We’ve all been there. Girl is a bit off and then she’s like “uuuug I’m on my period” and we all go “ooooh, yeah that makes sense”. We accept pain, moodiness, weeping, acne, anger, bloating, sugar cravings, night sweats, breast tenderness, depression, and so forth as just a normal part of the female human experience. 

Even worse, when we try to address these issues with our doctor, we are pushed to take birth control pills, which are touted as a panacea. Do you know what birth control pills are? They are fake hormones that trick our bodies into thinking we are pregnant and suppress our own hormones, thereby preventing ovulation. So the issue is hormones, and the solution is more (fake) hormones? Unsurprisingly, most women don’t do well on this treatment plan.

Some issues may resolve, for instance cramping or heavy bleeding with your period. This is because birth control pills completely suppress ovulation, so when you bleed on the birth control pill, you aren’t getting a period. Rather, your uterine lining has built up from the hormones in the birth control pills, and when you are on the week of sugar pills (yup, the 4th week of birth control pills are fake) blood levels of these hormones tanks and the lining sloughs off.

If you find yourself amongst the majority of women who have some hormonal symptoms but don’t want birth control pills or are not helped by them, don’t lose hope! It turns out there are lots of ways to help balance your hormones, and honestly you can find recommendations all over the internet. What I want to focus on here is explaining the mechanisms behind these symptoms. There are three main issues behind hormonal issues: Detoxification, nutritional deficiency, and inflammation.

Detoxification is a huge issue, and you can find more detail about it in the next blog post. As it pertains to hormones, there are two steps. First the liver has to process the hormones into a form that your body can excrete. If the liver doesn’t have all the ingredients it needs, hormones don’t get processed and they back up into the bloodstream. The body then makes a protein called sex hormone binding globulin to help carry around all these extra hormones.

Secondly, these hormone byproducts have to make it out of the body. The main route is for the liver to send the processed hormones into the bile, which is then excreted via the feces. 

Our bodies do something called enterohepatic recirculation. This means that we reabsorb things that we secreted in the bile, including cholesterol and hormone byproducts. 

If you don’t poop regularly, as in 2-3 times per day, you are reabsorbing all those hormones your liver worked so hard to get rid of. Furthermore, if you have a poor microbiome, you may have bacteria that make an enzyme called glucuronidase, which unpackages the hormones and makes them more likely to be reabsorbed. All of this sets you up to develop what is called “estrogen dominance” or even PCOS.

Nutritional deficiencies are far more common than you would think. Even if you eat a healthy diet, our food has no where near the mineral content it used to, thanks to our depleted soils. The most common nutritional deficiencies that impact hormones are zinc and magnesium. They are both important co-factors in many enzymatic processes. For instance magnesium is important for muscle relaxation, and so cramps could be a sign of magnesium deficiency. Zinc inhibits 5-alpha-reductase, the enzyme that converts testosterone to its most active form, and so zinc deficiency could be involved in PCOS.

Another type of deficiency is hormonal deficiency. Stress hormones and sex hormones like progesterone share the same basic ingredients. Because the body has limited resources, in times of stress these resources are shunted from sex hormone creation to stress hormone pathways. Before our period, hormone levels start dropping, and if progesterone is already low due to lack of ingredients, this drop puts a woman into a range where she experiences symptoms of low progesterone, like weepiness, poor sleep, and poor mood.

Lastly, inflammation makes everything worse. Because menstruation is an inflammatory process (remember not all inflammation is bad), having a higher base level of inflammation sets you up to experience more hormonal symptoms. If ibuprofen is your magic bullet for making your period as pleasant as a period could be, then you may have a high base level of inflammation.

Most likely several of these mechanisms are involved in a woman’s hormonal imbalance, and the best way to shed light on this is by testing hormone levels, looking for nutritional deficiencies, and then overlaying these with symptoms. Hormones can be frustrating especially since it takes up to 3 months to regulate a period, but I think every woman deserves to and can have a symptom free period.