The female body definitely has a daily, monthly, seasonal hormonal rhythm–and problems arise when those natural rhythms are ignored, neglected, silenced, overpowered, or disconnected from environmental cues. A good example is the environmental cue of the light/dark cycle of each day. When you are disconnected from bright natural light in the morning, your sleep hormone melatonin is lower and you may not sleep as well that night. Using screens at night, like a smartphone or binge watching your favorite TV show, can further lower melatonin, especially within one hour of going to bed. If you don’t sleep well, the stress hormone cortisol is higher that day, making you more likely to feel irritable and to crave sugar and other carbohydrates.
Hormones are chemical messages, like text messages sent from an endocrine gland through your blood to target cells. Hormones influence your behavior, emotions, brain chemicals, immunity, and metabolism. When your hormones are in balance, you look and feel your best. But when they are imbalanced, they can make your life miserable. You can feel lethargic, irritable, weepy, grumpy, unappreciated, anxious, and depressed. The message from most conventional doctors is that it is normal to feel like this as you age and that you should just accept it. As a functional medicine doctor specializing in women’s hormones, I can assure you that it’s not normal. You can balance your hormones and get back to feeling vivacious and genuinely content.
Another example is being of reproductive age, and working too hard at your job, slogging lattes, racing from the office to Soul Survivor for an hour of all-out spin, and then wondering why you can’t get pregnant. The control system for your hormones, the hypothalamic-pituitary-adrenal-thyroid-gonadal (HPATG) axis, can’t be fooled so easily. There’s a hormonal hierarchy in your body, and cortisol is the top priority, so if you’re stressed, it will be harder to ovulate normally, have a regular-ish monthly menstrual cycle, and get pregnant. You will be more likely to have difficulty calming down, to self soothe, and to experience PMS and even PCOS, polycystic ovary syndrome, a constellation of symptoms associated with cortisol dysregulation, and involving high testosterone and sometimes insulin block. High cortisol can also slow down thyroid function, because stress and the thyroid are related through the HPATG axis.
A final example is the seasonal hormonal rhythm. People with thyroid issues, mostly women, commonly find that their thyroid is more active in the summer compared with the winter. So they gain a few pounds each winter, and lose them again in the summer when metabolism gets a boost. If you’re on thyroid medication, you may find that your need for thyroid medication is lower in the summer compared with the winter.
What are the most important hormones for happiness and how do they cycle on a daily and monthly basis?
The happy hormones are estrogen and oxytocin, which support each other. Estrogen is the quintessential female hormone that gives you breasts and hips, and when you go through puberty, makes you want to hang out with your girlfriends and giggle. Low estrogen is associated with depression, and that typically occurs after age 40 (on average, about age 45 and older), but can also occur in younger women who go through premature menopause.
Thyroid, cortisol, and progesterone also play a role in mood. I think of depression as the opposite of happiness, and 20 percent of people with depression have low thyroid function. Fifty percent of people with depression have high cortisol. Women with PMS, also the opposite of happiness, have progesterone resistance, where their cells become numb to progesterone and they cannot calm down.
All of your hormones work best in the Goldilocks position of not too high and not too low, and not too high for the time of day or month, and not too low for that time. Testosterone is a good example. If it’s too low, as can occur in perimenopause, there’s a loss of vitality, agency and libidio; it feels like a dwindling of life force. If it’s too high, it can cause PCOS: irregular cycles, rogue hairs, infertility, weight gain, and cysts on the ovary.
Women in their twenties benefit from understanding that the best way to mind your hormones begins early in life. Most importantly, keep tabs on your cortisol, the main stress hormone, which also controls other key hormones in your body, including thyroid, estrogen, progesterone, and testosterone. Master your sleep (97 percent of us need eight hours each night), eat nutrient-dense food (and not too much), stop sitting so much, and detox your liver periodically (get off the alcohol). When you don’t indulge stress or let it overpower you, you’re actually creating hormonal grace.
Women in their thirties may feel increasingly tense and overwhelmed, desperately in need of better strategies on how to chillax. Your goal should be to prevent the high blood pressure, pre-diabetes, and accelerated aging that come with chronically high-perceived stress. Focus on keeping your thyroid and insulin in balance with a nutrient-dense diet, exercise, some form of mindfulness or meditation, and adding in supplements to fill in any nutritional gaps.
Are there times of the day or the month we can expect a sort of “peak happiness”? Does this vary a lot with different people?
For most women, day 9 to 12 of the menstrual cycle is a time of peak happiness because testosterone is highest (on day 9, so you want to have sex) and estrogen is rising (peaks on day 12). There’s always some variation woman to woman, but unless you’re on a birth control pill or otherwise messing with your monthly natural hormonal cycle, that’s when you feel your best.
What are some considerations for optimal hormonal health?
The good news is that there are several strategies to recruit optimal hormonal health. It’s about adding positive lifestyle choices rather than simply diet or spot-fix any problem areas. Here are my basic tenets:
- Burst train. It’s better than cardio. Interval training raises your growth hormone and melts the muffin top. It makes you more cortisol resilient.
- Master your sleep. Only 3 percent of the population does well on less than 7 hours of sleep, so chances are you’re not one of them. Sleeping 7 to 8.5 hours every night keeps cortisol in check, which prevents the muffin top and accelerated aging. Put yourself of a screen curfew every night at least one hour before bedtime. In Ayurveda, going to bed by 10 p.m. is considered optimal.
- Rewrite your relationship with stress. Develop a more playful attitude. Laugh more, roll with the punches, hang out with friends, take a hot detox bath with Epsom salt. Get rid of caffeine if it’s robbing you of sleep (caffeine raises cortisol). Make a “stop doing” list. Start a to-do list for your body (here’s mine: today I need a nap, to walk the dog in the forest, and to schedule a massage).
- Drink less. Alcohol raises cortisol, robs you of deep sleep, and lowers metabolism by more than 70 percent. I suggest getting off alcohol completely for a minimum of two weeks, twice per year, to give your liver a break.
- Activate the positive. Write a nightly gratitude list of three big wins. Practice forgiveness and intentionally connecting with those you love. Focusing on the positive has been shown to lower cortisol by 23 percent and raise DHEA, the precursor to testosterone.
- Remove estrogen disruptors. More than 700 synthetic chemicals mimic estrogen in a toxic way, and their prevalence in our environment is on the rise. These toxins, found in an array of items from receipts to canned foods and from plastics to pesticides, have now been linked with early puberty, female infertility, ovulation, miscarriage, endometriosis, male infertility, obesity, diabetes, and an increase in certain cancers.
Obviously our body chemistry is just one piece of happiness. What’s the intersection of our life choices, behaviors, goals, all the non-chemical aspects of happiness–and the hormonal side of things?
There is absolutely a synergy between lifestyle, behaviors, goals, hormonal health and mindset! Cultivating happiness is associated with astounding benefits to our health. It reduces cortisol, gives higher immunity, lowers disease rates, and improves longevity, according to UC Berkeley’s Greater Good: The Science of a Meaningful Life, a comprehensive summary of several studies.
Gratitude, for example, is a major booster of mental and physical health—a behavior and mindset that spurs good health. An attitude of gratitude upgrades your hormones, from oxytocin to cortisol, and your neurotransmitters, including dopamine and serotonin. Recent data suggests gratitude provides behavioral and psychological “glue”—oxytocin is associated with promoting the glue that connects adults in meaningful relationships. Not surprisingly, gratitude increases blood flow and activity in the hypothalamus, the master gland that controls hormones. Practicing gratitude has been shown to result in improved sleep, more frequent exercise and stronger cardiovascular and immune systems.
Adding awareness and gratitude is a major part of the weight loss strategies that I teach in my integrative medicine practice, yoga workshops, and online programs. Awareness enables choice and sustained happiness, and I teach people a long list of ways to break free from the ruts that have developed in their thinking when it comes to food and behavior.
In addition, I think it essential to define a “why” when trying to enact any fundamental lifestyle change for better hormonal health or slower aging. This belief is your motivation, and a touchstone that drives you to make real changes and develop new habits that will keep you in line with your goals. It’s your motivation to act, even when it’s difficult or inconvenient. Your why is far stronger than willpower or following the protocol because you think it’s a good idea. Your why is deeply personal and will sustain you over the long term. It’s the first step in a beautiful spiral staircase that connects feeling good, making healthy choices, and improving health all around.
I joke that I’ve had every hormonal problem a woman can have, so I’m sharing this information as a physician but also as a person living in a female body. Joking aside, I’ve learned over the years that I need a daily practice to keep my hormones in check: meditation every morning (I love the Muse headband; I’m a geek), yoga to wake up my spine, time with family, work I love, the right amount and types of food for me, intermittent fasting, time in nature, and making sleep non-negotiable. I constantly remind myself that keeping hormones in balance is always an evolving work in progress. What worked 10 years ago to keep me happy doesn’t work as well now, so it helps to stay open minded and to forget about the idea that hormonal nirvana is a destination. So I tune into what’s true for me, today, now, in this body of mine. I encourage you to do that too!
Want harmonious hormones? Check out my book, The Hormone Cure to get on track.