By Dr. Shawna Darou, ND
I have had many conversations over the past weeks with women noticing more changes and imbalances in their hormones. This is partly because life is different right now – the days look very similar so we notice how different we are through the month, and also because stress turns up the volume on all hormonal symptoms. Women are not the same every day of the month, and that’s a good thing! If this is interfering with your happiness and ability to get through your days with ease, then we need to address it.
What’s really interesting about hormones is that we rarely treat hormones directly. Hormones are influenced by digestion, your microbiome, stress, blood sugar balance, sleep, toxins, alcohol, genetics, and more. The key to hormone balance in most cases, is to restore balance to your overall lifestyle and set a strong foundation. Here are my top steps you can take now:
1. Track your cycles
Cycle tracking can range from very simply making a note of the first day of your period each month, to paying attention to signs and changes through your cycle. You can learn so much about your hormones by watching. Here are a few examples
- cycle lengths longer than 31 days often indicate hypothyroid (low-functioning thyroid), or PCOS
- very heavy periods could a sign of estrogen dominance or uterine fibroids
- spotting before your period can be due to low progesterone
- light or scanty periods often occur due to low estrogen or low body fat
Tracking your cycle can also be an empowering way to get to know your body, and your fluctuations through the month. These fluctuations can be positive traits, and also difficult symptoms. Here is an excerpt from my article “Tracking your cycle: Your Personal Blueprint“:
- Identify three positive feelings, states or attributes for yourself. Things that you notice seem to come and go but you would really love to tap into more. Here are some ideas to get you started:
- Articulate, artistic, Brainstorming, Brave, Confident, Coordinated, Creative, Decisive, Focused, Ideas flowing, Industrious, Joyful, Loving, Motivated, Optimistic, Playful, Productive, Resilient, Social, Strong.
- Next identify three negative feelings, states of attributes for yourself. Again things that seem to come and go. Here are some ideas:
- Anxious, clumsy, Depressed, Disconnected, Exhausted, Foggy, Grumpy, Impulsive, Insecure, Irritable, Jealous, Lonely, Pessimistic, Picking fights, Sensitive, Stressed out, Uncoordinated, Unmotivated.
- On a calendar or in your period tracking app start watching for these 6 things, and look for the patterns. You will be amazed at how predictable you really are through the month!
- “Embrace the positives” – when possible plan events, meetings and presentations around the times where you are at your peak. Work with your patterns.
- “Navigate the negative” – when you know that the less pleasant phases are predictable and short-lived, it’s easier to build in the self-care that you need to take care of yourself.
If you do not have regular cycles because of an IUD, PCOS, perimenopause or menopause, it can still be helpful to track your emotional and physical changes over a month. Women’s bodies are changeable, at any age and stage.
2. Test your hormones
There is no better way to learn about your hormone balance than accurate testing. This is most often done with bloodwork (on day 3 and/or day 21 of your cycle), testing for FSH, LH, estradiol, progesterone, testosterone (free and total), DHEA, thyroid panel, prolactin, fasting glucose and insulin, sex hormone binding globulin, morning cortisol, and possibly other androgens if indicated. Interpreting hormones takes practice to understand where optimal ranges are, and what are markers of hormone imbalance, so if you have been told that your levels are ‘normal’, and you still have symptoms of hormone imbalance, perhaps they weren’t tested thoroughly, or interpreted correctly.
There are also specialty tests that may be used, for example dried urine testing for hormone metabolites which is especially helpful in cases of estrogen dominant conditions to understand pathways that need support. This applies to endometriosis, fibroids, heavy periods in general, breast cancer, and a family history with many of these issues.
Once we understand your hormones, and where they are out of balance, we can personalize your treatment plan to address it.
3. Reverse insulin resistance
Insulin resistance is extremely prevalent in North America especially, with our standard diet consisting heavily of carbs and sugars. If you carry extra weight around your central abdomen, have difficulty losing weight, tend to crave carbs very strongly, have PCOS, or a family history of diabetes, insulin resistance or carbohydrate sensitivity is likely. The relevance for your hormones is that in the case of PCOS, insulin resistance directly impacts period regularity and fertility, but also causes more estrogen dominance, and symptoms of high androgens like acne and hair thinning. On a side note, insulin resistance during perimenopause and menopause years can contribute to more symptoms such as heavy periods leading up to menopause, and extra weight gain as estrogen drops.
Insulin resistance is reversible, and requires a comprehensive plan of nutrition changes (reducing the amount of carbs and sugars), stabilizing blood sugar with meals based on vegges, protein, healthy fats and fibre, ensuring optimal sleep, managing stress, and including regular exercise or movement. Insulin resistance develops over years, so it is not a quick fix to reverse it – it takes dedication to a treatment plan over months to see results. Read more about insulin resistance here: https://drshawnadarou.com/2017/06/05/testing-insulin-resistance-part-every-physical-exam/
4. Check for metabolic stress
Metabolic stress refers to a mismatch in energy in and energy out out. It’s commonly seen with intensive workout schedules (overtraining syndrome), inadequate calorie, protein or carbohydrate intake, or intermittent fasting in women pre-menopause. Metabolic stress causes the body to go into a state of acute adrenal stress, affects thyroid hormone conversion, and then impacts hormone balance and periods.
Metabolic stress sometimes happens by simply taking healthy habits too far, or jumping onto health trends that are too extreme like a keto diet or intermittent fasting. In these cases, hormonal signs like a late or missed period, increased anxiety or hair loss may get your attention first.
It is possible to reverse metabolic stress with a careful look at nutrition, exercise and rest, to ensure you are fueling properly.
5. Remove stacking stressors
What many people don’t realize is that stresses stack up – stresses like imbalanced blood sugar levels, not enough sleep, mental-emotional stress, intense exercise, high-paced living, pain and inflammation or chronic illness.
The goal is to reduce the total load of stress that your body deals with every day. Some of these stresses can be more easily tackled than others, such as:
- not rushing through your day
- blood sugar instability from eating irregularly
- over or under-exercising
- working too many hours without a break
- eating inflammatory foods
When you reduce the number of stressors in your life, your adrenal hormones can get back into balance, allowing the rest of your hormones get back into balance too.
6. Practice relaxation
You can also practice relaxation to lower the overall stress load on your body and its impact on hormones. The key to stress is building in downtime, rest, and relaxation. It’s not how hard you work, it’s how well you rest. Building in conscious relaxation with meditation, gentle yoga, time in nature, or simply breathing fully can positively affect thyroid function, ovulation timing, progesterone stability, fertility and reduce menopause symptoms.
7. Prioritize sleep
Too little sleep causes insulin resistance, and a more exaggerated stress hormone response. For healthy hormones, it’s essential to prioritize at least 7 hours of sleep each night. Sleep hygiene will help to get more deep, restorative sleep:
- sleeping in a very dark room
- avoiding screens before bedtime
- using a white noise machine if you live in a noisy place
- watching alcohol and caffeine intake, and
- not eating too late in the evening.
Our hormonal systems require balance with all of the lifestyle factors. Sleep is just as important as good nutrition, managing stress and regular exercise.
8. Rebalance the gut microbiome
One of the best ways to reduce PMS symptoms is to rebalance the gut microbiome. Moodiness, bloating, breast swelling and period cramps can all improve when the gut is functioning optimally – the last phase of hormone detoxification occurs in the intestines. The gut microbiome is especially important for estrogen dominance and inflammation.
We generally use a “5R Protocol” to optimize digestive function:
- Remove – eliminating pathogenic bacteria, fungus, parasites, and viruses from the GI system, as well as food sensitivities and allergens.
- Replace – replenishing hydrochloric acid, bile salts and digestive enzymes, as needed to breakdown and absorb nutrients.
- Repopulate – introducing probiotics, or healthy bacteria strains to reduce inflammation, replace pathogenic organisms and support immune function.
- Repair – after the microbiome is balanced, using nutrients to repair the mucosal lining and reverse intestinal permeability.
- Rebalance – remembering that a healthy lifestyle is necessary for optimal gut balance: healthy eating, regular exercise, restful sleep, and stress management.
In most cases, digestive issues are obvious and clear bloating, irregular bowel movements, constipation, heartburn or stomach aches. If you’re experiencing any of these, chances are your gut is impacting your hormones too.
9. Support detoxification
Hormones are more than what is produced, and levels measured in bloodwork. How they are transported, how sensitive the receptors are, and how they are detoxified also impacts your symptoms. There are two phases of hormone detox that happen in the liver, and the final stage in the colon. We can support these phases with supplements, nutrition, plenty of water, and minimizing things that further stress the liver like too much alcohol and certain medications.
Detox pathways can be supported with foods like the broccoli family of vegetables, spices like rosemary and turmeric, and supplements like DIM (di-indole methane), I3C (indole-3-carbinol) and calcium-D-glucarate.
10. Remove endocrine disruptors
Endocrine disrupt0rs are chemicals that mimic estrogen, affect thyroid function or block estrogen detoxification. Through these actions, they affect how hormones are expressed in your body and may create symptoms like heavy periods, period cramps, weight gain, fatigue and skin breakouts. The most significant endocrine disruptor chemicals include:
- bisphenol A
- perfluorinated chemicals
To reduce your exposure, minimize plastics, choose organic, and use natural personal care products and cleaning chemicals. If you have had significant exposure to these chemicals, and suspect they may be affecting your hormone balance, we can start a comprehensive detoxification plan, which includes nutrition to support detox pathways, targeted supplements, and also the use of sauna to move toxins that are stored inside body fat.
As you can see, many of the important factors affecting your hormones are things you can begin to change right now. If you would like support with your personalized plan, beginning with hormone testing, and addressing a healthy lifestyle plus targeted support, please ask at your next appointment.
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