Erica Kelly, a 35-year-old marketing executive, couldn’t believe there could be a simple solution to her chronic fatigue and depression. Two years ago, she felt tired and cranky all the time. “Around my period my symptoms were always worse,” says Kelly. “I went to one doctor who put me on 10 supplements; another specialist I went to said I needed 10 different ones. I bought books, and I tried journaling to track my moods and symptoms. Nothing worked.”
Then she went to see integrative internist Erika Schwartz, M.D., author of The Hormone Solution and The 30-Day Natural Hormone Plan. Schwartz was able to identify the common denominator underlying Kelly’s problems: hormone imbalance. Yes, at age 35.
If you saw that one coming, you’re one step ahead of many Western doctors. “We’re trained to address symptoms of hormone imbalance rather than putting them into context and treating the causes of the symptoms,” says Schwartz.
In healthy women—and forgive us if we sound a little Our Bodies, Ourselves 101 for a second—the ovaries and the adrenal glands produce various hormones that equalize the ebb and flow of everything from menstruation to metabolism to sleep, after which they’re broken down by the liver and then excreted by the kidneys and digestive tract. But if any part of the chain isn’t working properly, your hormones aren’t in balance, and the whole body can short out.
“Many female health issues are due to hormone imbalance,” says Susan Lark, M.D., a San Francisco-based clinical nutrition and preventive medicine specialist. And for most women, the problem boils down to one cause: estrogen dominance. “If you’re among the millions of women in the 35 to 55 age bracket experiencing headaches, sleep difficulties, fluid retention, anxiety, irritability, mood swings, cramps, weight gain, breast tenderness and heavy bleeding,” says Lark, “you’re likely to be affected by estrogen dominance.”
Estrogen is a wonderful hormone. In the right amount, it makes conception and pregnancy possible; it’s also a natural mood lifter and skin toner. But many women have too much of a good thing for too long. In addition to the unpleasant symptoms of PMS and perimenopause, too much estrogen can lead to fibroids, benign uterine disease and some female cancers.
Progesterone is the estrogen police; it helps balance estrogen. In the right ratio, the two hormones help the body burn fat for energy, act as an antidepressant, aid in reducing fluid retention, assist metabolism and promote sleep. Estrogen dominance occurs when a woman’s body doesn’t have enough progesterone to keep the estrogen in check.
So what causes this excess of estrogen? Beyond our bodies simply making too much, probable causes include environmental toxins, rampant stress, nutritional deficiencies and the estrogens introduced into the food supply.
“Commercially produced meat, eggs and dairy products can be full of hormones, which are often injected or fed to the animals to promote faster growth,” says Loretta Lanphier, NP, CN, a naturopathic practitioner and the CEO and president of Oasis Advanced Wellness in The Woodlands, Texas. “The hormones start in the grains we feed animals, then make their way up the food chain and into our bodies.” The concern compounds over the years. “By the time I see women in their 30s, their bodies are often a mess, hormone-wise.” (And not to scare you husbands, but estrogen levels—particularly of estradiol—rise in men as they age.)
To stabilize your body’s levels of estrogen, you need to reduce its production, block its ability to bind to tissues and assist its breakdown and elimination. By taking a natural approach—a combination of diet and lifestyle changes, bioidentical hormone therapy and supplements—you can see results in as quickly as 30 days. And begin now. “Don’t wait until you get steamrolled like your mother did,” Schwartz says. “Starting young can set you in a healthy pattern for the rest of your life.” To balance your hormones, take these five simple steps:
Women should first determine their hormone levels. A blood, urine or saliva test can be ordered from online suppliers; Lanphier likes one available from ZRT Labs at salivatest.com.
Typically, these tests will determine your levels of five different hormones (estrogen, progesterone, testosterone, DHEA and cortisol). “If any one of these is out of balance, the entire body can feel out of balance,” says Lanphier. “But the frequent mistake women make when they get their results is to run out and take more of everything they’re deficient in. That’s not the best way to achieve balance.” For many women, if their progesterone-estrogen ratio is out of balance, the addition of bioidentical progesterone can be enough to alleviate symptoms and help achieve balance, she explains. But the best bet is to always consult a knowledgeable practitioner, who can help you interpret your test results and apply them to your overall medical picture.
“It’s impossible to exaggerate the importance of good nutrition in controlling hormones,” says Lark. “No medication can entirely overcome the effects of a poor diet.” What’s the connection? A diet high in sugar and starch moves into the bloodstream quickly and causes insulin to spike—and high insulin levels trigger an increase in estrogen levels. Also, most women with PMS experience a drop in serotonin levels, which triggers cravings for carbs because the body uses carbs to make serotonin. A study in the British Journal of Nutrition showed that women who suffered from PMS consumed significantly more cakes, desserts and high-sugar foods before their periods; a 2013 study published in the American Journal of Epidemiology analyzed data from this study to reach the conclusion that foods rich in non-heme iron (vegetables) and zinc have also been linked with lower risks of PMS.
Schwartz recommends eliminating soda, sugar, caffeine, alcohol and highly processed foods; Lark adds saturated fat, red meat, dairy products and white flour to the no-no list. At the very least, look for organic meat and dairy products that are certified free of hormones, she says.
On the other hand, foods like complex carbohydrates break down slowly and help keep blood sugar levels stable. So, Schwartz says to load up on plant-based proteins, whole grains, healthy fats, colorful fruits and vegetables, green tea and “good” sweeteners (think natural organic honey, brown sugar or stevia). Soy foods, buckwheat and ground flax meal are particularly beneficial, Lark adds. “If your symptoms are mild to moderate, you can be a little less rigid. But if your symptoms are severe, dedicate yourself to the diet until you begin to get relief.”
“When we’re under severe stress, we’re less likely to ovulate,” says Lark. If you don’t ovulate, you don’t produce progesterone during the second half of your cycle. Without enough progesterone to keep estrogen in check, the negative effects of estrogen can become more pronounced. Stress also raises levels of cortisol, which causes other hormones to get out of balance.
If it’s immediate relief you’re after, try meditation or yoga—or an attitude shift. “When a stressful situation occurs, remember that you can’t control the situation, but you can control your reaction to it,” recommends Schwartz. “Try to keep cool, or at least accept that you can’t change the situation.”
The most direct way to offset high estrogen levels and regulate other hormones is to take in more bioidentical progesterone. Many doctors offer synthetic hormones in the form of hormone replacement therapy (HRT) or birth control pills, but be wary: The practice has been linked to increased risk of stroke and female cancers. Women can get the same benefits without the side effects by using bioidentical hormones—that is, hormones extracted from wild yams or soy oil that are molecularly identical to those produced by the human body. These are best applied as a cream. Patients rub on a small amount where skin is thin: the neck, upper chest, underarms or wrists.
Low-dose progesterone creams are available online and at health food stores, and most medical practitioners recommend using progesterone cream once a day for the two weeks before your period starts, which often coincides with the worst symptoms. Generally, the bloating, headaches, mood swings and insomnia abate within two menstrual cycles of using the cream.
After three months, women should stop hormone therapy and see how they feel; many patients can cease using the cream if they’re maintaining good lifestyle habits. After applying the cream for several months, Belson now finds she can maintain her hormonal equilibrium simply by watching her diet and exercising.
It’s safe to treat yourself with progesterone, Lanphier says; if you use too much, the worst side effect is fatigue. However, while younger women will do well with progesterone alone, women in their late 30s or older may need to combine progesterone and estrogen under the supervision of a physician.
In addition to lifestyle changes, Lark advises women—particularly those with estrogen dominance—to add the following supplements to their daily diet:
FLAX: Take 2 tablespoons of flaxseed oil or 4 to 6 tablespoons of ground flax meal to help promote more frequent ovulation, and thus more progesterone production. Supplementation will also provide essential fatty acids necessary for reproductive health.
VITAMIN B COMPLEX: Take 25 to 100 milligrams of a good multi-B formula to help support the liver so it can process estrogen more efficiently.
VITAMIN C: A premier antioxidant, vitamin C helps clean up toxins created by the body in nearly every one of its chemical processes, including the manufacture of hormones. Take 600 to 2,000 milligrams.
MAGNESIUM: This mineral is critical to helping the body produce energy and for keeping the cycle of hormone production and excretion in check. Take 500 to 600 milligrams.
CALCIUM: Essential to maintaining healthy bones, calcium also helps reduce moodiness, food cravings and water retention, especially when combined with magnesium. Take 1,000 to 1,200 milligrams. Give these changes a try. If you notice that between days 15 and 28 of your cycle you’re less edgy and crave fewer sweets, you’re on the road to natural balance.