All too often women just accept that their monthly cycle will be accompanied by pain or debilitatingly heavy bleeding, while others think it is great not to have the monthly ‘inconvenience’. Every woman is entitled to a regular, healthy, pain-free menstrual cycle so if this is not the case for you, read on and make it yours.
A delicately balanced 3-legged stool
The 3 endocrine glands – Ovaries + Adrenals + Thyroid (OAT) – are intimately connected and inter-dependent – they depend on each other for support of optimal health. What happens to one part of the OAT axis will affect the other components of this network, clinically or sub-clinically. For example, if adrenal function is impaired, there is often concurrent thyroid malfunction and menstrual cycle irregularity. Similarly, an under-active thyroid often makes adrenal fatigue worse and can predispose women to dysmenorrhoea, menorrhagia, and luteal phase defects. Finally, women who suffer from ovarian hormone imbalance symptoms such as oestrogen dominance often experience an exacerbation of sub-clinical hypothyroidism symptoms.1,2 Other axes that affect our hormones are the Hyperthalamus + Pituitary + Adrenals (HPA) and Hyperthalamus + Pituitary + Thyroid (HPT).
How adrenal and thyroid function impacts reproductive health
The adrenal glands are closely involved in regulating female sex hormone levels. High levels of stress over-stimulate the HPA axis, increasing endogenous corticotropin releasing hormone (CRH) activity and upregulating secretion of cortisol.3,4 Even relatively mild and/or short-term hyperstimulation of the HPA axis from stress can suppress ovarian function, causing:4,5
● Reduced secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus
● Inhibition of luteinising hormone (LH) secretion
● Lowered progesterone levels and luteal phase defects
Thyroid dysfunction is more common in females, including hypo- and hyperthyroidism, and can cause issues with fertility, the menstrual cycle, and pregnancy.1,6
The HPT axis and the HPO axis work very closely together to regulate reproductive hormone levels. Hypothyroidism especially can affect the menstrual cycle and fertility, causing:1,6
● Increased sex hormone-binding globulin (SHBG) levels, thereby reducing active sex hormone levels
● Reduced secretion of GnRH from the hypothalamus
● Increased prolactin production
Common menstrual disturbances linked to OAT disturbances
Many of the most common menstrual issues seen clinically can be caused and/or worsened by OAT disturbances.
- Amenorrhoea or absence of menstrual cycle: Stress-induced hypothalamic amenorrhoea is a result of adrenal hyperactivity and is seen in patients with chronically elevated cortisol levels, cortisol receptor site resistance, and suppressed ovarian function due to abnormally low levels of LH and/or slow frequency of LH pulses in the blood.4,7
- Polycystic ovary syndrome (PCOS): PCOS is one of the most common endocrine disorders in women of reproductive age. PCOS can disrupt the menstrual cycle and affect fertility. PCOS is linked to a number of factors, including progesterone deficiency from adrenal dysfunction, subclinical hypothyroidism, and insulin resistance.1,2,5
- Anovulation: The absence of ovulation can occur in PCOS, due to HPO axis blunting caused by high cortisol due to stress, and/or associated with hypothyroidism (subclinical or overt).3,4 Anovulatory cycles may be linked clinically with luteal phase defects, menorrhagia, dysmenorrhoea, and infertility.
- Menorrhagia: Excessive uterine/menstrual bleeding is associated with hypothyroidism as low thyroid function affects reproductive hormone response with disturbed GnRH, LH and hyperprolactinaemia. Women with unexplained menorrhagia or infertility can be tested for thyroid dysfunction, particularly thyrotropin-releasing hormone (TRH) levels.2,8,9,10
- Dysmenorrhoea: Research has shown that women experiencing painful periods often have a suppression of the HPA axis and lower cortisol levels, which affects the duration of the pain.5 This is often related to chronic, long term stress.
Supporting the OAT axis for optimal menstrual health
Naturopaths can help support women with menstrual issues by assessing and supporting not only the HPO axis, but the HPA and HPT axes as well. Diet, lifestyle and the addition of natural ingredients are very effective in improving the health of the female reproductive system through support of the OAT endocrine network.2 Some key recommendations may include:
- Stress management: Due to the interaction between endocrine pathways and subsequent effects of stress on HPA/HPO axes, stress management strategies are a key recommendation for menstrual issues.2,3
- Lifestyle strategies: Regular, but not excessive, physical activity, abstaining from cigarette smoking, reducing caffeine intake to no more than one cup of quality coffee per day, and reducing alcohol intake are all proven lifestyle strategies to support the OAT axis.1,2,7
- Weight management and maintaining a healthy body weight and hip-waist ratio are also important.
- Dietary recommendations: There are well-established links between diet and female reproductive system dysfunction, with beneficial results coming from diets high in plant-based foods and fibre; and low in saturated fats, trans-fats, sugar and refined carbohydrates.1,2,7
- Detoxification: Reducing exposure to xeno-oestrogens is critical, as is regular detoxification to remove these from the body.2
- Nutritional Support: Balanced levels of vitamins and minerals are essential to support the normal functioning of the thyroid gland and production of thyroid hormones; protection of the thyroid gland from oxidative damage and inflammation.11,12 Iodine is an important nutrient for the support of healthy thyroid and immune system function.13 The correct form of magnesium is essential for energy, decreasing symptoms of PMS, and dysmenorrhoea,2 while the B-group-Vitamins are critical for healthy thyroid functioning, energy production and a healthy stress response.14
- Herbal medicines are also beneficial for their anti-stress properties. Specific herbs can help improve symptoms of adrenal depletion, while also supporting thyroid health.2,10 Other herbs may help modulate hypothalamic and pituitary function, improve menstrual symptoms, and balance progesterone due to the balancing effect on the HPO axis.2
Helping women regain balance
The OAT axis is an important feedback and interaction system between the ovaries, adrenal glands and thyroid. Dysfunction of this axis can lead to menstrual issues and many woman will never experience true relief from their symptoms unless balance is restored to this endocrinological network. Fortunately, diet, lifestyle, and natural medicines can provide the necessary to support to help patients regain health and balance.
Contact us at True Medicine for qualified advice and guidance regarding your hormones –
call us today on 0468 774 633.
Article courtesy of: BioPractica and the Health Review.