RHR: What Causes Hormone Imbalance?

RHR: What Causes Hormone Imbalance?

by Chris Kresser

Published on

revolution health radio

Hormones don’t go out of balance for no reason. In a healthy, functioning person, hormones will be regulated and operating as they should, so when they are out of whack, it is a sign that something is not working properly.

Conventional medicine uses what we might call the replacement model of endocrinology. This is where you measure hormones — or not, in some cases — you see what’s low or you estimate that hormones are low, and then you replace them with that given hormone. The functional model of endocrinology is fundamentally different than the replacement model or the conventional model, in that we look at the underlying mechanisms that are causing the hormone imbalance in the first place. We’re going to the source of the problem and addressing it at that level instead of just dealing with the symptom, which is the hormone imbalance.

In this episode, we cover:

4:52  The underlying mechanisms that contribute to hormone imbalance
17:52  Four ways to balance your hormones

Play

Steve Wright: Good morning, good afternoon, and good evening. You are listening to the Revolution Health Radio Show. This episode of RHR is brought to you by 14Four.me. If you’re someone who has been listening to this show and you’re still trying to put together all the pieces of great health, maybe you’re still struggling with low energy, a little extra weight right now, digestive issues, acne, or anything like that, you know that Chris talks about the foundation of all health starts with four areas: diet, sleep, movement, and stress. These things can be very hard to create in your life. If you’ve ever tried to create multiple healthy habits at once, they are difficult, and what the 14Four program is, is a step-by-step way to integrate them all at one time. Whether you’ve fallen off the wagon or you want to get on the wagon for the first time, I’d really encourage you to check out 14Four.me and give it a try.

Chris Kresser: Hey, everybody, it’s Chris Kresser. Steve and I couldn’t sync up our schedules this week, so I’m going to be flying solo. This week we have a great question from Susan, so let’s give it a listen.

Question from Susan: Hi, Chris. I really enjoy your podcast, and I’d like to ask a question. This is regarding a 12-year-old girl who started her period and is having really bad menstrual cramps to the point where she can’t go to school and a lot of irregularity. She went to a physician, and they put her on birth control pills to help regulate her, and I’m wondering if there’s a better solution, something that’s not quite so, you know, added hormones or something more naturopathic. Anyway, thank you.

Chris Kresser: OK, thanks, Susan, for sending that in. This is yet another good example of how conventional medicine and functional medicine are fundamentally different. Conventional medicine uses what we might call the replacement model of endocrinology. This is where you measure hormones — or not, in some cases — you see what’s low or you estimate that hormones are low, and then you replace them with that given hormone. So if estrogen’s low, you give estrogen. If progesterone is low, you give progesterone. Likewise, if a particular hormone is high, you might give something to suppress that hormone, sometimes another hormone or sometimes something completely different.

In this situation, the symptom is dysmenorrhea or an irregular menstrual cycle, and in this conventional replacement model of endocrinology, what they’re doing is giving her hormones to regulate her cycle. There certainly may be situations where this is helpful, but here’s why I don’t think it’s a good idea: It doesn’t really fix the problem. And beyond that, it can actually make the problem worse because it suppresses the natural regulatory feedback mechanisms that lead to proper hormone production. And then, of course, there are also side effects that are associated with these drugs. Birth control pills are associated with numerous problems, some of which, ironically, are more likely to make hormone imbalance worse. For example, birth control pills can deplete zinc levels, magnesium, B6, and a whole bunch of other nutrients, especially when they’re taken over the long term.

But the most important question here is, what caused the hormone imbalance in the first place? That’s really important because hormones don’t just go out of balance for no reason. In a healthy, functioning person, hormones will be regulated and operating as they should, so the fact that they’re out of whack is a sign that something is not working properly. This is where we turn to the functional model of endocrinology, which is fundamentally different than the replacement model or the conventional model, in that we look at the underlying mechanisms that are causing the hormone imbalance in the first place. We’re going to the source of the problem and addressing it at that level instead of just dealing with the symptom, which is the hormone imbalance.

The underlying mechanisms that contribute to hormone imbalance

I’m going to talk about four or five of the major underlying mechanisms that I see contributing to hormone imbalance in my practice and also in the scientific literature. And then at the end, I’ll make a few basic recommendations. Of course, if you understand the mechanisms that contribute to hormone imbalance, then you can pretty much figure out what to do about it by addressing all of the various mechanisms that I mention. If we went into great detail on all of that, it would take several hours instead of 25 minutes that we have, but hopefully this will be a good overview to get you started.

We’ll start with the gut, as we often do. You’re probably tired of hearing at this point about how the gut contributes to virtually every modern chronic health problem, but it’s true and this is no exception. There are several studies that tie, for example, the microbiome to hormone balance. There’s even a term that was recently coined called the estrobolome, which refers to the complete set of bacterial genes that code for enzymes that metabolize estrogen within the gut. In other words, your gut flora can either predispose you to having excess estrogen or estrogen deficiency, based on how certain species of bacteria in the gut metabolize estrogen.

Another mechanism would be that dysbiosis increases levels of certain estrogen metabolites that are inflammatory and proliferative. In women, they can increase the risk of breast cancer. In men, they can increase the risk of prostate cancer. And then dysbiosis would also decrease the more protective estrogen metabolites.

Dysbiosis, of course, can promote intestinal permeability, which in turns leads to inflammation, which then disrupts hormone balance in several different ways.

That’s just a really high-level overview. There are several more mechanisms, actually, within the rubric of gut pathology that we could talk about, but as you can see, just those alone could be a significant issue for many people.

The next group of mechanisms would be cortisol dysregulation and HPA axis dysfunction, so hypothalamic-pituitary-adrenal axis dysfunction. This is relatively easy to understand because the hypothalamus and the pituitary are the glands that regulate all hormone production in the body, including adrenal hormones and sex hormones. So if you have an imbalance in that axis, then, by definition, you’re going to have a problem with sex hormone production or adrenal hormone production or thyroid hormone production.

Cortisol, as I’m sure you know by now, is the hormone that’s produced in the stress response, and if we’re under a lot of stress or continual stress, that can lead to high cortisol levels, and high cortisol can cause hormone resistance. This is when the cellular receptors to hormones that are on the outside of all of our cells become less sensitive to the effect of that hormone, and then the hormone can’t activate the transcriptors and do what it’s supposed to do in the first place. The hormone levels in the body could be normal, but if the receptors are insensitive to those hormones, then there’s going to be a problem. I’m sure you’re familiar with this concept with insulin resistance. That’s where the cells become less sensitive to insulin, and then the body might make more insulin in order to try to overcome that, and you end up with a situation where insulin levels are high but the cells aren’t sensitive to it, so you get rising glucose levels.

Problems with the HPA axis and cortisol can also lead to intestinal permeability or leaky gut, which causes all of the problems that we just talked about in the gut.

When the stress response is active, pregnenolone, which is the precursor to all hormones in the body, gets channeled into the cortisol pathway and away from the production of sex hormones, like estrogen. This is something that’s often referred to as the pregnenolone steal in the functional medicine world, and that can lead to low estrogen levels over time.

Another mechanism would be insulin and leptin resistance and problems with blood sugar regulation. One of the primary causes of this, in turn, would be poor diet or lack of exercise, inadequate sleep, and these things are all a lot more common these days in 12-year-olds and preteens and teenagers. I’ve read some pretty disturbing studies lately about how little sleep kids of that age are getting, which is really sad because kids at that age need even more sleep than we need as adults. It’s a very important developmental time. But with the intrusion of electronic devices into the bedroom and sleeping area, kids having their phone by their bed and getting text messages all night, using devices like phones and tablets late at night before bed, which emit blue light and suppress melatonin production and interfere with their circadian rhythm, is leading to an epidemic of sleep problems in that age group, and I think we’re seeing a lot of health consequences as a result of that.

Insulin resistance can also lead to high cortisol levels, so that, of course, contributes to everything that we just talked about when we talked about cortisol and the HPA axis just now.

Insulin surges can upregulate the production of an enzyme called 1720-lyase, which in turn leads to higher testosterone levels. This is a very common phenomenon in the US and the industrialized world. It’s one of the common causes of PCOS in women and a common cause of infertility, but, of course, it can cause just garden-variety hormone imbalance and dysmenorrhea as well.

Liver detoxification is another important mechanism. The liver plays an important role in the detoxification of hormones. If phase 1 or phase 2 of the liver detox process is compromised, then hormones will be only partially metabolized or broken down. These partially metabolized hormones don’t activate the receptor sites or initiate the cellular response like the fully active hormones do, but they actually would compete with those active hormones for receptor binding sites and throw off the normal regulatory feedback pathways. So they’re kind of like “Frankenhormones” in the sense that they don’t do what they’re really supposed to do, but they look enough like normal hormones that they interfere with receptor binding of those hormones and the feedback pathways. So the end result is a patient that has hormone imbalance symptoms but labs that actually might appear to be somewhat normal.

All of the enzymes that are important in the various phases of liver detoxification require nutrients as cofactors, so nutrient deficiencies from a standard American type of diet, which is really high in calories but low in nutrients, could certainly impair detox capacity, but so can exposure to a wide range of environmental toxins like heavy metals, mold, volatile organic compounds, pesticides, and other chemicals, like BPA, which have become ubiquitous in the environment.

Methylation, which is something we’ve been talking about a lot recently on the show, is crucial for proper detoxification, and as you now know, impaired methylation due to genetic and environmental causes, diet and lifestyle factors, is somewhat common and a really important thing to address.

The last mechanism that I want to talk about is essential fatty acid metabolism. These are the polyunsaturated fats. Alpha-linolenic acid is the essential fat on the omega-3 side, and linoleic acid is the essential omega-6 fat, but then you have the longer-chain derivatives of these, EPA and DHA on the omega-3 side and arachidonic acid on the omega-6 side. The reason these are so important is that essential fatty acids influence prostaglandin production, and prostaglandins modulate hormone receptor site sensitivity and the proteomic response that happens when a hormone binds to the receptor. Too much omega-6, for example, can lead to altered hormone receptor function, and this omega-6 linoleic acid is found in industrially processed plant oils, like soybean and corn oil, safflower, sunflower. These are oils that are typically found in processed and packaged foods, chips, anything fried, a lot of restaurant foods, but certainly most foods that come in a bag or a box, which comprise a disturbingly large percentage of calories for the average American. And EPA and DHA are found primarily in cold-water fatty fish and shellfish, and a fairly large percentage of people are not eating enough of this preformed EPA and DHA.

Now, in theory, alpha-linolenic acid, the plant-based omega-3 essential fat, can be converted into DHA, but that conversion is very inefficient. Less than one half of 1% of alpha-linolenic acid gets converted into DHA in most people. And too much omega-6 fat in the form of all of these processed and refined foods that are so common in the standard American diet actually reduces the conversion of ALA, alpha-linolenic acid, to DHA. So what happens with all of that extra omega-6 is that when the hormone binds to the receptor site, the proteomic response that is supposed to happen is either diminished or exaggerated, and that can cause problems related to hormone excess or hormone deficiency.

If we tie this all back to another issue, which is blood sugar and insulin, it’s worth pointing out that insulin resistance decreases the conversion of alpha-linolenic acid to EPA and DHA.

So we’ve talked about five of these mechanisms, and as you can already see, they’re not separate. It’s kind of like a perfect storm. They all contribute to one another so that if you have cortisol and HPA axis issues, that’s going to interfere with insulin and leptin signalling, which in turn will make your gut lining more permeable and lead to inflammation in the gut, which in turn leads to higher cortisol production, which leads to more insulin and leptin resistance, which interferes with liver detoxification, which can lead to a buildup of excess hormones, which — You get the picture. It just goes on and on and on. This is why it’s so crucial to address these underlying problems because if you don’t, just taking hormones, as you can clearly see, is not going to address all of these issues, and it should be also somewhat obvious how it could even make them worse, which is unfortunately why we see a lot of women in the clinic who have been on birth control pills for a very long time, not necessarily for contraception, but to regulate their cycle, and are having a ton of side effects and symptoms related to that, and they want to get off the pill, but it’s extremely difficult to do so, and it can take many months, if not years, to fully unwind all of the pathology and symptoms that were caused by being on the pill for that long.

Four ways to balance your hormones

There’s more to look at and talk about here, but I don’t want to go on for too long. These are among the most important steps that we would look at in the clinic. And I know it’s a lot of information and fairly technical, so let me, again, boil it down into a few basic recommendations.

The first is something we always talk about, which is eating a nutrient-dense, antiinflammatory diet. We talked about how the cofactors for enzymes in the detoxification process and also in conversion of the essential fatty acids into the longer-chain derivatives like EPA and DHA require certain nutrients, and it’s also true that for insulin and leptin signalling to work properly and the adrenals to function properly and the gut to function properly, we need those nutrients as well. So making sure we’re eating a very nutrient-dense diet and we’re avoiding some of the modern foods that can provoke oxidative stress and inflammation, like excess refined sugar, excess refined flour, some of the industrial plant oils could be inflammatory, some artificial ingredients and things like that, that’s a really good starting place. A paleo type of diet or a paleo-template type of diet is a great way to get started with a diet like that.

The second is to manage your stress. This is important not only for adults, but also kids. The methods might be different for a kid or even a 12-year-old versus an adult, but it’s really important. It’s a stressful time of life. There’s a lot going on, a lot is changing, and as we just discussed, problems with cortisol and the HPA axis are probably primary in a lot of these hormone imbalances, so it’s really important to do this sort of thing and talk about this with your children. It’s pretty fun. Both my wife and I are long-time meditators, and when we’re doing our meditation practice, sometimes Sylvie will just come and sit in our lap. She’s about 4 years old now, so she doesn’t sit for a long time, but I’ve been pretty surprised at times by how long she’ll sit there and just be quiet and sit with us. So I think these are things you can introduce to your kids. Certainly just spending time outdoors, having fun, laughing, watching funny movies, for example, taking walks on the beach, developing hobbies. A lot of the same stuff we talk about for adults is definitely relevant for kids, but I think it’s easy to overlook that with kids, and they’re so busy and so overscheduled these days that it can be hard to fit it in, but it’s really, really crucial.

Next would be getting enough sleep. We already talked about some of the threats and challenges in modern life to getting enough sleep, and this is, I think, especially dangerous for kids when they’re still developing. Their HPA axis is actually still developing, so the amount of sleep, as I said, that they need is even greater than adults. Most kids at that age around 12, I think, need about 10 hours of sleep ideally, and I think very few are getting that much, so that’s important.

And then exercise. You want to do just the right amount — not too much, not too little. Overtraining can certainly interfere with hormone balance, which is why amenorrhea, just lack of a menstrual cycle at all, is a common thing that you see among women who are training really, really hard. But not getting enough exercise, too much time sitting, which is pretty common now with kids sitting all day at school and then sitting at home doing homework, it’s really important to encourage them to move their bodies and create opportunities for them to do that that are fun so that they don’t look at it as just another chore.

These shouldn’t be surprising that the four kind of pillars of health that we often talk about, they’re the basis of my 14Four program, which you can check out at 14Four.me. We’ve actually had a lot of kids and teenagers go through the program and get a fantastic response. They really love it, and they seem to respond really well, so you could have her check that out as an entry point. But if these steps aren’t enough, I do think it’s worthwhile to seek out a functional medicine practitioner. They can do some testing to figure out where the source of the problem is. They can also prescribe herbs, botanicals, and other nutrients that can promote healthy estrogen balance. If you do a little research, you’ll probably come across herbs like vitex or chasteberry, which can definitely be useful in some situations, particularly for adults, but may not be a good choice for girls under the age of 18 because, as I said before, their HPA axis is still developing. We might be somewhat concerned about the effects that vitex might have on regulatory feedback, but I think it could be used in some cases under supervision.

Susan, I know that was a bit of a firehose of information, but I hope that some of that was helpful for you, and if you can implement those four steps that I talked about — the nutrient-dense diet, managing stress, getting enough sleep and exercise — hopefully that will do the trick, and if it doesn’t, maybe pay attention to some of the mechanisms that I talked about more specifically and seek out a good functional medicine practitioner that can help.

OK, everyone, thanks for listening. I’ll be back next week with Steve, and I’ll look forward to talking with you then.

48 Comments

Join the conversation

  1. Hi, i’m 15 turning 16 in few months, I’ve had bad hormonal acne for about 5 months now and it won’t get better. Its very stressful since i’ve tried almost everything but it still won’t go away. Any tips?

  2. I’m taking contraceptive pill like for 4 years now as the obgyne told me so it will balance my hormones and if I stop it I don’t see my period and I have lots of blind pimples on my chin and some on the other areas of my face…
    I really want to stop taking pills but….☹️how? Coz the pimples will appear…
    Help me..

    • I forgot to mention Magnesium glycinate (Bulk supplements carries it for a reasonable price.) I take 400-800mg per day. Cod liver oil provides Vitamin A and D which should improve your skin. For pain see Chris Kresser 4 natural substitutes for aspirin.

    • Are you eating enough? Maybe a thyroid problem. Try Chef AJ’s diet. See You Tube. If you want add meat or eggs but sparingly. Maybe eat meat/eggs/fish only 1-3 times a week. Have you tried cod liver oil? Avoid dairy.

    • Organic Chasteberry (also called Vitex). I would try up to 1000mg of this per day per a previous comment. She also uses 2 teaspoons of macs powder per day. If one doesn’t work try or add some of the other.

  3. Hi all, I have just been reading all your comments and would like to add that I have experienced most of what has been discussed, over the years. Finally, at the age of 45 I discovered my remedy – Vitex 1000mg/ day, and Macca 2 heaped teaspoons of powder/ day. I am now 49 and have
    – no more heavy bleeding or sever pain( had that since a teenager)
    – still having some periods
    – no signs of menopause( blood test one year ago suggested hormone levels non menopausal)
    – no insomnia
    – no irritability
    – more energy
    – no depression ( had severe post natal depression with last 2 children)
    – no bloating etc or IBS symptoms anymore
    – my iron levels had stabilised( I had to have an iron infusion 2 years ago)
    – my teenage daughter was having painful periods. She takes Vitex periodically and it has fixed pain and helped with mood swings
    – generally feeling better than I have since a young teenager
    I stopped taking the pill after my second child as I realised it changed my moods and outlook on life considerably (not that any Doctor would admit that the Pill could cause such symptoms!), and have used natural birth control for the past 19 years.

    I wish I had found out about these herbs earlier. It appears that Macca being an adaptogenic herb targets everybody in different ways, only sending nutrients to the parts of the individual body that need it. It took about 3 months, and I slowly started to feel better. Thought it might be worth a try for many of you as in my experience these 2 herbs combined help with many symptoms. Best wishes. Kate

  4. I get a little frustrated about all the hormone podcasts and talks when no one addresses the safest way to deal with surgical menopause. What are we supposed to do in that case? That is a huge issue for so many women but no one talks about it.
    Very frustrating.

  5. I too started my periods early in life. They were extremely heavy for a 10 year old kid. I was an active kid, walking over a mile to school and walking back, riding bikes, and riding the horses every day.
    The well meaning doctor put me on birth control pills to help regulate my periods. I would miss two days of school every month, my flow was so heavy I started using tampons & pads. I couldn’t get thru an hour before I would have to be visiting the bathroom. Teachers were not very accommodating either chastising me for disturbing class with request to be excused.
    So in the last 46 years the treatment for girls who had problems with their periods hasn’t changed. By putting me on the pill at such a young age all my upward growth virtually quit and the weight problems started.
    So I would not under any circumstances except for birth control purposes put my young daughter if I still had one on birth control pills to regulate her periods.
    I was, by the age of 14, able to get the weight under control.
    So when I was 14 I weighed 108 pounds but my pain with the monthly periods was out of control. I was then diagnosed with Endometriosis…not the large cyst type but the small cyst that invaded nearby organs and intestines.
    The cure…was pregnancy but since I was 14 that was out of the question so they put me on high levels of hormones to stop my periods. I was up to 80 mg of Enovid a day by the end of my 10 months of treatment.
    Needless to say I felt like crap, missed a year of school, gained weight that I have never seemed to be able to lose. I went from being active, slim & trim, to puking daily, sluggish, fat, couldn’t wake up until the afternoons, and our family had to move because the small community was relentlessness with their snide remarks and rumors as to what was wrong with me.
    My dad was a minister in the community and he was even asked by the church officials for him to step down as pastor of the church because of the whole ordeal…so he resigned his post and moved the family to a different town.
    This of course led him to blame me for his downfall… To this day I won’t have any thing to do with religions or their churches and not so much because of growing up in the church as I finally wised up to the sham of religion.
    After my parents divorced, I dropped out of school and got married. I did actually manage to get pregnant after two years of marriage, at which time my husband was killed on the job, so I raised our daughter by myself, and she is 35 years old now.
    I had to have a complete hysterectomy at the age of 40 due to the ever advancing return of the Endometriosis. I sure wasn’t going to go thru the nonsense of the Pill therapy again and being 40 and widowed I sure didn’t want to reproduce again either. Getting pregnant with the Endometriosis in the advanced stage that it was in sure wasn’t going to happen either.
    Thru all of this my Thyroid quit in my late 20’s…so I’ve been on Synthroid ever since but depression plagued me until one doctor said why not try dessicated Thyroid meds…and what a difference. I was able to quit taking the antidepressants that I had taken for over 25 years…but the weight still will not come off.
    The only type of diet that ever worked for me was Atkins but getting back to the frame of mind to do that has been very hard for me.
    I guess I just need to care enough to want to do something about changing my eating habits enough to stay with this type of program.
    If I get tired, I want or crave carbs, chocolate, and sugar which is something that I don’t normally eat. In order not to be tempted by these types of foods I stay home and just refuse to go to town to a store.
    I raise my own free ranging type pork, beef, chicken, and eggs. When the animals aren’t out grazing they get organic alfalfa hay and minimal grains to balance out their food rations.
    I am now on a drug called Contrave and I am not entirely sure I care for the drug.
    I’ve had a number of stressors the last 4 to 5 years that have proven very hard to deal with (my parents & step parents all died within 9 months of each other)…the only thing that makes me walk out of my door every day is that the animals must be fed & watered. I’ve given up the farm ground, irrigating, and riding horses the last 5 years. I had a couple of injuries injuries at work that cascaded into a number of work related (semi truck driving) problems like 2 bulging disk in my neck and 3 in my lower back, a torn meniscus in one knee, and the development of a painful bunion on one foot because of the misalignment of my leg.
    And to top all of this off I haven’t cleaned house in the last 5 years and the place is a friggin mess. My leg because of the pinching of nerves wants to lock up if I do certain movements like leaning forward over a counter to do dishes or scrub the counter tops.
    At one time I had 40 sows and raised 600 weaner piglets a year, irrigated and put of 40 acres of alfalfa hay, and drove semi truck. I would get up change the fields of water, go get in the truck by noon, drive 500 miles, drop the load, go to sleep, get up, load the truck, and be back home by 12pm the next day, come home change my fields of water, and do the same thing all over again the next morning. Plus I would find time to ride horses…now I am lucky if I get the animals fed. I am down to 8 sows, leased out the farm ground, and don’t ride anymore because if I lean forward my leg spasms and locks up and due to all the driving my hand strength gives up and I just drop the reins. And I can no longer do my own mechanical work on my vehicles because of the lack of strength in my hands. I have to wear popup splints at night or when I wake up my hands are numb.
    I am hoping that if I can get this weight off that much of my back issues will subside without surgical intervention. Of course with no medical insurance surgical intervention is out of the question.
    I live on Aleive and I used to take hydrocondone but had to quit that when I went on the Contrave. I do take HTZD oddly enough it prevents the migraines that used to plague me, I take Nature Thyroid, Turmeric supplements, MSM, bioperine, melatonin, cranberry supplements for bladder health (a problem that truck driving gave me), Vit B complex, and sometimes I take Avocado oil & coconut oil capsules.
    So what would I get if I signed up for the 14four program? Money is tight…so I haven’t been real willing to shell out $49.00 without knowing what the program entails.

    • hi Dawn
      I just read your story.Im s moved.l had hormonol imbance and ended up with ovarian cyst and endometriosis Im a prayerful woman.I took my medicine and prayed and God healed me after terrible pains in my abdomen and back.You story has moved me so much.I will pray for you caroll.

      • If I thought that praying to some mythical God was going to cure my ills I would have done so a long time ago. I have never believed that burning bushes would do anything but emit smoke into the air, or that snakes could talk, or that a 500 year old man could build a big boat that would hold two of every creature, or that 2 penguins walked from the far poles of this spherical earth just to get on a large boat with promises of survival (who knows maybe they were picked up on the way as the boat floated, and then rest of the worlds population sprung from just Noah’s family, and if only one believes they will have everlasting life.
        So if you want to then tell me that the New Testament over rides the Old Testament then please throw out the Creation Story, the 10 Commandments, and the Psalms that so many are in love with…ya nope I don’t buy any of it.
        But hey if this is the crutch that you need to tell yourself that you are better after praying then go for it. I will rely on Science (certainly not western medicine either) , eating right, my mind, and what my body tells me that I am doing right or wrong.

  6. A great overview of the many factors to look at and address, however I think it should be mentioned that it’s absolutely normal for hormones to be out of whack for the first several years after the menses begins. The system is ramping up for reproduction and it doesn’t simply turn on like a switch. Yes, it’s sensible to address every single factor Chris mentions, but I also think we should be a little tolerant of some of the symptoms women experience both at the start of menstruation in our teens and at the end of it in our forties and fifties. We can do what we can naturally to ameliorate some of the symptoms but we should also be teaching that a certain amount of hormonal imbalance at these stages in life is absolutely normal.

    • Yes I agree with Mel, changes are normal (within reason). I can’t say it any better than Mel did. I just want to emphasize it.
      Hormones change, but what we need to be concerned about is when they are “out of Whack” – in the extreme one way or another, or when they stay stuck in one extreme. Fluctuations are a normal part of life. I don’t think it’s the goal to stay at one balanced point and never change. But instead to gently move side to side of the balance point in response to life’s changes.

  7. Within 3 months of starting to supplent with vitamin D3, my debilitating painful periods stopped. I had been struggling with them for 13 years. I now tell anyone suffering to get their vitamin D levels checked…my results showed I was at the lowest end of ‘normal’.

  8. All great ideas but did absolutely nothing to address menopause and peri-menopause. The body wants to cease production of female hormones and you often can’t exercise or eat your way out of that.

    • I agree Mandy. I wrote in to Chris some time ago asking about hormone imbalance that comes with menopause (natural or surgically induced) and have been patiently waiting. Are we supposed to just endure the loss of hormones (hot flashes and lack of libido) or is supplementing (bio’s of course) helpful when we are dropping in them anyway as we age? Very confusing subject….

      • I see no reason to ‘endure’ rapid and permanent drops in our female hormone levels. After all, we want to remain women, not feminized males. When my female hormones are at pre-adolescent levels I am NOT happy.
        I had hot flashes every day every 15 minutes or so..and night sweats. Now it’s terrible vaginal dryness, urinary leakage, along with multiple other symptoms. .I went on hormones and will never go off them. They help me sleep, help with the symptoms listed above.
        Some suggest soy but unless you go organic and eat a lot of it, it simply doesn’t work for the horrid symptoms, at least for me. I think men don’t get this and they don’t get that we have two very important female hormones- estrogen AND progesterone. And our balance of hormones is further complicated by body mass, diet, having a uterus or not, having two kidneys or not, etc.
        I would love to know if Chris can figure this one out since he doesn’t have the same equipment and he’s still rather youthful.

        • I controlled my hot flashes & pms symptoms thru changes in what I ate.
          I absolutely refused to take these extra hormones when I got spayed because everyone I know that took them ended up with breast cancer…
          I got what I needed which was control of symptoms thru dietary changes.
          If I had known what I know now then the spaying may not have even had to of taken place.

    • I agree! Chris, please address menopause, particularly hot flashes and insomnia. At 51, I am doing everything right (in terms of diet, supplements and exercise) but still struggling with these.

    • DIM is amazing!!!! Has changed my life- massive full body pain due to excessive inflammatory estrogen metabolites– it opens up the pathway to get rid of these metabolites.
      Can be used for menopausal women too.

  9. What if we have been doing these 14four practices for months or even a year and have seen no changes in hormone balance?

    I still have adrenal fatigue and delayed periods with some PMS symptoms (crazy water retention and bloating). My transit time is slow, possibly also contributing to bloating through the month.

    I currently eat a gaps-ish paleo with maybe a 95/5 split, rare cheats are usually just added sugar/legumes/nuts or a restaurant meal, no gluten/grain/etc. I’ve tried antimicrobial protocols (generic and non-keto candida-specific), glutathione/mthf-boosting detox protocol, and elimination diets. I relax, say no, do gentle yoga and walking, chew my food, go to sleep at 10-11pm every day, use affirmations and gratitude, cultivate meaning/purpose, etc. I eat resistant starch, fermented foods, glyceine, cod liver oil, supplement wisely, etc.

    Is it just a case of waiting several years? Am I doomed to have wacky hormones forever because I’m just overly sensitive to stimulus?

    • Have you tried High Intensity Interval Training, 2-3 times a week, 10-14 minutes total time involved on the days you do it. I rotate running and kettle bells. Other days I do 15 to 45 minutes of an advanced Pilates CD (Stott pilates, advanced Matwork 3rd edition. Last I looked it was about $50.00, expensive but worth it!) Kettlebell program is free on you tube: “Kettlebell HIIt Workout-Fitness Blender HIIT Kettlebell Training”. It’s fantastic. Start with 8-10 pound kettle bell. For pain google Chris Kresser NSAIDs substitutes. Other than that try a plant based diet like Chef AJ’s (see You Tube). She recommends eating 2 pounds of cooked greens to start the day off. If you want to add meat or eggs do so but try to limit it to once a week. See Dr. Greger on Nutritionfacts.org. Eat a beet a day. Eat a tablespoon of flaxseed or chia seed. Walk with weighted vest (Start with 2 of the 20 one pound weights ands work up to twenty. I now walk with 40 pounds. (I wear one vest over the other. I use neoprene exercise belt to keep the vests from weighing down my shoulders). Why not try consulting with Chris Masterjohn. I think he knows a lot and can steer you in the right direction. He also appears to be a very decent guy as does Ray Peat. (Although I must admit I don’t agree with the sugar and ice cream theory. Also orange juice is about as healthy as soft drinks if you ask me. Eat fruit!)

  10. What alternatives do men have to HRT? There are tons of ads for men’s clinics that push testosterone shots, pellets, etc., but are there more natural ways of getting there?

  11. Very common complaint in patients with lower back issues, I’ve had hundreds if not thousands of women comment on how their periods are better after correcting their spinal imbalances. Just another option to consider.

  12. You wright that insulin resistence can also lead to hight cortisol, I eat a ketogenic diet. Is it bad for me? Haven’t had menstruation in 3 years after quitting the birthpill. I have read that ketogenic lifestyle also can make you insulin resistence. Do you need carbohydrates if you have hormononal problems?

  13. Hi you mention Fatty acids in your article I have a high loss of faecal Long chain fatty acids in my recent stool analysis but am finding it difficult to know where to find more info on the subject and how it is effecting my overall health situation. Could you possibly help. Thank you

  14. I have spent the last 4 years getting my 4 pillars of health in check, and have been feeling amazing! The best in my life! Until this year… BAM! Perimenopause. And now it’s all pear shaped.

    I’m 42 and suddenly I’m having flooding periods, weight gain, and sleep issues (apnea) due to my nose being constantly dry and blocked.

    I’m considering pregesterone cream just because I don’t know what else to try. Diet was clean Paleo, sleep was good, stress was low. My life was amazing.

    Now I’m sleep deprived stressed and waking up every night gasping for air.

    Hormones suck.

    • Try sea spray for your nose. I buy it in France but I would think it’s sold in many countries’ pharmacies.
      I take progesterone 100 mg and E

    • Lucy, this is the time that it’s important to get a specialized supplement protocol going. After identifying your exact hormonal imbalances, it would be good to look at your options for some hormonal support including adaptogens.

  15. Susan,
    if this child has heavy menstrual cycles, then I highly recommend calcium d-glucurate. This is summary (actually an abstract from a pubmed publication):
    Calcium-D-glucarate is the calcium salt of D-glucaric acid, a substance produced naturally in small amounts by mammals, including humans. Glucaric acid is also found in many fruits and vegetables with the highest concentrations to be found in oranges, apples, grapefruit, and cruciferous vegetables. Oral supplementation of calcium-D-glucarate has been shown to inhibit beta-glucuronidase, an enzyme produced by colonic microflora and involved in Phase II liver detoxification. Elevated beta-glucuronidase activity is associated with an increased risk for various cancers, particularly hormone-dependent cancers such as breast, prostate, and colon cancers. Other potential clinical applications of oral calcium-D-glucarate include regulation of estrogen metabolism and as a lipid-lowering agent.

    She might have dysbiosis, increases beta-glucuronidase activity. Beta-glucuronidase disrupts estrogen detoxification, leading to higher estrogen levels and heavy menstrual cycles. It is my personal experience that calcium-d-glucurate reduces heavy bleeding, reduces constipation, and improves acne-prone skin.
    I’ve tested a few brands, and I believe the most effective is Natrol, which also happens to be the cheapest at iherb.com.
    Good luck!

  16. Hey Chris,

    I’m a 38 year old healthy male, very active and follow a pretty strict paleo diet. I started noticing symptoms of lower testosterone when I was 35 and I’ve struggled with the symptoms ever since. For unexplained reasons I’ll notice that my T levels seem higher after doing nothing different. I’m certainly under more stress currently, but there was nothing unusual going on at 35 when the T levels drop. There seems to be no rhyme or reason to the ups and downs. Any thoughts? Thank you.

  17. Chris, do you think excessive chlorine exposure could be a contributing factor to hormone imbalance? I have had irregular and very painful periods since I was 12, and I’m now 26. I was a competitive swimmer as a child, which meant I was in the pool nearly everyday all year round. I’ve always wondered if that daily chlorine exposure has contributed to my current health problems (hormonal imbalance, acne, gut problems, etc.). Thanks.

    • otoh, I was a long distance swimmer in high school which meant a lot of time in a chlorinated pool.Rarely had painful periods, sailed through menopause… which isn’t to say all that chlorine isn’t bad for us… just that as with everything in health it seems mileage will vary.

    • Julie, I’ve had several clients who were competitive swimmers that dealt with hormonal disruption as identified by functional lab testing.

      Also, Catherine Garceau, an olympic swimmer has appeared on my podcast and talked about her health destruction that occurred from the excessive swimming in chlorine.

      There are ways to fix this though, but, yes, it’s real.

      • Thanks, Evan! I’m going to check out your podcast and website to get more resources on this. I appreciate it!

    • Chlorine can disrupt iodine uptake to the thyroid and also iodine is needed to downregulate estrogen receptors in the breast for example.

Leave a Reply