Are your hormones wonky?
The two female hormones oestrogen and progesterone are two of the main hormones that affect a woman’s mental wellbeing. A hormonal imbalance between these can cause a range of symptoms from anxiety, depression, irritability, headaches, poor concentration, poor memory, insomnia, brain fog as well as weight gain, irregular menstrual cycles, infertility and hot flushes. It is estimated that 75% of PMS sufferers have high oestrogen levels in relation to progesterone (3).
However, it’s not just women that suffer hormonal imbalances. Hormone imbalance in men may show as low libido, loss of muscle mass, erratic moods, aggression, irritability, lack of focus and hot flushes.
Many of the symptoms of hormonal imbalance overlap those of depression and xx% of women suffering hormone imbalances are offered SSRIs. Although these may help alleviate the symptoms, they do not address the root cause of the symptoms.
So what do our hormones do?
Oestrogen and progesterone are the two main female hormones that are best known for regulating the monthly reproductive cycle but their actions go much further than this and they work synergistically as a balancing act.
Builds up uterine lining
Increases body fat
Interferes with thyroid hormone
Increases blood clotting
Impairs sugar control
Increases risk of endometrial cancer
Increases risk of breast cancer
Maintains uterine lining
Helps use fat for energy
Facilitates thyroid hormone action
Normalises blood clotting
Regulates blood sugar levels
Protects from endometrial cancer
Possible protective effect against breast cancer
Testosterone is predominant sex hormone in men but both men and women have all 3 hormones and it is the balance between the three that is required for optimal wellbeing. In women testosterone can increase libido, build muscle and bones and is associated with feelings of confidence and assertiveness however in excess can be anger and aggression.
Whilst these are the major sex hormones, there are other hormones that play a part in keeping these hormones in balance. Thyroid, Cortisol, insulin and oxytocin all play a part in your wellbeing.
The hormone cycle
Oestrogen and progesterone fluctuate in a monthly cycle that culminates in menstruation. Although typically reported as a 28 day cycle this can vary by individual from 24-35 days. Typically the variation occurs in the follicular phase of the cycle which is the first half when oestrogen is rising.
Image source: Tortora, G.J & Derrickson, B. (2014) Principles of Anatomy and physiology, 14th end. Wiley, NJ.
The luteal phase starts after ovulation when oestrogen starts to fall and progesterone starts to rise in preparation for pregnancy.
Hormones and mood
Studies show around half of women suffer from PMS (1) with nearly half of these being offered SSRI or oral contraceptives as a way to manage their symptoms (2). It is thought that PMS is the result of changes in brain chemistry that are triggered by the sharp fall in levels in oestrogen and progesterone that precede a period.
Oestrogen helps support levels of serotonin which is known as the happy hormone and regulates mood, cravings and appetite. So when oestrogen drops, levels of serotonin may also drop leading to low mood and cravings. Oestrogen is also linked to dopamine production. Dopamine is the neurotransmitter associated with drive, feel good and rewards. During the first half of the cycle, when oestrogen is high you may feel happier, brighter and more of a go-getter.
Progesterone helps support the production of GABA which is a calming neurotransmitter that switches off adrenaline. Progesterone comes into play during the second half of the cycle when you may feel calm and chilled out however when progesterone levels start to fall levels of GABA may fall resulting in increased anxiety and irritability.
If there is an underlying hormonal imbalance, there may be less ability to respond to the monthly hormonal changes associated with the reproductive cycle and other hormonal changes such as menopause, leading to more severe symptoms.
What causes the imbalance?
The body uses a feedback system to keep the hormones in balance. This system works very much like the thermostat on your central heating. Much like when the temperature falls outside of the desired room temperature, the heating will either switch on or off to reach the desired temperature. When levels of the hormone fall outside of the desired range a chain of biochemical pathways is initiated that either stops or starts the release of the hormone.
However, there are a number of factors that can disrupt the balance of hormones in the body:
· Exposure to xenoestrogens – These are chemicals that mimic the effect of oestrogen in the body. This causes an increased oestrogenic effect without actually changing the levels of hormone in the body. The most common xenoestrogens include: Organochlorine pesticides (e.g. DDT), plastic compounds (e.g. Bisphenol A, phthalates found in soft plastics such as clingfilm, tin can linings and cosmetics) (1), industrial compounds (e.g. PCBs and dioxins) which contaminate the water and fields on which animals feed. The toxins accumulate in the fat of these animals which we then consume and they then accumulate in us.
· Stress – Exposure to prolonged, chronic stress may result in what is known as the cortisol steal, which can lead to hormonal imbalances.
The production of all the sex hormones starts with cholesterol and progesterone is the first to be made in a sequence of conversions that lead to the production of testosterone, oestrogen, cortisol (stress hormone) and aldosterone (which regulates water balance in the body).
In times of chronic stress, there is an increased demand for cortisol. As cortisol is designed to help us in life-threatening situations and deal with the flight or fight response, its production takes priority over progesterone. This is known as the cortisol steal. In the short term, this may result in less progesterone and an oestrogen dominant state. In the long term there may be reduced levels of testosterone and oestrogen.
· High sugar intake – Sugar is metabolised in the liver where it is converted into fat. Increased fat production in the liver shuts down the production of Sex Hormone Binding Globulin (SHBG) which is also made in the liver. SHBG is a transport protein which transports the majority of Oestrogen and testosterone around the body. When being transported by SHGB the sex hormones are inactive. As the amount of SHBG decreases, the amount of hormone that is not bound by transporting free and unbound increases. Unbound hormone is active and results in increased oestrogen and testosterone activity although total levels of oestrogen and testosterone may remain the same.
· Nutritional deficiencies – The production, transport and metabolism of hormones requires a number of vitamins and minerals including magnesium, zinc, B vitamins, protein and selenium. Nutritional deficiencies of these nutrients may affect balance of these hormones.
· Diets high in saturated fat – The sex hormones are made of fat and are therefore able to be stored in fat cells. Conventional farming uses synthetic hormones to increase the growth rates and slow down the metabolism of the animals which decreases the amount of animal feed they consume leading to greater cost efficiencies. However, these hormones can be stored in the fat of the animals and so eating high levels of animal fat may increase exposure to these hormones.
· Low fibre intake – adequate fibre regulates transit time of waste through the bowel reducing the chance of the hormone being reabsorbed and is a source of food for probiotics in the bowel.
Metabolic & biochemical
· Elevated insulin -Insulin acts directly on the ovaries to increase the production of androgen hormones including testosterone (1).
· Poor liver function – Once they are no longer required, sex hormones are metabolised in the liver and then excreted. A poorly functioning liver may result in ineffective breakdown of unwanted or used hormones allowing them to re-circulate around the body rather than being excreted.
· Poor gut health - Once detoxified by the liver, the deactivated hormones are released into the intestine for elimination. The intestine is home to trillions of bacteria. Some of these bacteria are able to convert the deactivated oestrogen metabolites back into active hormone which can then be reabsorbed back into the bloodstream. An overgrowth of these bacteria may therefore stop oestrogen being excreted from the body (3).
· Being overweight – Obese women have 50-100% more oestrogen than women of a healthy weight. Far from being simply a way to store fat, fat cells are metabolically active and they contain an enzyme that converts testosterone into oestrogen. In obesity, this additional conversion of testosterone into oestrogen may lead to oestrogen dominance.
· Hypothyroidism – One of the roles of thyroid hormone is to increase the liver’s ability to excrete oestrogen. In cases of hypothyroidism cases, this conversion may not be working as efficiently resulting in excess oestrogen in the body.
· Anovulatory cycles – An anovulatory cycle is a menstrual cycle in which no egg is released. The release of progesterone is triggered by ovulation. Without the release of an egg, there is no trigger for progesterone production, resulting in an oestrogen dominant state.
Supporting hormone balance with nutrition
As part of a hormone balancing diet, include:
· Healthy fats from foods such as nuts, seeds, olive oil, avocado and oily fish (such as salmon, mackerel, anchovies, sardines and herrings).
· Phytoestrogens, which are a type of nutrient only found in plants can help balance oestrogen levels. They exert weakly oestrogenic effects and so can help in cases of both high and low oestrogen. In cases of oestrogen dominance they blocking the action of the more powerful oestrogen hormone and in cases of low oestrogen such as menopause, they add oestrogenic influence. Examples phytoestrogen rich foods include soy, alfalfa, sunflower seeds, sesame seeds, flax seeds, brown rice, fennel, beans, chickpeas, oats, apples and pomegranate.
· Fibre which is found in plant foods. In particular wheat bran, fruit and vegetables, oats, okra, aubergine, chia seeds and flaxseed are good sources of fibre. The government recommends at least 30g of fibre per day.
· Fermented foods contain bacteria and so help to support a healthy microbiome in the gut. Examples include probiotic yoghurts, sauerkraut, kimchi, tempeh, miso and tamari whilst kombucha is a fermented drink.
· The brassica family of vegetables contain chemicals that support liver function and may positively influence the rate at which the liver processes oestrogen. Brassica vegetables include broccoli, cabbage, cauliflower, kale and Brussel sprouts.
· A good source of protein as the liver requires amino acids which come from protein to function optimally. Good sources of protein include lean meat, fish, legumes, eggs, poultry.
· Foods rich in the nutrients required for hormone production, transport and detoxification including magnesium (e.g. wholegrains, nuts, legumes, seafood), zinc (e.g. shellfish, ginger, meat, wholegrains, nuts and seeds), B vitamins (e.g. whole grains, eggs, meat, salmon, poultry) and selenium (e.g. brazil nuts, meat, seafood).
· Sugary, processed foods to optimise insulin levels
· Meat and dairy intake, especially non-organic. Replace with oily fish, pulses, seeds, nuts and eggs.
· Alcohol – alcohol is detoxified by the liver which is also the site of hormone detoxification where excess hormones are metabolised and removed making it a key factor in balancing hormones. If the liver is overwhelmed detoxing alcohol, there is little reserve left to remove excess hormones.
Lifestyle recommendations to support healthy hormone balance
· Maintain a healthy weight – As fat cells produce oestrogen, maintaining a healthy weight is key to healthy hormone balance.
· Reduce stress – As well as removing stressors, aim to improve resilience and response to stress. Meditation, breathwork, yoga, Pilates, Tai Chi may positively modulate the stress response.
· Exercise – Exercise has been shown to modulate the gut bacteria which may help with eliminating used hormones from the body, it also stimulates the lymphatic system to help clear waste and toxins from the body and improves insulin sensitivity and blood sugar balance which may impact hormone balance.
· Eliminate exposure to artificial oestrogens – use glass, ceramic or stainless steel containers for food storage, choose organic produce; choose natural detergents and cosmetics wherever possible and avoid products containing parabens.
In addition to the above dietary and lifestyle recommendations, there are a number of supplements that may help relieve the symptoms of PMS as outlined below:
For overall general support try a B -vitamin complex – that includes vitamins B6, B3, B9 and B7 (biotin), Vitamin C, Magnesium and Evening primrose oil.
To calm anxiety and irritability try glutamine, taurine, lemon balm, passionflower or hops. To help ease insomnia try valerian.
For menstrual cramps consider Dong Quai (Angelica sinensis) which has muscle relaxing properties and helps to balance hormones.
If symptoms disappear once menstruation starts consider Chasteberry (Vitex agnus-castus) which has been shown to help balance excess oestrogen and low progesterone and reduce symptoms by 42% (8).
If suffer bloating and water retention consider Dandelion which is a strong diuretic and also a liver supporting herb.
It is important that if you suspect you may have a hormone imbalance, you get your hormone levels checked out. At BrainFit Nutrition we use the DUTCH test which not only gives a comprehensive overview of hormones levels but also shows how well they are being metabolised to give a really clear picture on what action to take to normalise the balance.
Furthermore, genetic testing can tell us if there are any specific pathways that may not be working optimally as to how well these pathways maybe working and identify areas of additional specific nutrient and supplement support.
If you suspect you are suffering with wonky hormones, get in touch to see how we can help you come up with a personalised nutrition and lifestyle plan to get your hormones back into balance. Conctact us here.
Disclaimer: The information provided in this newsletter is not personalised medical advice and you must always consult your GP if you are suffering with ongoing symptoms.
ALWAYS consult a qualified practitioner before taking supplements as there maybe secondary effects and drug and nutrient interactions to consider.
1. Holford, P. Optimum nutrition for the mind. London : Piatkus Books, 2007.
2. Matthews, J.B., Twomey, K., Zacharewski, T.R. In vitro and in vivo interactions of bisphenol A its metabolite, bisphenol A glucuronide, with estrogen receptors alpha and beta. Cehm Res Toxicol. 2001, Vol. 14, 2.
3. Burghen, G.A., Givens, J.R., Kitabchi, A.E. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. The Journal of Clinical Endocrinology and Metabolism. 1980, Vol. 50, 1.
4. Hodges, R.E., Minich, D.M. Modulation of metabolic detoxification pathways using foods and food derived components: A scientific review with clinical application. J Nutr Metab. 2015, Vol. 16.
5. Holford, P. Balancing your Hormones. London : Piatkus Books , 2014.
6. Epidemiology of Premenstrual Syndrome (PMS) - A systematic review and meta-analysis study. Direkvand-Moghadam, A, et al. 2, 2014, Journal of Clinical and Diganostic Research, Vol. 8, pp. 106-109.
7. Recording and treatment of premenstrual syndrome in UK general practice: a retrospective cohort study. Sammon, C J, Nazareth, I and Petersen, I. 3, 2015, BMJ Open, Vol. 6.
8. Tice, J. Phytoestrogen supplements for the treatment of hot flashes: The Isoflavone Clover Extract (ICE) Study; A randomized controlled trial. Journal of the American Medical Association. 2003, Vol. 290, 2.