Feminine Health

In the intricate tapestry of human biology, the hormonal cycle stands as a testament to the marvels of the human body. While both men and women possess hormones that play crucial roles in their overall well-being, the cyclical nature of women’s hormonal fluctuations is a unique and awe-inspiring phenomenon. Women experience a monthly hormonal cycle primarily driven by the interplay of estrogen and progesterone. This cycle, known as the menstrual cycle, unfolds in four distinct phases: menstrual, follicular, ovulatory, and luteal. Each phase brings about specific changes in hormone levels, contributing to the dynamic nature of a woman’s physiology. Image Source: Freepik.com In contrast, men generally experience a more stable hormonal environment, with testosterone being the dominant hormone. While men do experience fluctuations in testosterone levels, these changes are less pronounced and occur over a more extended period compared to the monthly ebb and flow experienced by women. The hormonal cycle’s impact on mood is a well-documented aspect of women’s health. As estrogen and progesterone levels rise and fall throughout the menstrual cycle, they can influence neurotransmitters in the brain, such as serotonin and dopamine, which play key roles in regulating mood and emotions. This hormonal dance can lead to a range of emotional experiences, from heightened sensitivity and empathy to occasional mood swings and irritability. Unfortunately, societal stigmas surrounding women’s emotions, often dismissed as mere “moodiness,” persist. Women have historically faced judgment and discrimination based on stereotypes perpetuated by misunderstandings of hormonal fluctuations. This stigma contributes to the expectation that women should suppress or hide their emotions, perpetuating a cycle of shame and discomfort. It’s essential to recognize that emotions are a natural and integral part of the human experience. Just as the hormonal cycle is a fundamental aspect of women’s physiology, emotions are a universal language that transcends gender. By understanding and accepting the hormonal fluctuations that contribute to emotional variability, we can foster empathy, compassion, and a more supportive society. Empathy is key in dismantling the stigma associated with women’s emotions. Instead of dismissing emotional experiences as hormonal imbalances, we should encourage open conversations about the diverse range of feelings that both men and women navigate. Creating a safe space for dialogue allows for a better understanding of the complex interplay between hormones and emotions, fostering a culture of acceptance. Image Source : Freepik.com Moreover, acknowledging and respecting the cyclical nature of women’s hormones emphasizes the importance of tailoring support and accommodations in various aspects of life. From workplace policies to interpersonal relationships, a nuanced understanding of hormonal fluctuations can pave the way for more inclusive and compassionate environments. In conclusion, the hormonal cycle of a woman is a mesmerizing symphony of physiological changes that significantly influences mood and emotions. Rather than perpetuating stereotypes and stigmas, embracing and understanding these fluctuations can lead to a more compassionate and supportive society. By dismantling the stigma surrounding women’s emotions, we can create a world where individuals are celebrated for their authenticity, hormones and all.

During the reproductive years, women undergo many changes. This period starts from menarche and ends at menopause. The female reproductive organs, the ovaries, secrete important hormones like estrogen and progesterone. These two hormones are the major contributors in developing female sexual characters and in maintaining their menstrual cycle. However, there are other hormones which are equally important in the prior mentioned roles.   This network works in the hormonal circuit starting from the hypothalamus to the pituitary to the adrenal gland and finally acting on the gonadal axis releasing hormones. The role of these hormones is highly significant in maintaining the menstrual cycle. (1) Image Source: Freepik.com What is hormone optimization?  Hormone optimization refers to the estimation of declining levels of the hormones in the body and its overall threshold. The aim of optimizing these hormones is to suggest alternative options like hormone replacement therapies to improve the symptoms for the patient. Lifestyle changes like weight loss in obese patients and dietary changes are also advised. (2)  Role of gut microbiome in estrogen metabolism  There is a specific type of gut bacteria that plays an important role in hormonal balance in females. This is known as estrobulume. This class of bacteria that is present in the gut regulates and excretes estrogen in the body. It does this by producing a hormone called beta glucuronidase which prevents excess excretion of estrogen in the gut. However, if this hormone is overproduced it will cause dysbiosis and estrogen dominance in the body. This can be detected by blood or stool samples. It has been noted that women who have an estrobolme that causes estrogen dominance predisposes them to diseases like breast cancer, endometrial cancer and prostate cancer in men. (3)   Intergenerational trauma and its effects on the endocrine system  In many individuals, more commonly in females, the effects of emotional trauma can be passed on to their future generation. Their descendants are more susceptible to depression and other psychiatric disorders. They may present themselves with behavioral challenges and difficulty in problem solving. Trauma is passed via genes or through the behavior of mothers towards their children which impacts their development. It is greatly observed in females living in warzones (4). It affects their problem-solving abilities and their willpower to get through difficult situations.  The above-mentioned factors also influence the endocrine system. The hypothalamic pituitary gonadal axis is disturbed which causes hormone imbalance that can present as over or underproduction of certain hormones.  It predisposes the females to conditions like endometriosis, fibroids and polycystic ovarian syndrome. I can also attribute to constipation which is generally more in females than males. (5)  Hormone optimization options for women   A significant option for hormone optimization is Hormone Replacement Therapy (HRT). It is offered to post-menopausal women who are experiencing symptoms like hot flushes, mood swings, dry vagina, insomnia, vasomotor symptoms and osteoporotic symptoms (6). It is usually offered to women after their symptoms appear. However, experts like Dr. Sara Gottfried believe that women should be counselled and offered HRT in their premenopausal years which can prevent them from developing these symptoms in the first place and as provide maximum effect. This is the time when the estrogen levels begin to decline hence the HRT is most beneficial.   Before starting the therapy, it is very important to identify the hormones that are deficient which can be replaced accordingly. Surgical and medical history helps in determining the type of HRT to be used.  Image Source : Freepik.com Types of HRT  There are two major types of hormone replacement therapies,  Combined HRT  This typically has estrogen and progesterone. This type of HRT is ideal for women who have an intact uterus as progesterone protects the uterine lining from the stimulating effects of estrogen. This therapy can be given intermittently or continuously. This is available in the form of pills, patches and coils. (7)    Estrogen only therapy  This comprises of estrogen as the only hormone. It is preferable for women who have undergone hysterectomy (removal of uterus) since the proliferative effect of this hormone is ineffective. It is available in many forms like tablets, implants, patches, rings, gel and spray forms. (8)  There are certain medical conditions that may alter the indication and dose of HRT. Such conditions include breast cancer, uterine cancer, ovarian cancer, cardiac diseases, hypertension, liver disease, pregnancy and breastfeeding.   Conclusion  In conclusion, the various symptoms that women undergo throughout their reproductive years were rendered uncontrolled in the previous times. However, in recent times, the discovery and application of alternatives have minimized such inconveniences. These symptoms begin at menarche and continue till after menopause. The detrimental effects of menopause can be avoided by opting for appropriate measures in diet and lifestyle. Another alternative that can be offered is hormone replacement therapy, which has gained popularity in recent years. It saves women from declining estrogen effects after menopause and aids them in living a healthy life.     References  Christensen, A., Bentley, G. E., Cabrera, R., Ortega, H. H., Perfito, N., Wu, T. J., & Micevych, P. (2012). Hormonal regulation of female reproduction. Hormone and metabolic research, 44(08), 587-591.   Gottfried, S. (2014). The hormone cure: Reclaim balance, sleep and sex drive; lose weight; feel focused, vital, and energized naturally with the Gottfried protocol. Simon and Schuster.  Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas, 103, 45-53.  Bowers, M. E., & Yehuda, R. (2016). Intergenerational transmission of stress in humans. Neuropsychopharmacology, 41(1), 232-244.  Higgins, P. D., & Johanson, J. F. (2004). Epidemiology of constipation in North America: a systematic review. Official journal of the American College of Gastroenterology| ACG, 99(4), 750-759.  Barrett-Connor, E., & Stuenkel, C. A. (2001). Hormone replacement therapy (HRT)—risks and benefits. International Journal of Epidemiology, 30(3), 423-426.  Udoff, L., Langenberg, P., & Adashi, E. Y. (1995). Combined continuous hormone replacement therapy: a critical review. Obstetrics & Gynecology, 86(2), 306-316.  Tannen, R. L., Weiner, M. G., Xie, D., & Barnhart, K. (2007). Estrogen affects post-menopausal women differently than