The FemGuide: Issue 4

the vaginal microbiome, appetite across the cycle, and hormonal components of mental health

Hello and welcome to Issue 4 of The FemGuide - I can’t wait to share this one with you. Meanwhile, if you would like to share this with others, click the link below to do so! Otherwise, let’s get right to it. 

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Startups: Evvy and the value of the vaginal microbiome

I would like to introduce a company that is very near and dear to my heart: Evvy. Starting tomorrow, Evvy is inviting 500 women to get early access to their platform through this invite-only link. As the first hire at Evvy only eight months ago, I could not be more proud and excited.

Evvy’s first product is an at-home test that utilizes sequencing technology to help you understand and strengthen the defense of your vaginal microbiome. With an Evvy test, you can know what’s up down there, why it matters, and what to do about it.

Understanding the influence of the microbiome, and how to optimize it, is all the rage these days (at least in the scientific community). But the vaginal microbiome has been widely overlooked, despite an abundance of research demonstrating its importance for overall female health.

The composition of the vaginal microbiome (i.e. what bacteria, fungi, viruses, etc. are present) is the main determinant for protection from or susceptibility to infections such as bacterial vaginosis, yeast infections, UTIs, and more. 

Even as someone who researches female-specific problems for a living, I was shocked by the alarmingly high (and rising) rates of infection and recurrence. The symptoms of these infections can range from unwelcome to downright debilitating. Honestly, I don’t feel the need to describe this in depth because, statistically speaking, if you are female, you have almost certainly experienced this firsthand. 

Furthermore, the main aspect that drove my own involvement is the overlooked connection between vaginal microbiome health and women’s health more broadly. The vaginal microbiome affects one’s risk of STIs, pelvic inflammatory disease, fertility issues, pregnancy complications, toxic shock syndrome, and potentially even certain cancers. Most concerning, an imbalanced microbiome can occur without symptoms, meaning that without testing, women have little way of knowing if this may be affecting them.

The great thing about the vaginal microbiome - as opposed to say, genetic testing - is that everything is modifiable. Once you are empowered with this knowledge, there are many ways to both track and improve the composition of your vaginal microbiome, providing a path for individuals to take control of their own health. I hope to one day see Evvy’s test utilized as a tool for routine assessment of vaginal health throughout one’s lifetime.

For first access to a test, use the link here which goes live tomorrow, June 7th. 

Science: Cycle-specific appetite changes

We all know the classic cultural commentary around pre-period cravings. Along with the memes about instantaneously craving chocolate, I wish more information would circulate about how hormonal changes shift dietary preferences and needs throughout the whole cycle. 

In the follicular phase of the menstrual cycle, (from the end of your period until ovulation) estrogen is the dominant player, hormonally speaking. Estrogen creates an increase in serotonin and dopamine, which are both involved in increasing your mood, while inhibiting the hunger hormone, ghrelin. As this time is the lead up to ovulation, aka when you can get pregnant, sex drive increases accordingly. Sex drive and appetite have been shown to have an inverse relationship, so appetite is lower during this time. 

During the luteal phase (after ovulation, in the week or two before your period), progesterone increases and surpasses estrogen as the star of the show. Progesterone can be remembered by “pro-gestation” - it is the hormone that primes the body for pregnancy. In this phase, nutrient intake becomes a priority as your metabolism changes and your temperature increases. According to research, females consume an extra 200-800 calories a day during this phase compared to the first half of the cycle. Some studies show that an increase in healthy fats is most optimal here. 

So during the follicular phase, you may be more likely to be focused on drinks with a new date on a good time out with friends than your chocolate stash. While during the latter two weeks, you may become increasingly disinterested in a big night out in favor of a big dinner in. This is totally okay - moreover - natural. A caveat: if you are on hormonal birth control, this process is modified entirely and none of the above applies to you at this stage of time.

This is just one example of how hormones are involved in brain chemistry and influence daily life. As the topic can truly expand in a million directions, I’ll keep this brief. But if you are interested in the research on PMS cravings, how females respond to fasting, or whether or not seed-cycling is backed by actual science, drop me a line and I can provide some further insights! 

Social Change: Hormones and mental health

The chemical question: does focusing on hormones undermine mental healthcare?, The Guardian

If you are an OG follower of the FemGuide, you may recall my first issue on the topic of PMDD - a disorder caused by intense hormone fluctuations that often can go misdiagnosed or wrongly diagnosed as a different mental health issue. In early May, an article in The Guardian spotlighted research from prominent psychiatrists who are pioneering the use of hormonal therapy for mental health disorders.

I loved this piece because it highlights the complexity of hormone research. If the Science section got you wondering about the benefits and consequences of research crediting behavior change to hormones, this article is for you. 

Here are a few of my other favorite, female-focused articles of late:

Thanks to FG followers Alysha, Gavin, and Charlie for their submissions to this list!