MOST women will know that hormones can affect how they feel, but hormone problems go way deeper than just mood swings or period pain. Plus, they are definitely not something women simply have to put up with.
Women's health expert Dr Aviva Romm says 80 per cent of women have hormone problems at some point - struggling enough to seek medical help, take medication, or possibly even have surgery.
"Hormone problems are so common, we've just come to assume they're par for the course of being women," says Romm, author of new book Hormone Intelligence.
She says there's a "hormone epidemic" - with women's hormones causing problems because they're out of balance. Many common symptoms women experience, she explains - from migraines to hair thinning, weight gain to brain fog - are related to hormone imbalances.
"It doesn't have to be this way," says Romm. "Taking a holistic approach that includes a hormone-healthy diet, supporting our microbiome health, and getting enough sleep and self-repair time can allow us to go from feeling like our hormones are whipping us around to feeling comfortable and confident in our bodies, while bringing our hormones in alignment with our innate hormonal blueprint."
Here are six common hormonal health problems women can experience, plus some lifestyle advice from Romm to help rebalance...
1. MENSTRUAL CYCLE PROBLEMS
If you go less than 26 days or more than 34 days between periods, if your period lasts more than seven days or less than three, or if you have excessively heavy or extremely light periods, Romm says you technically could have an irregular cycle.
If the changes can't be explained by other factors, or continue for more than three consecutive months, she suggests they need investigating.
Plus, she points out, if women have had an irregular cycle for a long time, "there's a good chance you have an underlying hormone imbalance, or it's quite possible that you have polycystic ovary syndrome (PCOS) or endometriosis."
2. PREMENSTRUAL SYNDROME (PMS)
Romm says more than 150 physical, behavioural, emotional and cognitive symptoms have been attributed to PMS, including mood swings, anxiety, depression, change in appetite, sleeping too much or too little, and bloating.
Yet the exact physiological causes are still unknown, although it's thought to be linked to hormone imbalance.
"What we do know," she says, "is that many factors have been shown to increase a woman's risk of having PMS, and nutritional, lifestyle and other approaches have been proven to reduce or stop it."
3. MENSTRUAL MIGRAINES
Although up to 70 per cent of women who have migraines experience the menstrual type as well, Romm explains that some only have the menstrual type, caused by dramatic drops in oestrogen when levels have been high after ovulation, and before a period.
"Compared with non-menstrual migraines, the menstrual type tends to be more severe, lasts longer, and is less responsive to usual acute medication therapies," she says.
4. POLYCYSTIC OVARY SYNDROME (PCOS)
It's thought PCOS may affect around 10 per cent of women of childbearing age, although up to half may be undiagnosed, says Romm.
It occurs when insulin triggers the ovaries, while inhibiting the production of a protein which carries hormones including testosterone and oestrogen through the bloodstream. This leads to an increase of testosterone in the circulation, causing symptoms including weight gain, irregular periods, fertility problems, acne, hair loss, and hair growth in unwanted places.
Women with PCOS are also at higher risk of developing conditions like diabetes, cholesterol abnormalities and heart disease. "It's a big deal not to be glossed over or treated simply with a pharmaceutical," stresses Romm.
5. ENDOMETRIOSIS
In endometriosis, tissue that normally lines the inside of the uterus - the endometrium - grows on the outside, often on the ovaries, bowel or pelvis lining.
This can start in the teenage years, and is triggered by the menstrual cycle, says Romm. Wherever the endometrial tissue is growing, it thickens, breaks down and sheds, just like the uterus lining does during a period.
But because it's not growing in the right place, blood gets trapped, leading to the formation of scar tissue and adhesions, which can cause severe and chronic pain, as well as fertility problems.
Romm says endometriosis isn't just a hormone problem - the inflammation it causes affects immune function too, and women living with it may be at risk of other problems, including eczema, allergies and autoimmune conditions.
"Doctors are missing the diagnosis so often, and in many women for so many years, when catching it early can help prevent and reverse damage," she says.
6. UTERINE FIBROIDS
Fibroids are non-cancerous growths of muscle tissue in or outside the uterus, which can sometimes become as large as a grapefruit. They're not always problematic, but Romm says a third of women have symptoms from fibroids, which may include abnormal bleeding, pelvic pain, and increased need to urinate.
She points out that fibroids are the most common cause of hysterectomies after cancer. "They're another vital sign that something is up with your hormonal ecosystem, usually imbalances in blood sugar/insulin and elevated oestrogen."
Hormone Intelligence: The Complete Guide To Calming Hormone Chaos And Restoring Your Body's Natural Blueprint For Well-Being by Aviva Romm is published by HarperOne, £20.
THREE WAYS TO HELP BALANCE YOUR HORMONES
IF you are concerned about any of the conditions outlined above, or any other hormonal issues, consult your doctor for advice. Treating hormone-related health issues isn't always one-size-fits all, however here are three things Dr Romm says can be useful.
Try the Hormone Intelligence Diet
"What you eat - or don't - has a profound effect on your hormonal health," explains Romm, who says women can help balance their hormones by eating one serving of protein (poultry, low-mercury fish, eggs, legumes), a healthy fat (like avocado/olive oil/ghee) and two servings of vegetables at every meal.
She also recommends six to eight servings of vegetables a day, and up to two servings of fruit, one to two servings of slow carbs like grains, plus some nuts and seeds - and make sure you're eating a wide variety of different coloured foods.
Reset your body clock
Romm says irregular and lost sleep, plus sleeping in unnatural light, sound or temperature, leads to desynchronisation of the internal clock which keeps our hormones ticking.
"Your female hormonal physiology is deeply entrained to your circadian timing system," says Romm, explaining that loss of circadian rhythm affects ovarian hormone production.
To reset, aim for seven to nine hours of good quality sleep each night, going to bed and getting up at roughly the same time, staying off electronic devices first thing in the morning and before bed, getting as much daylight as possible, eating healthily and at consistent times, and listening to your body clock, so when you feel you have less energy, rest or at least slow down if you can.
Take steps to manage stress
Signs that stress is affecting your hormones include sleep problems and fatigue, brain fog, extra weight around your middle, and back, neck, shoulder and/or jaw pain.
"Even relatively short stretches of stress can impact your sex hormones and cycles," says Romm.
"The latest research on stress shows powerful links to irregular periods, menstrual pain, PMS, endometriosis, fertility challenges, PCOS and more. We have to take a radical, proactive stand in favour of our health by getting out of a chronic stress mindset and into one that intentionally invites inner calm and a slower, more rhythmic, natural pace of life," she adds.
How? Romm's suggestions include assessing your priorities, and "paying attention to your inner landscape" by asking yourself how you feel, then trying to relax through mindfulness, having a bath, yoga, dancing, or anything else that calms you down.
"If you want to bring hormone health back into your life, reducing stress has got to be a commitment," she says.
