Women have a useful barometer from the menstrual cycle to let them know when changes are occurring and health needs a boost. But there are also more subtle symptoms that serve as clues into women's health.
We'll explore the big picture of women's hormonal health, and the clues that the body offers when hormones are off balance, in this section. Here is a mnemonic for women's hormonal health, and though by no means complete, it helps you get an idea of the big picture:
Did you know that the hormones should stick to certain levels in the body in relation to each other? That is the whole gist of hormonal balance, both for women and men (in different ways). For women, a rough Progesterone: Estrogen ratio of 200:1 helps keep estrogen's effects balanced by progesterone. If this sounds complicated, don't worry--it isn't. All it means is that you don't want estrogen too high or progesterone too low relative to each other in the female body. And obviously you don't want either hormone to be too high or too low overall.
The female body also contains small amounts of testosterone and other androgens (male-type sex hormones) that are important for hormonal balance. When levels of all of these hormones are affected by diet, activity level, prolonged stress, mental-emotional factors, age, and other conditions, their harmonized proportions are thrown out of whack and so is a woman's health. How this imbalance affects each person is different and depends on so many factors unique to the individual. There are, however, trends in what we see of typical symptoms. Let's explore these trends more by clicking on the tabs below.
Women's Hormonal Balance
A woman's hormonal health mainly relies on the tango of two hormones mentioned earlier on the page: Estrogen and Progesterone. These two molecules, as well as all the sex hormones, are made from cholesterol. For a woman in her reproductive years, the average 28-30 day menstrual cycle comes in two parts:
A "follicular" phase lasting around 2 weeks is where estrogen builds up the uterine lining with tissue, blood vessels, and nourishment for a possible pregnancy. Meanwhile, an egg also develops in its follicle (sac) inside of one of the ovaries. Female hormone levels are pretty low and a woman will typically feel more energetic during this part of the menstrual cycle.
During the second two weeks of the cycle, the "luteal" or secretory phase begins. Ovulation takes place from hormonal cues coming from the pituitary gland near the brain. When the developed egg ruptures from its follicle, it leaves behind a temporary endocrine (hormone-producing) tissue called the corpus luteum. The corpus luteum will secrete progesterone for days 15-28 of the cycle, promoting two events.
One, progesterone prepares the uterine lining for implantation if an egg has been fertilized with sperm. Two, it will make the female reproductive system impenetrable to any further sperm. If fertilization has occurred, progesterone sticks around to support a pregnancy. If it hasn't, levels will drop, leading to menstruation and shedding of the uterine lining. And then it starts all over again the next month.
Before and After Reproductive Years
Before the reproductive years, teenage girls have fluctuating hormones with a dominance of estrogen over progesterone at first. Their sexual characteristics develop and their bodies prepare to start menstruation.
After the reproductive years, progesterone will drop again for peri- and post-menopausal women. Progesterone tends to drop more sharply and estrogen drops more gradually for most women. Once menstruation has stopped altogether, the ovaries continue to make smaller amounts of hormones for a while and the adrenal glands' production of them becomes more important for overall levels.
Other Benefits of Estrogen and Progesterone
Female hormones perform functions other than strictly reproductive or sexual ones. Their benefits, when in balance, are widespread throughout the body. The benefits are especially highlighted in their progressive decline when hormones start to go down with age and menopause. Here are the benefits of each hormone:
Estradiol is the most potent of the 3 estrogen types in the body. All the estrogens contribute to healthy and strong bones. Osteopenia and osteoporosis can start to set in as estrogen levels decline with age unless proactive steps are taken with a well-rounded diet and physical activity. Estrogen also keeps up heart health throughout life, another concern as the hormone declines with age. Finally, estrogen helps regulate levels of neurotransmitters in the brain, including ones that are uplifting and help the brain adapt to stress.
Progesterone has many benefits in the body, including the balancing act it plays with some of estrogen's effects in the body. While estrogen promotes fat storage, progesterone increases breakdown of fat. While estrogen promotes the building up of the endometrial lining, progesterone helps balance how much this occurs and thus helps prevent endometrial cancer. Too much estrogen can cause bloating, and progesterone counteracts this by serving as a natural diuretic (promoting urination). It is a calming hormone with anti-anxiety and anti-depressant properties. Progesterone also works with estrogen to keep up a healthy sex drive and help prevent osteoporosis. Finally, progesterone helps alleviate or prevent PMS symptoms and reduces the craving for excessive sweets and carbohydrates.
Click on the next tab to learn more about why a balance of hormones is necessary for overall women's health.
The mnemonic we mentioned earlier on the page mentioned that an ideal ratio (proportion) of Progesterone to Estrogen in the female body is around 200 to 1. That means ideally you want to see 200 parts of progesterone circulating in the body's blood stream to 1 part of estrogen. Why?
Estrogen is an intense and proliferative hormone. It promotes a building up of endometrial, or uterine tissue. This is a good thing in prepping for pregnancy, but what about the rest of the time? A female living today goes through many more menstrual cycles than women used to, based on a longer average life expectancy. That is a lot of estrogen. In addition, enzymes found in fat cells have the ability to convert testosterone and other androgens into more estrogen, which can be problematic when a woman is overweight. Where are the checks and balances in this equation?
One of the main balancing factors for estrogen is the hormone progesterone. Progesterone is a softer hormone that helps counteract many of the more aggressive actions of high amounts of estrogen, both physical and mental-emotional in nature. That is why the corpus luteum hanging around after ovulation is so beneficial to women whether they want to get pregnant or not. The corpus luteum usually secretes enough progesterone to balance out the unwanted effects of estrogen.
The modern day dilemma for women is that lifestyle factors and stress have made it increasingly harder to ovulate regularly, make enough progesterone, and keep estrogen levels in check. Read the next tab to find out more about Estrogen Dominance and the part it plays in women's hormonal balance.
When a woman is not properly ovulating every month, the body becomes short on its supply of progesterone. Other factors such as weight issues, diet, stress, and lifestyle habits can also promote an upper hand for estrogen levels over progesterone in the body. When all of this takes place, no matter what age a woman is at, Estrogen Dominance can wreak havoc on female hormonal balance. In other words, there are less than 200 parts of progesterone per 1 part of estrogen in the body. Progesterone has less success in balancing out estrogen's effect on the body.
Estrogen Dominance occurs when the hormone estrogen starts barking orders to the rest of the body more than it should be allowed to do. It's true that in peri- and post-menopausal women, the levels of both estrogen and progesterone start declining anyway, leading to common symptoms such as hot flashes and moodiness. But with estrogen dominance, progesterone falls too quickly and the predominance of estrogen makes these symptoms more severe or brings on new symptoms. In pre-menopausal women, estrogen dominance upsets menstrual cycle regularity, worsens or brings on PMS, and causes mental-emotional distress.
Because estrogen dominance is on the rise, we have to assume that lifestyle factors play a large hand in causing it. Before we get to the symptoms of Estrogen Dominance, let's look at how overall health and lifestyle choices affect female hormonal balance and vice versa.
If it were as simple as adding more progesterone or lessening estrogen, medications would ultimately solve female hormonal imbalances within no time. Realistically, hormonal imbalance sets in over time, often years, piggybacking with other imbalances in the body. Rebalancing the female hormones often takes time and attention to the whole body. The most effective and valuable way to approach female hormonal imbalance is by attending to each piece of the puzzle that is promoting it. Let's take a look at these pieces now.
The Adrenal system has an important relationship with the the female sex hormones. For one, the adrenal glands' main stress hormone, cortisol shares a common precursor (starting material) to estrogen and progesterone. That means that when stress is continuously high in a woman's life, the building blocks to make estrogen and progesterone are being shunted toward making higher amounts of cortisol for the body to alleviate the pressure. With a deficiency of sex hormones, the body will start to feel undesirable changes in mood, menstruation, libido, fertility, aging, and other sex-hormone related functions.
Number two, the effects high levels of cortisol typically have on the body, including insomnia, digestive problems, lack of energy, and cognitive impairment all place an additional burden on female hormonal function. Stress may be the female hormones' public enemy number one.
The liver and its role in detoxification affects how female hormonal balance plays out. The liver provides the supply of cholesterol that goes into making the precursors to sex hormones in general. An unhealthy liver places stress on the production of estrogen and progesterone by impairing sex steroid production overall.
The liver also plays the biggest part in metabolizing, or breaking down hormones after they perform their functions. The hormone metabolites can't be left to recirculate in the body and add to toxicity in the blood. The liver helps prepare them for elimination so that fresh supplies of hormones can play their part in female health. Detoxing the body's old hormone population is important in maintaining overall hormonal balance.
Excess weight, especially collected around the midsection, contributes to symptoms of estrogen dominance. An enzyme in the fat cells is able to convert testosterone and other androgens into estrogen, increasing the body's supply beyond what it needs. As estrogen levels rise, hormonal balance is upset and menstruation, ovulation, libido, and overall health often become derailed from their natural course.
The typical diets that lead to weight gain, especially when accompanied by physical inactivity, contribute to hormonal imbalance in a second way. The overabundance of unhealthy fats and carbs, sugars, and fillers typically present in the foods create a pro-inflammatory environment for the body. Excess inflammation speeds up aging of cells and wear and tear on the body, further promoting hormonal imbalance. High sugar content further feeds candida yeast populations in the gut, and growing candida likes to ingest progesterone. A pro-inflammatory diet coupled with weight gain often = Estrogen Dominance.
In the Women's Balance Stars section, we'll explore some of the symptoms that arise for women in their reproductive years, and especially peri- and post-menopausally from hormonal imbalance. Many of these symptoms are either brought on by, or exacerbated by estrogen dominance. They include:
- Menstrual problems and PMS
- Menopausal symptoms
- Mood swings
- Irritability and anxiety
- Weight gain
- Fibrocystic breasts
- Thyroid deficiency
- Low libido
It's important to remember that there is a natural decline of hormones with age and this is unavoidable. But ideally, the decline will be gradual and comfortable along with longer stretches of hormonal balance (rather than constantly unpredictable fluctations).
For many female hormonal symptoms, a large dose of "taking better care of oneself" goes a long way toward re-establishing balance. Along with that, natural hormone replacement, female-oriented herbs, and stress reduction can all help where applicable. As you read through each star, think of ways in which lifestyle changes can help improve your own symptoms if you have them.
Women's Balance Stars
Click through the symptoms below to find out more about the stars that make up the women's balance cluster. You'll notice how one star can easily affect other stars. For example, PMS can cause depression, which can cause weight gain and lead to even further hormonal imbalance. See how many connections you can spot among the women's balance stars. For more information and help on how to resolve hormonal imbalances that may be affecting your health, click on the button below to take the Women's Health Survey and visit our Services page.
Fluid retention is a symptom many women experience surrounding their periods and sometimes regularly. It produces an icky bloated feeling, abdominal distention, difficulty fitting into clothes, and affects self image. Though many women think that losing weight will make the bloated feeling go away, they often find that the belly is there to stay regardless of weight.
Bloating is a common symptom of estrogen dominance and the estrogen may also cause fluid retention elsewhere in the body, including swelling of the hands, ankles, and feet. Higher levels of estrogen tell the body to retain water and that is why women can experience bloating a few days before their periods (when estrogen is highest). Progesterone, on the other hand, is a natural diuretic and encourages the body to let go of water through urination.
The common problem occurs when estrogen dominance makes estrogen go up, progesterone go down, or both. The balance of the two female hormones is upset, stacking the odds in favor of keeping water in the body. Reestablishing the balance between estrogen and progesterone will go a long way toward reducing fluid retention. In addition, exercise, eating multiple small meals and snacks throughout the day, and keeping stress down are other tips that help too.
Hot Flashes and Night Sweats
Hot flashes and night sweats are a constellation of symptoms in a league of their own, as they often cause a host of other problems for peri- and post-menopausal women. Hot flashes, or hot flushes, are experienced as sudden and intense heat on the face and upper body, often causing:
- Increased heart rate
- An uncomfortable suffocating feeling
They can be embarrassing for women to go through during the day and often cause problems sleeping at night. Sometimes the flashes are followed by a cold chill afterward.
Female hormones, especially estrogen, play a part in the vasomotor response of a woman's blood vessels, as in whether the blood vessels constrict or dilate. When hormones are balanced, the vessels are more balanced in temperature control throughout the body. When hormone fluctuations set in during peri-menopause or hormones wane during menopause, the vasomotor response gets wacky.
Hot Flash Theories
Some say that the hypothalamus (temperature regulator in brain) registers a false overheating of the body from low levels of estrogen, and therefore sends a signal to dilate blood vessels for dispelling the imagined heat.
Others say that increased levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) cause hot flashes during menopause. FSH and LH come from the pituitary and tell the female ovaries to make estrogen and progesterone. They both increase for a while when menopause happens in response to low estrogen.
Clearly, we don't know for sure why this interesting and annoying phenomenon happens.
It may be that during reproductive years, a lot of energy and heat goes toward the core of the body and uterus for the menstrual cycle and potential for pregnancy. Once a woman's physiology starts to shift away from this task during peri-menopause and menopause, an adjustment takes place in energy and heat distribution for a time.
The symptoms are different for every woman and may last a short time for some and a prolonged period for others. Hormonal imbalance, stress, poor diet, inactivity, and did we mention stress?--during life can all set the stage for more intense and stubborn hot flashes and night sweats. Attending to all these factors even after menopause can help improve symptoms.
Estrogen and progesterone work their effects on not only the body, but also the mind. Don't worry women, this doesn't categorize you as "hormonal." Men's moods are also affected by the levels of hormones, primarily testosterone in their bodies. For you, estrogen and progesterone balance supports mental-emotional balance.
For younger women, the biggest disruptor to hormonal and mood balance is stress. Worrying, fretting, intensifying, and skipping opportunities to rest put the body into constant alert mode. Alert mode brings on higher levels of cortisol and every time cortisol runs the show, female hormones suffer. Cortisol competes with the female hormones for production and also disrupts levels of nervous system neurotransmitters that female hormones work toward balancing--such as serotonin. Often, younger women experience the mood swings most intensely surrounding their periods. It can look like:
- Unavoidable crying
- Everything is "wrong"
- Feeling alone
- Feeling sad
- Up one minute
- Down the next
- Desire for comfort
- Desire to be left alone
Taking steps to address high stress in life and regroup even after busy times are great first steps toward maintaining better hormone balance and mood support.
For women approaching menopause, stress is still a factor but so is the unavoidable fluctuation and eventual decline of natural female hormones. Mood swings can descend hard upon the nervous system and cause longer bouts of depression, fatigue, and feeling off. Often, stress that has accumulated throughout life will haunt the body during this transition and make mood swings even worse.
For peri- and post-menopausal women, it's first important to know that you're not alone. The transition can feel like a very lonely one but in fact is very common. Second, it's important to remember that there's something you can do about it. More now than ever, there are effective options for natural hormone replacement, mood stabilizing herbs and homeopathics, relaxation techniques, nutrition, and lifestyle changes so that the symptoms don't take over your life.
Please visit the Healthy Mindset section and Blog for more articles about mental-emotional health and support.
Are you familiar with the following imploring question:
"I do exercise and eat less, but the weight just won't come off!"
This is a common complaint of both men and women especially after the twenties have passed. You may know about the familiar scenario as you read this. Once upon a time, you could eat whatever you wanted, grab a few drinks, skip weeks of exercise, and watch hours of favorite T.V. shows while your weight magically took care of itself. And then one day--not only were the twenties over, but so were the days of not worrying about weight and belly fat.
Don't worry--those days aren'tover. It's true that the body won't quickly rebound from sugar and fat binges and shed calories as effortlessly. The metabolism has shifted a bit with age and hormonal changes. But that's okay because you don't want to go back there and can feel even better now than ever before. There is a grounding energy for women that enters life post thirties and even though hormones may start to fluctuate and decline, with a healthy mindset and lifestyle, the weight will adjust to fit you where you want to be.
Estrogen is a hormone that tells the body to retain fat while progesterone tells the body to burn more fuel. Estrogen dominance promotes retention of fat without enough progesterone to counteract the effect. Add to that estrogen's ability to make the body retain more water and there you have it--tight jeans.
With the following approaches, your body will remember how to balance its hormones and weight at any age:
- Stress reduction, to help re-balance hormones
- Hormonal support for a healthy progesterone to estrogen ratio
- A pro-hormonal balance diet
- Exercise that is fun; not a chore
- Restorative sleep
- A healthy weight mindset
Just know that as the body feels more in balance, it will know how to healthily manage your weight on its own. One more important thing to know. Estrogen dominance creates a weight gain cycle you may not be aware of. Fat cells in the body, especially around the tummy, are able to convert testosterone and androgens into estrogen. This increase of estrogen promotes more fat storage, and the cycle starts over again. If weight is stubborn in coming off even with a healthy lifestyle, it may be helpful to look into whether estrogen is dominating the effects of progesterone.
Fatigue and Thyroid
Perhaps the most life impacting symptom women experience during hormonal imbalance is fatigue. Along with the fatigue often comes a lack of motivation to do familiar activities, get out of bed, and to get spiffed up to go explore the world. This feeling can be very discouraging and lead to frustration and depression.
Female hormone balance is connected to two areas of the body involved in both physical and mental spryness. Read more about them below.
The thyroid hormones, more simply called T3 and T4, are the twin conductors of a symphony of all other hormones. For women, thyroid imbalance and hormonal imbalance often come as a package where both issues need to be addressed for whole health. Normal looking lab results don't always indicate what exactly is going on with thyroid functions in the body. For example, when stress and cortisol are high, thyroid function often gets suppressed even if actual levels are in the ballpark of normal.
When low thyroid symptoms pop up such as fatigue, dry skin, constipation, and depression, a woman may find that she is also experiencing more severe PMS, peri-menopausal, or menopausal symptoms (depending on what phase she's going through in life). The thyroid is normally saying "Okay people--let's get things going!" When it says "people" it's really referring to hormones and neurotransmitters. With this instruction, metabolism, menstruation, mental function, and energy maintenance can all flow together smoothly.
When the thyroid gland has been put in check by stress and unbalance in lifestyle habits, it becomes more lethargic about its instruction to the body. It sounds more like "It must be time to get going, but whatever." Not only does thyroid-related fatigue result, but the female hormones will also cause additional fatigue with their fluctuations and imbalance.
The Nervous System
Estrogen, progesterone, and testosterone all interact with the protein-based neurotransmitters in the brain. Balanced levels of the sex hormones promotes balanced levels of the the neurotransmitters and vice versa. For example, the hormone called serotonin that promotes feelings of well-being is affected when female hormones aren't communicating well. Increased sadness, depression, and feelings of loneliness can result. Dopamine is a neurotransmitter involved in memory and learning and it too can be dulled when the sex hormones are out of balance.
Mental energy and spryness relies on a mix of female hormonal balance, stress reduction, and attending to limiting thoughts and emotions that do arise during life challenges. Bringing these factors into balance can help women who are experiencing heavy fatigue revive motivation and the desire to get out and experience the world.
Estrogen helps mature an egg in the ovaries and prepare the lining of the uterus for pregnancy. Progesterone helps release the developed egg and prepare the body for pregnancy. Naturally if either one or both of these hormones is not able to do its job well, it can be more challenging to become pregnant.
Often what can occur is a snowball effect affecting the fertilization process involving stress, female hormonal imbalance, thyroid imbalance, and irregular or absent ovulation. These factors may have been setting in quietly for so long that it may slip the mind during attempts to conceive that the body has been under physical or mental duress. Adding to that, the frustration of difficulty conceiving, and the whole cycle seems to start all over again without an end in sight.
In many cases, the body can get back into baby mode as each part of the body that has become tired or stressed is brought back into balance so that it can play its part in the conception process. Female hormones can be tested and any imbalance corrected with safe and natural hormone replacement, stress reduction, and proper nutrition. Thyroid labs and taking inventory of any thyroid-related symptoms can help connect the dots toward healing the thyroid. Tracking for ovulation is important so that you know whether it's occurring and if not, to get help exploring why it isn't. By attending to the whole body, a woman can both feel healthier and increase her likelihood of getting pregnant.
Fibrous Breast Tissue
The breasts contain glandular tissue, fat, and connective tissue. Estrogen and progesterone affect the way in which breast cells grow and multiply. Other hormones such as prolactin and thyroid hormone also play a part in the cell growth. Especially before menstruation, a woman's breasts can experience a cyclical growth of the tissues leading to discomfort, a feeling of fullness, and fluid retention (from increased blood vessels). This is a common experience for many women.
When the menstrual cycle is over, the extra tissue breaks down and can cause scarring and fibrosis. Excessive scarring can cause lumpiness in the breasts, interfere with glandular tissue, and increase breast discomfort. While breasts naturally respond to sex hormones, keeping the hormones balanced can help prevent fibrous tissue in the breasts and reduce any existing symptoms too.
PMS and Irritability
Premenstrual Syndrome (PMS) is different for each woman who experiences it, and not every woman does. PMS is often accompanied by irritability and other forms of emotional lability along with a cluster of symptoms among:
- Lower abdominal cramps
- Back pain
- Food cravings
- Skin issues
- Breast pain
For some women, the cluster of symptoms will lead them to stay home and away from other people. For others, they can go about their day and just wait for the symptoms to subside. Natural medicine has many options for ways to promote better hormonal balance and reduce existing PMS symptoms.
PMS is frequently made worse from stress and the ensuing estrogen dominance that often results. When estrogen is dominant over progesterone, fluid retention and bloating happens, breasts are more fibrocystic, periods tend to be heavier and more painful, and muscles cramp up more easily. The softening effects of bringing progesterone back into balance and reducing stress and cortisol will curb the more aggressive symptoms brought on by unopposed estrogen.
When you flip on the T.V., most of the sex-related commercials for libido issues feature male sexuality. The women sitting next to the men in the commercials seem just dandy with their own levels of libido. What's the reality?
Many a women wants a jump start of her libido. Women of all ages experience highs and lows in the area of sexual arousal and libido, just like men do. Just like men, these fluctuations are part physical and part psychological in nature. That means that the body and mind work together to put the person in a sexual mood and give her enough energy to perform sexually.
What is libido anyway? Libido is sexual desire, but along with the desire there has to be enough energy to get the body and mind aroused enough to fulfill the desire. Many factors can challenge the libido and make it harder to get in a sexual mood. Stress is a huge factor that comes into play. It often wraps up the mind in worries that can easily take its attention off of sex altogether, even during the act. Physically, stress increases cortisol levels released from the adrenal glands. Cortisol put the body in a semi-alert state, ready for immediate stress and challenges. In this state, blood is directed away from sexual organs and toward mental and physical capacities that help alleviate stress.
When women enter peri-menopause and menopause, fluctuations and decreases in female hormones such as estrogen and progesterone also affect the libido. These female hormones support sexual arousal and when they are out of balance with each other or declining with age, this change offers an extra challenge in maintaining libido. Luckily, the female body produces small levels of testosterone too in the adrenal glands that help support libido even into older age, but for some women these levels become low as well from stress and other lifestyle factors.
Sleep habits, diet, excessive use of stimulants such as caffeine, neglect of mental-emotional health, and self perception of body image can all play a part in lowering the female libido.