FAQs: Facts on Hormone Balance Issues

Here at Menopausibilities, we receive quite a few questions related to hormones, so we have taken the most common and answered them here for you.

  1. I keep hearing people use terms like perimenopausal. What exactly does that mean and how do I know if I am perimenopausal? 

First, let’s define the term menopause, so you will have a better understanding overall. Once a woman has completed twelve consecutive months without having a period, she is considered to be “in menopause”. Perimenopause encompasses that time period prior to menopause; during this time, menstrual cycles often become quite erratic. Periods can get lighter or heavier, closer together or further apart. This is due to less predictable ovulation, which in turn causes changes in the levels of estrogen and progesterone.

In addition to menstrual changes, many women describe feeling as though they are on an emotional roller coaster, as well as experiencing many physical symptoms. These include moodiness, tearfulness, foggy thinking, memory changes, hot flashes, night sweats, weight gain, and decreased interest in sexual activity, to name a few.

So if you have recognized any of these changes in yourself, you may be perimenopausal. The good news is that it is not “in your head” and there are many treatments available to help you feel better again.

  1. I do get hot flashes out of the blue during the day. In the middle of the night, I alternate between sweating and kicking off the covers, and then a few minutes later, I am freezing cold and trying to get warm. This often happens several times a night and I am having so much trouble getting a good night’s sleep (plus my poor husband!!) What is going on?

You and 50-70% of US. women experience hot flashes and night sweats during the peri- and menopausal time periods. These symptoms can range from mild and infrequent to severe and as often as every hour! Hormonal changes cause your body’s thermostat to change erratically. A common culprit is the falling level of estrogen and rising level of another hormone, FSH (which is released as your body tries to regulate ovulation). As our bodies age, this hormonal balance is not as fine tuned as it once was, triggering hot flashes and night sweats. Stress, alcohol, smoking, spicy foods, and hot drinks can exacerbate the problem. Many women find that following a balanced diet, minimizing caffeine and alcohol intake, smoking cessation, and practicing relaxation techniques can help to diminish these bothersome symptoms.

Testing your hormone levels with a simple saliva or blood spot test can identify the imbalances, which then leads to appropriate and effective treatment.

  1. There are certain times during the month, just before my period starts, when I cry easily, get anxious and frustrated over things that usually don’t bother me and I just don’t feel like myself. Once my period begins, I feel “normal” again. Can you tell me what is going on? I am driving my family crazy….

PMS (Premenstrual syndrome) often gets worse as we enter our 30’s and 40’s. The definition of PMS is the recurrence certain symptoms before menses, followed by relief of these symptoms once the period begins. Although over 150 PMS-related symptoms have been reported, the most common ones are moodiness, bloating, depression, irritability, breast tenderness, cravings for sweets, fatigue, loss of libido (sex drive) and headaches.

Again, these symptoms are not in your head! There is no need to suffer in silence. Talk to your health care provider, who can order a saliva or blood spot test to measure your hormones. The most common cause is “estrogen dominance” (see question #6), although other imbalances do occur as well. Easy and effective treatments based on your results are available and can correct these problems, helping you to feel “normal” again.

  1. I used to look forward to having sexual relations with my partner but now I could care less. I have lost interest in sexual activity and when I do participate, I find that I don’t have as much feeling or responsiveness: sometimes it even hurts. I am getting very frustrated. Is this common and is there any help for me?

You are definitely not alone in your frustration. Many women experience a decrease in their libido (sexual drive) as they enter perimenopause and menopause. A changing balance of circulating hormone (particularly the key players estrogen, progesterone, and testosterone), can lead to decreased sexual response and desire. Declining estrogen levels can diminish nerve sensation, causing you to be less sensitive to touch and vibration. Estrogen is also responsible for increasing blood flow to sexually sensitive areas, so that lowered levels can slow or diminish the arousal response.

When there is an imbalance of estrogen and testosterone, the vaginal tissues become very dry and thin, which makes sexual activity very uncomfortable: this makes sex even more of a “turn-off”.

Other important hormone “players” are progesterone (which can be converted into estrogen and testosterone), thyroid hormone, responsible for enhancing your libido, and testosterone and DHEA: both with major roles on sexual drive.

Measuring your hormone levels with blood spot and saliva testing is an essential first step toward identifying your particular “hormone profile”. This takes the guesswork out and helps your provider formulate an effective and rewarding treatment plan.

  1. Lately I have felt so tired. I can barely get through the day and find myself reaching for sugary snacks and caffeinated beverages to keep me going. I could really use a nap after lunch. I seem to have lost my usual level of energy. I went to see my doctor, who said all of my lab tests look okay. Is there anything else I can try?

That is an excellent question and we hear that from so many of our clients. Stress and busy lifestyles play a major role in how your body functions and responds to various situations. The adrenal glands normally release cortisol (another very important hormone!!) in response to stress, exercise, excitement, and low blood sugar levels. If stress remains too high over a long period of time, the adrenals can’t keep up, total cortisol levels drop, leading to the fatigue of adrenal exhaustion.

Complaints such as “I feel tired all the time, even after sleep” are a key indicator of adrenal imbalance, often known as “adrenal fatigue”. Other common symptoms include sleep disturbances, anxiety, depression, increased sensitivities to infections and chemicals, and decreased tolerance to stress, sugar cravings, allergies, and a tendency to feel cold.  By measuring your cortisol levels in saliva throughout the day, we can determine the particular aspects of your adrenal issues. This then allows your provider to develop an individualized treatment plan, aimed at restoring your adrenal glands ability to optimal function. This will help you feel energized and rested again.

Another hormone system, which can impact your energy level, is that of the thyroid gland. It is important to measure several components of this system, which can be done with our blood spot kit. Your provider will put all of the information together and then make recommendations for you, so that you can get back to your usual energy level and feelings of well-being.

  1. I don’t feel as though my eating habits have changed, yet I continue to gain weight. I am particularly getting fat around my belly. Is this something that I have to live with or is there something I can do?

During perimenopause, many women develop the hormone imbalance known as “estrogen dominance”: as our bodies age, our levels of progesterone and testosterone drop first, and this allows estrogen to exert more of its effects on our bodies. This “build up” of estrogen blocks our thyroid hormones, creating symptoms of hypothyroidism, such as weight gain/inability to lose weight, thinning hair, sleep disturbances, fatigue, mood swings, decreased sexual drive, constipation, dry skin, peeling nails, to name a few. The thyroid regulates our metabolic rate, so that low levels lead to unwanted weight gain.

If you are suffering from any of these symptoms, we can measure your levels of E, T, P, C and DHEA with a saliva kit, and your thyroid levels with a blood spot kit. Your provider can review the results with you and develop a comprehensive treatment plan. This should include such elements as a regular exercise program, a Mediterranean style diet (rich in fruits, vegetables, olive oil, etc.) and various supplements. Weight gain is not an inevitable result of getting older. There are many things that are available for you to try to help you “battle back the bulge”!

  1. There are so many ads and commercials about osteoporosis. How do I know if I am at risk for this and can balancing my hormones help prevent this from happening to me?

Many factors contribute to the development of osteoporosis, which is a decrease in the density of our bones, leading to an increased risk of debilitating fractures. Bones are actually hormonally sensitive tissues and as the level of our hormones decline with age (particularly DHEA and testosterone), we begin to lose bone density. If at the same time we also have elevated levels of cortisol, the rate of bone loss occurs at a faster rate, so we are losing more than we are building. Higher than normal levels of cortisol interferes with the absorption of calcium, which is used to build up our bones and it also accelerates the rate at which our bones are broken down.

Other factors that increase the rate of bone loss are smoking, excess alcohol intake, lack of physical exercise, prolonged use of steroids and a strong family history of osteoporosis. One valuable tool for assessing your individual risk is our saliva test kit that measures your hormone levels: E, P, T DHEA, and C. Again, by identifying your particular “hormone profile”, your provider can make specific recommendations for treatment of hormonal imbalance and other preventive measures to decrease your risk of developing osteoporosis.

  1. It seems that a lot my friends have gone on anti-depressants once they hit perimenopause. I am so worried that this will happen to me as well. I have noticed that I do feel more “blue” lately than in the past. What’s happening and what can I do about it?

Hormones have a powerful influence on many parts of the body, including the brain. In particular, P, E, T and DHEA have potent effects on our state of mind, mood and memory. Commonly in mid-life, the balance of hormones shifts, resulting in less than desirable to quite devastating psychological changes.  When E is in charge, during the first portion of the menstrual cycle, a positive mood is more common. When the level of E is too low, this can lead to tearfulness and anxiety. When it is too high, and progesterone is too low (that estrogen dominance again!!), we experience more anxiety and unstable moods. In addition, DHEA and T help our brains function, improve our memory and make us feel more vital, so if these are too low, more problems arise. It truly is a balancing act when it comes to our hormones.

These hormone levels can easily be measured using our saliva test kit. The results from these tests provide valuable insight into the causes of our symptoms, allowing your provider to target particular areas for treatment. Doesn’t it make sense to treat the underlying imbalances first and then proceed to more advanced treatment, such as antidepressants, only as needed? Often times just treating your hormone levels results in alleviation of your symptoms: this combined with lifestyle changes(balanced diet, regular exercise, relaxation techniques, time management, etc) leads to optimal mental and physical health.

  1. I keep hearing the term “insulin resistance” and I am just not sure what that means…can you explain this to me? Is this more common as our hormones change with age?

Insulin is a hormone produced in the pancreas that is responsible for carrying glucose (blood sugar) from the bloodstream into the cells where it is converted into fuel for body functions.  Good health and energy depends upon the body’s ability to make and use just the right amount of insulin to keep our blood sugar at optimal levels and our metabolism working normally. Every cell of the body has receptor sites that allow insulin to open the door of the cell so that glucose can enter and go to work. If the body builds up a surplus of glucose, usually from high caloric intake of sugar and carbohydrates that are not burned up through regular exercise, the cells become overloaded and cannot accept more blood sugar. The door is closed. The cells have in effect become resistant to insulin’s attempt to provide them with more glucose. In this scenario, blood levels of insulin and glucose reach and remain at unnaturally high levels, leading to obesity, high blood fats and a heightened risk for diabetes. Early detection of insulin resistance through blood spot testing is the key to prevention of harmful changes in the body, leading to diabetes.

  1. Okay, one last question, and I hope it’s not too basic: can you help me understand what a hormone is and what it does?

Hormones are chemical messengers that are produced in one portion of our body (such as the ovaries, testicles, thyroid, pancreas, to name a few) and then travel in the bloodstream to many parts of our body and enter the cells to “do their work”. Hormones are part of the endocrine system and are in govern mental and physical functions throughout our lives.

When we hear the word “hormone”, we often just think of those relating to sexual and reproductive systems, when in fact, there are many different hormones throughout our bodies. For example, estrogen and progesterone do govern our menstrual cycles and maintain a pregnancy to term, but they also are essential to the health of our blood vessels, heart and brain, as well as the structural strength of our skin, bones and muscles. Cortisol, the “get up and go hormone” that animates us for the day is also the primary or “master stress hormone,” that governs our immune response and helps us to surmount the stresses and strains of everyday living. At the same time insulin and thyroid hormones are fundamental to energy, mood and metabolism, and work hand in hand with all the other hormones our body produces.  The most important thing for you to understand is that in order for our bodies to perform optimally, our hormones must be in balance with one another. When we develop various symptoms that are related to our hormones, it makes sense to measure these amazing chemicals in relation to one another, so that we can make the appropriate corrections, leading to optimal health. At Menopausibilities, we are committed to providing our clients with the most up-to-date information and options, designed to help everyone reach their goal of a healthy and productive life.

Abbreviation Key to Hormones:
E = estrogens
P = progesterone
T = testosterone
C = cortisol