Alison Acerra – Strategic Nutrition Design

The Connection Between Women’s Health, Hormones and Mood

As a nutritionist I knew everything I needed to know about how to eat and move my body in order to have incredible health and vitality. 

Except, I could never quite get there. 

Years of struggle with depression, anxiety, disordered eating and debilitating PMS symptoms – month after month – year after year, always kept me at an arm’s length from living my fullest life.  Never able to translate what I knew from years of education, training and professional experience into practice with any semblance of consistency – I was sick and I was stuck. 

I reached an all time low after nearly falling asleep at the wheel while driving home on the 101 during an evening commute.  It was just 5pm on some Tuesday, but it became one of the most important moments of my life.

This moment is what propelled me to get help.  I found a functional medicine doctor who understood my symptoms and prescribed several functional tests.  One of them, a comprehensive hormone test, called DUTCH, made everything crystal clear.  We found that I was barely producing cortisol, a later stage of HPA Axis Dysfunction, I had elevated estrogen levels in relation to progesterone, of which I was producing barely any and my liver detox pathways were less than optimized. My hormones reflected a perfect recipe for severe PMS and estrogen dominance and my symptoms and struggles should have been no surprise. 

I took a holistic approach to my healing. I used food as medicine as the foundation. I  incorporated self-care routines and rituals in support of my central nervous system and dug in deep with emotional work to heal old traumas.

In my reflection years later, I have come to realize that while my mood had its highs and its lowest of lows… I wasn’t me when I was in the throes of hormonal chaos. 

And neither are you…

Cycling Women and Their Hormones

As women, experiencing the ebbs and flows of our menstrual cycles, how we feel, our mindset and mood are influenced in large part by the state of our hormones. When our production of hormones such as cortisol, estrogen (estradiol), progesterone, testosterone and insulin are too high or too low, instead of feeling joy, we can feel depressed, instead of a sense of peace and calm, we can feel agitated, moody and anxious. Instead of feeling in control of our hunger, we can be overwhelmed by our appetite and intense cravings for sweets and simple carbohydrates. 

We can also experience a host of other unwanted side effects; brain fog, hair loss, digestive issues, hot flashes, painful periods…the list goes on. Chronic expression of these distressing symptoms can keep us from engaging in our health and trigger self-esteem issues, feelings of hopelessness and depression.  If we don’t tackle the root cause of these mood disorders, it may be more difficult to treat them and achieve sustained results.  

What if we approach better mood balance with better hormonal balance?

Healthy Hormones and Mood

Hormones are the body’s chemical messengers. They send signals into the bloodstream that target tissues and cells.  Hormones heavily impact numerous systems and pathways in the body, influencing everything from growth and development, to how we metabolize or process our food, to how we feel, from moment to moment. 

So let’s take a deeper dive into the important sex and adrenal hormones and how their influence on one another can influence our mood and mindset. 

Female Sex Hormones

• Estradiol (an Estrogen):  AKA the ” happy hormone,” estradiol increases levels of the neurotransmitters serotonin and dopamine. (And if you’ve been prescribed an SSRI, you already know the implications of serotonin on your mood!) Estradiol stimulates the central nervous system, enhancing mood and libido and feelings of wellbeing, happiness, motivation and pleasure. 

Can you imagine the effects when estrogen levels fall too low? Depression is all too common with falling estrogen production in the later days of the menstrual cycle, just before menstruation.  Yup…this is PMS. Depression, caused in part by these sharp drops in estradiol also occur in the years leading up to menopause (peri-menopause), in auto-immune conditions and with eating disorders.

• Progesterone: Progesterone is the yin to estradiol’s yang, with an almost tranquilizing effect, inducing feelings of peace and calm. It converts to the steroid allopregnanolone which calms GABA receptors.  Importantly, progesterone production occurs only after ovulation which offers a great explanation for why healthy periods and monthly ovulation (regardless of conception) are critical to stable moods. 

Stress in particular can take a toll on our progesterone levels. During chronic stress, the body is working over-tme to produce cortisol and because progesterone is the precursor to cortisol, when cortisol levels increase, progesterone levels decrease. When progesterone levels decrease in relation to estrogen levels, a condition called estrogen dominance can occur.  It’s characterized by a host of symptoms, including anxiety, irritability and PMS. 

• Testosterone – Generally considered a “man” hormone, testosterone is produced amply in women and levels too high or too low can trigger depression, mood swings, irritability and sluggishness. 

Adrenal Hormones:

• Cortisol:  Sometimes called the “flight or flight” hormone, cortisol is produced by our adrenal glands as a response to stress, whether physical, mental or emotional. Elevated cortisol levels can trigger intense carbohydrate cravings, weight gain (especially around the mid-section), cognition and memory issues.  In regards to mood, high cortisol can induce feelings of overwhelm, irritability and exhaustion – mental and physical. This hormone will even impact our reproductive cycle, telling the body it’s too stressed to be pregnant, leading to anovulation, longer cycles and infertility.  

• Melatonin: This hormone helps regulate our circadian rhythm and induces sleep. At night, melatonin levels should be high, while cortisol levels and the stimulation we feel should be low. Conversely, in the am, melatonin should be low while cortisol shines giving us the get up and go to get out of bed in the morning. 

Imbalances in these 2 crucial sleep hormones can trigger acute wakefulness and anxiety and chronic sleep deprivation. 

Keys to Better Hormonal Balance

1. Balance Blood Sugars: Insulin (another key hormone) resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood, resulting in unstable blood sugars.  As a result, your pancreas makes more insulin to help glucose enter your cells. This condition can lead to estrogen and testosterone dominance and other hormonal conditions like PMS, endometriosis and PCOS. 

What you can do: 

• Prioritize healthy fats and proteins.
• Be sure carbohydrates are fiber rich and incorporate resistant starches.
• Build muscle by incorporating strength training into your routine.

2. Optimize Liver Function: The liver plays a vital role in maintaining healthy hormone balance.  When our liver detox pathways are compromised, instead of excreting excess estrogens they get recirculated back into our bloodstream.  This leads to estrogen dominance and can increase risk for estrogen-related cancers.  

What you can do: 

• While “detoxes” aren’t necessary, we can optimize our detox pathways with good nutrition, including polyphenol rich foods, and cruciferous vegetables and reducing sugars and processed foods.
• Eliminate environmental toxins, e.g. plastics, PCPs, pesticides

3. Manage Stress: Finding ways to release stress and practice self care are essential to healthy hormones and stable moods. 

• Prioritize your rest and practice sleep hygiene
• Take time for the activities you love and enjoy
• Talk it out with someone you trust
• Know your limits, avoid people pleasing behaviors and practice healthy boundaries

4. Reduce Inflammation: Inflammation is a key driver of hormonal imbalances and can send cortisol levels through the roof and impact the health of our gut.  Minimizing inflammation is key to a healthy brain, improving mood and reducing brain fog. 

What you can do:

• Include plenty of colorful fresh fruits and vegetables, nuts, seeds, whole grains and healthy fats.
• Incorporate polyphenols, and plenty of omega 3 fatty acid rich wild salmon, sardines, walnuts, chia and flaxseeds.
• Cook with herbs and spices
• Avoid artificial ingredients, additives and preservatives
• Get plenty of sleep and manage your stress!

5. Check Your Hormones: Functional medicine practitioners commonly use The DUTCH. test to have an eye into the health of your hormones and estrogen metabolism pathways.  DUTCH stands for Dried Urine Test for Comprehensive Hormones and involves collection of a small amount of urine on filtered paper four times a day. The DUTCH TEST measures hormone metabolites from:

• Cortisol
• Cortisone
• Estradiol
• Estrone
• Estriol
• Progesterone
• Testosterone
• DHEA
• Melatonin
• This test also measures cortisol and cortisone rhythms and levels, and estrogen metabolism pathways.

Alison Acerra is a Functional Nutritionist, Health and Lifestyle Coach and principal at Strategic Nutrition Design. She provides 1:1 nutrition coaching and leads The Better Periods Program for women who want to experience transformations in their health including better moods, energy and wellbeing by balancing their hormones. If you are interested in more information including how to work with Alison, please schedule a 1:1 complimentary session to learn more about her coaching program options.