Anovulatory cycles – understand the cause of PMS & menstrual imbalances

March 27, 2016 Dr. Martin Gleixner, MSc, ND

Anovulatory cycles - understand the cause of PMS & menstrual imbalances

By Dr. Martin Gleixner, MSc, ND


Is it possible for women to have a menstruation without ovulating (aka anovulatory cycles)?


Does PMS (premenstrual syndrome), irregular menstrual cycles, painful menstrual cramps, and infertility have something in common?


Yes, and yes. Read on...


In the past, the majority of women began menopause in their mid-40s to early 50s. In more recent years, things are changing. Women are exhibiting anovulatory cycles already in their early 30s and yet, don't experience cessation of periods (menopause) until their early 50s.


Anovulatory cycles is a hidden epidemic affecting more and more premenopausal women. In other words, many premenopausal women in their 30s, 40s and early 50s are experiencing menstrual cycles in which they do not ovulate even though they continue to menstruate.


The menstrual bleed represents for women a physical manifestation of their monthly hormonal cycle. This renewal and shedding of the uterine lining doesn't go unnoticed. In contrast, most women are unaware of whether or not ovulation (release an of egg) takes place.


There are many unpleasant symptoms associated with anovulatory cycles. Symptoms can include: short or long menstrual cycles, PMS, heavy menstrual flow, and painful menstrual cramps. Infertility is also commonly associated with anovulatory cycles.


These symptoms are a warning signal that hormonal imbalances exist beneath the surface of the body. Most importantly, it is a state of estrogen dominance that is often underlying these problems, a term that will be discussed later in this article.


As I've explained in many of my previous articles, it is our goal to treat the cause of disease and not just manage symptoms.


Let's explore some of the underlying causes of irregular, long and/or painful menses, PMS, infertility, and many other menstrual related symptoms.


* Stress:

Our state of mind, whether relaxed or stressed, directly affects hormone balance.


The hypothalamus is the master control centre in the brain. It is on a constant 24 hours surveillance of what's going on in the body. It monitors and creates changes in the body based on our body temperature, hormone or mineral levels in the blood stream, and our emotions.


As it relates directly to the menstrual cycle, it regulates the pituitary gland's production of two hormones called LH and FSH. Simply put, FSH stimulates the ovaries to make estrogen, while LH triggers ovulation. The signals sent from the brain determine how much estrogen and progesterone are released by the ovaries.


When we understand the complexity of the hypothalamus, it is no wonder that menstruation and ovulation can be affected by stress, diet, and other hormones (such as the thyroid hormone or cortisol). Stress causes abnormal secretion of LH and FSH by the hypothalamus, which in turn can lead to anovulatory cycles.


Too often, synthetic estrogen in the form of birth control pills, IUDs, or hormone replacement therapy are used to treat hormonal imbalances. Although these can be effective at decreasing symptoms in the short term, it does not address the cause(s) behind hypothalamus disruption.


* Progesterone deficiency:

In a normal menstrual cycle, estrogen dominates the first half of the cycle. It encourages the thickening of the uterine lining and maturation of ovarian follicles (sacs that contain immature egg). Eventually the rising estrogen peaks, resulting in ovulation (an event triggered by the LH hormone).


When the egg is release from the follicle, the follicle then becomes the corpus luteum. This small yellow body remains in the ovary and takes on the important action of progesterone production. Progesterone dominates the second half of the cycle leading to further development of the uterine lining in anticipation of a possible fertilized egg. If pregnancy does not occur at this stage, both estrogen and progesterone levels drop abruptly triggering the shedding of the lining and therefore the menstrual flow of blood.


Without ovulation, no corpus luteum results, such that there is insufficient progesterone produced from the ovaries. Low progesterone levels are especially common in the second half of the menstrual cycle causing many PMS symptoms. Mood swings, bloating, breast tenderness, and weight gain are common symptoms of progesterone deficiency preceding the menses.


Menstrual cycles, however, can continue even with very low levels of progesterone, so most women aren't aware of the lack of progesterone.


* Estrogen dominance:

The proper amount and presence/absence of certain types of estrogens in the body are important for hormonal health. Estrogen, simply put, stimulates cell growth. When estrogen is deficient it leads to a sluggish female reproductive system. When in excess, it becomes a dangerous promoter of cancer. In proper amounts and in the presence of progesterone, it nourishes tissues throughout the body.


Progesterone protects cells against the negative effects of estrogen. For this reason, the balance between estrogen and progesterone is extremely important.


Dr. John Lee, MD, author of many books on female health, coined the term 'estrogen dominance.' The state of estrogen dominance occurs in the body when there is an apparent excess of estrogen resulting from a lack of progesterone. Even women with low estrogen levels can have estrogen-dominance symptoms if progesterone levels are very low. Estrogen dominance, therefore, is a state in which women can have deficient, normal, or excessive estrogen but has little or no progesterone to balance its effects in the body.


Can the use of cosmetics be part of this problem? What about heating foods in plastic containers? Can years of hormonal birth control use or hormone replacement therapy (HRT) be part of the problem? What about consuming non-organic meats and dairy products? Apparently so. These represent only a few examples of xenoestrogens sources.


Xenoestrogens are quickly becoming one of the most important contributing causes of estrogen dominance. Xenoestrogens are substances originating outside the body that have estrogen-like activity in the body. These foreign chemicals can either block the effects of your own estrogens or amplify the negative effects created by excess estrogen. These substances can be 1000 times stronger than estrogen produced naturally in the body.


These xenoestrogens, especially when unopposed by sufficient progesterone cause menstrual changes, and can lead to infertility, fibrocystic breasts, uterine fibroids, uterine/endometrial cancer, and breast cancer.


* Nutritional deficiencies:

Many patients are shocked to find out that estrogen and progesterone (as well as other steroid hormones in the body) are made from cholesterol. For this reason, no-fat or no-cholesterol diets can create hormone imbalances leading to menstrual irregularities.


Starting with a cholesterol molecule, numerous steps are required to make active female sex hormones. To make certain types of estrogen molecules for example, requires at least 6 steps. Each transformation depends on important proteins called enzymes. These enzymes, in turn, require specific vitamin and mineral co-factors in order to transform one hormone into another. No doubt, a healthy diet and vitamins and/or minerals in therapeutic doses can help promote our body's production of hormones.


This column will be one of a series of articles discussing female health. Already, we can understand the importance of addressing the underlying causes that are contributing to hormone imbalances.


Published by Dr. Gleixner on Wednesday March 31st, 2010 in Times & Transcript.


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