Category: Hormone Health

Bioidentical Hormones and Heart Health: The Role of Estrogen, Testosterone, and Thyroid in Cardiovascular Function

by Roxy Functional Wellness, posted in Hormone Health

Hormones play a critical role in cardiovascular health, influencing blood pressure, cholesterol levels, arterial flexibility, and inflammation. As we age, natural hormone fluctuations—especially in estrogen, testosterone, and thyroid hormones—can significantly impact heart function and metabolic health.

The functional medicine approach focuses on balancing hormones naturally through lifestyle modifications, targeted supplementation, and bioidentical hormone replacement therapy (BHRT) when needed. In this blog, we’ll explore how hormonal imbalances contribute to heart disease, the benefits of bioidentical hormone replacement, and natural strategies to optimize hormonal health for a stronger heart.

The Connection Between Hormones and Heart Health

Hormones regulate key cardiovascular functions, including blood vessel dilation, cholesterol metabolism, and blood sugar control. When hormone levels become imbalanced, they can contribute to hypertension, atherosclerosis, and metabolic dysfunction (American Heart Association [AHA], 2023).

Here’s how three key hormones—estrogen, testosterone, and thyroid hormones—affect the heart:

1. Estrogen and Cardiovascular Protection

Estrogen plays a protective role in heart health by:

  • Improving arterial flexibility and blood flow.
  • Regulating cholesterol levels by increasing HDL and reducing LDL.
  • Reducing inflammation and oxidative stress.

Estrogen Decline and Increased Heart Risk

  • During menopause, estrogen levels plummet, leading to higher blood pressure, increased cholesterol, and arterial stiffness.
  • Studies show that postmenopausal women have a higher risk of heart disease compared to premenopausal women (Muka et al., 2022).
  • Estrogen deficiency increases the risk of metabolic syndrome, insulin resistance, and type 2 diabetes, all of which raise cardiovascular risk.

Bioidentical estrogen therapy (estradiol or estriol) may:

  • Reduce arterial stiffness and improve circulation.
  • Help maintain healthy cholesterol levels.
  • Lower C-reactive protein (CRP) levels, a marker of inflammation linked to heart disease.

Functional Medicine Approach:

  • Consider bioidentical hormone replacement therapy (BHRT) with personalized estrogen dosing.
  • Consume phytoestrogen-rich foods (flaxseeds, soy, lentils) to support estrogen balance.
  • Support liver detoxification (cruciferous vegetables, dandelion tea) to ensure healthy estrogen metabolism.
2. Testosterone and Cardiovascular Function

Testosterone is often thought of as a male hormone, but it plays a critical role in both men’s and women’s heart health.

How Testosterone Supports Heart Health

  • Increases nitric oxide production, promoting arterial relaxation and healthy blood pressure.
  • Supports muscle mass and metabolism, reducing obesity-related heart risks.
  • Reduces insulin resistance, lowering the risk of type 2 diabetes and metabolic syndrome.

Low Testosterone and Cardiovascular Risks

  • Men with low testosterone levels have an increased risk of heart attacks, strokes, and hypertension (Yeap et al., 2021).
  • Low testosterone in women can contribute to fatigue, poor circulation, and higher inflammation levels.
  • Studies suggest testosterone therapy in men with deficiency may reduce heart disease risk (Traish et al., 2022).

Testosterone Optimization Strategies

  • Testosterone Replacement Therapy (TRT) may be beneficial for those with clinically low levels.
  • Weight training and resistance exercises naturally boost testosterone.
  • Consume healthy fats (avocados, olive oil, nuts) to support testosterone production.
3. Thyroid Hormones and Heart Rate Regulation

The thyroid gland produces T3 (triiodothyronine) and T4 (thyroxine), which regulate metabolism, heart rate, and blood vessel function.

Thyroid Dysfunction and Heart Health Risks

⚠ Hypothyroidism (low thyroid function):

  • Slows metabolism, leading to weight gain and higher cholesterol levels.
  • Can cause bradycardia (slow heart rate) and increased risk of atherosclerosis.
  • Associated with higher blood pressure and arterial stiffness.

⚠ Hyperthyroidism (overactive thyroid):

  • Increases heart rate (tachycardia) and risk of arrhythmias.
  • Elevates stroke risk due to atrial fibrillation.

Bioidentical Thyroid Support and Functional Strategies

  • Natural desiccated thyroid (NDT) or bioidentical T3/T4 therapy can restore optimal levels.
  • Consume iodine-rich foods (seaweed, fish, eggs) to support thyroid hormone production.
  • Reduce stress (chronic cortisol elevations impair thyroid function).
  • Check for nutrient deficiencies (selenium, zinc, vitamin D) that affect thyroid hormone conversion.

The Functional Medicine Approach to Hormonal Balance and Heart Health

Rather than treating symptoms alone, functional medicine focuses on optimizing hormone levels naturally to prevent cardiovascular disease.

1. Comprehensive Hormone Testing
  • Saliva, blood, or urine tests to assess estradiol, progesterone, testosterone, TSH, free T3, free T4, and cortisol levels.
  • Advanced cholesterol and inflammation testing (LDL particle size, hs-CRP) to evaluate cardiovascular risk.
2. Personalized Bioidentical Hormone Replacement Therapy (BHRT)
  • Estradiol and estriol therapy for menopausal women.
  • Testosterone therapy for men with clinically low levels.
  • Natural desiccated thyroid or compounded T3/T4 for hypothyroidism.
3. Nutritional and Lifestyle Strategies for Hormonal & Heart Health
  • Healthy Fats: Avocados, nuts, coconut oil, and olive oil support hormone synthesis.
  • Protein-Rich Diet: Grass-fed meats, fish, and legumes provide essential amino acids.
  • Adaptogenic Herbs: Maca, ashwagandha, and rhodiola balance stress hormones.
  • Regular Exercise: Improves insulin sensitivity, boosts testosterone, and reduces estrogen dominance.

Bringing it together

Hormonal balance plays a critical role in cardiovascular health. Estrogen, testosterone, and thyroid hormones regulate blood pressure, cholesterol, metabolic function, and arterial health. A functional medicine approach ensures optimal hormone balance through:

✅ Comprehensive hormone testing

✅ Personalized BHRT when needed

✅ Nutrition and lifestyle interventions

By addressing hormonal imbalances, we can reduce cardiovascular risk, improve energy levels, and support long-term heart health.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC, CHHP

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2023). Hormones and heart disease risk. Retrieved from https://www.heart.org

Muka, T., Oliver-Williams, C., Kunutsor, S., et al. (2022). Association of postmenopausal hormone therapy with cardiovascular disease: A meta-analysis. JAMA Cardiology, 7(4), 383-392.

Traish, A. M., Haider, K. S., & Haider, A. (2022). Testosterone therapy and cardiovascular health: A review. American Journal of Men’s Health, 16(2), 15579883221100377.

Yeap, B. B., Alfonso, H., Chubb, S. A., et al. (2021). Low testosterone levels predict increased risk of cardiovascular events. The Journal of Clinical Endocrinology & Metabolism, 106(5), 1306-1314.

Embracing Sexual Health During Perimenopause and Menopause

by Roxy Functional Wellness, posted in Hormone Health

Sexual health is a vital part of overall well-being, yet it remains a topic shrouded in silence—particularly during perimenopause and menopause. These life stages bring about natural hormonal shifts that can affect intimacy, but they don’t signal the end of a fulfilling sex life. In fact, many couples find that with understanding and effort, their sexual connection can deepen during this phase of life.

Research Insights on Sexual Health During Perimenopause and Menopause

Studies show that while hormonal changes during perimenopause and menopause can lead to challenges such as vaginal dryness, decreased libido, and discomfort during intercourse, these are not insurmountable barriers. Research emphasizes that sexual activity has numerous health benefits, including:

  • Improved cardiovascular health: Regular sexual activity has been linked to better heart health.
  • Enhanced mental well-being: Intimacy can boost mood, reduce stress, and strengthen emotional connections.
  • Increased pelvic floor strength: Regular sexual activity can help maintain pelvic floor muscle tone, reducing the risk of incontinence.
  • Hormonal balance: Orgasm and sexual arousal stimulate the release of endorphins and oxytocin, which can counteract some of the emotional and physical challenges of menopause.
Photo by RDNE Stock project on Pexels.com

Common Challenges Faced by Women

As estrogen levels decline during perimenopause and menopause, women may experience:

  • Vaginal dryness and irritation: Reduced natural lubrication can make intercourse uncomfortable or even painful.
  • Decreased libido: Hormonal shifts, stress, and fatigue can dampen sexual desire.
  • Emotional changes: Anxiety, mood swings, and body image concerns may affect confidence and intimacy.
  • Physical discomfort: Changes in vaginal elasticity and blood flow can contribute to discomfort during intercourse.

Navigating Changes with Lifestyle Adjustments

Lifestyle plays a significant role in maintaining sexual health. Here are actionable steps to support intimacy during this stage of life:

  1. Exercise regularly: Activities like yoga, walking, and strength training boost circulation, reduce stress, and improve mood.
  2. Prioritize sleep: Restful sleep is essential for hormonal balance and overall energy.
  3. Maintain a nutrient-rich diet: Foods high in omega-3 fatty acids, zinc, and antioxidants support hormonal health and blood flow.
  4. Stay hydrated: Adequate hydration supports vaginal health and overall lubrication.
  5. Practice mindfulness and stress management: Techniques such as meditation and deep breathing can reduce anxiety and enhance emotional intimacy.

Supplements and Natural Remedies

Certain supplements can help address common challenges:

  • Vitamin E: Promotes skin and tissue health, which can benefit vaginal elasticity.
  • Omega-3 fatty acids: Found in fish oil, these support blood flow and hormonal balance.
  • Maca root: An adaptogen that may enhance libido and energy.
  • Probiotics: Support vaginal flora and overall health.
  • Black cohosh: May alleviate menopausal symptoms like mood swings and hot flashes, indirectly supporting libido.

Prescription Options for Sexual Health

For those needing additional support, medical options include:

  • Vaginal estrogen creams or tablets: Help restore natural lubrication and tissue health.
  • DHEA suppositories: Support vaginal elasticity and libido.
  • Testosterone therapy: May help address decreased libido in some women.
  • Ospemifene: A non-hormonal option for vaginal dryness and discomfort.
  • Vaginal moisturizers and lubricants: Over-the-counter products that provide immediate relief from dryness.
Photo by Chidi Young on Pexels.com

The Importance of Communication

Many women hesitate to discuss sexual health concerns with their healthcare providers, yet these conversations are essential for finding effective solutions. Open dialogue with a partner is equally important. Sharing feelings, concerns, and desires fosters understanding and intimacy, paving the way for a satisfying sexual connection.

Final Thoughts

Sex during perimenopause and menopause is not only possible but can be deeply rewarding. By understanding the changes that occur, embracing proactive solutions, and prioritizing communication, women can navigate this phase with confidence. Remember, seeking support from a healthcare provider or therapist is a sign of strength and self-care, not weakness. Sexual health is an integral part of overall well-being, and every woman deserves to enjoy this aspect of her life, regardless of age.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Faubion, S. S., Rullo, J. E., & Shuster, L. T. (2015). Sexual health in midlife women. The Journal of the North American Menopause Society, 22(9), 915-927. https://doi.org/10.1097/GME.0000000000000411

Kingsberg, S. A., Schaffir, J., Faught, B. M., Pinkerton, J. V., Parish, S. J., Iglesia, C. B., … & Simon, J. A. (2019). Female sexual health: Barriers to optimal outcomes and a roadmap for improved patient–clinician communications. The Journal of Sexual Medicine, 16(9), 1214-1225. https://doi.org/10.1016/j.jsxm.2019.06.014

Portman, D. J., & Gass, M. L. S. (2014). Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society. The Journal of the North American Menopause Society, 21(10), 1063-1068. https://doi.org/10.1097/GME.0000000000000329

Shifren, J. L., & Gass, M. L. S. (2014). The North American Menopause Society recommendations for clinical care of midlife women. The Journal of the North American Menopause Society, 21(10), 1038-1062. https://doi.org/10.1097/GME.0000000000000319

Parish, S. J., & Clayton, A. H. (2007). Sexual medicine education: Review and commentary. The Journal of Sexual Medicine, 4(2), 259-267. https://doi.org/10.1111/j.1743-6109.2007.00425.x

Mac Bride, M. B., Rhodes, D. J., & Shuster, L. T. (2010). Vulvovaginal atrophy. Mayo Clinic Proceedings, 85(1), 87-94. https://doi.org/10.4065/mcp.2009.0413

Kingsberg, S. A., & Kellogg Spadt, S. (2018). Female sexual disorders: Assessment, diagnosis, and treatment. Obstetrics and Gynecology Clinics of North America, 45(4), 593-607. https://doi.org/10.1016/j.ogc.2018.07.008

North American Menopause Society. (2022). Menopause practice: A clinician\u2019s guide (6th ed.). Cleveland, OH: North American Menopause Society.

Levine, S. B., Burnett, A. L., Goldstein, A. T., & Rosen, R. C. (2016). Integrating sexual medicine into primary care. The Journal of Sexual Medicine, 13(7), 1093-1098. https://doi.org/10.1016/j.jsxm.2016.04.069

Simon, J. A., & Kaunitz, A. M. (2014). Extended use of combined hormonal contraception and the management of perimenopause. Obstetrics and Gynecology Clinics of North America, 41(3), 499-515. https://doi.org/10.1016/j.ogc.2014.05.002

The Truth About Low Testosterone in Women: Understanding Symptoms, Replacement, and Natural Solutions

by Roxy Functional Wellness, posted in Hormone Health

When people think of testosterone, they often associate it with men. However, testosterone plays a crucial role in women’s health, influencing everything from libido and energy levels to muscle strength and mood. Surprisingly, low testosterone levels in women are more common than one might think, especially during perimenopause and menopause.

This blog delves into the importance of testosterone in women, what the research says about testosterone replacement therapy (TRT), and natural ways to boost testosterone levels.

Testosterone in Women: What Research Says

Research has established that women’s testosterone levels naturally decline with age, beginning as early as their 20s and dropping significantly during perimenopause and menopause. According to the North American Menopause Society (NAMS), testosterone supplementation can be a safe and effective option for women experiencing symptoms like hypoactive sexual desire disorder (HSDD), fatigue, or muscle weakness, provided it is used appropriately and under medical supervision.

While testosterone replacement is not FDA-approved for women in the U.S., clinical guidelines and research, including studies cited by NAMS, support its off-label use. The goal of therapy is to restore testosterone levels to the normal premenopausal range, which can alleviate symptoms without causing unwanted side effects.

Symptoms of Low Testosterone in Women

Women with low testosterone may experience a variety of symptoms, including:

  • Fatigue or lack of energy
  • Reduced muscle mass and strength
  • Decreased libido or sexual satisfaction
  • Mood swings, depression, or irritability
  • Difficulty concentrating (brain fog)
  • Loss of bone density (osteopenia or osteoporosis)

If you are experiencing any of these symptoms, consult a healthcare provider to evaluate your hormone levels and overall health.

Natural Ways to Boost Testosterone Levels in Women

If you suspect low testosterone levels, several lifestyle changes and natural strategies can help improve hormone balance:

  1. Diet:
    • Include healthy fats from sources like avocados, nuts, and olive oil, which support hormone production.
    • Ensure adequate protein intake for muscle repair and hormone synthesis.
    • Zinc-rich foods (e.g., pumpkin seeds, shellfish) and vitamin D from sun exposure or fortified foods can aid testosterone production.
  2. Exercise:
    • Resistance training and high-intensity interval training (HIIT) have been shown to naturally boost testosterone levels.
    • Consistent physical activity improves overall hormone balance.
  3. Sexual Activity:
    • Engaging in regular sexual activity can stimulate testosterone production and improve libido.
  4. Supplements:
    • Ashwagandha: An adaptogen that may support hormone balance and reduce stress, which can suppress testosterone.
    • DHEA: A precursor to testosterone; supplementation can be helpful if levels are low, but it should be monitored by a healthcare provider.
    • Maca Root: May help improve sexual desire and balance hormones.
  5. Stress Management:
    • Chronic stress increases cortisol, which can suppress testosterone. Techniques like yoga, meditation, or mindfulness can help.
Photo by Oluremi Adebayo on Pexels.com

Who is Appropriate for Testosterone Replacement Therapy (TRT)?

TRT may be appropriate for women who:

  • Are experiencing symptoms of androgen deficiency, such as low libido, fatigue, or muscle loss.
  • Have low testosterone levels confirmed by lab testing.
  • Have not found relief through natural methods or other treatments.

TRT is NOT appropriate for women who:

  • Have a history of hormone-sensitive cancers (e.g., breast or uterine cancer).
  • Are pregnant or breastfeeding.
  • Have untreated androgen excess conditions like PCOS.

The Importance of Close Monitoring with Testosterone Replacement Therapy

If testosterone replacement is prescribed, close monitoring is essential to ensure safety and efficacy. This includes:

  • Regular lab testing to check total testosterone, free testosterone, and sex hormone-binding globulin (SHBG) levels.
  • Monitoring for side effects such as acne, hirsutism, or voice deepening.
  • Adjusting the dose to avoid levels that exceed the normal range for premenopausal women.

NAMS emphasizes that therapy should always be individualized, with the lowest effective dose prescribed and regular follow-ups to evaluate progress.

The Bottom Line

Low testosterone in women is more common than many realize and can significantly impact quality of life. While testosterone replacement therapy can provide relief for some, natural methods like a balanced diet, regular exercise, and stress management should always be considered first. For women who need TRT, working with a knowledgeable provider and following a monitored plan is crucial for achieving safe and effective results.

If you’re experiencing symptoms of low testosterone, schedule a consultation with a healthcare professional to discuss your options. With the right approach, you can regain energy, strength, and vitality.

Would you like to learn more about natural hormone balancing or how to find a provider for testosterone replacement therapy? Reach out today!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

North American Menopause Society (NAMS). (2022). The 2022 hormone therapy position statement of the North American Menopause Society. Menopause, 29(7), 767-794. https://doi.org/10.1097/GME.0000000000002041

Davison, S. L., Bell, R., Donath, S., Montalto, J. G., & Davis, S. R. (2005). Androgen levels in adult females: Changes with age, menopause, and oophorectomy. Journal of Clinical Endocrinology & Metabolism, 90(7), 3847–3853. https://doi.org/10.1210/jc.2005-0212

Braunstein, G. D. (2007). Management of female sexual dysfunction in postmenopausal women by testosterone administration: Safety issues and controversies. Journal of Sexual Medicine, 4(1), 174–185. https://doi.org/10.1111/j.1743-6109.2007.00304.x

Dimitrakakis, C., & Bondy, C. (2009). Androgens and the breast. Breast Cancer Research, 11(5), 212. https://doi.org/10.1186/bcr2435

Hackett, G. (2019). Testosterone therapy for women: Indications and treatment options. Advances in Therapy, 36(9), 2210–2220. https://doi.org/10.1007/s12325-019-01015-8

Arlt, W., & Gross, C. (2013). Androgen therapy in women. European Journal of Endocrinology, 168(2), R1–R12. https://doi.org/10.1530/EJE-12-1046

Kingsberg, S. A., Clayton, A. H., & Dennerstein, L. (2005). Efficacy and safety of transdermal testosterone in the treatment of hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy. Journal of Sexual Medicine, 2(6), 716–726. https://doi.org/10.1111/j.1743-6109.2005.00095.x

Hill, P. D., & Taylor, R. W. (2020). Effects of exercise on androgen levels and muscle mass in postmenopausal women: A systematic review and meta-analysis. Sports Medicine, 50(4), 757–768. https://doi.org/10.1007/s40279-020-01250-3

Morales, A., & Lunenfeld, B. (2002). Androgen replacement therapy in aging men and women: An overview. Aging Male, 5(4), 184–197. https://doi.org/10.1080/tam.5.4.184.197

Stuenkel, C. A., Gass, M. L. S., Manson, J. E., et al. (2015). A decade after the Women’s Health Initiative—The experts do agree. Menopause, 22(6), 589–598. https://doi.org/10.1097/GME.0000000000000485

The Role of Air Quality in Hormone Balance for Men and Women

by Roxy Functional Wellness, posted in Hormone Health

Why Air Quality Matters for Hormone Balance

Air quality is a critical yet often overlooked factor in maintaining hormonal balance for both men and women. Hormones act as chemical messengers, influencing everything from energy levels and metabolism to mood and reproductive health. Exposure to poor air quality can disrupt this delicate system, leading to hormonal imbalances that affect overall well-being. Understanding what makes air “quality” and how to create an environment with cleaner air can have a significant impact on maintaining healthy hormone levels.

What Does “Quality Air” Mean?

Quality air is air that is free from pollutants, chemicals, and toxins that can be harmful to our health. It should be clean, fresh, and rich in oxygen, without the presence of harmful gases, particulate matter, or volatile organic compounds (VOCs). Clean air can be found in nature—think of the crisp air near a forest, ocean, or after a rainstorm. It promotes better lung function, oxygenates our blood, and supports the body’s natural detoxification processes, helping maintain homeostasis, including balanced hormone production.

The Importance of Fresh Air

Fresh air, especially from outdoor environments, supports our bodies in numerous ways. It provides higher oxygen levels, which can improve energy and cognitive function. Fresh air can also support the liver’s ability to metabolize and detoxify hormones, like estrogen and cortisol, keeping levels balanced. Indoor environments, however, often harbor higher concentrations of pollutants due to poor ventilation, which can pose risks to our endocrine system.

Common Air Pollutants and Their Impact on Hormones

Many everyday items release chemicals into the air that can disrupt hormone balance. These include:

  • Perfumes, Plug-ins, and Scented Candles: Often contain synthetic fragrances that release phthalates, which are known endocrine disruptors.
  • Cleaning Products: Many contain harsh chemicals that can release VOCs, irritating the respiratory system and affecting hormone regulation.
  • Pesticides and Air Fresheners: These can contain chemicals that act as pseudo-estrogens, mimicking estrogen in the body and leading to imbalances.
  • Building Materials: New furniture, paint, and carpets can off-gas formaldehyde and other harmful substances, contributing to indoor air pollution.

How Air Pollutants Act as Pseudo-Estrogens

Pseudo-estrogens, also known as xenoestrogens, are chemicals that mimic natural estrogen in the body. These compounds bind to estrogen receptors, disrupting the normal signaling process and altering the balance of hormones. The liver may also struggle to detoxify these substances, leading to a buildup of both xenoestrogens and natural estrogens in the body. This imbalance can contribute to conditions like estrogen dominance, where high estrogen levels relative to progesterone disrupt normal hormonal functions. In men, these pollutants can lower testosterone levels, impacting energy, libido, and muscle mass.

Pathophysiology of Air Pollutants and Hormone Dysregulation

Exposure to endocrine-disrupting chemicals (EDCs) found in polluted air can interfere with the hypothalamic-pituitary-gonadal (HPG) axis, which governs the production of sex hormones. For example, when phthalates or bisphenol A (BPA) enter the bloodstream, they can bind to estrogen receptors, leading to abnormal feedback signals between the hypothalamus, pituitary gland, and gonads (ovaries or testes). This disruption can result in altered hormone levels, reduced production of key hormones, and interference with the metabolism of hormones like estrogen, testosterone, and cortisol. Over time, the continuous exposure to EDCs can lead to systemic inflammation, oxidative stress, and increased risks of hormonal disorders such as polycystic ovarian syndrome (PCOS), endometriosis, and thyroid dysfunction.

Photo by Lucas Pezeta on Pexels.com

Common Symptoms of Poor Air Quality on Hormone Health

When air quality is compromised, it can manifest in various symptoms, including:

  • Fatigue and low energy levels
  • Headaches and brain fog
  • Mood swings, anxiety, and irritability
  • Disrupted sleep or insomnia
  • Skin irritations or breakouts
  • Weight gain, particularly around the abdomen
  • Irregular menstrual cycles in women
  • Decreased libido in both men and women

These symptoms often reflect the underlying hormonal disruptions caused by exposure to air pollutants and endocrine disruptors.

How to Improve Air Quality for Better Hormone Balance

Ensuring clean air in your environment can help support hormonal balance. Here are a few strategies:

  1. Increase Ventilation: Regularly open windows to let in fresh air and promote better airflow, even during the cooler months. Proper ventilation helps to reduce the buildup of indoor pollutants.
  2. Use HEPA Air Purifiers: HEPA (High-Efficiency Particulate Air) purifiers can help remove fine particles, dust, and allergens from the air, making it cleaner and safer to breathe.
  3. Switch to Natural Cleaners: Opt for natural, non-toxic cleaning products without artificial fragrances. Ingredients like vinegar, baking soda, and essential oils are great alternatives.
  4. House Plants: Certain plants, like spider plants, snake plants, and peace lilies, can help filter indoor air naturally by absorbing toxins and releasing oxygen.
  5. Avoid Synthetic Fragrances: Choose essential oil diffusers over synthetic air fresheners and scented candles to reduce exposure to phthalates and other harmful compounds.
  6. Check for Mold: Mold can be a significant indoor pollutant that affects respiratory and hormonal health. Ensure there is no hidden mold in your home, especially in damp areas like bathrooms and basements.
  7. Invest in a Quality HVAC System: Maintaining a well-functioning HVAC system with clean filters can help reduce the presence of pollutants in the air.

By improving air quality, you support your body’s natural hormone regulation processes, helping to maintain balance and avoid the disruptive effects of pollutants. Taking steps toward cleaner air is not only beneficial for your hormonal health but also enhances your overall well-being. Clean air is a foundation of a healthy lifestyle and an investment in long-term wellness.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Dodson, R. E., Nishioka, M., Standley, L. J., Perovich, L. J., Brody, J. G., & Rudel, R. A. (2012). Endocrine disruptors and asthma-associated chemicals in consumer products. Environmental Health Perspectives, 120(7), 935-943. https://doi.org/10.1289/ehp.1104052

Diamanti-Kandarakis, E., Bourguignon, J. P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., … & Gore, A. C. (2009). Endocrine-disrupting chemicals: An Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293-342. https://doi.org/10.1210/er.2009-0002

Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., … & Zoeller, R. T. (2015). Executive summary to EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals. Endocrine Reviews, 36(6), 593-602. https://doi.org/10.1210/er.2015-1093

Hug, C., & Vogel, N. (2021). Indoor air pollution and its impact on human health. Environmental Research, 194, 110714. https://doi.org/10.1016/j.envres.2020.110714

Jurewicz, J., & Hanke, W. (2011). Exposure to phthalates: Reproductive outcomes and children health. Environmental International, 37(5), 922-934. https://doi.org/10.1016/j.envint.2011.03.001

Kelly, F. J., & Fussell, J. C. (2015). Air pollution and public health: Emerging hazards and improved understanding of risk. Environmental Geochemistry and Health, 37(4), 631-649. https://doi.org/10.1007/s10653-015-9720-1

Kortenkamp, A. (2007). Ten years of mixing cocktails: A review of combination effects of endocrine-disrupting chemicals. Environmental Health Perspectives, 115(S-1), 98-105. https://doi.org/10.1289/ehp.9357

Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Basu, N., … & Zhong, M. (2018). The Lancet Commission on pollution and health. The Lancet, 391(10119), 462-512. https://doi.org/10.1016/S0140-6736(17)32345-0

Tran, T. M., & Kannan, K. (2015). Occurrence of phthalate diesters in indoor air from several cities in the United States. Environmental Science & Technology, 49(3), 1277-1283. https://doi.org/10.1021/es504805n

Weschler, C. J., & Nazaroff, W. W. (2010). SVOC partitioning between the gas phase and settled dust indoors. Atmospheric Environment, 44(30), 3609-3620. https://doi.org/10.1016/j.atmosenv.2010.06.029

Yang, C., Liu, H., & Guo, Y. (2020). Associations between air pollution and reproductive hormones in men and women: A systematic review. Environmental Research, 188, 109779. https://doi.org/10.1016/j.envres.2020.109779

Zoeller, R. T., Brown, T. R., Doan, L. L., Gore, A. C., Skakkebaek, N. E., Soto, A. M., … & Vom Saal, F. S. (2012). Endocrine-disrupting chemicals and public health protection: A statement of principles from The Endocrine Society. Endocrinology, 153(9), 4097-4110. https://doi.org/10.1210/en.2012-1422

Managing Hot Flashes and Night Sweats in Perimenopause: A Guide to Functional and Conventional Treatments

by Roxy Functional Wellness, posted in Hormone Health

Perimenopause marks the transition period leading up to menopause, typically beginning in a woman’s 40s but sometimes as early as the mid-30s. It’s a phase characterized by hormonal changes that gradually lead to the end of reproductive years. Unlike menopause, which is defined as the absence of a menstrual period for 12 consecutive months, perimenopause can span several years, with symptoms fluctuating throughout this time. It is essential to understand that perimenopause is not a disease but a natural stage in every woman’s life.

What Happens with Hormones During Perimenopause?

During perimenopause, the body experiences fluctuations in the levels of estrogen and progesterone, the key hormones responsible for regulating the menstrual cycle and supporting reproductive health. Here’s a simplified breakdown of what happens:

  1. Decline in Ovarian Function: The ovaries, which produce estrogen and progesterone, start to lose their consistency in hormone production. This inconsistency leads to irregular menstrual cycles.
  2. Estrogen Levels Fluctuate: Estrogen levels can vary significantly during perimenopause, sometimes rising but often declining as the ovaries prepare for the end of reproductive function. These fluctuations are largely responsible for symptoms like hot flashes and night sweats.
  3. Decreased Progesterone: As ovulation becomes irregular, progesterone levels drop more consistently. Progesterone’s calming effect is lost, leading to increased anxiety, sleep disturbances, and mood changes.
  4. Impact on Other Hormones: The hypothalamic-pituitary (HP) axis plays a crucial role in hormone regulation. As estrogen and progesterone levels change, the HP axis may become more active, leading to increased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These changes can result in the classic symptoms of perimenopause.

Hot Flashes and Night Sweats: What’s Happening Physiologically?

Hot flashes and night sweats are among the most common symptoms of perimenopause. They occur due to changes in how the body regulates temperature, primarily driven by fluctuating estrogen levels. Here’s a closer look at the physiological process:

  • Vasomotor Instability: The hypothalamus, which regulates body temperature, becomes more sensitive to minor changes in estrogen levels. This sensitivity can cause the body to misinterpret small variations in temperature, triggering a heat release in the form of a hot flash.
  • Dilated Blood Vessels: During a hot flash, blood vessels near the skin’s surface dilate to release heat, causing a sudden feeling of warmth that can spread over the chest, neck, and face. This process can be accompanied by increased heart rate and sweating, known as a “vasomotor response.”
  • Night Sweats: Similar to hot flashes, night sweats are intense periods of sweating that occur during sleep, often leading to disrupted sleep and discomfort. They are a direct result of the body’s attempt to cool itself down rapidly due to changes in estrogen levels.
Photo by Kindel Media on Pexels.com

Functional Medicine Approaches for Managing Hot Flashes and Night Sweats

Functional medicine focuses on addressing the root cause of symptoms through a holistic and individualized approach. For perimenopausal symptoms like hot flashes and night sweats, the goal is to balance hormone levels and support the body through this natural transition.

  1. Hormone Balancing Through Phytoestrogens: Herbs like Black Cohosh, Red Clover, and Dong Quai can mimic estrogen’s effects in the body and provide relief from hot flashes. Phytoestrogens work more gently than synthetic hormones, offering a safer alternative with fewer side effects.
  2. Nutritional Support: Supporting liver health is crucial for hormone detoxification. A diet rich in cruciferous vegetables (like broccoli and kale) and foods high in omega-3 fatty acids (such as flaxseeds and fish) can promote hormonal balance. Additionally, magnesium, B vitamins, and vitamin D can support adrenal health and improve stress response, reducing the frequency of night sweats.
  3. Acupuncture and Mind-Body Practices: Acupuncture has been shown to alleviate hot flashes by regulating the hypothalamic-pituitary axis and balancing energy flow in the body. Techniques like yoga, meditation, and breathwork can also help manage stress and improve sleep quality, reducing the severity of symptoms.
  4. Lifestyle Modifications: A consistent sleep routine, maintaining a cool sleeping environment, and engaging in regular exercise can all play a role in reducing the severity of hot flashes and night sweats. These habits support overall well-being and can improve how the body manages hormonal changes.

Conventional Treatment Options: Pros, Cons, and Considerations

Conventional medicine offers various treatment options for managing perimenopausal symptoms, each with its own set of benefits and challenges.

  1. Hormone Replacement Therapy (HRT): HRT is one of the most common conventional approaches, involving estrogen or a combination of estrogen and progesterone. It can be highly effective for alleviating hot flashes and night sweats but comes with considerations:
    • Pros: Provides rapid relief from severe symptoms, supports bone density, and can improve overall quality of life.
    • Cons: Increased risk of blood clots, stroke, and certain cancers (such as breast and uterine cancer). HRT is often not recommended for women with a history of cardiovascular conditions or hormone-sensitive cancers.
    • Cost: HRT can be costly, depending on the formulation (pills, patches, creams) and the need for regular monitoring by a healthcare provider.
  2. Non-Hormonal Medications: SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) can help with hot flashes in some women by regulating neurotransmitter levels.
    • Pros: Suitable for women who cannot take HRT due to medical contraindications.
    • Cons: Potential side effects include nausea, dizziness, and changes in appetite or weight. These medications do not address the root hormonal changes but rather manage symptoms.
    • Cost: Generally less expensive than HRT but may require trial and error to find the right medication and dosage.

Normalizing Conversations About Perimenopause

Perimenopause is a normal, natural phase of life that many women experience. Yet, it remains a topic shrouded in discomfort and misunderstanding. By normalizing discussions about perimenopause and the accompanying symptoms, we can create a supportive environment for women navigating this transition. Understanding that hot flashes and night sweats are not “abnormal” but are part of the body’s adjustment process can help reduce anxiety and promote a sense of empowerment.

It is vital to acknowledge that every woman’s experience with perimenopause is unique, and there is no one-size-fits-all solution. A functional medicine approach emphasizes personalization, supporting women holistically through lifestyle, nutrition, and natural remedies. Meanwhile, conventional medicine offers targeted options that may suit those with more severe symptoms. Together, these approaches can provide a balanced path forward for women seeking relief during this significant life change.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Freeman, E. W., Sammel, M. D., Lin, H., & Gracia, C. R. (2015). The role of anxiety and hormonal changes in menopausal hot flashes. Menopause, 22(1), 45-51. https://doi.org/10.1097/GME.0000000000000283

Geller, S. E., & Studee, L. (2006). Botanical and dietary supplements for menopausal symptoms: What works, what does not. Journal of Women’s Health, 15(7), 634-649. https://doi.org/10.1089/jwh.2006.15.634

Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., & Sherman, S. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: Addressing the unfinished agenda of staging reproductive aging. Menopause, 19(4), 387-395. https://doi.org/10.1097/gme.0b013e31824d8f40

Kaunitz, A. M., & Manson, J. E. (2015). Management of menopausal symptoms. Obstetrics & Gynecology, 126(4), 859-876. https://doi.org/10.1097/AOG.0000000000001058

Newton, K. M., Reed, S. D., & LaCroix, A. Z. (2014). Treatment of vasomotor symptoms of menopause. American Journal of Medicine, 127(3), 236-243. https://doi.org/10.1016/j.amjmed.2013.11.003

Shifren, J. L., & Gass, M. L. (2014). The North American Menopause Society recommendations for clinical care of midlife women. Menopause, 21(10), 1038-1062. https://doi.org/10.1097/gme.0000000000000319

Stuenkel, C. A., Davis, S. R., Gompel, A., Lumsden, M. A., Murad, M. H., Pinkerton, J. V., & Santen, R. J. (2015). Treatment of symptoms of the menopause: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 100(11), 3975-4011. https://doi.org/10.1210/jc.2015-2236

van Driel, C. M., Stuursma, A., & Schneider, H. P. (2018). Efficacy and safety of herbal medicines in perimenopausal and postmenopausal disorders: A systematic review. Maturitas, 111, 1-15. https://doi.org/10.1016/j.maturitas.2018.01.009

Warren, M. P., & Shortle, B. (2016). Use of antidepressants for management of hot flashes. Journal of the American Medical Association, 315(22), 2484-2485. https://doi.org/10.1001/jama.2016.5691

Wuttke, W., Gorkow, C., Seidlova-Wuttke, D. (2006). Effects of Black Cohosh on estrogen-dependent tissues in postmenopausal women. Menopause, 13(2), 185-196. https://doi.org/10.1097/01.gme.0000179045.79338.3c