In my many years in private practice as a board-certified Ob/Gyn, I had many appointments with women who complained to me that they felt that their “hormones were off,” or that they were “feeling so hormonal.” They would say to me, “Dr. Wei! Why do I feel like I want to kill my husband and children the days before my period? Why can’t I lose weight? Why am I so tired?”
As a woman who also faced these issues firsthand, I understood fully what they were describing; however, in my conventional practice, I had few reliable tools to address the severe symptoms of premenstrual and/or perimenopausal mood irritability, depression, anxiety, and insomnia, often accompanied by physical symptoms of breast tenderness, bloating, headaches, as well as many others. Year after year, I also watched women struggle mightily with weight gain, fatigue, and digestive issues.
Although I would often counsel these women about nutrition and vitamin supplementation, exercise, adequate sleep, and stress reduction, very often I would prescribe either oral contraceptive pills (which often worsened symptoms) or low dose antidepressants to address hormone balance and mood issues. Admittedly, these did provide relief for some; however, I was often bothered that I was not able to address the root cause, to address the underlying hormonal and body imbalance that was manifesting as these myriad symptoms. Because these “hormonal symptoms” often profoundly affect the quality of our lives and of our relationships with those closest to us, it is vitally important to discover how we can restore balance in the body foundationally.
What are hormones anyway?
Hormones are chemical messengers produced by various endocrine glands throughout the body. These chemical messengers circulate throughout our bodies to bind to receptors on all cells to allow the normal and balanced functioning of our bodies. While there are dozens of hormones which all play important roles, some of the key hormones are cortisol, thyroid, and estrogen. Hormones in balance give us health, vitality, and a sense of well-being; however, hormones out of balance can wreak havoc, and not only make us feel miserable in the short term, but also profoundly affect our long-term health.
Cortisol is the main stress hormone in our bodies which allows us to respond to acute stressors by releasing stored energy throughout the body, to give us fuel to act in a threatening situation. Cortisol is released by the adrenal glands, which sit atop our kidneys. When in balance, cortisol promotes the burning of body fat, maintains mood and emotional stability, counters inflammation, directs sex hormone production, and promotes healthy gut function.
What does cortisol out of balance look like?
- Weight gain
- Fatigue
- Depression
- Digestive problems
- Sex hormone imbalance
Thyroid hormone is the conductor of the symphony of the body as it regulates metabolism and energy consumption. When in balance, thyroid maintains mood, brain function, and energy levels, as well as regulates weight gain/loss and digestive function. What many do not realize is that thyroid function is intimately linked with inflammation, as well as adrenal gland and gut function. While some may have primary thyroid issues, which require thyroid hormone replacement, most can regain balanced function of the thyroid by addressing the primary issues of inflammation and imbalanced function of the gut and adrenal gland.
What does thyroid out of balance look like?
- Weight gain
- Fatigue
- Depression
- Digestive problems
- Hair loss and dry skin
- Irregular periods
Estrogen is one of the sex hormones which helps to regulate menstrual cycles and ovulation, as well as stimulate growth and maturation of breast tissue and reproductive organs. It has immense influence over many different metabolic processes in the body which influence cardiovascular, immune, and neurologic health.
What does estrogen out of balance look like?
- Weight gain
- Fatigue/insomnia
- PMS with irritability/mood swings
- Fertility issues
- Hot flashes/night sweats
- Vaginal and skin dryness
- Increased risk for breast, uterine, ovarian cancer and autoimmune disease
- Endometriosis and fibroids
- Irregular menses and PCOS
No wonder we often don’t feel well! The good news is there is so much that we can do to influence and change the way in which our bodies work to restore the truly beautiful balance and rhythm of hormonal health which allows us to feel our best and be our best.
How do my hormones become unbalanced?
What causes hormones to move out of their intended balance and function in our bodies? Although there are some natural fluctuations in our hormonal function during different times in our lives (puberty, pregnancy, menopause), the basic answer is STRESS which comes from so many sources and is very different for each of us. This is not just referring to the immense and complex amount of emotional stress which we often experience from living our lives daily, but also:
- The stress on our bodies from eating poor quality “food,” or food that we are sensitive or intolerant to;
- The multitude of toxins to which we are exposed everyday which often mimic hormone function or block normal hormone function;
- The lack of good quality and quantity of sleep which disturbs the circadian rhythms vital for normal metabolism;
- Physical pain;
- Obvious and hidden inflammation (often in our gut);
- History of or ongoing trauma of any kind;
- Loneliness and social isolation (which affects our health much more than we realize);
- Genetically-determined (inherited) differences which influence how we individually handle the processing and elimination of hormones.
When we are exposed to a stressor, we ready ourselves to respond to the threat (real or perceived), and the adrenal glands are largely responsible for this response:
- Initially, epinephrine (adrenaline) is released to increase blood flow to muscles, increase the output of the heart, and to mobilize fuel needed to act (the “fight-or-flight response).
- Cortisol levels increase after being produced in the adrenal gland, in response to signals from the hypothalamus and pituitary gland in the brain (otherwise known as hypothalamic/pituitary/adrenal or HPA axis activation). Cortisol is catabolic, breaking down tissues to provide glucose, fats, and proteins for fuel in response to an event stressful to our body.
These are normal responses to episodic exposure to stress; however, the reality of modern life is that we are chronically exposed to an unbelievable amount of stress. Chronic HPA axis activation/dysregulation in response to ever-present stressors leads to the increasing imbalance of hormonal function leading to the symptoms of imbalance of cortisol, thyroid, and estrogen, and other hormones: weight gain, fatigue, issues with mood, digestive issues, and on and on! Oh, Calgon, take me away!
What can I do about hormone imbalance?
There is so much you can do! Ultimately, regaining balance in our bodies is about creating the conditions for the body to relax back into its natural rhythms. This involves looking at how we nourish ourselves, as well as exploring sources of stress, which are myriad and unique for each one of us. As challenging as it may seem, the key is to address and shift fundamentally how we think and live.
Where to start?
- Eat a largely plant-based organic whole foods diet to give your body the key nutrients and information it needs to function optimally;
- Reduce toxin exposure as much as possible from processed foods, hormonally-treated meats and dairy products, unfiltered water, plastics, beauty and personal care products (look up the “Dirty Dozen Endocrine Disruptors” from the Environmental Working Group);
- Practice optimal sleep hygiene to get enough quality sleep;
- Explore quieting the mind through establishing a daily meditation practice, practicing yoga, qi-gong, tai-chi;
- Foster connection by taking a break from social media and technology, and spending uninterrupted face-to-face with family and friends;
- Practice kindness toward yourself first, then towards others, and remember that we are all interconnected whether we are aware or not;
- Consider working with a therapist who is highly-experienced with treating those with a history of trauma;
- Consider consulting with a functional medicine practitioner to explore issues with cortisol and sex hormone metabolism, GI and detoxification issues. Specialty testing can provide personalized and in-depth information about what specifically is causing imbalance for you, and provide an individual roadmap to restore the intended balance and rhythm of your body.
Start where you are. Too often we give up before we start because it seems like too much to take on when we’re already overwhelmed with all that we have to do and face every day. Yet, when we take the time to create even the tiniest space of care for ourselves, this alone can energetically shift toward immense change and the realization of the life we’re meant to live in these amazing bodies we’ve been given.
Jessica Wei, MD, FACOG is a board-certified Ob/Gyn and functional medicine practitioner, who left her private practice of thirteen years to create the women’s functional medicine practice, Women’s Holistic Health, LLC in West Hartford, Connecticut. To augment her extensive conventional training, Dr. Wei completed a fellowship in Integrative Medicine at the University of Arizona Center for Integrative Medicine founded by Dr. Andrew Weil, the internationally recognized expert in integrative medicine. She also completed the Kalish Method Functional Medicine Mentorship, and is obtaining certification with the Institute of Functional Medicine with expertise in the areas of hormonal, GI, immune, energetic, and cardiometabolic health, as well as detoxification. She specializes in the evaluation and treatment of hormonal issues such as PMS, PCOS, fibroids, endometriosis, and menopausal issues, as well as fertility, fatigue, digestive problems, and depression/anxiety. Women’s Holistic Health, LLC is located at 18 North Main Street, 3rd floor in West Hartford. For more information, please visit: www.jessicaweimd.com; e-mail: [email protected]; or call 860-904-9728.