Dr Libby: What To Know About Hormone Imbalances

In this special series, guest writer Dr Libby Weaver shares her health insights.

Many women accept symptoms such as PMS, bloating, mood swings, anxiousness, disturbed sleep, tender breasts — and then into menopause the hot flushes, sleeplessness and night sweats — as “normal”.

I like to say these symptoms may be common, yet they are not normal. Such symptoms contain information about what’s going on inside us, not just in regard to our reproductive system, but other parts of us, too.

These symptoms might be related to our sex hormones — estrogen and progesterone in particular — or a reflection of the function of the regulatory systems for these hormones, like the liver, gut, and our stress hormone output.

Hormone imbalances

Sex hormone imbalances during the menstruation years may look like an irregular cycle or heavy, clotty, painful periods. They might involve volatile emotions — irritability, a rollercoaster of highs and lows, or a tendency to burst into tears that isn’t otherwise there. They are also present when there is polycystic ovarian syndrome (PCOS), hypothalamic amenorrhoea (HA) or endometriosis, although there are numerous other factors that drive and contribute to the persistence of these hormone-related challenges, too.

Changes in sex hormones during the menopausal transition may contribute to extended wakeful periods through the night or trouble falling asleep. It may look like waking up in sweaty sheets, overheating at any time of the day or night, or an increase in anxious feelings. Some women have described the way they feel as a creeping dread, taking their anxious feelings to a whole new level.

While it is normal for menstruation to become irregular through perimenopause, as our ovaries cease ovulating consistently each month meaning there is no progesterone when this occurs (other than a small amount made by the adrenal glands), some women can experience “flooding” — where a heavy period lasts for weeks rather than a few days and for some this happens repeatedly.

Whatever the symptoms of sex hormone imbalances and whatever age or stage we are at, we usually benefit from addressing the main sex hormone influencers — the liver (and gut) for estrogen and our stress (adrenal) response, as well as ovarian nourishers (like zinc) for progesterone. In females across their menstruation years, the ovaries are the main source of sex hormone production. The adrenal glands and fat cells are other production houses that make small amounts of sex hormones too. Even the brain makes some.

During perimenopause, as the ovaries begin to initially fluctuate hormone production before ovulation (and therefore progesterone production) ceases, and ovarian estrogen production becomes about 10 per cent of what it was during the menstruation years, a woman’s body wants the option to be able to call on the adrenals and other hormone production houses outside of the ovaries, for support, including post-menopausally.

Our adrenal glands are also where we make our stress hormones, namely adrenalin and cortisol. The body makes adrenalin after the consumption of caffeine or in response to our perceptions of pressure and urgency. Adrenalin communicates to every cell of our body that our life is in danger, even though all we may have done is had an intense conversation with a colleague and/or mindlessly consumed three coffees this morning.

Cortisol is the long-term, chronic stress hormone. When you are internally rattled, cortisol communicates that there is no food left in the world, and as a result it wants your body to break down muscle and store fat to get you through the lean times it perceives you are going through.

Even though food is abundant for you, and your cortisol production is likely to be coming from areas of your life about which you feel uncertain (such as your finances or relationships), your body relates it to the historical causes of long-term stress and an ensuing threat to the food supply.

Since your body links progesterone to fertility, if it perceives that your life is under threat and that there is no food left in the world, the last thing it wants is for you to bring a baby into that world, so it might prevent ovulation and shut down the adrenal production of progesterone, thinking it is doing you a great, big favour.

Yet not only is progesterone crucial to fertility, it is also a powerful anti-anxiety agent and a diuretic. Estrogen and cortisol remain, while you have lost the counterbalancing hormone that helps keep you calm and not anxious, and one that helps to get rid of excess fluid.

Liver loaders

In my opinion, the shift away from good progesterone production, so often due to the constant production of stress hormones, and the metabolic and biological consequences of this, is one of the biggest challenges facing Western women’s health today.

Sometimes, a woman might be making adequate amounts of progesterone, yet their estrogen levels are through the roof due to compromised estrogen detoxification, primarily the job of the liver and gut. The liver is responsible for changing the structure of substances that the body makes itself (such as estrogen) as well as any substances we ingest or absorb through our skin that are deemed potentially harmful if they accumulated.

When our intake of “liver loaders” is more than our liver detox pathways can handle efficiently, or if this exceeds our intake of substances that support the liver’s ability to do its incredibly important job (like substances in myriad vegetables), it can result in a “traffic jam” in our detox and elimination pathways. Some enzymes made by certain gut bacteria can promote the recycling of estrogen, pushing it higher to excess. This is one way you can end up with estrogen levels that are higher than is ideal — a common driver of symptoms.

To support sex hormone balance we need to take great care of ourselves — not only physically in terms of nutrition, moving our body regularly and prioritising sleep, but also emotionally. This includes considering our perceptions of pressure and urgency, and incorporating restorative practices to help reduce stress hormone production — particularly for women with very challenging periods or menopausal symptoms.

Supporting the liver by focusing on whole, real foods, especially plenty of green leafy vegetables from the Brassica family, as well as minimising caffeine, alcohol and refined sugars can also be extremely beneficial, especially for those with acne or heavy, painful periods as well as those experiencing a rocky transition through menopause.

Our hormones are wonderful substances that allow us to feel our best — when they’re in harmony with each other. I cannot encourage you enough to do what you can to correct any imbalances instead of suffering in silence.

Dr Libby Weaver PhD is a nutritional biochemist, 13 times bestselling author and international keynote speaker. To learn more about supporting the regulatory systems for your hormones, join the Detox by Dr Libby online course at Drlibby.com

Previously: Brittle nails or thinning hair? Now’s the time to listen to your body