Welcome to this blog where we will delve into the mechanisms behind how stress can drive hormonal imbalances and provide a comprehensive solution to improve and promote hormonal health and well-being in women. Many women are busy, tired, and stressed. I'm sure you're seeing these women as patients. They might even be your friends, family members, maybe even you. According to a recent survey, women across the globe say they are struggling with high daily stress levels, which are not without consequences. Female students experiencing high levels of stress are almost three times more likely to experience PMS and twice as likely to suffer with dysmenorrhea.
Stress impacts a woman's hormonal health in several ways, as depicted in this infographic created for you, the practitioner, to use in clinic with your patients. Stress impacts the functioning of several axes in the body, including the hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-ovarian (HPO) axis, and the hypothalamic-pituitary-thyroidal (HPT) axis. These pathways are bidirectional and interconnected, so when we experience prolonged or high levels of stress, this can increase the activity of the HPA axis, which governs our stress response and in turn can affect the functioning of the HPO axis.
When the HPA axis goes into overdrive, it leads to an elevation in glucocorticoids (steroid hormones involved in regulation of metabolism, immune function, and stress response). This can promote an imbalance in neurotransmitters linked with changes in mood, cognitive function, and pain processing, influencing the presentation of hormonal conditions such as PMS, PMDD, PCOS, perimenopause, and dysmenorrhea (painful menstrual cramps). Glucocorticoids can alter the secretion of gonadotropin-releasing hormone, which will then have a downward cascading effect, and ovulation may be affected due to alterations in sex steroid hormone synthesis.
Elevated cortisol can also increase prostaglandin synthesis within the myometrium, which is associated with heightened pain perception. Given the impact of this overactive HPA axis on a woman's hormonal health, we must address this heightened stress response as a primary target of our treatment. Magnesium is crucial for protection against chronic stress as it regulates the HPA axis and cortisol secretion. Alongside additional nutrients such as pyridoxal-5-phosphate (a form of vitamin B6), taurine, and zinc, these nutrients bring balance to neurotransmitter systems, supporting a healthy mood and modulating glucocorticoid synthesis.
Magnesium inhibits the production of prostaglandin F2 alpha, which is elevated in dysmenorrhea, and you can find these vital nutrients for enhancing resilience to daily stress in our new magnesium combination for women. This evidence-based nutrient combination has been designed to support the needs of every woman. Inadequate magnesium intake is prevalent among women, and the use of oral contraceptives has been associated with magnesium depletion. Magnesium deficiency has been linked with PCOS, PMS, and worsening climacteric symptoms during perimenopause. Supplementation with magnesium in women with hormonal imbalances has resulted in improvements in their symptoms. When magnesium was supplemented at 250 milligrams per day, both as a standalone and in combination with vitamin B6, the two significantly improved symptoms of PMS, with the nutrient combination offering the greatest benefit.
Vitamin B6 is required for the synthesis of neurotransmitters GABA, dopamine, and serotonin, and deficiencies in vitamin B6 have been reported in women suffering with PMS. Further, vitamin B6 is required to maintain healthy intracellular levels of magnesium, hence the benefits of using them in combination. A review found magnesium to be beneficial for those suffering with dysmenorrhea as it significantly lowered prostaglandin F2 alpha levels. There was also a reduction in work absenteeism, with the magnesium group missing only 3.2 hours per cycle compared to 17 hours per cycle in the placebo group. This is a significant difference, with a very low dose of magnesium being used at 120 milligrams per day. The recommended daily intake for magnesium in women is between 310 and 320 milligrams. Given the results from 120 milligrams per day used over four to six months, we can assume the potential positive effect of using a higher dose that meets the recommended daily intake.
Women experiencing PMS exhibit notably lower serum zinc levels than women without PMS. Low zinc results in dysregulated glucocorticoid secretion and has been linked with disturbances in HPO axis function. One of zinc's important roles is to safeguard the central nervous system and the reproductive tract from oxidative stress and inflammation. Administering 30 milligrams per day of zinc over 12 weeks in women with PMS significantly improved their symptoms and promoted healthy central nervous system activity.
Another influencer of hormonal health is thyroid health. Thyroid hormones directly influence reproductive tissues and impact sex hormone availability through their modulation of sex hormone-binding globulin expression in the liver. A greater prevalence of menstrual dysfunction is observed in women with thyroid abnormalities. An overactive HPA axis and elevated cortisol from heightened stress response can lead to a disturbance in thyroid hormones, altering cycle length and blood flow. Low thyroid function has been associated with PCOS and during perimenopause, alterations in thyroid function can manifest as anxiety, palpitations, sweating, sudden changes in weight, and insomnia. Thyroid hormones play a vital role in supporting estrogen metabolism in phase one liver detoxification. Reduced estrogen metabolism can further compound hormonal imbalances and reproductive issues.
To maintain a healthy functioning HPO axis, we must support thyroid function by providing the HPT axis and the thyroid gland with the nutrients it requires. Myoinositol, which facilitates intracellular signaling of thyroid-stimulating hormone, iodine, magnesium, and selenium are required for T3 and T4 synthesis, secretion, and activity. The thyroid gland stores as much selenium as it does iodine, and both are deficient in the soils of Australia and New Zealand. Ensuring patients receive both nutrients supports thyroid health and promotes estrogen detoxification. However, women today face another problem affecting their hormones: endocrine-disrupting chemicals.
Endocrine-disrupting chemicals are everywhere, and the latest research shows their impact on hormonal health. Bisphenol A (BPA) is implicated in the development of PCOS. In insulin-sensitive individuals, glucose outside the cell signals the aryl hydrocarbon receptor inside the cell to transcribe Glut4, promoting insulin sensitivity. BPA, however, blocks this transcription, disrupting blood glucose metabolism and elevating insulin levels, promoting hyperinsulinemia. Over time, this hyperinsulinemia may play a role in the development of PCOS.
A strategic approach for every woman is to enhance liver detoxification of estrogen and endocrine-disrupting chemicals. Optimal thyroid function, supported by iodine, selenium, magnesium, and myoinositol, promotes phase one estrogen detoxification. In phase two liver detoxification, estrogen conjugation occurs via methylation, catalyzed by the enzyme catechol O-methyltransferase (COMT). The activity of COMT and the availability of methyl groups depend on vitamins B6, B12, and folate. Glucuronidation, another phase two pathway, is required for detoxification of several endocrine-disrupting chemicals, including BPA, and magnesium is essential for this process.
Evidence shows how an overactive stress response and elevated stress hormones can induce hyperinsulinemia and insulin resistance, key features of PCOS. High serum insulin levels promote hyperandrogenism. High levels of androgens drive insulin resistance by inducing dysbiosis, altering insulin secretion, and influencing the function of adipose tissue, which is an endocrine organ itself. Myoinositol, a nutrient, targets both hyperandrogenism and insulin resistance in PCOS.
Myoinositol, made from glucose in the kidneys and, to a lesser extent, the liver and brain, sees reduced synthesis and absorption under insulin resistance. Western diets provide myoinositol through grains, seeds, and beans, but a healthy gut microbiome is required to extract it. Many patients with PCOS and insulin resistance also have gut issues, hindering their ability to obtain adequate myoinositol. Thus, supplementation is necessary.
In cells, myoinositol converts to D-chiro-inositol. Myoinositol is concentrated in tissues using high glucose amounts, like the brain, heart, and ovaries, whereas D-chiro-inositol is concentrated in glucose storage cells like the liver, muscle, and adipose tissue. Both enhance insulin sensitivity differently. Myoinositol is required for insulin signalling within cells, and D-chiro-inositol is needed for glucose uptake and glycogen formation.
In the ovaries, myoinositol acts as a secondary messenger for follicle-stimulating hormone, modulates anti-Müllerian hormone synthesis, influences oocyte maturation, transportation, embryo quality, and increases aromatase activity to support estrogen synthesis. D-chiro-inositol, however, promotes androgen synthesis and inhibits estrogen synthesis. Under insulin-sensitive conditions, myoinositol converts to D-chiro-inositol in muscle, liver, and adipose tissue, promoting glucose uptake. Under insulin-resistant conditions, the activity of the enzyme epimerase is hindered, reducing D-chiro-inositol and cellular glucose uptake. In PCOS women's ovaries, epimerase enzyme is overstimulated, leading to elevated D-chiro-inositol concentrations and myoinositol depletion, promoting androgen synthesis.
Myoinositol supplementation does not increase D-chiro-inositol concentrations or androgen synthesis in the ovaries. Instead, it supports insulin signalling, reducing insulin resistance, a driving factor behind elevated androgens. It also supports follicle-stimulating hormone and aromatase activity, improving fertility outcomes.
Numerous studies show improvements in HPO axis function and hormonal balance with myoinositol. A meta-analysis found myoinositol supplements significantly increased ovulation rates in women with PCOS. Supplementing myoinositol also improved acne, reduced BMI, and promoted ovulation and pregnancy in women with PCOS and insulin resistance. One study showed improvements in insulin levels after three months of supplementing with three grams of myoinositol and 400 micrograms of folic acid daily. While significant improvements occurred after three months, continued improvements were observed after six months. Another study showed improvements in pregnancy rates with myoinositol at three months of supplementation. However, the pregnancy rates continued to rise after six months.
Given the impacts of stress on the HPA, HPO, and HPT axes, the use of a multifaceted approach addressing both stress response and hormonal imbalance is crucial. Magnesium, myoinositol, and key nutrients support these axes and liver detoxification, reducing the burden of endocrine-disrupting chemicals and hormonal imbalances.
#WomensHealth #HormonalHealth #StressManagement #BalanceHormones #HealthyLiving #MentalHealth #PCOSAwareness #PMSRelief #MenstrualHealth #ThyroidHealth #Magnesium #VitaminB6 #Myoinositol #NaturalHealth #EndocrineHealth #StressRelief #HolisticHealth #WellnessJourney #HormoneBalance #SelfCare #WomensWellness #HealthyHormones #FunctionalMedicine #IntegrativeHealth #HealthyHormones #FemaleHealth #HormoneSupport #WellBeing #NutritionalSupport #StressFreeLife
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