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Hormonal havoc: what conventional medicine is missing

Throughout my career I have encountered a huge amount of confusion and misconception around the subject of hormones. While we have come a long way since the 1930s – when in extreme cases women were accused of insanity and institutionalised for hormonal stress – there is still widespread misdiagnosis. I have seen women prescribed everything from psychiatric medications to muscle relaxants for hormonal imbalances that could have been remedied with evidence-based natural therapies.

Women’s hormones change naturally throughout their lifetimes, and as a consequence hormonal imbalances can affect us at any age – and they are far more common than people realise. In the past 40 years, we have seen a global dramatic rise in hormone related conditions never seen before in history. Currently, the age of puberty (menarche) is dropping quickly to as young as 10 years of age, endometriosis is afflicting 10 percent of all women; Premenstrual Syndrome (PMS), rising and afflicting close to 30 percent of women, uterine fibroids affecting close to 25 percent of women from age 35 to 50, and breast cancer afflicting close to 10 percent of all women.

There are multiple causes for hormone imbalance, but the majority of cases are experienced due to oestrogen dominance or increased amounts of oestrogen in the body and not enough of progesterone. In the west, the prevalence of oestrogen dominance syndrome approaches 50 percent in women over 35 years old.

Common causes of the hormonal imbalance oestrogen dominance include stress, overloading the liver with toxins such as alcohol, a low fibre diet, toxins from the environment, consumption of non-organic animal products, genetics, tumours, obesity and lack of exercise.

While sex hormones such as oestrogen and progesterone decline with age gradually, there is a dramatic change in the rate of decline during the pre-menopausal and menopausal years. From age 35 to 50, there is a 75 percent natural reduction in production of progesterone in the body. Oestrogen, during the same period, declines by about 35 percent. By menopause, the total amount of progesterone made is exceptionally low, while oestrogen is still present in the body at about half its pre-menopausal level. So natural hormonal decline also leaves women with a state of oestrogen dominance, which may increase her risk for breast cancer and other reproductive cancers and make her feel anxious and fatigued.

Conditions associated with this include PMS, uterine fibroids, fibrocystic breast disease, breast cancer, endometriosis, endometrial polyps, PCOS, auto-immune disorders, low blood sugar problems, and menstrual pain, among many others.
We often believe that unpleasant symptoms which occur as a result of these hormonal deficiencies are either something we have to bear or are caused by another condition – so it’s important to understand how the imbalances manifest.

In a teenager a sign might be heavy periods, while in a woman in her late 30s it might be inability to lose weight, or perhaps irritability. A woman in her 50s might complain of low sex drive, while one in her 70s might complain of pain in her joints and high cholesterol. I have had patients suffering from all these conditions, and we were able to explain – and manage – each of these issues by taking charge of each woman’s hormonal health.

Of course it is important to remember that you should always be checked by a medical professional and in some cases there are other underlying causes. However it’s helpful to know the symptoms and signs of hormonal imbalance, and the options available to manage this.

Teens to mid 30s
Symptoms of hormone imbalance

From the start of menses, or first period, right up until the mid 30s, signs of hormone imbalance can take the form of heavy periods, severe cramping, sore breasts, back aches, headaches, irritability and anxiety.

Typically around this age endometriosis, a painful build-up of the uterus’ endometrial lining that attaches to other organs, is diagnosed. This is, in fact, due to hormonal imbalance in many cases (too much oestrogen).

Some women also have hair on their chin, facial acne and weight gain around the middle. They may have trouble processing sugars so they have high glucose levels in blood tests. They may have cysts on their ovaries as confirmed by ultrasound. This is oftentimes diagnosed as Polycystic Ovarian Syndrome (PCOS). This is, in fact, partially due to too much testosterone and not enough progesterone hormones.

Pregnancy is often a time when women feel quite positive; this could be due to the progesterone feel-good hormone skyrocketing to promote the growth of the foetus and prevent miscarriage. Some women that don’t have enough progesterone may have trouble conceiving or may miscarry while pregnant.

Why you feel this way
These symptoms may be due to progesterone deficiency, in which the calming, anti-pre-menstrual stress hormone is too low on days 19-21 of the menstrual cycle. The balancing hormone oestrogen may also be too high, causing the condition called oestrogen dominance.

Oestrogen dominance can also lead to weight gain around the hips, thighs and stomach, which may seem impossible to lose with just healthy eating and exercise. Women with this condition may feel anxious and have heavier periods than other women.

My top tip on hormone management at this age
Avoid the oral contraceptive pill for management of hormonal imbalances. Synthetic hormones have health risks and may increase the risk of high blood pressure, blood clots and stroke. Commonly I see in practice the side effects of weight gain, fatigue and low moods as well. Consider bioidentical hormones (natural and plant based) or herbal medicines instead to balance hormones at this age. Use barrier methods (condoms or diaphragms if with a monogamous partner) for birth control. Before having any hysterectomy (removal of the uterus) procedure for endometriosis ensure you get your hormones tested!

What else can you do about it?

  • Get a saliva or DUTCH (Dried Urine Test for Comprehensive Hormones) take home test kit from your integrative or natural health practitioner. Do these on days 19-22 of your cycle. By spitting into a tube or taking a dried urine sample at home, a broad spectrum of hormones are tested (cortisol to check for adrenal fatigue syndrome, our sleep hormone melatonin, all reproductive hormones, testosterone and metabolites- how our body is metabolising oestrogens).
  • Plant-based (soy or Mexican yam) bioidentical hormone cream can be applied to the inner arms or behind the knees daily for the last two weeks of the menstrual cycle to alleviate the symptoms.
  • A herbal formulation (I like capsules) that includes Vitex Agnus-Castus (Chasteberry) and other progesterone-inducing herbs from both western and eastern medicine, such as: Rehmannia, Bupleurum, Passion Flower, Coleus Forskohlii, Wild yam, Peony Root, Chuan Xiong and Cramp Bark may also help. Herbal therapies can be taken daily.
  • Herbs that detoxify the liver and break down oestrogen in the body, such as Calcium D-Glucarate, Chrysin, DIM (3,3’-Diindolylmethane), Milk Thistle Seed Extract, Chamomile extract and Sulforaphane may also help.
  • Diet, exercise and stress management addressed by a qualified nutritionist, personal trainer and natural health practitioner would be beneficial.

Mid 30s to 50
Symptoms of hormone imbalance

At this age women can experience ‘perimenopause’ which means pre-menopause. Signs of this imbalance may be feeling irritable, anxious and depressed, and having trouble sleeping. You may also have bloating, abdominal weight gain, flushes, night sweats and joint pain.

At this age some women have menstrual irregularities, vaginal dryness, lower sex drive, memory fog, heart palpitations, nausea, urinary tract infections, beginning stages of osteoporosis and elevated cholesterol as a result of oestrogen depletion closer to menopause, which may lead to heart disease in later life.

Why you feel this way
Your progesterone, oestrogen and testosterone hormones are starting to decline, which can prompt any or all of the above.

My top tip on hormone management at this age
Consider natural hormonal balancing before anti-depressant therapies, as often low moods and anxiety may be due to a drop in progesterone levels with perimenopause.

What else can you do about it?

  • Get a saliva or DUTCH (Dried Urine Test for Comprehensive Hormones) take home test kit from your integrative or natural health practitioner. Do these on days 19-22 of your cycle. By spitting into a tube or taking a dried urine sample at home, a broad spectrum of hormones are tested (cortisol to check for adrenal fatigue syndrome, our sleep hormone melatonin, all reproductive hormones, testosterone and metabolites – how our body is metabolising oestrogens).
  • Herbal supplementation such as Chaste berry, Black Cohosh and Siberian Ginseng promote natural progesterone production.
  • Throw out any personal and household products that contain xenoestrogens: foreign oestrogen mimickers that can play havoc with our delicate hormonal balance. Look to avoid products with parabens especially for this reason. Ecostore carries a wide range of ‘no nasty’ items.
  • Bioidentical hormone therapy cream applied to the inner arms and backs of knees from the soy and Mexican yam plants is highly recommended.
  • Increase intake of foods rich in vitamin B-6, including enriched cereals, fermented soy like miso soup and tofu and nuts. Thyme, turmeric, and oregano are spices are known to support healthy progesterone levels.
  • Maintain a healthy weight with mixed cardio and light weight bearing activities along with a Paleo style of diet. Oestrogen is stimulated by excess fat, which in turn depletes progesterone. To get started with Paleo I recommend: www.cavemanstrong.com. It’s easier than you think! Your junk food cravings will pass.

50-60
Symptoms of hormone imbalance

This is the time of menopause, when periods are typically absent for a minimum of 12 months.
Signs of hormone imbalance common to menopause are sleep difficulties, urinary problems (leakage, frequent and urgent desire to urinate), vaginal dryness, headaches, depression, anxiety, mood swings, memory fog, body aches, tinnitus, fungal infections, skin, eye and mouth dryness and fatigue.

Why you feel this way
During menopause, our ovaries stop producing eggs and hormones oestrogen, progesterone and testosterone decline rapidly.

My top tip on hormone management at this age
Menopausal women often start to refrain from sexual relations with their partner at this time of life due to the pain with intercourse resulting from vaginal dryness. It is possible to keep relationship intimacy alive and well with the use of bioidentical (natural plant-based) cream applied intravaginally to restore moisture. Lower sex drive is also common at this time. This can be replenished with herbal therapies such as Siberian Ginseng, Tongkat Ali, Panax Ginseng, Epimedium sagittatum, Maca, Mucuna pruriens, Tribulus terrestris, Damiana, Ashwagandha, Muira Puama that support healthy testosterone and stress-coping cortisol production.

What else can you do about it?

  • Get a saliva or urine DUTCH (Dried Urine Test for Comprehensive Hormones) take home test kit from your integrative or natural health practitioner any day of the month. By spitting into a tube or taking a dried urine sample at home, a broad spectrum of hormones are tested (cortisol to check for adrenal fatigue syndrome, our sleep hormone melatonin, all reproductive hormones, testosterone and metabolites – how our body is metabolising oestrogens).
  • Consume fermented soy products daily, such as tofu, miso soup from paste, fermented Korean soybean paste, Japanese natto and tamari soy sauce, the Indian curry Chagem pomba and Indonesian tempeh.
  • Bioidentical hormone therapy from the soy and Mexican yam plants is recommended to quickly reduce or completely eliminate hot flushes.
  • Get yearly breast thermographs, which involves a trained nurse or technician taking a photo of your breasts with a special thermal sensitive camera. They are radiation free and can detect vascular irregularities in your breast tissue prior to mammography and are analysed by a thermography qualified doctor.
  • Maintain a healthy weight by reducing consumption of foods with empty carbohydrates, such as processed foods, white breads, pastries, pastas and sugar.
  • Try walking, swimming, cycling, yoga or Pilates 3-4 times weekly to reduce the stress hormone cortisol so that you don’t hold onto weight.

60 plus
Symptoms of hormone imbalance

Women at this age are post-menopausal, so most women are finished with the majority of menopausal symptoms. However, some women continue to experience night sweats, and hot flushes into their 80s. Vaginal dryness and bladder leakage is also an unpleasant reality.

Some women also suffer from hip and wrist fractures.

Why you feel this way
Some women still suffer from hormonal fluctuations even in older years. Some predisposing factors for prolonged hot flushing include: previous hysterectomy, smoking history, and high alcohol intake. Also depression (low serotonin levels) or obesity may be factors.

The depleted oestrogen hormone can also lead to increased risk of osteoporosis (weakening of bones) which causes fractures. This same depletion is also responsible for an increased risk of heart disease.

My top tip on hormone management at this age
It is a myth that naturally we must accept that sore bodies, weight gain and fatigue are just part of getting older. With hormone restoration with natural hormone cream applied to our skin from Mexican yam and soy we can feel more like our old selves again, with more energy, improved skin appearance, less joint pain and stronger bones and hearts.

What else can you do about it?

  • Replenish hormones with a plant-based bioidentical hormone cream applied to the backs of knees or inner arms twice daily.
  • Can apply intravaginally to restore moisture.
  • For ongoing hot flushes, consider a serotonin boosting supplement such as SAM-e or acupuncture.
  • Ask your GP to test your Vitamin D and calcium levels to ensure you have enough of these key nutrients to maintain strong bones.
  • Ask your GP to refer you for a bone density (DEXA) test to analyse your bone health.
  • Eat calcium rich foods, such as deep green leafy vegetables, organic dairy (choose lactose free if intolerant) and salmon.
  • Ensure that you have 10 minutes exposure to natural sunlight daily with sunglasses off to support healthy vitamin D levels to keep bones strong.
  • Choose regular weight-bearing exercise (walking, stair-climbing, using light weights) 3-4 times weekly to keep bones strong.  
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