So many of my patients seek help through the treacherous territory of hormonal changes. Hormonal changes which began around age 40 are now occurring in the third decade of a woman’s life.
What is going on?
Researchers have shown that with today’s lifestyle, our cells are aging at warp speed. The degenerative processes in our bodies far exceed regeneration. Growth hormone levels are at an all-time low and for the first time in 3 decades, our lifespan may actually be shorter than that of our parents. As a matter of fact, it is predicted that American teenagers have about 30 to 40 years to live. They will be dead by midlife as their current cell age matches that of 40 to 50 year old. This is due to their unhealthy lifestyle choices.
No wonder women in their thirties are seemingly peri-menopausal, presenting with symptoms of hot flashes, night sweats, increases in belly size, heavy periods, fatigue headaches, and mental fog. What they are greeted with by traditional medicine is oral contraceptives, hormone replacement therapy, uterine ablation or in extreme cases, a hysterectomy. But none of these treatments work. They merely manage symptoms without correcting imbalances in the body which will continue.
Hormone imbalance occurs for a variety of reasons, the most important of which is a woman’s lifestyle – the food she eats (or doesn’t eat), the amount of exercise she gets, the health of her gut biome (the healthy bacteria in her gut – influenced by her diet and lifestyle), and how she handles stress. These factors are equally important for men, whose collective testosterone levels have been declining for over two decades.
The ovaries produce three major hormones- estrogen, progesterone, and testosterone. Estrogen and testosterone are produced continuously in premenopausal women, with estrogen peaking in the middle of her menstrual cycle, (around day 12 to 14 from the start of her period) just before she ovulates. When she ovulates, her progesterone levels rise to balance the estrogen, awaiting fertilization and pregnancy. If she does not get pregnant soon after ovulation, the progesterone level falls and menses begins around day 28. Over the past two decades, the frequency of ovulation has decreased dramatically in women, evidenced by the surge in infertility and the prevalence of estrogen dominance. This means women are producing estrogen without cyclic progesterone. If chronically experienced, estrogen dominance results in a host of symptoms, both physical and mental, so its rising presence is an indicator of the endocrine system gone awry.
What has caused this to occur?
The endocrine system is a delicate web, with hundreds of interconnections between the gut, the nervous system, and almost every cell in the body. When we eat unnatural foods, are exposed to environmental man-made toxins and hormone disruptors, use body care products that are not organic (petroleum based), drink from plastic containers, eat food treated with hormones and pesticides, ingest artificial sweeteners, and petroleum-based food colorings (among all the other detrimental lifestyle choices we’ve normalized), the delicate web of our endocrine system is disrupted. The communication between our cells is distorted and the myriad of medical symptoms common in our society emerge.
Our pituitary gland, the master gland in our brain that regulates our endocrine system, stops working efficiently and growth hormone levels decline, precipitating leaky gut. Our gut (1) is one cell thick and sewn together cell to cell by tight junctions. These depend on growth hormone levels and the integrity of the 90 trillion bacteria in our gut which are the ‘brain’ of our body. These bacteria regulate nearly all of our body’s functions, including influencing hormone balance and are very sensitive to what we eat and drink, as well as daily exercise and stress levels. When growth hormone levels fall, not only does the gut get leaky because of tight junction malfunction, but the integrity of the gut biome (which is heavily impacted by the quality of our food) is also compromised. When the gut leaks, inflammation abounds. This inflammation also impacts the brain. It makes the blood brain barrier leaky. This impacts clarity of thinking, mood, memory, and neurotransmitter levels.
Now imagine the scenario that I often see: a peri-menopausal woman whose hormones are out of balance with leaky gut, from which the majority of women suffer. We can safely see that hormone replacement, uterine ablation, birth control, or a hysterectomy will not solve this.
Progesterone levels are greatly affected by stress, exercise, and the food we eat. When we live a standard ‘American lifestyle,’ these levels fall, causing long term estrogen dominance. This can cause hypertension, headaches, breast cysts, breast cancer, irritable bowel, endometriosis, fibroid tumors, weight gain, and fatigue. Progesterone relaxes the gut, supporting the gut flora that produce 90% of the serotonin present in our body. When progesterone levels decline, our mood, the clarity of our thinking and our emotional body is greatly impacted.
Most physicians who use bio-identical hormones in their practice, add natural estrogen to their patient’s regimens even if they do not have symptoms of estrogen withdrawal such as night sweats and hot flashes. This further aggravates estrogen dominance, loading transitioning vulnerable cells with too much estrogen, needlessly burdening the estrogen receptors in the breasts, the uterus, and the brain. What I have found in my 30 years of medical practice is that ‘less is more’ when it comes to hormone balance. Maintaining an estrogen to progesterone ratio of 5 to 10 is what gives women the greatest sense of well-being and symptom relief during menopause. This is done by adding natural or bio-identical progesterone at a dose which provides this therapeutic ratio. Not supplementing with natural estrogen after menopause is a wise choice, unless menopausal symptoms, like hot flashes, night sweats, and body aches are intense. If indicated, a small dose of progesterone works well after menopause to maintain health and well-being, and can virtually eliminate most menopausal symptoms. Hormone balancing requires regular evaluation of blood levels every four months to make sure that estrogen to progesterone levels are staying balanced. Stress or changes in lifestyle can affect hormones leading to estrogen dominance, so it is very important to have levels checked three to four times a year.
Diet is an essential part of this integrative medical framework and eating a balanced, organic, and primarily plant-based, high anti-oxidant diet with a broad-spectrum probiotic does more for hormone balancing than any other intervention. Women in my medical practice who correct their diet and lifestyle have a much better response to hormone balancing than those who don’t. Furthermore, women whose diets are low in plants, have a higher rate of progesterone conversion to estrogen, furthering estrogen dominance.
Our bodies are designed to be healthy. However, this health depends upon the choices we make. Achieving optimal health is not a complicated or difficult goal. It is a simple result of eating in alliance with nature, getting plenty of sleep, exercise, and maintaining work-life balance. I call this self-care. Self-care requires consciousness. Without self-care, we become sick. With it, we can regain health, quickly and almost miraculously. Even diseases like cancer and Alzheimer’s are shown to be preventable and reversible through diet and lifestyle choices.
Think about it – no matter what state of health you are in, you can change it for the better through conscious choices.
And if you are a woman with symptoms of menopause, there is much you can do to improve your lifestyle and restore your microbiome, in addition to achieving a healthy hormone balance.
©Dec2018/Jun2015 Kalpana (Rose) M. Kumar M.D., CEO and Medical Director, The Ommani Center for Integrative Medicine, Pewaukee, WI. www.ommanicenter.com Author of 2nd Edition – Becoming Real: Reclaiming Your Health in Midlife 2014, Medial Press.