Smoothing the path from puberty to post-menopause
Gillian Flower, ND
Women’s lives are influenced by their hormonal changes. Discover how our hormones function and interact with each other from puberty to pregnancy and beyond. Nutritional, botanical, and lifestyle strategies can help ease the journey through the major hormonal changes in our lives.
What comes to mind when you think of hormones? Breakneck mood swings and acne breakouts? Junk food binges and gut-twisting cramps? Sheet-soaking sweats and lukewarm libido? With dips and valleys like these, it’s no wonder we often dread the trek through our changing hormonal landscape. Despite the negative associations they may conjure up, our hormones deserve some respect. They govern essential processes such as appetite, kidney function, sleep cycles, and reproduction without a second thought from us. So how can they be so good, yet sometimes feel so bad?
Hormones may be thought to affect one tissue, but because they’re distributed through the bloodstream, they have the potential to affect many cells. While our ovaries, breasts, and other reproductive tissues have estrogen receptors, so do our brains, bones, and blood vessels. When we struggle with symptoms of hormone fluctuations, this bystander effect may be to blame.
Like an ecosystem in the great outdoors, our bodies are integrated networks, and the endocrine or hormonal system is no exception. When a hormone is released, it can cause a reaction in a cell, the release of another hormone, or both. Hormones never act in isolation, but instead cause a domino-like chain reaction.
Additionally, our body’s response to one hormone can be mediated by the presence of other hormones. Symptoms can occur when hormone ratios are disturbed. Dietary, genetic, environmental, and metabolic factors can all influence this balance. The function of our liver and bowel can significantly affect hormone availability and excretion.
Girls generally begin puberty between ages eight and 13 with the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. The adrenal glands and ovaries respond, releasing progesterone, estrogen, and testosterone into the bloodstream.
Dramatic physical and emotional changes are set in motion by this chemical relay race. Breast development begins, and bodies grow upward and outward while hair and sweat glands abound. The first menstrual cycles start toward the end of puberty, often two years after its initiation.
Research into the developing adolescent brain reveals that estrogen is essential to normal cerebral growth. Excesses of other hormones, notably testosterone and insulin-like growth factor 1 (IGF-1), contribute to issues such as acne.
The concept of balance may be the antithesis of adolescence, but creating structure around food, exercise, and sleep habits can help regulate zany hormones. For example, a diet high in protein and low in dairy and refined carbohydrates may quell the hormones fanning acne flare-ups. Regular exercise may help to moderate symptoms of anxiety.
A regular pattern of menstrual cycles will normally emerge within three years of the first period, signalling a more predictable pattern of hormonal changes.
Most women will menstruate for about 40 years following puberty, experiencing as many as 500 periods in a lifetime. Over the average cycle, four primary hormones prepare the body for pregnancy.
Estrogen dominates the first half of the menstrual cycle, when the uterine lining is shed and rebuilt. FSH and LH influence egg development and release, peaking around the time of mid-cycle ovulation. Progesterone is in charge post-ovulation, and all hormones drop off leading up to menstruation.
The precise cause of period-associated mood changes is unclear, but hormonal fluctuations at the end of the cycle are implicated. Estrogen can have direct effects on brain function and on brain-stimulating chemicals such as serotonin or dopamine, so a drop in estrogen levels could explain mood changes.
Prostaglandins are released to control the contraction and shedding of the uterine lining. While they accomplish a noble function, they cause many typical features of premenstrual syndrome (PMS), including headaches, digestive issues, and pain.
Countering these compounds with anti-inflammatory essential fatty acids, including fish oil and evening primrose oil, may reduce the intensity of some PMS symptoms. Supplementing with vitamins B1, B6, and E alongside regular exercise and caffeine restriction may provide further relief.
Women suffering from PMS can be deficient in magnesium and calcium, suggesting that supplementing with these nutrients may help restore a sunny disposition during menstruation, or at least prevent incarceration.
Always speak with your health care practitioner before trying new supplements or making major changes in diet and activity.
If a pregnancy occurs, our old friends estrogen and progesterone soar to new heights, ensuring appropriate placenta function, breast changes, and fetal growth. A new hormone, human chorionic gonadotropin (hCG)—the target of commercial pregnancy tests—appears during pregnancy, prompting uterine growth and protecting the baby from its mother’s immune system.
Despite their essential roles, these hormones cause classic pregnancy symptoms. Nausea and vomiting, typically occurring in the first trimester, likely result from the initial surge of hCG, estrogen, and progesterone. These unpleasant symptoms may abate somewhat with the use of vitamin B6, ginger teas, and acupressure.
Progesterone, alongside the aptly named hormone relaxin, relaxes uterine muscles to accommodate the baby. Unfortunately, our digestive tract also bears the brunt of this relaxation, resulting in reflux and constipation. Adequate hydration and magnesium may ease constipation.
Relaxin loosens pelvic ligaments to facilitate vaginal birth but destabilizes our spine and hips in the process. Intense pelvic, hip, and low back pain can plague women in the later stages of their pregnancies, but regular massage and acupuncture can help.
Two hormones, present in all women but released in higher amounts during lactation, contribute to breastfeeding success. Oxytocin, also essential for sexual response and labour initiation, prompts milk “let down” and promotes bonding between mother and newborn. Happily, one of the spin-offs from this hormone is a calming, anti-anxiety effect. Prolactin maintains milk supply and suspends the menstrual cycle during regular breastfeeding.
Mood can be negatively impacted by dramatic drops in hormones, including estrogen and progesterone, immediately following delivery. Low vitamin D levels, changes in thyroid function, ongoing sleep disturbance, and the overwhelming responsibilities of parenthood can co-conspire, leading to a diagnosis of post-partum depression. While exercise and multivitamin supplementation may be helpful, professional support may be the best strategy.
Menstrual periods become irregular in the late 30s or 40s, signalling the onset of perimenopause and culminating in menopause at about age 51. Menopause, defined as occurring at 12 months after the last menstrual period, is well known for symptoms such as hot flashes, sleep disturbance, mood changes, and vaginal dryness. But women can suffer just as much during perimenopause.
Estrogen levels become erratic during perimenopause, but shifting ratios of estrogen to progesterone may be at fault, rather than an absolute drop in estrogen. Women with low levels of progesterone relative to estrogen, also known as estrogen dominance, appear to have the most difficulty.
Strategies for managing menopausal symptoms are as numerous and diverse as the women who use them. Maintaining a healthy body weight helps counter estrogen dominance, as this hormone can be produced by adipose tissue. Ensure adequate sleep and thyroid function to support weight management.
Ground flaxseed can help treat constipation, assisting in excreting excess hormones from the body. In addition, flax and other foods such as soy contain compounds that interact with our body’s estrogen receptors, potentially beneficially dulling the effects of our own estrogen on our cells.
Chasteberry has been shown to reduce PMS symptoms in perimenopausal women and may help normalize the menstrual cycle. Black cohosh is well known in menopausal circles for quenching hot flashes. Acupuncture can effectively treat hot flashes and associated symptoms, while bioidentical hormones are life-changing for some women.
A comprehensive care plan for the menopausal woman should also consider her increased risk of bone loss and cardiovascular disease. Nutritional guidelines, exercise strategies, and prudent supplementation with omega-3 fatty acids and vitamin D plus calcium may help address these risks.
Nutritional, botanical, and lifestyle strategies can provide essential support during our lifetime hormonal journey. When the going gets rocky, take a deep breath and some time to yourself—perhaps by sinking your hands into garden soil or hitting your favourite hiking trail. Take your hormonal journey one step at a time.
Regular sleep has an impact on the secretion of leutenizing hormone, which helps regulate the menstrual cycle. Time outdoors can improve sleep quality and solidify circadian rhythms.
Women suffering from PMS can be deficient in vitamin D; just five to 30 minutes in the sun a couple of times a week will help you maintain your vitamin D levels. Supplementing may also be necessary.
When the hormone relaxin causes constipation or pelvic pain, exercise can help. Exercise may also mitigate some of the symptoms of post-partum depression.
Once a woman reaches menopause, her risk of osteoporosis increases substantially. Getting adequate vitamin D through diet, supplementation, and moderate exposure to sunlight can help protect bones.