Preconception Health: Hormone Balance

What does Dr. Suhani look at when it comes to preconception health? During a thorough head-to-toe review of systems during the initial assessment, she will review all of the following areas to ensure they are all in balance + functioning optimally and provide you with individualized treatment recommendations as needed. Remember, the entire body is connected and what affects one system may have a domino effect on estrogen and progesterone downstream and therefore, make it harder to conceive.

Diet
Nutritional status
sleep
Stress
Exercise
Hormones
Environmental toxin and heavy metal exposure
Anything else that comes up...

We will break this down into 3 parts – The basics; Hormones; And environmental toxins. This is a general overview and during the naturopathic assessment, more individualized recommendations will be provided.

If you haven't read Part 1: The basics, you can have a read here!

An adequate balance of Estrogen, Progesterone, and Testosterone are all vital to follicle and egg maturation, ovulation, and maintaining the endometrial lining for implantation. Too much estrogen may contribute to decreased FSH (follicle-stimulating hormone) secretion. FSH is needed to help the egg and follicle mature so this could result in poor egg quality. Too little estrogen may not result in a desired endometrial thickness. Increased testosterone may inhibit ovulation and a sufficient level of progesterone is critical for early pregnancy to maintain the endometrial lining for implantation and minimize miscarriage risk until the placenta starts making its own progesterone.

It is very common for many females to be estrogen dominant meaning they have either too much estrogen or a normal level of estrogen with insufficient progesterone. A sign you may have inadequate levels of progesterone could be spotting before your period. If you aren’t ovulating on a monthly basis and having a period every month, this can be a cause for insufficient progesterone too because most of the progesterone is produced from that resulting corpus luteum that happens after one ovulates! As part of your preconception health screen, we will perform a thorough review of your health to identify any hormone imbalances and comprehensive hormone testing is also offered for a more objective measure for an additional cost.

Signs of estrogen dominance:

Acne
Premenstrual Syndrome a.k.a PMS (bloating, breast tenderness, mood changes, etc)
PMDD (Pre-Menstrual Dysphoric Disorder)
Menstrual cramps
Clots
Heavy flow
Anxiety
Menstrual migraines
Spotting before your period
And more

** Home lifestyle/nutrition tip: If you are having regular periods but feel like you get a lot of breast tenderness, bloating, PMS symptoms before your period, you may want to minimize alcohol and caffeine consumption to allow estrogen to be more readily eliminated through healthy detoxification of estrogens. This is especially helpful in the last 1-2 weeks before your period is due.

Thyroid hormones are also critical to pre-pregnancy health and optimizing your chances of fertility. Suboptimal thyroid hormones can affect the regularity of your cycles and may affect prolactin levels. Above optimal prolactin can affect follicular development and consequently estrogen and progesterone production. A comprehensive look at your thyroid hormones isn’t just assessing TSH but it looks at Free T4, Free T3 and thyroid antibodies. If you are getting your thyroid hormones tested, it is best to get a blood test in the morning and avoid any supplement containing biotin as this can falsely alter hormone levels.

Signs/Symptoms of low thyroid function

Always feeling cold
Hard time losing weight
Constipation
Hair loss/thinning
Weak nails
Fatigue
cold hands/feet
and more

For more detailed info on thyroid health, click here!

Adrenal health and cortisol is another key hormone to look at. Cortisol is secreted in response to a stressor, whether physiological or psychological. That means emotional stress OR inflammation can trigger a rise in cortisol. When cortisol levels increase, this can affect our insulin levels and also our androgen (ie testosterone), estrogen, progesterone, and thyroid hormone levels. The unfortunate thing is that it can take 3 months sometimes for the effects of high cortisol to play out on our other hormones. That means if we experienced more stress in September or October, its manifestations may show up around December. Managing these levels is vital to optimizing preconception health and there are lots of lifestyle strategies + herbal and nutritional supplements to help regulate cortisol levels.

Since 2020 has been a particularly stressful year with a wide range of emotions and frustration, many of us may be experiencing a dysregulation in our normal cortisol rhythm. Perhaps you've also seen a change in your menstrual cycle duration, length, more symptoms so if you are planning to try and conceive in 2021, now is a great time to start balancing those cortisol levels before you head into the burnout phase.