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How to treat hormonal imbalances

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Progesterone, produced in the ovaries, adrenal glands and in the placenta during pregnancy, influences a series of vital functions, including sleep, and plays a major role in the menstrual cycle and pregnancy. 

During a woman’s menstrual cycle, production of progesterone rises after ovulation (approximately day 14), peaking around day 21. The hormone’s primary function is to stabilize the uterine lining (or endometrium) to create a supportive environment for a fertilized egg. If a woman does not become pregnant, her progesterone levels begin to fall. 

By day 28 of her cycle, her uterine lining sheds, and she menstruates. If she does become pregnant, her progesterone levels continue to rise after day 21. The hormone is produced by the corpus luteum (the now-transformed lining of the ovulated cyst wall) for roughly 10 weeks until the placenta takes over, leveling off the production of progesterone after the first trimester.

For some women, however, increases and decreases in progesterone levels do not follow this path. One potential cause is the absence of ovulation. Ovulation is critical to progesterone production, so if ovulation does not occur, over time a progesterone deficiency (and estrogen dominance) will take hold. 

Ovulation may cease due to a variety of conditions, including excessive stress, extreme weight loss or gain, ovarian dysfunction and a number of hormonal and other chemical imbalances. 

Irregular ovulation can also cause low progesterone. In these cases, after ovulation, the ovaries do not release enough progesterone to support the growth of the uterine lining. This gives rise to a condition known as luteal phase defect (named for the second, or luteal, phase of the menstrual cycle),1 which often goes hand in hand with severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). 

The potentially debilitating symptoms of this disorder include depression and feelings of hopelessness, as well as fatigue, joint and muscle aches, headaches and interrupted sleep. 

A luteal phase defect can also cause miscarriage.2 In the event that an egg becomes fertilized following ovulation, a thin endometrial lining may not sustain implantation. 

Various illnesses and chronic conditions, such thyroid disease and rheumatoid arthritis, can cause hormonal imbalances that influence progesterone production. Emotional stress is another potential cause.

The good news is that a combination of the right foods and supplements can help correct this common problem.

Symptoms of progesterone deficiency

  • Breast tenderness
  • Migraines
  • Hot flashes and night sweats
  • PMS/PMDD symptoms such as fluid retention, bloating, headaches, constipation, backache, acne
  • Interrupted sleep
  • Difficulty concentrating
  • Depression
  • Anxiety
  • Emotional sensitivity
  • Severe fatigue

Nutrition

The role of nutrition is to help boost progesterone production. There are no foods that contain progesterone, per se, so supporting the body’s systems in ways that may help the body sustain its existing progesterone levels is ultimately the goal. Here are the foods to embrace.

Fiber 

Estrogen and progesterone work in unison, and with higher estrogen levels, progesterone may be less effective. By increasing the levels of fiber in your gastrointestinal tract, you can effectively lower your estrogen levels, which can, in turn, make your circulating progesterone levels more effective. 

Cruciferous vegetables such as broccoli, cabbage, celery and kale are a great source, as are whole grains, oats and seeds such as flax and sunflower. 

Beans, berries and fruits such as apples and pears contain helpful amounts of fiber, as do nuts such as almonds, pecans and walnuts. 

Two notes of caution with fiber: for one, you need to slowly increase the amount in your diet to avoid side-effects like excess gas and stomach pain. 

Second, cruciferous vegetables can contain phytoestrogens, which can have estrogenic effects, so keep your consumption to one serving every
other day. 

Foods containing magnesium 

Sufficient amounts of magnesium in your system will help prevent stress-induced inflammation, which in turn supports the healthy functioning of the pituitary gland. This produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are carried via the bloodstream to the ovaries, where they drive ovulation and the production of progesterone. 

I recommend an intake of between 400 and 800 mg of magnesium per day. 

Good food sources include: 

  • Dark leafy greens (spinach and chard) 
  • Nuts (almonds and cashews)
  • Seeds (pumpkin)
  • Dark chocolate 
  • Yogurt and kefir 
  • Avocados 
  • Bananas
  • Figs
  • Fatty fish, including halibut, mackerel and salmon 
  • Foods containing vitamin C 

This vitamin has been shown to boost progesterone by up to 77 percent. And research has shown that vitamin C can increase both endometrial thickness and progesterone serum levels during the luteal phase. 

A 2003 study found that women who ingested 750 mg of vitamin C per day experienced both increased progesterone levels and higher rates of pregnancy.3 

Although vitamin C can have these supportive effects, it is important to not ingest excessive amounts. 

Good food sources of vitamin C include: 

  • Citrus fruits, particularly   oranges and grapefruit 
  • Kale 
  • Red peppers (green peppers contain less vitamin C, but are also a good source) 
  • Brussels sprouts
  • Broccoli
  • Tropical fruits, including kiwi and guava 
  • Strawberries 

Foods containing vitamin B6 

Research has shown that vitamin B6 can help decrease estrogen dominance and increase progesterone levels, helping to both ameliorate symptoms of PMS and/or PMDD and decrease the likelihood of miscarriage.4 Vitamin B6 can also help offset the symptoms of nausea and vomiting during pregnancy. 

I recommend a vitamin B6 intake of 10 mg/day. 

Good food sources of vitamin B6 include: 

  • Chickpeas and pinto beans 
  • Tuna and salmon
  • Turkey and chicken breast 
  • Sunflower and sesame seeds 
  • Pistachios 
  • Prunes 

Foods containing zinc 

Similar to magnesium, zinc helps support the functioning of the pituitary gland, which secretes FSH and LH, hormones that trigger ovulation and have the downstream effect of reduced progesterone production. Also, studies have shown that inadequate zinc levels can contribute to symptoms of PMS and/or PMDD.5 

I recommend 15 to 25 mg of zinc per day. 

Good food sources of zinc include: 

  • Oysters and shrimp
  • Red meats, including lamb and beef 
  • Pumpkin, flax and watermelon seeds 
  • Cashews and peanuts
  • Wheat germ 

Foods containing vitamin E 

Research into the effects of vitamin E on women diagnosed with luteal phase defect has shown that it can increase progesterone production by the corpus luteum by improving blood flow to the ovaries. 

According to a 2009 study, 600 mg of vitamin E administered three times daily significantly increased serum concentrations of progesterone by virtue of its impact on the healthy functioning of the corpus luteum.6

I recommend 400 IU of vitamin E per day. 

Good food sources of vitamin E include: 

  • Sunflower seeds 
  • Almonds
  • Safflower and palm oils 
  • Asparagus 
  • Red peppers 
  • Avocado 
  • Spinach 
  • Sweet potato 

Other ways to balance low progesterone

Essential oils. The following essential oils can help raise progesterone levels: bergamot, cinnamon bark, clove bud, eucalyptus, frankincense and peppermint. Use them with a diffuser or dilute with a carrier oil and apply topically.

Stress-reduction techniques. Massage and acupuncture, used regularly, can help to reduce stress and potentially bring the ovulation signals back in line. 

Craniosacral therapy. This hands-on technique uses gentle pressure to realign energetic tensions deep within the body, the theory being that overt stressors misalign the brain and spine, causing dysfunction. I’m a fan of this therapy for progesterone deficiency to help realign the pituitary gland. 

Exercise. Practices that help strengthen your core, the muscles of your abdominal area, hips and lower back, such as Pilates, can be helpful. I also recommend walking, which can bring both physical and mental benefits—and you don’t need excessive amounts of time or energy to do it.

Supplements

Certain vitamin and mineral supplements can help support progesterone production and ameliorate some of the physical and psychological symptoms associated with progesterone deficiency. 

Magnesium

This mineral helps reduce stress-induced inflammation, which, in turn, supports the healthy functioning of the pituitary gland and the production of LH and FSH, the hormones that drive ovulation and the production of progesterone. 

Suggested dosage: 400–800 mg/day magnesium glycinate

Vitamin C

This vitamin can increase both endometrial thickness and progesterone serum levels during the luteal phase. 

Suggested dosage: 250–500 mg/day

Zinc

Zinc helps support the functioning of the pituitary gland and helps to alleviate symptoms of PMS and/or PMDD.5 

Suggested dosage: 15–25 mg/day

Vitamin B6

As mentioned earlier, B6 can help to ease symptoms of PMS and/or PMDD, reduce the risk of miscarriage4 and offset the symptoms of nausea and vomiting during pregnancy. 

Suggested dosage: 10 mg/day

L-arginine 

This amino acid is converted by the body to nitrous oxide, a chemical that relaxes your blood vessels, increasing blood flow. Improving ovarian blood flow can help support the production and secretion of progesterone by the corpus luteum. 

Suggested dosage: 3–6 g/day

Vitex agnus-castus

Also known as chasteberry, this herb has been shown in studies to increase the secretion of LH, which in turn boosts progesterone production. 

Suggested dosage: 400 mg two or  three  times per day

Note: Vitex is not recommended for women who are pregnant or breastfeeding. Some women who suffer from menstrual depression or PMDD have reported an exacerbation of these symptoms when taking vitex.

Licorice

Research shows that licorice can help counteract symptoms of PMS and PMDD, particularly those caused by fluid retention, including bloating and breast tenderness. 

Suggested dosage: 400–500 mg of powdered licorice/day

Note: This supplement needs to be treated with care, so take only under the supervision of a physician. 

Valerian root

Although valerian root extract has no direct impact on progesterone production, it can help with sleep-related issues. 

Suggested dosage: 100–200 mg/day, taken 30 minutes to two hours before bedtime

Note: Valerian root is not recommended for women who are pregnant or nursing, as its effects on fetuses and infants are unknown. It may also interact with prescription sedatives, including benzodiazepines and barbiturates, as well as other supplements, including St. John’s wort and melatonin.7


 

References

1 

Front Public Health, 2018; 6: 147

2

Gynecol Endocrinol, 2017; 33(6): 421–4

3

Fertil Steril, 2003; 80(2): 459–61

4

J Reprod Med, 1983; 28(7): 446–64; Am J Epidemiol, 2007; 166(3): 304–12

5

Fertil Steril, 1994; 62(2): 313–20

6

J Ovarian Res, 2009; 2: 1

7

National Institutes of Health Office of Dietary Supplements. Valerian Fact Sheet for Health Professionals. ods.od.nih.gov

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