Female hormonal conditions are common and frustrating. Many women will be familiar with mood swings, bloating, painful periods, irregular cycles, acne, hot flushes, and the list goes on. Symptoms can be related to conditions such as PMS, PCOS, Endometriosis, Fibroids, Menopause, and Infertility. Before I go on about how to manage and/or treat let me explain hormones so you can have a clearer idea on what is going on for you.
Men, I haven’t forgotten about you. You can click here. Or keep reading and learn a bit about female health.
What is a healthy menstrual cycle?
Ovulation is not just for making a body. It is an important indicator of general health. When I think of a healthy cycle, I think vitality. It suggests the body’s not stressed too much, there is enough foo, insulin levels are okay and thyroid is functioning well (1).
A healthy cycle is between 21 to 35 days, ovulation day will vary depending on your cycle length (28 the average). To work out the length you are counting from day 1 of heavy bleeding.
- The follicular stage: in this stage your follicles (usually 6 to 8) enter development to win the race to become the dominant one which releases the egg for ovulation.
- Ovulation: this is one day, it either happens or it doesn’t. it is day 14 if you’re a 28-day cycle person but may be later if your cycle is longer.
- Luteal stage: after ovulation, you will either get pregnant or you will get your period in approximately two weeks. This stage of your cycle, the luteal stage is 10 to 16 days.
- Your period: with enough progesterone your period will arrive smoothly with no pain.
Your menstrual fluid should be mostly liquid, with no large clots. Large would be bigger than a 5 cent coin. You lose about 50 ml which is equivalent to 5 soaked regular tampons or ten soaked regular pads. Less than 25 ml is scanty, more than 80 ml is heavy flow.
The below graph shows how the hormones fluctuate in the cycle.
What does Estrogen do?
- in the brain maintains body temptation, protects against memory loss, increases serotonin
- helps with collagen production, skin thickness and getting blood supply to the skin
- protects against atherosclerosis
- needed for bone health
- thickens the uterus for implantation, increases vaginal acidity to protect against infection and helps with vaginal lubrication
Why would Estrogen be low?
- age (menopause)
- irregular cycles
- low cholesterol
- extreme exercise
- under body weight
- hypothyroid
- PCOS
- opioid pain medication
- OCP
What are symptoms of low Estrogen?
- low mood
- low libido
- memory loss
- brain fog
- nights sweats
- joint pain
- loss of collagen
- infertility
- bone loss
Why would Estrogen by high?
- overweight
- diabetes
- PCOS
- poor liver clearance
- gut bacteria imbalances
- environmental toxins
- alcohol
What are the signs of high Estrogen?
- heavy bleeding
- cramps
- fibroids
- weight gain
- fluid retention
- tender breasts
- PMS
- mood swings
What does Progesterone do?
- helps with sleep and anxiety
- improves GABA function causing a calming effect
- helps with fluid retention
- prepares the uterus for implantation
- enhances serotonin receptors in the brain
- supports the development of neutrons in the brain
- reduces inflammation
- builds muscle
Progesterone is important. It’s like an anti-anxiety hormone. But also it holds and nourishes a pregnancy. The worse thing about the pill is that you don’t make progesterone and therefore can worsen anxiety.
Why would Progesterone by low?
- irregular cycles
- poor follicle development
- age
- anorexia
- low cholesterol
- extreme exercise
- underweight
- hypothyroidism
- PCOS
- opioid pain medications
- NSAIDS
- OCP
Progesterone counterbalances estrogen. Progesterone thins the uterus lining while estrogen thickens it. It also boosts thyroid function, while estrogen suppresses it.
Why would Testosterone and Androgens be low?
- age
- zinc deficiency
- Vitamin D deficiency
- low cholesterol
- low DHEA
- opioid pain medications
- diabetes
- high SHBG
- low ovarian/adrenal output
Why would Testosterone and Androgens be high?
- high insulin
- PCOS
- low SHBG
- hyper adrenal output
-
some psychiatric medications
What are the signs Testosterone and Androgens are high?
- facial or body hair (hirsutism)
- acne, especially on your chin
- hair loss and hair thinning
- oily skin
- irritibility
High testosterone is a real concern for women. No female wants hair on their chin. Testosterone is good for women, but like all hormones, we need them in the right amount.
How do you assess Estrogen, Testosterone, and Progesterone?
Testing needs to be done at the right time of your cycle. A few things to note:
- if you are on the birth control pill there is no point testing progesterone as you are not making it, estrogen will be low too.
- if you have the Mirena, in some women it can suppress ovulation causing progesterone to be low (but not all)
- if you are on the follicular stage, again there is no point testing progesterone.
- If you are post-menopausal, you have almost no progesterone.
Knowing what date to test is easy if you have regular cycles, test 7 days before your period.
If you are not regular it gets harder. There are physical signs of ovulation such as twinges in your pelvis. If you know the signs, count 5 to 7 days later and test. You can also chart your basal body temperature. I can post information about this in another post.
You can test at any time if you are postmenopausal or a male.
You can test with a blood test. However, for a complete picture, I use the DUTCH test which is a dried urine test. You can do it at home and you send the kit back to the lab for testing.
In my next post, I will explain some of the female hormonal conditions and provide information on how to balance your hormones. I don’t want to overwhelm you all at once.
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