Women’s Health & Hormonal Balance

Standard medical treatment is to attempt to control it with surgery to remove lesions and scar tissue; this may need to be done annually and hysterectomy is sometimes recommended. Doctors will attempt to alter hormone balance by prescribing hormone replacement therapies or hormonal intrauterine devices.

Heavy menstruation can have a variety of causes or contributing factors but a common underlying issue is an imbalance between oestrogen and progesterone. During the monthly cycle oestrogen stimulates the growth of the endometrial lining while progesterone “stabilises” the lining, therefore a relative excess of oestrogen or relative lack of progesterone can result in the lining coming away in a less than coordinated fashion. The result is heavy menses, often associated with clots and pain. In younger women this can be a true excess of oestrogen – either via excess production of or failure to metabolise/clear estrogens efficiently through the liver. In older women it is more likely a relative lack of progesterone as ovulation becomes less “robust” and more irregular and the ovaries subsequently produce less progesterone. It can also be due to a failure to clear estrogens well as peri-menopausal women often show signs of fatty liver. 

In younger women the periods tend to come more closely together (e.g. short cycles) less than 28 days but fairly regularly. In older women with more erratic ovulation the cycle length can be quite variable with the tendency towards “flooding” periods. Additional “oestrogen dominant” conditions such as endometriosis, adenomyosis and fibroids may further complicate things. 

Standard medical treatment is similar to those mentioned above for endometriosis, younger women will be offered the oral contraceptive pill or a hormonal intrauterine device and older woman may be offered a hysterectomy. The natural medicine approach is also similar, using herbal medicine to improve oestrogen metabolism through the liver and balance ovarian production of oestrogen and progesterone. 

Fibroids are solid non-cancerous tumours of the uterus that may cause very heavy menstrual bleeding often leading to anaemia and can sometimes affect fertility. It is estimated up to 40% of women develop fibroids by the age of 40 and they are the primary reason for hysterectomy. Oestrogen encourages the growth of fibroids, the underlying mechanisms are similar to those that cause endometriosis as discussed above with poor oestrogen clearance through the liver and inadequate progesterone production being contributing factors. Medical treatment of fibroids may include pharmaceutical drugs called GnRH agonists which suppress oestrogen and progesterone production and can suppress symptoms as well as shrink fibroids. However, they are not without possible side effects including hot flashes, headaches, vaginal dryness, reversible bone loss, depression and decreased libido. If symptoms are not well controlled or the pharmaceutical agents are not well tolerated, removal uterus is the most common surgical approach. Natural medicine can be used to balance the hormones and limit the excessive bleeding and specific herbs can help to shrink the size of the fibroids. For many women these treatment protocols along with dietary and lifestyle changes can significantly improve symptoms and provide a viable alternative to hysterectomy.

There are several types of PCOS, the most common type appearing in 70% of cases is caused by Insulin Resistance. High insulin levels in the blood will affectthe balance of hormones by increasing pulsatile GnRH (Gonadotrophin Releasing Hormone) which will then increase pulsatile Luteinizing Hormone which will lead on to an increase in androgen hormone production at the ovaries and lower aromatase activity. Aromatase is the enzyme that converts testosterone to oestrogen. The net effect will be more circulating androgen hormones and less oestrogen and this will give the classic signs of long cycles, commonly 6 to 12 weeks.

This is diagnosed through a blood test for fasting insulin or a glucose challenge test with insulin, elevated triglycerides and ALT and an increased waist circumference.

Treatment rests on a diet to lower blood sugar and increase insulin sensitivity. Herbs like Paeonia and Liquorice will increase aromatase activity. Magnesium, Chromium and Cinnamon can improve insulin sensitivity.

Oral contraceptive induced PCOS is fairly common as hormonal birth control can suppress ovarian function. This will be diagnosed if periods do not resume after 9 months of stopping the contraceptive pill. Oral contraceptive use can worsen a pre-existing insulin resistant PCOS.Time and Paeonia and Liquorice can help.

Adrenal PCOS accounts for 10% of cases and is not driven by insulin resistance or impaired ovulation. The adrenal androgen DHEAS will be elevated whereas ovarian androgens testosterone and androstenedione will be normal. Usually driven by the stress response and may be caused by increased stress at puberty. Herbs to support adrenal function and reduce the stress response like Rhodiola, Withania and Liquorice will help and nutrients including Zinc, Magnesium and B vitamins.

It’s important to realize that menopause is not a disease condition that requires treatment, as many would have you believe.

Menopause is a natural event – a period of years in a normal woman's life in which gradual hormonal changes bring about a shift away from the physical powers of childbearing, in favour of a more mature condition of mental development and wisdom.If you in are in the peri-menopausal years or in menopause suffering from flushing, sweating, sleeplessness, anxiety and a foggy brain or any combination of these symptoms and are looking for a natural solution help is at hand. Rather than taking synthetic hormone replacement or anti-depressants for these symptoms there are number of natural remedies that can help. For some women it is a simple matter of oestrogenic herbal medicines that provide enough phytoestrogens and or stimulate enough estrogen production to subdue the symptoms of oestrogen reduced oestrogen production. These include well-known herbs such as Red Clover and less well known herbs such as Shatavari.

Medicinal herbs can be specifically selected and combined to suit the individual woman’s symptoms. It is also very important to support the adrenal glands during these years. The adrenal glands make our energy and stress coping hormones and in peri-menopause and menopause these glands will play a major role in production of oestrogen and progesterone. If women approach menopause with reduced adrenal function often caused by many years of unresolved stress the adrenal glands will not respond well to the extra burden and tip over into adrenal exhaustion. This condition is noted by lethargy, fatigue, anxiety, depression and sleep disturbances – these are common findings in and around menopause. Supporting the adrenals is easy with herbal medicines called adaptogens. These include more well- known herbs such as the ginsengs and less well- known herbs such as Withania and Rhodiola. Adrenal recovery takes up to three months with these medicines and can be safely prescribed long term. The nervous system may also need support during this time from Magnolia, St John’s Wort and Lavender to help with sleep, stress and anxiety; Zizyphus is a very good herb for night sweats. If memory is affected herbs or thinking is “foggy” traditional Indian herbs such as Ginkgo and Bacopa can help. Read more