More Than Estrogen: The Benefits of Caring for Women’s Hormones

Understanding Women’s Hormones

Three key hormones affect women’s health—estrogen, progesterone and testosterone. Let’s take a closer look at each.

Estrogen

The female powerhouse hormones known as estrogens are responsible for quite a lot, including playing an important role in sexual and reproductive development. A woman’s ovaries are the primary producers of estrogen hormones, however, the body also turns to adrenal glands and fat cells to make trace amounts. Estrogen levels fluctuate with a woman’s menstrual cycle and begin to drop during menopause. In addition to reproductive health, estrogen also contributes to the development of secondary sex characteristics in people assigned female at birth, including breasts, hips, menstruation, pregnancy and menopause, and it doesn’t stop there. Estrogen also affects the cardiovascular system, bones, skin, hair and brain. 

Progesterone

Like estrogen, progesterone is elemental to reproductive health in women. It prepares the lining of the uterus for a fertilized egg to implant and grow during pregnancy. Once an egg is fertilized, the corpus luteum (a temporary mass of cells that forms in the ovary each month in preparation for pregnancy) continues to produce progesterone. This hormonal level continues to rise throughout pregnancy to prevent the body from ovulating during that time. 

Testosterone

A hormone less commonly associated with women’s health—but just as important—is testosterone. This is another type of sex hormone in the body produced by ovaries, adrenal glands, and other tissues and cells. Testosterone affects women’s bone and muscle health, mood, libido (sex drive) and menstrual cycle.

The Menstrual Cycle: Hormonal Fluctuations and Their Impact

Once women reach puberty, they begin to ovulate (release mature eggs into the ovary for fertilization). If an egg is fertilized during this time, it attaches to the lining of the uterus, the body begins heightened progesterone production, and pregnancy begins. In the case pregnancy does not occur, the menstrual cycle—or natural fluctuation of hormones and release of the uterine lining—continues. 

The average menstrual cycle lasts about 28 days, however this number can vary from 21 days to as many as 45 days. It’s worth noting that if your menstrual cycle falls outside of this window, you should talk with your primary care provider about what might be causing irregular periods. The average period lasts between three and seven days. There are four phases of menstruation, each of which is regulated by female hormones. 

Menstrual phase

If an egg is not fertilized, levels of estrogen and progesterone drop and the thickening of the uterine lining stops and sheds through the vagina. 

Follicular phase

This phase prepares the uterus for a potential pregnancy as estrogen levels surge, causing the lining of the uterus to thicken. 

Ovulation phase

Ovulation is the time during a woman’s menstrual cycle when it is possible for her to become pregnant. It typically happens around day 14 of a 28-day cycle (although this can vary) when a mature egg travels through the fallopian tube toward the uterus. 

Luteal phase

During the luteal phase, the corpus luteum causes an increase in both progesterone and estrogen, which keeps the uterine lining thick and ready for implantation should it take place. If pregnancy does not occur, the corpus luteum is reabsorbed into the body and estrogen and progesterone levels drop, triggering the onset of a period. 

Hormonal Imbalance: Causes and Symptoms

An imbalance in women’s hormones can lead to a variety of symptoms, including:

These hormonal imbalances occur when your body produces too much or too little of one or more hormones. Even small shifts in hormone production can lead to an imbalance. These imbalances can be short-lived or chronic, and some will remedy naturally while others may require treatment. Natural changes in hormone levels happen throughout a woman’s life with specific milestones causing the most notable shifts, including puberty, pregnancy and menopause.

Natural causes are not the only reasons for hormonal imbalances, however. Stress, certain medications, steroids, disease and illness, and injury can also cause these shifts. 

Beyond Reproduction: Hormones and Overall Health

Nearly 54 million Americans have osteoporosis, which is a thinning of the bones. Because women have lower bone density than men to begin with, they’re more susceptible to developing osteoporosis. Additionally, according to the National Institutes of Health, the majority of postmenopausal women with osteoporosis have bone loss related to estrogen deficiency. Maintaining healthy hormone levels is essential to protecting against osteoporosis. This goes hand-in-hand with getting the right amount of calcium and Vitamin D, exercise and strength training, and eating a well-balanced diet. 

Hormones also affect our mood and mental health. Abnormal levels of estrogen or progesterone can contribute to changes in mood and emotions, specifically leading to irritability and sadness, while dips in testosterone can also trigger feelings of sadness or sluggishness. 

When it comes to weight management and a healthy metabolism, estrogen plays a big part, affecting the risk of obesity and insulin resistance and the risk of diabetes. Women tend to begin noticing these effects most significantly around the time menopause begins. According to the NIH, “Loss of estrogen at menopause leads to significant changes in many of these systems, which can be stabilized with the use of hormone replacement therapy.”

Women’s Health Conditions and Hormones

A variety of health conditions are associated with irregular hormone production, including:

Polycystic Ovary Syndrome (PCOS)

PCOS happens during reproductive years when cysts develop along the outer edge of the ovary. The results can be frequent, heavy periods, or long stretches between periods. If you think you might suffer from PCOS, talk with your healthcare provider about treatment options. 

Menopause

If you’ve gone 12 months without a menstrual period, you are most likely experiencing menopause. The average age for the onset of menopause in the U.S. is 51, but it can happen anytime in a woman’s 40s or 50s. While menopause is a natural part of a woman’s life cycle, it can come with some less-than-pleasant symptoms, including hot flashes, night sweats, mood changes, weight gain, thinning hair, sleep issues, loss of libido and vaginal dryness. Talk with your primary care provider as you near menopause age or experience symptoms about important preventive healthcare screenings and medical interventions. 

Endometriosis

Women with endometriosis experience endometrial tissue that grows outside of the uterus. Approximately 2-10% of American women between 25 and 50 will have endometriosis. Symptoms can include painful or heavy menstrual periods, spotting between periods, and pain during or after sex. Endometriosis can lead to infertility or difficulty becoming pregnant, so it’s important to talk with your healthcare provider if you’re concerned.

Hormonal Health and Fertility

As women approach child-bearing age and hope to someday become pregnant—or avoid pregnancy—it’s important to pay close attention to hormonal health given its direct affect on fertility. 

You can track hormonal patterns for reproductive health in a variety of ways. There’s the old-fashioned approach, which is simply taking your basal body temperature (this might require a specific type of thermometer) first thing every morning and then charting the pattern to pinpoint your ovulation cycle. Or, if you prefer more modern technology, you can turn to at-home hormone monitoring kits and apps. Regardless of your approach, keeping at least some record of your menstrual and ovulation cycles is a good way to establish your body’s baseline flows and functions. 

Establishing the root cause

There are a variety of causes of hormonal imbalance that can lead to infertility, including thyroid disease, age, medications, low body fat, obesity, PCOS, and more. Depending on underlying factors and causes, there are also a number of effective treatments for infertility caused by hormone imbalance. These can include medications that help induce ovulation, surgery, weight loss to regulate menstrual cycles, and in vitro fertilization (IVF). 

Optimizing your hormonal health is critical for preconception and pregnancy. While some hormonal imbalances require medical intervention, there are important steps women can take to help ensure hormonal health. These include managing stress and getting plenty of quality sleep. Eat a wholesome, balanced diet and avoid alcohol and smoking. Learn more about your family history and whether or not hormone imbalances and infertility are genetic.

Holistic Approaches to Hormonal Balance

Focussing on lifestyle choices is an important step to maintaining healthy, balanced hormone levels. Make sure your diet is chock full of hormone-friendly foods, such as:

• Dark green leafy vegetables
• Avocados
• Salmon
• Tofu
• Nuts and seeds
• Berries

Learning how to manage your stress levels also has long-term impacts on your hormonal health. If you’re experiencing stress and are worried it’s affecting your hormone levels, try these stress management techniques:

• Meditation and mindfulness
• Breathing exercises
• Massage therapy
• Meeting with a mental health professional
• Social connection
• Exercise
• Journaling

Herbal remedies for hormonal support

Many people turn to herbal remedies and supplements for hormonal support. Make sure you talk with your healthcare provider before taking herbal supplements to mitigate any potentially harmful effects or interactions with current medications. Some of the more notable herbal remedies for hormonal health include:

• Nigella seeds – This antioxidant-rich flower contains thymoquinone, which some believe provides therapeutic effects for women suffering from PCOS. 
• Ashwagandha – Also known as winter cherry, this powerful shrub might help calm stress and restore hormone balance. 
• Maca – Native to South America and the high Andes, maca contains multiple phytonutrients that support a healthy endocrine system. 
• Red Clover – Some women turn to this flowering plant for its possible estrogen-like effects on the body. 
• Black cohosh – This potent herbal remedy is thought to support menopausal and postmenopausal hormonal health.
• Chasteberry – Native to the Mediterranean region, chasteberry has long been used as a hormone balancer and in support of fertility.

Medical Interventions for Hormonal Imbalance

As medical solutions continue to evolve and medical technology becomes even more powerful, many women are turning to medical interventions for hormonal imbalance. One of these medical advancements is hormone replacement therapy, which replenishes diminished hormone supplies and, in doing so, helps reduce symptoms caused by hormone imbalances. Women take estrogen and sometimes progesterone supplements. This supplemental therapy can increase bone health and potentially reduce a woman’s risk for Alzheimer’s disease. Possible risks of hormone replacement therapy include increased risk of uterine cancer (if you still have your uterus), increased risk of blood clots and stroke, higher chance of heart disease, and higher risk of breast cancer. 

Treating chronic disorders

If you’re someone who suffers from chronic hormone disorders, there are proven treatments to help. Common hormone imbalance treatments include birth control, hormone replacement medications, vaginal estrogen and other medications to help regulate hormone production. 

For those looking for a holistic approach to hormone imbalance, combining treatments can increase positive results, although make sure you talk with your healthcare professional before you do this to ensure optimum outcomes and mitigate any negative or unforeseen side effects. Some integrative approaches to hormonal health include acupuncture, massage, nutrition, exercise, stress management and other lifestyle changes. 

Lifestyle Factors and Hormonal Health

One of the most important steps women can take in maintaining healthy hormone production is exercise. Combining cardiovascular fitness with strength and balance training is important. A regular fitness routine supports healthy female hormones, and can help decrease excess estrogen, which in turn improves unwanted symptoms of the female menstrual and lifecycle. It’s important to note that too much exercise can have an adverse effect. Too much exercise done too frequently (think competitive high school and collegiate athletes, ultra-marathon runners, etc.) can cause a decrease in female hormones and an increase in the stress hormone cortisol. For this reason, it’s important to find a healthy balance, not pushing yourself too hard and allowing plenty of time for your body to recover in between workouts. 

Just like we strive to understand the inner workings of our body to maintain healthy hormone levels, it’s also important to know how our exterior environments can affect hormonal health. Toxic chemicals including certain pesticides and plastics in our air, water and food can adversely affect hormone production. Climate and nutrition also play a role in diverse hormone production.

Empowering Women Through Hormonal Health

This Women’s Health Month, it’s important to take stock of your health and the factors that might affect the other women in your life. Understanding how your body works, what your risk factors are, and how your genetics might impact your reproductive health is the first very important step in becoming an advocate for comprehensive women’s healthcare. Don’t be afraid to break down stigmas and taboos around hormonal health by talking with your healthcare provider, mothers, aunts, daughters, sisters and friends. We’re all in this together. Making sure women are armed with the appropriate resources, information and support is vital to ensuring long-term female health and wellness.