by georgia hartmann
Women’s Health Expert
Irregular periods; weight gain; acne; hair loss; sore breasts; mood swings; heavy periods; anxiety; depression; difficulty conceiving; spotting; PCOS; elevated stress; light periods; menstrual clots; PMS─can you relate?
These are just a few symptoms of hormonal imbalance and, in light of International Women’s Day, I thought I’d share how you can take charge of your health and hormones (once and for all). It starts by focusing on an event that occurs mid-way through your cycle. It’s called ovulation. And it’s kind of a big deal.
First, a recap on the four phases of the menstrual cycle
The first phase of your cycle is called the Follicular Phase. It’s approximately two weeks (though can last anywhere from 7 to 21 days) and is when a few follicles enter the final days of their race to ovulation. This process of follicle maturation actually takes 100 days. (Meaning that if your follicles were unhealthy for any part of that 3-ish months, the result could be a period problem months later. I know. Crazy, right.). [1,2]
As you get closer to ovulation, your follicles are stimulated to make oestrogen. The developing follicles release a specific type of oestrogen (called oestradiol) whose primary role is to thicken the uterine lining in preparation for a baby. Though, aside from this, oestradiol has many other benefits─It is your happy hormone that stimulates mood, motivation, and a sense of wellbeing. It supports libido, and healthy bones and muscles. Oestradiol is integral for healthy skin and sleep. It also supports metabolism and enhances your sensitivity to insulin (which helps prevent insulin resistance: a key player in weight gain).[3-5]
The second phase of your cycle is called Ovulation and occurs mid-cycle. We will get to this shortly.
The third phase of your cycle is called the Luteal Phase. This is the 10 to 16 days between ovulation and the next bleed. The length is determined by a gland called the corpus luteum, which is developed right after ovulation to support progesterone production. Progesterone is primarily made to support the early stages of pregnancy (this is how progesterone got its name: from being the ‘pro-gestation’ hormone). Though, progesterone does much more than that. It is our calming hormone that supports sleep, stress, anxiety and PMS. [6-8]
The final phase of your cycle is your period. If you had a healthy corpus luteum and made enough progesterone, your period will arrive smoothly and without irritability, pain or spotting. (Yes, you interpret correctly─PMS is not normal and is a sign of hormonal imbalance).
Ovulation: The secret to balancing your hormones
Ok, you’ve reached this point and understand the grand role oestrogen and progesterone play in allowing us to feel great. So, how do we ensure we are making adequate levels of these hormones?
One simple answer (yet one massive event): Ovulation.
As one of your follicles reaches the finish line, your dominant follicle swells and finally ruptures to release its egg. This release is ovulation. (And the event itself occurs over just a few minutes). If sperm is present, the egg will be fertilized in the fallopian tubes and you will be pregnant. Otherwise, you will get your period approximately two weeks later.
Remember: Even if you’re not trying to conceive, ovulation is a momentous event because it is how you make oestrogen and progesterone. Put simply, ovulation is important for balanced moods, glowing skin, good metabolism, healthy stress response, and normal periods.
So, do you ovulate?
This is probably the most important (hormonal) question you’ll ever ask yourself. The answer lies in simple clues─changes in cervical mucus, a rise in waking temperature, a positive urine ovulation stick, and an increase in mid-luteal progesterone (simple blood test). A period is not a definitive sign of ovulation.
While there are many factors that affect ovulation (and therefore your production of oestrogen and progesterone), here are the big drivers I see in my own clinical practice:
- Alcohol consumption─Did you know that a single standard drink can increase oestrogen levels? 
- Smoking─Both cigarettes and marijuana negatively affect ovulation and fertility. [11-12]
- Elevated stress─We know that stress increases the risk of absent ovulation by up to 70%.
- Trans fats─Research out of Harvard University shows that each 2% increase in the intake of energy from trans fats (cakes, biscuits, sweets, processed foods, fried foods) increases the risk of ovulatory infertility by 73%.
- Poor sleep─altered melatonin (our sleep-promotion hormone) secretion can cause ovulation problems. 
- Weight─both too little and too much weight affects ovulation. When it comes to weight loss, shifting as little as 5% of body weight in women experiencing obesity can restore ovulation.[16,17]
- Hormonal birth control─such as the Oral Contraceptive Pill suppresses ovulation. 
- PCOS─absent ovulation is a hallmark of PCOS, making it the most common endocrine disorder of reproductive-aged women.
- Environmental toxins─Today, more than 800 chemical products categorized as endocrine disruptors may strongly affect hormonal balance and lead to anovulation.
- Thyroid disease─Hypothyroidism has been associated with altered ovulation, menstrual irregularities, subfertility, and higher (recurrent) miscarriage rates.
- Nutrient deficiencies─lower levels of nutrients such as zinc, selenium, iodine, and vitamin D can alter ovulation. [22-24]
I know, there is a lot to digest here.
While it may seem overwhelming, balancing your hormones can be done! It all starts with working on the factors in your diet and lifestyle that affect ovulation. For additional support, and guidance on testing, click here to book a one-on-one online consultation with one of our in-house Naturopaths.
 Thiyagarajan, D.K., et al. Physiology, Menstrual Cycle. StatPearls, 2020. PMID: 29763196.
 Gougeon, A. Human ovarian follicular development: from activation of resting follicles to preovulatory maturation. Annals of Endocrinology, 2010. 71(13). PMID: 20362973.
 Holesh, J.R., et al. Physiology, Ovulation. StatPearls, 2021. PMID: 28723025.
 Cappelletti, M., et al. Increasing women’s sexual desire: The comparative effectiveness of estrogens and androgens. Hormones and Behaviour, 2016. PMID: 26589379.
 Rettberg, J.R., et al. Estrogen: A master regulator of bioenergetic systems in the brain and body. Frontiers in Neuroendocrinology, 2014. 35(1). PMID: 23994581.
 Crawford, N.M., et al. A prospective evaluation of luteal phase length and natural fertility. Fertility & Sterility, 2017. 107(3). PMID: 28065408.
 Yen, Y-J., et al. Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder. International Journal of Environmental Research & Public Health, 2019. 16(22). PMID: 31703451.
 Roomruangwong, C., et al. Lowered Plasma Steady-State Levels of Progesterone Combined With Declining Progesterone Levels During the Luteal Phase Predict Peri-Menstrual Syndrome and Its Major Subdomains. Frontiers in Psychology, 2019. PMID: 31736837.
 Su, H-W., et al. Detection of ovulation, a review of currently available methods. Bioengineering & Translational Medicine, 2017. 2(3). PMID: 29313033.
 Frydenberg, H., et al. Alcohol consumption, endogenous estrogen and mammographic density among premenopausal women. Breast Cancer Research, 2015. 17(1). PMID: 26246001.
 Whitcom, B.W., et al. Ovarian function and cigarette smoking in the BioCycle Study. Paediatric and Perinatal Epidemiology, 2010. 24(5). PMID: 20670224.
 de Angelis, C., et al. Smoke, alcohol and drug addiction and female fertility. Reproductive Biology & Endocrinology, 2020. PMID: 32164734.
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 Harrison, D., et al. Systematic Review of Ovarian Activity and Potential for Embryo Formation and Loss during the Use of Hormonal Contraception. The Linacre Quarterly, 2018. 85(4). PMID: 32431378.
 Goodman, N.F., et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome – Part 1. Endocrine Practice, 2015. 21(11). PMID: 26509855.
 Pizzorno, J., et al. Environmental Toxins and Infertility. Integrative Medicine, 2018. 17(2). PMID: 30962779.
 Cho, M.K., et al. Thyroid dysfunction and subfertility. Clinical & Experimental Reproductive Medicine, 2015. 42(4). PMID: 26816871.
 Günalan, E., et al. The effect of nutrient supplementation in the management of polycystic ovary syndrome-associated metabolic dysfunctions: A critical review. Journal of the Turkish-German Gynecology Association, 2018. 19(4). PMID: 30299265.
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 Kim, K., et al. Dietary minerals, reproductive hormone levels, and sporadic anovulation: associations in healthy women with regular menstrual cycles. British Journal of Nutrition, 2018. 120(1). PMID: 29673411.
by georgia hartman
Women’s Health Expert