on-going mostly unedited stream of thoughts

improving hormonal imbalances with cardiac data

I wrote in a previous post that I’ve been gathering data from my heart in order to understand my body. I’ve had chronic health issues since 2015, and thankfully a lot of it has cleared slowly over the past few years – like my previously dead tear ducts and oil glands in my eyes, they are now alive – but one persistent issue is chronic migraines that I get every month either during or after my monthly menstrual cycle. They last for days, and thereafter I take days if not weeks to recover from the fatigue and depression.

No one knows why hormonal fluctuations causes migraines, and actually no one knows why in general migraines occur.

There is a lot of history I could write regarding this, but to keep this post short my current hypothesis is that my inability to self-regulate is causing chronic stress in my body, which is in turn causing chronic hormonal imbalance, which causes my migraines. Since regulation is largely an autonomic process, there are two main things that one can try to improve it:

  • meditation: stimulates the parasympathetic nervous system
  • exercise: balances hormones and improves stress resilience

I’ve been regularly exercising since end 2015 to improve my symptoms. For a long time I was obsessed with forming habit streaks, so I pushed myself to exercise everyday regardless of how I felt. I started with swimming which is a gentle exercise, but when I lost access to a pool I started running. I grew to like running enough, but it didn’t stop my migraines.

I’ve had the Oura ring for about a year now. It measures my heart rate variability while I sleep, and along with other factors it calculates a score it calls “Readiness” which is supposed to inform me whether I should push myself hard for that day. Unfortunately my inability to self-regulate also means I would be in some form of denial when it comes to the score and I would continue to push myself regardless. So I would still regularly burn out from over-straining myself.

I couldn’t deliver things anymore because of the virus, so my main source of exercise is gone. I became worried about losing fitness because for me losing fitness is not just about energy levels but it also means the potential for my symptoms to worsen. I started cycling everyday, and when the country went into a partial lockdown I started cycling more to compensate for the sedentary lifestyle. In the middle of March I got sick, so for the first time I started paying serious attention to my cardio data to decide whether I should exercise for that day or not. Stress can impair the immune system, so I really didn’t want to compromise my immunity especially at this time.

After I recovered from that bout of sickness I decided that cycling wasn’t enough to improve my fitness, so I started running again. I got used to measuring my HRV every morning – a ritual I started when I was sick – and I used the data as signals to tune the intensity of my exercise that day. I remember burning out during the time I was running everyday, so this time I decided I would only run if my HRV during sleep and upon waking is trending positively, cycle for longer distances if my HRV is average according to my long-term baseline, and exercise minimally or rest if my scores are below average.

(Caveat: an unusually high HRV is also a sign of stress.)

Ultimately my goal is to improve my hormonal balance. I was never a healthy or fit person, so I am really curious if I can overcome my inherent biology to become healthy and fit.

While paying attention to my resting heart rate (RHR) and heart rate variability (HRV) I realised they were always trending negatively after ovulation. A quick google search confirms my suspicion. Basically because of hormonal fluctuations, a woman has a few days of good energy levels a couple of days after menstruation, and it lasts till ovulation, which thereafter it dips until the cycle starts again.

Perhaps for a healthy woman the difference between very good and a little bit worse is not a lot. I have friends who don’t even notice their period, which is the way it should be. For a person like me with PMS – both pre and post – I am basically healthy, sane and productive for like ten days out of an entire month if I am very lucky. This has drilled into me the point that wanting to achieve daily consistency is actually counter-productive. To really achieve well-being, I need to learn how to live according to the seasons of my body.

In health, I think what is important is to improve the baseline. It is the baseline that drives the overall system, and the baseline that determines how much stress one can endure before breaking down.

I decided that what I want to focus on is the baseline of my luteal phase, which is the phase between ovulation and menstruation. That phase is the hardest for me – emotionally, physically, and mentally – and it is fourteen whole days of every month of my life, until I reach menopause which is going to bring me a new set of problems. But I am hoping if I do this right now, I can have a gentler transition to menopause.

The past few days, I’ve been pulling data from my Oura ring and analysing it in the simplest way possible. I’ve only looked at the data for the past three months because that’s when I started paying a lot more attention to my health because of the virus.

To keep it simple for now, below is a table showing the data from my Oura ring, though I do use other devices as well. I included cycle length because my research tells me that the longer I take to ovulate, the unhealthier I was. This month, I had my first period in months that didn’t come with a serious migraine, but sometimes when it doesn’t happen during then it will happen a bit later (sometimes during ovulation) so I don’t want to jinx myself. Is this because of my newly started HRV-based exercise experiment since mid-March? Was 30 days enough to make significant improvements?

What I’m interested in is to improve my data during the luteal phase: I want a trending lower RHR, a higher HRV, and an average cycle length that is not more than 30 days. The goal is to use HRV to exercise dynamically to improve my body’s capacity to endure stress which a lower RHR and HRV will indicate, and hopefully my body will produce less stress-related hormones, and that will restore balance to the rest of my hormones, eventually leading to the cessation of my migraines, or at least allow me to reach more clarity on my own condition.

MonthAverage luteal RHR
Average luteal HRV
Cycle Length
data from past 3 months of menstrual cycles

It is too early to tell and I am still experimenting with my dynamic exercise regime, but I want to start documenting this process from the beginning.

As we can see from the table, during my luteal phase my average RHR is trending slightly upwards due to the increase in exercise, whereas my average HRV is improving though there was a dip in March because I was sick. What will be interesting is to see longer term trends. Will exercising according to my HRV lead to a drop in my RHR eventually? Will learning to be gentle with my body lead to the health improvements I’ve always wanted? How much exercise is too much?

It is probably a strange topic to most people, writing so much about my menstrual cycle. But in my own process of research I realised this is something not many people are willing to write about in an open manner, even though it heavily affects the health of many women.

There is also very little blog posts about using data to improve health on a personal level. Based on my own understanding on global trends, chronic health issues will be an increasing concern in time to come. I hope by trying to shed some light onto my process, this information may be useful to somebody out there, no matter how obscure it seems to be now.

Further reading:

Wikipedia: Menstrual migraine

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