Beyond reproductive waste- How menstrual blood is the next frontier for Personalized nutrition
During a woman's menstrual cycle, the hormones in her body change. This can affect how much food she eats and how her body breaks down food. In this article, we focus on the effect of menstruation on women´s nutritional status and how compnies are closing the gap with solutions to ease the pain.
The menstrual cycle
For women, menstruation happens every month, from menarche to menopause. This is called the menstrual cycle, and it is controlled by hormones. Length of the menstrual cycle¹ and phases vary from woman to woman - on average, it was reported that the follicular phase lasts 17.9 days while the luteal phase lasts 12.4 days. For most women,the ovulation day can be any time between 10 and 20 days after the cycle starts. Women's hormones change during their menstrual cycle.
These hormone changes can affect things like metabolism and nutrition.
How does menstruation influence nutritional status?
Changes in dietary intake
During a woman's menstrual cycle, the hormones in her body change. This can affect how much food she eats and how her body breaks down food. Research² shows that women eat more during the luteal phase than the follicular phase. Women could eat up to 529 extra calories during this time. But different women have different changes in their eating habits depending on where they are in their cycle, so it is important to consider each person's individual needs.
The HPG axis controls your period and how much you eat. It is also connected to the hormones in your body. Different women have different menstrual cycles, so it is helpful to check the hormones in their bodies to decide what kind of nutrition they need.
The shift in protein metabolism
Hormones change in a regular pattern during the menstrual cycle. During the luteal phase, more progesterone is released. This affects how the body processes different substances like amino acids and fats³.
Protein, lipids, and energy are needed to prepare the body for the luteal phase.. During the luteal phase, energy, amino acids, and lipids are used for the biosynthesis of the endometrial tissue of the uterus where the baby grows. This uses up some of the amino acids and lipids in your blood. So women should eat sufficient energy, protein, and healthy fats during this time.
Increased requirements for micronutrients
Research has found that the menstrual cycle can be affected by nutrients. Nutrients in our blood can change during the cycle. Magnesium and zinc⁴ levels may go down in healthy women of reproductive age. Vitamin D⁵ levels also change, and this affects hormones like FSH, LH, estradiol, and progesterone.
Women who are not yet menopausal lose iron⁶ when they have their period. They can lose between 10 to 40 mg of iron each time. Estrogen and progesterone help control the amount of iron in the body throughout a woman's menstrual cycle. When there is less iron in the blood like during a period, hepcidin levels go down, which helps make more red blood cells get more iron into the body.
Women could eat up to 529 extra calories during specific times during her cycle.
Disruption in the gut microbiome
In addition to the above, hormonal fluctuations across the menstrual cycle influence the gut microbiome⁷. This relationship can be bidirectional because fecal bacteria can affect estrogen levels by metabolizing sex hormones whilst decreased gut microbiome diversity, can lower estrogen levels which may result in reproductive diseases.
Premenstrual disorders (PMDs) are characterized by adverse behavioral and physical symptoms. A study showed that the diversity of microbes is associated with PMDs⁸. Butyricicoccus, Extibacter, Megasphaera, and Parabacteroides were reported to decrease in the women with PMDs, while Anaerotaenia was reported to increase. This means that changes in the gut microbiota related to menstruation disorders show that microbiota regulation can be used to improve women’s health.
How can biomarkers provide insight into what we need over a cycle?
In order to provide personalized nutrition advice, it is crucial that this is based on data. Below we outline a number of biomarkers that can be used to provide objective data.
Salivary cortisol
Cortisol is a stress hormone that regulates vital functions, including the body's stress response, tissue repair, and metabolism. Cortisol levels have been shown to change across the menstrual cycle phases. Cortisol levels are found to be higher in women in the follicular phase than in the luteal phase.
Salivary cortisol is a non-invasive method that provides data on cortisol changes in menstruation, menopause, and fertility status.
Microbiome tests
Dysbiosis of gut microbiota may adversely affect the menstrual cycle, fertility, menopausal symptoms, pregnancy outcomes, and ovulatory diseases such as PCOS. Microbiome tests can provide insights into how the microbiome composition shifts.
Nutrition and metabolic panels
Nutritional metabolism changes across the menstrual cycle as described above, also in health and disease. Tracking these changes and eating based on nutritional needs can improve women's health on and off the cycle.
Genetic testing
Genes and nutrition interact with each other. More than 600 genetic variations are associated with obesity, energy expenditure, and metabolism, which are closely related to female reproductive health.
Menstruation, a once ignored area is now gaining the attention that it deserves. however, there is an obvious need to provide nutrition solutions that are tailored to the individual based on objective data such as biomarkers.
Who are the innovators?
There are already a number of companies operating in this space offering a range of solutions with or without expert coaching. A few examples are listed below whilst a full list is detailed in the data brief.
Food Period
Food Period¹³ is a company that provides seed-based products. They help women to "seed sync," which is consuming a specific combination of pumpkin, flax, sunflower, and sesame seeds. Their two products combine these four seeds based on the follicular and luteal phases.
Telehealth
Every woman goes through a different experience with menstruation and menopause. Gennev¹⁴ provides a way for women to talk to healthcare providers without visiting the hospital. Healthcare providers help support women's health with nutrition, exercise, and mental health.
Active & Sports Nutrition
Cycle sync fitness is becoming more popular. Women want to learn about their bodies and exercise in the best way for them. Many people are starting to see that it matters what phase of your period you are in when exercising.
Scientists and companies are researching how hormones change during your period and how that affects sports performance. Companies such as Hormonix¹⁵ make special sensors to track hormones and metabolism to provide women personalized advice on nutrition and fitness activities.
In summary:
The menstruation industry is only at the beginning. Menstruation, a once ignored area is now gaining the attention that it deserves. however, there is an obvious need to provide nutrition solutions that are tailored to the individual based on objective data such as biomarkers.
Current Femtech solutions are focusing on technologies and clothing solutions whilst the nutritional aspect is largely untouched.
Menstruation although a natural phenomenon has a significant physiological impact that is only being unraveled now.
This means that there are opportunities to be grabbed by offering personalized nutrition solutions, as menstruation affects 49% of the global population.
New technologies can provide data points that can be used to target specific nutritional risks.
It is clear from online searches that women are seeking solutions that are beyond grandma´s advice of a hot water bottle and a painkiller.
References
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- Femtech—Time for a Digital Revolution in the Women’s Health Market.
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- Analysis: Why Digital Health Investors are Falling in Love with Femtech.
- Bull, J. R., Rowland, S. P., Scherwitzl, E. B., Scherwitzl, R., Danielsson, K. G., & Harper, J. (2019). Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. NPJ digital medicine, 2(1), 83. Doi:https://doi.org/10.1038/s41746-019-0152-7
- Rogan, M. M., & Black, K. E. (2022). Dietary energy intake across the menstrual cycle: a narrative review. Nutrition reviews. Doi:https://doi.org/10.1093/nutrit/nuac094
- Draper, C. F., Duisters, K., Weger, B., Chakrabarti, A., Harms, A. C., Brennan, L., ... & Van der Greef, J. (2018). Menstrual cycle rhythmicity: metabolic patterns in healthy women. Scientific Reports, 8(1), 14568. Doi: 10.1038/s41598-018-32647-0
- Aguree, S., Murray-Kolb, L. E., Diaz, F., & Gernand, A. D. (2022). Menstrual cycle-associated changes in micronutrient biomarkers concentration: A prospective cohort study. Journal of the American Nutrition Association, 1-10. Doi:https://doi.org/10.1080/07315724.2022.2040399
- Subramanian, A., & Gernand, A. D. (2019). Vitamin D metabolites across the menstrual cycle: a systematic review. BMC Women's Health, 19(1), 1-8. Doi:10.1186/s12905-019-0721-6
- dehghani Firouzabadi, R., Aflatoonian, A., Modarresi, S., Sekhavat, L., & MohammadTaheri, S. (2012). Therapeutic effects of calcium & vitamin D supplementation in women with PCOS. Complementary therapies in clinical practice, 18(2), 85-88. Doi:https://doi.org/10.1016/j.ctcp.2012.01.005
- The World Health Organizaiton. Anemia in Women and Children.