The conversation around hormones and health has been historically elusive; however, there is no denying the impact hormones have on our lives. Our very own Jennie Welner, FNP-BC, ABAAHP, FAARM, is a Family Nurse Practitioner at Essential Health’s flagship location in Cary, NC and an expert in hormone balancing. She lends her expertise in the below article to help educate and advocate for optimal hormone health through both lifestyle changes and expertly guided medical interventions.
Hormones play many important roles in our health, from regulating appetite to mediating cellular changes. The body has hormone receptor sites on cells nearly everywhere from the brain to the gut, heart, skin, bones, and more. Contrast to popular belief, hormones are not just estrogen, progesterone, and testosterone – there are also thyroid hormones, insulin, cortisol and other important signaling molecules that support the systems of the body in unique and complementary ways. This is why healthy hormone balancing is considered a “whole-body approach.”
How do hormones become imbalanced?
Hormones can typically become imbalanced due to several factors. One somewhat obvious “cause” of hormone imbalance is the natural aging process. In men, testosterone levels start to decline as early as in the 30’s, while women’s hormone production starts to decline in the mid-30’s. Generally, as hormone levels decline with age, risk for disease goes up. Medications, such as antidepressants, synthetic hormones like birth control, statins, and some blood pressure medications like diuretics can lead to hormonal imbalances over time. Chronic stress slows down the production of hormones as the body competes to make more of the stress response hormone, cortisol. Lifestyle factors like diet, exercise, poor sleep, smoking, alcohol intake, and environmental factors such as the use of plastics, toxins in cosmetics, and pesticides on foods can also disrupt hormone production and lead to downstream imbalances.
What are common symptoms of hormone imbalance?
On a day-to-day basis, common symptoms of a hormonal imbalance are heavy or irregular periods in women, difficulty falling asleep, or staying asleep, brain fog/poor concentration, feeling anxious or irritable, lack of motivation, mood swings, and lack of sex drive. Imbalances can also lead to weight gain or difficulty losing weight, difficulty maintaining and gaining muscle, dry skin, brittle nails, hair loss, fatigue, vasomotor symptoms (hot flashes/night sweats), muscle soreness after exercise, painful intercourse, vaginal dryness, and erectile dysfunction, swollen breasts in men, among other uncomfortable symptoms.
Can you “rebalance” hormones naturally?
Balancing hormones, whether naturally or through medical intervention, ultimately depends on the root-cause of a hormone imbalance. As previously stated, hormones can become imbalanced due to lifestyle factors. If a patient is experiencing inadequate sleep, high stress, poor diet, lack of exercise, or high alcohol intake, making the necessary lifestyle changes can naturally improve hormone levels over time. For example, in the case of nutrition, a high sugar diet can block healthy estrogen breakdown which may lead to excess estrogen. Limiting sugar and eating more cruciferous vegetables like broccoli can help promote healthy estrogen breakdown. Individuals who are overweight may also experience higher than normal estrogen levels, as estrogen is produced and stored in fat cells. Testosterone levels can potentially increase by eating a diet higher in protein, exercising, reducing stress, losing weight, and taking supplements like zinc, amino acids, and DHEA. Labs are important before starting any lifestyle changes, and repeating labs every three to six months is essential to track progress and truly know if a protocol is helping to rebalance hormone levels.
What does “optimal hormone health” mean?
When hormones are fully balanced in the body, an optimal state of health can be reached. Achieving optimal hormone levels is not solely based on lab values – treatment and management is individualized based on a patient’s symptoms and goals. A responsible provider always has a goal to help their patients achieve physiologic hormone levels that allow the body to function optimally, promote longevity, and reduce risk of future disease.
The benefits of optimizing hormones are vast. Clinical trials have shown that men and women with normal hormone levels have a lower risk of heart disease, stroke, osteoporosis, and Alzheimer’s disease, among other conditions. Alternatively, poor hormone health can increase health risks in both women and men. Women with low estrogen levels have more than twice the risk of hip and vertebral fractures. There is also a relationship between low testosterone and increased risk of obesity, high blood pressure, high cholesterol, high blood sugar and endothelial dysfunction. In fact, low testosterone is shown to be a risk factor for cardiovascular disease, heart attack, and stroke.
How to balance hormones with the help of a provider
To approach hormone balance safely and effectively, it is important to first assess the body’s current state of hormone health with a provider who is a hormone expert. This is primarily accomplished through blood work and conversations about current symptoms. For certain indications, saliva or urine testing may be recommended. When labs results are reported, it is important to review them fully with an experienced provider in order to better understand what results mean. To the untrained eye, a “normal” lab value may seem fine, but it may actually be sub-optimal.
When seeking a hormone balancing intervention, keep in mind that your journey does not have to be prescription-driven. There are different approaches to restore balanced hormones in the body, including lifestyle changes and supplementation, as previously discussed. However, hormone replacement therapy (HRT) is an effective option that can rebalance hormones using personalized doses of hormones in the form of pellets, topicals or injections. With HRT, one type does not fit all, as every woman and man are unique. There are multiple modalities for HRT and each have their unique benefits. Your provider should review all of your options, discuss the pros and cons of each, and help you choose the one that best suits your lifestyle. Then, you should routinely monitor hormone levels every three months and adjust dosing as needed, based on your symptoms and lab results. The goal of any appropriate HRT protocol is not to “super dose” a patient full of hormones: the body was not designed this way. Rather, everything should be in balance with one another.
What qualifications should a hormone expert hold?
A true hormone expert does not just give out topicals or insert pellets. Hormones are instruments involved in the large symphony we call our body. Every piece plays an important role and works together with one another in order to function optimally. This is why hormone balancing is truly a whole-body approach to health. One simply cannot balance hormones without looking at cholesterol, blood sugar, thyroid, stress management, sleep habits, vitamin, minerals, gut health, and other important markers. A qualified medical provider who has been expertly trained in conventional and functional medicine, with additional qualifications in hormone health, will be best suited to help guide you to optimal hormone health.
Monitoring is also key. If you are on hormones and are not monitored on a regular basis, or the provider does not emphasize the other health markers, it is similar to giving you a car with flat tires: it will only get you so far.
Essential Health providers have exceeded training required to be true hormone experts. In addition to completing additional certifications through the American Academy of Anti-Aging Medicine, many have completed the full Fellowship in Anti-Aging and Metabolic Medicine, which is an additional two-year commitment, and continue to take continuing educational courses on a regular basis.
If you believe a hormone imbalance might be at the root of your symptoms, schedule a Meet & Greet with our team to learn more about our approach to hormone balancing.
References:
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Lobo, R.A. (2017). Hormone-replacement therapy: current thinking. Nature Reviews, Endocrinology. April 2017, vol 13, pp 220-31. Doi:10.1038/nrendo.2016.164
Jay Jay Thaung Zawa, et al. Postmenopausal health interventions: Time to move on from the Women’s Health Initiative? Ageing Research Reviews 48 (2018) 79–86Khaw et al. (2007). Circulation
Ohlsson, C., et al (2011). High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. Journal of the American College of Cardiology. Vol 58, No 16, 1674-81. Doi: 10.1016/j.jacc.2011.07.019
Sharma, R. et al. (2015). Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men. European Heart Journal, 36, 2706-2715. Doi: 10.1093/eurheartj/ehv346
Morgentaler, A. et al (2015). Testosterone therapy and cardiovascular risk: Advances and controversies. Mayo Clinic Pro. February 2015; 90(2) 224-251. http://dx.doi.org/10.1016/j.mayocp.2014.10.011