Women’s Health and Hormones
Over the next month, I plan to cover topics all related to women ‘s health and hormones including: the basics of hormones, PMS, PCOS, estrogen dominance, fertility, and perimenopause. I will dive into the pathophysiology of these different disorders as well as what we can do to mitigate symptoms through lifestyle, supplements and medications. I am really passionate about women’s health and hormone health and it doesn’t get enough attention in the conventional world. Even when it does there is usually one solution: birth control. And there is so much more to it than that. Let’s get started!
Menstrual Cycle Basics
During our reproductive years (approximately 35 years during a woman’s life), a normal menstrual cycle is 21-35 days in length. This cycle consists of the menstrual phase (day 1-5), the follicular phase (day 6-14), ovulation (day 14) and follicular phase (day 15-28). The hormones involved in this cycling include: estrogen, progesterone, follicle stimulating hormone, luteinizing hormone, gonadotropin hormone-releasing hormone, and thyroid hormones.
A menstrual cycle is considered abnormal when there is more than 3 months between cycles, cycles occur more frequently than every 21 days or longer than every 45 days, menstrual flow lasts greater than 7 days, or there is a need to change menstrual products more than every 1-2 hours. There are also abnormalities that may be seen during puberty such as no menstrual cycle by age 15 or absence of cycle 3 years after breast development.
Symptoms that Suggest a Hormonal Imbalance
There are a wide variety of symptoms that can suggest a hormone imbalance including:
- Mood swings
- Breast tenderness
- Heavy periods
- Cramps
- Anxiety
- Fatigue
- Sleep disturbances
- Hot flashes
- Low libido
- PCOS
- Acne
- Infertility
- Hirsuitism
- Weight gain
- Hair loss
- Brain fog
- Endometriosis
- Uterine fibroids
- Constipation/diarrhea
I will discuss many of these symptoms in relation to different disorders and dysfunctions in the coming weeks but first, since we are talking about the menstrual cycle let’s talk about luteal phase dysfunction…
Luteal Phase Dysfunction
What is it? Luteal phase dysfunction (also referred to as luteal phase deficiency or defect) is defined as a luteal phase of less than 11 days or a maximum serum progesterone of less than 5 ng/ml and it can be that there is low overall progesterone production, or progesterone drops off too quickly or there is progesterone resistance in the endometrium. There is also typically lower mean estradiol, luteinizing hormone and follicle stimulating hormone.
Luteal Phase Dysfunction Clinically Defined:
- luteal phase less than 11 days
- maximum serum progesterone of less than 5ng/ml
- Lack of endometrial maturity via histology
- There is no diagnostic gold standard
What luteal phase dysfunction looks like?
- frequent periods/short cycles
- spotting between periods
- heavy periods
- miscarriage
- infertility
What can cause luteal phase dysfunction?
- eating disorders
- nutritional factors (low calorie or low fat diets)
- low cholesterol
- excessive exercise
- stress
- obesity
- PCOS
- aging
thyroid dysfunction - hyperprolactinemia
Treatment of LDP: First: correct any underlying condition that may be contributing.
If no abnormality:
- Improve insulin sensitivty (balanced, whole foods diet)
- 80mg/day progesterone cream (as effective as 200mg/day oral progesterone)
- Vaginal progesterone suppository
- Improving thyroid function
- If obese, weight loss may increase progesterone and lead to resumed ovulation
- Supplements that may be helpful: Vitamin C & E, Omega 3 fatty acids, B vitamins, vitex (chaste tree berry), antioxidants
In the coming weeks I will dive deep into women’s health and hormones and the associated conditions and symptoms that women can experience. I hope to offer an integrative approach with more options that are traditionally presented in the conventional model of women’s health and hormone treatment.
If you are struggling with any hormone concerns, reach out and book a free 15 minute intro call to see how I can help and head over to our services page to learn more about what Alison offers!