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The Intricate Dance of Gut Microbes and Hormones: A Key to Women's Health

Our bodies are home to trillions of microorganisms, collectively known as the microbiome. Recent research has shed light on the fascinating relationship between the gut microbiome and our hormonal systems, particularly in women. This interplay has far-reaching implications for various aspects of health, from reproductive issues to metabolic disorders.

Our bodies are home to trillions of microorganisms, collectively known as the microbiome. Recent research has shed light on the fascinating relationship between the gut microbiome and our hormonal systems, particularly in women. This interplay has far-reaching implications for various aspects of health, from reproductive issues to metabolic disorders.

The Gut Microbiome: More Than Just Digestion

The gut microbiome is a complex ecosystem of bacteria residing in our intestines. Far from being passive inhabitants, these microbes play crucial roles in our overall health. They influence not only digestion but also our immune system, metabolism, and even our mood. Remarkably, the gut microbiome is now considered an endocrine organ in its own right, capable of producing and regulating hormones.

Estrogen and the Gut: A Two-Way Street

One of the most significant interactions occurs between gut bacteria and estrogen, a primary female sex hormone. This relationship is so important that researchers have coined the term "estrobolome" to describe the collection of gut bacteria capable of metabolizing estrogen. Here's how it works:

  • Some gut bacteria produce an enzyme called β-glucuronidase, which helps activate estrogen in the body.

  • An imbalance in these bacteria can lead to either too much or too little active estrogen, potentially contributing to conditions like endometriosis, PCOS, and certain cancers.

  • Conversely, estrogen itself can influence the composition of the gut microbiome, creating a feedback loop.

Androgens and Gut Health

While often considered male hormones, androgens like testosterone also play crucial roles in women's health. Elevated androgen levels, a condition known as hyperandrogenaemia, are common in PCOS and can affect the gut microbiome. Studies have shown that:

  • High androgen levels correlate with changes in specific gut bacteria populations.

  • These alterations may contribute to the metabolic issues often seen in PCOS, such as insulin resistance and obesity.

Implications for Women's Health

Understanding these intricate relationships opens up new avenues for addressing women's health issues:

  1. Personalized Medicine: By analyzing an individual's gut microbiome, healthcare providers might better predict and treat hormonal imbalances.

  2. Novel Treatments: Probiotics or targeted dietary interventions could potentially help manage conditions like PCOS by modulating the gut microbiome.

  3. Preventive Care: Maintaining a healthy gut microbiome through diet and lifestyle choices may help prevent hormonal issues before they arise.

  4. Fertility Support: For women struggling with fertility, addressing gut health could be a complementary approach to traditional treatments.

Conclusion

The discovery of the gut microbiome's role in hormonal health is revolutionizing our understanding of women's health. It underscores the importance of a holistic approach to healthcare, considering the interconnectedness of various bodily systems. While research in this field is still evolving, it's clear that nurturing our gut health through a balanced diet, regular exercise, and stress management could have far-reaching benefits for hormonal balance and overall well-being. As we continue to unravel the mysteries of the gut microbiome, we may find new keys to addressing long-standing health challenges, offering hope for more effective and personalized treatments in women's health.

Steps to Prepare You for Bioidentical Hormones

References:

Qi X, Yun C, Pang Y, Qiao J. The impact of the gut microbiota on the reproductive and metabolic endocrine system. Gut Microbes. 2021 Jan-Dec;13(1):1-21. doi: 10.1080/19490976.2021.1894070. PMID: 33722164; PMCID: PMC7971312.

He S, Li H, Yu Z, Zhang F, Liang S, Liu H, Chen H, Lü M. The Gut Microbiome and Sex Hormone-Related Diseases. Front Microbiol. 2021 Sep 28;12:711137. doi: 10.3389/fmicb.2021.711137. PMID: 34650525; PMCID: PMC8506209.

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Erica Leazenby, MD, IFMCP, Chef Erica Leazenby, MD, IFMCP, Chef

Steps to Prepare You for Bioidentical Hormones

The symptoms and changes that occur in perimenopause and menopause are natural, however, women now have access to bioidentical hormones that can help alleviate symptoms such as hot flashes, insomnia, and mood swings. Additionally, many individuals opt for hormones for their benefits to the health of the brain, bones, heart, as well as preventing dryness and atrophy in skin and vaginal tissues.

Consider these steps to prepare for hormone therapy:

The symptoms and changes that occur in perimenopause and menopause are natural, however bioidentical hormones that can help alleviate symptoms such as hot flashes, insomnia, and mood swings. Additionally, many individuals opt for hormones for their benefits to the health of the brain, bones, heart, as well as preventing dryness and atrophy in skin and vaginal tissues.

Bioidentical hormones are demonstrated to be safe when prescribed appropriately by a physician who comprehensively understands your medical history and appropriately monitors your dosage. Despite their low-risk nature, it's essential to recognize that they are not entirely without risks. Therefore, if opting for hormone therapy, seek guidance from a knowledgeable prescriber who conducts in-person physical examinations, uses bioidentical products, and follows the steps outlined below.

5 Steps to prepare you for hormone replacement therapy:

  1. Boost your own hormone production to reduce reliance on prescriptions. You still produce hormones in menopause, just in smaller quantities. Your sex hormones—estrogen, progesterone, and testosterone—are crafted from cholesterol in your cell's mitochondria. So, optimizing cholesterol and ensuring healthy mitochondrial function is crucial. Check your cholesterol levels with a fasting lipid test and consider evaluating your mitochondrial health by checking targeted nutrient levels or oxidative stress markers.

  2. Enhance your hormone signaling for optimal production. Messenger chemicals from your brain, specifically the hypothalamus and pituitary glands, play a crucial role in signaling hormone production. However, this communication system can falter when your sleep, exercise, or stress levels are out of balance, leading to disrupted cortisol. A comprehensive plan for hormone replacement includes stratagies to optimize these important lifestyle habits.

  3. Revitalize your hormone receptors to address low hormone symptoms. Often, the issue isn't just insufficient hormone production or inadequate replacement hormone intake; it's the malfunctioning of receptors. The culprits behind receptor dysfunction is often inflammation. Inflammatory cytokines can clog up hormone receptors, preventing your precious hormones from attaching. This scenario is particularly evident in cases of insulin resistance.

    Here's a two-fold approach to tackle inflammation:

    • Investigate potential sources of inflammation, including dysregulated blood sugar (either too low or too high), obesity, heightened stress, sleep apnea, anemia, allergies, inflammatory foods, gut dysbiosis, and chronic infections.

    • Adopt an anti-inflammatory diet. Focus on eating lots of veggies and adequate protein— whole foods that are minimally processed. Ensure your intake of EPA and DHA omega-3 fats is sufficient. These fats help reduce inflammation. You can check your omega-3 levels with an Omega Check at Quest or Labcorp to determine your omega-3 levels and supplement accordingly. Remember, the dose on a fish oil bottle might not be the right fit for your individual needs.

  4. Ensure efficient breakdown and elimination of hormones. Your liver and gut play vital roles in managing your hormones. Hormones go through two phases of liver processing and are then expels into your GI tract through bile, where beneficial gut bacteria further break them down before they are excreted. Efficient hormone breakdown is crucial to prevent the backup or reabsorption of estrogen metabolites. Some women may face challenges in hormone metabolism due to genetic factors, fatty liver, or alcohol use. Before starting any hormone regimen, even topical hormones, ensure you're experiencing healthy bowel movements daily. Taking proactive steps in hormone breakdown and elimination contributes to overall well-being.

  5. Reduce your exposure to endocrine disruptors. These are chemicals pervasive in our environment that function as xenoestrogens. Xenoestrogens are “foreign” estrogens, substances that are close enough in molecular structure to estrogen that they can bind to estrogen receptor sites with potentially hazardous outcomes. Sources of xenoestrogens include plastics, pesticides, chemicals, and water systems. To limit exposure, prioritize organic foods, opt for clean beauty and household products, steer clear of hair dye and nail polish, and strictly avoid consuming or drinking from any plastic containers. Heat exacerbates the issue, so be particularly cautious with items like water bottles left in the car.

    If you’d like to learn more about avoiding endocrine disruptors, explore the guides provided by the Environmental Working Group for valuable insights and tips. Taking these steps empowers you to minimize exposure and support a healthier endocrine system.

Want some help determining if hormones are right for you? Scheduled an appointment with Relish Health.

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Erica Leazenby, MD, IFMCP, Chef Erica Leazenby, MD, IFMCP, Chef

Losing Sleep? Four Causes and Solutions for Insomnia

There is more and more research showing the importance of sleep and its impact on our health. Yet, insomnia is a common problem. In fact, as high as 30-45% of the adult population suffers from it.

The good news is that resetting your sleep is possible. Below is listed four common triggers for insomnia and ways to address it.

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There is more and more research showing the importance of sleep and its impact on our health. Yet, insomnia is a common problem. In fact, as high as 30-45% of the adult population suffers from it. After we drift off each night, our brain remains in an active and dynamic state. The glymphatic system continues to be hard at work cleaning house, eliminating waste and distributing compounds such as glucose, lipids, amino acids, and neurotransmitters. Also, a complex hormonal dance occurs as part of our natural circadian rhythm which regulates memory function, appetite and metabolism, focus, and many other aspects of our health. These hormone levels are directly related to how we feel on any given day, and the lack of sleep can further complicate many other health issues and recovery.

For example, we have all felt the irritably, mood changes, poor concentration and digestion changes that can come after a rough night of sleep. String together multiple nights of poor sleep and we can have more significant health problems like obesity, diabetes, weakened immune systems, and even decreased longevity. . 

The good news is that resetting your sleep is possible. Below is listed four common triggers for insomnia and ways to address it.

  1. Low blood sugar related insomnia

    • Problem: If you are waking up in the middle of the night I encourage you to examine what you had for dinner. Dinners that are predominately carbs or followed by sugar in the form of dessert or alcohol can leave us on an insulin-blood sugar roller coaster. If our meals are not adequately balanced there is a risk that our blood sugar dips down too low at night. This can trigger you to wake up. 

    • Solution: Eat a balanced dinner. Take a look at your plate. Ideally half of your plate is covered in fiber rich veggies that help slow glucose absorption from your digestive tract. Aim to include 15-20 grams of protein and a source of good fat like avocado, olive oil or nuts and seeds that help maintain steady glucose levels.

  2. High cortisol related insomnia

    • Problem: Cortisol is our stress hormone. It has a natural circadian rhythm that helps us maintain energy over the course of our day. Stress, either psychologic from life events, or physiologic from illness, pain or deficiencies, can trigger our normal cortisol rhythms to be disrupted causing broken and disturbed sleep.

    • Solution: Restoring our natural cortisol level can be challenging until we know the root cause of the disturbance.

      • For emotional stress the role of stress-coping skills cannot be overemphasized. Strategies like meditation, deep breathing exercises, counseling, gratitude journals, regular exercise and appropriately addressing relationship or job concerns are helpful. 

      • For physiologic stress it is best to work with a health care provider that can help uncover and address concerns like nutritional deficiencies, blood-sugar imbalances or chronic pain. 

  3. Sex hormone related insomnia

    • Problem: Many peri- and post-menopausal women can testify that sleep changes as our hormones change. Hormones that are unbalanced can trigger a change in sleep quality.

    • Solution: Addressing stress and optimizing digestive health go a long way toward supporting our hormones, but sometimes we still need additional help. If sleep disruption occurs during a particular part of your menstrual cycle or develops in peri-menopause, then I recommend formal hormone testing. The information gathered can help direct targeted treatment. 

  4. Melatonin related insomnia

    • Problem: Melatonin is one of the hormones that help regulate our sleep. Low levels of melatonin can be caused by exposure to blue light at bedtime or can occur when we have an imbalance in our serotonin levels. Serotonin is a neurotransmitter that is intimately tied to our mood and is a precursor to melatonin. Much of our serotonin is made in our gut and is a common chemical targeted by antidepressant medications. 

    • Solution: Minimizing our exposure to blue light a few hours before bedtime supports our natural melatonin secretion. We can do this by turning off computers, TVs and phones or wearing blue-light blocking glasses. Optimizing our digestive system, the site of much of our serotonin production is also indirectly helpful for our sleep. Talk to a health professional if you struggle with depression. You may need additional support for neurotransmitters. Some people benefit from direct melatonin supplementation, which is available over the counter in pharmacies.

If you think you are suffering from one or more of these issues and would like to discuss a customized plan for improving your sleep, make an appointment with Relish Health today.

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