One of the most important things for paleo women to consider is what we are going to do about birth control.
Should you take hormonal birth control? Is it really all that good? Bad? What happens to you when you’re on it? Of course, non-hormonal would be ideal for any woman who prioritizes having a natural menstrual cycle. Unfortunately, natural options are really not as abundant as they should be. Check out my top picks for low dose birth control options.
Non-hormonal birth control options
1) condoms and other prophylactics
2) pulling out
3) fertility awareness
4) the copper IUD
This last one is pretty powerful–and popular–but it carries a modest risk of copper toxicity with it and may exacerbate bleeding and cramps during your cycle. The copper IUD also costs a pretty penny… somewhere in the neighborhood of $500-$1000.
So, hormonal alternatives seem like a reasonable choice to many women. And they are. Side effects are often minimal (but again, I caution you against them), and many women are completely happy on the birth control pill.
One way to give yourself the best chance of this happening is to go on a low dose birth control option.
There are more than 60 varieties of the birth control pill available today, and every one of them is different. The dosages for the least impactful birth control pills are classified as: “ultra-low dose” and “low dose.”
Different ways higher hormone birth control can affect you
“Ultra-low dose” birth control pills are those that contain 0.02 mg of estrogen
0.02mg of estrogen is just about the lowest you can go and still prevent pregnancy. The reason many people opt for higher doses is that the side effects of spotting and breakthrough bleeding are more common with ultra-low dose birth control pills versus low dose birth control pills.
There are two ultra-low dose varieties:
Alesse (Aviane, Lessina, Lutera, Sronyx)
Contains 0.02 mg ethinyl estradiol and 0.1 mg levonorgestrel (a kind of progestin – read more about progestin types in my blog here and here)
Contains 0.02 mg ethinyl estradiol and 0.15 mg desogestrel (a kind of progestin)
Five low dose birth control pills:
Pills containing 0.02mg- 0.035mg.of estrogen fall into this category. They have a lower incidence of spotting and breakthrough bleeding.
ethinyl estradiol : 0.03 mg
norgestrel (progestin) : 0.3 mg
ethinyl estradiol : 0.03 mg
levognorgestrel : 0.15 mg
Ortho-Cept (Reclipsen, Solia)
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg
ethinyl estradiol : 0.03
levonorgestrel : 0.15 mg
ethinyl estradiol : 0.03mg
levonorgestrel : 0.15 mg
Other favorites of women interested in natural health are low dose “triphasic” pills, which better approximate the hormonal fluctuations a woman normally experiences. They also tend to be a bit better than average for weight maintenance and even weight loss.
- Phase 1: ethinyl estradiol : 0.025 mg and desogestrel (a kind of progestin) : 0.1 mg
- Phase 2: ethinyl estradiol : 0.025 mg and desogestrel : 0.125 mg
- Phase 3: ethinyl estradiol : 0.025 mg and desogestrel : 0.15 mg
Ortho Tricyclen Lo
- Phase 1: 0.025 mg ethinyl estradiol and 0.180 mg of norgestimate
- Phase 2: 0.025 mg of ethinyl estradiol and 0.215 mg norgestimate
- Phase 3: 0.025 mg of ethinyl estradiol and 0.250 mg of norgestimate
(Ortho Tricyclen and Ortho-Cyclen, each with 0.035 mg of ethinyl estradiol, contain slightly higher amounts of estrogen in each type of pill than Ortho Tricyclen Lo)
Finally, YASMIN and YAZ are two more low dose birth control pills containing 0.03 mg and 0.02 mg respectively of estrogen. What is unique about them is that they have a different type of progestin from the other pills called drospirenone (3.0 mg).
Drospirenone has the benefit of reducing acne and water retention in a lot of women. On the other hand, and this is a huge ON THE OTHER HAND, I have taken a similar substance and nearly died from a potassium overload, as well as developed a severe case of insomnia and anxiety that I am still dealing with two years later. If you take Yaz or Yasmin, please keep your potassium-containing foods to a minimum, drink plenty of fluids, and regularly check in with your doctor on your potassium levels. If you experience muscle weakness or heart palpitations, stop taking your pill immediately.
So aside from the YAZ, those are my favorite low dose birth control pills. These are the ones I fear the least, as they are the lowest dose birth control pills I know of. If I were to use hormonal birth control (to be clear: I don’t, I use prophylactics) – these are the ones I would investigate using, or at least ask my doctor about trying.
If you happen to struggle with acne and be on a birth control pill or contemplating it, take a moment and think about it. Each type of birth control pill has a different relationship with your skin! I discuss the nuances of hormone balance and specifics kinds of pills as they relate to acne in my brand new, 50% off program on the topic, Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin.
If you happen to struggle with PCOS, it is worth learning about the condition and how to overcome it naturally before going on the pill. I describe how I did and how you can do it too in my manual on the topic, PCOS Unlocked: The Manual.
I would say about ⅓ of the questions that come through for our podcast or email have something to do with understanding why our eating patterns are restricted. Or, questions regarding restricting and really, deep down knowing restricting is harmful to our health, but being unable to reflect or accept that fact without the feedback or acknowledgement of others. Which is OKAY. I have been there so many times before, too.
For example, when there is a question along the lines of, “I exercise “x” times a week and eat 1200 calories a day, but have “x” health problems, could this be originating with my calorie deficit?”. A lot of these inquiries are answered by the person asking in the question, but sometimes we need to hear confirmation from others that these things are affecting us negatively.
That is also why referring to ourselves as third person is a common way to gain perspective and insight on things that may be troubling us or if we are looking for insight on what we really need.
I too, have reached out to doctors, research, and my friends or family to understand why my body responds the way it does, or more importantly, why my body isn’t responding the way I want it to. We need to understand why our bodies don’t want to shed weight, recognizing that things like stress and inflammation can cause our bodies to enter a state where shedding weight isn’t the priority in keeping our body functioning. In a way, our bodies have a mind of their own and will make decisions to take care of themselves, even if we think we already are.
Processing and challenging our disordered thinking is not an easy task; in fact it is one that requires consistent work. I have to be mindful daily to make sure I am not falling into my past negative restrictive habits. This journey is a long one, and may often feel like you are taking 8 steps back and only a half step forward some days.
As with most people, I find that there is an ebb and flow of my moods and habits, and surrounding myself with positive people, eliminating negative social media outlets, and incorporating techniques like Cognitive Behavioral Therapy into my daily life can be grounding.
So – how can we use CBT to manage disordered eating?
What is CBT?
CBT is an evidence based treatment model focused on how our thoughts, feelings, environments, and behaviors are intertwined, and that they can be restructured to support better habits and actions. This type of treatment has been used for anxiety and depression in the past, but more so has been used for eating disorders and disordered eating patterns recently.
There are three phases to CBT – Behavioral, cognitive, and relapse/ maintenance. Each phase is targeted on different approaches to break down our existing thoughts surrounding restrictive or disordered eating. If you are interested in reading more on the specific phases, check out this book.
So How Can CBT Help?
The first portion of CBT is understanding why we have developed the patterns that we have. This stage is to gain a grasp on why we have developed the patterns that we have, and educating ourselves on the science behind disordered eating. In order to proceed with healing, we must understand how and why our brain’s have become wired to restrict the way we do.
- Setting Meal Times
This may seem counter intuitive, but it is an effective step in CBT. When we have regularly scheduled meal times at realistic intervals, we know when we will be eating again and as a result are breaking up the controlling binge restrict cycle that so often is in place.
- Challenging Our Dietary Rules
This one is commonly discussed on our podcast, and I find so many women have some sort of dietary rules in place. A few of mine included : eating heavier meals in the morning in order to have the rest of the day to burn it off, not eating after 9 PM, eating carbs throughout the work day, etc. So with these rules we need to challenge them by reversing our thoughts on them. This can include eating a light breakfast and heavier dinner, in my situation. What dietary rules do you have that you are willing to challenge? Did you ever tell yourself a food was off limits, and if so, why? Try eating that food and really reflect on how you feel in that moment. This brings me to our next item.
- Confront and Expose Fear Foods
After the above steps have been incorporated, the next gradual step is to give yourself the permission to expose our fear to food. Part of this is removing the fear from food itself, and understanding food is just food. There is no evil cookie out there, the reason we see the cookie as evil is because of the negative connotation WE place on the cookie. If we remove the fear of eating the cookie, it becomes just that again.
This helps often with those that experience binging or purging. If we got caught off guard in the middle of an area that we are wanting to binge or purge, say by a call from a loved one, or an unexpected immediate deadline, we usually are able to push back our binging which can often lead to no longer feeling the need to binge after the stressor has passed. I would recommend creating a list of things to pull out of your back pocket that can intercept restrictive behaviors. This article has a great list to start with that includes doing your nails, playing with a pet, calling a friend, or listening to music. By allowing yourself to complete this task before indulging the negative behavior, we can catch and stop that negative behavior from happening.
- Continue to Self Monitor
By journaling (this is a great workbook) and keeping track of consumed foods along with emotional feelings we can reflect on what ultimately is causing us to feel restrictive patterns in that moment. For instance, journaling at lunch time at work describing your current mindset and what your eating can allow you to see if you are stressed out about a project at work. Over time, journaling can show us what patterns we have surrounding our mindset. Maybe we only feel binging behaviors when we are stressed at work, or maybe the binging is at home before bed. This step is about maintaining self awareness and really “knowing thyself”.
By no means am I a registered, educated or licensed professional when it comes to CBT. I write purely from my own personal experience and research, and from my research working with women through PfW. All of these tips can be extremely helpful while navigating the world of CBT. However. CBT doesn’t work for everyone, especially when trying to complete on your own.
I was able to utilize CBT to manage disordered eating in the most effective way by utilizing a local mental health professional. CBT takes consistency to be fully optimized; by working with a professional you are more likely to have a successful experience with CBT. To locate a therapist that specializes in CBT, click here.
This website is the holy grail of resources. It contains informative handouts on eating disorders and disordered eating habits, as well as handouts, worksheets and exercises. There is also an extensive further reading page.
This website has a series of in depth modules that walk you through the CBT process.
As always, let me know if you have any questions or concerns or if I can help in any way. Everyday we are one step closer to eliminating restrictive eating if we consistently work towards improving. Keep an eye out for a few future posts on additional ways you can work to eliminate disordered eating tendencies.
One of the more esoteric but much beloved tools in the paleo dieter’s tool-kit is intermittent fasting.
What is intermittent fasting? I.F. is the practice of maintaining overall caloric intake while consuming those calories in fewer meals or in reduced time windows throughout the day. The goal is to create conditions of fasting in the body, but not for extreme lengths of time.
Some examples of intermittent fast strategies include 10, 8, or 5 hour eating windows throughout the day, or perhaps eating just two meals each day: one in the morning, and one at night. The evolutionary premise — the argument that proponents of intermittent fasting make — is that humans evolved to optimize their health under less-than-optimal conditions. Intermittent fasting, they say, is a natural and perhaps even necessary part of being human.
The modern-day scientific correlate appears promising, too:
Most people are nowadays aware that a calorie-restricted diet has the ability not just to decrease body weight but also to lengthen a human life. Emerging research is beginning to show, however, that intermittent fasting is just as effective as calorie restriction in ensuring these health benefits! Amazingly enough, this happens without any of the psychological crippling side effects of cravings and food obsession that practictioners of calorie-restriction often experience.
Intermittent fasting, proponents say, also may benefit the fight against cancer, diabetes, and autoimmunity. Here is an excellent, up-to-date review of the “benefits” of fasting. It is wholly understandable that fasting is all the rage these days.
Intermittent fasting women is a specific interest of mine because of what I have witnessed both in myself and in working with literally thousands of women in the PfW community.
Many women report to me (read more about that in this awesome book) that intermittent fasting causes sleeplessness, anxiety, and irregular periods, among many other symptoms hormone imbalance, such as cystic acne.
I have also personally experienced metabolic distress as a result of fasting, which is evidenced by my interest in hypocretin neurons. Hypocretin neurons have the ability to incite energetic wakefulness, and to prevent a person from falling asleep, in reaction to the body detecting a “starved” state. Hypocretin neurons are one way in which intermittent fasting may dysregulate a woman’s normal hormonal function.
After my own bad experience with IF, I decided to investigate intermittent fasting. I looked into both a) the fasting literature that paleo fasting advocates refer to, and b) the literature that exists out in the metabolic and reproductive research archives.
Intermittent Fasting Women: Problems in the Paleosphere
What I found is that the research articles cited by Mark’s Daily Apple (and others), focus on health benefits such as cancer-fighting properties, insulin sensitivity, and immune function.
However. I was struck by what seemed like an egregious sex-based oversight in that MDA post I linked to above. MDA cites this article as a “great overview” of the health benefits of intermittent fasting. This startled me because the article MDA cited was for me one of the strongest proponents of sex-specific differences in response to fasting.
Sex differences were relevant in two striking areas:
1) women in studies covered by the review did not experience increased insulin sensitivity with IF regimes and
2) intermittent fasting women actually experienced a decrease in glucose tolerance.
These two phenomena mean that women’s metabolisms suffered from IF. The men’s metabolisms on the other hand improved with IF across the board. Recall that the review was reported by MDA as “a great overview of benefits [of IF].”
Secondly, in another fasting post at MDA, of which there are many, the health benefits of fasting are listed and reviewed, but the sex-specific aspects of the hormonal response go unmentioned, and reproduction/fertility/menstrual health isn’t mentioned at all.
This is not to say that Mark is not attentive to who should and who should not be fasting. He knows very well and cautions people against the dangers of fasting while stressed. Still, the mere fact of being more sensitive to fasting simply by being a woman is, I would assert, pretty important for a woman who is contemplating or already practicing IF.
This goes nearly unmentioned in the blogosphere.
Intermittent Fasting Women: Problems in the Literature
Beyond reporting biases in the blogosphere, there remains an even greater problem of a significant testing bias in the fasting literature. Searching “men” + “intermittent fasting” in a Harvard article database yields 71 peer-reviewed articles. Searching “intermittent fasting women” yields 13, none of which are a) solely about women b) controlled studies or c) about more than body weight or cardiovascular benefits.
The animal studies are more equitable, but also a bit less applicable to human studies.
It is well-known in both the research and the nutritional communities that caloric restriction is horrible for female reproductive health. This is not news. There is an infertility condition – called hypothalamic amenorrhea – that millions of women suffer from due to being overly restrictive. But what of fasting?
Intermittent Fasting Women: Should we Fast?
The few studies that exist point towards no.
It is not definitive, since the literature is so sparse, and it necessarily differs for women who are overweight versus normal weight (and who have different genetic makeups), but when it comes to hormones, women of reproductive age may do well to err on the side of caution with fasting.
What follows first is a brief review of what can be gleaned in sex-specific responses to fasting in animal studies. Afterwards I talk about what has been concluded by the few relevant human studies.
Mice & Rats
First up is a study that demonstrates the hippocampal changes of calorie restriction and intermittent fasting for both male and female rats. In this study, they do alternate day fasting, which entails free eating on one day and a fast day on the next.
The study found that brain states while fasting were different for male and female rats. For male rats the change in hippocampus size, hippocampal gene expression, and ambulatory behavior was the same no matter what kind of restricted diet they were on – but for female rats, the degree of change in brain chemistry and in behavior was directly proportional to degree of calorie intake, demonstrating the unique sensitivity of female rats to the starvation response.
” The organization of the females’ response to the energy restricted diets is suggestive of some underlying mechanism that may allow for an organized, pre-programmed, response to enhance survival in times of food scarcity. Comparatively, the males’ genetic response was less specific, suggesting that the males respond to a general stressor but they seem to lack the ability to discriminate between a high energy and low energy stressor.”
Moreover, “IF down-regulated many gene pathways in males including those involved in protein degradation and apoptosis, but up-regulated many gene pathways in females including those involved in cellular energy metabolism (glycolysis, gluconeogenesis, pentose phosphate pathway, electron transport and PGC1-α), cell cycle regulation and protein deacetylation.” In this study, both male and female rats gained small amounts of weight on IF diets.
For female rats, even in the most innocuous form of restriction–intermittent fasting–significant physiological changes take place. Male rats do not experience as dramatic hippocampal and general brain chemistry change as female rats do, and their behaviors, specifically their cognition and their dirunal and nocturnal activity, do not change.
Female rats, on the other hand, “masculinize.” They stop ovulating and menstruating. They become hyper-alert, have better memories, and are more energetic during the periods in which they are supposed to be sleep. Theoretically, according to these researchers, this is an adaptive response to starvation. The more the female rats need calories– or at least the more their bodies detect a “starvation” state– the more they develop traits that will help them find food. They get smart, they get energetic, they get active, and they stop sleeping.
In a follow-up study conducted by the same researchers who explored the masculinzation of female rats, the researchers analyzed the gonadal transcription of male and female rats subjected to IF regimes.
This study found that male reproductivity up-regulates in response to metabolic stress. Female reproductivity down-regulates.
Completely opposite to the female rats becoming infertile while fasting, male rats become more fertile. In the researchers’ own words: “our data show that at the level of gonadal gene responses, the male rats on the IF regime adapt to their environment in a manner that is expected to increase the probability of eventual fertilization of females that the males predict are likely to be sub-fertile due to their perception of a food deficient environment.”
In the final relevant IF rat study I could find, researchers subjected rats to the same diets– to 20 and 40 percent Calorie-Restricted (CR) diets, as well as to alternate-day fasting diets, and monitored them over the long term for hormonal responses. The results were striking. Below is the abstract in full because it’s so powerful:
Females and males typically play different roles in survival of the species and would be expected to respond differently to food scarcity or excess. To elucidate the physiological basis of sex differences in responses to energy intake, we maintained groups of male and female rats for 6 months on diets with usual, reduced [20% and 40% caloric restriction (CR), and intermittent fasting (IF)], or elevated (high-fat/high-glucose) energy levels and measured multiple physiological variables related to reproduction, energy metabolism, and behavior.
In response to 40% CR, females became emaciated, ceased cycling, underwent endocrine masculinization, exhibited a heightened stress response, increased their spontaneous activity, improved their learning and memory, and maintained elevated levels of circulating brain-derived neurotrophic factor. In contrast, males on 40% CR maintained a higher body weight than the 40% CR females and did not change their activity levels as significantly as the 40% CR females. Additionally, there was no significant change in the cognitive ability of the males on the 40% CR diet.
Males and females exhibited similar responses of circulating lipids (cholesterols/triglycerides) and energy-regulating hormones (insulin, leptin, adiponectin, ghrelin) to energy restriction, with the changes being quantitatively greater in males. The high-fat/high-glucose diet had no significant effects on most variables measured but adversely affected the reproductive cycle in females. Heightened cognition and motor activity, combined with reproductive shutdown, in females may maximize the probability of their survival during periods of energy scarcity and may be an evolutionary basis for the vulnerability of women to anorexia nervosa.
They also found this:
The weight of the adrenal gland was similar in rats on all diets; however, when normalized to body weight CR and IF diets caused a relative increase in adrenal size, the magnitude of which was greater in females, compared with males.
The testicular weight was unaffected by any of the diets. In contrast, both CR diets and the IF diet caused a decrease in the size of the ovaries.
And this, bearing in mind that “daytime” for nocturnal rats is “nighttime” for humans:
The daytime activity of females was doubled in response to IF, whereas the IF diet did not affect the activity level of males. Nighttime activity levels of males and females were unaffected by dietary energy restriction.
Uterine activity was monitored daily with vaginal smear tests; cyclicity was scored as regular, irregular, or absent. The mild energy-restriction diets (20% CR and IF) significantly increased the proportion of animals displaying irregular cycling patterns, whereas the 40% CR animals displayed an almost complete loss of estrous cyclicity.
In males, corticosterone levels were elevated only in response to the 40% CR diet, whereas in females corticosterone levels were significantly elevated in response to all three energy-restriction diets, suggesting a relative hyperactivation in females of the adrenal stress response to reduced energy availability.
For lipids, all the rats did well: “Collectively, these data suggest that atherogenic profiles of both males and females are improved by dietary energy restriction.” Interestingly, too, as they pointed out in the abstract, human females also perform cognitively much “better” (memory and alertness) on CR and IF diets than on normal feeding schedules.
There are of course some caveats to this study: A) They are rats. B) They are somewhat “metabolically morbid” rats, which may make them more susceptible to disease. C) The rats were allowed to eat ad libitum on the IF days, but they simply did not meet their caloric requirements this way. So while it is a somewhat natural form of IF, it is still calorically reduced, such that that must be taken into account when gasping in horror at the hormonal responses of IF-ing female rats.
The Few Human Studies
I mentioned above that through the same review that MDA used as a “great overview” of IF benefits for all sexes, I found harmful metabolic effects for women subjected to alternate-day fasting regimes.
This is the study:
Heilbronn et al found that with IF, insulin sensitivity improved in men (21 participants) but not in women (20 participants): after three weeks of alternate day fasting, insulin response to a test meal was reduced in men. Women experienced no significant change. “It is interesting that this effect on insulin sensitivity occurred only in male subjects,” they report.
With respect to other health markers female health actually declined, specifically with respect to glucose tolerance:
“Another diabetes risk factor that has shown a sex-specific effect is glucose tolerance. After 3 weeks of ADF, women but not men had an increase in the area under the glucose curve. This unfavorable effect on glucose tolerance in women, accompanied by an apparent lack of an effect on insulin sensitivity, suggests that short-term ADF may be more beneficial in men than in women in reducing type 2 diabetes risk. ” The opening line of their discussion reads: “Alternate day fasting may adversely affect glucose tolerance in nonobese women but not in nonobese men.”
In a follow up study, Heibron et. al studied the effects of alternate-day fasting on cardiovascular risk. When human subjects fasted on alternate days for another three week period, circulating concentrations of HDL cholesterol increased, whereas triacylglycerol concentrations decreased. This is a good thing. However, the shifts in lipid concentrations were shown to be sex specific: ie, only the women had an increase in HDL-cholesterol concentrations, and only the men had a decrease in triacylglycerol concentrations.
The most recent review of IF agrees with my conclusion: sex-specific differences in metabolism exist and need to be studied further.
This study of alternate day fasting included 12 women and 4 men. In eight weeks, body weight decreased by about 10 pounds, and body fat percentage decreased from 45 to 42. Blood pressure decreased, total cholesterol, LDL cholesterol, and traicylglycerol decreased. These people were significantly obese, which limits the results of this study to an obese population. However, “perimenopausal women were excluded from the study, and postmenopausal women (absence of menses for >2 y) were required to maintain their current hormone replacement therapy regimen for the duration of the study.” (Their words, my emphasis)
The one, big study of intermittent fasting conducted on men and women looked at differences between isocaloric feeding schedules: 3 meals/day feeding versus 1 meal/day.
The study focused on body weight composition, blood pressure, and body temperature in subjects. Subjects were fed isocalorically either one meal each day or three meals each day. All subjects were between 40 and 50 years old (excluding women of reproductive age), and between BMIs of 18 and 25. They ate, so far as I can tell, a healthy diet with 35 percent fat, PUFA < MUFA < SFA. Only 15 of the original 69 completed the study (which goes to show just how fun everyone thought fasting was). As for the results,
“Systolic and diastolic blood pressures were significantly lowered by ≈6% during the period when subjects were consuming 3 meals/d than when they were consuming 1 meal/d. No significant differences in heart rate and body temperature were observed between the 2 diet regimens. Hunger was enormously larger in the one meal/day than in the three meals/day group. “The 1 meal/d diet was significantly higher for hunger (P = 0.003), desire to eat (P = 0.004), and prospective consumption (P = 0.006) than was the 3 meals/d diet. Feelings of fullness were significantly (P = 0.001) lower in the 1 meal/d than in the 3 meals/diet.” Body weight dropped only four pounds after several months. Cortisol dropped, but Total, LDL, and HDL cholesterol were 11.7%, 16.8%, and 8.4% higher, respectively, in subjects consuming 1 meal/d than in those consuming 3 meals/d.
In sum: patients on the one meal/day regiment were unhappy, hungry, lost a little bit of weight, increased cholesterol. This was a small sample, included somewhat menopausal women, and all people of normal body weight.
Intermittent Fasting Women: In Conclusion
All that being said, that’s it. That’s all that exists! Women don’t have much to go on.
There are a few rodent studies. They found that when alternate-day fasting,female rats and found significant negative hormonal changes occurring in the females.
There are even fewer human studies. Human studies on alternate day fasting have not been conducted on women of reproductive age at all, nor have any studies analyzed reproductive responses to fasting.
Moreover, the few studies that have been conducted on non-obese women have demonstrated that their metabolic responses are not nearly as robust as those of men, and may in fact be antagonistic to their health.
This post has focused on sex-specific responses to fasting, specifically intermittent fasting women. Another important distinction to make is between different body weights. Overweight and obese patients appear to experience significant improvements with IF regimes, but normal weight patients do not show the same across-the-board benefits. For women this may be a particularly sensitive issue. Overweight women may experience metabolic benefits, whereas normal weight women do not. I suspect that that may roughly be the case, but who knows. Honestly, no one at this point.
The practical solution, then, I believe, is to look at options, to be honest about priorities, and to listen to one’s body with awareness and love.
Is fasting worth trying if a woman is overweight and trying to improve her metabolic markers, and so far hasn’t had much success? Perhaps. Should it be undertaken if a woman is of normal weight? What if she is a light sleeper? What if her periods begin to dysregulate? Or stop? What if she starts getting acne, getting a stronger appetite, or losing her appetite altogether? These things happen, and I see them in women who fast and contact me time and time again.
We women (people!) should be honest with ourselves about our priorities, and act constantly with our mental and physical health foremost in our minds. All women are different. But the literature is so sparse in this area that we cannot make any real statements or predictions about the effects of fasting, other than that we just don’t know, and that we should continue to emphasize the centrality of awareness, caution, and loving nourishment in moving forward.
IF is one realm in which the female body has unique characteristics and needs that demand attention. There are boatloads of others. If you’re interested in reading about the collective set of them and learning how to optimize female skin, weight loss, and hormone balance, for a few examples, you could do worse than my best-selling book, Sexy by Nature, here.
And that’s a wrap! What do you think?
Sex is one of the most important things we do.
Desiring sex, therefore, is one of the most important things we can feel.
According to a Journal of the American Medical Association (JAMA) study reported on in February 1999, about 43 percent of women (compared to 31 percent of men) suffer sexual inadequacy for one reason or another. Interestingly, this is thought to actually underestimate the real level of sexual dysfunction in the U.S. Yikes.
What follows is a description of the physiological components of female libido, how to maximize those components, and then a discussion of the psychosocial components. The psychosocial components are the trickiest to get a handle on, but they are also treatable with proper therapy (if necessary), love, empowered embodiment, and raging, well-deserved confidence.
Need more information to find you raging, well-deserved confidence? Check out my bestselling book on women’s health.
What factors play a role in female libido?
Specific foods are not in reality relevant for female libido, except for how they may temporarily increase testosterone levels (a la oysters). Instead, all of the physiological factors that influence female libido boil down to long-term sex hormone levels and balance.
First, absolute levels of hormones are important: for example, the greater amount of sex hormones in the blood, the sexier a woman will feel.
Secondly, balance is also crucial. For example, estrogen is not typically considered important in arousing a woman’s sex drive. But having clinically low estrogen levels–that is, estrogen levels below the baseline for proper sexual function–prohibits absolutely any kind of sensation a woman might have in her clitoris. That’s scary.
This is the effect that all hormones have on sex drive, generally:
1.Testosterone: Increases female libido. Testosterone is the hormone primarily responsible for sex drive in both men and women. When women with hypoactive sexual dysfunction disorder are treated with testosterone, for example, they often experienced increased sex drive.
Higher testosterone levels also enlarge the clitoris (good to know if yours is shy!), but unfortunately if other hormone levels do not rise along with testosterone, symptoms of hyperandrogenism such as facial hair and acne may manifest themselves. For this reason, testosterone supplementation is not an advisable method of increasing female libido.
2. Estrogen: Crucial at baseline for sexual function. It is also the primary hormone responsible for vaginal lubrication. However, estrogen is a testosterone antagonist, so the more estrogen a woman has in her system, the less testosterone she has available to pump up her libido. Estrogen dominance therefore is one of the greatest culprits in contemporary Western sexual dysfunction.
3. Progesterone: Another testosterone antagonist. Having elevated progesterone levels relative to the rest of the sex hormones prevents a woman from achieving orgasm.
4. Prolactin: Not talked about very often, since it’s primary role is in lactation, but it is also involved in pituitary-ovary signalling. Increasing prolactin levels increase vaginal lubrication and sex drive.
5. Luteinizing Hormone: Highly correlated with sex drive. LH is a pituitary hormone that triggers ovulation in a woman. Many researchers believe LH is one of the primary game-makers in sexual arousal.
Because of the role each of these hormones play in female libido, the menstrual cycle demonstrates a clear pattern in fluctuating libido for most women.
So how does the menstrual cycle affect female libido?
Testosterone levels rise gradually from about the 24th day of a woman’s menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period women’s desire for sex has been shown, in general, to increase consistently. The 13th day (the cusp of ovulation) day is generally the day with the highest testosterone levels. It is also the day on which LH spikes. Ovulation, therefore, and no surprise here, is typically the randiest time of the month for a woman. In the week following ovulation, the testosterone level is the lowest and as a result women experience less interest in sex.
During the week following ovulation, progesterone levels increase, and this often results in a woman experiencing difficulty achieving orgasm. Although the last days of the menstrual cycle are marked by a constant testosterone level, women’s libido may boost as a result of the thickening of the uterine lining which stimulates nerve endings and makes a woman feel aroused.
Also, estrogen levels are at their lowest throughout menstruation and into the follicular phase (the first two weeks of the cycle) so women experience the least vaginal lubrication at this time. Because testosterone and estrogen are both increasing, however, sexual desire is ramping up again in time for ovulation.
What factors influence these hormone levels, and how do we make the best of them?
Estrogen Dominance: As I mentioned above, estrogen is a testosterone antagonist. When estrogen levels are too high relative to testosterone levels, female libido plummets. Women can become estrogen dominant by consuming too much soy (since soy acts as an estrogen in the body), by being overweight (since estrogen is produced in fat cells; see my book on healthy weight loss here), and by being stressed out (since estrogen can act as part of the inflammatory response). Women with estrogen dominance often experience symptoms of PMS, too, which does nothing to help libido.
Birth Control Pills: Birth control pills are another way that women can become estrogen dominant. But that is not the only way they negatively effect female libido. Progesterone levels are often elevated out of the normal range on birth control pills, and testosterone sometimes plummets.
Yet the effects of birth control pills on women is wholly unpredictable. Increasing levels of one hormone might decrease another, or might increase them exponentially, depending on how the woman’s HPA axis and ovarian feedback mechanisms work. Women also experience a whole range of side effects on birth control pills ranging from acne to suicidal depression. Birth control pills are no laughing matter, and their effect on female libido is wide ranging.
All that said, since birth control really is so unpredictable, birth control can play a stimulatory role on female libido, especially if she has chronically low levels of sex hormones in her blood. Some women feel like a million bucks on estrogen pills. If that is the case, however, birth control pills are only putting a band-aid on the problem, rather than solving it at its core. That often requires looking at physiological problems that deplete sex hormone levels such as low body fat, stress, and energy deficits.
See Birth Control Unlocked for more information on birth control options outside of the pill.
Testosterone blockers: Some women get on testosterone blockers to help them with symptoms of hyperandrogenism or problems in their menstrual cycles that come from high testosterone production. However, blocking testosterone is as good as eliminating it entirely. Spironolactone and flutamide are the two most commonly used testosterone blockers.
Hypothyroidism: Up to ten percent of women have clinical or sublicinical low thyroid issues. Hypothyroidism is significantly linked to low libido. T3, the active form of thyroid hormone, is crucial for the proper functioning of cells and organs. Without T3, the reproductive system barely manages to inch forward. Sex hormones suffer greatly, both at the ovarian level as well as in production at the hypothalamic and pituitary levels.
Hypothyroidism is caused by a wide variety of problems. Hashimoto’s thyroiditis is a an autoimmune condition that accounts for the vast majority of Western hypothyroidism. This can be mitigated by eliminating modern toxins, specifically wheat, dairy, and omega 6 vegetable oils, from the diet, and also by paying attention to gut health with gut-healing diets such as the GAPS diet or the one I recommend in Sexy By Nature.
Iodine-deficient diets can cause hypothyroidism. This used to be uncommon in western countries, since western countries iodize their salt, but sea salt often does not contain much iodine in it. Moreover, many Americans are now eschewing salt for “health benefits” (this is misguided), so their iodine levels are suffering. The solution to this is to consume iodized salt, or to perhaps supplement with kelp for a while. Iodine supplementation is tricky, however, and should build up slowly a la the recommendations of Paul Jaminet.
High intake of raw cruciferous vegetables can hurt an already suffering thyroid gland. Yet more importantly, low-carbohydrate diets contribute to hypothyroidism. Glucose is required for the conversion of T4 to T3 in the liver, so without adequate glucose supplies the body’s thyroid functioning suffers. This is a problem that many paleo women wrestle with. Adding just 50 or 100 grams of starchy carbohydrate to a daily diet, however, can increase energy, improve sleep quality, improve quality of skin and hair, and also boost reproductive function.
Repairing sub-clinical hypothyroidism has also been shown to remove ovarian cysts and help anovulatory women both ovulate and menstruate. For more on hypothyroidism, see Chris Kresser‘s work.
Stress: Stress is a psychological libido-killer, but it also has a physiological analog. When stressed, the body produces cortisol. Cortisol has a negative feedback effect on the hypothalamus, and it can inhibit all of the hormonal signalling that comes out of the hypothalamus. The hypothalamus is responsible for inciting pituitary function, so stress plays a very real role in inhibiting reproductive function. As many as five percent of women suffer reproductive symptoms of chronic stress.
Low Dopamine: Dopamine is the most important neurotransmitter for sexual prowess and reproductive function. Fortunately, dopamine deficiencies are very often corrected with the introduction of exercise into someone’s daily life. Almost nothing increases dopamine levels as well as exercise does. (Although sex also has potent dopamine-releasing effects: skin-to-skin contact shoots dopamine levels through the roof. But then dopamine levels plummet post-orgasm, creating withdrawal-type symptoms. This is how the body reinforces sexual behavior.)
Some women have reported to me personally the return of menstruation from amenorrhea after resuming regular sexual activity. They were as surprised as I was. Yet perhaps we should not have been so surprised. Dopamine is a potent neurotransmitter and, coupled with serotonin, can significantly up-regulate sex hormone production.
Low serotonin: Though excess serotonin has been linked to decreased arousal, serotonin also increases prolactin levels. Prolactin is important for vaginal lubrication and for sexual arousal. Ways to increase serotonin levels include adequate protein ingestion (.5 g/lb of lean body weight each day), adequate sun exposure, and perhaps most important of all, adequate sleep.
Low Body Fat/Excess Exercise/Energy Deficits: These three phenomenon almost always manifest in tandem. Yet the end result is the same: with low body fat, with excess exercise, and with caloric deficits, the body detects starvation. Leptin levels plummet, and the hypothalamus stops thinking that the body is sufficiently fed. Without leptin, the entire pituitary sex hormone cascade is not enacted. No LH, no testosterone, no estrogen, no prolactin, no progesterone. Body fat is unquestionably crucial for all reproductive function. Female libido just happens to be the one that’s the most fun to explore once proper body fat levels are restored.
Psychological factors effecting female libido:
There remain the psychological aspects to increasing female libido. And of them there are many. Perhaps a woman’s libido has been killed by a negative sexual experience. Or perhaps the woman is too stressed out by other factors to care about sex…or perhaps sexual relations between two people are strained because they can’t stand each other outside of the bedroom even more than they can’t stand each other inside the bedroom. Perhaps a woman’s lover is an ugly lump.
Many of those factors are outside my realm of expertise.
Some of them are inside of it, however, and fiercely.
Women need first to think they are sexy. I am so tired of women comparing themselves to others, and always thinking that beauty is relative. Beauty is not relative. It is everywhere. And in everyone. If she is beautiful it does not mean that you are less so. Period. I don’t care if you have a chubby stomach. I don’t care if you think your hair is boring. I don’t care if your right boob is larger than your left. Not a single other person cares either. At all. The only person who cares is you. No one wants to make you “perfect” but you.
You don’t have a single thing in the world to apologize for. No one is looking for apologies.
Instead, people are looking for statements. They are looking for fun. They are looking for inspiration, for character, and for life.
In that way, what other people want from each other is not necessarily for them to meet some ridiculous standard but instead to make them feel good. Whether that’s through sharing of your self-love, through your wicked personality, or through your liberated and unapologetically wild fantasies is totally up to you. The point being that confidence and self-love are the most important factors for actually being attractive. Sure, classic “looks” may follow, but only after a woman has convinced others that she is worth looking at.
Not a single person in the world wants to sleep with an apologizer. “Sorry, I don’t like who I am,” does not necessarily read like a 5-star resume. People won’t be throwing themselves at that. What they will instead throw themselves at is: “I am different from what you expect. But that’s an asset. I am worthy like you wouldn’t believe, and I am going to rock your world.”
Confidence is key. Beauty is key. And the thing is– damnit–it’s not faked confidence. It’s not faked beauty. You really are beautiful. You really are unique. You really are a natural, sexual, alive, vibrant woman. You do not have a thing in the world to apologize for. You are who you are, and you love being yourself, and you can share yourself powerfully and joyfully with others through sex.
This kind of self-love is why people get laid. It’s not because they have perfect torsos and racks as big as wombats. It’s because they have hot souls.
So confidence is important. So important, I wrote a book on how to find it through food and lifestyle. There’s one other crucial aspect I can speak to. It’s this:
SEX IS AWESOME.
IT IS NOT DIRTY.
Look. Sex is natural. Sex is so natural, in fact, that it’s the very reason we all exist. And sexual desire is natural. It is, by extension, the very reason we all exist. For that reason, along with many others, there is not a single immoral aspect to having sexual desire or having sex. Period.
And sex is not gross.
And a woman’s desire is not gross.
And a woman’s vagina is not gross.
And a woman having sex is not gross and not a slut.
Or maybe she is a slut, but that’s cool because that’s natural, too.
Men who don’t understand any of that are not real men.
The whole point being that American culture is a culture in which sexuality, and female sexuality in particular, is a dirty thing.
That is not okay.
It’s so not okay.
It is, in fact, plain old wrong. Sex is natural. If a woman (or man!) wants to be delighting in it, and more power to her. She is embracing her natural body. She is embracing her natural desires. She is owning her own confidence. And she is exalting in the vibrancy of her very existence.
If that’s not hot, I don’t know what is.
High fives for sex!
We already know how important the gut is to the health and functioning of the body. (Find my article A Healthy Gut in 4 Steps: This Week In Paleo here)
But did you know that the gut doesn’t just determine the health of our digestion or immune system but even the health of our brains and our offspring?
In fact, evidence is mounting that the microbiome (that collection of bacteria, fungi, and other creatures who colonize the colon, skin, etc) may determine whether you suffer from anxiety, depression, and may play a role in the development of autism in young children, among other things.
If you are pregnant, thinking of becoming pregnant, or have a young child, these are important things you should know.
The Microbiome and Pregnancy
Before birth, the mother’s microbiome actually changes to produce extra lactobacillus (which helps the baby digest milk) as well as several other bacteria that give the infant an important start in the world, helping with their immune systems and digestion, as well as several other things.
These bacteria coat the vaginal wall in preparation for the infant’s trip through the birth canal.
However, some mothers are placed on antibiotics while pregnant. They are sometimes important but these broad spectrum antibiotics destroy both negative and positive bacteria, meaning fewer bacteria overall for the baby.
It is wise to seek a doctor with a well-rounded view and respect for the microbiome, one who is careful with prescriptions of antibiotics, especially during pregnancy.
The Journey of Birth
When it comes time to give birth, the journey through the birth canal is one of the most important moments for the microbiological quantity and quality of an infant.
That trip through the birth canal is vitally important for a new baby. The microbiome of the vaginal wall infiltrates the babies mouth, eyes, ears, and gets into every mucous membrane, rapidly providing the important first colonization.
However, many babies are now born via cesarean section and therefore are not colonized by the bacteria on the vaginal wall, but rather by the skin of whoever they first spend time touching. This is significant because the microbiota of the skin is different than what is present in a healthy gut.
If C-sections are necessary (and they often are, though the medical community is beginning to admit they have historically been overused for many reasons) then many women are requesting or performing vaginal swabs to the mucous membranes of infants just after birth so that the infants can be colonized by the mother’s microbiome.
It might sound weird, but this could prove to be a vitally important procedure for the health, immune system, and psychology of children.
Since pregnant women spend nine months building this special colony for their baby, it’s a shame not to be able to pass it on, and may one day be shown to be quite damaging to the infant.
The first three years of life are vitally important for development of a child, especially their microbiome but many children experience ear infections early in life, or other issues which may be prescribed antibiotics.
Studies on rats have shown that those kept sterile or “germ-free” develop social anxiety, even autistic-like features, as well as a penchant towards obesity and other diseases.
Not only that, but with animals from conventional farms being fed antibiotics to both prevent illness and promote fat storage, we are all are inadvertently consuming antibiotics through food when we eat conventional meat.
Though there are times when antibiotics are necessary and can be lifesaving, it is generally agreed upon that they have been historically overused, often with little to no benefit and, it is being discovered, more and more detriment. In many cases, the condition would go away in time and may not even be a bacterial infection.
According to many medical professionals, it is often difficult to discern whether an issue is bacterial or a virus. Because many doctors receive pressure from patients for relief or are determined to “cover their bases”, antibiotics have been overprescribed. Pair that with the overuse of germ-killing products like hand sanitizer and it’s clear why there has been such a rise in antibiotic resistant bacteria, which can be deadly.
Most of us were probably placed on antibiotics at some point which threw our microbiome out of whack.
And it’s important for us to work with the best information and knowledge we have to try to put a healthy gut back together.
As adults, early childhood issues of the microbiome promote a range of conditions including obesity, diabetes, and associated illnesses, as well as diseases of the gut like Chron’s, and autoimmune conditions, allergies, and the like.
Psychologically there is growing evidence that an affected microbiome can stimulate anxiety, depression, and other mental health issues.
In several studies, as well as my work anecdotally, probiotics do seem to help many people improve mood, digestion, and symptoms of illnesses and conditions like irritable bowl syndrome.
For those with depression and anxiety, I think it makes sense to take a probiotic and for anyone- children and adults- who have had to use rounds of antibiotics, I think it is valuable to take a probiotic.
The probiotics used in most supplements are those with heavy research backing their efficacy. It’s hard to know just how much bacteria actually gets through the stomach acid with these probiotics, but several have special coatings to hopefully help them reach the colon intact.
I particularly like this probiotic for adults (find it here). Though it has fewer colonies, it is supposed to be more effective, remaining intact through the stomach and small intestine so that it can reach the colon.
This is a probiotic recommended for children (find it here). As with anything with kids, please make sure you get your doctor’s OK before giving these to your child.
Remember that a healthy diet is vital for the health of the gut as well. As much as I’d love it, we can’t just take a supplement and be done with it.
If you’ve had success with probiotic therapy, I’d love to hear from you! Which ones have worked for you? Which haven’t? And what have you done to improve your microbiome?
“Estrogen dominance” is not a term typically used by the research or professional medical community. If the condition were described to them, however, they would be able to identify it. It is a real and common thing for women to have excessive estrogen levels. It just so happens that the natural health community is deliberate about addressing it.
The basic problem of estrogen dominance is that estrogen levels are too high relative to other hormones, specifically progesterone. Usually it occurs when estrogen levels go too high, though it can also happen when progesterone levels fall too low. It can occur at any time during life — during reproductive years, perimenopause, or even menopause.
It can also be coming from a wide variety of sources within a woman’s diet and lifestyle. This makes estrogen dominance a bit of a complex nut to crack. But a holistic approach to health (you can read my recommendations for women’s health in my best-seller, here) should at least get everyone on the right track, and provide a proper learning environment in which you can figure out precisely where your dysregulation is coming from.
Estrogen dominance: symptoms
Estrogen dominance can cause a wide variety of symptoms, as well as increase the risk for a wide variety of diseases and conditions. Symtpoms associated with estrogen dominance include:
High emotional sensitivity
Conditions that appear to be more common in women with estrogen dominance and that may in fact explicitly develop as a result of estrogen dominance include:
Hypothyroidism (estrogen is antagonistic to thyroid hormone)
These aren’t problems we can just shrug off of our shoulders. In many ways, we can reasonably view estrogen dominance as contributing to the deaths of thousands of women every year.
Estrogen Dominance: Causes
The causes of estrogen dominance are wide and varied, but largely have to do with metabolic dysregulation and organ malfunction. Some dietary factors may also offset the balance.
1) Being overweight:
Fat cells perform a function called “aromatization” which converts testosterone to estrogen. The more body fat, the more the body tips the balance towards estrogen and away from testosterone.
Now, this does not mean testosterone levels are necessarily low in overweight women. To the contrary: testosterone levels tend to be high in overweight women. This is not always the case but is quite common: it’s because testosterone production is stimulated by insulin, and many overweight women have some degree of insulin resistance.
Woman predisposed to insulin insensitivity often experience increases in both testosterone and estrogen levels. Progesterone receives no bump from weight gain, however: progesterone thus remains incapable of offsetting the estrogen increases associated with higher body fat percentages in overweight women. (To learn how to lose weight in a way that is healthy, sustainable, and hormone supporting, check out this resource)
2) Overburdening the liver
The liver is responsible for clearing the body of “old” hormones, especially estrogen. If the liver is overburdened with a hyper-caloric diet, with high volumes of sugar, with high volumes of alcohol, or with high volumes of processing chemicals, then, it becomes sluggish in it’s ability to process everything. When the liver slows down, estrogen ends up becoming back-logged in a way, and wreaks havoc on the reproductive system as it waits for the liver to heal and to catch up in its bloodstream clearing capacity.
This effect is interestingly even more pronounced in men than it is in women, and it accounts largely for the development of breast-like fat deposits in heavy drinkers. Being overweight and being stressed may also contribute to this process in men.
Stress wreaks havoc on all body systems. Perhaps most pressingly for women, however, it decreases the production of progesterone in the body. When a woman is stressed, her adrenal glands “steal” the precursor to progesterone and instead use it to produce cortisol, the stress hormone. This process is called “pregnenolone steal.”
High volumes of stress can yank the rug out from under progesterone, which can precipitously tip hormonal balance in favor of estrogen.
4) Consumptions of phyto and xenoestrogens
Much as I have difficulty with soy in my own life, I typically preach caution when talking about soy. I honestly believe that it is a good therapeutic tool for some women, and each of us needs to use it appropriately. Sometimes it can be helpful. More often than not I think it is probably harmful.
In every single case, however, soy, flax, legumes, and other sources of estrogen interfere with natural estrogen production.
Phytoestrogens can increase the aromatization process in fat cells that I described above. They increase the rate of testosterone and other hormones being converted into estrogen.
They can also simply just dump an increased estrogen load into the body, which automatically tips the balance. In a properly functioning metabolism, the liver should probably be able to clear out this increased estrogen load. But sometimes the load is too heavy or the liver not quite strong enough, and that becomes an impossibility.
Phytoestrogens are from plants. Xenoestrogens are from chemicals in the environment, such as BPA. Plastics and aluminums typically have BPA and you may ingest it if you aren’t careful. Here’s my favorite BPA free coconut milk, and an awesome bottle that I use for my water.
It is also entirely possible to become estrogen dominance as a result of birth control pill use – a process which I describe in great length in this PDF.
5) A low fiber diet
Estrogen is processed by the liver, but it is also processed partly by gut flora, and also excreted through the digestive track.
It has been shown many times that low fiber diets are associated with estrogen dominance. There are many cofounding variables that may play a role here, but the general idea is that estrogen can be reaborsed through the intestinal walls. With poor gut flora and with slow intestinal motility, estrogen can sit too long in the gut and gets reabsorbed back into the bloodstream.
If you are constipated, this may be an issue for you.
So the answer is not necessarily fiber – fiber may not be what helps get rid of constipation for you – but it is one potential option.
Fiber is generally correlated with improved digestive pace and motion, though not exclusively. A proper amount of fiber helps push things along in the digestive track. Too much fiber can obviously be damaging. It causes something health advocates like to call “roughage.” It is abrasive, and it can lead to gut deteriorating conditions such as diverticulitis. In any case, however, regularly consuming fruits and vegetables can be quite helpful for gut motility… as well as the rest of the body.
If you are really struggling with constipation still you could always try paleo fiber. Though I believe magnesium (my favorite here) may be a healthier way to supplement for constipation. The best possible thing to do however may be to eat fermented foods like these or consider a probiotic supplement like this.
Estrogen dominance: treatment
The best possible thing for estrogen dominance is a natural, paleo-type diet. Cooling inflammation, supporting organ – and particularly liver – function, minimizing phytoestrogen intake, and maximizing nutrient status are all excellent, estrogen-managing aspects of paleo.
A paleo-template type diet includes healthy, grass-fed or wild-caught animal products (with both the protein and the fat), seafood, fruits, vegetables, olive oil, coconut products, starchy vegetables, and to some extent seeds and nuts.
However, in an estrogen dominant system, seeds and nuts can act as phytoestrogens and tip the hormonal balance in favor of estrogen, so they should be carefully stepped around.
Foods that support thyroid health such as seafood and seaweed should also be quite helpful for boosting metabolic health and hormone clearance (if you do not consume seaweed regularly consider a small dose kelp supplement).
Foods to emphasize for estrogen clearing are those that boost B vitamin levels, omega 3 levels (fermented cod liver oil is an excellent way to meet the body’s need for omega 3 while also getting the rare but crucial vitamins A, D, and K), choline (for the liver!), zinc (here), magnesium (here), calcium, and vitamin D.
For that reason, eggs (choline), fish (omega 3 fats, iodine, selenium, and vitamin D), liver and other organ meats (vitamin A, vitamin K, B vitamins, and iron, zinc, manganese, etc), and high quality animal protein may be your best companions in this journey.
Foods to be avoided are all processed sugars, grains, omega 6 seed oils, phytoestrogens which include soy, flax, legumes, seeds, and some herbs, which I list in great detail here, and alcohol.
Some herbs have also been rumored to be helpful. Personally, I don’t love to recommend herbs, especially ones that affect hormone balance, such as chasteberry. (Though chasteberry, and I did link to a good grand, has been rumored to be quite effective). They simply have not been studied to any significant depth. Everything we know about herbs and hormones comes from what people say – not science.
If you are still interested, the absolute best herbs I can recommend for estrogen dominance are ones that support liver health and may help support estrogen excretion. For that the absolute best are milk thistle and/or dandelion root, in my opinion. You can see a good milk thistle here and a good dandelion root here.
Additionally, L-taurine promotes bile circulation, which enhances estrogen’s excretion out of the body.
Exercise is incredibly important, as it can speed up the liver’s detox processes, sharpen insulin sensitivity, boost weight loss, help mitigate mood swing problems associated with estrogen dominance, and reduce levels of stress hormones in the body. You can read all about my exercise recommendations in this book.
Getting off of the pill or getting on a very low-dose pill is critical. You can read about the side effects, risks, and management tricks of birth control in this PDF.
Stress reduction is huge. I cannot emphasize enough how important this is. Without progesterone, it is nearly impossible to rectify estrogen dominance. They must be in balance. Even if every other aspect of estrogen mitigation is in place, if progesterone is low then estrogen dominance may persist.
Estrogen dominance: In sum
Estrogen dominance plagues a wide variety of women, and at all stages of life.
Supporting organ health, reducing stress, and generally focusing on healthful foods should get us most of the way there towards greater hormone balance.
There are, of course, many other things you can to do help mitigate problems associated with estrogen dominance– for example, experimenting with neurotransmitter supplementation or boosting neurotransmitter health with diet and supplements in order to mitigate mood swing problems– but those are wide and varied and left for their own places in this blog at an upcoming time.
Foods and supplements I have linked to above and which I have personally seen work really well with some clients:
Desiccated liver (in case you don’t like eating it!)
My favorite fermented foods for gut healing, healing constipation
cod liver oil for reducing inflammation and getting the important but rare A, D, and K vitamins
Milk thistle for liver support
Dandelion root for liver support
A great probiotic supplement like this
My favorite magnesium here
A list of my favorite fermented foods here
A good small dose kelp supplement
BPA free coconut milk
BPA free water bottle
And that’s a wrap!
You can check out my quick guide PDF on birth control and how to manage it’s symptoms – here – or check out my extensive work on another alarmingly common hormone condition, PCOS – here.
For the real skinny on the impact of hormones on your life, see my book, Sexy by Nature, at its site or read reviews and buy it directly from Amazon!
In the meantime: what is your experience? Does paleo help with these symptoms? Are you estrogen dominant? What parts of your diet and lifestyle are best for keeping you hormonally balanced and healthy? What’s worked, and what hasn’t?