Clinically challenging, often complex, and frequently frustrating for women and their Practitioners, female hormonal imbalances are a familiar presence within the natural medicine clinic. Given the high prevalence of hormonal conditions,4 and coupled with perceptions of lack of understanding within the medical model, women are increasingly turning to natural medicine for solutions.
There’s More to Hormones Than the Hormones
Clinical management of female hormonal conditions traditionally includes manipulation of sex hormones, often based on serum or salivary hormone levels – however recent thinking expands this view. The field of intracrinology explains that considerable variability exists between hormone levels within serum and saliva, compared to those within the tissues (where hormone synthesis may also occur); shedding light on the limitations of targeting reproductive hormones based solely on test results.5 Further, serum hormone concentrations in women with endometriosis,6 fibroids,7 premenstrual syndrome (PMS)8 and menopause9 rarely differ from healthy controls, suggesting that hormone levels are just one piece of the hormonal puzzle.
An integrative approach includes also addressing the wide variety of mediators contributing to hormonal imbalance. These include hypothalamic-pituitary-adrenal (HPA) axis dysfunction due to chronic stress, inflammation (including mast cell activation), functioning of endocrine glands (e.g. thyroid, pancreas), the microbiome, excess fat mass, endocrine disrupting chemicals, and diet and lifestyle factors. With such an approach, greater clinical outcomes may be achieved. As a Practitioner, you are like the conductor of a grand symphony orchestra, gently influencing these factors to create hormonal harmony in your female patients.
An Alter Ego Named PMS
Hormonal imbalance can be relentless, with many women experiencing hormonal symptoms throughout their lifecycle. An alarming 50-80% of women experience PMS10 influenced by alterations in progesterone – likely due to levels being too low11 or declining suddenly (rather than steadily).12 While the pathophysiology of PMS remains unclear, symptoms are correlated with increased inflammation and oxidative stress, HPA axis alterations, epigenetics, and the environment; in addition to cyclic variations in steroid hormones and neurotransmitters.13 Instrumental in the management of PMS, Vitex agnus-castus (vitex) binds to dopamine-2 receptors (as well as opioid and oestrogen receptors), inhibiting prolactin production and supporting healthy progesterone function to improve mood and other PMS symptoms.14 With the addition of Withania somnifera (withania) to alleviate stress and anxiety,15 and zinc and vitamin E reducing oxidative stress,16 Vitex, Ginger and Withania to Increase Progesterone provides an integrative approach in the management of PMS.
Proliferation Pandemic – Endometriosis and Fibroids
Affecting many; 1 in 10 women have endometriosis,17 ,18 and 50% of females develop fibroids by the age of 50.19 Endometriosis is a chronic inflammatory disease characterised by the presence of endometrial-like tissue outside the uterus, which proliferates and becomes encapsulated by immune defence mechanisms to form inflammatory cysts and lesions, resulting in abdominal pain, scar tissue and adhesions.20 With both conditions driven by oestradiol (E2) excess,21 this fuels proliferation of fibroids in the myometrium.22 Soy isoflavones competitively antagonise receptors and block the binding of E2, thus reducing proliferation and inflammation.23 BCM-95™ Turmeric also reduces inflammation and aids induction of cellular glutathione levels, helping to detoxify quinones and oestrogens,24 while rosemary stimulates 2-hydroxylation of oestrogens, diverting oestrogen away from the (more proliferative) 4- and 16-hydroxylation pathways.25 Soy, Methylating Nutrients & BCM-95™ Turmeric to Clear Oestrogen modulates oestrogen metabolism and addresses some drivers of these troubling conditions.
Inflammation is a Common Theme in PCOS
From foetal development in utero to puberty, middle-age and beyond menopause – for some women, there may be no escaping from PCOS throughout life.26 Interestingly, research is now indicating that inflammation rather than hyperinsulinaemia, is the primary driver of this condition: low grade, chronic inflammation is thought to promote the hyperandrogenism and ovarian dysfunction which occurs in PCOS.27 Paeonia lactiflora (peony) and Glycyrhhiza glabra (liquorice) inhibit the production of testosterone synthesising enzymes within the ovary, and increase aromatase, helping to convert testosterone to oestrogen.28 Through these mechanisms, symptoms of PCOS may be alleviated, including hirsuitism, acne and infertility. In conjunction with anti-inflammatory agents, Inositol, Peony & Liquorice to Clear Testosterone can assist by reducing androgen levels and improving metabolic health.
Managing the Menopausal Transition
As a woman journeys towards mid-life, hot flushes are an often inescapable reminder of declining oestrogen levels.29 In menopause, there is a narrowing of the thermoneutral zone; even slight elevations in temperature can trigger the flushing response, as the hypothalamus perceives the body as being too hot. While low oestrogen is partially responsible, this response is also attributed to increased sympathetic nervous system activity in the hypothalamus.30 The traditional Chinese medicine combination, Rehmannia Six may be viewed as Oestrogen Lifting Herbs, enhancing the expression of aromatase in the nervous system and increasing oestrogen receptors, resulting in greater tissue synthesis and activity of oestrogen within the hypothalamus.31 This is combined with Ziziphus jujuba var. spinosa (zizyphus) to harmonise the hormonal orchestra and alleviate hot flushes, anxiety, insomnia and night sweats.
Magnificent Magnesium for all Women
Research shows that magnesium either alone, or in combination with vitamin B6 and/or calcium,32 aids in alleviating symptoms of mood, premenstrual migraine and dysmenorrhoea.33 Moreover, magnesium plays a critical role in oestrogen metabolism, as it is required for glucuronidation,34 and decreases the activity of β-glucuronidase35 and aromatase.36 With deficiency a significant driver of chronic low-grade inflammation that underpins so many conditions,37 Magnesium and Broccoli for Women’s Health is fundamental for all women to support female health.
Be the Conductor of the Hormonal Orchestra
Female hormonal conditions are orchestrated by multiple mediators in concert with subtle alterations in sex hormones. A comprehensive approach to treatment involves herbal and nutritional interventions that promote hormonal modulation, in addition to addressing the various drivers behind symptoms. Support your patients on their healing journey towards hormonal harmony.
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Image coutesy of Leio Mclaren
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