The Hour is Blue

From the Archive: Dr. Jerilynn Prior on Perimenopause

This interview was recorded in 2021, during the COVID-19 pandemic, and originally broadcast on The Blue Hour on CiTR 101.9 FM at the University of British Columbia in Vancouver, Canada.

Dr. Jerilynn Prior is a professor of endocrinology and metabolism at the University of British Columbia and the founder and scientific director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR).

After meeting local Whistler writer Heather Hendrie, whose forthcoming memoir, Where the Eff Is My Red Tent?, touches on many of these same questions around women's bodies and health, I returned to this interview to transcribe it in full.

Listen: CiTR | Apple Podcasts | Spotify | YouTube

The Blue Hour, hosted by Farha Guerrero, airs live every Tuesday at 2 p.m. on CiTR 101.9 FM at the University of British Columbia in Vancouver, Canada and at citr.ca.

Transcript

Transcript lightly edited for clarity while preserving the natural rhythm of the conversation.

Jerilynn: Early on, in fact, there were very, very few women role models. There weren't any in my first two years of medical school. I did not know what it was like to be a woman and a physician.

We were weirdos. There were six in a class of 88. My anatomy partner, on the first day, when we were standing over our cadaver, sort of attacked me.

"How did you get into medical school? My buddy didn't, and he's a father of a family."

It really floored me. Finally I said, "Well, I don't know, but I must have been better."

It's really simple. Trying to understand women's experiences related to the menstrual cycle, related to how reproduction interacts with the rest of their lives.

The most important thing I think I've done is to introduce the idea of looking at the physiology of the menstrual cycle and recognizing that ovulation is highly variable. It's physiologically responsive to a woman's emotional, social, physical, nutritional environment. It's amazing.

Women need scientific and not pat answers. Women need to be effectively treated, which they're not currently.

So it's been hard, really hard. I've only begun a process of a long line of research that needs to be completed in order to enhance women's health.

Farha: Welcome to The Blue Hour. I'm Farha Guerrero. Tonight I speak with Jerilynn Prior.

She's a professor of endocrinology and metabolism at the University of British Columbia, working on women's health. She studies menstrual cycles, the effects of ovulation, and its later-life disturbances. She is the scientific director and founder of the Centre for Menstrual Cycle and Ovulation Research.

The centre publishes scientific results and disseminates information directly to women.

But first, let's start the night with a song that she has chosen for us, "Pie Jesu" from Lloyd Webber's Requiem.

[Music: "Pie Jesu"]

Farha: Jerilynn, good evening. We just listened to "Pie Jesu," a duet sung by Sarah Brightman and the young Paul Miles-Kingston. Tell us about how this song sums up, in some way, what you believe and how you want to live your life.

Jerilynn: I sang that with the Vancouver Bach Choir many, many years ago and always loved it. It was just uplifting. Later, my daughter and I sang the duets.

So it expresses a profound sense I have of being part of creation, actually. That every day is important.

Farha: And you grew up with many musical people in your household.

Jerilynn: My father had a lovely tenor voice, not very well trained. In fact, my mom and dad met because he was in the Boys Glee Club in his high school and she was the pianist. She was very young, only 15 when she graduated from high school. Later they found themselves through a church.

As I was growing up, Dad was studying, both in undergrad and then divinity school, to become a minister. So I grew up with hymns and mostly religious music.

As entertainment, we had, I still have, actually, an organ, a collapsing organ that's a pump organ. You push up and down with your feet to make the bellows work.

Again, it's not the finest instrument, but it had been part of a missionary operation in China. We had it when Dad was in training and we would sit around the organ. Mom would play and we would sing as a family.

Farha: And you are still singing with the Vancouver Bach Choir, is that right?

Jerilynn: When COVID isn't happening.

I haven't been so good with Zoom rehearsals. It's just a bit much to be on Zoom a lot of the day doing my work and then have to do a Zoom thing at night.

I haven't been very good at it, but I'm really missing it. Singing has been part of my life, and the Vancouver Bach Choir has been part of my life since 1978, when I first joined.

Farha: There's also an interesting story connected to the song we just heard. Some time ago, you were interviewed early in the morning on CBC Morningside. Tell us about that.

Jerilynn: Peter Gzowski was interviewing me because I, as a conscientious objector to taxes that go to promote or defend, or whatever, to make war, had ended up being the sort of test case that went through the court system.

So I was being interviewed by Peter, and he was not pleased with me. "Why would you do a thing like that?" kind of thing.

He had just played that "Pie Jesu," and so I was sitting there in the soundproof booth and crying. It was so touching.

Then I said, "It's part of my most fundamental belief that it's wrong to kill other people, no matter how you justify it."

Farha: That's an amazing story, how music can connect with our own personal beliefs.

Let's come back to your childhood a little bit. You grew up in Alaska. Tell us about that.

Jerilynn: It looks romantic going backward, but it was hard.

We lived in basically a tar-paper shack heated with an oil stove in the kitchen. We had a one-room grade school. The wind would blow through and the linoleum would lift up off the floor. The kids that were farthest from the single oil stove were freezing, and the ones that were close were burning.

But there was a real sense of working together. If someone had been duck hunting and brought home ducks, they would share with people in the village. Or we would go out on somebody's fishing boat and hike up into a mountain and berry-pick in the fall.

So there was a collective, "We're all in this together," kind of feeling.

Surprisingly, the one-room grade school had Territory of Alaska curriculum. I was able not only to do my grade-level work, but also help some of the younger kids. So it became a kind of review, as well as some leadership training, I guess.

It's quite amazing that I went from that kind of a primitive background.

I had to go away from home to go to high school. I had to live with basically strangers in order to attend high school.

In fact, I almost missed my SATs, or whatever test you had to have for university applications, because I'd gone home for the weekend and I was storm-bound there.

Eventually I got a ride in at midnight on a bigger boat. Even so, it was very, very dicey. The waves were splashing over and freezing on the deck and mast and everything.

Then I couldn't contact the people I was staying with, so I ended up sleeping in the church. I had a way to get in because I was a janitor there, my part-time job. I slept in a pew in the church, then got up and went to take my exam the next day.

There were rough bits about it, but I think it made me resilient. It made me realize that I've been in really rough places before.

So when things get really rough, as they often do in medicine and in science, you say, "What can I do? I've been in tough places before."

Farha: And just as we heard from the start, you were one of the few women in medicine at the time.

Jerilynn: That's right. There were six women in my class of '81.

We were, I have to say, all very strange people. We were treated very, very differently by both men professors and by our classmates. So it wasn't pleasant at all. It was very difficult.

Again, I was poor and alone. I survived on 25 cents a day for food that year by buying powdered skim milk in bulk, flour in bulk, making sourdough bread.

Farha: Now, it was in Alaska that you were first exposed to, or at least you started thinking about, working in health. Tell us that story.

Jerilynn: This little village had no health care. In fact, none of the villages did when I was growing up.

My mom, being a practical person, ended up doing first-aid stuff for lots of people.

But there was a not very big boat called the Hygiene that came across from the Alaska Peninsula across Shelikof Strait, which has some of the most stormy waters in the world. Huge tide differences, and that whole area is between the Bering Straits and the Japanese Current, so it's a very stormy place, Kodiak Island.

They'd all been really, really seasick. This nurse, they were charged with giving the whole village their basic DPT shots.

So we didn't hold school, and the little one-room schoolhouse became the place where everybody went to get their vaccinations.

Some of us, I think everybody in the school, got lice in their hair. I remember the public health nurse giving my head a wash with kerosene and vinegar. It was enough to kill me, much less the lice.

I thought that was pretty cool. I set about to become a nurse, in fact, got a scholarship in nursing, the National Science Foundation Scholarship in Nursing, eventually when I went to university.

Then partway through, I did some sort of a test and they told me I shouldn't be a nurse. Basically, I asked too many questions.

So then I had to retool and decide I was going to go into medicine. But that was by no means a sure thing back in the late '50s, early '60s.

I did a double major in English literature, thinking that I could probably become an academic, teach literature or something, as a fail-safe.

I only got in after nine tries. But I'm so glad I did.

Farha: Now tell us, Jerilynn Prior, how you got into studying women's health.

Jerilynn: That's an interesting one.

When I first went away to university, it was a huge change from the small town, 3,000 people in the biggest place I'd been for a long time, to the campus that maybe had 5,000 people on it in a small city.

But the worst thing is I was locked into a dormitory. They were trying to protect the women in those days. So they locked the door literally at 10 o'clock, and there were alarms on the door so you couldn't leave.

That was awful.

I didn't get my period that whole school year. I knew I was well fed. I knew I was healthy. And I knew I wasn't pregnant.

So I never told anybody.

My period came back when I went back to Alaska and worked in the summer.

Later, when I was engaged in my second year of medical school, I, like a good girl, went to Planned Parenthood and got the flavor-of-the-month samples that they had and started taking them.

I just blew up like a balloon, migraine headache, changed my personality, and I lasted five days.

So the combination of those two experiences myself, I coped with and got on with my life.

But when I got to Vancouver, it was the era of aerobics, and women were increasingly saying, "If men can run long-distance races, why can't we? What is it that makes us unable to run marathons?"

As soon as women started doing the longer races, some of them would lose their periods or some of them would have abnormal cycles, and these were all being blamed on the exercise.

My hunch was that it was prejudice. The view of the time was that women should be soft and sit on the couch and look pretty, rather than that they could be physically strong just like men.

So when I wanted to be an academic in endocrinology, I already had internal medicine and some of my endocrinology training, and I realized I needed a specialty.

There were plenty of diabetic specialists, and thyroid and pituitary already.

That was something that interested me. I was committed to figuring out if exercise was bad for people or not.

It turns out it isn't.

Women can do it. They need to, just like anyone does, gradually develop both their lungs and their legs and their heart, but also their reproductive system, to adapt to the new exercise.

Farha: It's really quite fascinating to think your curiosity about women's health and menstrual cycles, and and we're going to talk about this incredibly complex system, the women's reproductive system, was also a fascination with your own body and what was going on with yourself.

Understanding your own reproductive cycles and how they reacted to, say, the birth control that you experimented with.

It's a really interesting story, I think, to add to all the things that you did later and what you're still doing.

Jerilynn: I think so. But I wouldn't have been able to tell you at the beginning.

It took me a while to twig that those things were connected, which is interesting.

Farha: Would you say that is because a lot of us, myself included, women, we might not necessarily be attuned to our own bodies?

Even today, in 2021, we might know when our cycle begins, when it ends, but not everyone might actually understand all of the things that happen in between.

Farha: What is the reason for that, do you think?

Jerilynn: I don't know.

It's a peculiarity of our culture, I think, that somehow we, as women, feel that the period and things are yucky, that they're not mentionable.

We mustn't talk about them. And if we do, it should be in a whisper with our closest friends.

We end up being really disconnected from our bodies.

I think that's the biggest thing that I've learned, that there is such a tight connection between how we feel about ourselves and whether or not our reproductive system is perfectly normal.

It doesn't take very much disturbance, especially when we're younger, to upset our menstrual cycle.

Farha: One of the things that you've always advocated for is for women to keep track of their cycles, but quite in a detailed way.

It's more than what you might even find on an app these days. It's actually recording symptoms and feelings and emotions and even how we might feel sexually in the month, essentially trying to capture everything.

So let's listen to a little bit from the archive. A little blast from the past.

It's you speaking to four women, and you're basically telling them to keep track of their daily symptoms.

Let's hear some of the questions that they have for you and your answers. The title is The Puzzle of Perimenopause.

From the Archive: The Puzzle of Perimenopause

Jerilynn: Thanks for coming today. It's a chance to go over whatever you've learned already from doing the diary and answer any questions you may have.

Woman: I have a question. When you fill in the daily diary, should I compare myself to others or just to my own symptoms?

Jerilynn: That's a good question. You're the boss. You're the only one who knows how you feel.

So don't try to figure out how your neighbor feels or how some other woman might feel this. Do it for yourself.

Woman: I was just given the diary today. It's the 15th of the month. Should I put my responses down under number one in the diary or under number 15?

Jerilynn: You did it correctly. This is a calendar month here. So starting with today, the 15th is the correct thing to do.

Woman: I was wondering if it's necessary to do these every day. For example, check your breasts for tenderness.

Jerilynn: I think it's important that you go through each item each evening and fill it in with something. Then I know that you've at least checked in with yourself about it.

Sometimes you may think you have no breast tenderness, but if you touch yourself, it's a little bit sore.

So I think it's important to do that. It doesn't actually take much longer.

Woman: I've had a hysterectomy. Is this form really for me?

Jerilynn: Very definitely the form is for you.

You can ignore the line about flow, draw lines through it, whatever you want. But often having had a hysterectomy makes it more difficult for you to get in touch with the hormonal changes that you still may be experiencing, or even the feelings that you may have.

Woman: If I forget to fill out the diary for a few days, shall I try to go back with memory and fill it out?

Jerilynn: No. Just leave those days blank and start with the next day. That's fine.

Woman: I'm a single person and sex isn't really a big issue in my life, so I'm wondering how to answer the question, "interest in sex," on this form.

Jerilynn: That's a good question. A lot of women aren't very comfortable thinking of themselves as a sexual person.

The question is intended to ask how you feel about your body, about yourself as a sexual person, not whether you have an available partner.

So fill it in as best you can. And if that means you can get in touch with some sexual feelings you wouldn't otherwise get in touch with, that's good too.

There's some real serendipity there because just this very day we got the notification that a description of the interest-in-sex item on the diary in healthy premenopausal women has been published.

Most of the world, at least those who are sex experts, believe that women get sexy around the middle of the month, when estrogen levels peak and to some degree androgen levels also peak.

What we found on the diary was that there was absolutely no difference from usual on any particular day of a normal menstrual cycle.

When we looked further and put all of the variables in the diary, feelings and everything, we found that interest in sex for women fitted into the same bin as feeling of self-worth and feeling of energy.

I think that is amazing and important information.

Farha: Wow. And that just came out?

Jerilynn: Yes. In fact, it took us 10 years to get that published.

Farha: How did it feel to hear yourself in the past? Do you feel you're saying very similar things today?

Jerilynn: Absolutely.

I think because as we learn to integrate our bodies and our minds and spirit and the rest of us, we become much more confident individuals.

This disconnect between especially our sexuality and our bodies, and our mind and what we think and what we do, is really typical of women.

It makes us more likely to behave in an inferior-status way in the culture.

Farha: I guess it's empowering to know how everything connects for you, for me.

Tell us about a concept in a recent paper that you published, where you talk about women's reproductive system as a complex system that you state is multidimensional, interactive, dynamic, nonlinear and balanced, with all kinds of different feedback loops.

What do you mean by that?

Jerilynn: I mean that it's essential for a lot of layers of control to be coordinated before we end up with an approximately month-long cycle in which we've released an egg, with enough time between ovulation and the next period for an egg, if it's fertilized, to implant and begin the process of pregnancy.

That's not a new idea, that everything needs to be working emotionally, physically, nutritionally, socioculturally for reproduction to work.

What's really new is the idea that the two hormones, estrogen and progesterone, need to be in balance because our culture has typically focused primarily on estrogen.

In fact, a physician wrote in a Kelowna newspaper years ago, "Estrogen is what makes a girl a girl," if you can believe it.

He was trying to get women to take hormone, we then called it replacement therapy, which is totally erroneous.

But estrogen is only one part of a two-hormone system.

It turns out that the body is very, very careful and protective because estrogen is a powerful growth stimulator.

But you need progesterone to control that proliferation of cells, and progesterone to help cells become mature and specialized.

That is true for every cell in the body.

So what I've learned, basically, in my 40 years of research is that stressors, even worrying that what you're going to eat is going to make you fat, or something minor, like your boss being on your case all the time, is potentially enough to disturb ovulation.

If ovulation is disturbed and you don't make enough progesterone to balance estrogen, you end up at risk for osteoporosis.

You also end up at increased risk for heart attacks, breast cancer and endometrial cancers.

In other words, what happens in our menstruating years matters for the health of ourselves for the rest of our lives.

Farha: One of the things you also advocate for is that we urgently need a convenient, home, one-cycle, inexpensive test of normal ovulation.

Jerilynn: Yes. Something that a woman could easily do for herself, that doesn't cost a lot, that's reliable.

Currently we don't have that.

Women who are wanting to get pregnant will use the home LH test. But LH is only one of the signals in the cycle.

About 20 percent of the time we don't time it exactly right and get that peak so we know when to have sex to try to get pregnant.

And it's a pain in the neck, that testing.

So I envision something that women could do during the flow of their next cycle that would say whether or not the previous cycle was ovulatory, and ideally was normally ovulatory with enough time and duration of progesterone.

Farha: That would allow women, in a way, to have more autonomy over their own bodies and understanding what is actually going on month by month. Is that right?

Jerilynn: Exactly.

If she found that she wasn't ovulating normally, she can then say to herself, "Am I eating okay? Is my weight steady? Are my relationships with people around me stressful? What is it that's bothering me that is interrupting this normal process?"

I think one of its major purposes, this normal ovulation test that's so far a dream of mine, is that a woman could use it when she's pushing 30 and trying to decide whether to take a promotion or something that advances her vocation in life, or to take time to have children.

Because often women are feeling young and healthy and having regular periods and busy in their lives. Then they say, "Now's the time to have children."

Sometimes by that time, it's difficult for them to become pregnant.

Farha: Would it also help women understand the kind of symptoms that they experience week by week or day by day with their monthly cycles?

Jerilynn: It might, but the concept that the menstrual cycle gives symptoms, and that word is often used for things that are medically disturbing, is basically a cultural misunderstanding.

Most women don't have problematic experiences during their menstrual cycle.

The mood, fluid retention, bloating, breast tenderness, strange appetite, all those things that are ascribed to the cycle are really complexly related to lots of things in their life, and not so tightly related to the hormone changes in a normal cycle.

Farha: I see. So how can women be more attuned to, as you said, the things that are outside the cycle and also what's happening in the cycle?

Because in the end, it needs to be harmonious for a woman to understand.

Jerilynn: I think that's why I actually made the diary in the '80s, when PMS was all the rage.

Basically all of these tools that are used to diagnose PMS make a disease out of the menstrual cycle.

I wanted to understand normal everyday experiences and feelings.

Interest in sex is one, but ordinary things like constipation and headache and sleep and feeling stressed in your everyday life, as well as feelings of self-worth and feeling of energy, positive feelings, not just negative.

Because they really do help you figure out what's going on for yourself.

Farha: So I think there have to be some changes to the vocabulary that we use, even when we're talking about reproduction and menstrual cycles.

Jerilynn: We have to stop seeing the period, in other words the flow, as all that matters, and think of it as a very clever way for the whole system to potentially prepare us for pregnancy, but also to allow us to adapt to stressors.

Because there's no way that it's good for somebody to become pregnant when there's a food shortage, when there's a war or a famine or something horrifying happening in their environment.

So this is a fail-safe process that is carefully worked out over millions of years of animals and now humans.

Farha: And what else needs to change in our understanding?

Jerilynn: I don't know, but I think that women are now asking the questions that need to be asked.

They're asking for the information that needs to be obtained.

There's been a very big confusion of perimenopause, which is a transitional time, often years long, but still a transition between regular cycles that are potentially fertile and the changing hormone levels until menopause, when rightly and correctly both estrogen and progesterone are low.

So the perimenopausal time is a very difficult time for women, often, and it's a time when that feedback system is out of kilter.

In fact, estrogen levels go much higher in the women who are very symptomatic than they were when those same women were having regular cycles.

But still, in common belief, perimenopause and menopause are put in one bin as estrogen deficiency, which is just not accurate.

Farha: Do you think that doctors, even family practitioners, are still maybe advocating too much about estrogen versus progesterone, as you mentioned earlier?

Jerilynn: Oh, yeah.

The birth control pill has, even our low-dose pills today, about four times higher than the natural level of estrogen.

The amount of progestin, a synthetic type of progesterone, is only close to physiological.

So there's an imbalance in estrogen in the very birth control pill which so many women rely on for contraception.

All of our therapies have been imbalanced toward favoring estrogen and minimizing the amount of progesterone, especially compared to the amount that the normal ovulatory cycle makes.

Farha: Micronized progesterone is what you advocate for. Can you tell us what that is?

Jerilynn: It just means that the natural hormone, the one that's similar to or the same as what our ovaries would make, isn't very well absorbed when you take it by mouth.

But if the chemists can break it into tiny, tiny segments and put it in oil, then it's absorbed sufficiently to do its physiologic job in the body.

The amount that matches what our ovaries make in the second half of a menstrual cycle after an egg is released is 300 milligrams at bedtime.

Farha: You founded the Centre for Menstrual Cycle and Ovulation Research, CEMCOR, at the University of British Columbia in 2002.

On your website, you have a huge amount of resources, a wealth of information, including, as you said, dosage.

If a woman is not able to get the information, say, from their family doctor, they can go to your website.

Jerilynn: Absolutely.

They can also use the Ask Us feature on the CEMCOR website and ask a question, and I will do my very best to personally answer.

Farha: Really?

Jerilynn: Really.

It needs to be a question they haven't been able to find the answer to on the website first.

Obviously, we keep trying to update, and as we learn new things, put the new things there.

But if it's not there, I'll do my best to answer.

Farha: I'd like you to take some time, if you have it with you, to read an excerpt from your novel that you wrote, The Estrogen Storm Season.

Jerilynn: It's a very peculiar thing for a doctor to write a novel, but I realized that women were having such a difficult time with perimenopause because those who were really symptomatic, there was really no accurate information they could find.

I had done the necessary research, studied the hormone changes, and I'd been seeing all these miserable women in my practice.

The word gets around when someone is focusing on something.

So basically, I made up a woman doctor, and I made up eight different women with different problems and issues.

They meet as a group for a sort of information session, and then each one comes to see that Dr. Madrona.

Let me read a little about Jennifer, who's a teacher of differently abled children, and her main problem is nausea.

She's hungry and she's nauseated at the same time.

So Jennifer asks:

"So you're saying that even if progesterone didn't help my nausea, I need it to be in balance with the extra estrogen my ovaries are making?"

Jennifer asks. I nod.

"Does taking progesterone suppress my own progesterone?" she asks.

"Probably, but perimenopausal changes and all of your life stresses already are suppressing your own progesterone production," I say, trying to explain complex things simply.

"Progesterone therapy just adds to your own levels to make them better able to offset the tissue effects of your high estrogen levels."

So that's one woman.

Another is Allison, who's from Newfoundland, a high school math teacher. Strange, I just found two that are teachers.

She's struggling with migraines, and migraines can be terribly difficult in perimenopause.

So Allison says:

"I still carry some pill like Imitrex, only it's new and experimental. I forgot the name. I avoid it if I can help it.

"I start with 50 milligrams of dimenhydrinate and a couple of ibuprofen.

"If that doesn't work, I call my friend and ask her to pick up the younger two boys after school and I go to bed with a bucket."

Except that the migraines have become more frequent.

"Has anything else changed in the last couple of years since they started?"

"I'm getting more stretchy mucus and at any old time in my cycle, and I'm gaining weight. Amazing that I can gain weight when I'm vomiting and I've eaten next to nothing. Whatever is making me gain is the fuel of the future."

That'll give you some idea.

Farha: Why was it important to write this novel?

Jerilynn: I was struggling with how to get information that I knew would be helpful to women themselves.

I'd already put it on the website. There were all kinds of things there. But I still wasn't reaching everybody.

I thought this might be a more intimate or personal or interesting way to do it.

So that was first published in 2005. We won Honorable Mention by the Independent Publishers Book Awards in the health area.

Then we reprinted it in 2007. In 2018, we did a second edition, updating it with more recent information.

The book, by the way, has a glossary that defines the medical terms that are used, as well as Dr. Madrona explaining them as she goes through.

It also has a list of references. So if someone's really a keener, they can look them up.

What we're doing now is we've translated it into Portuguese, and it's published in Brazil.

We've translated it into French, but it's not yet published. So we're working to publish that in the next year.

Farha: And all royalties go to CEMCOR. Is that correct?

Jerilynn: That's right.

So it helps to keep the centre, which is run by donations and entirely funded by donations, and not supported, other than my salary, by the University of British Columbia.

Farha: Part of your research is also about women's, and also men's, bone health.

You've done a lot of research about understanding our bone density and the kinds of things that can help us have healthy bones.

So let's listen to this. It's produced by your centre, by CEMCOR.

It's titled The ABCs of Osteoporosis Prevention for Premenopausal Women.

From the Archive: The ABCs of Osteoporosis Prevention for Premenopausal Women

Bones are complex and important parts of us. That is why maintaining and building bone is so important.

These brief ABCs will assist you in understanding the many everyday healthy habits that will support strong bones.

A is for active.

Being active doesn't mean being an athlete. It means regularly choosing to use the stairs and walk, such as parking further away from work.

Aim for half an hour of walking or something active every day.

B is for brawny.

This means having strong muscles. Don't confuse this with being thin like a model.

Healthy bones require a steady, normal weight, as bones are closely tied with your weight.

If weight loss is necessary, lose no more than half a pound a week with a healthy diet.

C is for calcium.

An essential part of bone and important for our metabolism in muscles and other tissues.

One thousand milligrams of elemental calcium a day is recommended.

Each glass of milk or three-quarter cup of yogurt gives approximately 300 milligrams of calcium. So make sure you get at least three to four, with one at bedtime.

D is for vitamin D, which is naturally in some foods and made from the sun's actions on our skin.

Vitamin D is needed to make calcium useful.

To ensure adequate vitamin D during the darker days of winter, it's wise to take vitamin D alone, up to 1,000 international units, or at least a multiple vitamin daily.

E is for easygoing.

When you're tense, worried or depressed, our bodies produce too much cortisol, a stress hormone that causes bone loss.

Daily relaxation is a helpful strategy for promoting optimal bone health.

F is for bone formation.

Regular, normal-length menstrual cycles mean we are making enough estrogen.

But we also need to ovulate and make progesterone to build new bone, to prevent bone loss and to be able to become pregnant.

Women with normal cycles who don't make progesterone are losing almost one percent of spine bone each year.

Ovulation disturbances usually relate to stress, abuse, weight loss or even worrying about becoming fat.

You can take progesterone in its natural form cyclically to build bone.

G and H are for good habits.

This means regular meals and sleep and drinking no colas regularly.

Cigarettes interfere with estrogen and cause bone loss, so smoking should be avoided.

Maintaining and building bone is about the whole meal deal.

We hope you take time to consider all of these factors in supporting a healthier you.

For more information, go to CEMCOR.ca.

Farha: So, Jerilynn Prior, there are important connections between women's social, emotional and physical environments, as well as nutrition and exercise, as we just heard.

Jerilynn: I think what's important to realize, and this was amazing from the Canadian Multicentre Osteoporosis Study, a population-based study, one centre is still going here in British Columbia, and at the time when it started in the mid-'90s, there were nine centres all the way to Newfoundland.

Basically, women who eat a more calorie-dense diet, or Western-type diet, versus women who eat a nutrient-dense or prudent diet, were having more fractures and lower bone density.

In other words, if you eat junk, it's hard on your bones.

That's quite amazing, that everyday eating behaviour has been shown now in a large population study to relate to healthy eating.

The odd French fries is okay, but the fruits and vegetables, it's amazing that there are lower fracture rates in those who do eat well.

Farha: I want to turn now to a woman that you greatly admire. Her name is Ursula Franklin.

She was a physicist, educator, feminist and social activist.

So let's listen to an interpretation of her speaking. This is produced by Canada's Heritage Minutes.

Ursula Franklin

Ursula Franklin

“The question of my own impact in my field is hard to answer.

I think that my most important contribution was, in fact, being there, my ongoing presence. The fact that young women knew where to find me, that I was ready to be consulted, and that my own career evolved clearly and openly.

I do not think that any single thing that I did was unique, but the trajectory of a consistent professional life gave a sense of reality and possibility to others.”

Farha: So, Jerilynn Prior, you, like Ursula Franklin, have a similar vision, I think.

Jerilynn: Ursula Franklin was a kind of a mentor for me in several ways.

In part as a scientist because of her very careful, critical approach to any kind of scientific question.

But also as somebody who succeeded in being hired in the engineering faculty at the University of Toronto in the '40s as a woman.

It's pretty impressive.

In her later life especially, she became known as a humanist, a feminist, someone who was willing to speak out when she saw a truth that was not being recognized in the culture.

I admired her for all of those things.

The world is full of mysteries. And that's fun because if you know how to collect information, then you can start trying to answer the questions that are still out there.

I also connect with Ursula. Both of us are members of the Quaker religious group, which meets in silence and which has as one of its primary principles that there is that of God in every person.

So she was fully supportive of my peace tax witness.

Acting on what you believe is a way of life.

Farha: You have been tuned into an episode of The Blue Hour on CiTR, the broadcasting voice of the University of British Columbia.

Run by the Student Radio Society of UBC, CiTR broadcasts over 100 locally focused radio programs in seven different languages, streamed online and available as podcasts.

My name is Farha Guerrero. I'm the volunteer host and producer of The Blue Hour.

My guest today was Jerilynn Prior. She's a woman who has begun a new morning ritual of listening to Beethoven's Violin Concerto.

You can learn more about her work through the Centre for Menstrual Cycle and Ovulation Research at CEMCOR.ca.

We're going to end today's show with another favorite song of hers. This one is an old Quaker tune entitled "How Can I Keep from Singing?"

Thank you for listening tonight.

[Music: "How Can I Keep from Singing?"]

Further reading