Female Hormones & Menstruation 101
By Stepfanie Romine
Hormones are one of the body’s great mysteries: We usually know that they’re important, we might know that they matter, but we are often not exactly sure what they do or how they impact health and wellness.
Though hormones play an integral role in women’s (and men’s) health 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.
To understand the role that hormones play in the body, first we should look at the menstrual cycle and the normal ebbs and flows of hormones that accompany it. In addition to estrogen and progesterone, there are two other hormones that are related to a woman’s cycle: follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are brain hormones that help regulate ovarian activity. All those hormones and their respective activities throughout the cycle are visible in the chart below.
The menstrual cycle is divided into two sections: the follicular phase (days 1-14) and the luteal phase (days 15-28). The luteal phase coincides with the natural increase of progesterone, as well as a number of 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, as well as 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 as it tapers off by days 4 to 6, estrogen levels begin to increase.
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.)
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, which signals for 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 over the course of 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,” says Mary Bove, ND, the medical educator for Gaia Herbs.
There are many lifestyle factors that support a healthy menstrual cycle:
- A balanced diet that provides an adequate amount of dietary fat
- Regular exercise at moderate levels to support a healthy fat-to-muscle ratio
- A normal body weight
- Adequate sleep in a quiet, dark environment to support healthy levels of melatonin, a hormone that supports the circadian rhythm
- Normal levels of cortisol, a hormone produced by the adrenals that helps maintain a healthy stress response and blood sugar within normal ranges
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 that is 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 response to stress 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 herbs have traditionally been used to support a healthy menstrual cycle. For example, 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. 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 known as vitex, maintains the connection between the brain and the ovaries to facilitate the production of progesterone.
In addition, wild oats and schisandra promote a healthy mood and appropriate hunger levels. These herbs provide overall tonifying support and nutrition for the body systems, and they possess antioxidant qualities. Wild oats and schisandra can also help to maintain blood glucose already within normal ranges.
Adaptogenic herbs such as ashwagandha, rhodiola, and holy basil promote a healthy response to stress, too. By supporting the normal function of the adrenal glands (and their production of cortisol), the adrenals do not need to steal it from the progesterone made by the ovaries.
Dandelion helps with healthy fluid elimination and supports the liver’s breakdown of hormones. By supporting that function of the liver, the body can maintain the normal hormonal balance, which in turn supports appropriate fluid levels. Dandelion also supports the body’s receptors for estrogen, progesterone, and FSH, which promotes normal, efficient use of those hormones.
We hope this blog has demystified the body’s hormones as they relate to normal menstruation. For more information, visit the Tips From Our Doctors section on the Gaia Herbs website.
And now: Stay tuned! This fall, Natural Solutions will be publishing a specialty issue on women’s wellness—focusing on not only hormone health, but also the root of cravings, what it means to live a balanced life, easy-to-implement fitness tips, the best sustainable fashions, and more!
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Selected information in this blog, including sources cited, came from a webinar by Wendy Werner, MD, ABIHM, who is board certified in obstetrics and gynecology as well as in integrative holistic medicine. Dr. Werner is a member of the Gaia Herbs Scientific Advisory Board.
You can view the original blog post on the Gaia Herbs website here.
Mary Bove, ND, the medical educator for Gaia Herbs and a member of the Scientific Advisory Board, reviewed and approved this content.