5 Common Symptoms That May Indicate A Hormonal Imbalance
By: Dr. Rachel Heussner
The menstrual cycle is so much more than a period, it gives us insight into a person’s overall health. It is becoming more and more understood why menstrual irregularities occur and how to address them. Because we can get so much information from the details of a person’s menstrual cycle, it is now becoming thought of as a vital sign, alongside blood pressure, heart rate, etc. Some of the most commonly seen menstrual symptoms are, yes, common, but not always normal. It is important to understand that a person does not have to live with certain symptoms and these symptoms may actually indicate certain hormonal imbalances that we can address through naturopathic medicine.
Our hormones naturally fluctuate throughout the month, and this causes an expected change in mood and energy levels. Although this shift is normal, an imbalance in hormones can lead to mood changes that affect our quality of life. Most of us feel a drop in energy around that time of the month, and would prefer to spend the evening curled on the couch. However, there are some signs that we can look for suggesting an imbalance in our hormones.
There are two main presentations for mood swings with premenstrual disorder (PMS) that can be supported through lifestyle changes, nutrition, supplements, herbs and other naturopathic treatments. The first presentation is PMS-A, with symptoms including anxiety, insomnia, irritability, mood swings and clumsiness. The other is PMS-D, with symptoms including depression, anger, poor concentration, feelings easily hurt, violent feelings and low self worth. The cause of these symptoms is unique to the individual based on factors such as lifestyle, environment and genetics. Some common causes are progesterone deficiency, excess estrogen, serotonin imbalance, imbalanced detoxification, high levels of inflammatory cytokines and vitamin or mineral deficiencies.
The cause of symptoms are going to be individual to the person, which also means the treatment will be unique to the person as well. Some of our favorite treatments to help address mood changes are herbs such as Vitex, supplementing with magnesium, eliminating simple carbohydrates and increasing fiber in the diet.
Breast tenderness during the menstrual cycle is commonly a result of high levels of unopposed estrogen. This means that there is an imbalance between estrogen and progesterone. High levels of estrogen combined with increased levels of inflammation in the body leads to tender and fibrocystic breasts. As a side note, it is important to be aware of these changes and if you notice any lumps in your breast that raise concern, please schedule an appointment with your doctor to have them properly assessed. It is important to address these imbalances because high levels of unopposed estrogen contributes to some forms of breast cancer. An ounce of prevention is worth a pound of cure!
Lowering inflammation in the body and helping to support proper estrogen detoxification are the two main goals for treatment with breast tenderness. Evaluation of hormone levels through lab work is a helpful tool when addressing hormone imbalances as well.
Helpful treatments for breast tenderness include herbs such as vitex, evening primrose oil, avoiding caffeine and increasing daily fiber intake. Vitex is a commonly used herb that helps to support the optimal balance in female hormones through reduction of prolactin, leading to an increase in progesterone and a decrease in estrogen. Evening primrose acts as an anti-inflammatory, helping to lower inflammation in the body and reduce breast tenderness. Increasing dietary fiber will be important for any symptoms stemming from an imbalance of hormones. The body needs fiber for proper detoxification, and this includes detoxification of our hormones. Without an appropriate amount of fiber, the body cannot eliminate these hormone metabolites or other forms of toxins in the body.
You may have heavy uterine bleeding if you are bleeding more than 7 days, need to change a tampon or pad after less than 2 hours, or if you are passing clots that are the size of a quarter or larger. Heavy menstrual bleeding is called menorrhagia and may result in anemia from losing too much blood.
It is important to see a medical professional for a proper evaluation if you are experiencing heavy or abnormal uterine bleeding. Menorrhagia may be due to underlying endometriosis, fibroids, ovarian cysts, bleeding disorders, or cancers. Proper blood tests and imaging may be done to determine if there is something more serious going on.
Once more serious conditions are ruled out, we need to find the root cause. Often, the culprit for heavy menstrual bleeding is unopposed estrogen. Estrogen normally stimulates the tissue lining the uterus to thicken before it is shed during menses. If there is too much estrogen or more inflammatory levels of estrogen, the tissue is overstimulated to thicken. This results in heavy bleeding during menses and you may pass larger clots than normal to release more of that thickened tissue.
As with other symptoms caused by excess estrogen, supporting estrogen detoxification and lowering inflammation are the best ways to address heavy periods caused by hormonal imbalances. Additionally, it is pertinent to remember each individual may have different reasons for why they have excess estrogen and inflammation. Usually there are underlying factors such as an inflammatory diet, stress, high alcohol or caffeine intake, thyroid conditions, or other hormonal imbalances. So in addition to detoxifying the excess estrogen and balancing other hormones, other diet and lifestyle changes will need to be made to prevent estrogen from creeping back up. You can’t fix it completely if the true cause is not being addressed.
Menstrual cramping, also known as dysmenorrhea, is due to the uterine contractions that occur in order to shed the lining of the uterus during menstruation. Prostaglandins are chemical substances that float around in the blood and are involved in pain and inflammation pathways. Prostaglandins trigger the muscle contractions of the uterus, so the higher the amount of prostaglandins, the more intense uterine contractions. In dysmenorrhea, prostaglandins are being overproduced in the body due to inflammation in the diet, stress, alcohol, or other inflammation causing factors. Additionally, it is commonly seen that estrogen is too high in relation to progesterone. Progesterone itself is anti-inflammatory so when progesterone is too low, inflammation levels can be higher and cause more menstrual cramping. Lastly, certain metabolites formed when estrogen is broken down may be more inflammatory and lead to higher amounts of prostaglandins circulating in the blood.
Anti-inflammatory diets, proper nutrition, stress management, and low alcohol intake throughout the entire month are some of the best ways to reduce cramping around the time of menses. Anti-inflammatory supplements like turmeric or fish oil may be beneficial to help lower high levels of inflammation. Topical castor oil is wonderful for lowering inflammation when placed over the lower abdomen. Gentle movements like yoga, warm packs, and antispasmodic herbs can help reduce the intensity of uterine contractions. The best way to improve dysmenorrhea is to prevent cramping by focusing on your health all month long, rather than just around the time of menstruation.
There are several reasons why you may notice spotting in the middle of your cycle. As with all of these symptoms, it is important to get properly assessed if you are experiencing abnormal bleeding patterns to rule out infection, pregnancy, or more serious conditions. Spotting can commonly be seen when starting a new birth control. However, if it persists, you should make an appointment with your doctor.
More commonly, insufficient progesterone levels around ovulation (mid-cycle) while estrogen levels are dropping can cause mid-cycle spotting. It may be that progesterone is too low or that estrogen is too high in comparison to the ratio of estrogen and progesterone. Treatment may include detoxifying excess estrogens, or boosting progesterone with herbs like Vitex. Seed cycling is another wonderful way to boost healthy levels of estrogen in the first half of the cycle and progesterone in the second half of the cycle.
Many of these symptoms are common, but there are solutions to help you optimize your menstrual health. We encourage our patients to track their cycle, as well as their symptoms to raise awareness around how you can treat these imbalances. If you are experiencing any of the above symptoms, we would love to support you and help you get your hormones back into balance!
Disclaimer: This is intended for educational purposes only and is not considered medical advice. Please see your healthcare provider before starting any new treatment including but not limited to supplements and herbs.
About: Dr. Rachel Heussner is a licensed Naturopathic Doctor. She completed her medical training at Bastyr University in San Diego, California. She holds a bachelor's degree in biology and chemistry from the University of North Carolina at Chapel Hill. Dr. Rachel is certified in advanced IV therapy, Cranial Sacral Therapy, and PRP (platelet-rich plasma) microneedling and injections. Her areas of focus include hormonal imbalances, women’s health, metabolic conditions, mental health, stress management, and gastrointestinal health.