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Female Hormones & Menstruation 101

Published on May 27, 2022


By Mary Bove ND, Medical Herbalist

Mary Bove

Dr. Mary Bove is a herbal advocate, educator, and innovator holds a Doctorate of Naturopathic Medicine, Midwifery Certification and Diploma of Phytotherapy/Herbal Medicine. She practiced Naturopathic Family Medicine, herbal Medicine, and Midwifery for over 30 years, specializing in naturopathic pediatrics, botanical medicine, natural prenatal care and homebirth.

Once full-time faculty at Bastyr University, Dr Bove chaired the departments of Botanical Medicine and Naturopathic Midwifery. Dr Bove is the author of the Encyclopedia of Natural Healing for Children and Infants and co-authored Herbs for Women’s Health.

Mary has been published in many magazines, journals and collaborative books on botanical and natural medicine. She has worked as Medical Educator and in formulation research and product development for Gaia Herbs Brevard, NC, belonging to Gaia’s Scientific Advisory Board for over 35 years. Dr Bove currently consults, lectures, writes, and teaches internationally for Heartwood Institute on the topics of naturopathic medicine, botanical medicine, pediatrics, natural pregnancy and childbirth, traditional food medicine, and mind-body healing.

Female Hormones & Menstruation 101
Female Hormones & Menstruation 101

Hormones are one of the body's great mysteries: We usually know that they're important, and we might know that they matter, but we are often not exactly sure what they do or how they impact health and wellness. Here, we take an in-depth look at female hormones and how they impact menstruation. 

Disclaimer: For this article, the term "women" refers to individuals assigned as biologically female at birth. We recognize that gender identity is a personal and complex matter and do not intend to exclude or invalidate the experiences of individuals who identify differently. We acknowledge and support the diversity of gender identities and expressions.

What Are Hormones?

Though hormones play an integral role in women's health (and men’s) during all life stages, their mention is usually limited to the sex hormones during puberty, menstruation, and menopause, often only in reference to emotional health. 

These undervalued offspring of the body's glands perform diverse functions, supporting everything from hunger levels to the sleep-wake cycle. Hormones promote crucial aspects of health, such as the body's fight-or-flight impulse and programmed cellular death (apoptosis).

Simply put, hormones are the body's messengers. Secreted into the blood, they carry vital information to organs and tissues. When the hormones are functioning normally, the body's systems also function normally. 

Compare the body's complex system of hormones to your mobile phone network. For your device to function normally, you need to be within your network's range or have a Wi-Fi connection, in most cases, but sometimes calls are dropped, you run out of data for the month, or your battery dies.

The hormones with which most people are familiar are the sex hormones, particularly estrogen and progesterone in women. While those hormones tend to get the most attention during puberty, at every point from menarche through menopause, a woman's body is working to keep the hormones in normal balance.

How Do Hormones Affect Menstrual Health?

To understand hormones' role in the body, first we should look at the menstrual cycle and the normal ebbs and flows of hormones accompanying it. Menstruation is one of the processes in a woman's body that is heavily regulated by female sex hormones. 

There are several hormones at play. In addition to estrogen and progesterone, two other hormones are related to a woman's cycle: follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are brain hormones that help regulate ovarian activity. These all play a role in menstrual flow.

Hormonal imbalances can lead to numerous health issues.

These can include:

  • Heavy periods
  • Prolonged menstrual bleeding
  • Severe period cramps
  • Painful periods (dysmenorrhea)
  • Infertility 
  • Missed periods (amenorrhea)

In most cases, these problems can be addressed with a hormone-balancing regimen or medication (such as birth control).

Cyclic Issues Caused by Hormone Activity

Progesterone levels tend to drop at different points during a woman's cycle. This can cause menstrual irregularities such as hot flashes and PMS symptoms. Irregular periods, menopausal symptoms, menstrual cramps, and certain health conditions can also be attributed to imbalanced hormone levels in the body.

For instance, premenstrual syndrome (PMS) is caused by an imbalance of progesterone and estrogen. Beside period pain, it can also cause emotional symptoms (such as irritability or mood swings). 

This is why a woman's health should be closely monitored to ensure her hormone levels are in check. Women should consult their healthcare provider if they experience any menstrual problems or other issues related to their hormones.

How Do Hormones Affect the Menstrual Cycle?

The menstrual cycle is divided into the follicular phase (days 1-14) and the luteal phase (days 15-28). The luteal phase coincides with the natural increase of progesterone and several normal physical and emotional events that are not present during the follicular phase, as the body prepares to shed the lining of the uterus. 

Supporting a healthy response to stress and the body's natural increased demand for progesterone helps support the luteal phase of the menstrual cycle. When bleeding begins on Day 1, hormone levels are relatively low, but estrogen levels begin to increase as it tapers off by days 4 to 6.

About halfway through the cycle (Day 14 in a 28-day cycle), estrogen reaches peak levels, and the reproductive system receives hormonal signals from FSH and LH via the brain. FSH tells the ovaries to ovulate, while LH signals for progesterone to be made. 

At that point, as estrogen decreases, progesterone increases until it peaks during the third week. (Progesterone production is dependent on ovulation. It is secreted by the corpus luteum, the area within the ovary where ovulation has occurred.)

The Role of Women’s Hormones: Estrogen and Progesterone

Estrogen and progesterone work in concert, and they "talk" to each other from one cycle to the next. Estrogen works to lay down the cells in the uterine lining, called the endometrium, while progesterone engorges the tissue to get it plump and ready for an egg to be implanted. 

By the end of the cycle, if pregnancy does not occur, both progesterone and estrogen levels drop, signaling the blood vessels to pull away from the endometrium, causing it to die and slough off. This triggers the body to start bleeding. The cycle then restarts to create healthy tissue for the following month. 

The cycle is continuous- not an arc- with each one influencing the next; maintaining good communication between estrogen and progesterone ensures the cycle continues normally. This continuum means that sometimes balance happens throughout more than one cycle (think of the "carry-over" minutes on your cell phone plan).

"The health and wellness of a woman's endocrine system is very much dependent on balanced hormonal function as one part of the network of efficient communication leading toward a more radiant, healthy, functioning body," said Dr. Mary Bove, ND, a member of the Scientific Advisory Board at Gaia Herbs.

There are many lifestyle factors that support a healthy menstrual cycle: 

  • Maintaining a balanced diet that provides an adequate amount of dietary fat.
  • Getting regular exercise at moderate levels to support a healthy fat-to-muscle ratio
  • Maintaining a normal body weight.
  • Getting adequate sleep in a quiet, dark environment to support healthy levels of melatonin, a hormone that supports the circadian rhythm.
  • Normal cortisol levels, a hormone produced by the adrenals that helps maintain a healthy stress response and blood sugar within normal ranges.

    Hormones and the Endocrine System

    In addition to the normal pathway of making cortisol from scratch, the adrenal glands can shunt progesterone away to produce this stress hormone. This happens because, in the totem pole of the endocrine system, the ovaries (as well as the testes in men) are on the bottom. Reproduction is not necessary for survival, but, for example, the adrenal and thyroid glands are.

    In conjunction with the pituitary gland and the hypothalamus, the area of the brain responsible for the production of many hormones and links the nervous and endocrine systems, the adrenals form the HPA (hypothalamic-pituitary-adrenal) axis. 

    The endocrine system has an axis for each gland in the body to maintain proper communication. The main function of the HPA axis is to support the body's response to normal stress. When the axis includes the ovaries, it is called the HPO axis. 

    When the HPO axis is functioning normally-meaning that the brain, ovaries, and adrenal glands are all communicating as usual-it supports healthy menstruation. The normal function of the body's stress hormones, including cortisol, is to rise and fall quickly. 

    They increase long enough to help get the body out of danger, then return to a low level. Though the levels fluctuate, this is considered normal functioning of those hormones. 

    Supporting a healthy stress response ensures the body is ready for those peaks and valleys, which also allows the adrenals to take the time needed to create cortisol versus taking it from the ovaries (in the form of progesterone) without notifying them. This also supports a healthy estrogen-to-progesterone ratio.

    Herbal Support for Healthy Menstruation

    A number of remedies herbs have traditionally been used in herbal medicine to support a healthy menstrual cycle.* Chaste Tree Berry and Red Clover help support normal reproductive hormone balance.* As such, Red Clover supports normal body temperature regulation and appropriate perspiration levels by promoting the normal production of estrogen. REF#1749

    In turn, the support it provides for estrogen also promotes a healthy mood during the luteal phase of the menstrual cycle.* Chaste Tree Berry, which is also called also known as Vitex agnus-castus and Chasteberry, maintains the connection between the brain and the ovaries to facilitate the balanced production of progesterone and prolactin. REF#1750

    Wild Oats and Schisandra promote a healthy mood and appropriate hunger levels.* These herbs provide overall support and nutrition for the body systems and possess antioxidant qualities.* Wild Oats and Schisandra can also help maintain blood glucose within normal ranges. REF#1751 REF#1752

    Adaptogenic herbs such as Ashwagandha, Rhodiola and Holy Basil promote a healthy response to stress. REF#1753 REF#1754 By supporting the adrenal glands' normal function (and their cortisol production), the adrenals do not need to steal it from the progesterone made by ovaries.

    Dandelion helps with healthy fluid elimination and supports the liver, the organ responsible for breaking down hormones. REF#1755 By supporting that function of the liver, the body can maintain the normal hormonal balance, which in turn supports appropriate fluid levels.* 

    Dandelion may also support the body's receptors for estrogen, progesterone and FSH, which promotes normal, efficient use of those hormones. REF#1756

    We hope this blog has demystified the body's hormones related to normal menstruation.

    REFERENCES:

    • 1. Chen, Y. et al., "Red Clover Isoflavones Influence Estradiol Concentration, Exercise Performance, and Gut Microbiota in Female Mice", Sport and Exercise Nutrition. 2021.. https://www.frontiersin.org/articles/10.3389/fnut.2021.623698/full 1 1. Chen, Y. et al., "Red Clover Isoflavones Influence Estradiol Concentration, Exercise Performance, and Gut Microbiota in Female Mice", Sport and Exercise Nutrition. 2021.. https://www.frontiersin.org/articles/10.3389/fnut.2021.623698/full
    • 2. van Die, M. D., Burger, H. G., Teede, H. J., & Bone, K. M. (2013)., "Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials.", Planta medica, 79(7), 562–575.. https://pubmed.ncbi.nlm.nih.gov/23136064/ 2 2. van Die, M. D., Burger, H. G., Teede, H. J., & Bone, K. M. (2013)., "Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials.", Planta medica, 79(7), 562–575.. https://pubmed.ncbi.nlm.nih.gov/23136064/
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    • 4. Kim, D. S., Baek, H. I., Ha, K. C., Cha, Y. S., & Park, S. J. (2022), "Efficacy and Safety of Omija (Schisandra chinensis) Extract Mixture on the Improvement of Hyperglycemia: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial.", Nutrients, 14(15), 3159. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370295/ 4 4. Kim, D. S., Baek, H. I., Ha, K. C., Cha, Y. S., & Park, S. J. (2022), "Efficacy and Safety of Omija (Schisandra chinensis) Extract Mixture on the Improvement of Hyperglycemia: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial.", Nutrients, 14(15), 3159. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370295/
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    • 6. Lopresti, A. L., Smith, S. J., Metse, A. P., & Drummond, P. D. (2022), "A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (HolixerTM) on stress, mood, and sleep in adults experiencing stress", Frontiers in nutrition, 9, 965130.. https://pubmed.ncbi.nlm.nih.gov/36185698/#:~:text=Background%3A%20In%20Ayurveda%2C%20Ocimum%20tenuiflorum,tenuiflorum%20has%20anti%2Dstress%20effects 6 6. Lopresti, A. L., Smith, S. J., Metse, A. P., & Drummond, P. D. (2022), "A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (HolixerTM) on stress, mood, and sleep in adults experiencing stress", Frontiers in nutrition, 9, 965130.. https://pubmed.ncbi.nlm.nih.gov/36185698/#:~:text=Background%3A%20In%20Ayurveda%2C%20Ocimum%20tenuiflorum,tenuiflorum%20has%20anti%2Dstress%20effects
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