Hormone Balancing During Weight Loss

Hormone Balancing During Weight Loss

This journey (and education) started with my desire to lose a few pounds. I’m a pear shape and my weight was evenly distributed like a wet suit, but it was stubborn to normal weight loss tactics (I already eat an anti-inflammatory, organic, whole foods, no added sugar, vegetable based diet with grass fed/finished protein).  I decided to do alternate day fasting.  I already intermittent fast for 14 hours every night and skip dinner on the nights I teach yoga. What I did differently was a 24-hour fast every other day for nearly four weeks.  I ate three meals of very healthy quality (lots of vegetables) on even days, and on odd days I would only drink water till dinner.  Dinner was healthy and of normal or sometimes larger portion size than my regular meals. Fasting like this is also called an alternating keto day. On the day you are eating (feasting), you are going through normal glucose metabolism, then the next day you are going from dinner to dinner with only water (fasting), putting your body into a state of ketosis where it has to burn stored fat for energy.

I lost the weight over the month.  I’m visually leaner, it never affected my energy or mood, and it was easy to do. Win, win, win… except… I missed my period.  This was surprising, and immediately I saw this as a big red flag and not a good tradeoff.  

I’ve been regular my entire life and this one month of intermittent fasting every other day created a hormone imbalance.  Having a consistent reproductive cycle is not just a sign of fertility; it’s a sign of wellness and vitality, a signal that your body is optimally nourished (and could be resilient enough to create life if you wanted it to.)  Yes, I lost that stubborn weight, but now I have to concentrate on rebalancing my hormones.

One missed cycle is no big deal, what I want to ensure however, is that it doesn’t get worse and create a cascade of hormone symptoms – belly fat, heavy periods, breast tenderness, mood swings, anxiety, depression, hormonal headaches/migraines, decreased sexual drive, blood sugar imbalances, fibroids, insomnia, changes in energy and more. This is really important as I’m 48 and I don’t want to start perimenopause in a state of imbalance.

I’m hoping my journey and subsequent learnings will help you learn more about your body and how to keep your hormones balanced during weight loss.  First some background and science because learning is fun!

Hormone Overview

Hormones are signaling molecules and are mainly created in the endocrine glands (I.e., Hypothalamus, Thyroid, Adrenals).  Synthesis of your sex hormones depends on the signals of other endocrine glands, and imbalance in one gland (Thyroid or adrenals are common) can create an imbalance downstream. I talk to my hypothyroid and stressed-out clients about this a lot (so contact me if you want to know more).

Estrogen and progesterone are the two major hormones regulating menstrual cycles.  When balanced, we have an approximately 28-day monthly cycle that is free from pain, PMS, pimples, and other problems.  Imbalances disrupt this harmony and cause issues in energy, mood, fertility, aging, inflammation, weight and fat distribution, and brain fog.

Sex hormones are cholesterol based signaling molecules created from low density lipoprotein (LDL) cholesterol (so yes, you need some LDL cholesterol!). Progesterone is made in the adrenal gland, and estrogen is made from it (via the precursors DHEA and androstenedione) in the ovaries.

Estrogen promotes cell growth and fat accumulation, as well as salt and water retention. Progesterone balances out the growth effect of estrogen, stimulates fat burning, balances blood sugar, and is a natural anti-depressant.

How your cycle should work

The menstrual cycle starts with the 1^st day of your period.  During this time, progesterone is low, and estrogen increases, estradiol specifically.  This is known as the follicular phase and it’s marked by an initial increase in estrogen to prepare for the release of an egg. Rising estrogen levels increase luteinizing hormone (LH) levels, while decreasing estrogen levels cause the release of follicle stimulating hormone (FSH). The follicular phase is varied and can last about 14 days or more (it’s common for it to be longer if you are a teenager or perimenopausal).  The Luteal phase happens due to the drop in estrogen which occurs after ovulation, noticed by discharge and/or a rise in basal body temperature.  Ovulation triggers the increase in progesterone.  Estrogen levels also increase during the luteal phase, but optimally are lower than the levels of progesterone.  If Estrogen levels get too high in the luteal phase, they can create PMS. Progesterone keeps estrogen in check, and so modulating healthy progesterone levels is vital for hormone balancing. The luteal phase is typically 14 days.

Skipped Period (Anovulation)

When you skip a period, it’s called an anovulatory cycle as you aren’t ovulating to trigger the increase of progesterone.  In this instance, progesterone stays low for the whole month; you continue your follicular phase, and you don’t have a luteal phase.  This leaves estrogen as the dominant hormone in that cycle.   The drop in estrogen at the end of the month can trigger a bleed.  Most cycles are 21-35 days.  If your cycle is shorter or longer than this average, you can suspect an anovulatory cycle.  

Cycle Changes

An occasional anovulatory cycle (like I experienced during my keto month) is nothing to worry about, but over time, anovulatory cycles can lead to thickening of the lining of the uterus (as it’s not being triggered to slough off) and an increase in uterine polyps, as there is no ovulation. This can commonly happen to both teenagers and perimenopausal women, those coming off hormone replacement therapy such as the birth control pill, or those who have just given birth or stopped lactating.  When this happens to a childbearing age woman, we may want to look further to rule out potential for polycystic ovary syndrome (PCOS), an eating disorder or prolonged restriction of caloric intake, or other causes.

Do you need to eat more?

We used to think that amenorrhea (a missed ovulation cycle) occurred with simple caloric restriction, but new research shows that it’s not about caloric restriction as much is it is about energy expenditure.  You can be at any weight (low, normal or high), but if your energy expenditure (activity, stress, illness) exceeds your caloric or starch intake at the right time in your cycle, it can switch off the signal from the hypothalamus (upstream endocrine gland) in the brain to your ovaries.  This is your body’s natural conservation of resources, and your body will halt fertility .  

Too low caloric or starch intake compared to energy expenditure creates a hormonal imbalance and is commonly accompanied by low fasting insulin (<4 mcU/ml) and low luteinizing hormone (LH).  This imbalance can be remedied by optimizing your diet and lifestyle factors. Note: PCOS is often accompanied by high LH and normal to high fasting insulin. These measurements can be obtained by a lab test to help you figure this out.

Perimenopause

Your sex hormones will naturally decline between the ages of 35-55 for most women.  On average there is about a 75% drop in progesterone, but only about a 35% drop in estrogen.  This keeps progesterone low through the entire cycle so the hormone you have more of is estrogen.  Estrogen isn’t necessarily high in this scenario, but because progesterone is low, estrogen is the dominant hormone.

Many women experience this “estrogen dominance” in perimenopause due to the drop in progesterone. Estrogen levels fall after a woman’s last period.  Menopause is defined as not having had a period for an entire year. 

Estrogen Dominance

In addition to hormonal imbalances described above, environmental toxins, a high sugar diet, ketogenic diets and/or low-calorie diets, and chronic stress can all increase the risk for estrogen to be dominant, where estrogen is in greater concentration than it should optimally be, compared to progesterone. This can also be referred to as low progesterone or high estrogen.  It’s a comparative scenario, as levels change throughout your cycle.  Symptoms of estrogen dominance are increases in weight – especially belly fat, heavy periods, breast tenderness, mood swings, anxiety, depression, hormonal headaches/migraines, decreased sexual drive, blood sugar imbalances, fibroids, insomnia, changes in energy and more.

Environmental toxins

Heavy metals and xenoestrogens can increase risks for estrogen dominance. Heavy metals (i.e. mercury, lead, aluminum) can decrease the detoxification functionality of the liver.  When the liver cannot perform detoxification optimally it can’t rid the body of estrogen which can then recirculate and cause the imbalanced ratio. Remove sources of heavy metals from your environment as well as possible; avoid aluminum soda cans, deodorant with aluminum, fish contaminated with mercury, and other contributing sources.  

Xenoestrogens are also considered toxins.  These compounds mimic estrogen in the body so increase the effect of estrogen (creating estrogen dominance). These xenoestrogens increase your risks for PMS, weight gain, estrogen cancers and more. I once heard a doctor at a conference say, “your plastic water bottle is making you fat” and that helped the audience understand how important it is to stop drinking bottled water or water from plastic sources.

Xenoestrogens are found in bisphenol acetate (BPA), plastics and phthalates, fragrances and perfumes used in cosmetics, detergents, and cleaning products, as well as in pesticides and herbicides. Read more about the harmful components of plastics in my article Plastics in Food Packaging.

Read labels to look for sources of heavy metals, switch to stainless steel or glass for all food storage and consumption, and avoid anything with the word “fragrance”.  

Soy is a natural xenoestrogen, so if you are suffering from these hormonal imbalances you should limit your dietary intake of it. Soy protein isolates, soy isoflavones, tofu, edamame, soy milk… it’s all a xenoestrogen.  To avoid the estrogenic properties of soy you need to ensure your soy is fermented like in natto or tempeh.

Sugar and Cortisol

If you are suffering from hormonal imbalance symptoms and eating simple sugars, the easiest thing to do to rebalance is to avoid simple sugar.  Sugar is inherently inflammatory; that means that sugar intake and blood sugar elevations increase insulin and cortisol.  This increases inflammation directly and indirectly due to the triggering of more estrogen being released.  Unfortunately, this can further be exacerbated by the use of magnesium, vitamin C, and vitamin B6 by the liver to detoxify estrogen metabolites leaving you at risk for the side effects of deficiencies of these needed nutrients.

Chronic Stress and Sleep Deficiencies

Both stress and sleep deprivation affect the body similarly, as sleep deprivation ultimately puts the body into a state of stress.  “Cortisol and sleep play a reciprocal role in the regulation of the other, as cortisol levels rise during wake times and fall during sleep time. Alterations in either one may negatively impact the other.”³ Both cause an alteration in adrenal hormone production, we call it the pregnenolone steal.  When under stress, the sympathetic (fight or flight) nervous system produces cortisol.  Like other hormones produced in the adrenal gland, cortisol is built off the precursor pregnenolone.  This “steal” is when resources are shunted to make cortisone to deal with the stressor at the detriment of the other hormones (aldosterone controlling blood pressure) and the gonadal hormones (testosterone, progesterone, and the estrogens).

Figure 1Modeled after Brook, C.G.D. & Marshall, N.J.; Essential Endocrinology, 3rd Ed., Blackwell Science, 1996

Stress blocks progesterone and further exacerbates estrogen dominance.  This imbalance can exacerbate PMS symptoms, increase cellulite, fibroids and cysts, affect mood, increase risk of insomnia, create brain fog, increase osteoporosis risks, and increase risks for estrogen cancers (breast, uterine, ovarian, prostate and colon).

Other Considerations

• Caffeine Consumption:  Caffeine increases estrogen secretion and leads to depletion of key nutrients like magnesium, vitamin C and B vitamins that are necessary for the process of neutralizing bad estrogen metabolites in the liver.²
• Poor Diet:  A diet loaded with chemicals from commercially raised meat, pesticides & herbicide laden produce, and processed foods massively increase the levels of xenoestrogenic molecules and put the body into an estrogen dominant state. ²
• Obesity:  Fat cells have an enzyme that converts adrenal steroid hormones into estrogen.  The greater the percentage of body fat one has the more this conversion takes place.²

Fasting and Feasting

I’ve learned this past month that my body needs either more calories or more starch/carbohydrates to keep my hormones balanced, so that my hypothalamus feels nourished enough to trigger ovulation.

According to Dr Jockers, the best time for women to either diet, intermittent fast, or be ketogenic is days 1-10 and that some women (like me) will do better with additional starches at the end of their follicular phase.  This will help keep the body from panicking and shutting down ovulation due to conservation of resources.  He also states that dieting/fasting on days 17-22 is better than doing it on days 22-28. Thinking back this makes sense, as I’m typically very hungry when I ovulate, where I could care less if I eat when menstruating.

It may also help to do something less extreme that what I tried.  A 6 or 8 hour eating window and a 18 or 16 hour fast as opposed to the 24-hour fast I did (which created my imbalance).   This could be eating dinner at 5:30pm one evening then not eating again till 10:30 or noon the next morning.

Seed Cycling

Seed cycling is a dietary approach to supporting more balanced hormones (in addition to removing toxins, managing stress, avoiding soy, eating enough etc.). There are a few different seeds that have natural hormone boosting effects in the body.  Seed cycling is rotating when you eat these seeds, so they align with an optimal cycle.  You eat seeds that contain phytoestrogens in the follicular phase of your cycle and seeds that boost progesterone in the second half or luteal phase of your cycle.  

Seed Cycling:

• Estrogen boosting seeds to eat in the follicular phase = flax and pumpkin seeds
• Progesterone boosting seeds to eat in the luteal phase = sesame and sunflower seeds

To seed cycle, you consume 1 TBSP of each seed in a raw freshly ground state every day. You would consume for example 1 TBSP of flax and 1 TBSP of pumpkin seeds on day 1-14 of your cycle.  Seeds should be raw, organic, freshly ground, and stored in the fridge or freezer.  To make this simpler on myself I just eat them as energy bars; my Seed Cycling Energy Bites (recipe below) or “medicinal chocolate” as my husband refers to them.

I’ve tried to seed cycle previously and all it did was give me headaches during my period. This time, I’m only trying the second phase, the progesterone/luteal phase seeds to see if that will help bring my hormones back into balance next month. I’m also back to eating my regular healthy meals. I want to ensure I’m well fed enough not to scare my hormones into hibernation.  It can’t hurt, as these seeds are healthy, and my energy bars are delicious.

Fixing your imbalance

I do not recommend alternate day fasting or going into ketosis from day 10-15 of your cycle as there is a real risk of causing hormonal imbalances.  There are likely women who can go keto and fast at any time and have no consequences, but I personally won’t fast for more than 16 hours or eat ketogenic in the first half of my cycle again as I’m obviously very sensitive to it. Upon resuming my normal eating cycle my hormones rebalanced; I caught it early and acted upon it immediately.

If you have hormonal imbalances and experience PMS or other symptoms, you will need to address your overall diet quality, when and what kinds of macronutrients you are eating, and other lifestyle factors (plastic, heavy metals, stress, sleep…); i.e., you will need more than seed cycling. The more imbalanced you are, the more you need a multifaceted approach, and it will take longer to lesson symptoms and regain optimal health. I’m always here to help if you have questions and/or need more guidance.

Sources:

1. Period Repair Manual; Every Woman’s Guide to Better Periods – Lara Briden ND
2. Dr Jockers, https://drjockers.com/estrogen-dominance/ & https://drjockers.com/menstrual-cycle/
3. Sleep loss results in an elevation of cortisol levels the next evening, Leproult et al., Sleep, 1997 Oct;20(10):865-70, https://pubmed.ncbi.nlm.nih.gov/9415946/

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Erin Williams, MSN CN LMP, is the founder of EZBalance.com, a health and wellness company established in 2001. Erin has a bachelor’s degree in Chemistry from Purdue, a master’s degree in Nutrition from Bastyr University, and is currently studying to become a Functional Medicine Practitioner. Erin enjoys sharing her love of natural health and wellness with people through lectures, blogs, and consultations.