PMS Isn’t Normal: The Cycle Syncing Women Are Missing | Alisa Vitti

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In this episode, I’m joined by Alisa Vitti to talk about something women have been conditioned to normalize for far too long: PMS. We’ve turned it into a cultural joke, when it can actually be a sign of a very real hormone imbalance. Alisa explains research linking untreated PMS in your 20s, 30s, and 40s to a higher risk of major inflammatory diseases later in life, and why your cycle is now considered a “fifth vital sign.”

We also get into the difference between the circadian rhythm and the infradian rhythm, and why women’s monthly biology impacts far more than ovulation and menstruation. Alisa breaks down how this rhythm influences metabolism, immune function, brain health, and stress response - and how disrupting it can create downstream issues that many women are told to “push through.”

From there, we make it practical. We talk about the luteal phase, why blood sugar stability matters, and how nutrition needs shift across the month - including why many women feel worse when they fast or go too long between meals. We also discuss how men and women respond differently to fasting, and why “one-size-fits-all” health trends can backfire for cycling women.

Finally, we talk about exercise strategy and identity-level change. Alisa explains why high-intensity training after ovulation may work against your goals, and why she wants women to stop chasing quick outcomes and start thinking in terms of becoming a “hormone biohacker for life.”

A few of my favorite things we cover in this episode: 

• Why PMS is not “normal” and how untreated PMS is linked to long-term inflammatory disease risk
• The Biocycle Study and the claim that untreated PMS “doubles your risk” postmenopausally for heart disease, diabetes, cancer, and dementia
• Why the menstrual cycle is now considered a “fifth vital sign” (and what that changes clinically)
• Circadian clock vs infradian clock: how women’s 28-day rhythm impacts metabolism, immune health, brain function, and stress response
• A practical “partner playbook” for PMS support, including the luteal phase window and why blood sugar stability matters
• Luteal phase nutrition: “feed her every three hours,” slow carbs, higher protein and fat, and more fiber for estrogen clearance
• Fasting differences: why she supports fasting protocols for male physiology, but not extended fasting for cycling women
• Training across the cycle: strength training consistently, but modulating cardio and HIIT, especially after ovulation
• Post-ovulation workout reality: her claim that HIIT after ovulation can “turn on muscle wasting” and “turn on fat storage”
• “Hormone biohacker” identity shift: focusing on long-term self-trust and habits over quick goal-chasing
• Supplement basics she prioritizes: melatonin for women over 35 (3mg), omega-3s, and methylated folate (MTHFR)
• Her “real life” travel lunchbox and meal-prep examples (balanced macros, avoiding plastic transfer)

Products Mentioned:  

• In The Flo (book)
• WomanCode (book)
• MyFLO app 
• Flo Living 

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Happy listening and we hope you learned a little bit more on the art of being well!

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In Health,

Dr. Will Cole