As women, hormonal fluctuations throughout our life cycles are natural and important for our health and well-being. Hormonal fluctuations that cause pain and illness, however, are not. A widespread misconception among women and traditional medical practitioners alike is that common “female problems” are simply to be endured as a normal part of being a woman. In extreme cases, symptoms are treated with pharmaceuticals—including hormones—but the underlying cause often is not addressed.
Hormonal Problems: the Bigger Picture
What practitioners often do not recognize or acknowledge is that these maladies are a manifestation of a cascade of hormonal imbalances—they don’t just stem from the sex hormones estrogen and progesterone. Most traditional healthcare practitioners don’t look beyond the female sex hormones to identify the root cause, but these hormones tell only part of our stories—and not necessarily the most important part. Other hormones involved in this story include epinephrine, norepinephrine, insulin, cortisol, ghrelin, leptin, and neurotransmitters, just to name a few.
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Getting our hormones into balance is not difficult to achieve, nor does it always require pharmaceutical intervention.
The Most Common Hormonal Conditions
Premenstrual Syndrome (PMS): PMS can begin well before a woman starts her first menstrual cycle. Symptoms can ebb and flow throughout her years of menstruation. Common symptoms include headaches, nausea, moodiness, weight gain, bloating, irritability, lethargy, fatigue, and food cravings.
Dysmenorrhea: This is when pain—a deep ache, cramps, or sometimes acute pain—occurs at ovulation, shortly before, or at the onset of a menstrual period.
Polycystic Ovarian Syndrome (PCOS): This endocrine disorder is characterized by irregular periods, lack of periods (amenorrhea), infertility, acne, excess hair, obesity, and high cholesterol. The key features concern hormone levels, especially insulin, testosterone, estrogen, and progesterone. In fact, compelling research links PCOS with insulin resistance, something that will be addressed in more detail later in this article. The good news is that this is easy to treat.
Difficult Perimenopause: This is the female body’s natural transition out of childbearing age: it is often associated with symptoms of hormonal imbalance like fatigue, moodiness, hot flashes, foggy thinking, loss of sensuality, anxiety, night sweats, and weight gain (especially around the waist and hips).
The most important fact in all of this is that these are not problems to be endured or treated. No matter your age or how long you’ve battled these issues, this is not your lot in life. Effective and permanent relief is readily available, within reach, and in your control.
The word “hormone” comes from a Greek word meaning “messenger.” Each of the body’s dozens of hormones has a specific type of message to relay. Our hormones are intricately interrelated and interdependent, much like a symphony, so an imbalance of one causes a cascade effect on the others. Finding and maintaining a hormonal balance is in every woman’s reach. I’ll share some basic tips on how to do that.
Common Types and Causes of Hormonal Imbalance
Many lifestyle factors affect hormonal health, including diet, stress, exercise, and sleep. Environmental toxins like noise pollution and toxic ingredients in everyday products like cosmetics also affect hormonal health. But the main drivers of hormone imbalance are food and stress.
A key hormonal cascade—or downward spiral—begins with cortisol, the stress hormone that’s produced in your adrenal glands. The cascade begins when your adrenals produce either too much or too little cortisol, affecting everything from emotions to hunger and energy levels. Ensuring proper adrenal function is critical.
When cortisol levels remain elevated for prolonged periods of time, the effects are detrimental. This state of being can lead to serious problems including thyroid dysregulation, hormonal havoc, blood sugar dysregulation, and suppression of the immune system.
Cortisol and Insulin: a Devastating 1-2 Punch
Another cascade is triggered by insulin imbalance. Insulin is a hormone produced to help regulate blood sugar whenever a carbohydrate is consumed. In the short term, insulin imbalance affects how you feel physically and emotionally. The initial blood sugar surge affects dopamine, our “feel good hormones” in the brain. But, because carbohydrates are so easily broken down, the blood glucose level ultimately drops. In fact, craving sweets or starchy foods is a symptom of hormonal imbalance.
Due to the hormonal cascade, imbalanced insulin levels affect other hormones, including cortisol. When our blood glucose levels drop, cortisol kicks in, trying to compensate for the dip in energy level. It’s not uncommon for women to ride this carb-induced hormonal roller coaster every day.
Sustained high levels of insulin can lead to more serious problems, including insulin resistance. That occurs when the body’s insulin receptors start to shut down in order to protect it from glucose overload. Insulin resistance is the precursor to diabetes and is also implicated in depression and even heart disease.
A combination of consistent imbalance of both of these hormones—cortisol and insulin—is metabolic syndrome. While it affects either gender, it is far more common in women. Its most obvious outward indicator is fat stored in the mid-section: the apple shape. Metabolic syndrome is marked by insulin resistance, increased stress hormones, and high cholesterol levels. It leads to conditions such as diabetes and heart disease.
Food: Information for the Body
For better or worse, when it comes to hormonal health or imbalance, food is an absolute game-changer. Food is information to the body and is what helps or hinders its ability to keep its hormones in balance. Eating for hormonal health isn’t difficult to do once you have the knowledge—and it’s as much about what to eat as what not to eat.
Eat more often. Eat real food with as much color as possible. This helps maintain consistent blood sugar levels, which in turn leads to appropriate and consistent hormone levels.
Include protein at every meal. Protein is a key component for so many hormones. Among many other functions, protein helps maintain a constant blood glucose level.
Eat more variety. The more colorful, the better. At least half of your plate at every meal should consist of colorful vegetables.
Include cruciferous vegetables, such as broccoli and cauliflower. They are among the foods and nutrients that help encourage your body to send estrogen metabolites down the pathway that helps prevent female cancers.
Add healthy fats. Sources of healthy fats include flaxseeds, chia seeds, almonds, and avocado. Fat is a key component to the production of sex hormones and brain hormones.
Beware of undiagnosed food sensitivities. Many more people are realizing later in life that they may have sensitivities to foods like gluten, dairy, and others.
Limit carbohydrate intake as much as possible. This has a powerful and rapidly noticeable effect on health and well-being.
At the right levels and for short periods of time, stress hormones can be helpful to increase concentration and productivity. Unfortunately, too many of us are just too stressed. Increased levels of stress hormones cause a cascade of hormonal dysregulation, including interruption of thyroid hormone conversion from T4 to T3, blood sugar dysregulation, and suppressed immune function.
Stress comes in different forms. There are physical stressors like inadequate sleep or chronic illness and there are emotional stressors, like the pressure of a work deadline or being late. Though these are different kinds of stress, they have the same impact on the body.
There also can be issues of historical stress. This is stress from our life’s personal stories: experiences that we naturally bring into adulthood. They are conditioned stress responses we learned as kids and may not even realize are connected to our past. So how can you address stress to achieve and maintain hormonal health?
The first step is to eliminate stress wherever possible. It’s common for us women to have “overcommitment syndrome” that comes from not being able to say no. Next time someone asks you to chair that committee, think about whether or not your plate is already full.
When you can’t eliminate stress, manage it. Take a look at your personal story—it might mean that your body produces cortisol more readily. You might consider using therapy to help work through something especially tough. You may find you don’t have to make structural changes to your life, just to how you automatically respond.
Exercise is also invaluable in the stress-reduction process—it releases hormones that improve mood and counteract stress hormones. It also helps boost the production of sex hormones that in turn increase libido. Find something you love to do so that the very notion of “having to exercise” doesn’t cause stress.
Lastly, transition out of toxic relationships or, if that is not possible, work to manage them. Toxic relationships are the relationships you have with the people around you who drain your energy.
Change won’t happen overnight
No one ever found themselves in a state of hormonal imbalance overnight. So, while you may find a difference in how you feel pretty quickly, it can take some time to return to perfect hormonal balance. Also, these tips may represent a drastic shift in your lifestyle. Do what you can, and perhaps start with what’s easiest for you. Trying to do it all at once can set you up for failure. The most important thing to remember is to shoot for progress, not perfection.
By Marcelle Pick, OB/GYN, NP