“Irregular menstruation is not a problem of female hormone. It is very likely a insulin problem.”
– Dr. Andrea Salcedo
In a landmark conversation hosted by Tamzyn Murphy of the Nutrition Network, Board Gynecologist Dr. Andrea Salcedo revealed why we may need to fully review our approach to uterine bleeding abnormality (Aub), fibroids and even menopause.
Her new study, The uterus as a final organ: a preliminary study of insulin resistance and abnormal uterine bleedingpublished in the magazine MenopauseIt is a bold call to shift the example from hormones to metabolism.
And the consequences – for patients, clinicians and the future of women’s health – are deep.
The uterus as a metabolic final instrument: a new frame
What does it mean to call the “final instrument” uterus?
In medicine, the final organs are the final receivers of damage from systemic diseases – such as kidneys in diabetes or heart in hypertension. Dr. Salcedo argues that the uterus is worth the same classification, especially in the context of metabolic dysfunction.
“The uterus is made of smooth muscle cells, the same cells found in the blood vessels,” he explained. “It is essentially a large vascular organ – so when it hits inflammation, it suffers exactly as the heart or kidneys do.”
This inflammation, he says, can be driven by chronic hyperinsulinemia that develop with insulin due to insulin resistance, often years before blood sugar levels are still abnormal.
This understanding redefines common gynecological conditions – such as heavy periods, fibroids and irregular circles – not as isolated hormone problems, but as manifestations of deeper metabolic problems.
Heavy periods are not “normal”
One of the biggest waking calls from live was how normal abnormal bleeding has been done.
“A normal period is 3 to 5 days long and should only include 30 to 60 milliliters of blood,” Dr. Salcedo said. “This is about two shooting glasses. If you change a pillow every hour or bleed more than five days – you are not only unlucky, you show signs of possible metabolic discomfort.”
The problem? Most women – and many clinicians – do not recognize these symptoms as pathologically. They are rejected as “only part of being a woman”.
But Dr. Salcedo warns that when Aub is smoothed, it ignores a red flag for systematic illness.
Insulin Resistance: The missing link
Dr. Salcedo compared women with Aub to those with normal menstrual cycles. The results?
- Women with Aub had significantly higher levels of fasting insulin
- A fasting insulin over 10 miu/l was associated with three times higher risk Aub
- Even Women “normal weight” With Aub showed signs of metabolic dysfunction
And here is the kicker: when it is regulated for obesity, the insulin-aub link was weakened but did not disappear.
“Obesity and insulin resistance are cooperating-corrupted,” he explained. “We also see this in lean women, especially those with PCOS or high stress and bad sleep. Their insulin levels may not be higher, but their bodies continue to show signs of metabolic inflammation.”
Because your period is your vital sign
Tamzyn put it perfectly during the interview: “Your menstrual cycle can just be the most overwhelming vital sign in women’s health.”
Dr. Salcedo agreed.
“I can learn so much from only two questions,” he said. “Is your cycle regular and heavy? Can normal reflects ovulation – and so insulin function.” Gravity reflects inflammation.
This makes it clear: a woman’s circle is not only reproductive – it is metabolic.
Metabolic Chaos in Menopause and Waiting Disease
While much of the focus was in women of childbearing age, Dr. Salcedo stressed it Metabolic agents play a huge role during the await and menopausealso.
“If you go through menopause with severe hot flashes, mood swings or sleep problems – these are not just estrogen problems. They are often signs of underlying inflammation and insulin resistance,” he said.
Obesity, especially visceral fat, aggravates vasomotor symptoms producing estrogen -like compounds and inflammatory cytokines. This explains why women with higher grease often have more severe symptoms of menopause.
The contraceptive mask: hidden health risks
What about women in the pill?
The combined hormonal contraceptives regulate the bleeding pattern – but not the underlying cycle.
“Bleeding in the pill is not a real period,” Dr. Salcedo said. “It’s a withdrawal bleeding from lack of hormones in the last week. You can’t use it to evaluate metabolic health.”
In other words, hormonal contraceptives may provide relief – but they can also cover warning signs of dysfunction, delaying appropriate research and intervention.
Strategies to manage AUB and Menopause Symptoms
The approach of Dr. Salcedo is not anti-pharmaceutical treatment. It is a full -hub gynecologist who performs surgery, prescribes medicines and supports nutritional intervention. But it is clear: Metabolic health comes first.
Its practical strategy includes:
1. Reduction of carbohydrates to reduce insulin
“The therapeutic restriction of carbohydrates is often the first and most effective step,” he explained. “Reduces insulin, reduces inflammation and supports weight loss – especially around the abdomen.”
2. Sleep and anxiety optimization
“I always ask, ‘Do you like your husband? »Laugh. “Because stress is important. Cortisol leads insulin, which leads to inflammation.”
3. Insulin test, not just glucose
Constitutes fasting insulin As a critical workshop for patients with Aub or PCOS suspicions – even if blood sugar is normal. This can signal malfunction long before increasing HBA1C.
4. Using continuous glucose screens (CGMS)
For data-based patients, CGMS or pastry can strengthen tools to learn how foods affect glucose-and indirectly, insulin.
5. Lifting weights for muscle construction
“The muscle is a glucose sink,” he said. “It is an endocrine organ in itself.
6. Nutrition support
It also uses dense nutrients, omega-3s, liver oil and vitamin D as part of a holistic anti-inflammatory protocol.
Menstrual cycle as a red flag for metabolic dysfunction
If there is a message to remove, this is:
“The irregular, heavy or painful periods should not be ignored. They are not only hormonal problems. It is often the first visible sign of metabolic dysfunction – year before prediabetes or cardiovascular disease.”
This is the application of the real life of what the nutrition network teaches through the medical certification route and the training of women’s health.
Join the movement for revolution in women’s metabolic health
Dr. Andrea Salcedo is not just a gynecologist-he is a leader in a growing field of metabolically informed health care of women. Her work reflects a strong integration of conventional gynecology with therapeutic nutrition and metabolic knowledge.
He is also a proud graduate of Nutrition Network Medical Certification RouteA comprehensive vocational training for clinical doctors ready to transform how they approach insulin resistance, chronic illness and women’s health.
Do you want to practice like Dr. Salcedo?
Start your journey with Nutrition Netrition Medical Certification Trail and do not miss out on women’s health training for more innovative evidence -based content.
It’s time to stop rejecting women’s symptoms – and start decoding them. Because your period is more than a circle.
It’s a message.
