It has become more and more common for women to look for natural therapies to “cure what ails them”. As women age or experience changes in their bodies, many look for supplements to balance hormones, as hormone imbalance is often the root cause for many of the symptoms that are experienced. There are a variety of reasons that women refuse hormone replacement therapy (HRT). This article will discuss why an estimated 70% of women refuse HRT and explore natural ways to balance your hormones without the use of pharmaceutical treatments.
The endocrine system is responsible for the production of all hormones in the body. Glands that are part of the endocrine system include the thyroid, adrenal, pituitary, and pancreas. Each of these glands produce specific hormones that are released into the bloodstream and act as chemical messengers to other organs and tissues. Also known as the hormone system, the endocrine system regulates all biological processes from conception through advanced age (10). The largest endocrine organ in the body is the gut (1).
Hormone imbalances can occur for a variety of reasons, including but not limited to premenstrual syndrome (pms), menopause, and thyroid disorders. These imbalances not only take time to diagnose, but the symptoms can become quite frustrating when trying to determine the best method of treatment. The root cause of the hormone imbalance may determine the symptoms that you experience.
Symptoms of hormone imbalance
During pms, women may experience symptoms such as angry outbursts, anxiety, depression, irritability, abdominal bloating, breast tenderness, weight gain or headaches (8). Women with hormone imbalance may experience polycystic ovary syndrome (pcos), infertility, and endometriosis (6). During menopause, the most common symptoms include hot flashes, osteoporosis, mood disorders, and weight gain (3,5). Finally, individuals with thyroid disorders may experience inflammation, insomnia, mental, physical, and emotional fatigue, mood disorders, and autoimmune conditions (4).
Hormones and the Gut
The gut produces and secretes over 20 different hormones that play an important role in metabolism, glucose response, appetite control and fat storage. These hormones carry out their metabolic functions by interacting with various organs and tissues that are necessary for metabolism, such as the liver, pancreas, fat tissue and the brain (1).
Blood Sugar Balance
Gut hormones are required to maintain a balance in blood sugar by activating other organs that are involved in this process. Without this balancing act of glucose input and output, the risk of developing metabolic diseases such as type 2 diabetes and cardiovascular disease are increased (1).
Energy intake is determined by the drive to eat and the rate at which nutrients are absorbed, while energy expenditure is determined mostly by how much energy is needed to maintain basic metabolic processes, such as maintaining body temperature, and voluntary activities, such as exercise. This delicate balance between energy intake and output ultimately determines our body weight. When we have a surplus of energy, our body stores it as fat, and this is one key driver of obesity. Some gut hormones target this fat tissue for metabolism, helping our body utilize it for energy (1).
Satiety and Hunger
The gut brain axis sends signals between the gut and the brain to inform the brain of energy status, which creates either a feeling of hunger or fullness. This demonstrates the importance of how hormones and neurotransmitters that are found in the gut help control appetite and food intake. For this reason, gut hormones offer a desired target in the treatment of overweight and obesity. Ghrelin, for example, is an appetite stimulating gut hormone that increases following weight loss, which explains why some individuals tend to regain weight after a period of dieting (2).
Nutrient absorption relies heavily on efficient digestion of food, which is regulated by gut hormones and optimized by the gut brain axis (1,2). Gut hormones send signals that start a cascade of events, one of which is the activation of digestive enzymes, that are critical in breaking down macronutrients so that they can be utilized by your body. Macronutrients are categorized as carbohydrate, protein and fat (1).
Conventional and Alternative Treatments
Hormone Replacement Therapy (HRT)
More than 70 million women in the United States experience menopausal symptoms. In women with moderate or severe symptoms, HRT is generally the first line of treatment. HRT is often considered the best option for therapeutic relief of menopausal symptoms, however many women refuse HRT for a variety of reasons, including but not limited to concern for cancer or other adverse effects, drug costs, dissatisfaction with conventional healthcare, a desire for more personalized medical care and the perception that “natural is good”. Adverse effects of inappropriately dosed HRT include fluid retention, nausea, headaches, breast tenderness, bloating, leg cramps and vaginal bleeding, which may be why it has been reported that less than 30% of menopausal women take HRT and only 15% continue the therapy for a prolonged period of time (5).
Women experiencing premenstrual syndrome (PMS) suffer from symptoms similar to menopausal women, such as abdominal bloating, breast tenderness, and weight gain. About 80% of women report at least one physical or psychiatric symptom during PMS. Psychiatric symptoms may include angry outbursts, anxiety, depression, and irritability. The primary treatment for women in the United States suffering from PMS is selective serotonin reuptake inhibitors (SSRIs) and other psychiatric medications such as Zoloft, Paxil, Prozac, Celexa, Lexapro, and Seroquel. Some studies suggest that oral contraceptives also provide benefit when looking to treat psychiatric and physical symptoms of pms (8)
Nutraceuticals have gained popularity in recent years because many women desire a more natural approach, such as using herbs and supplements to balance hormones. In 1989, Stephen De Felice coined the term “nutraceutical” as a “food, or parts of a food, that provide medical or health benefits, including the prevention and treatment of disease”. (4) The use of nutraceuticals is thought to have originated in Asia and throughout ancient China and is what we have termed traditional Chinese Medicine (TCM) (5). Nutraceuticals include dietary supplements, herbal medicines, functional foods, and medicinal foods. They are particularly desirable because they are easy to use, can help with many menopausal complaints, and can be used together with many drugs without contraindication (5). Nutraceuticals are used as supplements to balance hormones, have antioxidant properties and are used as an efficient preventative and therapeutic tool for pathological conditions, such as thyroid disease (4).
While HRT is generally the first therapeutic option for menopausal symptoms, a majority of women choose not to use HRT and opt for a more natural approach, often seeking supplements to balance hormones. On the other hand, nutraceuticals often lack clinical trials that demonstrate evidence-based results and are not regulated by the Food and Drug Administration (FDA). Therefore, when choosing products, it’s important to pay close attention to good manufacturing practices, a guarantee for consistent, standardized composition and clinical studies to support effectiveness and safety (5).
Supplements to Balance Hormones
There are a considerable number of vitamins, minerals, herbal derivatives, adaptogens and other natural therapies used to improve symptoms of hormone imbalance. For example, Ashwagandha, Magnesium and Vitamin C have been shown to reduce stress and anxiety, among other things, which is often felt when hormones are out of balance. Vitamin E is thought to play a role in the prevention of hot flashes and to have an effect on sleep quality (5). Five of the most common supplements to balance hormones are discussed in more detail below. It should be noted that supplements alone will not provide the best benefits if dietary and lifestyle modifications are not also taken into consideration.
Probiotics provide a host of benefits, including but not limited to gut health, mental wellness, immunity, and hormone balance. If you have ever wondered which strains of probiotics to take or how long it takes for probiotics to work, check out this blog post.
In regards to supplements to balance hormones, probiotics have been shown to help maintain weight stability, promote energy balance, control fat deposition, decrease inflammation, and provide a protective effect against autoimmune diseases (11).
Vitamin D is a hormone and a vitamin that is relatively inexpensive, yet gives a lot of bang for the buck. It has been shown to reduce metabolic syndrome risk, hypertriglyceridemia and hyperglycemia in vitamin D deficient women. Vitamin D is required for calcium and phosphate absorption, which is necessary for bone mineralization and helps with appetite control, insulin sensitivity, metabolism and keeping the stress hormone, cortisol, from becoming elevated (5). Currently, there are large amounts of research being conducted on the effects of Vitamin D3 on its protective effects from the COVID-19 virus, when taken in adequate amounts. Most multivitamins do not offer adequate amounts of Vitamin D to experience beneficial effects (12).
Omega 3 fatty acids are precursors to eicosanoids, locally produced hormones, that are important in the prevention and treatment of various diseases, particularly in women. Some evidence has been reported that omega 3 may help prevent preeclampsia, postpartum depression, menopausal problems and post-menopausal osteoporosis (14). Omega 3 may also be recommended for the treatment of PCOS with insulin resistance, which is one of the most common endocrine disorders in women (13). Additionally, omega 3 has powerful anti-inflammatory properties.
Supplementation of the micronutrient, selenium, has been associated with improvement of thyroid antibodies and improved quality of life in patients with autoimmune thyroiditis. The thyroid requires selenium for antioxidant function and metabolism of thyroid hormones. Selenium supplementation has been shown to improve immune function, even in individuals that are not deficient in the micronutrient. Interestingly, consuming too little or too much selenium can be associated with adverse outcomes, therefore supplementation is generally only recommended for patients with a true selenium deficiency (17).
A deficiency in B12 may present itself as impaired memory, dementia, depression or anemia. This vitamin is essential for every aspect of brain function and early supplementation can prevent long term consequences of B12 deficiency, such as cognitive impairment. Deficiencies in B12 also may result in a folate deficiency, as these two vitamins are linked to each other. Vitamin B12 also plays a key role in generating energy within the cells (15, 16).
When it comes to our bodies, our individual health needs and varying lifestyle factors, there is no one-size-fits-all when it comes to supplements to balance hormones. Many women are moving away from conventional methods of treating hormone imbalance and seeking a more natural approach. Many natural remedies, such as vitamin, mineral and naturopathic supplementation have been shown to effectively balance hormones, or at the very least improve the symptoms that accompany hormone imbalance. As always, information contained in this article is not meant to replace medical advice and is a vehicle to provide knowledge and an understanding of hormone imbalance, symptoms and natural solutions that may provide relief to women.
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