Balancing Hormones and Improving Sleep

I know you know the drill, but with a topic as complex as this one, I really do have to stress that I am not a doctor and I am not dispensing medical advice. I do, however, work in the functional medicine world and am always studying the new developments in that world. In fact, when my kids get in the car with me and my podcasts start playing, they crack up and tell me how weird I am because it’s always something about thyroid health, gut dysbiosis, hormones or some other scintillating topic that teenagers love. Ha! How else am I qualified to discuss this tricky topic of balancing hormones and sleep health? I’m a 48 year old female and smack in the middle of (or maybe the end – who knows!) perimenopause.

If you (a late-30s to mid-50s woman) were to go to your regular doctor and complain of trouble sleeping, mood swings, hot flashes, appetite irregularities and diminished libido, your doctor would declare you in perimenopause and tell you to wait it out. Those of us living in the functional medicine space, don’t mind taking a non-medication route to health, but in this particular case, “waiting it out” might take ten years! Or more! That’s a long time to suffer.

Thankfully, there are A LOT of things you can try at home, without medical intervention, and some without even a visit to a medical practitioner of any kind.

Let’s go about this in a systematic way. Again, it’s a huge topic and I’m really just scratching the surface here. Sleep health is it’s own topic worthy of discussion, but because our sleep is often one of the things that suffers when we hit a certain age, we’ll address it here somewhat, but I do have a recent post all about sleep health to which I’d like to direct your attention.

Here’s what we’ll cover in this article:

• Easy things you can do to help your sleep
• Non-medical avenues to try to balance hormones
• Testing and treating based on results

Easy things you can do to help your sleep

If you’re having trouble sleeping, it could very well be a result of hormonal imbalance. One tell-tale sign that it is your hormones wreaking havoc with you is that your sleep is great except for a few days of your cycle and it’s pretty consistent from month to month. This is not to say that some of the easy, at-home options won’t work if it’s hormones that are causing your poor sleep – they most certainly can help. However, you might find more or faster relief with some supplementation. We can talk more about that in our health coach-client relationship should you choose to go that route.

Do all the easy stuff first, which means sleep hygiene. Create a sleep-inducing environment that is quiet, dark, and cool. Hop off of technology at least 1 hr. before bed. Create a wind down routine. Don’t plan stressful conversations, check the news, exercise or do anything else extremely stimulating right before sleep time. Use the sleep tracker I created for you.

Remember to go back and read my sleep tips post for more details.

Non-treatment avenues to try to help balance hormones

• Clean up your diet. An anti-inflammatory diet, Mediterranean diet, paleo diet, will all work. You can find many recipes here on this website to help. If you are currently following a standard American diet, this will be harder. If you’re paleo-ish already, but have loosened up perhaps a little too much, then it shouldn’t take too long to get this piece of the puzzle back in place. Some people love the structure of a plan and so some form of elimination diet might work for you, especially if you might have food allergies. Whole30 is a good plan with lots of resources available for free.

• Remove the hormone/endocrine disrupters from your environment. Again, this is a huge topic unto itself. If you haven’t cleaned up your skincare, beauty and household products, choose one place to start. This will help keep you from becoming overwhelmed and will also help you spread out the expense. There are many clean beauty brands on the market now. I still use/sell/recommend Beautycounter because I trust their testing processes and commitment to quality, clean ingredients, but there are other brands you can try.

• Check the gut microbiome. You can either just begin taking a probiotic, add more prebiotic foods to your diet or ask your doctor for a test to see which bacteria are currently colonizing your gut and then choose a targeted probiotic.

• Begin Intermittent Fasting (IF). Insulin resistance can play a huge role in hormone changes during perimenopause and then again once you hit menopause and estrogen dramatically drops. If your blood sugar is all over the place, this can certainly have a negative impact on your hormones.
  • It can take up to 12 hours for your blood sugar to get to a baseline, so if you’re going to try IF, make sure you are fasting for at least 12 hours, which is not hard to do. Think about it – if you finish dinner at 7 and don’t eat again until 7 the next morning, you’ve fasted 12 hours. No actual meal skipping required! This information is for those of you who are very resistant to the idea of fasting. The truth is that 12 hours of fasting is likely not enough to make a real difference long term. Yes, it’s a good place to start, but if you want IF to help you balance your hormones, a minimum of 13 hours is best.
  • A way to transition and sort of trick your body into thinking you’ve had a longer fast is to have a low carb dinner and then start your fast.

• A few extra tips regarding fasting: Caffeine can increase your blood sugar which can make you hungry, making fasting much more difficult. This is not true for everyone (it’s not true to me), but it is for some. Some hardcore (and mean) doctors tell you to fast without even black coffee. I would never suggest such a thing! Just know that if you try fasting and your hunger is just uncontrollable and you are still including black coffee or tea in your fast, that might be the culprit.

• The later in the day you eat, the more insulin your body produces and the more your body goes into storage mode. The same meal eaten at 7 pm vs. 5 pm can increase insulin secretion 40-70% more. That’s huge! Remember that insulin is a storage hormone. It takes what you’ve eaten and stores it away for later use – some in the form of glycogen in the liver and some in the form of fat. This is not what you want if weight management, insulin sensitivity and metabolic flexibility is your goal.

• Stress also raises your blood glucose, so getting a handle on stress management might be a huge factor for you.

Bottom line: You want to keep your blood sugar levels stable. Fasting is a great way to do that though there are other ways – low carb, keto, carnivore, protein-sparing modified fasts and more. By keeping your blood sugar under control, you may be able to help your body naturally keep its hormones in balance.

high stress or high blood sugar –> insulin resistance –> hormone imbalance

One more topic under the non-medical interventions heading is sort of medical because it does involve prescriptions. After discussing with your medical team and your husband/partner and making alternate plans for birth control, stop taking synthetic hormones. We need to ovulate – that is how your body produces hormones. Taking synthetic hormones, particularly progestin, stops the ovulation, which is NOT what you want heading into perimenopause and beyond. I won’t spend anymore time on that topic because it really is something you must discuss with your doctors and your spouse, but it’s something you need to know about. There are many doctors who will suggest these synthetic hormones as a way to deal with the problems of perimenopause, but those in the functional space believe that approach will do more harm than good.

Testing and treating based on results

And now the last topic for this post: testing and then how you might proceed once you receive your results.

Ideally, you want a functional medicine doctor to manage your testing and then supplementation based on results. You can order some blood tests on your own and there are many functional medicine practitioners working via telemedicine, so I’m not going to make specific recommendations here. If you want to work with me as your health coach, we can get into those sorts of specifics.

Just know that you are going to want to test your estrogen and progesterone at a specific day of your cycle and then supplement with bio-identical hormones. Also know that there is likely a lot of experimentation in your future. You need to be tuned into how your body is feeling and responding and feel comfortable making adjustments as needed.

There are many misdiagnoses of thyroid problems particularly around perimenopause. Again, you need a functional medicine practitioner to order the proper tests for you. Many doctors will only order TSH, which is a marker of how well your brain is signaling to your thyroid. This is important, but you really need to know your levels of T3 and T4, the actual thyroid hormones. You also need to check reverse T3, which acts like a brake. If reverse T3 is high, you may be experiencing unwanted symptoms. Sadly, many endocrinologists don’t even order this complete panel of thyroid tests.

Let’s go back to high school biology for a moment. Do you remember studying the cell and all those fancy, little organelles? If so, you probably remember the mitochondria, often called the “power house” of the cell. They are largely responsible for energy production in the form of ATP. Suffice it to say, this is something your body wants and needs. The ovaries contain the highest number of mitochondria of any part of the body, male or female! So if you are feeling sluggish, you may need mitochondrial support. Guess what can help “boost” your mitochondria? Intermittent fasting, exercise, deep breathing, some targeted supplements and more. Yes, all those other functional medicine “prescriptions” work here too.

So yes, you can do some testing, and I recommend it if you have the means to do so, but there is SO much you can right now with zero medical intervention.

If you read, “anti-inflammatory diet, exercise, deep breathing, intermittent fasting” and you have no idea where to begin, I can help. This is exactly what I do as a functional medicine health coach. You can visit this page to learn about how I work with women just like you.

Do you think you are suffering from hormone imbalances, related to perimenopause or not? If so, here are some parting thoughts:

Do one thing at a time – overwhelming yourself with thoughts that you must do it all, all at once, will only add to your stress. Figure out where you want to start – diet? exercise? environmental toxins? stress management? Again, this is something I can help with as your health coach.

Move more – Yes, exercise was mentioned as a place to start, but really, everyone needs to move more. Think about how you can work little movement breaks into your day. Do you work from home? Go outside and walk down your street for 10 minutes. Work in an office? Go see that co-worker rather than sending a message.

Build supportive relationships – If you have relationships that are stressing you out or dragging you down emotionally, they are not helping your overall mood and might possibly be contributing to sleep issues. Figure out how to fix those relationships or break up with them altogether. I realize that is much easier said that done, especially if those stress-inducing relationships are family. Sometimes you have to try to counteract the stressors by adding in more time with those relationships that are good for you.

Keep a journal – of sleep, diet, mood, food and beverage intake, stressors, life-giving moments and be sure to note how you feel and see if you find any connections. Believe it or not, simply becoming aware of what is affecting you and how it is affecting you can be the beginning of a very powerful and productive journey!

Work on your sleep hygiene – Read that post and see what changes you can make. One tip I really can’t stress enough is ditching the alcohol. I know there have been studies that seem to show some cardiovascular benefits of certain types of alcohol, but for most of us, especially if you have having trouble sleeping, there is more harm than good. It’s just something else to try.

If you want to hear me discussing this information rather than reading it all yourself, you can watch this YouTube video that covers basically the same information. Because I’m admittedly a talker, it’s a little longer and more detailed – I give more ideas for how to address some of these topics. I have an idea! Turn on the video and go for a walk while you listen!

As always, I wish you health! I’m going through all of this with you. Let’s help each other! If you’ve run across an awesome product or technique that has been helpful to you, please share it in the comments.