Mood swings, anxiety, irregular or unusual periods, tiredness, increased appetite and cravings, weight gain, bloating, breast changes, sleep problems, pelvic and abdominal or joint pains, sexual dysfunction, libido loss, vaginal dryness, pounding heart, headaches, temperature dysregulation, blood pressure problems, behavioural changes, acne and that recalcitrant hair growing out of your chin resisting all attempts at annihilation…
These are common symptoms that might indicate there is a disturbance, change or imbalance to the careful equilibrium of normal bodily functions that is expertly and largely silently coordinated like a symphony orchestra by our complex and wondrous endocrine system.
Our hormones control our sleep, hunger, satiety, metabolic rate, growth, development, stress response and reproduction, in a state of homeostasis.
The “mother gland” the pituitary in the base of our brain is the nerve-centre of many of these functions, controlling the production and distribution of several hormones that then trigger specific hormones to be produced by distant endocrine organs in the body such as the thyroid gland, ovaries, and adrenals that act at widespread receptor sites throughout the body to allow all our cells to function well.
It is literally amazing. Well, I am amazed anyway. There are over 50 hormones in the body each with a unique but complex role. Often, they coordinate and interact in perfect synchrony to allow miraculous things like pregnancy to happen.
However, like any elaborate equilibrium, balance can be fragile. Small changes anywhere in the system can trigger a plethora of problems. One of the most common examples being changes to our menstrual cycles.
During periods of biological stress our ancient primitive hormonal reflexes inhibit ovulation to prevent a pregnancy occurring at a time that might not be optimal for survival such as in times of famine or war.
The same reflex kicks in when our stress hormones are triggered for other reasons such as over exercising, under-nourishing our bodies, or perpetually stressed emotionally. Treating the root cause and soothing the stress response can stabilise and regulate things again.
Often an inconvenient necessity, our periods and menstrual health provide us with a window into our general hormonal health and wellbeing. If cycle length changes and become irregular (oligomenorrhoea), periods stop (amenorrhoea), bleeds get heavier and more prolonged (menorrhagia) or more painful (dysmenorrhoea) this may be a sign from your body that something is amiss.
Even with regular cycles many of us will experience profound physical, behavioural, and emotional symptoms (such as those mentioned earlier) on a regular basis in the premenstrual phase of our cycles. Pre-menstrual tension syndrome (PMS) and more severe Premenstrual Dysphoric Disorder (PMDD) are thought to manifest when our brains are more sensitive to the hormonal changes seen in the luteal phase i.e. oestrogen is low, and progesterone is higher.
This same pattern of imbalance can be seen in the post-natal period, particularly when breast feeding and in perimenopause and menopause.
If you need relief of symptoms, whatever they may be, one of the most empowering things to do is to track them. Do they have a pattern? Do they relate to your menstrual cycle? Are they persistent or completely random? I like the Clue app and Flo Tracker app for this, but a traditional diary or note in your phone can be just as helpful.
Secondly, look at any modifiable lifestyle changes that are achievable to move back towards that state of equilibrium. Exercising regularly, but perhaps in sync with your cycle (see “Wild AI” app or www.periodoftheperiod.com for evidence based research on this) helps balance metabolic, growth, stress and sleep hormones.
Nourishing the body with unprocessed, whole foods including plenty of plants for fibre, vitamins, minerals and pre-biotics to keep the gut functioning evenly as well as limiting caffeine, alcohol, sugar and salt (within reason, it's all about balance after all) can help to get blood sugar and stress hormone levels on an even keel which in turn supports our reproductive hormone balance.
Thirdly, approach how you manage stress proactively and try not to wait for a crisis to start implementing mindful moments, relaxation and emotionally nourishing “self-care”. Prioritise sleep (if you can).
Finally, consider whether you may need to explore your symptoms with a healthcare professional.
For generations, we have been encouraged to accept and put up with pain or other symptoms that we intuitively know are telling us something. This narrative must change and if there is single important take-home message from this blog it is this: you know your body better than anyone; if you listen to her she will tell you what she needs. Be that some restful nurturing movement to calm a heightened stress hormone response or medical intervention for menstrual pain please trust your instincts and seek an assessment with a health care professional before symptoms are intolerable.
About the author
Dr Fionnuala Barton is a GP, Women's Health Doctor and registered member of the British Menopause Society. She is passionate about optimising physical and emotional wellness for women at all stages of life and has particular interest in early recognition and management of perimenopausal and menopausal symptoms, POI, PMS and PMDD. She draws on a wealth of clinical and personal experience to provide an empathetic, holistic, personalised and proactive, evidence-based hormone therapy approach. Private 1:1 appointments can be booked directly at www.themenopausemedic.com or complete a contact form for group or corporate services.