How do Hormones Impact our Mood?
As women, we are no strangers to mood swings, crying spells, and irrational angry outbursts. These often come with low libido, weight gain, anxiety, night sweats and fatigue. Whether it's once a month or for years leading to menopause have you ever wondered just how hormones can impact your mood so profoundly?
I always tell my patients that our hormonal status at any one time is the lens through which we see the world. For me personally, the same innocent comment of “Are you wearing that?” by my partner can elicit a range of responses from me depending on where I am in my cycle. During the first part of my cycle, it may result in a “Hell yea and I look damn hot”, but a few weeks later, before my period it may leave me feeling completely dejected and offended perhaps deciding I'm not even leaving the house.
In my practice whenever I encounter women experiencing emotional difficulties, it's always a powerful sign to look into hormones. While of course mood swings, depression and anxiety have many causes, hormone imbalances almost always a key component of or at least a driving factor in women's mental health. Unfortunately, many GP’s in the span of a 15-minute visit, do not have the training or experience to investigate hormone imbalances and will put women on antidepressants when they are much more likely to be suffering from a progesterone, not Prozac deficiency!
As women mood is closely related to our main sex hormones; estrogen and progesterone. These two hormones were designed to be in balance, with estrogen rising earlier in the cycle and progesterone dominating from mid-cycle to our next period. From day one of our cycle (first day of bleeding) to day 7, estrogen is rising. With this rise, we begin to feel more optimistic, social and chatty. During the second week, estrogen is still climbing. You may feel more upbeat, positive, have a sharper memory and have better focus. This is because estrogen is “neuroprotective” (literally protects brain cells or neurons). Behaviourally, estrogen also makes you feel more self-assured and less depressed, as it increases the excitatory neurotransmitters; dopamine, norepinephrine, and serotonin. When estrogen levels are low, serotonin drops as well, when estrogen rises they enzyme that clears neurotransmitters decreases, meaning our brain chemicals stick around for longer. Just as low estrogen can cause problems with mood, however, so can too much! From day 15-22, estrogen plunges and progesterone rises. Progesterone is like nature's Xanax or Zopiclone. It makes us feel chill and sleep well. When women have low progesterone they are prone to anxiety and insomnia. The problem is in our high stress, junk food, meat and dairy eating and personal care smearing, polluted society, many of us have what is known as estrogen dominance.
Instead of estrogen playing its essential role within the well-balanced system of our female hormones, it has begun to overshadow the other players (especially progesterone), creating a major biochemical imbalance. As we mentioned estrogen-mimicking substances (increased exposure to pesticides, herbicides, plastics, and PCB's) all drive this dysfunction. Estrogen dominance may be caused by normal levels of estrogen and relatively low levels of progesterone, or by low levels of estrogen and extremely low levels of progesterone. The rise in psychiatric complaints by women beginning in their 30’s is often caused by the imbalance between these two key hormonal players. In our mid-thirties, we will often begin to experience “anovulatory cycles”. When this happens we do not get a surge of progesterone during the second part of the cycle, so the stimulating effects of estrogen last all month.
Our brain loves progesterone just as much as estrogen! The levels of progesterone in the brain are generally 20 times higher than blood levels. Insomnia, anxiety, and migraine are just a few of the conditions linked to an imbalance of progesterone. In the brain as elsewhere in the body, progesterone balances the effects of estrogen. Whereas estrogen has an excitatory effect on the brain, progesterone's effect is calming. Women with estrogen dominance tend to sleep restlessly, whereas targeting this imbalance enhances sleep.
Several studies have shown progesterone to have anxiolytic (anti-anxiety) effects by acting on gamma-aminobutyric acid (GABA) receptors in the brain. GABA is an inhibitory neurotransmitter that aids in relaxation and sleep. In the brain, GABA helps balance excitation with calming inhibition. For women with low progesterone taking a bioidentical dose of progesterone at bedtime can be a lifesaver.
Stress also profoundly impacts mood and plays a role in the onset of anxiety, through the way it changes our sex hormone balance. Under stress our bodies secrete adrenalin and cortisol and make less progesterone. When we are stressed our livers have to deal with the burden of detoxifying stress hormones (as well as environmental toxins and female hormones). Add in too much coffee, maybe a bit more sugar and alcohol as well as the fact that high estrogen may stimulate the adrenal glands to produce even more cortisol.
Cortisol and adrenaline both interfere with the production of the calming neurotransmitter serotonin. Lack of sleep, poor nutrition, minimal exercise, stimulant usage, and negative thought patterns can also cause excessive cortisol release that may eventually result in anxiety in both men and women. Finally breaking down stress hormones (as well as synthetic hormones from the Pill), deplete our levels of B complex vitamins, magnesium, and zinc. These vitamins are all important cofactors in the production of neurotransmitters, and when levels are compromised can severely impact emotional health. It's easy to see therefore how easy it is to get stuck on the estrogen dominance emotional roller coaster.
Estrogen dominance also interferes with the conversion of thyroid hormone to its active state (T4-->T3), contributing to hypothyroidism. Symptoms of hypothyroidism include lethargy, depression, mood swings, brain fog and weight gain. Although an overactive thyroid gland will more often trigger bodily symptoms that are similar to panic symptoms, occasionally a form of autoimmune hypothyroid (Hashimoto’s autoimmune thyroiditis) has been associated with anxiety and panic attacks as well as bipolar depression.
1. If you are experiencing mood difficulty, try tracking symptoms throughout the month. Often hormonally related mood problems will show a cyclical pattern.
2. If you take birth control pills, be cautioned that these can also throw off emotional balance. Birth control pills raise estrogen and may cause depression, anger, anxiety, and insomnia. If you take birth control be sure to supplement the minerals and vitamins they deplete.
3. Support your liver. Supplementing brassica/cruciferous vegetables (watercress, broccoli sprouts, cabbage etc) increasing fibre, turmeric, Calcium Glucarate, NAC (great for depression!), can all profoundly benefit mood, through improving the liver's ability to clear excess estrogen.
4. Manage excess bodyweight. An overweight postmenopausal woman still has much more circulating estrogen than a lean cycling woman. Fat cells convert available testosterone to estrogen. Insulin stimulates testosterone production so overweight women often have high estrogen and testosterone. Progesterone levels tend to stay the same as women gain weight, thus contributing to estrogen dominance. The tricky thing here is estrogen dominance often causes us to gain weight, as turns off our thyroid hormones. It may be wise to begin to approach weight loss from an adrenal/stress reduction point of view, vs purely eat less and exercise more ( which can further depress thyroid function). Exercise is important, however, as it can speed up the liver’s detox processes, improve insulin sensitivity and mood. The key is to find the correct intensity and duration. Generally, extended periods of high intensity or excessive cardio may contribute to high cortisol and further stress the body.
5. Stress reduction is essential. I may sound like a broken record but you have to learn to quiet your mind or meditate for at least 10 min a day. No other technique is as profoundly powerful in reducing stress hormones. When cortisol is high (stress hormone) we do not make as much progesterone and we promote estrogen dominance. Check out this breathing exercise, shown to reduce cortisol in only a few minutes. Walking in nature, watching a funny video or playing with your pet or child is also profoundly stress reducing.