PCOS Symptoms

What Are PCOS Symptoms And What You Can Do About It!

How To Know Your PCOS Symptoms Before you get into this article, if at anytime you want to speak to one of our Naturopathic Doctors about PCOS, we have a free consultation call available. Click here to book one. Have you ever felt like something with your hormones and menstrual cycles are “off” and may be wondering what could be going on? Could you have symptoms of PCOS? Or, maybe you’ve been newly diagnosed with PCOS and are wondering, now what? Either way this blog post is for you, as we discuss the most common hormonal disorder in women of reproductive age- PCOS, also known as Polycystic Ovary Syndrome. PCOS is a complex hormonal and metabolic disorder. Despite its name, it goes far beyond having polycystic ovaries; in fact, it is possible to have PCOS without having ovarian cysts (more to come on that later).

Did You Know Approximately 10% Of All Women Have PCOS. Some Will Never Know They Have It!

First and foremost, you are not to blame for your PCOS. The exact cause of PCOS has yet to be determined; however, we do know that many factors are believed to play a role. These range from genetics, androgens, AMH, insulin resistance and environmental endocrine disruptors. Although we have made profound progress with beginning to understand this illness, there is a lot we do not know, but we do know the symptoms of PCOS and what to look for so we can begin to help.

Top 10 Signs and Symptoms of PCOS

Moderate to Severe Acne, commonly along the jawline: Both insulin resistance and androgens can be to blame for acne in women with PCOS. Both insulin and IGF-1 can increase the production of androgens, and also decrease sex hormone binding globulin (SHBG), which further increases serum testosterone. In addition to increasing androgens, insulin resistance can trigger unregulated growth and keratinization of the skin cells which is a factor in acne. Androgens can cause excess sebum production, resulting in clogged pores and bacterial overgrowth.  Another red flag that may indicate PCOS is in patients whose acne did not fully respond to Accutane. Hair growth on the Chin, Upper Lip, Stomach, or Chest: Higher levels of androgens can cause excess hair growth in areas of the bodies where hair is typically not seen in women. These hairs can be coarse and dark, and is one of the keynote signs of hirsutism in women who have PCOS. Irregular periods: One of the major signs of PCOS is that your periods can be irregular including being far apart, or skipping periods altogether. Difficulty in Conceiving: Individuals with PCOS may have difficulty conceiving for a variety of reasons. As mentioned above, cycles can be either irregular or absent which also means that a woman may not be ovulating regularly. Identifying the fertile window can be difficult, and ovulation tests typically used (LH strips) are not reliable for those with PCOS since LH tends to be elevated throughout the cycle, resulting in false positives. In addition, less ovulatory cycles can equate to less fertile windows throughout the year. Furthermore, egg quality can become impaired due to the hormonal and inflammatory changes seen within the ovaries. It’s important to note that PCOS does not mean you can’t get pregnant; however, it can mean that more targeted treatment options may need to be explored to optimize conception and pregnancy outcomes. Hair Loss: Higher levels of androgens can also be the culprit of hair loss seen in those with PCOS. Testosterone gets converted into another androgen called DHT within the scalp. DHT does not play nice with hair follicles, causing damage and shrinkage which ultimately results in the hair to enter the telogen phase where they then fall out. Hair loss in PCOS is typically seen around the frontal area behind the hairline, but can also appear as overall thinning. Pigmentation in the folds of your skin: This is known as acanthosis nigricans, and results in the skin being very dark in colour, and velvety in texture. If present, it is commonly seen in the crease behind the neck, under the arms, or in the creases of the thighs. This occurs as a result of insulin resistance, and can typically be improved or reversed when insulin sensitivity is improved. Skin Tags: Small, flesh coloured tag-like growths that appear on the skin, and are related to insulin resistance. Ovarian Cysts: The cysts seen in PCOS are not typical ovarian cysts. They are actually partially developed follicles that have grown, but have stalled during the process of preparing for ovulation. This will be seen on ultrasound as what’s referenced as the “string of pearl” appearance. It is important to note that having polycystic ovaries is not a required factor in diagnosing PCOS. Weight Gain, or difficulty losing weight:  For some women with PCOS, they may tend to gain weight very easily, or may have difficulty losing weight. This can be related to both insulin and leptin resistance. Insulin resistance causes our bodies to store fat more easily since glucose cannot enter the cells as readily, it is also associated with gaining weight around the midline and abdominal area. Leptin resistance has also been discovered as a factor in PCOS, and can make our brain think we are in starvation mode, which ultimately messes with our hunger and fullness signals. Depression and Anxiety: Women with PCOS have higher rates of both depression and anxiety. These changes in mood can be related to a variety of factors including inflammation, hormonal imbalances, and the stress associated with dealing with the symptoms of PCOS. It is important to screen for mental health disorders in patients with PCOS and offer additional support where needed.

How To Assess If You Have PCOS

Typically the diagnostic criteria for PCOS is having 2 out of the 3 present:
  • A pelvic ultrasound indicating the presence of cysts, or multiple immature follicles
  • History of oligo (irregular) or anovulation
  • Hyperandrogenism assessed via physical exams and/or lab work
Additionally, your Toronto Naturopathic Doctor may consider all or some of the following lab work in order to develop an individual and comprehensive treatment plan for you:
  • Hormones
    • Day 3 FSH- stimulates follicles to grow in the ovaries
    • Day 3 LH – triggers ovulation and can often be 2-3x higher than FSH in individuals with PCOS (LH:FSH ratio).
    • Day 3 Estradiol – to ensure you can build a uterine lining, also plays a role in ovulation
    • Testosterone – an androgen that is often elevated in patients with PCOS
    • DHEA-S – an androgen secreted by the adrenal glands that can also be elevated in patients with PCOS. Of note, this androgen is often elevated in those with “lean” PCOS
    • Progesterone- 5-7 days after suspected ovulation to confirm of ovulation did occur
  • Metabolic
    • Fasting Insulin + Fasting glucose to measure insulin resistance
    • HbA1C to rule out diabetes
    • Lipid Panel – to monitor cardiovascular risk associated with PCOS
  • Inflammatory
    • Hs-CRP – often elevated in PCOS due to chronic low grade inflammation
    • ESR – a measure of general inflammation
    • Vitamin D- typically low for individual with PCOS. Vitamin D is very important for proper immune functioning, reducing inflammation, hormone regulation, and overall health
  • Ruling out other conditions
    • Thyroid panel – women with PCOS have higher rates of Hashimoto’s thyroiditis, thyroid dysfunction can also contribute to weight gain and hair loss
    • 17’OH – to rule out a condition called NCCAH that signs and symptoms can mimic PCOS
    • Prolactin – elevated levels can also cause irregular cycles
    • AM cortisol – to rule out Cushing’s disease, but can also be a factor in PCOS

How Naturopathic Medicine Can Help Your PCOS Symptoms

Nutrition The overall goal with targeting nutrition in those with PCOS is to regulate blood sugar, improve insulin resistance, and reduce inflammation. There have been many studies looking at the impact of diet on outcomes for those with PCOS and some of the most important strategies are around reducing glycemic load, managing caloric intake, improving food quality, and increasing healthy fats. Nutrition is something that is individual to each person, and recommendations are made so that they are realistic and sustainable for the person to optimize success. Overly restrictive diets (for example very low carb, diary free, gluten free) do not result in better outcomes, and can further exacerbate stress and declining mental health in those with PCOS. Exercise Overall the goal with exercise is to promote movement, ideally a minimum of 120 minutes a week. Different types of exercise have been studied with PCOS including resistance training, HIIT training, yoga, and aerobic exercise. Ultimately, the most important factor is choosing a form of exercise that you enjoy doing, that you can commit to doing on a regular basis and that will help you reach your movement targets. Your Naturopathic Doctor can dive into this further with you and help make specific recommendations that meet your health goals. Targeted Supplementation There are some key supplements that have been studied to improve health outcomes and symptoms in those with PCOS. Some of these include:
  • Myo-Inositol: Can help to improve insulin receptor activity, and improve insulin resistance. It has also been found to improve ovulation, and decrease excess androgens.
  • NAC: Can help to improve insulin resistance, lower testosterone levels, regulate ovulation and menstruation, and improve fertility.
  • Berberine: An herb that can improve insulin sensitivity, increase rates of ovulation, decrease androgens and also decrease unhealthy cholesterol.
  • Vitamin D: A deficiency is common amongst those with PCOS and can lead to more intense PCOS symptoms. Optimizing Vitamin D levels can help to improve insulin resistance, ovulation, menstrual irregularities, infertility and reduce androgens.
  • Zinc: A mineral that can have a positive effect on PCOS symptoms like acne, hair growth, and hair loss.
This is not an exhaustive list by any means. Our Toronto Naturopathic Doctors at Higher Health have extensive experience in treating and helping individuals manage their PCOS, and will target supplementation on an individual basis. Think you could be suffering from PCOS, or have been recently diagnosed? Reach out to one of our Toronto Naturopathic Doctors and book a free consultation today! References: https://www.pennmedicine.org/updates/blogs/fertility-blog/2020/march/five-myths-about-pcos https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos https://www.jogc.com/article/S1701-2163(16)32915-2/pdf https://cwhn.ca/en/node/44804 https://pubmed.ncbi.nlm.nih.gov/31749393/ https://pubmed.ncbi.nlm.nih.gov/18097891/ https://pubmed.ncbi.nlm.nih.gov/33260918/
Leaky gut picture

What Is Leaky Gut And How You Can Help Fix It!

Before you get into this article, if at anytime you want to speak to one of our Toronto Naturopathic Doctors about Leaky Gut, we have a free consultation call available. Click here to book one.

If you’re reading this article, odds are you’ve been experiencing some digestive issues and may be wondering if it’s due to leaky gut syndrome. Well, you’ve come to the right place!

First, let’s start off with a quick recap about the function of how your gut lining works. Our intestines, referred to as our gut, contain specialized cells called enterocytes that line the gut wall.

The small intestine lining is a single celled mucosal layer, responsible for the absorption of water, glucose, peptides, amino acids, lipids, vitamins, and more! This lining is covered with enzymes that promote digestion, and covered in mucus that helps food and waste products make its way through the intestines.

In a healthy state, your gut is extremely selective for what it is permitted to pass through and get absorbed into the bloodstream and into systemic circulation.

These gatekeepers called “tight junctions” keep the cells just that, very “tight” together. Think of them as the bodyguards of your gut, only allowing entry to those that are on the guest list.

 

What Is Leaky Gut?

Leaky gut, also known as intestinal permeability refers to when the gaps (tight junctions) between neighboring cells in the gut lining are disturbed. Bigger openings allow the passage of foreign substances that normally would not be allowed to pass through, this is known as the gut becoming “leaky”.

This can allow bigger molecules of undigested food, toxins, and pathogens to make their way into the bloodstream and into the body. Your body recognizes that these molecules should not be there, and this triggers an immune response and subsequent inflammation, which is linked to many inflammatory and auto-immune diseases.

 

What Causes Leaky Gut?

The causes of leaky gut can vary, and are often due to a variety of factors. This could include small intestinal bacterial overgrowth (SIBO), bacterial dysbiosis, food allergies or intolerances, NSAID use, stress, high intake of sugar, alcohol, or highly processed foods, or low stomach acid.

It’s important to note that leaky gut is a syndrome, and often there are a variety of contributing factors. A leaky gut has also been found to be associated and play a role in many different diseases.

 

What are some of the symptoms of Leaky Gut?

  • Bloating
  • Gas
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Nutrient deficiencies
  • Food sensitivities
  • Fatigue
  • Joint/ structural pain
  • Immune issues/ dysfunction

It’s worth highlighting that you can have a leaky gut, even if no gastrointestinal symptoms are present; an individualized assessment by your Toronto Naturopathic Doctor is critical.

What are some of the diseases associated with Leaky Gut?

  • Cardiovascular diseases and conditions
  • Central nervous system conditions: migraines, chronic fatigue syndrome, fibromyalgia, fatigue, anxiety, depression, mood disorders
  • Digestive conditions and diseases : irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), celiac disease, food sensitivities
  • Immune system conditions: autoimmune disorders, recurrent or chronic infections
  • Skin conditions: eczema, psoriasis, severe acne, hives
  • Musculoskeletal system: rheumatoid arthritis, joint pain, muscle pain
  • Respiratory system: allergies, asthma, chronic congestion, COPD
  • Endocrine diseases: PCOS, type 2 diabetes

How can Toronto Naturopathic Medicine help?

It’s important to discuss diagnostic options to determine whether a leaky gut could be an underlying factor for your symptoms. Your Naturopathic Doctor can discuss what may be the best option for you to test and assess this.

In terms of gut health, Toronto Naturopathic Doctors will often talks about the 4 R’s.

Let me introduce them to you: remove, replace, repair, reinoculate!  This targets the identification and removal of provocative agents that may be worsening the intestinal permeability, helps to get to root cause of its development, and also supports the healing and regeneration of the intestinal wall!

Remove:

  • Eliminate potential toxic and offending foods from your diet. For example, gluten and dairy, and alcohol can damage the tight junctions in the gut.
  • Avoid additives often found in pre-packaged food that can damage the gut lining (i.e. emulsifiers and stabilizers like carrageenan, polysorbate 80, and carboxymethylcellulose).
  • Avoid processed and inflammatory foods such as deep fried foods and foods high in refined oils (canola, vegetable, sunflower oils), and foods high in trans fat. When possible, stick to real, whole foods.
  • Identify factors contributing to stress, and discuss possible treatment strategies to manage stressors.
  • IgG Food sensitivity testing may be relevant to identify any triggering foods unique to you, and to remove while allowing the gut to heal.

Replace:

  • Replace gut irritating foods with foods that promote the health of your gut; bone broth is great here!
  • High, easy to digest fibre rich foods that promote a healthy bacteria balance, and help to promote regularity of bowel movements (important in eliminating toxins).
  • Replace processed, high-sugar, inflammatory foods with things such as fruits, vegetables, fish, and avocado/olive oil that are anti-inflammatory in nature. These foods can also help to decrease pathogenic bacteria and promote the proliferation of beneficial bacteria.

Repair:

  • Supplementation: L-glutamine and zinc can help to repair the intestinal lining. Anti-inflammatories like curcumin, Boswellia and omega-3s can help reduce inflammation.
  • Botanicals: Herbs like slippery elm, licorice, and marshmallow root can help protect the lining of the digestive tract.
  • Continue to avoid triggering foods.

Reinoculate:

  1. Supplementation with probiotics specific to you and your gut health goals to ensure a well-balanced microbiome
  2. Continue eating a fibre-rich diet, which act as prebiotics (food for the healthy bacteria to proliferate)
  3. Consider adding in fermented foods that are rich in probiotics (like kimchi, kefir, sauerkraut, miso, tempeh)

As every individual is unique, your treatment plan will also be unique to you; there is no one size fits all approach. Your Toronto Naturopath will work with you to help determine whether leaky gut may be a contributing factor to your symptoms, and tailor a treatment plan accordingly to help you feel your best self!

If you have more questions about leaky guy, digestive health, or your health in general, please book a free consultation with one of our Naturopathic Doctors today.

References:

https://www.hindawi.com/journals/mi/2015/628157/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637104/

https://www.health.harvard.edu/blog/putting-a-stop-to-leaky-gut-2018111815289 

https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451

estrogen

Estrogen Hormone. What You Need To Know.

Before you get into this article, if at anytime you want to speak to one of our Toronto Naturopathic Doctors about Hormones, we have a free consultation call available. Click here to book one.

The Estrogen hormone gets a really bad wrap, but is that rightfully so? We always hear the term estrogen dominance, but what does that really mean? Can estrogen be good for us too? Let’s explore some of these questions together with a Toronto Naturopathic Doctor.

What is Estrogen?

Estrogen is a female sex hormone made primarily in the ovaries of cycling women. Estrogen hormone can also be made through a process called aromatization from testosterone. The latter process increases as women go through menopause, and is also the process for which men produce estrogen.  The main star of show is called Estradiol (E2), and is considered the most potent form of estrogen. Estradiol is made primarily in the ovaries, but is also produced by adipose tissue, liver, and adrenal glands. Estrone, also known as E1, is also made in the ovaries and to a lesser extent adipose tissue. Estrone is less potent than Estradiol, but becomes the predominant form of estrogen a women’s body makes after menopause. A third type of estrogen exists as well, Estriol (E3) and is the main estrogen during pregnancy.

The Benefits of Estrogen

One of the most widely known functions of the estrogen hormone is its role in regulating the menstrual cycle, pregnancy, and for setting off puberty in young females. It also very well known for the array of symptoms women experience as they begin to experience both perimenopause and menopause as estrogen levels begin to fall (is it hot in here, or is it just my menopause?). Although sometimes demonized, estrogen has a wide array of benefits and is required (in appropriate amounts) for optimal functioning.

Brain Health: Estrogen hormones helps to maintain body temperature, aids in cognitive health and prevents memory loss, and helps to regulate parts of the brain responsible for sexual and reproductive development.

Cardiovascular Health: Estrogen helps to regulate the liver’s production of cholesterol, and plays a role in decreasing plaque build-up within the artery walls.

Bone Health: Estrogen plays a role in both the growth and maturation of bone. In adults, it is involved  in the regulation of bone turnover as it promotes the activity of osteoblasts, cells which produce bone.

Reproductive Health: The Estrogen hormone has many benefits and roles within reproductive health. It stimulates the maturation of the uterus, and aids in preparing the uterus to nourish and support a growing fetus. It stimulates the maturation of the vagina, and maintains a thick vaginal wall and lubrication. In addition, it also stimulates the maturation of the ovaries, and the onset of a woman’s menstrual cycle. Furthermore, estrogen also stimulates the development of the breast tissue at puberty, and prepares the breast glands for future milk production.

Symptoms of Low Estrogen:

A low estrogen hormone predominantly occurs as women transition through perimenopause and menopause. Other causes of low estrogen may be due to premature ovarian failure, surgical removal of the ovaries, excessive exercise, eating disorders and other hormonal issues. In women of child bearing years, or those wishing to conceive low estrogen can be a serious cause for concern and must be investigated thoroughly by your Naturopathic Doctor.

Symptoms may include:

  • Menstrual periods that become less frequent, or stop altogether
  • Hot Flashes
  • Night sweats
  • Difficulty sleeping
  • Dryness or thinning of the vagina
  • Lowered libido
  • Mood swings
  • Breast tenderness
  • Brain Fog and impaired brain functioning (notably memory)
  • Fatigue
  • Decreased bone mineral density and increased risk of fractures
  • Abnormal lipid profiles

Symptoms of High Estrogen:

The term estrogen dominance speaks to higher levels of estrogen, relative to progesterone. A hyper-estrogenic state occurs when levels of estrogen are high, regardless of progesterone levels. This could be because your body is producing too much estrogen, you are not detoxifying and eliminating it properly, or a combination of both. High estrogen levels may also occur during perimenopause, in which estrogen can spike up to three time higher than what it was in your younger self, sometimes referred to the ovaries’ “last hoorah”.  It should be noted that these estrogen spikes during perimenopause can be intertwined with symptoms of low estrogen which can feel like hormonal chaos to women (think a combination of heavy periods, breast pain, irritable mood, and night sweats).

Symptoms may include:

  • Heavy menstrual bleeding
  • Irregular menstrual cycles
  • Worsening PMS symptoms (breast tenderness, headaches, mood changes, acne-flare ups)
  • Increased vaginal discharge
  • Weight gain, especially around the hips, thighs and mid-section
  • Bloating
  • Insomnia
  • Depression/ Anxiety
  • Fatigue
  • Lowered libido

How to assess Estrogen Levels:

If you’re experiencing any of the symptoms for either low or high estrogen hormones, it is critical that you investigate further. Prolonged elevation, or depression of hormones can lead to various health conditions, some potentially being life threatening. Your Toronto Naturopathic Doctor can investigate the cause of your estrogen imbalance, and determine a proper course of action and next steps. These are some of the tests they may discuss with you. They also may look at a more complete picture of your hormones, as often times hormonal imbalances influence each other.

Blood Test: Estrogen levels can be assessed through serum with a blood test; this is the most validated test for diagnosing disease and conditions.

DUTCH Test:

The DUTCH test stands for the Dried Urine Test for Comprehensive Hormones. It measures several different hormones, their metabolites, and certain neurotransmitters. Specifically for estrogen, it looks at the different estrogens and how your body is metabolizing it. Our livers are our master detoxification system, and during phase one detoxification estrone (E1) and estradiol (E2) are converted into three different metabolites; 2-OH-E1, 4-OH-E1 and 16-OH-E1. The second phase of detoxification prepares these metabolites to be secreted out of the body and involves methylation. Basically, this phase 2 is responsible for neutralizing the phase 1 metabolites, and preparing for elimination.

If an individual’s phase 2 methylation detoxification is not functioning optimally, this can increase the amount of circulating estrogen metabolites, instead of being able to properly excrete them. This can become an issue because the estrogen metabolites can exhibit estrogen like effects causing estrogen dominant symptoms, increasing cell proliferation, and may increase the risk of certain cancers. It should be noted that the 4-OH-E1 metabolite is considered the safer, and more desired metabolite in this pathway, and that increased volumes of the other metabolites may indicate that your estrogen detoxification pathways require support. Your Naturopathic Doctor is trained to be able to look and interpret the results of your DUTCH Test to determine if your liver, and detoxication pathways require support to optimize both estrogen levels, and its detoxification.

How Naturopathic Medicine can help:

A Toronto Naturopath can help support you in many ways when its come to estrogen. You will want to look at Xenoestrogens: Xenoestrogens are exogenous molecules that imitate the actions of estrogen in the body. They can either be “natural” or “synthetic”. Natural xenoestrogens include phytoestrogens (soy, flax seed) and synthetic xenoestrogens include environmental toxins and synthetic hormones (oral contraceptives etc.). It is important to note that xenoestrogen is an umbrella term, and that there is a difference between natural and synthetic xenoestrogens.

Synthetic xenoestrogens include things like BPA found in plastics and on receipts, phthalates commonly found in personal care products and cosmetics, and dioxin and DDT found in pesticides and herbicides. Synthetic xenoestrogens have the ability to strongly bind to estrogen receptors and can negatively alter its activity.

Natural xenoestrogens, also known as phytoestrogens, are things like flax-seed and soy that can weakly bind to estrogen receptors to help modulate and balance estrogen levels without overstimulating the production of estrogen.

Your Toronto Naturopath will want you to look at how you can reduce and when possible eliminate these from your life.

The EWG has an interesting article speaking about the Dirty Dozen Hormone Disruptors in further detail, and identifying ways to reduce our exposure to synthetic xenoestrogens and endocrine disruptors. Your Naturopathic Doctor will also assess the impact synthetic xenoestrogens may be having, and discuss strategies to reduce or minimize your exposure.

Liver and Detoxification support: As was discussed, the liver is the primary organ responsible for the detoxification of estrogen. Working alongside the liver, our digestion system is responsible for the excretion of estrogen. Both systems need be functioning optimally in order to help estrogen levels balance. Your Naturopathic Doctor will ask you specific questions to determine whether any support is needed for both your liver and gut. In addition, the results of your DUTCH test may provide objective evidence to help support these pathways.

Replenishing micronutrients: Our minerals are like spark plugs that kick off essential reactions in the body to get things going. The cells in our body require minerals to make energy and hormones. In order to assess hormonal health, your Naturopathic Doctor will first look at your mineral status and assess for any micronutrient deficiencies. This is the foundation before tackling your hormones.

Bio-identical hormone therapy: Bioidentical hormones have a molecular structure that  are identical to that of our human hormones, but are made from plant based extracts. Bio-identical hormone therapy may be a helpful adjunct to your treatment plan to help support your hormonal health and changes, and alleviate perimenopause and menopausal symptoms.

Supplementation: Certain botanicals have been research and studied to help support the levels of estrogen and certain hormones in the body. Herbal discussions may include Tribulus, Black Cohosh, and Rhodiola for examples. At Higher Health, we take an individualistic approach to your health care and will develop a supplementation protocol that is unique for your needs. No two individuals or their hormone support will be the same. When you want to talk more about health with a Toronto Naturopath, you can book a free intro call by clicking here.

 

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104637/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050441/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226184/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763482/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726893/

https://dutchtest.com/video/estrogen-tutorial/

https://www.ewg.org/consumer-guides/dirty-dozen-endocrine-disruptors

Symptoms of Perimenopause

Natural Help For Symptoms of Perimenopause

Natural Help For Symptoms of Perimenopause

Before you get into this article, if at anytime you want to speak to one of our Naturopathic Doctors about Hormones and Perimenopause, we have a free consultation call available. Click here to book one.

You started noticing changes to your menstrual cycle, you’re experiencing sleep disturbances and hot flashes, and your mood is all over the place; you’re thinking, could this be perimenopause?

What is Perimenopause?

Perimenopause is defined as the transitional period from your reproductive years (pre-menopause) to menopause as progesterone and estrogen levels begin to fall. Women typically start to notice some of these changes beginning in their 40’s and up to their 50’s, some women even starting as early as in their late 30’s. The duration of perimenopause can vary, but the average length is normally around four years. In early perimenopause estrogen is typically higher, and progesterone begins to lower due to less consistent ovulatory cycles.

In later perimenopause, hormone levels start to resemble closer to what we see in menopause, as ovulation and menstrual cycles becomes even less frequent,  with both estrogen and progesterone levels decreasing. Menopause is defined as 12 consecutive months without menstrual bleeding, in the absence of any surgery or medical condition that may have caused your body to artificially stop bleeding.

Clinically, we often see that some women are caught by surprise when they start experiencing these symptoms, and may assume that they are too young to start experiencing these hormonal changes. This may result in a delay seeking care to help support and manage the symptoms they are experiencing, and a reduction in quality of life. Perimenopause is a natural part of aging, and it doesn’t have to get in the way of living life to your fullest; a Naturopathic Doctor can help address your concerns and support your body through these changes by supporting the whole person.

What are some of the signs and symptoms of perimenopause?

Perimenopause can be highly symptomatic for about 20% of women but almost all women will experience some symptoms to a certain magnitude. One of the most common complaints we hear in office is that women state they just don’t feel like themselves anymore, and often do not realize that the symptoms they start describing are due to the hormonal changes occurring in their body.

 

Signs and symptoms of perimenopause may include:

  • Changes to the menstrual cycle including periods that may be heavier, more erratic, cramping, and bleeding
  • Mood swings including anxiety, depression and irritability
  • Loss of libido and sexual desire
  • Vaginal dryness
  • Hot flashes and night sweats
  • Insomnia and difficulty sleeping
  • Headaches and/or migraines
  • Dry and thinning hair
  • Weight gain, especially around the abdomen in spite of proper diet and exercise
  • Breast pain and tenderness

 

What tests are available for perimenopause?

Blood tests: If you’ve noticed your menstrual cycle has started to become irregular, day-3 FSH, LH and estradiol may provide important data on menopausal status. In addition, AMH may be useful to help determine ovarian reserve.  A thyroid panel may be ordered to rule out any thyroid problems that can mimic perimenopausal symptoms. Furthermore, a fasting panel for lipids, insulin and HbA1c may be ordered to assess risk factors for cardiovascular disease and metabolic disease that may be increased for women through this transition and at menopause.

Saliva testing:  We may use salivary testing to help assess cortisol rhythm. Cortisol is a hormone produced by the adrenal glands in periods of stress. What some people don’t realize; however, is that the adrenal glands also produce estrogen and progesterone, with this role becoming more significant as the ovaries slow down production of these hormones. This important role of the adrenal glands helps to promote a smoother transition through perimenopause and to menopause. If the adrenals become overworked or tired due to prolonged stress, this can affect their ability to provide support through this transitional period.

Testing is not always necessary, your Naturopathic Doctor will take an individualized approach to help determine whether any of the above tests will be helpful for you based on your signs and symptoms.

How can Naturopathic Medicine help?

Toronto Naturopathic medicine focuses on a whole body approach when assessing natural help for symptoms of perimenopause and menopausal symptoms. This includes physical, emotional, mental, and spiritual health to assess the totality of symptoms.  Many women are seeking alternatives to standard hormone replacement therapy, SSRI’s, or other conventional treatments to support this period of hormonal changes. There are several safe and effective therapies Naturopathic Doctors can use to support individuals in this phase of life, that will help achieve optimal health and improve quality of life to make the transition as smooth as possible.

Natural Help For Symptoms of Perimenopause may include:

Diet:

Eating a diet focused on whole foods can help promote balanced blood sugar and hormones during this transition. Focusing on high quality proteins, healthy fats including olive oil, avocado oil, nuts and seeds, as well as a variety of fruits and vegetables can help provide your body with the nutrients it needs during this phase of life.

Stress Management:

We have all stress in our lives from many aspects of our lives; however, when we are continually exposed to this stress it may start to have impacts on our physical, mental and emotional health. Learning ways to help manage this stress can have profound effects on our mind and body. This may include targeted supplementation, mindfulness based strategies, and self-care practises to help our bodies manage this chronic stress.

Examples can include taking an Epsom salt bath, meditating for 10 minutes a day, or even taking some time to do some deep breathing exercises.  Your Naturopathic Doctor will discuss how stress may be playing a role in your symptoms, and appropriate strategies to help balance and manage it.

Acupuncture:

More clinical trials have been conducted that have shown acupuncture can be effective in reducing some of the signs and symptoms (notable hot flashes), as well as quality of life in women with perimenopausal and menopausal symptoms.

Botanicals:

Many botanicals have been shown to help support women suffering from hormonal symptoms. Talk to your Naturopathic Doctor to discuss if any of these may be helpful for your individual symptoms.

Vitex: A hormone balancing herb that can help improve irritability, sadness, breast tenderness, mood and sleep during perimenopause and menopause.

Rhodiola: A wonderful female adaptogen that can supports fatigue, focus and symptoms of burnout; perfect for women that may be experiencing difficulty managing stress levels or adrenal fatigue along with perimenopausal symptoms.

Ashwagandha: A calming herb that can help to relax the nervous system, and improve stress and cortisol levels. In addition, it has also been shown to improve sexual function and memory in perimenopausal women.

Black-cohosh:  A herb with estrogenic effects,  may help to reduce both the frequency and intensity of hot flashes, and thus sleep disturbances.

Bio-identical Hormone Therapy:  Bioidentical hormones have a molecular structure that  are identical to that of our human hormones, but are made from plant based extracts. Bio-identical hormone therapy may be a helpful adjunct to your treatment plan to help support your hormonal health and changes, and alleviate perimenopause and menopausal symptoms.

The Take Home Message

If you are experiencing any of the above symptoms, please reach out to any of our qualified Toronto Naturopathic Doctors to support your health during this time and enjoy a smoother transition; you do not need to suffer during perimenopause. It’s important to work with a qualified health care practitioner that has experience in hormonal health, and with these modalities to ensure a safe and effective treatment plan is developed just for you.

There are many natural options for help with symptoms of perimenopause that your Toronto Naturopathic Doctor can implement swiftly to help manage your perimenopausal symptoms and improve your quality of life!

References:

https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal

https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause

https://www.healthline.com/health/menopause/difference-perimenopause

https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause

https://pubmed.ncbi.nlm.nih.gov/26653408/

https://pubmed.ncbi.nlm.nih.gov/25621768/

14 Symptoms of Hormonal Imbalance in Women

Before you get into this article, if at anytime you want to speak to one of our Toronto Naturopathic Doctors about Hormones, we have a free consultation call available. Click here to book one.

Hormones play a critical role in physical and mental health. Biological changes can alter the amounts of hormones within the body, leading to symptoms of hormonal imbalance in women, which can have a significant impact on wellbeing and quality of life. No two women are alike, so signs of hormonal imbalance can vary significantly from one individual to another. What’s more, as you age, you may notice that you experience more or different symptoms than you did in your younger years.

Symptoms of Hormonal Imbalance in Women

Hormonal imbalances may occur cyclically, but the imbalances may also become more persistent. Natural biological changes can lead to hormonal imbalances, but high stress levels can also contribute to or exacerbate them. Here are 14 symptoms that indicate you may have a hormonal imbalance.

1. Irregular Periods

For most women, their menstruation cycle is between 21 and 35 days, and the flow can last anywhere from two to seven days. If you experience some variation in duration or time between periods, that isn’t unusual. However, if you’ve always been regular but your cycle or flow alters significantly, it’s one of the common symptoms of hormonal imbalance in women.

2. Sleep Problems and Fatigue

Approximately 47% of women have difficulty getting a full night’s sleep, and the percentage of postmenopausal women who experience regular insomnia is between 61% and 83%. Low levels of progesterone can lead to sleep issues. Fluctuations in melatonin and cortisol can also be a factor. When you don’t get enough sleep or sleep quality is poor, you may experience a persistent sense of general fatigue throughout the day.

3. Mood Swings

If you find that your mood changes course abruptly, and sometimes for no apparent reason, it could be because you have a hormone imbalance. Many women feel more agitated or cry easily before the start of their periods. During perimenopause, these mood swings can happen more frequently. Sometimes, mood swings become more chronic, which can significantly impact physical and mental health.

4. Brain Fog

Do you have difficulty concentrating or struggle with memory recall? These are symptoms of hormonal imbalance in women. Low estrogen, specifically, may be to blame. Women with a hormonal imbalance frequently experience what many refer to as brain fog. If you have it, you understand why it is an apt description, though you won’t find it on a list of medical terms.

5. Gastrointestinal Issues

Your digestive health is key to overall health, and gut function is linked to your hormones. A hormone imbalance can lead to constipation, bloating, cramps, diarrhea and nausea due to imbalances in estrogen and progesterone levels in the gastrointestinal tract.

6. Weight Gain

One of the sneaky symptoms of hormonal imbalance in women is weight gain. You may find that before your period, you feel ravenous and want to eat everything in sight, particularly if it is fatty, salty or sweet. A healthy diet, personalized for your body’s dietary needs, can help you to combat this symptom.

7. Headaches

People get headaches for numerous reasons, including stress and tension. However, declining estrogen can also cause headaches. Some women experience this symptom before the onset of their period every month, but consistently low estrogen levels can result in more frequent headaches.

8. Hot Flashes

One of the more disturbing symptoms of hormonal imbalance in women is hot flashes. You may have witnessed someone having one, but you won’t be prepared for the sudden and intense heat that arises in the upper body and face until you experience your first one. This intense heat can be accompanied by dizziness, nausea, headache, weakness and rapid heart rate. It may last only a few seconds, but it can go on for up to an hour.

9. Night Sweats

The hot flash’s sibling is night sweats. Both are caused by depleted estrogen, resulting in a miscommunication with the hypothalamus, which regulates body temperature. When a severe hot flash occurs at night, you wake up drenched in sweat, though the room temperature is perfectly normal. Some women experience both hot flashes and night sweats, while others experience only one or the other.

10. Vaginal Dryness

Vaginal dryness is one of the symptoms of hormonal imbalance in women. It is common in those who are in perimenopause and postmenopausal women. Falling estrogen levels result in dry and thinning vaginal walls, which can make intercourse painful.

11. Low Sex Drive

In addition to painful intercourse, declining testosterone levels may be to blame when women experience a low sex drive. Though you may think of testosterone as a male sex hormone, women have it as well. Low levels of progesterone and estrogen may also contribute to a low sex drive.

12. Breast Changes

Have you noticed that your breasts have changed? Perhaps they’ve become denser and lumpier. If so, you may actually have high estrogen levels. If your breasts have altered in the other direction, losing density, then your estrogen levels may be falling. Increased estrogen and progesterone can also cause your breasts to feel tender and sore.

13. Acne

Many women discover the fallacy behind the belief that acne is just for teenagers. In fact, it’s one of the common symptoms of hormonal imbalance in women that shows up again as women’s hormones start to fluctuate during perimenopause. Chronic acne is a sign that your androgen levels may be too high. Androgen is another hormone that is considered a male sex hormone, but women have it, too, and sometimes the body produces too much of it.

14. Hair Loss

Falling progesterone and estrogen levels lead to slower hair growth rates. However, sometimes women actually experience hair loss. If it seems like your hair has gotten thinner, it may be one of the symptoms of hormonal imbalance in women that you can blame on too much androgen. This hormone causes the hair follicles to shrink, resulting in thinning hair.

Find Support for Symptoms of Hormonal Imbalance in Women

If you are experiencing symptoms of hormonal imbalance in women, the professionals at Higher Health are here to help. We offer support throughout your journey to improved health, from hormone testing to a personalized treatment plan. To get started, book your Free consultation call today.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760052

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800285

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843314

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488