our head. When our body and our hormones are giving us all these signals and we’re saying, “No, well I will deal with you next week because right now I really need to focus on this …” or “Right now I have this deadline …” or “Right now whatever …” We would never say that to our best friend, “I’ll get back to you in six months. I’m sorry that you’re suffering and falling apart, but too bad. We’ll talk later.” That can happen so easily when we’re over-training and eating inappropriately or just in some other way stressing ourselves out.

If we’ve got someone who has maybe already realized that they are not doing well with exercise, like every time they train they’re just kind of wiped out and it doesn’t feel good for them to work out harder or doesn’t feel good for them to work out regularly, we have to think too with that, is there something that needs a change in your workout? Maybe we don’t … This is hardest when women that are dealing especially with thyroid issues, they have some bad days so they don’t train, but then they have a really good day where they’re like, “I feel great …” and so they go to the gym and they do a bunch of stuff at home, and they have a great day at work and then they go back to the gym because they’re like, “I feel so good today …” and maybe they stay up too late.

When you’re someone who’s been dealing with adrenal stress or thyroid issues or Hashimoto’s, which is autoimmune hypothyroidism, when you’re doing that and you notice that you over train and you’re trying to work your way back up, especially I see women coming out of that adrenal fatigue place like, “Okay, I’m feeling good and I’m going to do more …” don’t add another 45 minutes to your training session. Add another five minutes and see how you do and maybe add another day per week, but what we do, I think, we feel … If we’ve been feeling bad it feels so good to feel good we just want to do a bunch and we set ourselves back. That’s another thing, back to the quote there Amy, is test yourself and listen. Don’t try to do a ton of something that you’re afraid is not working for you.

It can be hard when you have been in that place and you don’t want to stress yourself out or push yourself so then we get sort of scared to do anything. Especially if you’re working on losing weight, we always have to create a little bit of stress or change won’t happen. The question is always, can you give yourself a teeny bit of stress without giving yourself so much stress that you’re back to wrecking yourself.

Amy Medling: I loved that you brought up the idea of being good to your body and I think a lot of women approach exercise as it’s kind of this way … From like a way of punishing themselves to exercise out those calories, like we were talking about in the beginning. I really want women to think of exercise as a way to kind of love up their bodies. You want to feel good after, and if you’re feeling exhausted, like you need a nap after your workout, then you have to listen to that. I think that there’s something that’s not quite right there and try some other types of exercise. I always come back and talk about Pure Barre, but for me at 45 I can’t exercise the way that I did at 25, and I was doing Body Pump for quite a long time but then my shoulders started to get sore. I think it was too much weight, too much repetition. I started feeling kind of that exhausted afterwards, so I’ve switched it up and feel really good. I’m energized and ready to take on the day after I go to Pure Barre class and that really works for me.

I want women listening to exercise so they feel good and not so that they feel, that they’re punishing themselves or they feel burned out because that’s what’s going to make it sustainable because you keep going back for more of that feeling good feeling.

Dr. Brooke: Yeah, there’s the biochemistry of that that feels bad and there’s all the psycho, emotional stuff that we have about. Exercise has always been kind of thought of as a punishment. I have to go do this because I ate something bad, or I have to go do this because my body doesn’t measure up in one way or another. That’s a whole important conversation. You mentioned Girls Gone Strong. I was one of the original advisory board members for Girls Gone Strong and that’s definitely something we talk about a lot. Every body is a good body and we have to honor this body that we have. No one ever got anywhere, no one ever got happy hating it into change. If you’re someone who’s like, “You know, I’m trying to work on …” maybe you had a baby and you’re trying to work on getting stronger again and getting your body to a place where you feel more comfortable or more at home.

I’m very gentle with women when they’re post-partum. It takes a long time to put things back together, and I don’t think that post-partum ever ends. I think our bodies are … We’re forever changed by babies and we’re forever changed by decisions we make. I talk to women who maybe they don’t have children, but they’re high level executives and they’ve done great things in their career and we made compromises with our stress and our hormones. A lot of stuff can happen for women and we have to just continue to listen and continue to kind of honor the choices we’ve made and where we’re at. It doesn’t always fit sometimes with our goals in the gym or our goals to have our body look or be a certain way.

If we’re going to go about changing our body in any way, whether you want to get stronger or you want to lose body fat, going about it from a place of love is going to just be so much less miserable. You’ve still got to do the work, but it’s not … I would say nourish, not punish. Food is nourishment. Exercise is nourishment. We always have come at it from the other way so I always go back to the just simple analogy of be your best friend. What would your … I think some women they’re kind of like, “I don’t know how to do that, I don’t know how to listen.” Think about how your best friend talks to you or how you would talk to your best friend and just adopt that voice.

I think too with PCOS in particular, you mentioned earlier getting bulky. I am one of those people as well, I put on muscle really easy, I’m really quite strong. I also really love heavy strength training. It’s funny, when I used to run, I’d sort of run myself into the ground because I always just wanted my legs to be smaller. They’re smaller but not leaner because it was causing a lot of stress response for me and so it wasn’t burning body fat very effectively. Now that I’ve sort of finally appreciated the body that I have, that I do put on muscle easy and that I do get strong easy, I don’t take off body fat as easy. My sort of formula has been two-fold. One is I tolerate a little bit more like traditional cardio that everyone’s telling you is a waste of time, is going to kill you, which is not true. We have, there’s a dose for all of our kinds of exercise and we balance that dose with our own hormone analysis.

I do the best on heavy training and some intense cardio and some moderate cardio. I’ve also had to balance my metabolic issues with my mindset around the fact that I am, unless I do things that drive my hormones crazy, I am not going to be super, super skinny. I’m not going to be super small because if I keep myself healthy and keep my body fat low I train a little harder and then put on some muscle and I’ve had to sort of get my head around the fact that that’s okay. I’m going to make this body that I have the best that it can be, rather than sort of punishing it and trying to just make it something it’s not. My legs right now are probably in some ways bigger than they’ve ever been but leaner because I’ve kind of found my own formula.

I think when we move towards training, whereas if you’re someone who has just never even picked up a weight or someone who has only done really like things when you move into something heavier, but I also think something great can happen with that too where we can have a strength goal, which is I think a lot more motivating most days than a fat loss goal because some days you just don’t care so much about that, but you get to see a little progress and you’re feeling stronger.

Amy Medling: Yeah, I love that, embrace the body that you have and make it the best body it can be. I love the idea of the strength goals. I really encourage women to throw away the scale, and I think when you’re into body fat composition and it just really, those numbers drive you, like if the number goes up then mentally it kind of takes you out of your day. I think often it can cause a lot of self-sabotage. When the number goes down you have this kind of sense of everything’s right in the world but it’s just not driven from the right place, so I love the idea of kind of ditching those metrics and focus on the strength. I often say it’s how you feel in your clothes because your legs might be bigger but they might be leaner and they’re fitting better in the jeans anyway. I think that kind of changing the metrics around fitness and your body is the way to go as well.

Dr. Brooke: Remember, you get to make those decisions. You get to decide that you don’t want to lose a pound, you want to lose a pound. Those are all choices that we get to make and that if it feels good, and I feel more at home at X, Y or Z then move towards that in a way that works with your hormones for two reasons: One is you’re going to have more success and you won’t wreck yourself in the process, and probably three reasons, it’s going to be more sustainable and then if you don’t feel that way, that you just want to focus on balancing health for other reasons, then we have to remember too that we’re grown up girls and we get to decide what we want for our bodies and what we want for our lifestyle.

It’s hard to do that work and trying to keep it focused, kind of eyes on your own paper. This is what is important to me and this is how I’m going to feel about my body and how I’m going to make the choices, but when we’ve got stuff like PCOS or thyroid issues we just have I think one other layer to honor and that’s the fact that we already have a somewhat kind of deranged metabolism and so much of the popular advice is just going to blow up in our faces. It’s why even I help so many women just with this one condition because these women are super frustrated and we get it. We’ve been there.

Training with a lot of different hormones is tricky but it can be done. I think focusing on just your PCOS crux of insulin resistance and then focusing on stress and sleep and are you managing those things well and checking in with those symptoms can really give you a lot of insight into what you should be doing differently. I wanted to say, one thing you mentioned, Amy, about doing the higher repetition weight, that is such a common thing I see with women that are doing maybe a weight that is too light for them but they’re lifting it 15 times. It’s so easy to get repetitive strain injuries like that, especially if you have a thyroid condition, but that can happen with any of us. It’s something to think about if you’re taking a class like that but if you’re getting those issues then it’s really not working for you right now.

Doing what you did, it’s finding a form of exercise that seems to kind of manage your hormones and make you happy and that you enjoy showing up to do.

Amy Medling: This has been such great information. I think you answered all my questions, Dr. Brooke. I would love for you to just kind of tell us again how we can learn more about your work and maybe just another plug for your opt-in about the different types of exercise, I think that’s going to be helpful for a lot of women listening.

Dr. Brooke: Yeah. My website is betterbydrbrooke.com. If you go there now there is it talks about a lot of the things we talked about today, which is just if you’re somebody who is trying to manage your hormones and work on weight loss and you’re feeling frustrated, whether you’re going through PCOS, perimenopause, thyroid issues or all of the above. There’s a lot of good information in there that’s free. I’m putting together my e-book too with all the stuff I talked about today, so how do you modify your exercise to honor all these different hormone imbalances, whether that’s, again, menopause, PCOS, thyroid issues or stress issues. I also have a podcast as well, it’s Better Every day with Sarah and Dr. Brooke, I do that with Sarah Fragoso who is most known for being the face of Everyday Paleo, although she stepped away and now is just Sarah Fragoso. You can find me on Facebook at Better By Dr. Brooke and on Instagram, same thing, Better By Dr. Brooke there as well.

Amy Medling: You also work with clients one-on-one, I wanted you to just mention …

Dr. Brooke: Again, on the website you can fill out a … Yeah, there’s a little contact form on my website so just send me questions that you have if you’re curious about working with me, or just if I’m someone that might be able to help you. E-mailing that contact form is great or you can send an e-mail to me directly, which is [e-mail]. My website is a great way to get in touch with me if you’re interested in working with me. I do work with women all over the world these days.

Amy Medling: Excellent. Thank you again for joining us. I want to just thank everybody for listening. I hope you enjoyed this episode, and if you liked it don’t forget to subscribe to PCOSDiva on iTunes, the podcast app, or wherever you might be listening to the show. If you have a minute, please leave me a quick review on iTunes; I love to hear from you. If you think someone else might benefit from this free podcast, please take a minute to share it with a friend or family member so she can benefit from it too. Don’t forget to sign up for my free newsletter, just enter your e-mail at pcosdiva.com to get instant access and make sure you never miss a future podcast.

This is Amy Medling wishing you good health. Until next time, bye-bye.

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