How to Interpret Your Period Report Card


written by:

Emily Hage, MS, RD

Your period is a valuable benchmark that can be thought of as a monthly report card of overall health status. Along with body temperature, heart rate, respiratory rate, and blood pressure, the menstrual cycle can be considered the fifth vital sign. Period symptoms are another tool we can use to assess various body systems (immune system function, thyroid function, adrenal function, hormonal balance, inflammatory response, etc.).

Positive (A+) period report cards are predictable, painless cycles without noticeable symptoms. Negative report cards (missed, heavy, painful, or irregular periods) can signal your body trying to tell you something. Paying attention to the timing and the physical and emotional symptoms occurring with your period provides useful data in assessing the ‘why’ and potential underlying causes.

In this article, we’ll explain how to interpret your period report card (heavy bleeding, irregular cycles, absent periods, mid-cycle spotting, painful cramps, and PMDD symptoms) and strategies to manage symptoms. First, let’s break down the characteristics of a normal menstrual cycle.

What a normal period typically looks like:

  • Cycle length: 21-35 days (calculated starting with the 1st day of bleeding of one period to the 1st day of bleeding of the next period; varies for individual women–what’s important is what a normal length is for you)
  • Bleeding length (menstrual phase/number of bleeding days): 2-7 days 
  • Pain level: minimal pain and cramping that doesn’t interfere with your normal daily routine or require anti-inflammatory OTCs or prescribed medications
  • Heaviness: ~50-60 mL of blood loss for the entire period, which is ~6-12 regular tampons/pads or filling a 25ml menstrual cup 2-2.5 times (Note: these numbers can be much higher depending on the specific sanitary products you’re using and the frequency you prefer to change your tampons/pads)
  • Color: cranberry
  • Clots: none

While shorter or heavier cycles occurring infrequently (due to stress or other factors) are still in the realm of normal and not usually a cause for concern, the below symptoms may be indicative of a deeper issue that is worth further investigation.

1. Heavy Bleeding

Abnormally heavy bleeding (menorrhagia) can be indicated by bleeding for more than 7 days, soaking through one or more tampons every 1-2 hours, needing to double up on sanitary products to manage your flow, bleeding through pads/tampons while sleeping, passing large blood clots (the size of a quarter or larger) and experiencing fatigue, shortness of breath, and/or other anemia symptoms.

Common causes of heavy bleeding:

1. Estrogen Dominance (Low Progesterone) – estrogen and progesterone collaborate to prepare the body for a potential pregnancy each month. When estrogen levels are in excess and progesterone levels are too low, this is known as estrogen dominance. Heavy and painful periods are commonly associated with estrogen dominance (aka lack of progesterone), along with PMS, breast pain, fibroids, PCOS, and endometriosis.

Potential solutions:

  • Consuming high-sulforaphane cruciferous vegetables (1-2 cups daily) – Sulforaphane is a naturally occurring compound found in cruciferous vegetables. It’s activated when these vegetables are chopped or chewed. Broccoli sprouts can produce an especially large amount of sulforaphane. Other sources include broccoli, cabbage, kale, bok choy, arugula, and watercress. While the largest amount is found in raw vegetables, mustard seed/powder can elevate the bioavailability of sulforaphane in cooked cruciferous vegetables. Sulforaphane supplements are an option to receive a therapeutic dose of concentrated sulforaphane (products such as BroccoProtect and SulforaClear) when used under the guidance of a licensed practitioner
  • Consuming healthy fats – olives, olive oil, coconut oil, avocados, nuts, seeds, wild-caught fatty fish, and grass-fed meat to support healthy progesterone levels
  • Vitamin C (citrus fruits, broccoli), vitamin E (almonds, sunflower seeds), vitamin B6 (salmon, chicken) magnesium (spinach, pumpkin seeds), zinc (oysters, lentils), are all important nutrients for proper hormone balance and support healthy progesterone production
  • DIM – DIM (Diindolylmethane) is produced by the digestive breakdown of a phytochemical (indole-3-carbinol) found in cruciferous vegetables and can aid in modulating estrogen metabolism. DIM supplements should only be used under the guidance of an expert practitioner based on lab results, including a comprehensive hormone panel
  • Chasteberry (Vitex) – Vitex, also known as Chasteberry or Chaste Tree, is an herbal extract from the Chasteberry plant that is native to the Mediterranean region. While more research is needed, there is some evidence that Vitex supplementation may help to decrease levels of follicle-stimulating hormone (FSH) and enhance levels of luteinizing hormone (LH), leading to a reduction in estrogen levels and increased levels of progesterone. Some research has indicated that Vitex can be effective in reducing heavy bleeding/menorrhagia

2. Copper IUD – heavier bleeding and longer periods commonly occur with the copper IUD (Paraguard), especially in the first 6 months after insertion. Abnormally heavy bleeding that continues beyond this point should be assessed by your doctor. Copper IUDs release copper ions which increase inflammation in the endometrium to repel sperm and prevent pregnancy.

Potential solutions:

  • Consuming an anti-inflammatory diet – made up of mostly whole, minimally processed foods and rich in fiber, antioxidants, and omega-3s. An anti-inflammatory diet typically includes healthy fats (fatty fish, nuts, seeds, avocado, olive oil), vegetables, fruits/berries, legumes, whole grains, green and herbal teas, and moderate amounts of poultry, meat, and dairy
  • Vitamin E – as an antioxidant with anti-inflammatory properties, Vitamin E is effective in mimicking the effects of progesterone in the body, reducing the symptoms of excess estrogen and menorrhagia, and helping to mitigate the inflammatory impact of an IUD. Foods high in vitamin E include nuts, seeds, vegetables, and fruits (with sunflower seeds and almonds being some of the richest sources). A high-quality vitamin E supplement (ideally a blend of tocopherols) can be effective at reducing heavy bleeding and period pain
  • Ginger –  ginger has been shown to have potential benefits in reducing menstrual blood loss and improving menstrual pain in some studies
  • Yoga nidra (guided meditations, such as NSDR) and acupuncture can also be beneficial in managing menorrhagia

Other possible causes of heavy bleeding:

  • Endometriosis
  • Adenomyosis
  • PCOS
  • Fibroids 
  • Thyroid dysfunction
  • Endometrial hyperplasia
  • Polyps

2. Irregular cycles

Irregular cycles include when your period starts earlier or later than expected, or the length of your cycle changes (to be shorter or longer than normal).  

Common causes of irregular cycles:

1. Stress – High stress levels have been associated with irregular menstrual cycles. The HPA axis (hypothalamic-pituitary-adrenal axis) is a system that helps regulate stress tolerance and can become activated by various psychological and/or physical stressors. When chronically triggered, the HPA axis can produce a dysfunctional stress response, keeping the “fight-or-flight” mode of the sympathetic nervous system activated (instead of entering “rest and digest” mode). This prolonged stress response interferes with hormone balance and can impact the menstrual cycle.

Potential solutions:

  • Stress management techniques – such as meditation, visualization, deep breathing, yoga and other forms of movement/exercise, NSDR, journaling, cognitive behavioral therapy, and nature walks can all be effective ways to reduce stress. Starting with a small but consistent practice of one or more of these techniques and gradually increasing intensity can help make the practice more sustainable. For example, meditating for at least 10-30 minutes a day for 4 weeks has been shown to lead to benefits such as decreased physiological markers of stress and a reduction in self-reported stress levels. A longer-term practice (eight weeks of mindfulness meditation for ~30 minutes daily) has been shown to induce significant changes in brain grey matter and the amygdala, correlating with a reduction in stress levels
  • Getting quality sleep aids in more effectively managing stress
  • Exercising regularly – physical activity has a stress-reducing effect, with even low/moderate levels of daily movement shown to significantly reduce stress levels
  • Adaptogens – Adaptogenic herbs and mushrooms (such as ashwagandha, ginseng, holy basil, and Rhodiola) may help regulate the body’s response to stress
  • L-theanine – L-theanine is an amino acid extracted from green tea shown to regulate neurotransmitters in the brain, reduce stress, and promote relaxation through its ability to elevate alpha brain wave activity. A 2019 randomized controlled trial found that L-theanine supplementation of 200mg daily for 4 weeks reduced symptom scores related to stress (depression, anxiety, sleep issues) while also improving cognitive function scores
  • Consider adrenal testing and support – Specific herbal and plant extracts, such as magnolia, Phellodendron, and licorice root, can help promote healthy cortisol metabolism and manage the body’s stress response. A comprehensive assessment of sex and adrenal hormones like the DUTCH test includes a 4-point cortisol urine test. A qualified functional practitioner can offer personalized adrenal support and targeted supplementation based on your results
  • Consider supporting gut health – underlying gut dysbiosis could be contributing to stress and vice versa; current research indicates a potential bidirectional relationship between stress/mood, nutrition, and the gut microbiome. Consider working with a functional practitioner to complete comprehensive GI testing and address any imbalances in the gut contributing to stress and overall health status

2. PCOS – PCOS (polycystic ovarian syndrome) is a collection of symptoms indicating a hormonal imbalance. There are four main types of PCOS: insulin-resistant PCOS, adrenal PCOS, post-pill PCOS, and inflammatory PCOS. Insulin resistance, excess adrenal hormones, gut dysbiosis, coming off of birth control pills, and overall inflammation can all drive PCOS. It’s crucial to understand your type(s) of PCOS when determining the proper intervention. We recommend working with a functional practitioner for personalized support to identify and treat your PCOS root causes.

Potential solutions:

  • Maintaining balanced blood sugar and improving insulin resistance – Excess blood sugar triggers the pancreas to release more insulin, which can lead to insulin resistance over time as cells become less responsive to insulin. Increased insulin can prompt the ovaries to overproduce testosterone, leading to hyperandrogenism symptoms (i.e. acne, hirsutism). To keep blood sugar stable, aim to eat a protein-rich meal within an hour of waking, and a combination of protein, fat, and fiber-rich carbohydrates every 3-5 hours thereafter. Avoid consuming naked carbs; pairing carbs with protein/healthy fat helps to slow digestion and keep blood sugar and energy levels smooth and stable
  • Inflammation reduction through an anti-inflammatory diet – omega 3 fats, a variety of whole plant foods, vegetables, nuts, seeds, mushrooms, herbs, spices, berries (and avoiding inflammatory triggers such as added sugar, alcohol, and ultra-processed foods)
  • Spearmint tea – spearmint tea has been studied for its antiandrogen effects; a randomized controlled trial found a significant decrease in testosterone levels following the use of spearmint in PCOS patients
  • Optimizing sleep – improving the length and quality of your sleep with sleep hygiene techniques and sleep optimization strategies
  • Exercise – physical activity helps to improve insulin sensitivity and reproductive function. Regular exercise (30-minute sessions, 5 days a week) has been shown to help benefit the menstrual cycle and ovulation frequency
  • Minimizing toxic load and endocrine disruptors in your home and environment where possible -consider switching to non-toxic skincare, cleaning products, and cookware; consider investing in a high-quality air purifier and water filtration system; avoid scented products, plastics, and non-stick cookware whenever possible
  • Targeted supplementation under the supervision of a licensed practitioner:

Note: since these supplements can interact with certain medications and impact hormonal balance, they should only be used under the guidance of a qualified practitioner

Other possible causes of irregular cycles:

  • Thyroid dysfunction
  • Low progesterone, high estrogen

3. Absent periods (missing 3 or more) 

If you typically have a period every month and your period stops for 3 months or longer (and you’re not pregnant), this is known as secondary amenorrhea or hypothalamic amenorrhea. 

Absent periods (≥ 3 months) can be a sign of:

1. Undereating – Not eating enough or restricting food (regardless of body weight) can signal the hypothalamus to go into survival mode and pause the secretion of gonadotropin-releasing hormone (GnRH). Without GnRH triggering the creation of sufficient FSH and LH levels, ovulation and menstruation stop. Chronic undereating can have a severe impact on the body’s endocrine, cardiovascular, gastrointestinal, and neurological systems. A lack of optimal nutrient intake can lead to depression, anxiety, insomnia, nutrient deficiencies, electrolyte imbalances, slowed digestion (gastroparesis), irregular heartbeat, and a variety of other issues.

Potential solutions:

  • Addressing your relationship with food and drivers of disordered eating behaviors with a qualified practitioner and/or licensed therapist
  • Repleting nutrients and optimizing meal timing; eating balanced meals of protein, fat, and fiber-rich carbohydrates every 3-5 hours

2. Thyroid issues – The thyroid gland plays a key role in the endocrine system and hormonal regulation. A dysfunctional thyroid gland (overactive or underactive) can cause secondary amenorrhea, irregular cycles, and interfere with ovulation and fertility. Prolonged spotting before your period and heavy bleeding may also be indicative of a potential thyroid issue.

Potential solutions:

  • Incorporating foods rich in nutrients essential for proper thyroid function, such as vitamins A, B, C, D, minerals such as iodine, copper, zinc, selenium, magnesium, iron, and omega-3 fatty acids:
    • Vitamin A – sweet potatoes, carrots, tuna, dark leafy greens, cantaloupe, bell peppers
    • Vitamin C – citrus fruits, bell peppers, strawberries, broccoli, kale
    • B vitamins – whole grains, meat, fish, nuts, seeds
    • Iodine – seafood, seaweed, pasture-raised eggs, dairy
    • Copper – nuts and seeds, sweet potatoes, chickpeas, shellfish, liver
    • Zinc – oysters, beef, chicken, beans, nuts, and whole grains
    • Selenium – Brazil nuts, seafood, meat, and dairy
    • Magnesium – spinach, almonds, avocado, black beans, cacao
    • Iron – red meat, poultry, fish, beans, leafy greens
    • Omega-3 fatty acids – fatty fish (salmon, mackerel, anchovies, sardines, herring) flaxseeds, chia seeds, walnuts
  • Stress management techniques (mentioned above)
  • Working with a functional practitioner to assess hormonal balance, thyroid function, mineral status, and underlying stressors in the gut through comprehensive testing and create a targeted protocol to address the root cause of symptoms

Other possible causes of absent periods:

  • Stress
  • Menopause/premature menopause
  • Illness
  • Celiac disease
  • Post covid vaccination
  • Hormonal birth control 
  • High prolactin (common when on hormonal birth control)
  • Overexercise

4. Mid-cycle spotting

Mid-cycle spotting is lighter than normal vaginal bleeding that occurs in the middle of your menstrual cycle. The timing of this spotting may or may not involve ovulation. Before ovulation, the hormone estrogen reaches its highest level which changes the texture of cervical mucus from thick and creamy to a more elastic and transparent texture similar to raw egg whites. This change in mucus allows for sperm to more easily travel through the vagina and reach the uterus to potentially fertilize an egg. Other signs of ovulation include an increase in LH (can be measured using ovulation strips), and a decrease in body temperature prior to ovulation followed by a marked increase post-ovulation (can be measured by tracking basal body temperature).

What mid-cycle spotting can be a sign of:

1. Anovulatory cycles – anovulatory cycles are cycles in which ovulation (egg release) does not occur. An insufficient amount of progesterone can lead to heavy bleeding that can be mistaken for normal menstrual bleeding. Anovulatory cycles can be triggered by rapid shifts in hormone levels (mainly GnRH, LH, and FSH) as well as high prolactin, stress, Hashimoto’s or underactive thyroid, pituitary gland dysfunction, changes in body weight or eating habits, or overexercising.

Potential solutions:

  • A nutrient-dense Mediterranean/anti-inflammatory diet including progesterone-supporting nutrients, vitamins, and minerals – high intake of fiber/whole plant foods, sources of omega 3s, vitamin C, vitamin E, B6, B12, calcium, iodine, iron, selenium, magnesium, and zinc, can help support healthy ovulation and fertility
  • Consuming healthy fats and dietary cholesterol – cholesterol is a building block for hormone production, including estrogen and progesterone, which are essential for ovulation and maintaining a healthy menstrual cycle. These hormones are synthesized from cholesterol through a series of chemical reactions in the body, and a deficiency in cholesterol (egg yolks, liver, shellfish, cheese, grass-fed butter) or healthy fats (fatty fish, nuts, seeds, avocados, olive oil) in the diet can lead to hormone imbalances that can disrupt ovulation
  • Stress management techniques (mentioned above)
  • Minimizing toxic load and endocrine disruption in your home and environment (tips mentioned above). Environmental exposure to chemicals and heavy metals has been studied for its potential impact on anovulatory cycles and fertility
  • Comprehensive testing to assess thyroid function, adrenal function, hormonal balance, and heavy metals (which may impact progesterone levels)
  • Targeted supplementation under the guidance of a practitioner based on labs – for example, a blend of chasteberry, maca, and active folate has shown promising results for regulating the menstrual cycle, stimulating ovulation, and increasing the likelihood of pregnancy. Supplementation with Vitamin D, methylated B vitamins, a high-quality multivitamin or prenatal may also be indicated

2. Normal ovulation spotting – Normal ovulation spotting can occur when you release an egg in the middle of your menstrual cycle, likely due to a rapid shift in hormone levels. It’s relatively uncommon but not a cause for concern. This spotting is much lighter than a normal period bleed and could occur between 11 and 21 days (more or less) after the first day of your last period.

Potential solutions:

  • Consider tracking ovulation – To track ovulation, use an ovulation test which measures the levels of luteinizing hormone (LH) in your urine–LH levels increase just before and during ovulation. You can also monitor changes in cervical mucus and basal body temperature, and consider using an ovulation tracking app. Keep in mind that ovulation can occur with or without spotting (and spotting is not a reliable indicator of ovulation)

Other possible causes of mid-cycle spotting:

  • Endometriosis 
  • PCOS
  • Ovarian cysts
  • Uterine polyps
  • Fibroids
  • Adenomyosis
  • Infection

5. Painful periods and cramps (dysmenorrhea)

Painful cramping (dysmenorrhea) in the lower abdomen right before or during a period is common and caused by contractions in the uterus. Primary dysmenorrhea is defined as common menstrual cramps that recur. Secondary dysmenorrhea is defined as painful cramping due to the presence of a reproductive disorder such as endometriosis (tissue lining the uterus grows outside the uterus), adenomyosis (lining of the uterus grows into the muscular wall of the uterus), pelvic inflammatory disease (PID), or fibroids. Although period cramping is considered common, it doesn’t mean it’s normal, especially when you experience severe cramping and pain before, during, or around your period. Painful cramping can signify a deeper issue or condition.

Common causes of painful periods and cramps:

1. Endometriosis – Endometriosis is when endometrial growth occurs outside the uterus in other parts of the body (fallopian tubes, ovaries, surface of the uterus, bladder). While some cramping can be normal during your period, debilitating cramps can be a possible indication of endometriosis. Common symptoms include heavy and painful periods, severe cramping, spotting, clotting, pain during and/or after sex, pain in the lower back or pelvis, painful bowel movements or urination. Endometriosis can also cause digestive issues, miscarriage, and fertility problems. Endometriosis can be difficult to diagnose due to its varied symptoms, which can overlap with other conditions; definitive diagnosis can only be achieved through laparoscopic surgery. Research is growing to identify how endometriosis develops, with genetics, the environment, endocrine disruption, the gut microbiome, and immune reactions all playing a potential role. Endometriosis can be managed with a holistic approach that targets overall inflammation reduction, supports detoxification, and incorporates personalized diet and lifestyle strategies.

Potential solutions:

  • Inflammation reduction through an anti-inflammatory diet – omega 3 fats, a variety of whole plant foods, vegetables, nuts, seeds, mushrooms, herbs, spices, berries (and avoiding inflammatory triggers such as added sugar, alcohol, and ultra-processed foods)
  • Anti-inflammatories and antioxidants – curcumin, quercetin, and NAC may help reduce pain and inflammation associated with endometriosis; supplementation with omega-3 fatty acids may be helpful in reducing the symptom intensity of dysmenorrhea
  • Ginger – Ginger has been shown to be significantly effective at reducing period pain and cramps. It also supports digestion and helps reduce nausea. Fresh ginger root or ginger tea are great options
  • Magnesium – Magnesium is crucial for hormone health and overall health. Through food sources, supplementation, and/or Epsom salt baths, magnesium can be effective at reducing pain, cramping, and tension, promoting relaxation, and calming the nervous system
  • Vitamins C and E – antioxidant support from a combination of vitamin C and E has been shown to be effective in helping to reduce the severity of pelvic pain, dysmenorrhea (painful periods), and dyspareunia (painful sex)
  • Quality sleep and rest – overexertion during periods of painful cramping can exacerbate symptoms; rest days and quality sleep are crucial to pain reduction
  • Acupuncture – while more research is needed, there is some evidence that acupuncture may benefit endometriosis pain and reduce serum CA-125 levels (a cancer antigen and glycoprotein marker that may be an important predictor of the clinical-pathological characteristics of endometriosis)
  • Heating pads – heating pads and hot water bottles placed on the abdomen and/or lower back can help alleviate period pain
  • Consider a TENS device – transcutaneous electrical nerve stimulation (TENS) device; a method of pain relief involving the use of a mild electrical current may help to reduce dysmenorrhea

2. Zinc deficiency – Zinc is needed for optimal health and deficiency is common. It plays a crucial role in hormone release, immune system function, wound healing, taste, and DNA and protein synthesis. Optimal zinc levels may help prevent painful periods; zinc supplementation has been shown to significantly alleviate painful cramping during periods when taken before and during the menstrual cycle.

Potential solutions:

  • Consuming food sources of zinc – oysters (and other shellfish like king crab and mussels), beef, pork, chicken, legumes (chickpeas, lentils), nuts and seeds (pumpkin seeds, cashews), whole grains, eggs, dairy, 85% dark chocolate
  • Consider zinc supplementation (possibly in combination with other minerals) only if indicated by a practitioner based on comprehensive lab testing. Too much zinc can lead to absorption issues and potential deficiencies in other essential minerals like copper and iron.

Other possible causes of painful cramps:

  • PMDD
  • PCOS
  • PID
  • Infection
  • Inflammation
  • Adenomyosis
  • Excess estrogen, low progesterone
  • Copper IUD

6. Premenstrual Dysphoric Disorder (PMDD symptoms)

Premenstrual dysphoric disorder (PMDD) is a more severe form of premenstrual syndrome (PMS). Those with PMDD typically experience a variety of emotional and physical symptoms in the weeks leading up to their period, such as depression, anxiety, difficulty sleeping, headaches, mood swings, panic attacks, fatigue, severe irritability, appetite changes, and suicidal thoughts. While PMS symptoms can also include depression, fatigue, and mood swings, PMDD symptoms can be much more pronounced and debilitating.

What PMDD can be a sign of:

1. Nutrient deficiencies – Research has indicated that deficiencies in nutrients such as Vitamin D, calcium, thiamine, and riboflavin may contribute to PMDD symptoms.

Potential solutions:

  • Consuming food sources of thiamine (pork, salmon, nuts, seeds, beans, peas, tofu, brown rice, squash, asparagus), riboflavin (beef, tofu, fish, pork, mushrooms, spinach, almonds, avocados, and eggs), calcium (leafy greens, sardines, sesame seeds/tahini, chia seeds, beans/lentils, tofu, yogurt), and vitamin D (fatty fish, cod liver oil, egg yolks, beef liver)
  • Comprehensive lab testing to identify any vitamin and mineral deficiencies
  • Targeted supplementation under the supervision of a licensed practitioner to replete nutrients to optimal levels (based on lab results)

2. Hormonal and neurotransmitter shifts – Those with PMDD appear to be severely impacted by hormonal fluctuations occurring during the menstrual cycle. Shifts in neurotransmitters such as serotonin, GABA, and glutamate have been shown to be potential contributing factors to PMDD symptoms. At Birchwell, we utilize DUTCH testing, a test in which you collect daily dried urine samples throughout your cycle. This test is a comprehensive assessment of sex and adrenal hormones, as well as metabolites of neurotransmitters (dopamine, norepinephrine, and serotonin)

Potential solutions:

  • An anti-inflammatory diet rich in fiber, antioxidants, omega 3s (and other healthy fats), vegetables, fruits/berries, legumes, whole grains, green and herbal teas, and moderate amounts of poultry, grass-fed meat, eggs, and dairy
  • Comprehensive hormone and neurotransmitter assessment (such as DUTCH testing) through a functional practitioner
  • Minimizing toxic load and endocrine disruption in your home and environment (tips mentioned above)
  • Supplementation (under the guidance of a functional practitioner) with herbs such as Chasteberry (Vitex) or evening primrose oil. Calcium, magnesium, vitamin D, B vitamins, or L-tryptophan supplementation if indicated 

Other possible causes of PMDD:

  • Inflammation
  • Stress
  • High estrogen, low progesterone 
  • Endocrine disruption 
  • Neurotransmitter shifts

How to Interpret Your Period Report Card – Final Thoughts:

Changes in your menstrual cycle and associated symptoms are your body’s way of alerting you to potential underlying issues that need attention. When we think of our menstrual cycle and period symptoms, we think of hormonal shifts; while hormone levels are an important assessment tool, they are not a root cause of a condition or imbalance. Hormones are impacted by a variety of body systems and an imbalance can be a reflection of something else that needs to be addressed (such as inflammation, chronic stress, adrenal function, thyroid function, or nutrient status). 

At Birchwell, we utilize bloodwork (captured during days 19-21 of your cycle), DUTCH urine testing, and hair tissue mineral analysis (HTMA) testing to assess hormone status along with mineral status and specific metabolites to get a comprehensive picture of your hormonal status and overall health. 

Interested in teaming up with a Registered Dietitian who specializes in functional medicine? Book a non-obligation, complimentary discovery call to chat with one of our practitioners and see if our functional health consulting is right for you.


Feeling better is possible. Meet with one of our practitioners to find out if 1:1 Functional Medicine Consulting is right for you.

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Anya is a Registered Dietitian, Functional Medicine Practitioner and founder of Birchwell, a virtual integrative health clinic based in New York City.

She specializes in helping her clients identify the root cause of their health concerns through advanced lab testing and her comprehensive assessment. She uses functional diet, supplement, and lifestyle strategies to address any imbalances in the body. Through her integrative and functional nutrition practice, Anya has helped hundreds of adult women and men fix their gut health (e.g. SIBO, reflux, candida, etc.), balance their hormones (e.g. PCOS, peri-menopause, estrogen dominance, etc.), clear their acne or eczema, boost their energy and performance, combat anxiety and depression, improve their body composition, reduce their joint pain - and more.

Anya Rosen, MS, RD, LD, IFNCP, CPT

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