The Ultimate Guide to Women’s Nutrition: Hormones, Exercise, PMOS & Endo with Dr Hazel Wallace

Key Takeaways

Fuel exercise adequately

Exercise increases the energy your body needs, so increase your intake when your training volume rises. Under-fuelling can affect performance, mood, gut and bone health, and menstrual cycles.

A change in training followed by irregular or missing periods is a notable warning sign, though regular periods are not a perfect measure of adequate fuelling. Include carbohydrates, protein, and healthy fats; carbohydrates are especially important for moderate- and high-intensity exercise. Check your iron, calcium, and vitamin D intake, particularly if you are active or do not eat dairy. If you use plant-based milk alternatives, check whether they are fortified.

Choose practical pre-workout food

About 30–60 minutes before exercise, try an easy-to-digest, carbohydrate-based snack, such as a banana, a crumpet with honey, dried fruit, or a small flapjack. With more time before a longer or harder session, you could have a bagel with jam, toast with peanut butter, or porridge.

Keep fat and fibre relatively low immediately before exercise if they upset your stomach; include them later in the day. Fast-acting carbohydrates, such as a white bagel with jam, can be useful before or during a run. Food choices depend on context, not simply on whether a food is processed.

Be “cycle aware,” not bound by rigid plans

Cycle-tracking apps or paper notes can help you learn your own patterns. Evidence for prescribing different workouts by cycle phase was described as limited and inconsistent. Adjust training if you personally feel worse at certain times, but exercise throughout your cycle if it suits you. Exercise may also help with PMS and painful periods.

Treat high-intensity exercise as an option, not a hormone threat

High-intensity exercise is not inherently harmful for women or people with PCOS/PMOS. The important considerations are overall training load, adequate food, sleep, and recovery. Rest days, walking, strength training, and lower-intensity activities can help create balance.

Approach cortisol claims cautiously

The “cortisol cocktail” has no supporting evidence, and cortisol is an essential hormone—not something that should simply be eliminated. If you feel stressed, consider the broader picture: regular meals, sleep, phone habits, work boundaries, exercise load, and recovery. Avoid interpreting random cortisol tests or relying on supplements without appropriate medical advice.

Improve iron intake and absorption

Iron sources include meat, poultry, and fish, as well as beans, legumes, leafy greens, figs, and apricots. Pair plant-based iron sources with vitamin C. Soaking and cooking grains may also help.

Tea, coffee, and matcha can reduce iron absorption, so have them away from iron-rich meals. Keep calcium supplements separate from iron supplements. For active people, avoid taking iron supplements immediately after exercise; iron absorption may be reduced shortly after intense activity.

Heavy periods should be investigated rather than simply managed with repeated supplements. If you feel unusually tired or your workouts are suffering, ask a clinician about checking your iron levels.

For PCOS/PMOS, focus on overall diet quality

Research does not establish that a very low-carbohydrate diet is superior to a moderate-carbohydrate one. Prioritize higher-fibre, lower-glycaemic carbohydrates—such as oats, beans, quinoa, and whole grains—and pair them with protein, fat, and vegetables to slow energy release.

A varied diet with colourful foods, nuts and seeds, herbs and spices, and oily fish can support overall diet quality. Avoid unnecessary food rules.

Consider supplements individually

The guest discussed myo-inositol, alone or combined with D-chiro-inositol, at 2–4 g daily. She commonly recommends 4 g, split between morning and evening, and suggested assessing whether it helps over about three months. Products may not contain the studied dose or formulation.

Vitamin D may be worth considering, particularly in the UK during the darker months. Omega-3 may be relevant depending on oily-fish intake. Other supplements should depend on a person’s diet and needs—for example, B12 for some vegans or folic acid when trying to conceive. Supplements are not regulated like medicines, so seek appropriate professional guidance.

For endometriosis, consider a Mediterranean-style eating pattern

A Mediterranean-style pattern may help with pain. It consists mostly of minimally processed foods, fruit and vegetables, oily fish, nuts and seeds, moderate amounts of dairy and poultry, and less red and processed meat. Consider checking vitamin D and iron when appropriate.

For bowel symptoms, IBS overlap, or suspected bowel-related endometriosis, a low-FODMAP approach may help some people, but specialist dietitian support is advisable.

Use budget-friendly staples

Frozen fruit and vegetables can be nutritious and convenient. Tinned beans, lentils, and other legumes are inexpensive sources of protein and fibre. Eggs are versatile, and nut butter can add healthy fats and enjoyment to meals.

Be cautious about GLP-1 use outside appropriate clinical care

GLP-1 medicines can be valuable for some people, including certain people with obesity or type 2 diabetes. However, unsupervised or inappropriate use may lead to low calorie and nutrient intake, possible effects on muscle and bone health, hair loss, nutrient deficiencies, and disordered-eating behaviours. Clinical counselling and follow-up are important.

Pay attention to your menstrual pattern

The guest’s closing advice was to treat the menstrual cycle as a “monthly report card”: learn what is normal for you so you can notice when something changes.

Sponsored skincare mention

The host described using La Roche-Posay Cicaplast Repair Balm for dry or irritated skin and scarring, noting that it contains panthenol (vitamin B5). This was presented as a sponsored recommendation.

Presenters and Sources

• Dr Faye Bate — host and interviewer.
• Dr Hazel Wallace — guest; doctor, registered associate nutritionist, and founder of The Food Medic.
• Unnamed speaker in a social-media clip — demonstrated seed cycling. Dr Wallace said there is not enough evidence to support the clip’s claims about balancing hormones or reducing heavy periods.