Hormones can have a substantial impact on our mental and emotional health. If hormones are elevated, deficient  or imbalanced, they can impact the functioning of other hormone groups as well as the brain and the nervous system. Dr. Jennifer Yee explains:

Stress Hormones

The production of stress hormones like adrenaline and cortisol can be triggered by acute stress (fight-or-flight situations, situational temporary stressors, temporary illness or injury, etc.), chronic ongoing day-to-day stress (e.g. being very busy, carrying a heavy mental load, anxiety, sleep deprivation, chronic health issues, etc.). Elevated cortisol can lower our energy level, negatively affect our ability to focus and stay on task, and contribute to brain fog and short-term memory issues. Chronically elevated cortisol can contribute towards “burn out” and negatively affect our body’s ability to adapt to and respond effectively to stress. Cortisol levels can be assessed in the urine and supported appropriately.

Melatonin

Melatonin is a hormone that regulates our circadian rhythms (our sleep and wakefulness cycles) and therefore, has a direct impact on our energy levels and sleep quality. For the majority of people, when we are sleeping better, we also feel better and function better. We know that lower than ideal melatonin levels have an impact on symptoms of anxiety as well as obsessive compulsive disorder (OCD) while results are mixed regarding its impact on symptoms of depression.

Thyroid Hormone

Thyroid hormones help to regulate our metabolism, energy production, hair growth, and also our mood. Thyroid hormones, particularly in the T3 form, are found in concentrated levels in the brain, and too little or too much of it can contribute to symptoms of anxiety and/or depression. Some people who are more sensitive to thyroid hormone fluctuations, may notice these effects even if their blood (serum) thyroid hormone levels are “within the normal range” and may still benefit from naturopathic thyroid support. Thyroid hormones can be checked in the blood (serum) with ideally a complete panel of thyroid hormones rather than just a single assessment of thyroid stimulating hormone (TSH). More comprehensive hormone testing can also be performed on urine samples.

Estrogen & Progesterone (PMS & Menopause)

Estrogen and progesterone are hormone groups that regulate different aspects of our health including the menstrual cycle, ovulation, pregnancy as well as other aspects of our bodies including our mood, immunity, bone density, supporting the production of testosterone and many other things. All human beings produce estrogen and progesterone so their levels can have an impact on everyone.

Pre-menstrual syndrome (PMS) is a common experience for many menstruating people and can also be experienced by people who are not actively having a period such as people who have had a hysterectomy (uterus removal), those taking certain medications (e.g. some types of birth control), and those with amenorrhea (very irregular or absent periods). PMS symptoms can include physical changes such as headaches, water retention, breast tenderness, cramping or neurological symptoms such as mood swings, sleep disruption, anxiety, and depression. Some people may experience a more severe form of PMS called pre-menstrual dysphoric disorder (PMDD) where PMS are very intense and disruptive to daily life, but improve dramatically, once the period arrives.

One common pattern I see frequently in my patients with PMS is an imbalanced cycling of estrogen and progesterone. In the first half of our menstrual cycle (starting on the first day of the period), estrogen should be the most dominant hormone and progesterone should remain relatively low. After the middle of the cycle, progesterone should now become the most dominant hormone while the estrogen levels sit relatively low. The amounts of estrogen and progesterone are important as well as their timing and their levels relative to each other. As they relate to mood, elevated estrogen tends to augment (increase) anxiety whereas progesterone will tend to have a more inhibitory (reductive) effect on anxiety. 

Substantial fluctuation in estrogen and progesterone levels occur during peri-menopause and menopause. A decline in both of these hormones can cause physical changes like weight gain, more challenges regulating blood sugar levels (making us more susceptible to diabetes and hypoglycemia), hot flashes, decreased bone density as well as neurological symptoms such as depression, anxiety, sleep disruption, and brain fog. 

Estrogen and progesterone (as well as other hormones) can be assessed in the blood or more comprehensively through the urine. The timing of when the samples are collected is important so we can assess whether the levels are optimal for where the patient currently is in their menstrual cycle. The use of hormone replacement therapy and hormonal contraceptives like the birth control pill or hormonal IUD, can have a dramatic effect on the hormone levels circulating in our bodies as well as the amounts of hormones we naturally produce, and some people may experience undesirable side effects from the long-term use of these particular medications which naturopathic medicine can aim to re-balance.

Pregnancy & Post-Partum Hormones

There are many hormonal changes that happen during pregnancy, childbirth, and the post-partum period. During pregnancy, for example, the production of thyroid hormone is suppressed as well as other body systems, such as the immune system. Progesterone levels will elevate to support the pregnancy and prevent pregnancy loss. Hormonal changes during pregnancy can also affect mood – making people more prone to anxiety, sadness, frustration, and depression. Hormones will continue to change as we approach the end of pregnancy and the body is preparing for the birthing process. Prolactin levels will increase to support breastmilk production and assist with the post-partum healing process. Breastfeeding will typically continue to suppress estrogen and progesterone cycling (to inhibit the menstrual cycle); however, for some people hormonal cycling, ovulation and the period can return relatively quickly after childbirth. It is important to note that ovulation can also occur in the absence of a period, so breastfeeding alone is not a foolproof contraceptive method!

It is estimated that 10-20% of people may experience post-partum depression or post-partum anxiety. Symptoms of post-partum depression and/or anxiety can appear immediately after childbirth or can take up to 2 years to develop. Post-partum mood can be impacted not just by hormonal changes that occur naturally during the post-partum period but also by other factors that can directly affect hormone production such as sleep deprivation, stress (elevated cortisol hormone), less rest & self-care (focus on baby and other household/work/life responsibilities), nutrient depletion (breastfeeding, not prioritizing eating, using more nutritional resources to support post-partum healing and recovery), and thyroid changes. Sometimes the system may struggle to find its equilibrium again and this can be compounded by the number of pregnancies (including pregnancy losses). 

A variety of different hormones can have a profound effect on our mood. We have several valuable assessment tools to determine if imbalances are present and to what severity. This information in turn, can then allow us to determine the best ways to support and bring balance back to the body.