Hormone Health For Women – Naturally

Hormones are an integral part of a woman’s health and vitality, influencing everything from mood and energy levels to reproductive function and overall well-being. As a naturopathic doctor with a focus on women’s health, I emphasize the importance of maintaining healthy hormones throughout a woman’s lifespan. In this article, we’ll explore practical tips to support hormone balance.

During early life, hormones promote growth and maturation. Proper nutrition, care, and a nurturing environment are crucial to foster healthy hormonal development in these formative years. During adolescence, hormones play a key role in puberty, influencing emotional well-being, skin health, and of course, menstruation. Many young women are told that it is just normal to experience PMS, painful periods and excessive flow. But these can be signs of hormone imbalances that can be corrected with natural methods. My favorite herb for teens with period problems is Chaste Tree, or Vitex Agnus Castus. This remarkable herb aids the pituitary gland in balancing hormones and has been proven to safely help some menstrual cycle problems.

In adulthood, hormones like estrogen and progesterone regulate the menstrual cycle, fertility, and libido. Hormone balance is essential for reproductive health during these years. In an age where more women are choosing to delay pregnancy, fertility challenges have become increasingly common. I guide my patients in understanding their body’s rhythms and how to optimize their fertility if that is their goal.

Of course, balanced hormones are critical for a healthy pregnancy, and particularly in the postpartum period. Nutritional support and stress management are vital, and naturopathic physicians can provide guidance to women on the safe use of natural medicines during and after pregnancy.

As women approach middle age, menstrual issues and PMS can become more pronounced as the hormone glands struggle to regulate the cycle during perimenopause. This is when active intervention with naturopathic approaches can be pivotal. For instance, natural anti-inflammatory herbs like ginger have been shown to significantly reduce blood flow in menstruating women. Menopause can be a relief or a challenge as rapid hormone changes can give rise to a range of symptoms, including hot flashes, mood swings, and insomnia. There is so much conflicting information out there about hormone replacement therapy, but the most recent scientific findings indicates that it can be used safely long term, and it can help prevent some diseases of aging like cognitive decline and osteoporosis. If it is done right. (See my detailed blog post for more information.)

As women age, we need to keep in mind other hormones that can affect our health and wellbeing. Cortisol, the primary stress hormone, when imbalance, can contribute to lowered immunity, abdominal weight gain, blood sugar imbalance and more. Maintaining blood sugar with the hormone insulin can be more challenging but is critical for disease prevention. Hypothyroidism affects up to one in six women in their lifetime, and the risk increases with age. So just because you were “fine” five years ago, doesn’t mean that your fatigue, depression and weight gain aren’t attributable to low thyroid hormone now.

The body’s hormones are all interconnected and are influenced by our immune system, our digestion (think microbiome) and our lifestyle. Key lifestyle factors that can improve your hormone health include moderating caffeine and alcohol intake, embracing whole food nutrition, regular exercise, ensuring adequate sleep, effective stress management, and maintaining a healthy weight. As a naturopathic physician I often recommend natural medicines and bioidentical hormone prescriptions to help women optimize their hormones.

Empower yourself with knowledge. Stay well-informed about hormonal health and its impact throughout the lifespan. A naturopathic physician with a focus on women’s health can serve as an invaluable resource for guidance and education.

 

Bioidentical Hormones – Research Update

The pros and cons of hormone replacement therapy (HRT) for perimenopausal and menopausal women have been hotly debated for many years. As a naturopathic physician, I’ve helped women navigate the choppy waters of menopause for over two decades. I believe that hormone management should be very individualized and I  generally recommend lifestyle first, natural medicines second, and pharmaceuticals third, if possible. I recently completed a course that analyzed the research on HRT over the last 20 years. When you look carefully at the research, there is a role for hormone replacement therapy to help manage symptoms of perimenopause and menopause safely and effectively and to serve as a preventative medicine. 

First, some history. HRT was used for 70 years before the Women’s Health Initiative (WHI) did the first large placebo-controlled study in 2002. This groundbreaking study sounded alarms regarding increased breast cancer risk in women who took Premarin (estrogen) and Provera (synthetic progesterone).  In addition, they found a higher rate of blood clots, potentially leading to strokes and more, so many women were unprescribed HRT as a result. 

Subsequent analysis determined that the study had major flaws. The average age of the women starting estrogen therapy was 65. We now understand there is a critical window for starting hormone therapy to maximize the benefits and reduce the risks, which is within ten years of one’s menopause, or under 60. 

Second, the estrogen used in the experiment was extracted from pregnant mares’ urine and contained non-human estrogens. Now, most prescriptions written use a bioidentical estrogen called estradiol or E2. It is processed much differently in the body and has fewer risks. The progesterone used was a synthetic cousin of our progesterone called progestin, which comes with many more side effects. Third, the route of administration of estrogen matters. Yes, taking oral pills of estrogen does increase blood clotting, especially in women over 60. However, using a patch or cream on the skin does not do so in any significant way. We’ve come a long way from 2002 to understand how to use these hormones safely. 

According to the esteemed North American Menopause Society, estrogen has strong evidence showing it helps with hot flashes and night sweats. They say it can be used for women of any age in low doses locally for genital and urinary symptoms and to improve sexual function. Systemic estrogen also helps to prevent bone loss and fracture associated with osteoporosis. The research shows this benefit is most relevant if estrogen is started within five years of menopause and the benefit is lost after ceasing the estrogen therapy. Topical estrogen therapy can slightly reduce cardiovascular disease risk but only if started early.  

The most interesting evidence regarding estrogen replacement therapy is around reducing cognitive decline. One in three people develop a significant cognitive decline in their lifetime, and ⅔ of the people with Alzheimer’s are women. Estrogen has many protective effects on the brain, including increasing neuronal growth and repair, increasing neuroplasticity, decreasing the build-up of tau proteins and amyloid plaques (associated with Alzheimer’s), and much more. Estrogen therapy seems to help slow cognitive decline, not reverse it. One study showed that women who started estrogen at 75 years old had a worse rate of decline. So, yes, there is a critical window for starting estrogen. Women who have their ovaries removed or have very early menopause may especially benefit from starting estrogen therapy right away. 

Evidence shows that estrogen may help somewhat with joint pain, muscle weakness, sleep issues, depression, skin aging, dry eyes, hearing loss, and diabetes. But what about breast cancer? Well, after years of analysis of the WHI study, it has been shown that when they started giving horse estrogens and synthetic progestin to women far older than the critical age window in oral vs. transdermal doses, after three years, an increase of less than one case of breast cancer over the placebo rate per 1,000 women per year could be attributed to the hormones. That risk is less than the increased risk of breast cancer associated with drinking two glasses of wine a day, and the same as the risk of being obese or inactive. In women who took only estrogen (women who’d had a hysterectomy), there was a slight decrease in breast cancer rate vs. placebo. Three French studies showed that when bioidentical estrogen is used with women in a better age window and coupled with bioidentical progesterone, there was no increase in breast cancer rates.  

HRT isn’t for everyone, so discuss it with a conventional or naturopathic doctor up to date on the latest research analysis to see if you would be a suitable candidate and what to expect. For people without extended health insurance, compounding pharmacies can make up HRT prescriptions for about ⅓ to ½ the cost of pharmaceutical suppliers—tell your naturopathic or conventional doctor your preference.  Another advantage of compounded bioidentical hormones is various delivery methods can be used depending on the desired effects and preference of the patient. Transdermal absorption of hormones has been well established in scientific research. So the bottom line is that bioidentical estrogen with bioidentical progesterone can have a role to play not only in the management of symptoms of menopause but also in the enhancement of the ageing process.


Stop the Pain of Endometriosis Naturally

Menstrual cramps are part of life for many women, but extreme, debilitating pain during the menstrual cycle and beyond can be a sign of an underlying condition called endometriosis. This condition has mystified doctors and deeply affected the lives of millions of women. There have been breakthroughs in the understanding of the mechanisms that drive this painful condition. Treatment options designed to target the underlying cause of this condition are helping women to reduce pain and improve fertility.



Endometriosis is a condition where uterine tissue flows in the wrong direction, up the fallopian tubes, and ends up in the abdominal cavity. That wayward tissue should be detected and destroyed by the immune system, and in fact, that process regularly occurs for many women. But for women with endometriosis, the immune system turns a blind eye to the uterine tissue that has gone astray. These small bits of uterine tissue can adhere to the bowel, the ovary, and other organs. They are sensitive to the same hormones as the regular uterine tissue, so they fill with fluid and blood, which is released during menstruation. The lesions can cause pain throughout the cycle, but when the fluid is released into the abdominal cavity, the pain can be debilitating.



The real question isn’t how come the uterine tissue flows backward, as that seems to be common. The question is, why doesn’t the immune system recognize and destroy the lesions; why are they left to grow unchecked? There is a complex interaction between the hormones and the immune system that is to blame for this problem. It turns out that for people with endometriosis, the immune cells that usually prevent us from attacking our own tissues are working overtime. These T-regulator cells tell the immune system to back off, causing the endometrial lesions to evade surveillance and destruction. But T-regulator cells are just taking instruction from certain immune-suppressing chemicals called cytokines. And those cytokines are influenced by a common hormone imbalance where there is too much estrogen and not enough progesterone. This “estrogen dominance” at the heart of endometriosis can be influenced by a number of genetic, lifestyle and environmental factors.



The other mechanism that drives the growth of endometrial lesions is the presence of naturally occurring chemicals that encourage growth of this specific type of tissue. People with endometriosis have more Vascular Endothelial Growth Factors (VEGT) in their abdominal cavity. VEGT stimulates the uterine cells to proliferate, helps the tissue to grow more blood vessels and ultimately makes the endometriosis lesions grow. People with endometriosis are also found to have more oxidative stress markers in their abdominal cavity as well as increased inflammation. These three factors create a favorable growth environment for the painful lesions.



Treatment is designed to reduce pain but also to try to reduce the size of the lesions or eliminate them. Some treatments provide immediate pain control while others try to address the underlying cause by balancing the hormones and promoting a proper immune response to the lesions. Surgery can be done through a minimally invasive procedure that basically zaps the lesions. While this treatment can provide some relief, I’ve seen patients who just keep developing more lesions. Hormone therapy should be aimed at correcting the estrogen dominance. Oral contraceptives contain estrogen, and while they can help to some degree, progesterone only pills and uterine implants are preferable. The later can help reduce the amount of blood build up in the lesions and reduce pain. However, they prevent ovulation and therefore pregnancy, which may not be suitable for a patient trying to have a family.



The naturopathic treatment strategy can be used alone or in combination with conventional medical approaches. It endeavors to address the mechanisms that drive endometriosis. Firstly, we target the immune dysfunction that allows the lesions to evade detection. Herbal medicine and antioxidant nutrients can target the hormonal imbalance, oxidative stress, immune imbalance and pro-inflammatory state that typifies this condition. Secondly, hormones and immune system are affected by the intestinal microbiome; the trillions of bacteria that live primarily in the intestine. Our diet influences the microbiome so naturopathic physicians encourage a diet that is low in sugar and refined flour and may give probiotics and other treatments to bolster the microbiome. Thirdly, healthy fats, like omega 3’s have been shown to help prevent and treat endometriosis lesions and reduce pain.



Finally, hormone balance plays a critical role in the naturopathic treatment of endometriosis. To balance the estrogen dominance typical of this condition, there are nutrients that help the body to eliminate old estrogen and herbs that assist the body produce more progesterone. It is also important to support the liver during this process, as it plays a major role in the elimination of old estrogen. The role of environmental toxins in endometriosis is an area of significant concern. Many environmental toxins, like pesticides and plastics, can actually act like super-estrogens once inside the body and have long term effects. Hormones in red meat and dairy may also tip the delicate balance of hormones for women. Reducing exposure to these external sources of estrogen is critical to the prevention and treatment of endometriosis.



With proper guidance, many women with endometriosis can have less pain, better quality of life and preserve their fertility.