Thursday, January 30, 2014

Steroid Hormones Part 5: Hormonal Imbalances

Steroid Hormones Part 5: Hormonal Imbalances

At the core of many symptoms suffered by both men and women are hormonal imbalances.  Imbalances occur several ways.  There are deficiencies, there are excess, and there are relational imbalances.  We have previously mentioned “estrogen dominance” which is an example of a relational imbalance.  Relational imbalances are challenging as they can be a combination of deficiencies and excesses. 

To begin our understanding let’s start with some basic lists.  Estrogen imbalances include estrogen deficiency and estrogen excess.

Symptoms of Estrogen Deficiency

·         Hot flashes
·         Night sweats
·         Insomnia
·         Mood swings
·         Mental fogginess, poor memory
·         Dry eyes, nose, sinuses
·         Vaginal dryness, dry skin
·         Vaginal wall thinness, vaginal dysplasia
·         Vaginal and/or bladder infections
·         Incontinence, urethral irritations, urinary frequency
·         Headaches, migraines
·         Decreased sexual response
·         Loss of ambition or drive
·         Depression
·         Lack of stamina
·         Decreased breast size
·         Wrinkling of skin
·         Osteoporosis
·         Loss of subcutaneous fat
·         Increased risk of cardiovascular disease

Symptoms of Estrogen Excess

·         Heavy bleeding
·         Clotting, cramping
·         Water retention, bloating
·         Breast tenderness, lumpiness, cystic breasts, enlarged breasts, fibrocystic breasts
·         Weight gain
·         Headaches, migraines
·         Emotional hypersensitivity
·         Depression, irritability, anxiety, anger, agitation
·         Decreased sexual response
·         Thyroid dysfunction (resembling hypothyroidism)
·         Cold hands and feet
·         Blood sugar instability, sweet cravings
·         Insomnia
·         Gall bladder dysfunction (coagulated bile)
·         Acne

Progesterone imbalances include progesterone deficiency and progesterone excess.

Symptoms of Progesterone Deficiency

·         PMS
·         Heavy bleeding
·         Clotting, cramping
·         Inability to concentrate
·         Short term memory impairment
·         Muscle tension, spasm, Fibromyalgia
·         Water retention, bloating
·         Insomnia
·         Breast tenderness, lumpiness, cystic breasts
·         Weight gain
·         Thyroid dysfunction (resembling hypothyroidism)
·         Acne
·         Headaches, migraines
·         Anxiety, irritability, nervousness, moodiness
·         Hot flashes
·         Depression
·         Decreased sexual response
·         Osteoporosis
·         Amenorrhea (no periods at all)
·         Oligomenorrhea (infrequent periods)
·         Spotting
·         Endometriosis, adenomyosis (uterine endometriosis)
·         Fibroids

Symptoms of Progesterone Excess (usually from overdose resulting from progesterone replacement therapy)
·         Sleepiness
·         Bloating or constipation (excess progesterone slows the digestive tract)
·         Candida (excess progesterone can inhibit anti-candida immune system response)
·         Depression
·         Ligament laxity which can cause: persistent back pain; other joint pains and problems; incontinence; or mitral valve prolapse.
·         Progressive progesterone deficiency symptoms (Progesterone overdose, especially with creams and gels down-regulates and eventually shuts down progesterone receptors.)
·         High levels of free (unbound) cortisol which can lead to: high blood sugar; insulin resistance; weight gain; low thyroid function; sleep problems; osteoporosis; immune system dysfunction; and GI system problems. (Progesterone and cortisol compete for the same binding protein. When free progesterone floods the system long enough, it can compete with cortisol for the binding protein and release excessive amounts of cortisol into the system.)
·         Loss of hormonal feedback loop coordination which disrupts multiple other hormones balances.

Testosterone imbalances can occur in both men and women. 

Symptoms of Testosterone Deficiency
·         Decreased stamina and energy.
·         Low or absent libido.
·         Poor muscle tone.
·         Weakened, osteoporotic bones.
·         Trouble with balance and coordination.
·         Decreased sense of well-being.
·         Decreased armpit and body hair.

Symptoms of Testosterone Excess
·         Acne, oily skin.
·         Loss of head hair (male patterned baldness).
·         Excess facial hair, excess body hair.
·         Mood disturbance, excessive aggressiveness, irritability.
·         Deepened voice.

Estrogen Dominance

Estrogen dominance is a condition in which a woman or man can have deficient, normal, or excessive levels of estrogen, but has too little progesterone to balance the estrogen level. Estrogen Dominance has become common in both cycling and menopausal women, and men.  So, why is this?

Estrogen dominance has become so predominant due to many of our modern lifestyle choices.  One of the main causes is stress which sets off a whole range of hormonal chain reactions.  The increased need for cortisol to handle the stress response causes more progesterone to be converted to cortisol.  This may cause a shortage of progesterone to balance estrogen. 

As cortisol rises insulin rises increasing fat storage.  As cortisol rises thyroid hormones decrease, thus slowing metabolism and leading to fat storage.  Fat cells make estrogen, exacerbating the imbalance.

Weakened glands are another reason.  The adrenals may be fatigued from cortisol production and slow down progesterone production.  The ovaries may not produce sufficient progesterone during the luteal phase of the cycle.  Or there may be anovulatory cycles (cycles where menstruation occurs, but no ovulation) resulting in no ovarian progesterone being produced. Low thyroid function may slow down the adrenals and the ovaries as well.  All these activities can create a shortage of progesterone to balance estrogen.

The use of oral or injected contraceptives by its very nature is disruptive to the production of progesterone.  Remember contraceptives to not “regulate” the cycle, they “suppress” it.  Their usage can have both short term and longer term impacts on progesterone production. 

For menopausal women conventional hormone replacement therapy has been to provide estrogen.  As we have seen, progesterone is also needed in menopause.  Therefore an unbalanced replacement approach may lead to estrogen dominance.

There are also dietary and nutritional deficiency concerns.  The typical American diet: usually high in carbohydrates, low in good fats, high in trans-fats, and low in vegetables and healthy sources of protein leads to nutritional deficiencies and obesity.  Deficiencies in magnesium, zinc, copper, iodine, and B complex vitamins play a major role in the health of the endocrine glands and their production of hormones.  Obesity is a concern as estrogen is made in fat cells and excess fat cells make excess estrogen.

Last, but certainly not least is exposure to external hormones.  This includes xenohormone exposure and plant and animal hormones.  The animal hormones are found in our food supply while other hormones are typically found in health and beauty products (a small amount does not have to be labeled!).  Xenohormones are chemicals that disrupt our hormonal balance.  These are found in health and beauty products, cleaning products, plastics, and many other unsuspecting places as well as pesticides, fungicides, and medications. 

Symptoms of Estrogen Dominance

·         Anxiety, irritability, anger, agitation
·         Cramps, heavy or prolonged bleeding, clots
·         Water retention/weight gain, bloating
·         Breast tenderness, lumpiness, enlargement, fibrocystic breasts
·         Mood swings, depression
·         Headaches/migraines
·         Carbohydrate cravings, sweet cravings, chocolate cravings
·         Muscle pains, joint pains, back pain
·         Acne
·         Foggy thinking, memory difficulties
·         Fat gain, especially in abdomen, hips and thighs
·         Cold hands and feet (low thyroid function because estrogen blocks thyroid hormones)
·         Blood sugar instability, Insulin Resistance
·         Irregular periods
·         Decreased sex drive
·         Gall bladder problems (bile becomes thick and sluggish)
·         Infertility
·         Insomnia
·         Osteoporosis
·         Endometriosis, Adenomyosis
·         Functional ovarian cysts; Polycystic ovaries
·         Uterine fibroids
·         Cervical dysplasia
·         Allergic tendencies
·         Autoimmune disorder
·         Breast, uterine, cervical, or ovarian cancer

Natural solutions for estrogen dominance include dietary modifications, stress reduction techniques, animal glandular extracts without hormones, specific nutrients, and herbal remedies.  As you can see, estrogen dominance is even more complex than the previous hormonal imbalance issues we have discussed.  It is multi-faceted as it includes multiple organs and hormones.  We can use the symptom lists as guides to identify which hormones are in excess or deficient, yet for long term health and healing we want to support all the affected glands. 

There are times when a form of hormone replacement therapy is needed.  At those times the  more natural solution is “bioidentical” hormones.  Here too, just providing hormones does not address the underlying deficiencies and ultimately the health of the glands.  We are dealing with multiple glands and hormones so supplementing with specific hormones may throw the entire system even more out of balance, by creating additional communications challenges for the endocrine system.  Therefore, except for extreme cases, it may be best to start with glandular and nutrient support and allow the body to bring itself back into balance naturally.

Bernard Rosen, PhD is a Nutrition Consultant and Educator. He works with individuals, groups, and at corporations to create individualized nutrition and wellness programs. His office is in Mequon, WI. To learn more or to schedule an appointment, e-mail at, call (262) 389-9907 or go to

Tuesday, January 28, 2014

Steroid Hormones Part 4: Female and Male Life Cycles

Steroid Hormones Part 4: Female and Male Life Cycles

Before we look at hormonal imbalances, let’s get a quick understanding of the hormonal stages of the typical female and male life cycles.

Female Life Cycle

Once the female reaches puberty she has entered her reproductive years.  To reach full reproductive maturity can take up to four years.  It is also common for the initial menstrual cycles to be irregular for several months or years.  The reproductive years last for approximately 30 plus years.

The next stage is called perimenopause.  It marks beginning of the transition to menopause. This can be one of the more difficult stages for the modern female as things begin to change.  Cycles and hormones now fluctuate creating more mood swings and fatigue.   In addition there are more cycles without ovulation.  Perimenopause officially ends with menopause which is considered to be 12 consecutive months with no cycle.

The biological wiring of the human female is for this process to take 2-3 years.  However, it has become common for this transition to take 8-12 years in the modern female.

Menopause is the permanent cessation of menstruation due to loss of most ovarian function.  There is another common misperception here.  While it is true that ovarian estrogen and progesterone production have stopped, there can still be testosterone production.  Therefore, the ovaries still do serve a purpose after menopause.  The average age for menopause is 51. Smoking has been shown to accelerate the process by two years.

Menopause is known for some unpleasant symptoms, some of which are also experienced during perimenopause.  Most of these originate with hormonal imbalances which we will discuss later.  Menopause symptoms affect both the physical, mental and emotional bodies. 

General physical symptoms include: hot flashes; night sweats; insomnia; dry skin, eyes, and sinuses; headaches; migraines; water retention and bloating; weight gain; liver and gall bladder congestion (leading to constipation); cold hands and feet; increased sugar cravings; muscle tension; increased risk of osteoporosis and cardiovascular disease; and loss of subcutaneous fat and increased wrinkling.

Symptoms affecting the reproductive system include: cystic or lumpy breasts; vaginal dryness, vaginal dysplasia and atrophy; more frequent urinary tract infections; and incontinence.  

General mental and emotional symptoms include: poor memory and foggy thinking; mood swings; depression; decreased ambition; irritability; anxiety; anger; and decreased libido.

A variety of factors have been identified that affect these symptoms.  Positive factors which reduce the symptoms include being in general good health and having a low stress lifestyle as the transition begins.  These women typically have strong adrenals, a healthy thyroid, have a good balance of minerals, and normal cholesterol levels (220-240).

Factors associated with a greater likelihood of experiencing these symptoms include: obesity; chronic stress; adrenal fatigue; estrogen dominance; liver congestion; thyroid imbalance; and insulin resistance.

Male Life Cycle

Yes, there is such a thing as the “grumpy old man.”  This is called andropause.  While it does not receive all the attention of its female counterpart menopause, it is just as real and disruptive to the person experiencing it.  The “official” definition of andropause is the loss of androgen dominance in men.

Andropause is different than menopause in that its onset is often gradual.  The symptoms are often missed or treated as separate issues without recognizing the underlying change in male hormone status.  The key hormone is testosterone.  Once men reach around 40 years old their free testosterone levels (the active form) begin to decline 1-2% each year.  You can see that it starts out slow, but 10-15 years or more down the road it is a significant drop from where the man was at age 20, 25, or 30!

Andropause impacts men on physical, mental, and emotional levels.  Typical physical signs and symptoms include: loss of energy, strength, and stamina; gradually increasing fatigue; loss of libido, fewer spontaneous morning erections, and erectile dysfunction (ED); muscle soreness, weakness, and decreased muscle mass; thinning and dry skin; sleep problems; blood sugar problems, insulin resistance, and increased risk for diabetes; weight gain; increased fat in hips and breasts; increased risk for cardiovascular disease (increased cholesterol, triglycerides, and blood pressure); increased risk for osteoporosis; and increased prostate and urinary tract problems.

Typical mental and emotional symptoms include: low mood; irritability; depression; discouragement; pessimism; withdrawal from activities and relationships; concentration and memory difficulties; less productive, decreased initiative, motivation, and drive; and loss of libido.

Positive and negative factors affecting a man’s experience during andropause are similar to those described above impacting menopause. 

It is important to note from our earlier discussion testosterone is made from cholesterol and plays an important role in maintaining healthy levels of cholesterol and triglycerides. Statin medications have been shown to lower testosterone levels.

Bernard Rosen, PhD is a Nutrition Consultant and Educator. He works with individuals, groups, and at corporations to create individualized nutrition and wellness programs. His office is in Mequon, WI. To learn more or to schedule an appointment, e-mail at, call (262) 389-9907 or go to