There’s one time in EVERY woman’s life that she will experience “hormonal problems“. This is during that beloved time of menopause. When a healthy woman goes through menopause, the only sign or symptom that should happen is that her periods stop. It can sputter a bit, be off and on, then off again, but that’s all that is supposed to happen if the woman is healthy. Unfortunately, this is not the case for many women out there.
Perimenopause is the time before complete menopause when the hormone fluctuations are erratic. The brain, through the hypothalamus and anterior pituitary gland, release increasing amounts of FSH, a hormone that tells the ovaries to produce estradiol- the main form of estrogen, in an attempt to try and keep hormone production at certain levels and in that familiar monthly pattern.
The ovaries however, become desensitized to the hormone FSH and gradually shut down. The safety net is the adrenal glands. They are programed to step in and come to the rescue of the declining estradiol (the main form of estrogen), by producing estrone (compensating estrogen). When this happens as designed, the woman does not have any negative experiences or symptoms that are so common today. Her monthly cycle gradually just stops.
Periods are like mini “Menopauses”. A woman’s monthly cycle is in many ways like a mini monthly menopause. If there are problems each month, or throughout the month, there will most likely be problems when the cycles stop as well. The good news about that is that your body is talking to you. Are you listening? Each month it is giving you updates on hormonal balance and strength, and opportunities to make things right. Your cycle is a way to check in with yourself and to get monthly feedback to let you know how you’re doing. Mother nature truly is caring.
WHEN MONTHLY HORMONAL FLUCUATIONS HAPPEN
When estrogen levels drop, and if the woman’s some health issues which she may or may not be aware of, there are problems. Does any of this sound familiar?
3. Weight Gain
4. Irregular or Short Periods
5. Infertility (possibly the most disheartening)
7. Decreased Libido
WHAT CAUSES THESE SYMPTOMS?
When hormonal fluctuations happen, and the adrenal glands are not capable to step in sufficiently, there are symptoms. These symptoms come from three different root causes.
Inflammation: This is a big one, and has numerous downstream effects. One article stated, “There is now a large body of evidence suggesting that the decline in ovarian function … is associated with spontaneous increases in proinflammatory cytokines” . With the natural decline in estradiol levels, the inflammatory cytokine system is upregulated and may stay upregulated even after estrogen levels are restored . That means that with each cycle a woman could become more and more inflamed systemically depending on her health status at the time of menstruation . One of the main lab markers noted in this inflammation is IL-6. Unfortunately, the body also becomes more sensitive to this inflammation, making things all the worse. That’s one of the reasons a woman’s mood, health, energy levels, etc can change on a dime. Inflammation goes up, the body’s sensitivity to that inflammation goes up which influences the mesolimbic part in the brain making it hard to concentrate, be happy, feel any kind of reward or even to have energy to get off the couch. That helps explain the brain fog, depression, PMS and decreased libido, even to some extent weight gain.
Nitric Oxide: Ever wonder why a woman’s hands are always cold? Along with an increase in inflammation, there’s also a natural shift in the nitric oxide system (NOS). This causes a decrease in endothelial nitric oxide (eNOS), which help the open blood vessels stay open and healthy, and a decrease in inducible nitric oxide (iNOS), which causes tissue damage. Some of the hormonal symptoms women experience can be related back to a lack of blood flow. These include brain fog, decreased metabolism leading to weight gain, irregular or short periods and unfortunately infertility.
HPO: The HPO axis stands for the hypothyroid-pituitary-ovary line of communication. Really this should also include the HPA axis with the adrenal glands, and the HPT axis with the thyroid too. It is very common when one hormone goes out of whack that others follow. Afterall, they tend to cover for one another as mentioned earlier with the adrenal glands and the ovaries. When estrogen goes down, androstenedione from the adrenals should step in and fill the gap to some extent. This won’t happen if the adrenal glands are focused too much on producing cortisol throughout the day. This is why female athletes typically have less female characteristics and dysmenorrhea or amenorrhea (missed periods).
Each day the body can only produce a certain amount of the pre-homone called pregnenolone. Pregnenolone is used to make testosterone, all the estrogens, progesterone and cortisol. If the body demands more cortisol throughout the day, then it “steals” pregnenolone to make it, therefore taking it from being made into the sex hormones. Additionally, excess cortisol will effect at least four different parts along the thyroid production pathway. These things together will of course affect the brain fog, depression, weight gain, irregular periods, infertility, PMS, and libido.
ALL OF THIS IS VERY CONFUSING – WHERE DO I START?
First and foremost, find a functional medicine provider! Regular medicine likes to think about things in a linear model. Meaning that they diagnose the problem by putting a label on it, then prescribe the solution. Period. Done. If that doesn’t work, they move onto solution #2, or maybe just try more of solution #1. With regards to hormones as we have discussed, the problems usually come when the adrenals fail to compensate correctly to the hormonal shifts. The medical answer? Just keep estrogen high all the time. Like really high. This approach only partially helps two out of the seven symptoms listed above. Instead, a systems biology approach is what’s needed. This means we look at all the players, identify the root causes, and understand that they have a dynamic balance that needs to be achieved. Which when it is achieved, is beautiful.
One of the most important things that always needs to be addressed when looking at hormonal dysfunction and imbalances is the adrenal glands. There are only two ways to strengthen these glands. Of course everybody wants a pill, so let’s start there. Adaptogenic herbs have been shown to really strengthen and support, along with vitamin C and magnesium. In the end this just helps you get by, and is not enough for lasting change. What is needed is strength and endurance. The only way to get this is through the right balance of exercise and rest. Exercise needs to be almost daily, enough to push your limits, but not too much that you can’t do it again the next day. Sometimes this starts out very little and that’s alright. When this is brought up clinically, most will say how much work they are doing throughout the day. We have all experienced the difference between doing something we enjoy for exercise and hauling a laundry basket and vacuum up and down the stairs. One builds you up, while the other tends to wear you out.
Inflammation: When it comes to inflammation and keeping the cytokines under control it is unwise, and often not enough just to take some Ibuprofen. The diet needs to be addressed along with lifestyle modifications, especially those involving cortisol. There’s a whole list of natural anti-inflammatory products that can be very successful. These often have very little to no side effects except for improving your overall health. Take them often and enjoy.
Nitric Oxide: There is no drug that will increase eNOS while bringing down iNOS. If there were, the general public would know all about how important it is. For a while, it was thought that the best way to improve the NO pathway was to supplement the amino acid arginine . Unnfortunately, arginine pushes both pathways, the good eNOS and the bad iNOS. Instead, try huperzine A and vinpocetine   .
HORMONES – BEST FRIEND OR WORST ENEMY?
Hormones are like a symphony. Beautiful if correct, ugly if not. To really achieve a great hormonal balance, and all the beauty that goes with it, a daily self assessment must be learned. A functional medicine provider is a key teammate to have at this time. Ideally, we all wake up, assess how we are that day, use the appropriate tools (supplements, exercise programs, meal plans, meditation, spiritual practices, etc.) as needed. Reassess periodically throughout the day and adjust as needed to maintain the dynamic balance of life.
Concerned about your hormones? Tired of not getting the outcomes you’re looking for? Call us today for a consultation with our functional medicine provider for solutions that work.
Girasole G1, Giuliani N, Modena AB, Passeri G, Pedrazzoni M. Oestrogens prevent the increase of human serum soluble interleukin-6 receptor induced by ovariectomy in vivo and decrease its release in human osteoblastic cells in vitro. Clin Endocrinol (Oxf). 1999 Dec;51(6):801-7. https://www.ncbi.nlm.nih.gov/pubmed/10619987
Salvador Moncada, Annie Higgs. The L-Arginine-Nitric Oxide Pathway. December 30, 1993. https://www.nejm.org/doi/full/10.1056/nejm199312303292706
Zhi‐Fei Wang Juan Wang Hai‐Yan Zhang Xi‐Can Tang. Huperzine A exhibits anti‐inflammatory and neuroprotective effects in a rat model of transient focal cerebral ischemia. August 01, 2008. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1471-4159.2008.05504.x
Hayder M. Alkuraishy, 1 , * Ali I. Al-Gareeb, 1 and Ali K. Albuhadilly 2. Vinpocetine and Pyritinol: A New Model for Blood Rheological Modulation in Cerebrovascular Disorders—A Randomized Controlled Clinical Study. Biomed Res Int. 2014; 2014: 324307. Published online 2014 Dec 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274818/