There are many factors that contribute to female health issues, but by far the most well-recognized are hormonal imbalances. Sex hormones like estrogen, progesterone, and testosterone all exist in levels that are relative to each other, and are finely tuned to be released at very specific times and in very specific levels. Conditions like endometriosis, uterine fibroids, painful periods, and PMS are often correlated with an estrogen predominant state. Polycystic ovarian syndrome (PCOS) is characterized by high levels of androgens (male hormones) like testosterone. Drops in progesterone can precipitate the painful cramping of dysmenorrhea. During the normal process of menopause, the ovaries cease to produce female hormones, relying on the adrenal glands to take over. If this doesn't happen, symptoms associated with low estrogen levels can ensue, like hot flashes, insomnia, and low sex drive. Failure of hormones to follow normal patterns throughout the month can lead to amenorrhea, or absence of menses.
This all seems interesting, but rather complex and vague unless we understand what hormones are, and what they are supposed to be doing in a normal situation.
What is a hormone?
Hormones are chemical messengers produced by various glands in the body that are then transported in the blood to instruct other glands or organs to carry out certain functions.
What are sex hormones?
The major ones you should be aware of are the female hormones estrogen and progesterone, and the male hormone testosterone. These hormones have many jobs, but the most obvious one is that they are concerned with human reproduction.
Estrogen: Produced during the first half of your menstrual cycle (from the end of bleeding to ovulation, which typically falls around day 14), proper estrogen levels are responsible for thickening of the lining of the uterus, in preparation for pregnancy. Estrogen also plays a role in the secondary sex characteristics of females, proper metabolic function, storing fat, forming bones, and normal libido.
Progesterone: Produced during the second half of your menstrual cycle (from ovulation, around day 14 to the onset of bleeding, around day 28), a healthy level of progesterone prepares the uterus for implantation and is responsible for maintaining pregnancy. It also decreases contractions of uterine smooth muscle, reduces tendency to bloat, prepares the breasts during pregnancy for breastfeeding, and is anti-inflammatory
Testosterone: Although a predominantly male hormone, testosterone is also produced in small amounts by the ovaries and its functions in women include increasing muscle mass, strength, and bone density, and normal libido.
How do hormones become imbalanced and cause symptoms?
Think of each hormone like a very finely tuned instrument in an orchestra. In order to be harmonic, each hormone must be secreted in optimal levels at various times of the month. If hormones are secreted at proper levels at the proper times, AND are able to be successfully cleared from the body by the liver and other organs, normal menstruation occurs with very minimal symptoms. Here's what the hormones should look like throughout the month:
As you can see, normal menstruation is heavily reliant on normal cues from the body, good communication among the organs and glands that secrete hormones, absence of inflammation, and proper hormonal clearance. Abnormally increased or decreased levels of any one hormone wreaks havoc on the rest of the system and can disrupt normal menstruation and cause symptoms. In normal physiology, there are two major events in a woman's life that disrupt this pattern normally: pregnancy and menopause. In pregnancy, levels of female hormones, especially progesterone, remain very high to maintain fetal health. In menopause, the ovaries gradually slow and eventually stop producing female hormones, at which time, the adrenal glands are expected to take over. Again, it is plain to see that if either of these normal physiological processes go awry, infertility or menopausal symptoms can result.
The take-home point here is that normal hormonal balance is very complex and doesn't become disrupted by one single factor, and the culprit is rarely abnormal levels of one single hormone. For example, you may have heard of something called "estrogen predominance." Predominance implies that there is too much estrogen in relation to progesterone, which is true. However, some practitioners argue that this imbalanced ratio isn't an estrogen predominance, but low progesterone, giving the impression of an estrogen predominant state. Still others say that progesterone levels can be normal, but estrogen levels are too high due to environmental exposures and improper clearance. Which is true? A better question is, why does have it have to be one or other? A better solution is to look at the problem in the context of the individual and recognize that it can be either one, or even both.
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