The female hormonal sphere, so complex and sophisticated, is
frequently treated in an oversimplified and rushed manner. Working
together with many women, I frequently hear their stories that confirm a
more and more standardized medical approach that rarely takes into
account the individual hormonal characteristics.
measurements are infrequent, mostly incomplete and almost always today
contraceptive pills are used to cure any menstrual problem. To
illustrate the complexity of hormonal action in women, I will focus on
the effects on mood that cyclic hormonal variations cause. We can
distinguish specifically two moments of the menstrual cycle in which
changing hormones cause important effects on mood: ovulation and the
days before menstruation.
Beyond undeniable individual psychological
characteristics, mood changes during the menstrual cycle are the direct
effect of the action of estrogens and progesterone in the brain. These
hormones bind to specific brain receptors especially present in areas
controlling emotions, such as the limbic system. Estrogens increase the
speed and intensity of information transmission in the brain, allow
better sugar and oxygen utilization and increase blood flow to the
central nervous system. They are thus activating hormones, improving
mood but also capable of generating irritability, anxiety and insomnia.
Progesterone has opposite effects: it is a calming and relaxing hormone,
it helps sleep and has even pain killing properties.
syndrome, which affects so many women, is caused precisely by a decrease
in progesterone (after 2 weeks of high levels in the second phase of
the cycle) that comes some days before the decrease in estrogens. During
those days of imbalance the women lives a condition of
estrogen-dominance with symptoms ranging from irritability to breast
tension, from mood changes to fluid retention. A similar condition of
estrogen-dominance can be present at mid-cycle ovulation when there is a
moment of great increase in estrogens that is usually followed by the
rebalancing increase in progesterone typical of the second half of the
In some women though the production of progesterone is
insufficient (this happens frequently after age 35-40 and lasts until
menopause). These 14 days of elevated estrogens and scanty progesterone
make the second half of the cycle for these women very unpleasant and
frequently the following bleeding very intense and painful. Specific
laboratory exams and a complete medical history and clinical evaluation
help the clinician identify the hormonal pattern of each patient.
interventions need not to be exclusively a contraceptive pill but also
the use of natural substances and bioidentical hormones, drugs with a
chemical formula that is identical to the one of the hormone that needs
to be replaced. Frequently these interventions, associated with a
correct nutrition and a physical exercise plan, contribute to a complete
resolution of the hormonal imbalance. Moreover an untreated condition
of estrogen dominance increases the risk of estrogen-dependent cancer,
including breast cancer.
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