This blog delves into the role of the hormones responsible for a normal – or abnormal – period.
Menses – time of fertility
Known by many names, this period of a women’s life can be one of silent dread, pain, embarrassment or even shame. But it shouldn’t be like this! Imbalances in our hormones creates signs that alert us that something is out of balance, and herbal medicine is a powerful ally in helping to regulate a woman’s cycle, having been used for thousands of years.
This week will discuss some of the key issues we see in the clinic with our patients who present with menstrual imbalances, some success stories, and some inspiration that your menses can actually be a magical part of your life – or at the very least, not a painful one.
Given the huge role that the endocrine system and hormones play in overall wellbeing, it’s not surprising that a hormone imbalance can cause some debilitating symptoms. From difficulty sleeping, to anxiety and fatigue, all the way to depression and fertility issues, so many elements of your health depend on maintaining a healthy hormonal balance.
Let’s have a look at the key hormones involved in our menstrual cycle.
Progesterone
Progesterone, often referred to as the “pregnancy hormone”, is largely responsible for fertility. Much like oestrogen, progesterone levels fluctuate in line with the menstrual cycle, and are at their highest 5-7 days after ovulation.
Testosterone
Men do produce far more testosterone than women, the role this hormone plays in women’s bodies is still important. In men, testosterone affects sex drive, sperm production and hair
growth. In both men and women, testosterone is involved in bone and muscle mass and signals the body to produce new blood cells.
Oestrogen is arguably the best- known sex hormone, and while it is present in both men and women, it plays a bigger role in women’s bodies. There are three types of Oestrogen in women; all of them are present throughout a woman’s life, but one will dominate depending on life stage. Oestradiol during childbearing years, oestriol during pregnancy and oestrone after menopause.
Oestrogen levels fluctuate in line with the menstrual cycle, being at their highest during the middle of the cycle (ovulation), and lowest during menstruation.
Know your Cycle
Menstrual Phase
This phase starts when the released egg is left unfertilised. Levels of oestrogen and progesterone drop because pregnancy has not occurred. Menstruation generally lasts for 3-7 days.
Ovulation Phase
Rising oestrogen levels during the follicular phase signals to the pituitary gland to release luteinising hormone which starts the process of ovulation. This phase, occurring around day 12- 14 of the cycle, is the only point in the cycle in which pregnancy can occur, and typically lasts about 24 hours.
Follicular Phase
This phase overlaps with the menstrual phase. At this time, the hypothalamus signals to the pituitary gland to release follicle-stimulating hormone which stimulates the ovaries to produce small sacs containing immature eggs. The maturing of one of these eggs triggers a surge in oestrogen. This phase lasts 16 days on average, however, can range from 11- 27 days.
Luteal Phase
During the luteal phase, assuming pregnancy does not occur, levels of oestrogen and progesterone will fall, triggering a period. During this phase, there may be some symptoms of premenstrual syndrome, such as cramping pain, breast swelling and tenderness, severe mood changes, cravings, fatigue and depression.
What is Normal?
Given the private nature of a woman’s cycle, many women never really know if what they are experiencing is actually normal. So lets break it down.
What is a normal flow?
How much blood you lose during your period will vary from woman to woman, and can change slightly each month. Usually, your period will be heaviest in the first one to two days, but should never be so heavy that you’re running to the bathroom every hour.
How much pain is too much?
Some women experience mild cramps at the onset of their period, however severe or prolonged cramping is not normal. Cramps should not feel like a stabbing pain, or be so strong to interrupt your day. If it is, there could be a hormone imbalance or other issue to be addressed.
Is it regular?
There are some lifestyle factors that can make your period come sooner or later, such as dieting, excessive exercising, or stress. If your period is irregular outside of these factors, there may be hormone imbalance.
Length of bleeding
This does vary a little bit between people, but 2-7 days is generally considered normal.
Also, some small clots in the blood may be normal, but large, dark coloured clots are a sign of imbalance.
The thyroid connection
Up to 60% of women who have a thyroid condition also experience menstrual disturbances such as irregular periods, painful periods, heavy flow, PMS, and painful breasts. The reason this correlation is so significant, is because our sex hormones have a wide range of direct and indirect effects on the way our thyroid hormones are made and carried around the body.
For example, someone may be experiencing these symptoms;
- heavy, painful periods lasting 7 days
- PMS up to a week prior to menstruation
- tender, swollen breasts
- generalised weight gain
- fatigue and depression
This can indicate an imbalance between levels of progesterone and oestrogen (either high oestrogen or low progesterone) and is typically described as oestrogen dominance. This is important to know prior to commencing thyroid treatment and can be detected using a salivary hormone test.
The reason for this is that there are oestrogen receptors in the thyroid follicular cells, and oestrogen can stimulate the growth of the thyroid (as it does with the uterine lining, bone, and fat cells – it’s a nurturing and growing hormone!).
Too much oestrogen and your thyroid may become enlarged, too little and thyroid hormone production may be negatively impacted. This is why so many women experience the onset of hypothyroidism at menopause, when their oestrogen drops! Oestrogen also increases the amount of Thyroxine-Binding Globulin (TBG) in the blood, which binds thyroid hormone, making it unavailable to be used by the cells.
This is just one of many hormone interactions that exacerbate symptoms. I will dive into more detail about progesterone, oestrogen and thyroid in tomorrows email
Learn more about how naturopathy can balance your cycle by booking a FREE 15 minute appointment with one of our naturopaths. We would love to chat!