“My hormones are out of whack!” “Sorry, I am hormonal!” “I really feel like I have a hormonal imbalance.” This seems to be all that everyone is talking about lately, but what does a hormone imbalance even mean, is it a diagnosis or the cause of your symptoms?
A hormone imbalance literally means that you are making more of one hormone compared to another. Whenever you over produce one hormone or under produce the another you can have symptoms. Simple right? Not so much! The most common patterns we think of when discussing hormone imbalances are high male sex hormones, commonly testosterone or DHEA, or high estrogen. Let’s break it down!
If you experience symptoms of acne, hair growth, hair loss, anovulation or irregular periods then you might have high androgens. Most of the time this hormonal imbalance is what I define as a laboratory imbalance. This means that when we take your blood and measure these hormones either free testosterone, DHEA-s or DHT will be high. In rare cases you can have normal androgens but very low female sex hormones and still have symptoms. This is because you do have more androgens so the teeter totter swings in that direction. Ideally we want a balance between estrogen, progesterone and androgens.
Heavy, painful periods, fibroids, weight changes, bloating, PMS, breast tenderness and headaches are often associated with ‘estrogen dominance’. In this situation you can have three main causes, high total estrogen, high 4-OH estrogen metabolites or low progesterone. All of these patterns can give similar symptoms but the treatments are completely different. Hence why I love lab testing!
High total estrogen can result from poor estrogen detoxification or increased estrogen production (which can happen from the ovary or adipose tissue/ fat cells). Here we need to look into estrogen producing cysts, genetics, total body burden, liver health, gut health and body composition.
High 4-OH estrogen metabolites are breakdown products of estrogen metabolism. Essentially, when your body is trying to get rid of estrogen it starts to break it down in the liver. In certain cases, either due to genetics or environment, your body makes a more reactive type of estrogen byproduct in a larger ratio than normal. In this case, you can have symptoms of estrogen dominance even when your blood work looks relatively normal. The DUTCH test is a comprehensive functional medicine test that we use to help isolate this pattern.
Low progesterone has got to be one of the main causes of estrogen dominance. Here you might have slightly less heavy periods or fibroids but more emotional and sleep symptoms. Progesterone is also pro-gestation, or baby making, so it is important to investigate if you are having troubles conceiving. In addition to this, progesterone is an antiinflammatory hormone so even outside of lab work seeing more issues with inflammation can be a hint. Low progesterone levels is currently a huge issue in women of reproductive age. Progesterone is made only after ovulation from a tissue known as the corpus luteum. This tissue is sensitive to inflammation, low antioxidants, nutrient deficiencies and many other things. Your brain is also what controls ovulation and this is really sensitive to stress from all sources, among many other things!
No matter what the cause of your hormonal imbalance this does not have to be something that you struggle with! There are many natural treatment options to support estrogen, androgens and progesterone.
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