Our endocrine system is comprised of numerous glands that produce the hormones required to ensure proper communication between our organs and tissues.
This can range from the thyroid gland producing hormones that control our metabolic rate to the pancreas that regulate our glucose metabolism. Our hormones are on a very tight leash, meaning they are regulated under tight control and only small amounts of hormone being released can have a profound effect on a number of physiological and behavioral changes in the body. Therefore endocrine imbalances are fairly common, affecting 25-50% of adults. Given that these imbalances can be easily disturbed by stress, birth control pills, environmental toxins, nutritional deficiencies, reduced physical activity, lifestyle factors and many more that we encounter on a daily basis, it can likely be the cause of many illnesses.
Hormone imbalance is often overlooked when a patient comes in with complaints of infertility, fatigue, depression, acne, diabetes, painful periods, or insomnia, to name a few. We forget that it is our hormones that regulate many of the processes that help keep those above complaints in check! Hormones regulate our digestion, sleep, reproduction, mood, growth and development, tissue function, excretion, menstrual cycles, and glucose metabolism, therefore targeting treatment around the endocrine system and hormone balance can be beneficial.
I wanted to shed more light on this topic to educate more women and men about other options for hormonal balancing since conventional medicine has very limited treatments. Some common conventional options are birth control pills, anti-depressants, metformin, non-steroidal anti-inflammatories (Advil, Tylenol) for pain, medications, hysterectomy (complete removal of the uterus), and other surgical procedures. All of these treatments have their own long-term side effects and are not necessarily focusing on the root cause of the illness, along with most of these not being conducive for women wanting to conceive in the future.
Here is a review of some of the most common hormonal dysfunctions and ways Dr. Kirti can help restore optimal endocrine function.
One of the most common imbalances found in women, especially dealing with infertility, frequent miscarriages, acne, low libido, uterine fibroids, premenstrual symptoms, fibrocystic breasts, heavy and painful menstruation, and polycystic ovarian syndrome (PCOS).
Common symptoms indicating LOW estrogen are:
• Low libido
• Vaginal dryness
• Irregular uterine bleeding
• Vasomotor symptoms (ie. Hot flashes)
• Migraine headaches
In non-menopausal women, a low estrogen can be caused by numerous factors. One common cause being high stress. Activation of our HPA (hypothalamic-pituitary-adrenocortical) axis during times of stress inhibits the HPO (hypothalamus-pituitary-ovarian) axis, therefore causing a reduction is estrogen. In patients with adrenal fatigue (when your stress hormones stop responding to chronic stress), cortisol levels are low which can lead to low estrogen levels and correlate to the severity of menopausal symptoms and depression.
Some pesticides can mimic the action of estrogen at the hypothalamic receptors causing a reduction in the gondadotropin-releasing hormone, therefore reducing estrogen further.
Angelica sinensis (Dong Quai) is a common tonic given for amenorrhea or menopause with hot flashes and migraines. False unicorn root is another common herb known to normalize hormones and regulate menses.
Common symptoms/conditions indicating HIGH estrogen are:
• Uterine fibroids
• Breast cancer
• Heavy menses
• Painful menses
A number of causes exist for excess estrogen. An important factor that continually plays a role in the excretion of “bad” estrogens is your body’s detoxification pathways (phase 1 and phase 2). Environmental toxins, such as PCBs and cadmium, have estrogenic effects and increase the likelihood of estrogen-dependent cancers.
Diet can be an important role in and for the treatment of estrogen excess conditions. Usually diets low in fiber, high in protein and fat will contribute to excess estrogen. Poor sleep, sedentary lifestyle and reduced levels of Vitamin D and calcium are other factors that also come into play.
Specific herbs and supplements can help kick start those detoxification pathways and enhance the metabolism and excretion of those hormones. Common elements used are indole-3-carbinol (I3C), calcium-d-glucarate, flax seed, chelidonium majus, B vitamins, garlic, rosemary, schisandra, to name a few!
Progesterone deficiency is most often seen clinically, compared to progesterone excess.
Common symptoms/conditions seen with LOW progesterone are:
• Ovarian cysts
• Fluid retention
• Recurrent pregnancy loss
• Spotting throughout menstrual cycle
Progesterone is involved in the luteal phase of the menstrual cycle and is often called the “hormone of pregnancy,” since it is essential before and after pregnancy. It lays down the framework to help prepare the uterus for fertilization. During pregnancy, it helps nurture and maintain a healthy fetus until week 8-10, then the placenta takes over. Therefore, infertility caused by a luteal phase defect or recurrent pregnancy loss in the first trimester can indicate a progesterone deficiency.
Some common causes of low progesterone are excess prolactin, excessive weight loss and exercise, stress, alcohol consumption, excess fat and sugar intake, antidepressant use, exposure to environmental toxins, and nutritional deficiencies (ie. Zinc, Vitamin A, B6 and C).
It is common for women with PCOS to have reduced progesterone levels also. All of the sex hormones are regulated by one another, therefore they are dependent on each others production during the menstrual cycle. In PCOS, it is common to see an excess estrogen picture, due to the lack of progesterone during the luteal phase. This lack of progesterone is recognized and tells your brain to keep producing LH and FSH, telling the ovaries to stimulate more follicles toward ovulation. With the lack of progesterone present, a mature ovum cannot be produced, causing a cystic ovary and a menstrual cycle that is dominated by increased estrogen and androgen production.
Stress is another common cause of low progesterone and should be considered while optimizing hormone levels, since results could be disappointing if this is not accounted for. When chronic stress is present, cortisol and adrenaline are produced from your adrenal glands. In order to produce cortisol, our adrenal glands require progesterone. Therefore, your progesterone is used by the adrenal glands to produce hormones that help you adapt to stress better, leaving your body deficient in progesterone to support a pregnancy. This imbalance can also affect estrogen and testosterone levels, since our bodies require progesterone to produce those sex hormones. High cortisol can also lead to increases in blood sugar, leading to insulin resistance and production of androgens (male hormones) that will often worsen PCOS symptoms.
Acupuncture can have a profound effect on regulating menstrual cycles and stimulating ovulation in PCOS patients. Studies have shown that through regular acupuncture appointments, changes are seen in FSH, LH, E2 (type of estrogen) values, and basal body temperature, thus stimulating ovulation.
Vitex is another common herb used to regulate progesterone levels since it has prolactin inhibiting effects. It is commonly used in women with frequent pregnancy loss and in women with shorter cycles.
Male Hormone Imbalance
Male infertility accounts for 30-50% of infertility, so hormonal imbalance in men is not something to be overlooked.
Common symptoms/conditions associated with hormone imbalance in men are:
• Low libido
• Abnormal hair growth
• Low sperm count/motility
• Erectile dysfunction
• Weight gain
• Bone Loss
• BPH (benign prostate hyperplasia)
The common hormones that are typically out of balance include: estrogen, testosterone, DHEA, prolactin, cortisol and thyroid hormones.
A common cause of low testosterone is obesity. Men with excess weight around the waist-line have higher amounts of an enzyme called aromatase, which converts testosterone to estrogen, leading to a deficiency in testosterone and commonly enlarged breasts. Chronic low levels of testosterone can affect how the testes function and may lead to lowered production of mature sperm. Research has also shown that the incidence of oligozoospermia (decreased sperm count) increases with increasing BMI (body mass index), with obese men having the highest incidence. The prevalence of low motility and sperm count was also greater with increasing BMI. Testosterone also helps maintain muscle mass and bone, helps control blood sugar and is needed for heart health, and improves sex drive.
Chronic stress can also have a strong effect on sex steroids, since our adrenal glands is what secretes them. Increased cortisol levels can cause unstable blood sugar levels, which can further increase sugar cravings and cause more weight gain. High cortisol levels have the ability to break down bone and interfere with the bone-building action of testosterone.
Adaptogens are herbs that help build up your adrenal system so you are more resilient to stress and you prevent the common hormonal fluctuations that occur with chronic stress. Common herbs/supplements given to support the adrenal glands are Withania, Ginseng, Licorice, Holy basil, B Vitamins, and Magnesium.
More than often, women who get their hormone levels tested are told that everything is “normal.” Well then why am I having these problems?? Unfortunately, a one-time blood or saliva sample does not give an accurate measurement since hormones can fluctuate greatly throughout the month. A month long hormone assessment or 4-point salivary cortisol test (7-11 saliva samples) can be more indicative of any abnormal hormonal variations. Not only do they measure estrogen and progesterone, but also DHEA, testosterone and cortisol, giving a more complete picture and helping to target where treatment is required. We also offer a full hormone panel for male patients.
Depending on the underlying cause of your hormone imbalance, treatment can vary greatly and is individualized to your specific case. Dr. Kirti offers naturopathic and acupuncture services to help address the cause of your hormone imbalance. So come in and find out how we can help you today!