Depression, insomnia, fatigue, weight gain, acne—many women can chalk these symptoms up to hormone imbalance. If you’re one of them, try this 8-point plan to restore hormonal harmony.

ELIZABETH BELSON couldn’t believe there could be a simple solution to her chronic fatigue and depression. Two years ago, at age 36, she felt tired and cranky all the time. “Around my period I was worse,” says Belson, who works as an office manager and marketer in a physician’s office in New York. “I went to one doctor who put me on 10 supplements; another specialist I went to said I didn’t need half that. I bought books, and tried journaling to track my moods and symptoms. They were all ill-fated attempts.”

Then she went to see Manhattan-based integrative internist Erika Schwartz, M.D., author of The Hormone Solution and The 30-Day Natural Hormone Plan. Schwartz was able to identify the common denominator under-lying Belson’s problems: hormone imbalance.

If you saw that one coming, you’re one step ahead of many Western doctors. “We’re trained to address symptoms of hormone imbalance rather than putting them into context and treating the causes of the symptoms,” says Schwartz, who recently joined the NATURAL HEALTH board of advisors.

In healthy women, the ovaries and the adrenal glands produce various hormones (see “the 5 Major Hormones”) that handle the ebb and flow of everything from menstruation to metabolism to sleep, after which they’re broken down by the liver, kidney, and digestive systems, then excreted. But if any part of the chain isn’t working properly, your hormones aren’t in balance, and the impact can be widespread.

“Many female health issues are due to hormone imbalance,” says Susan Lark, M.D., a San Francisco-based clinical nutrition and preventive medicine specialist.

When estrogen attacks….

FOR MOST WOMEN, the problem boils down to one cause: estrogen dominance. And it affects those on either side of menopause. “If you’re among the millions of women in the 35-to-55 age bracket experiencing headaches, sleep difficulties, fluid retention, anxiety, irritability, mood swings, cramps, weight gain, breast tenderness, and heavy bleeding,” says Lark, “you’re likely to be affected by estrogen dominance.”

Estrogen is a wonderful hormone. In the right amount, it makes conception and pregnancy possible; it’s also a natural mood lifter and skin toner. But many women have too much of a good thing for too long. In addition to the unpleasant symptoms of PMS and peri-menopause, too much estrogen can lead to fibroids, benign uterine disease, and some female cancers.

Progesterone is the estrogen police; it helps balance estrogen. In the right ratio, the two hormones help the body burn fat for energy, act as an antidepressant, aid in reducing fluid retention, assist metabolism, and promote sleep. Estrogen dominance occurs when a woman’s body doesn’t have enough progesterone to keep the estrogen in check.

So what causes this excess of estrogen? Beyond our bodies simply making too much, probable causes include environmental toxins, rampant stress, nutritional deficiencies, and the estrogens introduced into the food supply. “Commercially produced meat, eggs, and dairy products are full of hormones, which are often injected or fed to the animals to promote growth” says Loretta Lanphier, a naturopathic doctor and the CEO and president of Oasis Advanced Wellness Center in Baytown, Texas. “The hormones start in the grains we feed cows and chickens, then make their way up the food chain and into our bodies.” The problem compounds over the years, she adds: “By the time I see women in their 30s, their bodies are a mess, hormonewise.”

Balancing act….

TO STABILIZE your body’s levels of estrogen, Schwartz and Lark agree, you need to reduce its production, block its ability to bind to tissues, and assist its breakdown and elimination. By undertaking a natural approach—a combination of diet and lifestyle changes, bioidentical hormone therapy, and supplement—you can see results in as quickly as 30 days. Learning to manage hormone imbalance naturally is something you can benefit from all your life—and the earlier you start, the better off you’ll be. “Don’t wait until you get steam rolled like your mother did,” Schwartz says. “Starting young can set you in a healthy pattern for the rest of your life.”

1. Start with a test.
Women should first learn where their hormone levels are, Lanphier says. A blood, urine, or saliva test can be ordered from online suppliers; Lanphier likes one available from ZRT Labs.

Typically, these tests will determine your levels of five different hormones (estrogen, progesterone, testosterone, DHEA, and cortisol). “If any one of these I out of balance, the entire body feels out of balance,” says Lanphier. “But the frequent mistake women make when they get the results is to run out and take more of everything they’re deficient in. That’s not how to get in balance.” Often, just adding more progesterone is enough to balance everything else, she explains. But the best bet is to consult a physician, who can help you interpret your results and apply them to your overall medical picture.

2. Eat hormone-friendly.
“It’s impossible to exaggerate the importance of good nutrition in controlling hormones,” says Lark. “No medication can entirely overcome the effects of a poor diet.”

What’s the connection? A diet high in sugar and starch moves into the bloodstream quickly and causes insulin to spike—and high insulin levels trigger an increases in estrogen levels. A study in the British Journal of Nutrition showed that women who suffered from PMS consumed significantly more cakes, desserts, and high-sugar foods before their periods.

Schwartz recommends eliminating soda, sugar, caffeine, alcohol, and highly processed foods; Lark adds saturated fat, red meat, dairy products, and white flour to the no-no list. At the very least, look for organic meat and dairy products that are certified free of hormones, she says.

On the other hand, foods like complex carbohydrates break down slowly and help keep blood sugar levels stable. Schwartz advises boosting your intake of whole grains, plant-based proteins, good fats, colorful fruits and vegetables, green tea, and “good” sweeteners (such as fruit juice, natural organic honey, brown sugar, or stevia). Soy foods, buckwheat, and grand flax meal are particularly beneficial, Lark adds.

“If your symptoms are mild to moderate, you can be a little less rigid,” Lark says. “But if your symptoms are severe, dedicate yourself to the diet until you begin to get relief.”

“I don’t want women to get so stressed thinking about what they should eat that their diet becomes torture—life is meant to be lived,” Schwartz concludes. “But I do want them to be more conscious of what they’re putting in their bodies and of how it affects every aspect of their well-being.”

3. Drink with care.
Water helps cleanse your liver and kidneys, allowing your body to excrete hormones efficiently. Lanphier tells women to drink an ounce of water daily for every 2 pounds they weigh (if you weight 128 pounds, you should drink 64 ounces, or 8 cups). Avoid caffeinated beverages; while caffeine produces an initial lift, it also stimulates the adrenal glands to produce more cortisol (the stress hormone), exacerbating anxiety, fatigue, and other symptoms. A study published in the American Journal of Public Health found that women who ingested caffeinated cola, coffee, or tea were more likely to suffer severe PMS symptoms than those who used no caffeine. As for alcohol, consuming too much can compromise the liver’s ability to metabolize estrogen, which can cause estrogen levels to rise—minimize its use or avoid it altogether.

4. Keep stress in check.
“When we’re under severe stress, we’re less likely to ovulate,” says Lark. If you don’t ovulate, you don’t produce progesterone during the second half of your cycle. Without enough progesterone to keep estrogen in check, the negative effects of estrogen can become more pronounced. Stress also raises levels of cortisol, which causes other hormones to get out of balance.

Consider what changes you may need to help you feel good in the long run: Switching jobs, ending a bad relationship, or getting your financial house in order can make you feel better on many levels. If it’s immediate relief you’re after, try meditation or yoga—or an attitude shift. “When a stressful situation occurs, remember that you can’t control the situation, but you can control your reaction to it,” recommends Schwartz. “Try to keep cool, or at least accept that you can’t change the situation.”

5. Get your z’s.
Getting eight uninterrupted hours isn’t easy for women whose sleep cycles are being disrupted by hormonal imbalance, but it’s crucial: “Sleep is when the body makes hormones,” says Schwartz. Try to get into bed by 10 p.m.; our body systems, including the hormone system, heal and repair optimally between 10 p.m. and 2 a.m. Sleep in a cool, dark room. Drink a cup of chamomile tea before bed. Use aromatherapy—add a few drops of lavender to a tissue you then tuck under your pillow. And take an hour to unwind before retiring.

6. Move your body.
Exercise reduces stress, improves sleep habits, and helps excrete surplus hormones. “The body has only five ways to excrete toxins, including excess hormones: breathing, sweating, menstruating, urinating, and defecating,” says Lanphier. “Whit the possible exception of your period, exercise promotes all those avenues.”

For optimal health benefits, aim for a mix of cardiovascular, strength, flexibility, and restorative movements. At the very least, a daily 30-minute walk will do wonders.

7. Boost progesterone.
The most direct way to offset high estrogen levels and regulate other hormones is to take in more bioidentical progesterone. Many doctors offer synthetic hormones in the form of hormone replacement therapy (HRT) or birth control pills, a practice that has been linked to increased risk of stroke and female cancers. Yet women can get the same benefits without the side effects by using bioidentical hormones—that is, hormones extracted from wild yams or soy oil that are molecularly identical to those produced by the human body. These are best applied as a cream. Patients rub on a small amount (typically about 1/8 teaspoon) where skin is thin; the neck, upper chest, underarms, or wrists.

Low-dose progesterone creams are available online and at health-food stores. Avoid products that have Stearalkonium chloride, a chemical used in fabric softeners and hair conditioners, or methyparaben propylparaben; both have been linked to cancer. “You want micronized progesterone in its purest possible form in the highest concentration available,” says Schwartz.

Most medical practitioners recommend using progesterone cream once a day for the two weeks before your period starts, which often coincides with the worst symptoms. Generally, the bloating, headaches, mood swings, and insomnia abate within two menstrual cycle of using the cream. After three months, women should stop hormone therapy and see how the feel; many patients can cease using the cream if they’re maintaining good lifestyle habits. After applying the cream for several months, Belson now finds she can maintain her hormonal equilibrium simply by watching her diet and exercising.
It’s safe to treat yourself with progesterone, says Lanphier—if you use too much, the worst side effect is fatigue. However, while younger women will do well with progesterone alone, women in their late 30s or older may need to combine progesterone and estrogen under the supervision of a physician, says Schwartz.

8. Supplement your efforts.
In addition to lifestyle changes, Lark advises women—particularly those with estrogen dominance—to add the following supplements to their daily diet:

THE 5 MAJOR HORMONES

Estrogen
Source: Ovaries, adrenal glands, fat cells.
Role: Makes every cell in the body grow; it’s a rejuvenating hormone that keeps you young, lifts your mood, and protects your heart and bones.
Too much: Unpleasant symptoms of PMS, including moodiness and foggy brain. Excess is also linked to cancer.
Not enough: Rapid aging, unpleasant symptoms of menopause, including hot flashes and vaginal dryness.
NOTE: There are three types of estrogen: estriol (pregnancy), estradiol (youth), and estrone (menopause). Some women have enough estrogen, but too much of the wrong kind.

Progesterone
Source: Ovaries.
Role: Balances other major hormones. Calms you, regulates cell growth, boosts metabolism.
Too much: Excess progesterone can lead to fatigue and possibly depression.
Not enough: Signs of menopause.

Testosterone
Source: Ovaries and adrenal glands.
Role: Considered a male hormone (women produce about 15 percent the testosterone per day that men do), it aids clear thinking, a positive outlook, and sex drive.
Too much: Makes you feel edgy, and may induce masculine elements.
Not enough: Low sex drive; decreased ability to build muscle.

DHEA (dehydroepiandrosterone)
Source: Adrenal glands.
Role: Little is understood about DHEA. Production starts around age 6, peaks in the mid-20s, and steadily declines from the early 30s on. Men have higher levels than women. It converts easily into other hormones, particularly testosterone.

Cortisol
Source: Adrenal glands
Role: It’s the stress hormone that hammers you right before you give a speech or right after you have a near miss on the highway. Small amounts are helpful in regulating the body’s use of proteins, carbohydrates, and fats, and may aid weight control.
Too much: Taxes body systems; contributes to rapid aging; makes every hormone level rise.
Not enough: Fatigue, weakness, depression—but this is rare. Most people have too much.