Demystifying Hormone Imbalance

Let's decode the mystery of the menstrual cycle hormones.

“Hormone imbalance” is a very commonly used term, but what does this really mean? It seems like every day I hear another person went to their doctor and was told their hormones are out of balance, and they’ll need to use the contraceptive pill to regulate them. Not only do contraceptives shut down the hormones of the menstrual cycle, this dynamic does nothing to actually teach people about their menstrual cycle hormones, how they work, or why they are important.

If you want to learn more about the process of ovulation, please visit this blog - or listen to this podcast. Both of these aim to teach you what a healthy hormonal pattern resulting in ovulation looks like, and why its important to your overall health to ovulate regularly as a person who menstruates.

This blog will specifically discuss some of the major players in “hormone imbalance” - how they function and interact - and what you can do about balancing them so that the body is in a state of homeostasis.

1.  Understand first that fluctuations are normal

The first thing to understand about the menstrual cycle hormones is that they fluctuate. This is important to how the body produces the hormones it needs in the proper amounts. The brain makes all the decisions in this complex feedback loop system we call the hypothalamic-pituitary axis. The brain is able to send messages to the reproductive system instructing the organs what to do, and when. If we can understand that hormones change throughout the cycle, we can stop thinking there is a certain ‘level’ to be reached in the first place. Just like there is no pH of the vagina (it fluctuates under the control of the endocrine system too), there is no static hormone level that indicates balance, only an interaction between hormones that brings balance.

Which brings me to my next point

2. The hormones of the menstrual cycle interact - most importantly on an inverse relationship

A healthy menstrual cycle doesn’t maintain the same levels, it maintains the same pattern. This is why fertility awareness charting is an invaluable tool for understanding your hormones. You are able to observe your unique pattern (or lack thereof) each cycle that you decide to chart. There are many feedback loops in the cycle, but the two main hormones involved are estrogen and progesterone. Both of these are good for your health beyond the ability to become pregnant, and it’s important that they interact with each other properly to produce a healthy hormonal pattern throughout each cycle. 

Estrogen should come first, as it’s main role is during the follicular phase. It tells the uterine lining to thicken, the cervix to produce fertile quality cervical fluid, and instructs the ovary to mature the follicles that are in the running to become the next egg. Once the egg leaves the ovary, the follicle turns into a temporary endocrine organ called the corpus luteum. The corpus luteum produces progesterone. So we can see in a graph that estrogen rises on an arc first, and after estrogen peaks and begins to fall, the egg is released, and soon after the corpus luteum creates progesterone for the rest of the cycle. You need both of them to be working together in this inverse pattern throughout the cycle.

 In FAM, we measure estrogen through cervical fluid, and we measure progesterone through basal body temperature. 

• Estrogen becomes dominant when ovulation is impaired because progesterone isn’t there to balance it out

• Liver disease or gut dysbiosis can negatively affect your ability to excrete estrogen properly

• Histamine excess or impaired histamine excretion may result in a cycle of estrogen excess

• Low progesterone is the result of anovulation, or less commonly issues with ovarian follicle quality

• Progesterone is needed for several body functions, and long term low progesterone has serious consequences to bone, cardiovascular, and brain health

• You need progesterone to balance estrogen

• Hyperandrogenism is the result of either the ovary, or the adrenal glands making too many androgens

• Insulin resistance is the main factor in why the ovary is instructed to make excess testosterone

• Too much testosterone impairs the ability to ovulate

• Therefore, its common to have hyperandrogegism AND unopposed estrogen at the same time as low progesterone

• Certain kinds of contraceptives have high androgen indexes, and almost all of them impede ovulation

Thanks for reading! I hope this has been able to help explain the complex relationship between estrogen, progesterone, and androgens!

Questions? Drop them in the comments below!