Hormonal health
Many women notice that when life becomes stressful, their mood, energy and menstrual cycle change. According to Dr. Sasha Hakman, a double board certified OB/GYN and fertility specialist, this is not a coincidence. Emotions and hormones are closely connected inside the body.
The endocrine system is the body’s hormone control center. It includes the brain, thyroid, ovaries and adrenal glands, and these organs constantly communicate with each other. When you are under stress, the adrenal glands release cortisol, the main stress hormone. A small amount of cortisol is normal and useful, but when stress is ongoing, levels can stay high for too long. This can confuse the normal feedback loop between the brain and the glands, affect thyroid hormones and disrupt reproductive hormones that control the menstrual cycle. As a result, some women experience irregular or late periods, mood changes and a general feeling that their body is “off” without a clear reason.
It is not only cortisol that influences emotions. Estrogen also has a strong impact on mood, because there are many estrogen receptors in the brain. During a typical menstrual cycle, estrogen rises before ovulation, peaks again about a week later, then falls in the days before a period. When estrogen drops, some women feel more irritable, sad, low or anxious. In premenstrual dysphoric disorder, a severe form of premenstrual syndrome, these changes can cause very strong mood swings, anxiety and depression before the period starts. In such cases, treatment may include birth control to smooth hormone levels or antidepressant and anti anxiety medication.
Polycystic ovary syndrome, or PCOS, shows another clear link between hormones and mental health. PCOS affects about one in ten women and can cause irregular periods, acne, hair growth and weight changes. Research now shows that women with PCOS have higher rates of anxiety, depression and body dysmorphia, even when they are not overweight. When a patient reports irregular cycles, Dr. Hakman often moves quickly to questions about anxiety and depression, because they are so often connected. At the same time, doctors are seeing more PCOS overall, which she connects not only to better diagnosis but also to environmental chemicals that can interfere with hormones, such as those found in some plastics, fragrances, cleaning products and cosmetics. It is not realistic to avoid all of these, but reducing exposure can help.
Emotional stress also appears in the body as physical symptoms. This process, called somatization, can show up as headaches, pelvic pain, muscle tension, fatigue and low energy. Estrogen is often responsible for the upbeat, high energy feeling many women notice at certain points in their cycle. When estrogen is low, whether due to a hormone disorder or menopause, energy and mood may drop as well. Some women barely notice these shifts, while for others they define the rhythm of the month.
For that reason, Dr. Hakman encourages women to track their cycles and moods together. When you know where you are in your cycle, you can begin to see patterns, such as feeling more irritable a couple of days after ovulation or very low in the week before your period. Understanding that hormones play a role can reduce shame, help you communicate with people around you and even guide you to plan around the days that tend to feel harder. She also stresses that women do not need to suffer in silence. If mood changes are extreme, there are medical treatments and strategies that can help.
Much has been said in recent years about “balancing hormones”. Dr. Hakman is careful with that phrase, because hormones are meant to rise and fall. Levels can change from one hour to the next and still be perfectly normal. Even so, there are situations where lifestyle changes and supplements can support hormone health, particularly in insulin resistance and mild PCOS. Changes in nutrition, regular movement and specific supplements such as myo inositol and D chiro inositol can improve insulin sensitivity in some women, which can in turn help reproductive hormones and mood. Others, however, will still need medical treatment, and no single approach works for everyone.
There is one supplement she recommends almost universally, even for women who are not trying to conceive. That is a prenatal vitamin. Most people do not get enough vitamins and minerals from food alone, and a prenatal helps fill those gaps. She also highlights vitamin D, as many people are deficient and this can affect both mood and overall health.
For Dr. Hakman, the main message is simple. Emotions and hormones are deeply connected. Stress, sleep, environment, cycle changes and mood all influence each other. When a woman’s mood feels unstable and her periods are irregular, it is not “all in her head”. It may be her hormones, and that deserves serious attention and care.
