What do you think of when you hear the word “hormonal?” Sadly, most person immediately associate the adjective with “emotional,” and often relate it to a woman’s menstrual cycle or perimenopausal years. But from a physiological (and therefore accurate) perspective, “hormonal” pertains to the many different types of messenger compounds the body produces that stimulate action at another site in the body. These can include everything from estrogen, testosterone and progesterone (often referred to as “sex hormones”); to cortisol, one of the main stress hormones; to thyroid hormones (critical for calorie burn); to insulin, a hormone critical to regulating blood sugar and more.
Make no mistake, hormonal imbalances can absolutely cause emotional roller coasters, as well as changes in libido, PMS symptoms, fat distribution and fertility. Specifically, a category of hormones sometimes referred to as “women’s sex hormones” (although they are found in both women and men) — such as estrogen, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and progesterone — may be misbehaving. In my experience as a dietitian, I’ve had countless clients who discovered that an imbalance in hormones was to blame all along for a frustrating weight-loss plateau and unwanted symptoms — and working in conjunction with their medical team to address it ended up being key to their success.
HOW DOES THE BALANCE WORK?
For those of you interested in the physiology of what happens during the course of the month, here’s how these sex hormones work in premenopausal women when all is well:
- The first half of the cycle is often called the follicular phase, and is dominated by follicle-stimulating hormone (FSH) and estrogen. Progesterone is low, and estrogen is relatively high, so this is sometimes described as the “estrogen-dominant” part of the cycle.
- Around mid-cycle, there is a surge of luteinizing hormone (LH) which stimulates ovulation, or release of an egg.
- In the second half of the cycle, referred to as the luteal phase, estrogen drops off while progesterone rises. As a result, it’s the more “progesterone-dominant” part of the cycle.
- Assuming there is no conception or pregnancy, FSH, estrogen, LH and progesterone all get cleared toward the end of the cycle (with the help of the liver, gallbladder and digestive tract), triggering menstruation and the start of the next cycle.
- After menopause, FSH and LH are high while estrogen and progesterone are lower. The ovaries no longer release hormones needed for pregnancy, and the adrenal glands (in charge of the stress response) take over.
The above description only scratches the surface of the delicate balance of women’s sex hormones and, as you can imagine, imbalances are pretty common and can happen for a variety of reasons. Some common issues are challenges in releasing FSH or LH (often related to stress), sluggish clearance of hormones toward the end of the cycle (often related to detoxification), inflammation (can be related to lifestyle, processed foods or blood sugar issues) and constipation (since the digestive tract helps clear used hormones).
WHAT CAN I DO?
The most important thing to know from the physiology outlined above is that a healthy balance of these hormones depends on healthy blood sugar control, support of detoxification and a happy digestive tract. Certain habits can help lay the foundation for a healthier balance of hormones and can be beneficial whether you are a woman still menstruating regularly, approaching menopause or postmenopausal. Here are 5 practical ways to set yourself up for success:
1. Manage your blood sugars
Balancing your intake of carbohydrates, fats and proteins (sometimes referred to as “tracking your macros,” or macronutrients) is paramount to keep blood sugars steady. Make sure to consume a healthy source of protein about the size of the palm of your hand at each meal. Think organic, pastured chicken; eggs from chickens raised on pasture; wild-caught fish; legumes/lentils; or even a high-quality protein powder (free of artificial colors and sweeteners) if you’re in a pinch. Include a source of healthy, unprocessed fat such as avocado, olive oil or raw nuts/seeds. Carbohydrates should ideally be based on your activity level (you likely need less if you’re not active), and ensure that carb intake is from whole-food sources such as fruit, starchy vegetables or unrefined grains like steel-cut oats or quinoa instead of cereal, breads and pasta. Avoiding added sugars, especially in unexpected places such as fruited yogurt and coffee creamers, is also key to keeping blood sugars in check.
Your body depends on adequate hydration to detoxify well. If you’re a coffee lover like me, be extra mindful to get enough filtered water daily. Most person feel best by aiming for half of their goal body weight (in pounds) in ounces of water daily. When well hydrated, urine is usually the color of lemonade. If yours is darker, drink up. One of my favorite tips is to use the same glass or stainless steel water bottle daily, determine how many fill-ups are needed to hit your water goal daily, and put that many rubber bands on the outside of it each morning. Each time you finish a fill-up, take a rubber band off to keep track.
3. Focus on fiber
For women, fiber intake should be a minimum of 25 grams per day (often more). Aim to get the majority of fiber from non-starchy vegetables, beans, and some berries, nuts and seeds. Fiber helps bulk up the stool and move things along in the GI tract, which is critical for detoxification of hormones. When working on increasing your fiber intake, take it slow. A rapid increase in fibrous foods can cause some digestive upset, bloating and gas. If you use protein shakes, adding some prebiotic fiber is one of my favorite hacks for boosting fiber intake (and helping with satiety).
4. Include cruciferous vegetables
Most cruciferous vegetables come from the Brassica family and include broccoli, cauliflower, cabbage and Brussels sprouts. These veggies contain a compound that gets converted to DIM (3,3’-diindolylmethane) after being chewed and mixed with the enzymes in the stomach. DIM is known for its ability to support healthier estrogen metabolism, which is an important implication in cancer risk, and it can also be found in supplement form.1
5. Get your hormones checked
If you’re a woman struggling with extreme cramping, significant mood swings, a tanked libido, irregular periods, hot flashes or night sweats, testing your hormone levels is a critical first step. Hormone balance is like a symphony (each one impacts the rest), and an objective view of the hormonal interplay can help you work better with your medical provider to game plan a personalized solution. Evaluating estradiol, estrone, testosterone and progesterone is a good first step, and pairing it with blood sugar markers (like Hemoglobin A1C) might give a fuller picture. Regular testing can help provide the insight you need to track changes and make pivots in real time. (Side note: If you are still menstruating and your periods are regular enough to predict, aim to test at the same time of your cycle each time. Most of my clients aim to test three-quarters of the way through their monthly cycle, i.e., day 21 if the full cycle is 28 days.)
WRAPPING IT UP
Regular testing, management of blood sugars, hydration, a higher-fiber diet and more cruciferous vegetables in your nutrition program may seem simple, but that does not always mean it’s easy. Some out-of-the-box thinking, coaching and support can go a long way in implementing these habits without feeling like you’re in a trap of daily steamed broccoli and tracking every bite you eat in perpetuity. Prioritizing these habits the right way can be sustainable and can taste nice.
One of my favorite ways to reset my own habits is with the Life Time D.TOX℠ program. It’s a higher-protein, fiber-rich approach that focuses on whole, unprocessed foods for a minimum of two weeks. When I find that my habits are slipping out of my “ideal” routine, the focus and commitment — as well as the simple and easy recipes — are the perfect way for me to reprioritize what I know I should already be doing.
If you’re struggling with a fat-loss plateau, are not feeling your best or have questions about your hormones, lab testing options, coaching or the Life Time D.TOX program, we’re here to help. Reach out to our team of registered dietitians any time at firstname.lastname@example.org. Thanks for reading!
In health, Samantha McKinney — Life Time Lab Testing Program Manager
This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.