February 16, 2008

Balance Your Hormones

Use natural therapies to reduce menstrual irregularities, and learn about the most common nutrient depletions associated with birth control pills

Q: What is estrogen dominance? I've heard that many women develop this as they approach menopause. Can natural therapies help bring hormones buck into balance?

-Julie T., Dearborn, Mich.

A: Estrogen dominance, which is quite common in perimenopause- the time leading up to menopause-can start as early as your late 30s and last for as long as 10 years. As we age, we ovulate (release eggs) less regularly. Progesterone is secreted from the ovaries only after ovulation, so women tend to have more steady estrogen production from the ovaries during perimenopausal years (versus progesterone). This creates an imbalance of hormones. Typical symptoms include heavier menstrual bleeding tender breasts premenstrually (or all the time), increased irritability (especially two to 14 days before menstruating), constipation, fatigue, and easy weight gain.

Younger woman tend to testosterone dominance. During a typical ovulation in a 30-year-old woman, the blood levels of estrogen and testosterone are about 300 units and 350 units respectively. At menstruation, the numbers change dramatically to 25 units of estrogen and 275 of testosterone.

Your question was about hormone balance, and due to space, I'm not able to address adrenal and thyroid hormones, which are significant players in hormonal balance. However, you can begin with some basics to help even out your hormones: 500 mg of magnesium at bedtime and 250 mg of B6 in the morning 10 days before your period. Also, decrease or eliminate excess salt (which can promote bloating) and red meat (due to the animal hormones). If you do eat red meat, make it organic and grass fed. If you have PMS, these strategies will help ease monthly symptoms.

If you are in perimenopause and want to bind excess estrogen, use 2 tablespoons of ground flaxseed daily, or at least during the first half of your cycle (from the first day of your period until ovulation). Also, black cohosh (providing 20 mg twice daily), red clover isoflavones (80 mg per day), or soy isoflavones (200 mg per day) can help quite a bit. Two cautions: Red clover can increase breast tenderness, and soy (including soy foods) may not be ideal if it upsets your digestion, or if you have low thyroid function.

If these suggestions are not sufficient, you can increase progesterone (to balance out the estrogen dominance) with the herb chaste tree berry (Vitex agnus-castus), but it's important to first consult a naturopathic physician for timing and dosing (visit naturopathic .org to find a naturopath in your area). Evening primrose oil, 1,500 mg daily, especially in the second half of your cycle, can also help promote progesterone production. For excess testosterone, 500 to 750 mg of saw palmetto daily (look for products with at least 85 percent fatty sterols) is very effective, because it promotes testosterone excretion. Saw palmetto is best known as a remedy for enlarged prostate, but works just as well for women in eliminating excess androgens, which is why it is also useful for those with polycystic ovary syndrome (PCOS).

Q: What are the most common nutrient deficiencies caused by taking birth control pills?

-Norah W., West Palm Beach, Fla.

A: Addressing nutrient deficiency caused by birth control pills is especially important if you have been taking the Pill for more than seven years-drug-induced nutrient deficiency worsens over time. Studies have consistently shown that B vitamins are the most commonly depleted nutrients with birth control use. The B vitamins are critical to nerve health, and women taking any form of birth control should simultaneously take a high-potency B-complex vitamin (with at least 50 mg of B6, 1,000 meg of B12, and 800 meg of folate). Folic acid, a B relative, is important for nerves and brain, and is also necessary for cell repair and development. Cells that turn over rapidly, such as those in the mouth and gut, quickly become ulcerated when folate stores plummet.

Another commonly depleted nutrient among women on birth control is magnesium; marginal deficiency is common in the general population already. Deficiency symptoms include muscle cramps, weakness, insomnia, kidney stones, bone loss, depression, nervousness, anxiety, and high blood pressure. Take 500 mg at bedtime in a liquid or powdered form for easy absorption. Zinc is another essential mineral depleted by oral contraceptives and is important for wound healing; supplement with 20 to 50 mg daily.

A great resource is Drug-Induced Nutrient Depletion Handbook by Ross Pelton, James B. LaValle, Ernest B. Hawkins, and Daniel Krinsky; consult this reference for any drug you take. I would also caution that most oral contraceptives deplete the amino acid tyrosine, which, among other functions, helps maintain healthy thyroid function and is important for making some neurotransmitters. Low tyrosine can also contribute to depression. This depletion is one of the reasons birth control is often associated with weight gain and moodiness. The highest food source of tyrosine is cottage cheese: 1 cup provides 1.5 g. Or you can take a supplement (1.5 g daily), particularly during the second half of your menstrual cycle.

If you are in a stable relationship, I recommend committing to fertility awareness-this is not the rhythm method. My favorite resource for learning fertility awareness is Taking Charge of Your Fertility by Toni Weschler.

Q: I am a woman in my 20s with asthma, which is particularly bad after I exercise. What do you suggest?

-Laura K., Denver, Colo.

A: Many doctors think of asthma as a bronchospasm phenomenon, and will therefore prescribe a variety of bronchodilators, some steroidal. Certainly, bronchospasm is a component of asthma-in your case, because the body has been warmed by exercise, the shock of colder air into the lungs is a factor. However, asthma is also a disease of inflammation around the tiny alveoli (the air sacs at the ends of the branches of the bronchi, which are where the oxygen is diffused into the blood). As such, natural anti-inflammatories are key to reducing symptoms of asthma; however, they will not provide immediate short-term relief. My favorite kitchenmedicine anti- inflammatory is turmeric. see if you can order a 1 pound bag from an organic supplier at your local health food store. Plan on ingesting at least 1/4 teaspoon of turmeric daily (in your morning smoothie, or stirred into water and chugged down, or simply sprinkled liberally on your food). Also, cook with lots of this bioflavonoid- rich spice When I make a soup or pot of stew for my family, I put a large quantity ( 1/4 cup) of the mild-flavored spice into a 4-quart pot. If you are lucky enough to get fresh turmeric roots at a local market (they look like tiny ginger plants) then you will be able to enjoy an even more vital product. Peel off the outer skin and chop finely. Beware: Turmeric is a potent pigment, and stains plastic cutting boards and cloth. Other deeply pigmented foods also contain natural anti-inflammatories, such as anthocyanadins (in berries) and epicatechins (in green tea). Eat foods with natural anti- inflammatories regularly.

Whenever possible, breathe in through your nose. Your nose hairs are designed to filter and warm the air before it hits your lungs. It seems paradoxical, but when you feel asthmatic, try breathing less and more shallowly. Your natural instinct will be to take in big gasps of air, but this is counterproductive. I would also suggest learning the Buteyko breathing method. It is somewhat similar to breathing into a paper bag when you feel an asthma attack coming on. When you increase the amount of carbon dioxide in the air flow mix (as happens when breathing into the paper bag), this signals your brain to cause oxygen to be more aggressively taken into the blood. Look around your area for a Buteyko practitioner, or buy some CDs with instructive exercises. Visit buteyko.com.

By Emily Kane, ND, LAc

Emily Kane, NO, LAc, (aka Dr. Em) received her naturopathic training at Bastyr University in Seattle. She is the author of Managing Menopause Naturally and Ask Doctor Em. She lives in Juneau, Alaska, with her husband and daughter, and enjoys helping patients achieve optimal wellness. Visit dremilykane.com.