From headaches and irritability to bloating and night sweats, hormones can have a significant effect on women’s health. In addition to the hormone changes related to their monthly menstrual cycle and menopause, women are more likely to have hormonal disorders that cause unwanted symptoms.
In this video, San Diego Health host Susan Taylor talks with Sarah Dalhoumi, MD, a family medicine physician at Scripps Clinic Torrey Pines and a specialist in integrative medicine, about diagnosing hormone issues and options for treating them.
Simply put, hormones are chemical messengers sent by the brain to the rest of the body through the endocrine system. Hormones affect our energy levels, mood, sleep quality and more – especially during a woman’s menstrual cycle. In the days before a woman’s menstrual period begins, the levels of two female hormones, estrogen and progesterone, drop sharply. Other hormones are impacted as well.
“Hormones like dopamine or serotonin that are the ‘feel good’ hormones, or aldosterone, which causes fluid retention and bloating, are also affected,” says Dr. Dalhoumi. “This can cause symptoms of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), a much more severe form of PMS.”
As a woman’s reproductive years begin to wind down during perimenopause, her estrogen and progesterone levels peak and fall with declining regularity, often for several years or more. Once her menstrual periods completely stop at menopause, these hormones are no longer detected in her blood. For many women, these changes cause problems, such as weight gain, headaches, insomnia, night sweats and hot flashes.
A variety of hormonal disorders also can affect health. Symptoms depend on which hormones are out of balance. The thyroid gland, for example, produces hormones that regulate metabolism, so an underactive thyroid may cause weight gain and fatigue. An overactive thyroid can lead to unintended weight loss, anxiety and an irregular heartbeat.
Dr. Dalhoumi says the first step is identifying the underlying cause of the hormone imbalance, which may not always be clear. Some hormonal disorders, such as an autoimmune condition called Hashimoto’s thyroiditis, may be inherited from a parent.
Many chemicals, both natural and manmade, may mimic or interfere with hormones. Called endocrine disruptors, these chemicals are linked with a range of problems. Endocrine disruptors are found in many everyday products, including some plastic bottles and containers, detergents, flame retardants, cosmetics and pesticides. Other causes of hormone imbalances may include medications, tumors, chemotherapy, stress and trauma.
Bringing hormone levels back into balance is key to treating hormone-related symptoms. For instance, giving a woman estrogen and progesterone during the transition into menopause can relieve many menopausal symptoms.
Moreover, without treatment, these imbalances can raise the risk of serious concerns, such as high blood pressure, cardiovascular disease and cancer risk.
“It’s important to make sure we’re appropriately identifying, addressing, and treating these hormone imbalances,” says Dr. Dalhoumi. “It’s not a one-size-fits-all solution. At Scripps Center for Integrative Medicine, we really treat the body as a whole. We spend time with our patients to understand their concerns and what their day-to-day functioning looks like, and give them education and resources to help.”
For women in menopause, Dr. Dalhoumi may recommend bioidentical hormone replacement therapy, which replaces estrogen and progesterone with artificial hormones that the body sees as identical to actual hormones. Another option, nutraceuticals, are non-hormonal, plant-based supplements that can significantly improve symptoms, as can complementary medical therapies, such as acupuncture and hypnotherapy.
“I encourage all my patients to listen to your body and if something doesn’t feel right, have an open conversation with your doctor,” says Dr. Dalhoumi. “Most primary care physicians are very comfortable treating hormone imbalances, but if it requires a little deeper evaluation, talk to your gynecologist or an endocrinologist and have it addressed.”