Is it just me, or do you feel as though you have spent half your life having a period but not really knowing what the heck is going on? It’s as though we are groomed to believe that talking about our menstrual cycle is taboo and unladylike. Our body sends us a handful of symptoms, and these symptoms are a report card for what is going on inside. Many of us have come to expect and accept obvious signs of hormonal imbalances as “normal” because we have not been taught otherwise. Rates of infertility, miscarriage, reproductive disorders (i.e. PCOS, endometriosis, etc.), adult-onset acne, and hormonal imbalances are higher than ever. All the while, the symptoms are bodies are screaming to us have fallen on deaf ears because they have probably been masked with some sort of pill that never really solves the problem.
I’ll admit, I never really understood (nor cared about) the complex orchestra that is the female hormonal cycle until taking a Fertility Awareness Method (FAM) class right before my husband and I got married. It was amazing how acknowledging and understanding signs and symptoms that my body naturally provided could either help me or prevent me from getting pregnant. In addition, identifying potential underlying issues based on irregularities in my menstrual cycle connected me deeply to my body and made me achieve a sense of belonging to an ancient sisterhood. I no longer feel like a foreigner in my own skin since learning how to read my body’s cues through the course of the month. It has been liberating and empowering to pinpoint and translate specific symptoms into practical solutions. Learning about my body and the natural processes it goes through has helped me, and several of my clients, work with their bodies to regain their woman-hood.
I respect that there is a time and place for birth control pills and that FAM is not for everyone, but I also strongly believe that as women, we should arm ourselves with knowledge about our own hormones and bodies to, at the very least, reduce our risk of reproductive disorders, infertility, and certain cancers. We all deserve the chance to make informed decisions about our care and not be funneled into the pharmaceutical treatment model right away.
During this series of blog posts, my goal is to provide you a tangible and easy to understand explanation of women’s hormones, the menstrual cycle, fertility awareness methods, reproductive disorders, and real-food strategies you can incorporate to better manage your health.
If you’ve ever thought to yourself:
- “When was the last time I had my period?”
- “Is this heavy cramping and bleeding normal”
- “Doesn’t everyone have to take a sick-day on the first day of their cycle?”
- “Why do I have acne now as an adult?”
- “Wait, I don’t need ovulation sticks to know I’m ovulating?”
- “What is with all this facial hair?”
- “Ugh, sex again? No thanks!”
…then this series is for you!
In Part 1, Women’s Hormones 101, I am going to introduce you to the stars of the female menstrual cycle: estrogen, progesterone, and testosterone. It is a beautiful symphony of hormones that all must be finely tuned and orchestrated, and when one is out of whack, the entire ensemble is affected.
First up, ESTROGEN:
Estrogen is what makes a woman a woman. It tells the body to develop breasts, widen hips, add mass to your booty, and make fertility possible. “Estrogen” is a broad term for hormones within the estrogen family (estradiol, estriol, estrone) that helps to build the uterine lining to prepare for pregnancy, keeps a woman’s body lubricated (think joints and vagina), and induces menstruation.
Estrogen has over 400 other functions in the body including:
- Regulation of body temperature
- Increases in metabolic rate
- Muscle maintenance
- Sleep quality
- Blood pressure regulation
- Provides smoothness and softness to skin (decreases pores and wrinkles)
- Increases sexual interest
- Helps with reasoning and creating new ideas
- Improves fine motor skills
- Manages blood sugar
Types of Estrogens Include:
- Estrone (E1)
- High levels of this are believed to increase risk of breast cancer
- During reproductive years, this is the least abundant type of estrogen
- The main estrogen the body makes post-menopausal
- Can be made into
- 2-OH-estrone (Protective)
- 16a-OH-estrone (Carcinogen & Active Estrogen)
- 4-OH-estrone (Carcinogen & Active Estrogen)
- Estradiol (E2)
- The most common estrogen made by women who are still cycling.
- Responsible for growth of the uterus, breasts, fallopian tubes, and vagina.
- Distributes fat in a “female” pattern over the body
- Can be made into:
- Estrone (E1) (See above)
- 2-OH-estradiol (Protective)
- 2-Methoxy-Estradiol (Reduces cancer cell growth)
- Estriol (E3)
- Much weaker than E2 and is less stimulatory
- Protective against breast cancer; blocks receptors keeping E1 (pro-cancer) out
- Main estrogen of pregnancy
- Can help control symptoms of menopause, including vaginal dryness
Symptoms of EXCESS Estrogen:
- Depression, anxiety, agitation
- Weight gain in abdomen, hips, thighs
- Heavy periods
- Short time between periods; decreased length of luteal phase (2nd half of cyle)
- Uterine fibroids
- Increased risk of breast cancer, autoimmune disorders
- Swollen Breasts
Symptoms of LOW Estrogen:
- Hot flashes, night sweats
- Vaginal dryness
- Decreased sexual interest
- Weird dreams
- Painful intercourse
Optimizing estrogen levels with real-food:
- Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, kale, etc.)
- Support proper liver detoxification
- Avoid “xeno-estrogens” (estrogens found in environment) and too many “phyto-estrogens” (estrogens found in plants)
- If you have low levels of E2 (good estrogen), consider adding flaxseed, fermented soy, and kudzu
Progesterone is the “checks and balances” to estrogen that is derived from a pre-hormone, “pregnenalone”. While estrogen is working to build up the lining of the uterus, progesterone steps in to make sure the lining doesn’t get too thick. Progesterone, or “pro-gestation”, is the hormone that remains elevated all during pregnancy. It is part of the mineral-corticoid family, meaning it affects salt and water ratios in the body. Progesterone balance with the other sex hormones, namely estrogen, is critical for menstrual regularity and reproduction. It is a delicate dance that can be easily and negatively influenced by outside factors. Progesterone is not only important as a gestational support, but it is required for keeping your body temperature up, helps your thyroid function optimally, and is a natural diuretic. It also enhances your sense of well-being, has a “calming” effect on the body, and helps you get better sleep.
Symptoms of Low Progesterone:
- Migraine headaches before cycle
- Weight gain
- Poor libido
- Overly sensitive
Stress is the #1 Cause of Low Progesterone
While the majority of circulating progesterone is produced by the ovaries, a large portion is also made in the adrenal glands. The adrenal glands walnut-sized glands that sit on our kidneys and are responsible for the secretion of stress hormones (cortisol, epinephrine, and norepinephrine). These stress hormones are very important as they give us the focus, energy, and “get-up-and-go” that we need to escape danger. Cortisol production in the body is a necessity as it is a survival mechanism. Cortisol and progesterone are alike in that they are both produced from the mother hormone pregnenalone. Pregnenalone is the mother of progesterone, and progesterone is a precursor hormone to cortisol.
Pregnenalone → Progesterone→ Cortisol (when stressed)
Under times of chronic stress, the body demands more and more cortisol production. Because progesterone is the pre-hormone to cortisol, the body utilizes that progesterone to continue making cortisol to meet the demand. Pregnenalone, or the mother hormone to progesterone, is also stolen away and bypasses making progesterone and goes straight into cortisol production. Not only does this deplete progesterone levels, when the body senses stress, it blocks progesterone receptors entirely. Progesterone and cortisol compete for the receptor sites, and cortisol usually wins. This is a protective mechanism in our body so that we do not become pregnant during a time that would be potentially dangerous for a baby.
When your is in “fight or flight” versus “rest, digest, and reproduce”, you will feel anxiousness, mood swings, poor stress adaptation, reacting irrationally to certain situations, fluid retention (as progesterone is a natural diuretic), breast tenderness, and possibly infertility.
Improving Progesterone Levels with Real-Food:
- Reduce caffeine consumption
- Vitamin C & vitamin C rich foods
- Stress management
- Decrease refined carbohydrates in diet
Testosterone is mostly known as the “male hormone”, but the truth is that females have testosterone floating around their bodies too! Testosterone in women is produced in the ovaries and adrenal glands and is responsible for peaking sexual interest. About half of a woman’s testosterone can be produced from other types of androgens (male hormones) like DHEA and androstenedione in the skin and fat tissues. Women peak their testosterone levels in their mid-20’s and gradually decline from there. Testosterone helps to maintain muscle mass, provide a sense of well-being, keeps skin from sagging, maintains bones, and maintains memory. Testosterone peaks right before ovulation which induces a higher urge for sexual intercourse, which if you haven’t caught on by now, is your instinctual signal to make a baby!
Three types of Androgens (“male” hormones):
- DHEA: A pre-hormone to testosterone as it can be converted into testosterone when needed. Much of your DHEA is made in the adrenal glands (think STRESS center of the body).
- Androstenedione: An intermediary steroid sex hormone that helps create testosterone and estrogen from cholesterol. This sneaky little thing has both estrogen and testosterone activity, which can confuse hormone receptor sites (“keyholes” on cells)
- Dihydrotestosterone (DHT): Very potent type of androgen. This is the main culprit behind male-pattern hair loss in women and men.
Some women have issues with their testosterone being too elevated in cases such as PCOS (polycystic ovarian syndrome). When this happens, a woman may experience:
- Lack of ovulation
- Irregular periods
- Male pattern facial hair; rogue hairs
- Male pattern baldness
- Weight gain; difficulty losing weight
- Sleep apnea
- Blood sugar dysregulation; insulin resistance; diabetes
- Voice deepening
- Clitoral enlargement
Causes of elevated testosterone:
- Genetics: Nearly half of all women with PCOS have a sibling who also suffers. The risk can be inherited from either mother or father.
- Chronic stress: When you’re really stressed, your adrenal glands makes a lot of stress hormone (cortisol) and can also make high levels of DHEA along with it.
- Excess body fat: This is a “chicken and egg” scenario. We know excess body fat can cause insulin resistance, which can in turn increase androgen levels in the body. Excess testosterone can be converted into estrogen in the body, and one of estrogen’s jobs is to create more body fat. More body fat leads to more insulin, insulin resistance, more testosterone, more estrogen… you get it.
Managing optimal testosterone levels and insulin resistance:
- Watch the amount and type of carbohydrates you’re eating. This will help to improve insulin sensitivity and get your cells communicating better.
- Avoid dairy. Dairy is a huge culprit behind hormone related acne and systemic inflammation in those who have elevated testosterone levels. Dairy also naturally has hormones in it (think, it has to grow a baby cow into a big cow), and if you’re hormonally imbalanced, you want to avoid anything that can disrupt you even more.
- Emphasize vegetables, healthy fats, and quality proteins. Make sure your plate is mostly vegetables.
- Supplements like inositol, Vitamin D, fish oils, chromium, and spearmint tea