From PCOS to thyroid troubles- an exploration of women’s hormones

Hormones are our bodies’ communication messengers. They are chemicals that are released by one organ/tissue that are carried in the blood and impact another organ/tissue and thus coordinate different functions in our body.

These signals tell your body what to do and when to do it and cause significant issues when there is hormonal imbalance.

Hormonal balance is very often related to our lifestyle. The environment we bathe our genes in impacts which genes are switched on and off.

Our body is always trying to be balanced and so our hormones adapt to try to create balance within the body and are a reflection of environmental and mental inputs.

Unlike men who have a 24hr testosterone cycle with testosterone peaking in the morning, the female menstrual cycle requires a complex dance of hormones to interplay to release an egg monthly.

This includes building up the lining of the womb in preparation for a fertilised egg and if there is no pregnancy to allow the lining to break down and start the whole process again.

This roughly 28-day cycle can be easily unbalanced by a number of factors, including poor nutrition, suboptimal movement, disturbed sleep, excess stress, poor relationships and high toxic burden from environmental toxins.

Reproductive hormonal symptoms can show up in a variety of ways including painful and/or heavy periods, infertility, altered cycle and PMS.

PCOS is a common (one in five to 10 women) but often poorly understood whole body hormonal/metabolic disorder that affects women of reproductive age.

The defining feature of PCOS is irregular/anovulatory cycles and the over-production of male type hormones- androgens. The increased androgens can lead to acne, oily skin and hirsutism.

Many women with PCOS also struggle with weight gain, particularly in the abdominal area.

The irregular cycles can interfere with getting pregnant and so balancing the hormones is key to restoring fertility.

There are genetic predispositions for PCOS which had a survival advantage in the past when food was scarce, and we had to fight predators.

It has been said that women with PCOS have the genes of warrior princesses and this is why it has perpetuated.

Women with this condition are struggling in today’s modern society because we are often sitting at work for hours at a time and then sitting in front of screens in the evening.

Our genes expect movement in the day and to follow natural rhythms and the sedentary nature of modern day life results in a mismatch and health issues.

The name arises from the multiple follicles seen on ultrasound of affected women- these are not true cysts.

Many young women will have these appearances and should not be automatically diagnosed with PCOS unless they have the androgen excess symptoms and irregular periods.

Women suffering from PCOS have hormonal imbalance that has a few root causes including blood sugar regulation (insulin resistance), inflammation and poor gut health. Addressing these areas is foundational to managing and reversing PCOS symptoms.

The conventional medical model is focussed on managing symptoms of PCOS and will often result in putting women on the pill to regulate periods and reduce androgen symptoms, but this is not dealing with the root cause and bringing the body back into balance.

When women have difficulty getting pregnant, they are given drugs to try to induce ovulation or referred for IVF. These are useful options to explore when lifestyle interventions have not been fruitful and should remain a reserve option.

The functional medicine approach to PCOS focuses on:

1. Optimising diet to improve insulin sensitivity through encouraging low-carb nutrition which helps improve insulin resistance a cornerstone driver of the condition.
2. Supporting gut health to reduce inflammation which is another key factor. Pre and probiotics can support the gut microbiome which modulate hormone balance and detoxification.
3. Reducing exposed to toxic ‘endocrine disrupters’ in the environment like BPA in plastics because they’ve been shown to disrupt the hormonal system by altering the way in which hormones interact with their receptors and how they are used/ metabolised within the body. Thesexenoestrogens can be found in plastic bottles/containers and in many skincare products/makeup which get absorbed through the skin so it is important to use ‘clean’ products and work on minimising exposure.
4. Minimising stress through lifestyle tweaks like meditation and yoga which help support the parasympathetic rest and digest nervous system.
5. Using targeted supplements and herbs to support hormones further, including magnesium, which improves insulin sensitivity and is anti-inflammatory, omega 3 fatty acids, inositol and zinc.

We can also use natural bioidentical progesterone to help women with PCOS kick start a regular ovulatory cycle.

Progesterone is released in the second half of the cycle after ovulation.

Professor Jerilyn Prior has been a pioneer in her work on the use of cyclical natural progesterone for two weeks on and two weeks off to help trigger ovulation in women who are not ovulating, and this helps correct the hormonal imbalance. This can fully explored in a bioidentical hormone clinic.

Thus, in the example of PCOS we can see the far-reaching, whole-body consequences of reproductive hormone balance.

Interestingly, women are also five to eight times more likely than men to have thyroid hormone problems, with one in eight women developing a thyroid disorder during her lifetime.

The thyroid is a butterfly-shaped gland at the base of the neck that produces hormones (thyroxine) essential for regulating metabolism, body temperature, energy, heart rate, menstrual cycle, mood, and hair and nail growth.

Essentially, it serves as the body’s thermostat controlling how fast things happen in the body by its actions on different organs/tissues.

There are two main categories of thyroid problems hypothyroidism (an under-active thyroid) and hyperthyroidism (an overactive thyroid).

In the case of hypothyroidism, the body literally slows down and causes symptoms like weight gain, brain fog, constipation and sluggishness.

The thyroid is not producing enough of the thyroid hormones – triiodothyronine T3 (active form) orthyroxine T4 or both.

The thyroid is a sentinel gland assessing the environment and ensuring the body adapts appropriately.  It requires a number of nutrients to function optimally and lack of these can cause it to under function. These nutrients include selenium, zinc, vitamin A, iron and iodine.

Reversing these deficiencies can help the thyroid improve its functioning.

In addition, the immune system can become muddled and produce autoantibodies which mark the thyroid for destruction by the white cells of the immune system. This is called Hashimoto’s disease an autoimmune condition which is more common amongst women.

There is a triad of genetic predisposition, increased gut wall permeability which allows the immune system to be more activated and a trigger e.g. stress/gluten exposure which ignites the whole process resulting in the production of antibodies which label the thyroid as foreign and for attack.

The conventional medical model works on trying to reduce the symptoms of hypothyroidism by giving replacement thyroxine support.

This can help the situation but does not address the immune activations and high levels of antibodies causing the thyroid to be attacked. Patients will feel a bit better, but it certainly does not bring vitality and full wellbeing to the majority.

In the functional medicine world patients are often given replacement hormone but there will also be emphasis on addressing the root cause by:

1. Improving gut health and reducing gut permeability. This requires working on the gut microbiome and nutrition. 85 per cent of patients with Hashimoto’s do better on a gluten-free diet because there is molecular mimicry between the gluten molecule and the thyroid and in individuals with a genetic predisposition the immune system reaction against gluten ingested can also target thyroid tissue.
2. Working on the other pillars of health sleep, relaxation and movement can also help bring the body back into balance and help the immune activation.
3. Ensuring there are not nutritional deficiencies impacting the gland.

Women in the perimenopause and menopause are more at risk of thyroid disorders as there are oestrogen receptors on the thyroid and at this time there is hormonal fluctuations which can trigger thyroid dysfunction.

During the menopause, as a result of the lack of estrogen, thyroid function can be suboptimal and this can contribute to the menopausal weight gain around the middle that happens and the deterioration in lipid panels.

We can see how endocrine glands interact with each other; the body has a complex web of interconnection which help keep the body in balance.

When we are seeing hormonal dysfunction symptoms is important not only to look at symptoms control but to look at deeper root causes driving the issues.

Careful consideration to the environment we are bathing our genes is key to optimal hormonal health and this is best done with a medical professional who understands the importance of hormonal health.

To find out more, visit the Marion Gluck Clinic.