The following is a guest post by a fellow health blogger – Kate – who had an infertility problem then fell in love with leptin.
If you are facing infertility due to PCOS or want to learn to embrace your natural sexiness, my books, Sexy By Nature and PCOS Unlocked may be incredibly helpful for you!
I used to have a bit of a body fat phobia. Although at 13% body fat, I didn’t really have that much to worry about from what other people would think. I was impressive right?
Problem was, along with no body fat, I also had no period, no ovulation, and, no fertility. I was diagnosed with hypothalamic amenorrhea. I looked “healthy”, but my reproductive dysfunction indicated otherwise. I knew I had to get this sorted, and fast, as my partner and I were trying to conceive.
I consulted a few of my health practitioner friends. They all suggested that maybe putting on a bit of body fat might help kick things back into gear. As a group fitness instructor who was paid to stand up in front of others in skimpy lycra, this was the last thing I wanted to do. Being the stubborn person I was, I needed justification as to why, and how, fat would help to restore my fertility. Cue leptin.
Leptin is one of the more recently discovered hormones and is often referred to as the “anti-obesity” hormone. In fact, the word “leptin” is derived from the Greek term “leptos” meaning “thin”. This little hormone, which is produced predominantly in adipocytes (fat cells), conveys information to the brain about the amount of energy available in the body. Leptin levels rise with increasing food intake, telling the brain “Yay! All is well. We have sufficient nutrients to do our thang”, and the fall in times of food deprivation, telling the brain “Things aren’t so good. Looks like we’re in a famine and need to shut off non-vital functions”. Unfortunately, reproduction is one of those non-vital functions. We do not need to reproduce in order to survive. Simple as that.
But really, it’s not as simple as that.
We now know that leptin acts as more than just an energy thermostat. Indeed there are over 19,000 papers that have been published on leptin (no, I have not read them all, sorry), showing that leptin has various physiological roles. But back to the case in point – aside from signaling energy sufficiency to my brain, how would body fat and, as a by product of increased body fat, leptin help me to recover from hypothalamic amenorrhea and restore my fertility?
That depends on what’s going on during a healthy menstrual cycle.
During the first half of the cycle, otherwise known as the “follicular phase”, follicles (in the ovaries, which house an egg that has the potential to be fertilized) develop. The pituitary gland releases Follicle Stimulating Hormone (FSH) to, as the name suggests, stimulate the follicles to mature and secrete estrogen, which will have the lovely effect of producing fertile cervical mucus. Sorry, we’re getting graphic now.
Once FSH and estrogen have things looking all fertile and sexy, the pituitary gland releases Luteinizing Hormone (LH) to stimulate ovulation, where an egg will burst out of a follicle and wait patiently (for about 12-24hrs…pretty impatient, really) to be fertilized. Meanwhile, the follicle that was left behind becomes the corpus luteum, which secretes progesterone and prepares your body to house a mini-human (think pro-gestation).
So FSH and LH (also called gonadotropins) are pretty important. Without them, your sex organs would not receive the message to produce your sex hormones, or to ovulate, or to menstruate. But we are missing an important step. FSH and LH need a little encouragement too, and this comes in the form of another hormone – Gonadotopin Releasing Hormone (GnRH), which is released by the hypothalamus. Are you lost yet? Female hormones are confusing! Quick recap – GnRH stimulates the release of FSH and LH, which promote ovarian function and a healthy menstrual cycle.
Now here’s the kicker – leptin has been found to play a regulatory role on GnRH secretion and hence, overall reproductive function. Whether this is a direct or indirect role remains to be discovered. However, what we do know is that women with hypothalamic amenorrhea (when menstruation ceases due to dysfunctional signals between the hypothalamus and the pituitary) tend to have lower leptin levels than women with healthy, ovulatory cycles, as a result of low body fat and/or increased physical activity and/or insufficient food intake often found in amenorrheic women. These low levels of leptin then contribute to alterations in GnRH secretion, as evidenced by disruptions to LH secretion (Ackerman et al, Goumenoua et al). Interesting, right? Thought so.
Now I know what you’re thinking – what happens if we give someone leptin? Will that get things back on track? Well yes, Welt et al (2004) treated a small number (n=8) of women with hypothalamic amenorrhea with leptin over a period of 3 months and found that the treatment did restore menstruation, ovulation and hence, fertility.
Similarly, Mantzoros et al (2011) boasted this: “Our results indicate that leptin therapy resulted in resumption of menses….in 70% of the subjects [and] 60% of these women also ovulated”
Woo hoo! Let’s all go and get us some leptin to inject….
OR we could just eat more, exercise less and embrace our booty!?
[Stefani notes: You cannot get leptin over-the-counter, or have it tested for in a blood test. I’ve tried both.]
After 2 years of being in denial about the importance of body fat and desperately holding on to my 8-pack abs, which I had thought was my defining feature, I succumbed. I put on (quite) a bit of body fat. I ate more. I exercised less. And I realized that my friends and family probably loved me for more than just my body. Doctor Seuss was right after all when he said:
Smart man that Dr Seuss.
I put on weight. That was the goal, after all. And I definitely was no longer 13% body fat, as evidenced by my increasing bust line (yay) and decreasing (absent) thigh gap (also yay, I think – that shit is just not normal for my body.). One other lovely effect – my period returned. Hurrah! It just goes to show that with a little dedication and a (pretty big) mental shift, beautiful things can happen.
Ladies – your period is a luxury, not a right, and definitely not an inconvenience! If your lady holiday is MIA, see it as the canary in the coalmine and do something about it before the shit really hits the fan (think osteoporosis, heart problems and infertility). Stop trying to reach some warped perception of the “ideal” body and start embracing your natural feminine curves. And remember – you are so much more than what you look like. Be kind to yourself for once.
If you want to know more about women’s fertility, check out Stefani’s book, Sexy By Nature. It’s AWESOME. You can also see PCOS Unlocked and Birth Control Unlocked.
References for all you fellow nerds out there:
- Ackerman, K.E. et al. (2012) “Higher ghrelin and lower leptin secretion are associated with lower LH secretion in young amenorrheic athletes compared with eumenorrheic athletes and controls”, The American Journal of Physiology – Endocrinology and Metabolism, 302: E800–E806
- Goumenoua, A.G. et al. (2003) “The role of leptin in fertility”, European Journal of Obstetrics & Gynecology and Reproductive Biology, 106:118-124
- Holtkamp, K. et al. (2003) “Reproductive function during weight gain in anorexia nervosa. Leptin represents a metabolic gate to gonadotropin secretion”, Journal of Neural Transmission 110: 427–435
- Mantzoros, C.S. et al. (2011) “Leptin in Human Physiology and Pathophysiology”, The American Journal of Physiology – Endocrinology and Metabolism, 301: E567–E584
- Moschos, S. et al. (2002) “Leptin and reproduction: a review”, Fertility and Sterility, 77(3): 433-444
- Quennell, J.H. et al. (2009) “Leptin Indirectly Regulates Gonadotropin-Releasing Hormone Neuronal Function”, Endocrinology, 150(6):2805–2812
- Rexford, S.A (2004) “Body Fat, Leptin and Hypothalamic Amenorrhea”, New England Journal of Medicine, 351 (10): 959-962
Kate is a Holistic Nutritionist, Personal Trainer and Lifestyle Coach specializing in hormone healing. Kate has over 13 years of experience in the health and fitness industry. She is passionate about helping others achieve optimal wellness through nutrient-dense traditional whole-foods, adopting mindful and sustainable life practices, and moving in ways which rejuvenate rather than deteriorate the body. Kate’s goal is to educate, inspire and empower others to live life to the fullest each and every day. Kate can be reached at www.theholisticnutritionist.com
Mannequins do not menstruate, and this is not just because they are made out of plastic.
Here are some images of mannequins in clothes and fully nude. I think this difference is important to pay attention to because seeing mannequins in clothes the majority of the time impairs our ability to process just how specifically manufactured they are to drape clothing just so and to go beyond all reasonable body size aspirations. We don’t regularly see what’s underneath. But what’s underneath is nothing but angles and Barbies.
Note, for example, how hip bones often jut out, which is a way to cause skirts and pants to taper and hang low and stereotypically sexy. Note also how waists are tiny. Note also how legs are longer than the list of activity on my credit card accounts. Which is to say – Long. Disproportionately so.
To which I can only say, holy crap thigh gap.
Mannequins are problematic for a lot of reasons. One of the worst is that this is a subconscious problem. We are well aware of the damage magazines and celebrities and runways and the like do to our self-love, but how often do we consciously acknowledge the power mannequins have over us?
Not very often.
Which is unfortunate – because it has been at least somewhat scientifically proven that mannequins do not have a high enough body fat percentage in order to menstruate.
Two Finnish researchers, Minna Rintala and Pertti Mustajoki, tested standard accepted body fat percentages for women against measurements they made on mannequins (of arm, thigh, waist, and hip circumference are all standard means by which to measure body fat percentage) they found in Finnish museums that were from the 20s, 30s, 50s, 60s, and 90s.
Women need, on average, at least 17% body fat to begin menstruating. The researchers also use the data point of 22 % body fat for regular cycles – though I would argue that this is a statistic biased from the sample being drawn from the super industrialized nations of Western Europe and the United States. For the purposes of our investigation, however, their standards hold since we are largely of industrialized nations such as the US. Our mannequins, we should also note, are typically about 5’10 — the same size as the “fit” models on runways.
In this study, the pre-WWII mannequins had levels of body fat that were consistent with those seen in a healthy, young female of reproductive age population: up to 23 percent, at least. All the way up to 23 percent! That feels incredible – though it makes me sad to write that sentence. Women are known to be quite healthy up to and around 30 percent.
Starting in the 1950s, the estimated body fat on the mannequins decreased significantly. By the 1990s, a significant number of mannequins would not have sufficient body fat to menstruate if they were, you know, actual people. Check out the graph below. The bars detail body fat percentages for hypothetical women of “healthy” body mass indexes of 20-25. In the early decades the mannequin measurements come close, but in later decades fall far below a healthy BMI (note also that the WHO standard for “healthy” BMI goes down to 18.6..though this is contested, as in all things).
So what do we do with this knowledge?
Stop expecting clothes to look on us like they do on mannequins, I think.
And think about that maybe not even as a neutral thing, but as a good thing.
Sure, there are women out there with body types as slender and tall as mannequins with as little body fat, and perhaps naturally so. That’s great – beautiful – natural, what-have-you. I am sure some of them menstruate, especially if they live in less industrialized countries. But the majority of us plain old are not, and its a simple fact that extremely low body fat percentages result in impaired fertility, and, hey, isn’t it cool that we have enough body fat to menstruate?
And, hey, isn’t it cool that we know (more about which forthcoming in a HuffPo article by yours truly) that runway models starve themselves precisely in order to be the same size as mannequins, and that when we do the eat-sufficient-calories-healthy thing we are simply doing the human thing?
And, hey, isn’t it cool that we have lumps and jiggly parts and quirks and scars that only real human beings who love and dance and have sex and laugh can have, and not ones made out of plastic?
My book, Sexy by Nature
, describes a whole foods approach to health, sex appeal, and confidence for real human beings.
The one thing that we talk about most in this community is how to be in hormone balance. How to be fertile. How to enjoy being a woman instead of constantly fighting the basic facts of natural womanhood.
Every day I send emails to women making recommendations regarding food choices, lab tests, and self-love and body image issues. I thought it perhaps best, then, to share with you the differences I have experienced at different points in my life regarding my hormone balance.
Pre-weight loss; pre-exercise-binger; pre-paleo
As an adolescent and very young adult, I had some but not extreme acne. I weighed 137 pounds at my “heaviest,” which at 5’2 is approximately a size 7, and on my larger days a 9. I was also quite stressed out so did not menstruate super regularly, but still menstruated on a fairly regular basis. My periods were not always, though sometimes, incredibly painful, and lasted approximately 6-8 days. I do not have any good photos from the time (and I deleted off of my facebook any of the ones that actually showed my body fatness… choosing to leave tagged only those photos that were most flattered). But here is what I looked like, more or less:
(College “I’m drunk meditating on the side of the road in Beijing” phase)
(College “I’m dressed as a fairy holding the ‘make out’ hat” and “this photo is actually super flattering” phase)
Yet I dug up one from another angle in which I appear a bit less flat:
(Yes, I’m kissing someone, not a phase.)
(College “I’m a crunchy hippy” phase)
In the fall of 2009 I finally achieved the momentum I needed on my low fat, low calorie, vegetarian diet, 90-minute-sprint-workouts-every-day regimen to shrink down to, at my lowest, I think I was probably around 105 pounds. I bounced back up to 115 for the next few years but I still wore size zero, 25 inch waist pants.
In this time period, I experienced:
-the complete cessation and continued absence of anything resembling a sex drive
-an vagina that was, all of the time, as dry as Oscar Wilde (if not more so-if such a thing is possible)
-a completely absent menstrual cycle
-constant hunger (though I did not know it at the time since I had yet to experience the real cycle of intuitive eating yet)
These five bullet points might not look like much – but when you’re a woman who prided herself on her voracious sex drive and then it completely vanished, and you became infertile, and had acne… the thing was, I always suspected that my weight was to blame for my acne, at least in part, but I always thought it still worth the trade off. I’d rather have acne and be thin than be fat with clear skin.
This is what I looked like in this time period:
(“I cover my face because the sun burns my acne” phase)
(“I have eight pack abs, so what, b*tches?” phase)
(“Thigh gap!” phase)
(“Holy crap I’m so comfortable in this tiny body please don’t take it away” phase)
Lots of women probably menstruate at the size I was in the photos above. They probably had sex drives. I did not. All I had managed was to salvage my skin, mostly by reducing the fiber and protein contents of my diet, as well as by adding a topical probiotic to my daily regimen and ceasing to use conventional soaps and such. I had also managed to ovulate a few times, mostly by radically reducing stress or by having a particularly potent sexual encounter, but I did not have a true menstrual cycle, not by a long shot.
I also ate paleo the whole time, so anyone who says all you need to be healthy is a paleo diet is woefully uninformed.
Then came a time in which I prioritized my work and energy over everything else, and was extraordinarily stressed out. I gained weight. fast. And surprise of surprises, I menstruated. (Literally, it smacked me right out of the blue.) My sex drive had steadily increased up until that day, and has remained not just “oh thank god sex doesn’t disgust me anymore” or “well sure I’ll kiss you I guess” but “holy crap I want to do it now” since then. I have continued to cycle since. And my skin has cleared, almost entirely (to be fair: my stress has also been radically reduced), and I have, to my mingled dismay/resignation/fear/acceptance, continued to gain weight.
This is what a Stefani that can menstruate looks like:
(“I’m such a big deal I do photoshoots and holy crap I’ve got hips” phase)
(“Holy crap back fat stomach fat” phase)
(“Bear in mind that the camera on my phone elongates and I’m not nearly this tall or slim” phase)
If you want to see a video of me partner dancing in a body that menstruates (which is, still, a size or two smaller than I am now, I am more than happy to invite you to do so, here).
Looking at these photos, you might hardly see a difference. So what, you say. “She’s not overweight.”
No, of course not. I agree. I mean — there is definitely a difference, and just about everybody in my life has remarked upon it. My thighs are about 3 inches thicker, each. My face “fuller.” My abs, gone. My periods, pain free, and quite short (thanks to paleo!). I used to be a size 26 jean, and last night I wore a 30. I can no longer wear any outfit with carefree abandon — I now have to worry about placement and what the most flattering cut is and how to handle the parts of my that jiggle.
Some people say I look better. I don’t know. Can I compare? I don’t know. I know I look different, and that’s all that has mattered, and all that made this, while on one hand the best thing in my life, also, on the other hand, one of the harder things I have done (at least in 2014 🙂 ).
It’s been a small difference, but I had to read my own writing, and reach out to others for reassurance, and make a deliberate effort to arm myself against the tides of psychological baggage that tells me putting on weight makes me a failure, marks me as lazy, and renders me unfit for love. I believe so strongly in allegiance to our natural bodies, but that does not mean that I still did/do not have to fight for it on my “bad” days. Only because the gains I have had have been so great — I’m never giving up sex again — and because I have such loving, supportive people in my life, and because I’m currently finishing editing a book all about self-love, was I able to fall asleep peacefully at night rather than in a fit of frustrated, frightened tears.
Our society makes it hard. Even at my own relatively small weight gain and size. It makes it hard to “lose ground.” It makes it hard to “backslide.” But that doesn’t mean we give up. We remind ourselves of our own inherent worth, and we push through, and we change the face of womanhood one woman at a time.
I am no longer a fitness champion. I can no longer compare myself to Victoria’s Secret models. But I am different. I’m a new kind of sexy (more about which in coming days). I am me. And I am happy, and fertile, and healthy, and alive.
Far back in the very beginning weeks of this blog, I wrote a long series of articles on the sources of infertility. In terms of the kinds of infertility caused by diet and lifestyle, there are two primary categories: PCOS and Hypothalamic Amenorrhea. Long time readers of this blog know that I believe the relationship between these two disorders is much more complicated than regular doctors and medicine would have us believe. Nonetheless, while I was writing about PCOS and HA (read more about HA here and here and here), I promised to write a post on how to overcome HA.
I never did.
The reason I didn’t write it is because the answer is both way too complex and way too simple. I couldn’t come up with anything coherent to say.
Hypothalamic Amenhorrhea is the fancy way of saying “stress-induced loss of menstruation.” The hypothalamus is the part of the brain that determines if you are in a safe enough environment to bear children. If your body receives signals that you are not “safe” enough, then your hormone production will decrease and you will stop menstruating. You may also suffer symptoms of low libido, depression, anxiety, insomnia, acne, and fatigue.
“Safe” means both physiologically and psychologically. Mental stress can hurt your fertility just as much as physical stress. Unfortunately, these two stressors commonly occur in women today, and commonly in paleo dieters. Mental stress comes from pressure and ambition and work and life as well as body image issues, low-self-esteem, and disordered eating. Physical stress comes from low body fat levels, rapid fat loss, excessive fat loss, fasting, over-exercising, under-sleeping, and under-eating. It’s no wonder that so many women struggle with this.
Estrogen, progesterone, LH and FSH — all female hormones — decrease with hypothalamic stress. LH and FSH come directly from the pituitary and fall off the wagon, and then estrogen and progesterone, which take their cues largely from LH and FSH, fall off of it, too.
Can it be overcome?
Is it easy?
The thing about HA is that its severity and “cure” are different for each woman. The trick is to address all of the kinds of stress that play a role in HA, and to focus on the type of stress that caused your problem in the first place.
For example: say you recently dropped from 130 to 110 pounds. The primary problem — the thing that if it looks like a duck and quacks like a duck, it’s a duck, so stop fighting the reality of your weight loss — is that you lost too much weight too fast. Your body couldn’t keep up with your changing leptin levels. And you likely underate calories and gave your body starvation signals while you were losing. So that needs to take precedence. You also, however, exercise a fair bit and have a fairly stressful life. To that end, you should also reduce your exercise, work on your priorities and your stress level, and be sure to eat as much as you need to. Address all of the ways in which you can increase your body’s detection of “safety.” Focus on perhaps gaining a little bit of weight back, however, since that was your primary “problem.” The faster you can convince your body you are no longer starving, the faster you’ll regain hormone balance and fertility.
Other women, on the other hand, might have to focus on stress, or might have to give up marathoning for a while.
HA is all about convincing your body that it’s no longer in danger. It doesn’t need to stress. It doesn’t need to shut down hormone production to prevent a poorly timed pregnancy. So you have got to nourish it as best you can. Err on the side of over versus under eating. Dial down your exercise — particularly the sprint based kind — and do only what feels comfortable. Stop pushing through being so tired. Don’t wake up in the morning to an alarm after a short night’s sleep to go for a run. Be sure to eat plenty of carbohydrates — at very minimum 100 grams of carbohydrate a day — and make sure to eat even more if you are an athlete. Learn to move more slowly, to eat more gently, to be less hard on yourself. Relax, eat, relax, eat, relax, eat, repeat. Don’t eat garbage– no way! Some women do, and find that their fertility comes back. But go wild with your diet, and eat as much as you are craving. Your body has been starved, and it’s important to respond to hunger signals when you have them. That is, if you want your fertility back.
To that end, there’s a simple answer to HA:
-Eat more. Relax more. Repeat.
On top of that, we can get more specific:
-Focus on nutrient-rich foods that support healthy hormone production. Liver, egg yolks, other organ meats, bone broth, leafy greens, fruits, and vegetables are all great.
-Make sure to eat plenty of fat. At minimum 40 grams a day. This amounts to approximately three tablespoons of your favorite paleo oil (such as coconut oil) — one for each meal. Including saturated fat is particularly helpful since it is the backbone of hormone production.
-Make sure to eat plenty of carbohydrates. Your body can think it’s starving if it doesn’t get enough for a significant period of time. Eat at least one piece of fruit or serving of starchy carbs with every meal. Make sure to do more on active days.
-Eat when you are hungry. Do not go hungry. Ever.
-Only exercise when you feel energetic and excited to do so, and refuel appropriately afterward.
-Do not sprint more than a couple of times a week.
-Consider eating a fuck ton of calories. Many women have spent ages on different forums learning about what works, and debating how many calories should be eaten at any given point in time. Some argue you need as many as 3000 calories a day to recover. Others assert 2000. I wouldn’t go crazy, but consider the fact that there’s a good chance you are undereating relative to your needs.
-Consider weight gain. Anywhere from 1 pound to 10 might be necessary, or 30, depending on where you are. How much did you weigh when you stopped menstruating? Is it much more than where you are now? How much more? What else was going on in your life? You may need to close the gap a bit between where you are now and where you stopped menstruating in order to do so again. Each woman’s body is different and requires a different level of fat to feel safe and be fertile.
-Sleep as much as possible. 9 hours a night!
-Consider supplementation. Magnesium supports hormone production. Calcium is helpful with the magneisum. Take the magnesium and calcium in a 1:1 or 1:2 (at most) ratio. Vitamin D can support functions with magnesium and calcium. Fermented cod liver oil will never hurt.
Which is all that I’ve got. I know it’s a lot and also a little at the same time. Hypothalamic amenorrhea is all about you and your body and your own particular needs. You’ve got to think deeply about the kinds of stress you might be dealing with, and then go ahead and rectify it.
And then give it time.
It takes time to recover from this sort of thing. Hormones don’t leap ahead of us, they follow behind, peaking around all of the corners, making sure it’s safe before they come out and play. I can say, however, that your recovery will be faster the more you nourish yourself, the more you eat, and the more you relax. You can go more slowly if you are fearful of the process. This is what I did. And it’s good — the body learns to adjust to new leptin levels over itme. But know that it takes longer the more slowly and cautiously you move forward with your hypothalamus.
I highly recommend checking out the Fertile Thoughts forum on hypothalamic amenorrhea. It contains 108,000 posts and counting. Women all across the world come to this forum to share their experiences with HA and infertility. Definitely worth the read if you’re interested in HA at all.
One of the biggest hormone problems that plagues women is having low progesterone levels.
In some cases, this is somewhat natural: it happens during menopause, perimenopause and in periods of hormonal flux.
Nonetheless: a diagnosis of low progesterone is fairly common even among women of reproductive age. This occurs to two main groups of women: first, the estrogen dominant, and secondly, the stressed.
Low progesterone and estrogen dominance
Estrogen dominance is the condition of having too much estrogen relative to progesterone.
Symptoms of estrogen dominance include being overweight, PMS, menstrual cramps, decreased libido, bloating, breast swelling and tenderness, fibrocystic breasts, endometriosis, PMS-related headaches, mood swings, and thyroid malfunction.
You can become estrogen dominant if progesterone levels fall too low – yet you can also experience symptoms of low progesterone if estrogen levels become too high. Phytoestrogens in the diet, birth control pills, inflammation, and a sedentary lifestyle are a few of the many ways to cause unnaturally high estrogen levels. Check out this post on estrogen dominance for more.
Low progesterone and pregnenolone steal
Hormones are produced in a cascade. I like to think of the system like a set of dominoes: the hypothalamus (a part of the brain) tells certain glands like the pituitary and adrenal glands how hard to work, then their own hormones go on to signal to other hormones, and on and on. The dominoes fall in a perfectly regimented pattern if all of the surrounding dominoes do their jobs, too.
Unfortunately, when things go wrong early on in the hormone production process, there can be many significant problems down the line.
Progesterone is affected by one such problem.
Progesterone is synthesized fairly early in the hormonal cascade, and it’s activity is highly influenced by the level of stress–either physical or emotional–a woman is experiencing. I wrote about this in a post about a year ago, titled “The HPA axis: what is pregnenolone steal?”
Another name for pregnenolone steal is as progesterone steal.
Pregnenolone is the primary “precursor” hormone. It sits at the top of the domino chain and is directed to be used by the body however it sees fit. The primary decision the body makes with pregnenolone is whether it wants to make sex hormones like progesterone or stress hormones like cortisol.
If a woman is stressed, her body “steals” the pregnenolone and uses it for stress hormone production instead of progesterone production.This means that other female hormones also take a hit — accounting for why some women have low hormone levels across the board — but progesterone is one of the hardest hit. If a woman has low progesterone in her labs, it’s a pretty good bet that her body is using her resources to produce cortisol rather than progesterone.
For this reason, reducing stress is actually the only clinically well-known way to increase progesterone production.
This isn’t an easy answer. Stress reduction takes real work. We cannot just promise to sleep more or to spend more time with ourselves or our families, and then let these promises drift away as life marches on. Instead, we have to make concrete changes to our schedules, to our jobs, to our relationships, to our feelings about our existence. Often, psychologists can be uniquely helpful, as can group involvement, friendship, spiritual communities, and yoga and meditation.
Stress levels can also be reduced by making sure to eat a nourishing diet that doesn’t have any kind of a starvation component. Physical stress is nearly as important to address for this as emotional stress. Eat when you are hungry, and do your absolute best to assure your hypothalamus that it has nothing to stress about.
Symptoms of low progesterone (without estrogen dominance) include:
classic hypothalamic amenorrheic symptoms: irregular cycles, infertility, anxiety, low libido.
If you reduce your stress levels, you may see these problems slowly tick away. Perhaps most delightfully, progesterone is well-known as carrying with it significant libido-enhancing power. Reduce your stress, and your sex life make thank you, too.
This is a common theme for women’s health. Stress can have a very significant impact on us — far more so than it does on men.
Why? It is actually an evolutionary adaptation. The female body needs to protect itself against becoming pregnant at a time of famine, war, or other kind of life-threatening strife. The way it does so is by shutting down hormone production whenever stress appears to be too strong or chronic. Stress indicates that it may not be a “safe” enough environment to be pregnant.
Hormones may be a complex and challenging part of being a woman – but they can also be a rewarding one. The trick is simply to learn how to raise a white flag and stop being in a state of constant warfare against the body – and instead start practicing how to live in harmonious dialogue. I talk in great depth about how to do so in my best-seller – Sexy by Nature – which you can take a look at at Amazon, here. It was a real adventure, but I finally learned how to do it (and get my progesterone levels back up!), and you most certainly can, too.
What about you? Are you low in progesterone? What success have you had working with it?
While the title of this post may sound hyperbolic, it nonetheless is grounded in truth. There are a wide variety of dietary and lifestyle factors that affect reproduction. Stress may be one of the greatest of all.
Dozens of studies performed on cynomolgus monkeys, bonobos, chimps, and baboons have demonstrated that having low social status–even while maintaining the exact same diet at high social status individuals–induces impaired fertility in primates.
Human models, while approximations, do not differ. In some, a simple progesterone-dampening effect occurs, in others the levels decrease precipitously, in most cortisol levels skyrocket, but in general a wide spectrum of reproductive disorders- from hormone deficiency to full-blown long-term amenorrheic infertility- follow from psychological stress.
This is something about which I have written before, and it’s a serious problem, causing not just outright and obvious infertility but also sneakily impaired and sub-optimal fertility all across the country.
Pysychological stress wreaks all sorts of havoc on the body. Most importantly, cortisol levels rise, and the body’s inflammatory and immune responses become impaired. Blood sugar levels rise, and insulin levels rise, too. When these things happen, healing cannot occur, and tissues become progressively damaged with time. This applies to reproductive tissues as much as it does to the rest of them. Hypercortisolemia is good for nobody.
Several hormone responses also occur. Three of the primary ones are as follows:
1) As I mentioned, due to elevated cortisol levels, insulin levels may rise, and testosterone levels rise right alongside it. This is because insulin directly stimulates testosterone production in the ovaries. This is bad for reproduction because a proper balance between testosterone and female balance needs to be maintained in order for proper reproductive signalling and tissue development to occur. One particularly potent way in which this imbalance often hurts women is in the hormone condition Poly Cystic Ovarian Syndrome. It is not the only thing that contributes to PCOS– definitely not– but it can play a big time role in it. For more on stress and PCOS (and overcoming PCOS!), check out the book I wrote.
2) Moreover, another effect that may occur as a result of stress is an increase in production of DHEA-S, a hormone produced in the stress glands. DHEA-S is, like all other hormones, an important and very healthful hormone in proper balance. But if the stress glands are in overdrive, they might over-produce everything, including DHEA-S. This is detrimental, because DHEA-S is also a classically male sex hormone, and it plays a role similar to testosterone in PCOS. DHEA-S in excess blocks estrogen signaling, interferes with LH and FSH signaling, and also increases hormonal acne. DHEA-S can play a role in both type I and type II PCOS.
3) Finally, the brain, via the hypothalamus, sometimes turns off pituitary activity in response to stress. This often leads to a cessation of LH and FSH signaling–the two primary pituitary signalling molecules–which in turn decreases levels of estrogen and progesterone in the blood. Recall that reduced progesterone levels are one of the primary markers of reproductive distress in primate studies. Prolactin levels may also decrease. These facts make it impossible both to ovulate and to menstruate.
*Graphic extracted from PCOS Unlocked: The Manual.
These three categories– testosterone elevation, DHEA-S elevation, and pituitary decreases may occur differently in all women. And there are a wide variety of other, more subtle, hormonal responses that also occur, especially when considered in conjunction with all of the other bodily stress that follows from psychological woes.
All that being said, STRESS IS BAD. We know some of the reasons why, as I’ve explained above. Others likely exist. Even if you don’t have infertility problems, you may have hormone imbalances or deficiencies, and those can be just as insidious. Eat right, sleep right, live well, breath deeply. Repeat.
Stress is a significant problem for women’s health, and particularly women’s hormonal health. This is manifested in a wide array of problems, but also most predominantly these days in the condition PCOS, or Poly Cystic Ovarian Syndrome.
You can read more about stress and it’s interplay with cysts, as well as how to overcome it all, in my guide, PCOS Unlocked: The Manual.