"My hormones feel so out of balance," a female patient will tell me. "I'm tired of feeling crappy and terrible all the time. Do I need to do hormone replacement to feel better, or is there a natural way to get my hormones in balance?"
Hormone imbalances are epidemic these days. When talking about hormones, I want you to think of a symphony. All of them interact, so when one gets out of whack, others quickly follow. There are many key players in this orchestra -- adrenals, thyroid, insulin -- but today, we're focusing on women's sex hormones.
While many things can cause an imbalance in our sex hormones, the good news is that many women can fix these imbalances without medications.
You might never know this from conventional medicine, which seems to subscribe to the idea that women are destined to suffer throughout their reproductive life. Women suffer from mood and behavior swings resulting from the three Ps: puberty, premenstrual syndrome (PMS), and peri-menopause (the years leading up to and just after their final period), or the three Ms: menstrual cramps, menopause and mental anxiety!
Are Women's Bodies Defective?
Why do sex hormone levels drop up to 90 percent during the aging process? Are women destined to suffer from impaired mood, muscle loss, poor sleep, memory difficulties, and sexual problems?
Of course not!
The suffering related to your reproductive life cycle is unnecessary. It is not a result of bad luck; it's due to bad habits, such as drinking alcohol and smoking; eating a high-sugar and refined-carbohydrate diet; consuming dairy and often, gluten; not exercising enough; being exposed to environmental toxins; and being chronically stressed.
To think that 75 percent of women have a design flaw that gives them PMS and requires medical treatment is just absurd. To think that women have to dwindle, shrivel, and lose emotional, physical, and sexual vitality is a burdensome, self-fulfilling prophecy.
We now have endless examples of balance and thriving at any age. An 81-year-old female patient once told me, with a twinkle in her eye, about her new boyfriend and their wonderful love life! Thriving is possible at any age and it doesn't always have to result from a pill.
Simply put, PMS, menopausal symptoms, and other problems are all signs of imbalances in your sex hormones. They are not the result of mutant genes that destroy our sexual vitality as we age. Instead, they are treatable symptoms of underlying imbalance in one of the core systems in your body. Get your sex hormones back in balance, and these problems will usually disappear.
The truth is: Women do NOT need to suffer.
Instead of immediately resorting to a hormone replacement (which might be your conventional doctor's first line of treatment), you need to figure out the "why" -- what is causing the symptoms. If you find that you do need hormones, then you need to find the way to replace them that most aligns with your body -- low dose, topical, bio-identical, short duration.
In other words, figure out what creates these imbalances -- and treat the underlying problem. That's where Functional Medicine comes in: You treat the underlying cause(s), create balance, and symptoms get better.
Most of us are living life completely out of balance. Unfortunately, many symptoms we come to accept as "normal" are just signs of imbalance, and the type of imbalance that affects almost everyone in our society is hormonal imbalance.
These and other imbalances are all fixable.
Do You Struggle With Out-of-Balance Sex Hormones?
When female patients suspect sex hormones might be out of whack, I ask them to self-evaluate using this quiz:
I have premenstrual syndrome.
I have monthly weight fluctuation.
I have edema, swelling, puffiness, or water retention.
I feel bloated.
I have headaches.
I have mood swings.
I have tender, enlarged breasts.
I am depressed.
I feel unable to cope with ordinary demands.
I have backaches, joint, or muscle pain.
I have premenstrual food cravings (especially sugar or salt).
I have irregular cycles, heavy bleeding, or light bleeding.
I am infertile.
I use birth-control pills or other hormones.
I have premenstrual migraines.
I have breast cysts or lumps or fibrocystic breasts.
I have a family history of breast, ovarian, or uterine cancer.
I have uterine fibroids.
I have peri-menopausal symptoms (hot flashes, mood swings, headaches, irregular cycles, heavy bleeding, fluid retention, breast tenderness, vaginal dryness, brain fog, muscle and joint pain, low sex drive, weight gain).
I have hot flashes.
I feel anxious.
I have night sweats.
I have insomnia.
I have lost my sex drive.
I have dry skin, hair, and/ or vagina.
I have heart palpitations.
I have trouble with memory or concentration.
I have bloating or weight gain around the middle.
I have facial hair.
I have been exposed to pesticides or heavy metals (in the food, water, and/or air).
Score one point for every time you answered "yes," and then check out how you scored using the scale below:
0 to 9 -- You may have a mild sex hormone imbalance.
10 to 14 -- You may have a moderate sex hormone imbalance.
15 or more -- You may have a severe sex hormone imbalance.
Now that you have determined the severity of your imbalance, let's talk about the one thing you can do today to begin treating your symptoms.
The Right Diet Becomes Your Number-One Reset Button
Balancing your hormones is a process, and sometimes it has little twists and turns. But by sticking with it, you can become vital, happy, alert, brilliant, and thriving.
Your diet is the foundation that helps balance your sex hormones.
The first step involves removing the bad stuff. We know that sugar, caffeine, alcohol, stress, and lack of exercise all contribute to worsened PMS and all hormonal imbalances -- including menopause.
Imbalances in your hormones are triggered by bad food. If you eat sugar, you'll produce more insulin, more estrogen, and more testosterone. Any type of flour and sugar can lead to these imbalances. Dairy and gluten are often triggers for inflammation and hormonal imbalances. Xenobiotics or environmental chemicals like pesticides in our food can act like powerful hormone disruptors and trigger our own hormones to go out of balance. If you are interested to know how these toxins disrupt our hormones then read Our Stolen Future by Theo Colburn.
Dairy is one of the biggest triggers of hormonal imbalances because of all the hormones found naturally in milk and because of the hormones and antibiotics added to milk. Even organic milk can come from pregnant cows, jacking up hormone levels. In fact, dairy has over 60 hormones that can contribute to imbalances. Dairy and gluten are among the most common food sensitivities that you might benefit from eliminating from your diet.
After removing the bad stuff, you will want to replace it with good stuff. Eat a whole, real, unprocessed, organic, mostly plant-based diet with organic or sustainably raised animal products. When you focus on this type of diet, you minimize intake of xenoestrogens, hormones, and antibiotics. Taking simple steps like choosing organic food and drinking filtered water can hugely impact hormone balance.
You might consider doing my Blood Sugar Solution 10-Day Detox Diet, which will naturally help reset your hormones by eliminating sugary, processed foods and food sensitivities while focusing on organic, whole, unprocessed foods. To reset female hormones, focus on specific hormone-balancing foods. Increase certain foods like flaxseeds, cruciferous veggies, good fats, and traditional organic non-GMO whole soy foods (tofu, tempeh, miso, natto, and edamame). Add 1 to 2 tablespoons of ground flaxseeds a day to your diet.
Other Strategies to Balance Your Sex Hormones
Diet aside, there's a lot you can do to balance your sex hormones without resorting to medication.
Supplement smartly. Fish oil and additional vitamin D and B vitamins help balance estrogen. Take these in addition to a good multivitamin and mineral with sufficient calcium and magnesium. Probiotics, antioxidants and phytonutrients (vitamin E, resveratrol, curcumin, n-actetyl cysteine, green tea, selenium), and the anti-inflammatory omega-6 fat (GLA or gamma linoleic acid) can help balance sex hormones. You can find these and other hormone-balancing supplements in my store.
Exercise. When you exercise, you have less PMS and other problems. Find something that you love to do. Running, long walks, weight training, dance, or any other form of movement that you enjoy.
Reduce stress. Chronic stress can trigger or exacerbate hormonal imbalances. The key here becomes finding something that works for you to reduce stress. That might include meditation, yoga, tapping, therapy, or finding a creative or expressive outlet. My UltraCalm CD helps melt away stress, anxiety, and tension.
Sleep well. Insufficient sleep can adversely impact PMS, menopause, and other conditions. Getting eight hours of quality, uninterrupted sleep every night is one of the best things I can think of to balance hormonal levels. You will find 19 ways to do that in this blog.
Reduce or eliminate alcohol. Alcohol -- yes, even red wine -- jacks up estrogen and increases chances of cancer.
How to Do Hormone Replacement Therapy Safely
For 50 years, hormone replacement therapy was thought to be the fountain of youth that would keep women "feminine forever" until it was found that unopposed estrogen increased the incidence of uterine cancer eight-fold.
For more than three decades, women were the subject of widespread experimentation founded on absent or weak evidence, creating unnecessary harm through increases in uterine, breast, and ovarian cancer, as well as heart attacks and strokes. These methods provide a temporary solution to intractable (and often transient) menopausal symptoms.
Despite potential drawbacks, there are some cases in which hormone replacement and medications are helpful and even necessary for women whose symptoms are unmanageable. Occasionally, despite lifestyle therapies -- diet, exercise, stress reduction, nutrient supplementation, and herbs -- hormone therapy can be lifesaving (as well as mood- and brain-saving).
Only a physician knowledgeable and experienced with bio-identical hormone therapy should prescribe them. I recommend if you go that direction, talk with a knowledgeable functional practitioner who could discuss the pros and cons of hormone therapy so you make the most informed decision.
If you believe hormone replacement therapy might be necessary for you, please discuss the pros and cons with your Functional Medicine practitioner.
If you've struggled with PMS, peri-menopause, or other problems, what did you find best helped alleviate the issue? Did you have to look beyond conventional medicine to find those answers? Share your thoughts below or on my Facebook page.
Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, M.D. believes that we all deserve a life of vitality -- and that we have the potential to create it for ourselves. That's why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. He is a practicing family physician, a nine-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is the Director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and has been a regular medical contributor on many television shows including CBS This Morning, the Today Show, CNN, The View, the Katie Couric show and The Dr. Oz Show.