Dreading your period can be one of the worst feelings in the world. For some extremely #blessed women, menstruating is NBD: Your period rolls in every 28 days, lasts a few days, and fades out. No drama. For others, though, the monthly cycle is a ticking time bomb, complete with pain, fatigue, bloating, depression, acne—and those are just a few examples.

But a difficult period doesn’t have to be the status quo. My friend Lauren Bille started a really cool summit for women’s health called Cycles + Sex with two other women, Ashley Spivak and Natalia Hailes, so I dropped her a note to ask if she knew of any hormonal experts who might be able to shed some light on the ongoing mystery that is the menstrual cycle. C + S is a conference, complete with panels of experts, bomb Q&A sessions, and booths full of women-centric products and services, so I figured Bille would probably know a specialist (or 20) who could give me more information about WTF is happening when things go awry every month.

Bille connected me with Dr. Jolene Brighten, naturopathic physician and women’s health expert who did a deep dive on the ins and outs of hormones, periods, and all of the afflictions that can be part and parcel of the average woman’s cycle. Whether you’re plagued with food cravings, heavy periods, or just general monthly malaise, Dr. Brighten revealed why such things happen—and what you can do to start clawing your way out of that ditch you fall into every month, and stay out.

SC: What does it mean if you have hormonal acne along your jawline?

JB: Acne can be a sign of blood sugar and hormonal imbalances, and elevated testosterone. We commonly see acne in women who have PCOS (Polycystic Ovary Syndrome).

SC: What can you do about hormonal acne?

JB: Eating regular meals, avoiding refined sugars and carbohydrates, and including antiinflammatory foods like turmeric and cold-water fish can help improve skin overall and reduce acne.

SC: What does it mean if you get bloated every month just before and during your period?

JB: Bloating is caused by the changing levels of estrogen and progesterone, which can affect your bowels and cause you to increase water retention.

SC: What can you do to fight bloating?

JB: Drinking plenty of water and including fiber-rich foods like fresh ground flaxseeds, leafy green vegetables, and chia seeds supports healthy digestion and helps keep bowels regular. Dandelion leaf tea can help reduce water retention, as can potassium-rich foods like avocado, sweet potato, and beets.

MORE: An Adult Film Star’s Guide to Having Sex on Your Period

SC: What does it mean if you have terrible pain the first day of your period?

JB: There are several reasons women have painful periods, but the most common reason is elevated prostaglandins. Prostaglandins are hormone-like substances that stimulate contraction of the uterus. Because pelvic pain can also be a sign of endometriosis, infection, and other serious conditions, it is important to meet with your doctor if you’re concerned.

SC: What can you do to address the pain?

JB: Magnesium and zinc are two beneficial nutrients that lower prostaglandins and support hormonal balance. Hot water bottles and magnesium oil massages over the low abdomen can help reduce pain to make periods more manageable.

SC: What does it mean if you have hardcore food cravings just before your period?

JB: The PMS cravings are real. It is a sign that your estrogen (and serotonin) levels are dipping too soon in your cycle, leaving progesterone to be in abundance.

SC: How can you deal with the cravings?

JB: Getting good sleep, eating protein when you’re hungry, and getting adequate dietary fat can help with cravings and begin to balance hormones. Some women find supplementing with 5-HTP, Rhodiola, and B6 helpful to reduce cravings.

SC: Are mood changes—like depression—before your period related to a hormonal imbalance?

JB: Getting a full hormone panel, which includes testing sex hormones, cortisol, thyroid hormones, and inflammation markers is important to understand the underlying hormone imbalance.

SC: What can you do about mood changes?

JB: Exercise, getting adequate sleep, and eating healthy fats like Omega-3 fatty acids, avocados, and olive oil can support hormones and mood. Vitex is an herb that can help improve progesterone levels and has been shown to be more effective than antidepressants in some studies.

MORE: Health Advice for Every Phase of Your Cycle

SC: What does it mean if you have super-heavy periods?

JB: Common causes of heavy periods include high estrogen levels, or what is known as estrogen dominance; fibroids; iron-deficiency anemia; endometriosis; and using a copper IUD. If you’re experiencing heavy periods, having lab testing is important to understand the root cause.

SC: Is there a safe way to curb a super-heavy flow?

JB: Begin increasing iron-rich foods into your diet, and include cruciferous vegetables to support healthy estrogen levels. Heavy or irregular periods can also be a sign of thyroid disease, which can be diagnosed from a simple blood test.

SC: What does it mean if you see blood clots in your menstrual blood?

JB: The most common reason for women to see clots in her menstrual blood is due to a hormonal imbalance, namely high estrogen and low progesterone. Having a blood test on day 19-22 (about seven days before you expect your period) can help you determine if you have an imbalance.

SC: Is there any way to cut down on clots like this?

JB: Increasing vitamin C, increasing fiber intake, being social with your girlfriends, and reducing stress are effect ways to start shifting these hormones into balance.

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