Quite often when we think about hormone imbalance in menopause we think about low estrogen and other female hormone imbalances. I’ve seen thousands of women and prescribed bioidentical hormones for them. These are hormones that have the same chemical structure as those that the body makes; therefore, they are metabolized through the same pathways. Essentially, when they are used, the body recognizes them and reacts well to them; they are not a drug with hormonal properties, they are actual hormones. However, after prescribing hormones and consistently following up with my patients for over a year, I noticed a trend. If other imbalances aren’t examined and managed, the symptoms of menopause come back and the woman needs increasing amounts of hormones to feel better.
What do I mean by other imbalances in addition to hormone imbalance?
I mean nutritional imbalances following lifestyle changes like incorporating exercise into your routine, balancing other hormones like the thyroid and insulin, and the biggest one – balancing the adrenal glands by reducing stress and managing cortisol.
High stress can cause elevated levels of cortisol which can affect energy, mood, sleep, focus and concentration. It can make hot flashes worse, make digestive issues worse, cause palpitations and make you feel wired and stressed out. If you take hormones but don’t address any underlying issues or manage stress, then the symptoms may be temporarily alleviated, then come back after some time.
What are some of the factors that cause adrenal fatigue and what can we do about it?
When the adrenal glands are healthy, they secrete precise amounts of the steroid hormones. However, too much physical, emotional, environmental, or psychological stress causes imbalances in their functioning. This can result in adrenal fatigue, meaning the adrenal glands are no longer coping with the strains put on them. The classic symptoms are tiredness, low energy, cravings, insomnia, irritability, anxiety, and poor concentration.
Many people with adrenal fatigue get into the habit of relying on stimulants, such as caffeine and sugar, to keep them going as they feel fatigued in the day, and alcohol or other relaxants to help wind down at night. There can be many causes of adrenal fatigue, such as work pressures, emotional traumas, relationship strains, chronic illness, infections, surgery, pain, grief, financial difficulties, lack of sleep, or depression and anxiety.
What are the symptoms of adrenal dysfunction?
Do you:
- Feel tired for no obvious reason?
- Experience light-headedness upon standing?
- Feel more awake at night?
- Crave salty foods, sugar or licorice?
- Feel stressed, restless, overwhelmed or exhausted?
- Find it hard to lose weight?
- Get absentminded or feel that your short-term memory lets you down?
- Keep yourself going on sugar, caffeine and/or nicotine?
- Spend the whole day rushing from one thing to another?
- Experience anxiety, irritability or nervousness?
- Have a low libido?
- Suffer from interrupted sleep or insomnia?
If you answered yes to many of these questions you might have adrenal fatigue. If a patient was to see me and ask for the adrenal gland to be checked, there are tests available to measure the DHEA and cortisol in a saliva sample. These would be taken at four different times over a 24-hour period. The levels would then be measured and compared to healthy controls. There are many nutritionists, naturopaths and doctors with similar training who would be able to conduct these tests for you.
If you have access to a blood pressure monitoring device, you could try this: lie down for five minutes, check your blood pressure, and record the result. Keep the blood pressure cuff on, stand up, and immediately record your blood pressure again. The top figure of the reading should normally increase or stay the same. If it drops, it could be an indicator of adrenal fatigue. Repeat the test twice to confirm the results.
The steroid hormone DHEA, which contributes to energy levels, can also be measured as a blood test to see if levels are within a normal range. If the levels of DHEA come back as low, then you could be suffering from an adrenal imbalance.
How raised cortisol can make you fat
Many menopausal women complain about increased weight gain, especially around the middle. When you are stressed, your body sends a message to the adrenal glands to release more cortisol. Cortisol stops the hormone leptin from being produced. Leptin sends signals that make us feel full. Without it we are prone to overeating, and this absence makes us crave foods rich in carbohydrates, in particular. When we experience long-term stress, cortisol and insulin remain high in the blood, and the extra glucose that isn’t needed for energy gets stored in the form of fat – primarily abdominal fat cells. Scientists have discovered that fat cells have special stress-hormone receptors for cortisol, but there also seem to be more of these cortisol receptors on the fat cells around the stomach than anywhere else in the body.
How to manage raised cortisol
1. Identify and Resolve Your Main Sources of Stress
When stress is our predominant state, our bodies will try to protect us by storing fat. We need to reduce stress to coax our bodies away from ‘crisis mode.’ Go through your main causes of stress and identify a solution. For example, if you have a lot of debt you might plan to discuss this with your local Advice Bureau or a financial advisor; or if you have problems at work, you might organize a meeting with your boss. Make a list of actions and put time-frames on them. It’s important to take practical steps to improve your situation. If you need professional help, making an appointment to see your doctor or a counselor would be a great first step.
2. Eat Your Way Back to Energy
Eating regular meals throughout the day will stop your blood sugars and hormones from fluctuating too much. When we have a big meal, cortisol, the fat-storing hormone, is released so it’s better to have your big meal earlier in the day. Perhaps it’s no surprise that cutting back on sugary snacks will help heal adrenal dysfunction. The body often craves sugary or salty foods in this state. Many people rely on caffeine to keep going, but overall, this leads to a greater drop in energy. The best foods to support the adrenal glands with micronutrients are asparagus, avocado, garlic, cabbage, and ginger.
3. Take Supplements
Vitamins B and C and omega-3 fish oils all support the adrenal glands. You could take these in the form of supplements or eat more foods rich in vitamins B and C, such as avocados, grapefruits, strawberries, bananas, oranges, and blueberries. Omega-3 fish oils are found in oily fish like mackerel and salmon. In addition, herbs such as ginseng, Rhodiola, ashwagandha, Timo cordyceps mycelium extract, and L-theanine can be helpful. There are some herbal supplements that can help support the adrenal glands, as well as, a supplement with pituitary and adrenal concentrate from bovine sources to aid the healthy functioning of the adrenal and pituitary glands, but this should be done under the supervision of a healthcare professional.
4. Exercise, Gently
When you have adrenal fatigue, over-exercising, such as a strenuous gym session, will only put more strain on the adrenals. It’s more beneficial to do 15–30 minutes of gentle exercise a day. Walking, yoga and swimming are ideal forms of exercise. It’s also good to get some fresh air whenever possible, so ensure to walk outdoors.
5. Make Time to Relax
Schedule some relaxation in your diary every day, even if it’s only 5–10 minutes. Walking, hot baths, massages, reading, and meditation are all simple, but effective. Go out and have fun too. We relax when we are doing things we enjoy. Whenever you are stressed, take a few deep breaths through your nose. This helps to slow the heart rate down. We’re all extraordinarily busy nowadays, but it pays to learn how to notice when we’re first getting stressed, acknowledge it, and take time out to have a cup of herbal tea or to gather our thoughts.
For more on hormone imbalance, read Dr. Roked’s post about progesterone and how it can improve women’s health.
