Harness Your Hormones

Women's hormones are a pesky chemical soup that rules many aspects of our lives, from sex drive to sleep habits. We may not be able to outwit them entirely, but there are simple (and even enjoyable) natural ways to ease the symptoms they cause.

If ever there were a case for the beauty of balance, our sex hormones would be it. When chemical messengers like estrogen and progesterone work in symphony -- telling cells throughout the body exactly what to do and when -- miraculous things happen: Breasts and hips round out at puberty. Eggs are released into a uterus perfectly prepared to nurture them. And, no secret to women, peaks in these hormones make us feel most attractive and passionate at the very time of the month when we're most fertile.

But these miracles don't always feel amazing. Dips and spikes leading up to menstruation, ramping down from pregnancy, or on the long road to menopause can do a number on body and mind. Irritability erupts, breasts become sore, the head throbs, and sleep suffers. "Hormones have to fluctuate so the body can do the right thing at the right time, and those fluctuations can influence how you feel," says Jeffrey Brantley, M.D., founder and director of Mindfulness-Based Stress Reduction at Duke Integrative Medicine in Durham, North Carolina.

But instead of going with the flow, we fight through fatigue, work when we'd be better off resting, soldier through soreness rather than slow down to soothe it. Many of us resort to painkillers or sleeping pills so we can keep up with our long to-do lists.

Medication -- such as birth control pills and hormone therapy (or HT, drugs containing female hormones that supplement the body's own levels as we age) -- have their value, says Shelley Wroth, M.D., integrative medicine physician and assistant professor of obstetrics and gynecology at Duke University School of Medicine. However, these solutions also can carry complications. Combination birth control pills, which contain estrogen and progestin, may put some women at increased risk of heart attack and stroke. The use of HT moves in and out of favor among the medical community as research evolves (it currently appears to be in good standing again).

The truth is that hormones remain largely a mystery to doctors and researchers. "We have an idea about the role they play, but not the exact mechanisms, such as how they interact with each other and how they affect the complex systems in our body," says Neill Epperson, M.D., director of the Penn Center for Women's Behavioral Wellness in Philadelphia.

Now amidst the controversy surrounding HT comes a surge of research focused on gentler ways to address our hormonal issues, revealing that some of our most powerful tools come not from a pill or a patch. Indeed, giving our body what it intuitively needs can help us manage -- and change our attitude about -- what is not a "disease" but a part of our design.

Feel-Better Fix 1: Fight Fatigue

If counting sheep leaves you climbing the walls, you're not alone: According to the National Sleep Foundation, 67 percent of menstruating women say they toss and turn at least three nights during every cycle, likely due to hormonal flux, cramps, and other discomfort. Poor sleep is also common during midlife. "Every chemical and hormone in the brain -- including those influenced by estrogen and progesterone -- can affect sleep," says Phil Gehrman, Ph.D., of the University of Pennsylvania. "As soon as those start changing, there's potential for [sleep] disturbance."

Can't Sleep?
Train Your Brain "Stressing out about not sleeping adds fuel to the fire," Gehrman says. Mindfulness training may calm you. A 2009 study from Northwestern Memorial Hospital in Illinois showed that patients who meditated twice a day for 15 to 20 minutes over two months fell asleep faster and slept longer and more soundly than those who didn't practice. Previous insomnia research suggests that regular meditators also have lower levels of the stress hormone cortisol. "Meditation, yoga, and other mindfulness-based interventions are thought to reduce stress and improve sleep," Epperson says, "in part by balancing the sympathetic (fight or flight) and parasympathetic (rest and digest) nervous systems in such a way that winds us down. And when you're less arousable, you're better able to calmly go off to sleep."

For occasional problems drifting off, Gehrman recommends Progressive Muscle Relaxation (PMR) -- a practice you can do in bed that involves deep breathing while tensing and then releasing all the muscles in your body in succession. (Start with the foot, calf, and thigh of one leg, then move over to the next and slowly work up the body. Click here for more details.) "PMR slows the sympathetic nervous system and gives you something to focus on other than the fact that you can't sleep," Gehrman says. "Tensing and releasing muscles helps people identify what truly relaxed muscles feel like."

Chill Out Jolting from bed soaked in sweat is a sleep spoiler all too familiar to about 85 percent of women in midlife. Lowering the heat, avoiding spicy foods, and keeping a fan on the night table are strategies that can help. But research from Baylor University shows that relief from hot flashes -- day or night -- might also be found in hypnosis, especially when it incorporates cooling visualization.

Daily hypnosis has been linked to a 68 percent reduction in hot-flash frequency and severity; findings suggest that visualizing a scene like a mountain stream or a snowy landscape is a key part of what makes hypnosis so effective. "Hypnosis reduces stress, which is known to increase the frequency and intensity of hot flashes," says researcher Gary Elkins, Ph.D. "Cool visualization under hypnosis may work because the part of the brain that's activated by visualization is the same part that's switched on by actual events." Once they get the hang of it, women can benefit from a five-minute daily self-guided session. To find a certified clinical hypnotherapist, ask your physician or check the online directory of the American Society of Clinical Hypnosis (asch.net).

Feel-Better Fix 2: Improve Mood

Estrogen ratchets up energy by boosting levels of feel-good chemicals like dopamine, while progesterone promotes calm. When both climb around ovulation, we can rule the world. When they dip just before menstruation and when they start to fall during perimenopause (the decade, usually after age 40, leading up to menopause), our energy, attitude, and even our sex drive can take a hit, says Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom.

Feeling Crabby?
Try Aggressive TLC Around our monthly period and leading to menopause, progesterone levels generally begin to dive before estrogen does. The result, often referred to as estrogen dominance, can bring on irritability or anxiety, Northrup notes. When this happens it's time to back off on after-work commitments or get some fresh air on your lunch break.

Taking a breather may help trigger the relaxation response -- a process that slows heart rate and relaxes the body. "Stress hormones [like adrenaline and cortisol] are major regulatory hormones in the body," says Woodson Merrell, M.D., chairman of the Department of Integrative Medicine at Beth Israel Medical Center in New York City. "So when they are out of balance, they can knock many other hormones out of whack."

The crucial link between stress and mood swings in women may be the adrenal glands, which produce the hormones that make our hearts race in the face of imminent threat. In our full-throttle society, the fight-or-flight response is triggered so frequently that stress hormones can stay elevated, keeping the body under constant siege, says nurse practitioner Marcelle Pick, author of Are You Tired and Wired? Pick and some others believe that when the adrenals are overworked, they may not produce enough DHEA, a hormone that eventually converts into sex hormones in the body. The validity of this theory remains to be seen, but doing stress-reduction exercises can help flip the switch on irritability.

Getting Weepy?
Head for the Hills As menstruation or menopause approaches, hormone levels fluctuate, leaving us weepy, lethargic, or downright depressed, Pick says. If this sounds like you, consider trying something as simple as a regular stroll outside. Numerous recent studies have linked "green exercise" (defined as essentially any activity performed in nature -- those studied include gardening, walking, and fishing) with improvements in mood and overall health. According to research done in Japan, where "forest bathing" is popular among health enthusiasts, being in a natural, wooded environment can lower cortisol, pulse rate, and blood pressure and stimulate parasympathetic nerve activity, resulting in a more relaxed mood.

The best part: It's a quick fix. In fact, as little as five green minutes can make a difference, found researcher Jo Barton, Ph.D., of the University of Essex in the U.K.: "Green exercise can also protect you from future stresses, so it can be either therapeutic or preventative."

Not in the Mood?
Work It Out Hormonal changes can interfere with desire throughout the menstrual cycle, but especially as we age, according to Cindy Meston, Ph.D., author of Why Women Have Sex. Around menopause, waning testosterone can dampen drive, while estrogen loss can reduce elasticity in the vaginal wall, making sex not just less appealing but all-out painful. Hormone therapy might ultimately be in the cards -- especially if dryness is a major issue. But there's evidence that physical activity can help offset some of the frustrating symptoms.

Strength and resistance training (such as weight lifting or swimming) have been shown to improve female libido at any age, possibly because they increase testosterone levels, according to Mary Jayne Johnson, Ph.D., of the American Council on Exercise. Meston's research at the University of Texas at Austin found that women who exercised vigorously before being exposed to sexual stimuli had significantly increased blood flow to their genitals -- a key factor in sexual arousal -- after 15 minutes. "Contrary to the standard advice that women should take bubble baths and relax to get in the mood," Meston says, "revving up your system and getting blood flowing may actually be more helpful."

Read more mood-boosting techniques

Feel-Better Fix 3: Relieve Pain

Women feel pain more often and in more body parts than men do, according to Fernando Cervero, M.D., of the Alan Edwards Centre for Research on Pain at McGill University in Montreal. We're also four to five times as likely to develop painful syndromes like migraines and irritable bowel syndrome. "Estrogen is a protective hormone, and women sense more pain when their estrogen levels fluctuate," Cervero says.

Cramps Kicking In?
Get Needled According to traditional Chinese medicine, freeing energy along our body's "spleen channel" can reduce period cramps. "It's not really known whether acupuncture relieves menstrual cramps because it affects prostaglandin levels [which are what cue the uterus to contract]," says Joseph Alban, M.S., a licensed acupuncturist practicing at Alban Acupuncture in New York City. "But we do know that it affects the cascade of hormones that cause and regulate pain in the body." The result? Sweet relief.

Needles aren't always necessary, if you're averse. "Acupressure is also effective," Alban says, and is something that you can try on your own. In Alban's experience, two of the most powerful points for relieving menstrual cramps are located a couple of inches above the inner ankle bone (known as Spleen 6) and below the knee on the outside of the leg (Stomach 36). For relief, massage each for about 30 seconds at the onset of symptoms. (Find a diagram at acupressureonline.org.) "The more severe your cramps, the harder you should press," Alban advises. If you prefer, you can have a professional tailor a prescription specifically to your menstrual complaints. Find one through the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org).

Migraine Brewing?
Stick With a Routine For decades, studies have shown that dramatic fluctuations in estrogen -- either just before our periods or at menopause -- can trigger migraine headaches in women. "The migraine brain doesn't like change, so when estrogen is in flux or when hormone levels aren't where they're supposed to be, it's more vulnerable," says Joel R. Saper, M.D., of the Michigan Head Pain and Neurological Institute in Ann Arbor.

With that in mind, Saper strongly recommends building as much regularity into your lifestyle as possible. "As you approach your period or in perimenopause, be sure to go to sleep and wake up at the same time and eat at the same time every day," he says. "It may not be easy, but the results for many of my migraine patients have been significant." Biofeedback -- a technique that teaches people to monitor their heart rate, blood pressure, and other involuntary stress responses -- is worth considering, since "it can help restore some of that regularity," Saper says. Personal biofeedback monitors, such as the Stress Thermometer ($20, cliving.org), are relatively easy to use with a little practice.

Text by Peg Rosen

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