Two Hormonal Types

TWO HORMONAL TYPESThus it would seem that the two common period problems, the pre-menstrual-syndrome and spasmodic dysmenorrhea, are related to a deficiency in the levels of the two menstrual hormones progesterone and estrogen respectively. A marked progesterone deficiency will cause severe pre-menstrual-syndrome, while a mild deficiency will cause only mild premenstrual syndrome. On the other hand a moderately low oestrogen level will only cause mild spasmodic dysmenorrhea, but a severe oesteogen deficiency will cause severe period pains. In between these two are those fortunate women who do not experience any problems with menstruation. Although women may move slightly up and down this scale during the course of their life, the movement will tend to stay within the limits of the same group, unless either progesterone or oestrogen is given or a pregnancy occurs. These two groups of women tend to have other common characteristics.

PROGESTERONE DEFICIENT GROUPWomen in the pre-menstrual-syndrome group will tend to be fertile, but their pregnancies may be followed by post-natal depression, and they are more prone to depressive illnesses and high blood pressure during their life span. Among those who become pregnant one in every five will be likely to have pre-eclamptic toxemia, with a marked gain in weight and high blood pressure during pregnancy, while the others will blossom in pregnancy, being free from their usual pre-menstrual migraine, asthma and depression, and will later look back on the last months of pregnancy as the healthiest days of their life. These women, if given oestrogen, will tend to get side effects as they already have a high level of this hormone. They will be prone to minor side effects of nausea, gain in weight, headaches and depression, but will also risk the more serious ones like thrombosis. The pill contains oestrogen, together with a synthetic progestogen, and as already mentioned progestogens lower the normal progesterone level in the blood, so making their existing progesterone deficiency worse.

OESTROGEN DEFICIENT GROUPOn the other hand, the women with spasmodic dysmenorrhea will grow out of their period pains, either following pregnancy of during the mid-twenties, and thereafter will have trouble-free menstruation. These are the women who feel positively better on the pill, even preferring the ones with the relatively higher dose of oestrogen, as these boost their low oestrogen levels. However at the menopause their already low estrogen levels are not helped by the declining oestrogen output from the ovaries, so these women are likely to develop their menopausal symptoms early, even before menstruation has stopped, and unless they are given oestrogen replacement treatment during the menopausal years they are likely to be the ones who suffer most from the ending of their child-bearing years.

As with other hormonal disorders it is not surprising to find that there is a marked family tendency with daughters, sisters and mother belonging to the same menstrual hormonal group, either progesterone deficient or oestrogen deficient.

WHAT ARE THE OBSTACLES?The attitude of some drug companies, doctors and psychiatrists is not always conducive to the active participation of women in their health dilemmas. Some doctors may prefer to keep control by fostering dependent relationships with their patients and keep them "in the dark". Other doctors may be reluctant to accept the biological causes of psychological disorders and there is an urgent need for more interspecialty collaborative research to assess the role of hormones, nutritional supplements and drugs in various types of depression. Some psychiatrists, (usually males), still see women through the teachings of Sigmund Freud who believed that women were inherently more neurotic than men with their inability to resolve subconscious conflicts shown in the typical neuroses of depression, anxiety, hysteria or hypochondriasis. This narrow perspective leads to the stereotyping of women, reinforcing their inferiority and dependence upon mind-altering drugs.

In reality, today's women is psychologically, if not hormonally, just as liberated and aware as today's man. She is increasingly reluctant to accept psychotropic drugs (sedatives, tranquillisers and anti-depressants) for fear that they may take the edge off performance and blunt feelings and self expression.

It is interesting that often it is not only psychiatrists, but also some feminists who are cynical towards the idea that hormone fluctuations affect female psychology and behaviour. Such feminists also have a narrow perspective, preferring to say that the higher incidence of depression and suicide attempts in women is entirely due to environmental and psycho-social issues. They may feel it demeaning or trivialising to admit that one's hormones could wreak mental havoc, fearing that this will give women a handicapping vulnerability or a uniquely female "Achilles heel". This nihilistic attitude of denial is no denial is no longer appropriate and hormone therapy will enable us to compete and share with our male counterparts in a world where we need to keep our wits about us not for two, but, for four weeks every month.

Another obstacle to overcome is the sometimes confuses and crossed messages about our hormones that are given to us by the media, lay press and "pseudo experts" who have never had any clinical experience with women. We read negative and patronising articles with no clear strategies or hopes of cure offered. For example, we are told that pre-menstrual-syndrome women should avoid giving dinner parties at that time of the month as if the most serious implication was a collapsed souffle or lumpy sauce! This is ineffectual advice for the many professional women to today who are surgeons, airline pilots or politicians.

Another common obstacle is our self-image. Many women have very low self-esteem, and are unable to love and admire themselves as unique individuals and find it uncomfortable to be assertive with their doctors. This lack of confidence makes it difficult for them to express their needs, anger, aggression or resentment expecially in front of a professional.

To overcome these limitations, the establishment of support groups for women with such problems as pre-menstrual-syndrome, postnatal depression, drug dependence or midlife depression can be invaluable.Support groups provide an environment where women can begin to express themselves, building skills in confidence, creativity and self assertiveness. For women who feel they have "lost it", support groups can act as a stepping stone back into the real world.

At the end of the day we need to keep our sense of humour which can be hard when the struggle for mental and physical harmony seems elusive. Yes, it's true now, as ever, laughter is a great form of medicine!

OESTROGEN AND YOUR BRAINWe start with oestrogen. Multiple recent studies show that oestrogen enhances a woman's sexual and emotional arousal by sensitizing her vision, hearing, smell, taste and touch. Now we are discovering that oestrogen's influence extends even to your most secret thought.

OESTROGEN REPLACEMENT MAINTAINS BRAINSIf I'm right that oestrogen maintains your ability to think, then oestrogen replacement therapy should not only help maintain female sexual potency, but should also help protect female brains.

NUTRIENT BRAIN BOOSTERSIf your oestrogen supply has already been interfered with by the medicine men, or if tests show it is declining, or you are already past menopause, acetyl-l-carnitine is a potent nutritional strategy to preserve both brain and sexuality.

This nutrient amino acid is used by your brain every day to help maintain acetylcholine metabolism. In amounts of 1000-2000 mg per day, acetyl-l-carnitine is non-toxic. This level is probably more than sufficient to prevent acetylcholine decline. The second nutrient brain booster is ginkgo biloba. Since the '70s controlled research has consistently confirmed, that the active substances extracted form this herb improve brain function, by dilating arteries and increasing the supply of oxygen-rich and nutrient-rich blood to the brain.

HORMONE BRAIN BOOSTERSThe second strategy for you to maintain both hormonal potency and cognition, depends on whether you have menstrual cycles. If you are producing your own oestrogen, then don't allow any medicine man to mess with it. And don't use the contraceptive pill.

A woman's immunity varies directly with her oestrogen. The higher her oestrogen levels the stronger her immune response. Prior to ovulation every month, oestrogen rises to strengthen immunity, increasing her store of lymphocytes so she can resist bacteria and viruses. The high level of oestrogen also affects her brain, revving both acetylcholine and dopamine systems to the point of overactivity in many women. This excess causes the classic symptoms of anxiety, irritability and hypersensitivity of the senses, which constitute the cognitive component of the pre-menstrual-syndrome.

The high oestrogen before ovulation primes the immune system for essential house-cleaning of the uterus and reproductive tract, to protect the descending egg from stray viruses and bacteria, and to clean the womb of debris in preparation for fertilization and implantation.

But at ovulation, oestrogen levels drop sharply. Progesterone also increase to further depress immunity. Otherwise the immune system would kill incoming sperm. Even if one sperm did survive, and oestrogen-spiked immune system would kill and expel the fertilized egg as a foreign body.

To prevent the immune system killing the fetus, oestrogen levels remain suppressed, and progesterone levels remain high, throughout pregnancy. Then, at birth, oestrogen levels rebound and progesterone drops dramatically in most women. Immunity rises to its highest level. This miracle of design occurs, so that the mother can resist infection at a critical time of nurture, and can also pass strong immune factors to the immune-weak newborn through her milk.

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