Back in Balance
Hormone Balancing Consultation
Are you feeling out of sorts and wondering if your symptoms are related to perimenopause or menopause?
Common Symptoms of Perimenopause:
- Vaginal dryness
- Painful intercourse
- Blunted motivation
- Night sweats
- Hot flashes
- Loss of libido
- Mood swings
- Hair loss
- Memory lapses
Many women experience perimeopausal symptoms as early as their mid-thirties! Hormone balance can be disrupted by many factors such as poor diet, chronic stress, environmental toxins, and autoimmune conditions, among others. Alternatively, hormone balance can be supported by dietary composition, herbs, vitamins, stress management and exercises as well as hormone supplementation when needed.
Dr. Sholes-Douglas or Barbara Cooper, CNM, NP will assess your individual history, evaluate hormone levels as indicated, and devise a plan to support your body’s ability to self-regulate. She will use an integrative approach to powerful nutrition, the support of herbs and plant-based supplements, and mind-body exercises and relaxation techniques as the foundation to support and restore balance. Hormone supplementation can be added when necessary. Our goal is to get you feeling great and back in balance!
The thyroid regulates your metabolism. The two main thyroid hormones are T3 and T4. Thyroid disorders are common, and they include goiters, hyperthyroidism, and hypothyroidism.
The thyroid’s main role in the endocrine system is to regulate your metabolism, which is your body’s ability to break down food and convert it to energy. Food essentially fuels our bodies, and our bodies each “burn” that fuel at different rates. This is why you often hear about some people having “fast” metabolism and others having “slow” metabolism.
The thyroid keeps your metabolism under control through the action of thyroid hormone, which it makes by extracting iodine from the blood and incorporating it into thyroid hormones. Thyroid cells are unique in that they are highly specialized to absorb and use iodine. Every other cell depends on the thyroid to manage its metabolism.
The pituitary gland and hypothalamus both control the thyroid. When thyroid hormone levels drop too low, the hypothalamus secretes TSH Releasing Hormone (TRH), which alerts the pituitary to produce thyroid-stimulating hormone (TSH). The thyroid responds to this chain of events by producing more hormones.
Diseases and Disorders of the Thyroid
There are many diseases and disorders associated with the thyroid. They can develop at any age and can result from a variety of causes—injury, disease, or dietary deficiency, for instance. But in most cases, they can be traced to the following problems:
- Too much or too little thyroid hormone (hyperthyroidism and hypothyroidism, respectively).
- Abnormal thyroid growth
- Nodules or lumps within the thyroid
- Thyroid cancer
Below are some of the most common thyroid disorders:
Goiters: A goiter is a bulge in the neck. A toxic goiter is associated with hyperthyroidism, and a non-toxic goiter, also known as a simple or endemic goiter, is caused by iodine deficiency.
Hyperthyroidism: Hyperthyroidism is caused by too much thyroid hormone. People with hyperthyroidism are often sensitive to heat, hyperactive, and eat excessively. Goiter is sometimes a side effect of hyperthyroidism. This is due to an over-stimulated thyroid and inflamed tissues, respectively.
Hypothyroidism: Hypothyroidism is a common condition characterized by too little thyroid hormone. In infants, the condition is known as cretinism. Cretinism has very serious side effects, including abnormal bone formation and mental retardation. If you have hypothyroidism as an adult, you may experience sensitivity to cold, little appetite, and an overall sluggishness. Hypothyroidism often goes unnoticed, sometimes for years, before being diagnosed.
Solitary thyroid nodules: Solitary nodules, or lumps, in the thyroid are actually quite common—in fact, it’s estimated that more than half the population will have a nodule in their thyroid. The great majority of nodules are benign. Usually a fine needle aspiration biopsy (FNA) will determine if the nodule is cancerous.
Thyroid cancer: Thyroid cancer is fairly common, though the long-term survival rates are excellent. Occasionally, symptoms such as hoarseness, neck pain, and enlarged lymph nodes occur in people with thyroid cancer. Thyroid cancer can affect anyone at any age, though women and people over thirty are most likely to develop the condition.
Thyroiditis: an inflammation of the thyroid that may be associated with abnormal thyroid function (particularly hyperthyroidism). Inflammation can cause the thyroid’s cells to die, making the thyroid unable to produce enough hormones to maintain the body’s normal metabolism. There are five types of thyroiditis, and the treatment is specific to each.
The adrenal glands are two glands that sit on top of your kidneys that are made up of two distinct parts:
The adrenal cortex — the outer part of the gland—produces hormones that are vital to life, such as cortisol (which helps regulate metabolism and helps your body respond to stress) and aldosterone (which helps control blood pressure).
The adrenal medulla — the inner part of the gland—produces nonessential (that is, you don’t need them to live) hormones, such as adrenaline (which helps your body react to stress).
When you think of the adrenal glands (also known as suprarenal glands), stress might come to mind -and rightly so! The adrenal glands are arguably best known for secreting the hormone adrenaline, which rapidly prepares your body to spring into action in a stressful situation.
Anatomy of the Adrenal Glands
The adrenal glands are two, triangular-shaped organs that measure about 1.5 inches in height and 3 inches in length. They are located on top of each kidney. Their name directly relates to their location (ad—near or at; renes—kidneys).
Each adrenal gland is comprised of two distinct structures—the outer part of the adrenal glands is called the adrenal cortex. The inner region is known as the adrenal medulla.
Hormones of the Adrenal Glands
The adrenal cortex and the adrenal medulla have very different functions. One of the main distinctions between them is that the hormones released by the adrenal cortex are necessary for life; those secreted by the adrenal medulla are not.
Adrenal Cortex Hormones
The adrenal cortex produces two main groups of corticosteroid hormones — glucocorticoids and mineralcorticoids. The release of glucocorticoids is triggered by the hypothalamus and pituitary gland. Mineralcorticoids are mediated by signals triggered by the kidney.
When the hypothalamus produces corticotrophin-releasing hormone (CRH), it stimulates the pituitary gland to release adrenal corticotrophic hormone (ACTH). These hormones, in turn, alert the adrenal glands to produce corticosteroid hormones.
Glucocorticoids released by the adrenal cortex include:
Hydrocortisone:Commonly known as cortisol, it regulates how the body converts fats, proteins, and carbohydrates to energy. It also helps regulate blood pressure and cardiovascular function.
Corticosterone:This hormone works with hydrocortisone to regulate immune response and suppress inflammatory reactions.
The principle mineralocorticoid is aldosterone, which maintains the right balance of salt and water while helping control blood pressure.
There is a third class of hormone released by the adrenal cortex, known as sex steroids or sex hormones. The adrenal cortex releases small amounts of male and female sex hormones. However, their impact is usually overshadowed by the greater amounts of hormones (such as estrogen and testosterone) released by the ovaries or testes.
Adrenal Medulla Hormones
Unlike the adrenal cortex, the adrenal medulla does not perform any vital functions. That is, you don’t need it to live. But that hardly means the adrenal medulla is useless. The hormones of the adrenal medulla are released after the sympathetic nervous system is stimulated, which occurs when you’re stressed. As such, the adrenal medulla helps you deal with physical and emotional stress. You can learn more by reading a SpineUniverse article about the sympathetic nervous system.
You may be familiar with the fight-or-flight response—a process initiated by the sympathetic nervous system when your body encounters a threatening (stressful) situation. The hormones of the adrenal medulla contribute to this response.
Hormones secreted by the adrenal medulla are:
Epinephrine: Most people know epinephrine by its other name—adrenaline. This hormone rapidly responds to stress by increasing your heart rate and rushing blood to the muscles and brain. It also spikes your blood sugar level by helping convert glycogen to glucose in the liver. (Glycogen is the liver’s storage form of glucose.)
Norepinephrine: Also known as noradrenaline, this hormone works with epinephrine in responding to stress. However, it can cause vasoconstriction (the narrowing of blood vessels). This results in high blood pressure.
Female needs not just her own female hormones, but also male hormones in adequate amounts for proper functioning and well-being. The ovaries produce both female and male hormones. The main female hormones are estrogen and progesterone and the main male hormones are testosterone and androstenedione. Let’s review these hormones and their functions for female body functioning in more details.
Estrogen refers to a group of female “sex” hormones, produced primarily in the ovaries, and to a lesser extent in the body’s fat cells. It is important for adolescent sexual development and for regulating the menstrual cycle. Estrogen prepares the uterus for receiving the fertilized egg by stimulating the uterine lining to grow. During days 10 – 14 in a woman’s cycle, the uterus is mainly under the influence of estrogen, which begins to climb right before ovulation, which is usually between days seven to fourteen, peaking at ovulation in preparation for a fertilized egg. Estrogen also improves skin tone and reduces vaginal dryness. There are three main types of estrogen that a woman makes: Estradiol (E2), which accounts for 80% of her estrogen, Estriol (E1), and Estrone (E3), each accounting for 10% of the remaining estrogen.
Estradiol is the main source of estrogen for women up until the time of the menopause, and is produced by the ovaries. From puberty to around the age of 30, the levels of estradiol reach their highest (average blood levels of 450 to 550 pmol/l). After around the age of 30 years the production of estradiol gradually lessens. A few years before the menopause, estradiol blood levels are around 200–300 pmol/l. After the menopause, however, levels of estradiol fall to around 80 pmol/l.
The other source of estrogen (estrone) comes from the adrenal glands, which sit on the top of each kidney. These glands produce a male hormone called androstenedione, which is converted in the fatty tissue to an estrogen called estrone. The average level of estrone after the menopause is around 100 pmol/l. Since the conversion of androstenedione takes place in the fatty tissue, women with greater amounts of fatty tissue produce higher levels of estrone.
Each individual hormone follows its own pattern, rising and falling at different points in the cycle, but together they produce a predictable chain of events. One egg (out of several hundred thousand in each ovary) becomes ‘ripe’ (mature) and is released from the ovary to begin its journey down the Fallopian tube and into the womb. If that egg isn’t fertilized, the levels of estrogen and progesterone produced by the ovary begin to fall. Without the supporting action of these hormones, the lining of the womb, which is full of blood, is shed, resulting in a period.
The main functions of estrogen are to:
- Help regulate menstruation.
- Help in growth and development of female organs.
- Help prepare the body for fertilization.
- Stimulate the lining of the womb so that it thickens.
- Maintain lubrication of the vagina.
- Help maintain the acid level in the vagina, thereby protecting against infections.
- Work in conjunction with progesterone to help with the breakdown of the endometrium (lining of the womb) in the second stage of the menstrual cycle.
- Maintain a supply of calcium to the bones.
- Help maintain the health of blood vessel walls.
- Reduce the blood cholesterol level.
- Bring about the development of secondary sex characteristics, i.e. the breasts and nipples.
Influence body shape at puberty, resulting in women having broader hips and narrower shoulders than men, and a tendency to deposit fat on the hips and thighs.
- Increase elasticity of the skin, promoting the performance of hormone collagen.
- Influence the growth of body hair, so that women have less body hair and more scalp hair than men.
Stop the growth of the arm and leg bones, resulting in women being generally shorter than men.
- Stop the growth of the arm and leg bones, resulting in women being generally shorter than men.
Progesterone is another female “sex” hormone, produced in the ovaries, that prepares the uterus for a fertilized. Its sudden withdrawal causes the uterus to shed its lining if pregnancy does not occur. While estrogen is high (during days 1-10 of the menstrual cycle), progesterone is at its lowest level. Its levels climb to a peak between days 14 – 24, and then dramatically drop off again just before the start of menstruation. Ideally, women should have five to ten times more progesterone than estrogen in the blood and 40 to 150 times in the saliva. The lower the ratio of progesterone to estrogen, the higher the risk of health problems. Progesterone has the unique ability to change its structural form to become other hormones, allowing it to be converted and utilized by the body to the point of depletion.
The main functions of progesterone are to:
- Help prepare the body for fertilization and maintain pregnancy. Progesterone during pregnancy and prolactin during lactation promote nest building.
- Work in conjunction with estrogen, to help with the breakdown of the endometrium (lining of the womb) in the second stage of the menstrual cycle.
- Help regulate menstruation.
- Change the mucus produced by the glands in the cervix so that it becomes thick and acidic, thus protecting a potential pregnancy from infection.
- Aid development of the glands in the breast.
- Increase water and salt retention, which may lead to painful breasts and weight gain.
- Improve the immune system.
- Have a relaxant effect on some of the muscles in the body (i.e. stomach, uterus, and fallopian tubes).
- Increase production of sebum, leading to more oily skin and spots.
- Increase the body temperature.
In addition, progesterone may have an impact on mood, leading to an increased irritability. Hence, women often report experiencing changes in mood prior to having a period when the levels of progesterone are at their highest.
Testosterone and androstenedione
Both female and male sex hormones are produced by men and women, but at different levels. Up until the menopause, women have about one-tenth of the amount of male sex hormones that are found in men.
Both testosterone and androstenedione are produced in the ovary, and after the menopause, these hormones go on being produced for a few years. In addition, androstenedione is produced by the adrenal glands (on top of each kidney). The amount of androstenedione produced by the adrenal glands is unchanged after the menopause, although after the menopause it is converted to a form of estrogen (estrone) in the fatty tissue.
The role of male hormones in women is not fully understood, although they have been shown to:
- Increase libido.
- Stimulate the growth of pubic, facial and underarm hair.
- Possibly enhance mood.
- Increase the density of specific bones (for example, the hip bone).
As can be seen from the above lists, both male and female hormones have a number of functions within the body. Although levels of these hormones change around the time of the menopause, this does not happen suddenly. Ovarian changes occur from around the age of 35 until around the age of 55 to 60 years.
For more information about balancing your hormones contact your women’s health center in Tucson, we can help!