Radio Show Talking Points: Female Sex Hormones

Tonight I was invited back on the radio (Community-Minded Radio) as a guest of The Wellness Workshop with Celeste and Phil Davis. As we move ever so quickly into the fall season and with only two live shows remaining (with me) I wanted to talk more about female sex hormones because they are closely associated with thyroid function and vice versa.

There are rather obscure tidbits to be considered pertaining to estrogen, progesterone, and testosterone and their relationship to thyroid health. Often these are discussed as if they’re not associated with one another and then observed and treated through a mechanistic lens. In reality, it’s important when considering thyroid or any other hormone to differentiate between protein bound and free forms of the hormone because they’re all connected…hormones are the chemical messengers of the body. We won’t be discussing chemistry, however. 🙂

Over the past few months I’ve worked with several women; some who are in perimenopause, and others who are post-menopausal and I’ve been taken aback to see so many hormone similarities in the two age groups. I’ve also been taking weekly classes (Clinical Rounds) as an observer listening in to multiple functional medicine practitioners as they discuss case studies and current protocols. It’s been fascinating!

When there is a thyroid imbalance there is almost always a sex hormone imbalance and vice versa. Not to go into the physiology of the hormone cascade, but do know that they are all interconnected. This truth bomb is a little known fact believe it or not among many conventional practitioners. And so what happens, when a woman presents with complaints in one area, she is often treated for only that issue, wreaking havoc on the opposing system as the body tries to maintain balance.

Before we go any further let’s briefly review:

Menopause is the time when menstruation stops. Estrogen drops and there has been no bleeding for one year. A woman may have bleeps during that time and this is why it is important to wait one full year of no bleeding to deem she has gone through menopause.Too hot or too cold

Perimenopause is a time of hormonal chaos. It is the time when major hormonal disturbances begin and is a time when women actually make more estrogen…NOT less. It is also a time when a woman may experience:

  • Uterine fibroids
  • Heavier periods and flooding
  • Endometriosis
  • Hot flashes
  • Migraine headaches

Perimenopause is also the time many women may be advised or have had a hysterectomy and it is the time when breast cancers begin related to too much estrogen…not too little. In addition, the hot flashes which appear during perimenopause result from two causes:

  • Estrogen spikes: A very sudden drop in estrogen from a high level to a low level (this can also trigger a migraine)
  • Adrenaline: Since estrogen sets the rheostat so to speak – it sets the sensitivity of the temperature control mechanism in the hypothalamus. But the on/off switch that causes the hot flash is actually adrenaline. So, if you have a spurt of adrenaline, you’ll get a hot flash.  Functional medicine practitioner Dr. Bethany Hays shared her story during a lecture:

“I used to have a regular hot flash every day at 11:15. I ate the same breakfast every morning and at 11:15 my blood sugar would drop. So, with a drop in blood sugar, the body has to do something to fix the problem [to raise blood sugar] and this causes adrenaline to get released. When I figured this out, I started having a handful of nuts at 11:00, and the hot flashes went away.”

SIDENOTE: It is essential and very important to treat hot flashes as a sign of too much adrenaline! The adrenal glands release adrenaline so it is critical to heal them.

Hot flashes should be your barometer for too much stress
Womens menopause sign in red and black
If you are experiencing hot flashes your focus should be on getting better sleep, eating better, lowering your stress level, learning to let go of things, and learn to say “no” more often.  Bio identical estrogen replacement therapy should never ever…never(!) be given before you have had your very last period.

Testosterone and Perimenopause


Low testosterone is almost always related to an adrenal problem. When women are under stress the adrenal hormones get pulled away to make cortisol and they get pulled away from the pathway that makes testosterone and progesterone.
A woman will continue to make estrogen from fat cells but the testosterone levels will become depleted. Sex-Binding Hormone Globulin (SBHG) goes up and you bind estrogen only to feel really bad at this point because at this point thyroid hormone is blocked as well.
The treatment is not testosterone! It is far better to treat issues of underlying stress because in this situation to give testosterone will only increase the risk of cancer. Address your stress and heal the adrenals.

Bioidentical Progesterone and Perimenopause


There is some evidence that shows if bioidentical progesterone is used before menopause it helps to prevent breast cancer. It decreases estrogen’s effects by down-regulating estrogen receptors.
Progesterone is very hard to measure in blood because there are too many pathways it can go. For example, it can go to cortisol, testosterone, and it can even be metabolized down the pregnenolone pathway so according to functional medicine practitioners, progesterone is difficult to accurately measure through a blood test. With this in mind…if a woman has been prescribed bioidentical progesterone and her levels measure high in a blood test, she is certainly being over-dosed on her progesterone.

SIDENOTE: Sometimes, especially in the clinical setting, high doses of progesterone are given to get a specific brain effect (e.g. in traumatic brain injuries) because it is very calming. If you make it for one of the brain pathways, allopregnenolone is a fantastic brain calming chemical.

Many functional medicine practitioners are divided when it comes to topical vs. oral bioidentical progesterone therapy. Some still use transdermal cream, however, others say oral sublingual and troche versions are potentially better absorbed, and they have expressed concerns over transdermal creams regarding transference to others (spouses, children, etc) and the potential for toxicity issues.

The standard for testing hormone balances is a saliva test, however, I’m seeing many practitioners going back to blood tests merely because a blood test is covered by most insurance plans whereas a saliva panel is not . . . this is where a Flexible Savings Account comes in handy because even though insurance may be covering a blood test, it’s not an accurate measure of hormone levels.

Metabolites

Metabolites are molecules that look like estrogen. When a practitioner orders a metabolites urine test it is to measure ones overall lifetime exposure to estrogens. For example, all of the following are estrogen mimickers and contribute to a woman’s estrogen profile. Without testing for metabolites, a practitioner cannot truly discern a woman’s estrogen levels because these estrogen-like molecules look like estrogen whether it be in a blood or a saliva test:

  • BPA from plastics
  • Xenoestrogens from the environment
  • Synthetic birth control pills
  • Glyphosates from GMO products & herbicides (Roundup)
  • Food additives & foods that contain hormones
  • Soy
  • Parabens
  • Flax seed in high doses

These aggressive and toxic estrogen mimickers are also endocrine disruptors…they wreak havoc on the endocrine and immune systems and they increase physiological stress in the body. And again, if metabolites aren’t tested it is a challenge for a practitioner to asses a woman’s true estrogen profile. As a result, she may be under/over-dosed on her bioidentical hormone replacement. Word to wise women: if you are considering the need for estrogen, please have the metabolites test done in addition to saliva or blood tests for hormones.

Women, Girls, Stress, and the Female Hormone System

Earlier I referred to a common theme among post-menopausal, perimenopausal, and even young women being discussed a lot lately among functional medicine practitioners. What they’re beginning to see is that many young women from high school age to the early 20’s to 50 year old women have the hormone output of an 80+ year old woman. Particularly for the younger women this is affecting their ability to conceive. They say this phenomenon is mostly seen in educated, intelligent, and over-achieving women who are exceeding above and beyond their male counterparts.

The female hormone system is a much more delicate and well-balanced system than the male system is and it tends to “crash” as the result of extreme over-achieving, emotional pressure, body-image pressure & wacky dieting, extreme academic and career stress…pressure to perform and exceed. I’m talking “over-the-top.” Of course, the environment and toxins also contribute. Unfortunately, women pay a higher price with their hormones than men do with theirs.

Obvious Signs of Female Hormonal Imbalance

  • Teens:  Acne, sugar cravings, compulsive behavior & eating, late periods, erratic cycles, craving chocolate, excessive bleeding or a complete absence of cycles.
  • 20’s/30s: Fertility issues, migraine headache, mood swings, weight gain (the fat-burning hormones can become decreased).
  • Mid 40’s/50’s: Hot flashes, night sweats, vaginal dryness, irritability, crying for no reason.
  • #1 Blanket Problem among 20 year old women to 65 year old women: Low to No sex drive. I find this to be shocking especially for younger women.

Non Obvious Signs of Hormonal Imbalance

  • Gut Issues – the more damaged the hormone system is, the greater the damage to the digestive system. There is a deep interconnection between the hormone and gastrointestinal system.
  • Adrenal & Thyroid Issues – it’s all connected!
  • Increased stress = increased cortisol = decreased female hormones
  • Cortisol causes inflammation and damage to the GI tract; at the same time cortisol regulates the health of the lining of the GI tract. As the lining deteriorates, leaky gut syndrome results making one susceptible to:
  • Infections & parasites
  • Autoimmune disease
  • Gluten and other food intolerances
  • DECREASED HORMONES = INCREASED DIGESTIVE TRACT PROBLEMS

What Do We Address First?

  1. The #1 priority should be to implement an Adrenal Hormone Healing Protocol to balance cortisol and female hormone correction.
  2. Secondary to that is to implement a GI Healing Protocol after a couple of months of healing the adrenals and balancing hormones.

Major Stressors to the Hormonal System

  1. Emotional stress
  2. Dietary stress
  3. Inflammatory & Pain stress

Emotional stress is the number one stressor; however, for any of these that accumulate over time there is an increase in cortisol which ultimately taxes the adrenal glands. When we are under stress and aren’t managing it very well, what happens is that as stress increases, cortisol follows, and our hormones crash. Our relationship to food then changes and we are driven to eat – and it’s not a “mind over matter” issue that we can necessarily control. Under long term stress we actually need to eat a fair amount of carbs just to function normally. The problem is, we get addicted, and this is referred to as “Disordered Eating” (not to be confused with an eating disorder) which further dysregulates our hormones. Often we tend to keep eating the wrong food even if we are reacting to it because:

  • Gluteomorphins, found in many carbs; and Caseinomorphins found in dairy makes us feel a sort of “high” which feels good and it’s hard to stop…we keep going back for more of what makes us feel good when we’re physiologically or emotionally stressed.
  • Combine this with low serotonin and dopamine levels and it’s really hard to overcome – and very easy to get past the point of no return.  This is where will-power doesn’t seem to help very much and is why we must learn positive and healthy coping skills to manage stress and practice them on a daily basis.
  • The bottom line is that declining hormones lead to declining health.

Lifestyle Changes to Improve Thyroid & Hormones

  • Diet (eliminate sugar & refined foods, otherwise hormones will never recover).
  • Exercise (not too much & not too little).
  • Learn to Manage Stress (think about leaving the iPhone at home, get off Facebook, email, and texting…we don’t need to be doing these things every minute of the day), get outside in nature…walk barefoot in the grass – without your phone! I personally love to journal, meditate, pray, exercise, and I’m a big visualizer…I “see” myself healthy. See my tips for journaling to heal here and my article Coping with Stress here. 
  • Sleep patterns – in bed and asleep by 9 or 10 pm.

Love Hate Computer Keys Showing Emotion Anger And ConflictOf all the stressors a woman can encounter, emotions impact hormones most significantly. Bad relationships, whether it be a bad marriage, bad boyfriend or other relationships rank at the top of emotional stress because they impact a woman’s soul on such a deep level and result in automatic, perpetual feelings of frustration, anger, and irritation.  Women who are perhaps emotionally or spiritually disconnected are the most affected. It is difficult however to seek emotional or spiritual growth when one isn’t well physically. I love the phrase “physical health is our platform for emotional and spiritual growth.” We need to heal the physical so we can get on with our real purpose in life for being on this earth…we certainly aren’t here to constantly be having lab tests and taking a bunch of supplements all the time! No no…our purpose is much higher.

 

 

 

 

 

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