Are you hot, angry, irritable, weepy, fatigued, not yourself? You may be experiencing symptoms of fluctuating hormones that go along with pre-menopause and menopause. Unfortunately we are told it’s in our heads or prescribed anti-depressants or a birth control pill. Lets take a step back and think about this. Symptoms are not a disease; they are a way of our body healing itself (think a fever) or a clue to something else. Instead of covering a symptom (like feeling depressed or not sleeping) with a drug why not try addressing the root cause first so that our bodies can do what they are suppose to do! Nothing wrong with using a short-term therapy to reduce pain, help with sleep etc., but if we find ourselves relying upon a drug to get by day by day maybe its time to reassess what’s really going on in our well-made, strong, beautiful bodies that we were given.
What is going on??
First stage: As we grow older (around 40) our bodies slowly stop being stimulated to produce as much of our sex hormones, primarily estrogen and progesterone. We aren’t meant to have babies anymore and our bodies change to accommodate this fact. Ovulation starts to become intermittent, we might have really heavy or light periods or some of both! Because of these dropping levels of hormones, we get symptoms like hot flashes, sleep problems, mood swings, weight gain and loss of energy. Our brain actually becomes resistant to the estrogen we do have!
Second Stage: (40-45) Pre-menopause
Progesterone is dropping (this stuff gives you that glow during pregnancy) Progesterone is like an anti-anxiety hormone, it makes you feel good and when it starts to go away, we may feel crazy! We experience hot flashes, can’t sleep, and want to kill our husbands! At this stage we usually have higher estrogen than progesterone. It’s important that we keep our progesterone to estrogen (primarily E2 or Estradiol) ratio healthy and watch how we are metabolizing our estrogens (how we rid or recycle them in the body). The DUTCH Hormone test is a good test to assess these levels. Naturally at this point we become estrogen dominant and diet and environmental factors can contribute to this dominance. Not eating enough fiber and being overweight can contribute. Also exposing ourselves to too many fake estrogens or estrogen mimickers like BPA’s, triclosan (toothpaste, hand sanitizer), fragrance in your beauty products, fire retardants, lead, arsenic (can be found in people that eat a lot of rice) mercury (avoid those big fish like tuna), non-stick cookware, pesticides on our food and phthalates in cleaners and beauty products can make the ratios even worse.
Stage 3: (45-50)
Now our estrogen levels start to drop. We experience lower sex drive, vaginal dryness, brain fog, bone loss and possibly depression. Low estrogen can impede the production of serotonin in some women. Low serotonin can affect mood, sleep and appetite. It can also cause constipation. Estrogen is low but higher than progesterone so you have the symptoms from above for estrogen dominance and you also have the symptoms of low estrogen. This may all seem awful and unfair, but menopause is a natural part of the life cycle and if we go in with a positive attitude in the best health we can, symptoms can be reduced. After 12 full months of no cycle you are officially post-menopausal and symptoms mayl go away. The average age for this is 51.
Nutritionally speaking what can we do to combat some of these symptoms?
- Vitamin C naturally boosts progesterone- there are many foods rich in vitamin C (red peppers, kiwi fruit, oranges, strawberries, broccoli, kale, brussels sprouts, cauliflower) you can also supplement.
- Vitamin E (look for a mixed tocopherol) may help to alleviate hot flashes, vaginal dryness and mood swings.
- Magnesium is important in helping reduce hot flashes, and fatigue. It is found in spinach, lentils, oatmeal, bananas, almonds and chocolate.
- Omega-3’s help to reduce inflammation, 2-3 servings of salmon per week or supplementation with a good quality product is recommended.
- A B-complex, specifically pantothentic acid or B5 has been shown to help with stress during this time.
- Maca may act as an endocrine adpatogen (does not contain hormones but may support normal hormone production) helping to balance estrogen levels. 1 Tbsp to start and up to 2-3 a day may help.
Herbs: Remember herbs can act like drugs; they should be used short-term and only from a reputable company like Gaia herbs and other professional supplement companies. Anything in my recommendations (sign up for a fullscript account with me to see them) are well studied. Also be aware that some classes of herbs can interact with prescription drugs so always check with a health care practitioner before taking.
- Ginseng-another adaptogen that may help with stress and immune function as well as menopausal symptoms.
- Black cohosh contains isoferulic acids which may have anti-inflammatory effects.
- Also plant based phytoestrogens. Other foods and supplements that contain phytoestrogens are tempeh, miso and natto (make sure they are fermented and organic) red clover, daidzen, pycnogenol and genistein. These products can have similar effects (although usually much less) as hormone replacement so make sure to work with someone and get tested if you choose to go this route.
Diet: We’ve all heard it before: cut down on processed food and the white stuff (sugar and refined carbs) but during this time of life it is really important to eat a nutrient rich diet to help with stress, weight (fat is estrogenic and messes with our ratios) and sleep. Also our fatty acid balance is important. Fatty acids are the precursors to prostaglandins (these are things that cause cramps!) that regulate hormone receptor sites. Too much Omega-6 fatty acids and not enough Omega-3’s can increase the production of these prostaglandins, which creates inflammation. But remember it is important to get healthy fats in our diet (olive oil, ghee, nuts and seeds, avocado, coconut oil). Do you know where all sex hormones come from? Cholesterol! Cholesterol is the precursor to pregnenolone the beginning of all sex hormones. Our bodies need healthy fats to make cholesterol. Lastly, for some people reducing their intake of caffeine and alcohol can also help with menopausal symptoms as they both can alter the levels of estrogen, and as we age our bodies hold less water and we become more sensitive to the effects of both.
Exercise the right way! For those with hormone imbalance, intense extended exercise can actually make the problem worse in the short term. Long distance running actually increases the intestinal permeability in your gut, in some this may not be a problem, for others who already have a compromised gut function this can cause major issues, as we will see below. Workouts that include short bursts of heavy lifting may trigger a beneficial hormone reaction.
Heal the gut- GI issues can cause inflammation. Inflammation can suppress the hypothalamus in the brain telling the body to make hormones or suppress the function of the glands actually making the hormones. It can also make you hormone resistant. The receptors on the cells become less sensitive to the circulating hormones and you experience the same symptoms even with normal levels of hormones in your body. Dysbiosis (microbial imbalance) in the gut can increase the production of the estrogen metabolites we want to be lower (4-OH and 16-OH) and decrease the production of the protective (2-OH). The gut really is the center of overall health including balanced hormones. Having dysbiosis during menopause can make the problem that much worse! (We can see markers for dysbiosis on two of the nutrient tests I mention here) and don’t forget 70% of our serotonin is made in the gut. Unhealthy gut=mood imbalances. Healing the gut is a 5-step process that involves removing stressors, replacing enzymes or other things to aid digestion, reinoculating with probiotics and fiber, repairing the lining with supplements and rebalancing our lifestyle in order to keep our GI healthy. If you need help with GI issues please let me know.
Increase your detoxification mechanisms. If we are recirculating estrogen this can contribute to estrogen dominance, they compete with the active hormones and bind at the receptor sites but don’t have the same effect so they are actually blocking the active hormone and disrupting the regulation. We can also look at DNA mutations that predispose people to these detoxification problems (looking at your 23 and me data) this helps us to know where to supplement or support. We can look at detoxification markers on the ION nutrition test mentioned here, we can also look at liver markers on your blood chemistry reports, we can look at symptoms like sensitivity to chemical smells and how you react to medications. Certain supplements can help support the liver like glutathione or liver support supplements. If your estrogen is clearing down the wrong pathway we can give support like the supplement DIM (found in cruciferous vegetables) and/or increase your intake of cruciferous vegetables and things like flaxseeds which contain lingans or phytoestrogens that can help change estrogen metabolism (ps I would not blindly recommend flaxseeds to men without looking at his biochemistry first-men can also do the DUTCH Hormone test!) The DUTCH Hormone test is an amazing dried urine based hormone test that I think every women should have run. You can read more about it on their website here. You can work with me to have this run, please ask.
- You can look under Menopause in my fullscript account to see some of the supplements and herbs mentioned above. I believe in testing instead of guessing but changing your diet, adding some supplementation, exercising appropriately, reducing stress and embracing aging can all be done very easily. If you need help personalizing the right diet for you please let me know. Fullscript
- In regards to hormone replacement I am supportive of bio-identical hormone replacement. It can be a lifesaver for some women who are not helped with the above methods (but I would try diet/lifestyle/supplements first) you need to work with a doctor who will monitor you every 3-6 months. I would choose a naturopathic or functional medicine doctor who understands all aspects of hormone replacement. If you need help finding one please contact me.