I was anxious, I couldn’t sleep, I cried at random junctures, and often. I felt worthless, sapped of energy and suicide entered my consciousness for the first time in my life.
It took some persuasion, because I was a bit embarrassed; I mean what did I have to be sad about?! But I eventually went to the doctor, who concluded I was likely depressed and prescribed me antidepressants.
But then, by chance, I went to see another doctor, who probed a little deeper, asked an exhaustive list of questions, ran tests and determined I had a hormonal imbalance. A few weeks of pills and the inexplicable sobbing sessions stopped, and each day dawned a little brighter.
Confessing these feelings in the very public forum of my weekly newspaper column resulted in an overwhelming response, not only from people who were struggling with their own mental health, but from women who wanted to know whether they, too, could be struggling because of a hormone imbalance.
The more I looked into the subject, the more the answer seemed obvious. Here was one of the clinchers for me, and prepare yourself, because Ben Warren, the founder of the holistic health and nutrition company BePure, dropped a bombshell.
“PMS is not normal.” Yep, you heard right. “It should just be like any other day. Many women do not realise they have a diseased state when they have PMS, because it’s considered so normal they don’t even record it as a problem. But it is not normal.”
Dr Frances Pitsilis, an integrated medicine doctor, is not quite so cut and dried about it, but the premise remains the same.
“When it affects your life, it’s not normal. One to two days of being a bit on edge is not a problem, but when family members are doing sign language around the house half the time, it’s not normal. Some women suffer two or three weeks of their cycle and they only have a week of sanity. That shouldn’t be happening and yet it’s very, very common.”
If every month you curse the male version of our species for failing to understand what you’re going through, this little analogy from Warren might help explain why they just don’t get it.
“A man’s hormonal system is very much like a Toyota Hilux; it’s a basic vehicle, it does what it needs to do and you don’t get a lot of problems with it. Whereas a woman’s system is like a Formula One racing car; it’s incredible what it can do, absolutely unbelievable, but unfortunately it doesn’t take much to throw the timing out”.
The good news is that we don’t need to feel like irrational, teary she-devils every month. The bad news according to Warren, “The modern environment we live in is just absolutely carnage for women’s hormones. It’s like the whole modern world is basically set up against women’s hormones”.
Still reeling from the revelation that feeling like the world was caving in every month wasn’t normal, I went back to the doctor who discovered my hormone imbalance, Dr Pitsilis, to ask a few more questions about how my hormones should behave and why they weren’t behaving that way.
I don’t know about you, but I think I missed the bit in biology or sex ed in high school where they taught us about how things are supposed to work.
I remember the bit about how an egg is fertilised and how to put a condom on a banana, but not much about what happens to my body every month for about 30 years.
The body has many hormones, which act as messengers – it’s their job is to tell different cells what to do. Hormones are your body’s communicators. For women, we have several key sex hormones that fluctuate at different times of the month.
So, in a normal month, “your estrogen will be very low in the first half, peak for ovulation and then drop away with a little blip in the second half. Your progesterone is low in the first half and then has a big blip in the second half of your cycle”.
It’s a clever, complex tango of two hormones, until something comes along and trips up one of the dancers. It could be endometriosis, polycystic ovary syndrome, menopause… or stress.
Yep, that ubiquitous factor of modern life that most find almost impossible to avoid can cause you untold grief. Great!
Dr Pitsilis sums up what got me into the predicament pretty well. “What happened to you was chronic stress. You were a shift worker so for a start you weren’t getting melatonin, which supports all antioxidant pathways, it’s what restores you when you sleep. You were already permanently jetlagged, or you could say tortured, because they do use it for torture! So, you were on the back foot when it came to changing jobs and not knowing what you wanted to do. Throw in getting married – it all causes stress. Especially for someone who wants to have all their ducks in a row, like you.”
Pointing out I’m a serial perfectionist is an important point, because as Warren explains, “Your body can’t differentiate between stressors – whether it’s emotional stress or financial stress, work stress, exercise, it’s releasing cortisol.” So while my life was never in danger, for all my primitive brain knew I was being chased by a tiger – constantly.
Dr Pitsilis says, “Stress drains everything, it really does. Your vitamins and minerals, hormones like testosterone, progesterone, DHEA – which is your quality of life hormone – and it drains your neurotransmitters, which can be one reason people get depressed.”
If you want to get into the nitty gritty, what happens when you get stressed is your body responds by producing cortisol, the stress-response hormone. If you’re chronically stressed, your cortisol levels start to get drained.
That then drains your progesterone, the bit you need in the second half of your cycle for fertility and wards off PMS. It can also drain your thyroid – the gland that’s key to weight control and energy – because the thyroid needs cortisol and progesterone to function properly.
Then, with the cortisol depleted, that leaves your other stress response hormone, adrenaline, pulsing around your body unchecked. That, Dr Pitsilis says, results in her patients being both “wired and tired”.
Throw into the mix that chronic stress can also deplete your body of magnesium, which your body needs to make serotonin (y’know, the happy hormone!), and cue weepiness, fatigue, anxiety, irritability, acne, migraines, bloating, perhaps an irritable bowel, and a libido that packs up its bags and leaves. So when Dr Pitsilis said chronic stress could drain everything, no hyperbole was employed.
As a starting point, Warren suggests yoga as an alternative to higher intensity exercise as over-exercise is a big risk factor in hormone imbalances.
Try meditation to help cope with stress or seek counselling. Cut down on coffee and alcohol – both burden the liver, which then can’t focus on getting rid of excess oestrogen.
Both Dr Pitsilis and Warren advise you to do what your mum has been telling you all your life: eat your greens, especially brassicas like broccoli and cauliflower.
Dr Pitsilis recommends taking a multivitamin, fish oil, or magnesium, and getting your zinc levels checked with the zinc taste test. Your next step could be to see a nutritionist like Warren at BePure, whose team treats hormone imbalances through a combination of dietary and lifestyle changes, herbs, supplements and healing the gut.
You could ask your GP to test your vitamin D, iron and vitamin B12, but blood tests often aren’t that helpful in making a diagnosis about the hormones themselves.
You could also try visiting an integrated medicine doctor, like Dr Pitsilis. She works her way through all the things stress may have depleted in your body and advocates using micronised progesterone as one of the tools to help treat hormone imbalances.
A combination of everything from chowing down on broccoli by the bucketload to taking vitamin D and progesterone has me in a much better place than I was just a few months ago. I can’t tell you how different a month looks when your hormones are happy!