Hormones are the body’s chemical messengers.
Long understood as the catalyst of acne, fatigue, and insomnia during the body’s periods of transition such as puberty and the various stages of menopause, more and more practitioners are recognizing hormonal imbalances as the root cause of many health concerns among women.
These concerns can manifest in a number of ways.
Polycystic ovarian syndrome, or PCOS, has been frequently diagnosed in women in recent years. Similar to gluten intolerance and celiac disease, which doctors in the know now understand to exist on a spectrum, rather than a binary, “you either have it or you don’t,” diagnosis, PCOS and its symptoms are starting to appear in similar patterns in women.
Heavy and painful menstrual cycles are a telltale symptom of PCOS that can lead to a quick diagnosis, but there are also subtler symptoms, such as young women who have difficulty losing weight, appetite issues, or acne, which present a milder version of PCOS.
Beyond PCOS, there are myriad other symptoms that may be attributed to a hormonal imbalance. These symptoms include regular hot flashes, night sweats, and memory issues, which can range from general fogginess to trouble with short-term memory.
Identifying a Hormonal Imbalance
The first step in identifying a hormonal imbalance is understanding the patient’s full medical history.
As with any ailment addressed through functional medicine, it’s important to acquire a full picture of the patient’s health if the goal is to address the root cause of an issue as opposed to simply putting a Band-Aid over the symptoms.
For example, say you have a patient who is experiencing constant fatigue, which can be caused by either a hormonal imbalance or blood sugar levels. Knowing that hormones can affect blood sugar, and blood sugar can affect hormones, you’ll have to determine whether the patient’s hypoglycemia is caused by the hormonal imbalance or other factors affecting blood sugar levels. Fact finding provides more clues and is the vital first step to treating a patient who shows these signs.
The best thing to do is stay focused on the total person.
A human is not just a set of hormones. There are many factors that need to be addressed in a patient from lifestyle to weight and diet. However, a saliva test or blood test will reveal a patient’s hormone levels, and once a hormonal imbalance has been identified, there are a number of routes that might be taken to address the root cause.
Managing a Hormonal Imbalance
The care plan for a woman experiencing a hormonal imbalance will vary depending on symptoms and severity.
As with all aspects of functional medicine, there is no one-size-fits-all course of action. It’s wise to look beyond a patient’s estrogen, progesterone, and testosterone levels when testing. A patient’s DHEA, cortisol, and insulin levels can also cause symptoms. According to the University of Rochester Medical Center, high DHEA levels in women may cause acne, increased hair growth, female pattern baldness, missed periods, and even sterility.
One method of treatment is bioidentical hormone replacement therapy or BHRT, which is a natural version of the synthetic hormones that doctors have been prescribing post-menopausal patients for years.
Unlike their synthetic counterparts, which are derived from pregnant horses, bioidentical hormones are natural, replicated from plant materials, and identical in chemical structure to hormones produced in the human body. BHRT can be a solution for patients beyond menopause as well, even into old age.
If a full BHRT regimen isn’t the right solution, there are other pathways to consider. Indole-3-carbinol is a supplement that can help balance and regulate hormones. There are also adaptogenic herbs, such as black cohosh and Siberian ginseng, which can balance, support, and regulate hormones.
In some cases, progesterone may be used to regulate hormones. Even mild, over the counter dosages have proven effective. At the end of the day, it comes down to creating a specific plan for the patient, as their symptoms and medical history will dictate the right course of action.
Lifestyle is an Important Factor
As with other disorders, lifestyle plays a significant role. Hormone levels are greatly affected by a patient’s diet, but also by how much exercise they get, their stress levels, and whether they have a regular sleep schedule.
Hormone levels and lifestyle have a reciprocal relationship: hormone levels can affect a patient’s lifestyle, and their lifestyle can affect their hormones. Finding balance within that cycle is the key to feeling healthy. Additionally, though not very widely known, there’s a large amount of estrogen in our environment. Many chemicals we’re in contact with everyday carry estrogenic chemicals. Our bodies absorb those, too, which can contribute to imbalance.
Hormone imbalances can appear in obvious or subtle ways. To determine whether a hormonal imbalance is responsible for symptoms you are seeing, look beyond the surface at the bigger picture. Assess lifestyle patterns and rule out other causes of symptoms via testing, then develop a supplement regimen that’s best for your patient’s specific situation.