Do you suffer from PMS (distinct mood changes, depression, breast tenderness, fluid retention), heavy menstrual bleeding with clots, weight gain and/or hormonal acne? Or perhaps you have been diagnosed with polycystic ovary syndrome (PCOS), endometriosis and/or uterine fibroids?

What all these symptoms and conditions potentially have in common is a situation of oestrogen dominance. Oestrogen dominance may be:

• True: oestrogen levels are very high, or
• Relative: oestrogen levels are normal, however progesterone levels are low, cortisol high, testosterone high and prolactin high.

A blood test can assist with working out which presentation you fit into, and which treatment strategy is most appropriate.

Insufficient progesterone results in luteal phase (second half of the cycle after ovulation) insufficiency. This can result in mid-cycle spotting and early ovulation causing shortened cycles. An optimal healthy cycle is 29 days in length with ovulation occurring approximately on day 15.

Stress demands the release of cortisol, a critical survival hormone. When cortisol levels are high, unfortunately the production of progesterone will fall, as the sex hormones are not considered important in a survival state. Progesterone is a steroid hormone, and unfortunately the precursor to cortisol, which is another steroid hormone. When you are stressed your adrenal glands, which release cortisol, steal progesterone to make cortisol.

Elevated testosterone, a common presentation in PCOS, may prevent or significantly delay ovulation each month. Associated symptoms include acne, facial hair and hair loss.

High prolactin, also common in PCOS, inhibits ovulation, resulting in anovulatory and/or longer cycles.

The key to balancing hormones in the body is to ensure that oestrogen is efficiently metabolised in the liver, and oestrogen metabolites are excreted through the bowel. Therefore optimal liver and bowel function is very important for hormone regulation.

The key to healthy hormones is eating a balanced diet with tons of variety from whole foods from nature, providing a balance of protein, fats and carbohydrates from good sources. Hormones do not like trans-saturated fats, sugar and icky chemicals found in processed foods.

Liver detoxification consists of 2 phases of detoxification that must be in balance and working efficiently for effective oestrogen metabolism.

Phytonutrients, found in dietary interventions, nutritional supplementation and herbal medicine, can support optimal liver function through induction or inhibition of phase 1 processes, or up regulation of phase 2 processes.

Dietary tips for top liver function:

• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, kale): contain the compound indole-3-carbinol that shifts the metabolism of oestrogen to the protective 2-hydroxy oestrogen metabolite, and away form the harmful 16-hydroxy metabolite.
• Sulphur containing foods such as garlic and onions: support the phase 2 liver detoxification pathway.
• Antioxidant rich foods such as brightly coloured vegetables and fruits: the intermediate phase, between phases 1 and 2, produces free radicals which damage cells in the body. Antioxidants mop up free radicals.
• Complete protein: the amino acids are needed for phase 2 liver detoxification reactions. Complete protein is found in animal sources such as eggs, fish, chicken and meat. Vegetable protein must be consumed from a variety of foods to be complete including grains, legumes, nuts and seeds.
• Turmeric: the compound curcumin has been shown to boost liver detoxification processes.

Nutrients vital for efficient liver function include:

• B vitamins: particularly B6, folate, B12 to support methylation
• Amino acids: especially glutamine, glycine, cysteine, taurine
• Antioxidants: vitamins A, C, E, selenium, zinc, coenzymeQ10 and bioflavonoids (quercetin, rutin, hesperidin)

Herbal medicines shown to support liver detoxification include schisandra, rosemary, and st mary’s thistle.

Constipation facilitates the re-absorption of oestrogen from the bowel, thus preventing adequate removal. Therefore good bowel function (passing 1-2 well formed stool(s) per day) is such an important strategy for balancing hormones, not to mention prevention of oestrogen-dependent cancers (breast, endometrial, cervical).

Good bowel function demands healthy gut flora. Refined foods and alcohol wipe out your gut flora. The gastrointestinal tract is nourished by consuming real foods, and absolutely loves fermented foods such as sauerkraut, kimchi and yoghurt (pot set, natural).

We all know how important fibre is for healthy bowel motions. Linseeds are a great source of fibre, and particularly effective for oestrogen detoxification by binding to free hormone levels and improving the ratio between 2:16 oestrogen metabolites.

The support of progesterone production is vital to normalise ovulation and maintain the luteal phase. The only way to make sufficient progesterone is to ovulate each month. The herb chaste tree stimulates the hypothalamic-pituitary-ovary axis, and promotes ovulation. Vitamin B6 and zinc are also extremely important for progesterone support.

As already mentioned consistently raised cortisol can mess with your hormones because your body switches off vital functions such as reproduction and digestion. Adrenal fatigue, through the chronic release of cortisol, is all too common in this modern world. Herbal medicine is an absolute winner for nourishing the function of the adrenal glands and restoring health. My favourite adrenal nourishing herbs are rehmannia and licorice. Other herbs assist you to cope better with any stressors in your life. These herbs are called adaptogensand include withania, rhodiola, Siberian ginseng and Korean ginseng.

And don’t forget the beauty of exercise, yoga, mediation and most importantly sleep for restoring adrenal function.

As you can see balancing hormones in the body can be achieved through gentle detoxification with nutritional and herbal medicine support. Once the body is back in balance symptoms should reside coinciding with a healthy ovulation. The exciting part is that once you become more in tune with your body and know when you are ovulating you can start to adopt

practices quite easily.