“Something feels off, I think it’s my hormones” is something I hear quite often from my female patients. Many women have some level of hormone imbalance throughout their lifetime and unfortunately, their symptoms are often dismissed or covered up. When they go to the doctor to explain their symptoms they are often told, “Your labs are normal” or “It’s all in your head” or are given a prescription for an antidepressant or the birth control pill. 

None of this addresses the root of the issue. And it’s when we address the root of the issue, that women can finally find relief and no longer suffer from the many unnecessary symptoms that come from hormone imbalances.

Yes, women’s hormones do have times of natural fluctuation, but outside of that, hormones don’t go out of balance for no reason. When it does, it’s a sign from the body telling us something is wrong.  In this article, we will discuss what normal sex hormone fluctuations are and the steps we can take to keep our hormones balanced each step of the way. 

The Root of the Matter

Our hormones are signaling messengers circulating throughout our bodies that allow communication between our brain, thyroid gland, sex organs, adrenal glands, heart, bones, digestive, and immune systems. This hopefully paints the picture that our hormones do not function independently from the rest of our body – it’s all connected! 

This is why to address the root cause of hormone dysfunction many things need to be addressed including:

• • Diet

• • Lifestyle

• • Inflammation

• • Nutrient Imbalances

• • Environmental exposures

• • Poor Detox Capacity

• • Gut microbiome imbalances

Puberty and the Teenage Years

The transition into puberty is a big one with estrogen, progesterone, and testosterone ramping up in their bodies. Many physical changes take place during this time and also the two most unwanted symptoms include mood swings and acne. Girls often experience irregular menstrual cycles which is normal at first and can take several months to balance out.  But they can also experience cramping, PMS, and heavy bleeding. 

Unfortunately, this is often the time when many girls are put on the birth control pill to help control these symptoms. While this may be medically necessary in some cases, there is a better approach without having to completely shut down their own natural hormone rhythm. The birth control pill may mask unwanted symptoms temporarily, but often these symptoms will be right there waiting for them (and often worse) when they try to come off it.

To address the root cause we need to focus on gut health, decreasing inflammation, and helping them get the nutrients they need. A great first step is ensuring kids eat a nutrient-dense diet with lots of protein. Unfortunately, a large percentage of kids’ diets these days consist mostly of ultra-processed packaged foods. While we often can’t avoid this completely, making sure our kids are eating mostly whole foods is a great place to start with a big emphasis on quality protein.  I like to aim for the 80/20 rule with 80% of foods being whole foods and 20% wiggle room for processed foods. 

Also, kids need adequate movement and quality sleep daily. I encourage teens to get about 10,000 steps per day and aim for 8-10 hours of sleep each night for optimal development and well-being.

Managing stress is another big one – and stress includes screen time. Looking at the blue light on screens and always being “on” triggers cortisol and glucose spikes that can alter the hormone signaling of our sex hormones too.  It’s important to build in screen-free time and engage in fun non-electronic activities, preferably outside. 

To fill nutrient gaps and ensure optimal gut health I recommend getting on a good quality multivitamin and a probiotic which helps support the gut and detox pathways.

The Reproductive Years

During the reproductive years, cycling hormones like estrogen and progesterone regulate the intricate dance of the menstrual cycle and prepare the body for potential pregnancy.  Many factors can disrupt this beautiful rhythm and women often struggle with PMS, PCOS, endometriosis, and infertility during these years. 

Areas I focus on in this group include:

• • optimizing vitamin/mineral levels

• • treating underlying inflammation in the gut (1, 2)

• • balancing blood sugar

• • optimizing detox pathways

• • managing stress

• • removing hormone disruptors from the environment

Addressing inflammation is key and often stems from the gut. I recommend doing an elimination diet for 30 days or doing a Cyrex food intolerance test to identify any issues with common food sensitivities like gluten or dairy. I also recommend taking a high-quality probiotic which can also help tune up the gut, decrease inflammation, and improve detoxification.  Our gut microbiome plays a big role in how we metabolize and detox everything in our bodies including our sex hormones. 

In this age group, I also recommend:

• • getting on a good multivitamin to bridge any nutrient gaps

• • getting optimal protein with each meal to help balance blood sugars

• • eating omega-3-rich fish like salmon several times per week

• • finding ways to manage stress

• • getting 7-9 hours of sleep each night

I also encourage women to minimize xenoestrogens in their environment as much as possible.  These are chemicals that mimic estrogen and disrupt the endocrine system and can lead to unwanted symptoms such as PMS, heavy periods, heavy cramping, fertility issues, and even cancer. (3) These can be found in plastics, cleaning products, hair products, makeup, lotions, deodorants, sunscreen, dryer sheets, perfume, pesticides, and insecticides. (4) Finding safe natural alternatives can drastically reduce your exposure and help normalize estrogen levels in the body. 

Perimenopause and Menopause

Ovarian reserves start declining in the late 30s and 40s causing hormone output to be more chaotic which can lead to symptoms such as mood changes, hot flashes, brain fog, and disrupted sleep. 

In these women, I focus on optimizing metabolic health and decreasing inflammation. Optimizing gut health and identifying food sensitivities can play a big role if inflammation is the primary driver. For other women, focusing on getting enough protein, stabilizing blood sugars, and optimizing the circadian rhythm can be a game changer. Getting 7-9 hours of sleep and getting 10 minutes of natural light on the eyes in the morning while minimizing blue light exposure at night can make a huge difference. 

Optimizing thyroid function and adrenal hormones is also important. Doing the steps mentioned above, while also emphasizing stress reduction can be extremely helpful. I also recommend working with a provider who will check a blood panel which includes a full thyroid panel with both thyroid antibodies along with other markers including a full iron panel, B12 and folate, homocysteine, insulin, hemoglobin A1c, inflammatory markers, vitamin D, lipid panel, zinc, copper, as well as the standard complete blood count and complete metabolic panel. 

It’s during this time that we can start thinking about bringing on some nutraceutical support and/or bioidentical hormone replacement if needed.  For bioidentical hormone replacement, I recommend always checking a full extended blood panel and hormone panel first and working with a functional medicine provider familiar with interpreting these results.  

Post-Menopause

After menopause, cardiovascular and bone health become priorities as estrogen levels drastically decline. (5)  Inflammation and metabolic health are the biggest drivers of increased cardiovascular risk and decreased bone density so this is a top priority when working with women post menopause. (6)  Once again, getting a minimum of 7 hours of sleep, identifying and addressing any food sensitivities, optimizing the gut, and stabilizing blood sugars can help women have a much better experience transitioning through this phase of life and also help decrease their risk of cardiovascular disease and osteoporosis.  

Additionally, topical bioidentical estradiol paired with oral progesterone can be extremely helpful with alleviating hot flashes and many other symptoms associated with menopause as well as help with bone, breast, and cardiovascular health. Once again, I recommend working with a functional medicine provider who has experience with prescribing these hormones and monitors urine metabolites to be sure these hormones are given safely and at the correct dose for your body. 

Healing your Hormones 

Taking an integrative functional medicine approach can make a huge difference in reducing unwanted symptoms as women transition through each hormonal phase of their lives. By uncovering and addressing the root causes of these imbalances, we can help women feel better now and prevent unwanted issues in the future. Removing what the body doesn’t want and giving it what it needs brings true health and healing so women can thrive and feel their best.