Conventional medicine often dismisses ‘women’s problems’ as inexplicable and complex. Dr. Doni explains the wonder of (and science behind) the menstrual cycle.

When Melanie, a 32 year old mother of three, came to see me she told me how she had been to see a gynecologist to discuss how she could address her irregular menstrual cycle, heavy bleeding, bloating, mood swings, acne, and weight gain. The doctor told her that her symptoms were “normal” and recommended that she take a birth control pill. When she tried taking the pill, she felt awful almost immediately so she stopped taking it.

Eva, who is 49 years old and has two children in college, came in describing how she doesn’t feel like herself. She has anxiety that has worsened in the past few months, and she’s gained ten pounds in the past year. Her joints ache and she hasn’t slept well since her son was born. Her last period was three months ago. When she asked her doctor, he said that her bloodwork was all normal, so her symptoms must be “all in her head.”

Rita, 28 years old, lost a pregnancy last year. She and her partner are now ready to try to conceive again. When she met with her doctor to find out what she can do to prevent another pregnancy loss, the doctor said all her tests were normal so she should just keep trying. They will only investigate further if she loses three pregnancies.

I hear stories like this every day in my office. Stories of women who would like to feel better and who are willing to do whatever it takes to feel better – exercise, change their diets, and even meditate – yet conventional medicine has nothing to offer them, or only offers solutions that are inconsistent with the way they want to help their bodies.

Conventional medical practitioners tend to be dismissive of women’s symptoms and often make hormones and the neurotransmitters that work alongside them seem mysterious, as if they are too difficult to understand or figure out. Instead of explaining how our physiology works, or looking for ways to balance hormones, they tend to prescribe synthetic hormones or medications that mask the cause of the problem. As a result, women end up feeling trapped in their bodies or as if the only option is to take a prescription for the rest of their lives in order to “fix what is broken.”

From my perspective as a naturopathic doctor, midwife, and woman, none of this is true. There is a science to hormones and neurotransmitters, which means that we can do something about them. As a naturopathic doctor, I help women look at the details of their hormones and neurotransmitters to understand how they function optimally, what throws them out of sync, and what we can do to help bring a state of balance again. This way, together, we can address their health issues now and into the future.

How Our Bodies Challenge Who We Want To Be

Compared to a hundred years ago, women have more rights, responsibilities, and with it, more stress, and yet we continue to deal with discrimination related to education, careers, political influence, equal pay, and I would say in medicine as well. In this time, women have become more likely to be assertive, question authority and make choices that put themselves first. Yet even now, one of the first things women share with me is that they are often hard on themselves, wishing they had done things differently or wondering why they don’t feel happy despite having everything they ever wanted.

Some of this is at least partially due to hormonal and neurotransmitter imbalances, and how they are perceived and dismissed. When we feel like slaves to our hormones and our neurochemicals, it can make it difficult to feel confident, no matter how competent, experienced, or brilliant we are. If you add to that the fact that many women are told not to be “so emotional,” it can be hard to find trust in ourselves and in our bodies. It’s also common that women tend not to talk about our experiences, such as pregnancy loss and menstrual difficulties, often in order to avoid judgement and criticism, and so we are left feeling alone.

The truth, however, is that all of our hormonal fluctuations, and the neurotransmitter shifts that accompany them, are what make us women. Puberty, PMS, menstruation, pregnancy, childbirth, postpartum, lactation, menopause, and hormone fluctuations in general – our bodies are constantly shifting and changing, and that makes us who we are. It doesn’t mean we have to suffer through them, but it also doesn’t mean that we should feel the need to apologize for them. As we learn to embrace these experiences not just as normal, but as a real and valid part of being a woman, perhaps we will find more community support with each other and more empowerment to find solutions that allow us to thrive.

The Unique Science of the Female Body

Women’s bodies differ from male bodies primarily in terms of our reproductive systems – men have testicles and a penis; women have ovaries, a uterus, and a vagina – which sounds simple but results in strikingly different experiences and sensations throughout our bodies and our lifetimes.

Between the ages of roughly 13 and 51, hormones from a women’s brain tell her ovaries to ovulate each month, releasing an egg which travels through the fallopian tubes to the uterus where estrogen and progesterone (hormones released by the ovaries) have stimulated and maintained the growth of blood vessels. If a pregnancy is conceived, those blood vessels will provide nutrition for the growing fetus, otherwise they are sloughed off at the end of each cycle – what we recognize as menstruation.

Estrogen and progesterone don’t just affect the uterus. 

Estrogen and progesterone also travel throughout a woman’s body, signaling to every other system in the body to shift and adjust in a way that creates the feelings and experiences we as women know only too well, including changes in our body temperature, energy level, mood, weight, digestion, our skin and our hair, and even our focus and sleep patterns.

When estrogen and progesterone are out of balance with each other – for example if detoxification of estrogen is impeded in the liver or if the ovaries produce less progesterone, both of which are more likely when women are stressed – then the way we feel changes. In this situation, and when peri-menopause occurs (causing a significant flux in hormone levels), women often feel “off-balance” and as if their life is on hold, unsure of whether they can shine through.

In many ways the menstrual cycle is beyond amazing.

Did you know that in an optimal balance, ovulation occurs two weeks after the start of the last period? And that the time between ovulation and next period is also two weeks? That’s why the menses comes (optimally and when hormones are balanced) every 28 days.

Did you know that women’s menstrual cycles tend to align with the moon’s schedule and that women are both more likely to conceive and go into labor during a full moon? This is because exposure to light at night (consider how much light the full moon can produce) decreases melatonin production. With less melatonin, the ovaries are less suppressed and therefore are more likely to ovulate and produce hormones.

Stress and cortisol also affect ovary function and hormone balance. 

When women are exposed to stress (whether emotional or physical, from toxins or overexposure to ‘stressful’ foods like sugar and gluten, or due to a lack of sleep or an infection), cortisol levels become imbalanced, shifting the signal to produce hormones away from the ovaries and toward areas of the body that help address stress. When cortisol levels are too high, for example, blood sugar levels also tend to be higher and beneficial gut bacteria tend to be lower, both of which are associated with irregular menstrual cycles and/or PCOS (polycystic ovarian syndrome).

When stress happens, a woman might skip ovulation altogether that month. Or she may still ovulate but produce less progesterone which can result in spotting, an early period, heavy bleeding, or a late period. Symptoms of PMS (premenstrual syndrome) increase, as does the likelihood of developing fibroids, as well as cysts in the ovaries and breasts. Fertility decreases during times of stress, and menopause becomes more likely. This is why many women report entering menopause after a death in the family or following a time of extreme stress.

Women’s transitions can be a cultural experience. 

Back in history, the menses was a spiritual event when women would gather together to celebrate renewal. Even today, in some cultures, women’s bodies are honored during times of change. However, in the United States and many other countries, women often feel on their own and like they are out of control of what is happening in their bodies. This doesn’t have to be the case.

Taking a Natural Approach to Women’s Health

Fortunately, hormones are not a mystery: there is a science to them, which means there is something we can do when they cause us problems other than taking synthetic hormones in the form of oral contraceptives, and psychotropic medications, both of which have significant side-effects and long-term risks associated with them.

Tests now exist to measure a woman’s hormones in a way that allows us to see exactly what is going amiss. These are not blood tests – which are known to have little usefulness – but urine tests. We can measure not just hormone levels in the urine, but also the metabolites, which means we can trace hormone levels throughout the body and determine where more support is needed. With that information, we can then address the problem, systematically and scientifically.

There are a number of nutrients and herbs that are known to support optimal hormone levels so, armed with your test results we can work out what is needed. For example, I mentioned above that estrogen detoxification can become an issue. This can especially be the case when women have an MTHFR mutation, COMT mutation, and/or CYP1B1 mutation – and can be addressed with supplements* in a highly-individualized, sequential plan. You can find out if you have these (or any other) mutations by doing a 23andme ancestry panel and analyzing the data using specific software programs. Read more about how I support patients through this process here.

We can also measure cortisol, adrenaline and DHEA levels – stress hormones made by the adrenal glands – and our neurotransmitters (including serotonin, dopamine, and GABA) so we can ensure they are playing their part well, too. Neurotransmitters are made in our bodies from nutrients (amino acids to be exact) so, if you have too little of a particular neurotransmitter, you can rectify this by taking more of the precursor nutrient. It’s important to have a practitioner help guide you through this process, especially if you are currently taking medications that affect neurotransmitters. (Learn more about finding a practitioner below.)

You can also support hormone and neurotransmitter levels by making careful choices every day about how you spend your time, what you eat, how you exercise and when you sleep.

By supporting these basic activities each day, the body can better balance hormones and neurotransmitters on its own. I want to emphasize this! It sometimes seems so basic, but many of my female patients tell me that it is this that ends up making the most significant difference. By making time for you, prioritizing your needs for nutrient-rich foods, plenty of good sleep, opportunities to de-stress (whether by laughing with a friend, taking a bath, reading a book, or breathing and meditating) and exercising regularly, your ovaries and hormones will respond in a way that helps you feel better. And when you feel better it means you’ll have more time and energy to help others, be there for your family, accomplish that task you’ve been wanting to complete for ages, and simply enjoy the day.

This leads me to remind you of what I refer to as CARE Activities (refer the the image to the right). It’s nothing short of a celebration when women tell me about the changes they’ve noticed in their bodies in a relatively short period of time having simply shifted their schedule and made time to give their body what it needs.

To get started with making these changes in your life, you may find the 7 and 21 day Stress Remedy Programs to be helpful. These programs include a meal plan that encourages you to avoid the foods that disrupt your hormones, and steps you can take to rebalance. The 7 day plan is the perfect way to get a quick reset (you could even use it over a 3-day weekend) with food, sleep, stress, and exercise.

The 21-day plan includes more in-depth stress recovery, including daily mini-steps to help you integrate change gradually over 3 weeks and supplements to get you started with healing leaky gut, one of the major roadblocks (health-blocks) caused by stress. Getting started with healing your digestion means you are one step closer to balanced hormones. Once you complete these programs, you’ll be set to continue these healthy habits into the future.

More About Women’s Health

Hormones can trouble us, but they are also an essential part of what makes us women. Making sure they are balanced can help us feel better, stronger, and more confident.

In this new blog series, I’m going to write more about women’s experiences. I’ll discuss in more detail the health challenges that are unique to us and the tools we can use to resolve them.

To be sure you receive my next article, please subscribe to my weekly newsletter here. When you do, you’ll also receive a free guide to recovering from stress.

I’m so inspired by this topic that I’ve decided to create a Women’s Wellness Solutions Package, which includes the tests I find help women discover their bodies best, and one-on-one sessions with me so I can help guide you through the process.

If you want more specialized care, you can find out about scheduling an in-person or phone consultation with me here. Or to find a practitioner in your local area who will acknowledge your experiences in your body instead of dismissing them, I encourage you to search for a Naturopathic Doctor. You could start at Naturopathic.org.

If you are a practitioner, wanting to learn more about my approach and how to implement it in your practice, I welcome you to sign up for Practitioner Updates from me, including information about a course I’m developing. I also have a few Practitioner Tips for you below.

I look forward to sharing more of my women’s health insights with all of you soon.

–Dr. Doni
24th October 2016

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Tips for Practitioners

• Listen and acknowledge your patient’s experience. Many times, patients go through medical experiences that are dismissive of how they feel and what is happening to them. Giving patients a chance to be heard and understood is one of the best ways you can help them heal.

• Demystify hormones for women. Explain the cycle of hormones so that women understand their bodies better and can help you understand where things are going awry. In my quick explanation, I compare ovulation and progesterone production to throwing a basketball through a hoop. Here is what I say: Your goal is to have a healthy period at Day 28 without negative symptoms, so think of that as the hoop. Your ovaries ovulate and make progesterone – that’s your “shot.” If your shot is too short or too long, it won’t go in the basket. The same thing happens with your cycle. If the cycle is too short or too long, women can experience various symptoms of PMS and are at increased risk of infertility, PMS, PMDD, fibroids, and cancer. But if the ovaries make just the right amount of progesterone – then the shot goes through the hoop and the menses comes at Day 28. Hormones don’t have to be complicated, it’s just a matter of getting your body back in balance so that it can function the way it’s supposed to.

• Women’s intuition is a powerful tool. As your patients become more confident about “following their gut feeling,” they will need you less and less. By teaching women how to care for themselves, you’ll be giving them a roadmap for dealing with issues that may come up in the future and the empowerment to help others as well.

*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.