Quick: How well do you know your estrogen from your progesterone? Hormones are a huge player when it comes to your well-being — both physical and mental — yet the whole concept can be admittedly confusing and complicated. Why do we have PMS again? What happens when you’re on birth control? Ahead, a simple and straightforward guide to hormonal health.
Like with the other hormones we’ll get into here, it’s easiest to look at estrogen within a 28-day menstrual cycle. Between days one to five, your ovary produces follicles, one of which eventually will contain a mature egg that will be released once you ovulate. Another hormone, follicle-stimulating hormone (FSH) comes into play, triggering the ovaries to produce estrogen. Both FSH and estrogen — as well as luteinizing hormone (LH), which triggers ovulation — spike mid-cycle when ovulation occurs, explains board-certified OBGYN Diana Hoppe, MD, author of Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life.
PROGESTERONE IS ALSO IMPORTANT
Think of progesterone as estrogen’s counterpart, kicking in during the second half of your cycle. Post-ovulation, the corpus luteum (a hormone-secreting body in the ovary) produces progesterone. This means if you’re not ovulating, you’re not producing progesterone, notes Dr. Steelsmith. Progesterone’s primary role is pregnancy-related; it helps support fertility and thickens the lining of the uterus, she adds. If there’s a fertilized egg in the mix and implantation occurs, a signal is sent back to the ovary to keep pumping out progesterone, says Dr. Hoppe.
If, like during most of your cycles, you’re not pregnant, progesterone production stops and both estrogen and progesterone levels drop. This is when those oh-so-pleasant PMS symptoms kick in; the most common ones are a result of both that high level of progesterone around day 21 and the drop in both hormones, Dr. Hoppe explains. Like estrogen, progesterone also produces neurotransmitters, specifically calming GABA, says Dr. Steelsmith. It also makes our hair, skin, and nails look good, which is why pregnant women often have crazy glowy skin and amazing hair.
YES, WOMEN HAVE TESTOSTERONE, TOO
While obviously men have more of it, this hormone is important for women, too. “It affects our sex drive and spikes mid-cycle, during ovulation,” says Dr. Hoppe. (Consider it your body’s way of helping you get pregnant when you’re at your most fertile.) Testosterone also plays a role in how much hair grows on our faces and bodies, as well as how much sebum our oil glands produce. Ever taken spironolactone to treat acne? The commonly-prescribed treatment works by blocking some of our production of androgens, like testosterone.
IT’S ALL A DELICATE BALANCE
“We’re riding a hormonal roller coaster every month,” says Dr. Hoppe of the constant fluctuations we experience (file under “things men will never have to experience.”) While the 28-day cycle timeline is what theoretically should happen, it often doesn’t. Anything can throw a wrench into the mix: changes in weight, jet lag, fatigue, and, of course, stress.
Hormonal health is also a fine balancing act, particularly when it comes to the interplay between estrogen and progesterone. Symptoms such as heavy periods, breast tenderness, weight gain, and weepiness can indicate estrogen dominance, notes Dr. Steelsmith. And if you have too much estrogen, that then goes hand-in-hand with not having enough progesterone, symptoms of which include anxiety, fatigue, and super intense PMS.
WHAT YOU CAN DO TO BALANCE YOUR HORMONES
It’s no surprise that birth control pills have been used for reasons other than their intended purpose for years. “When you’re on birth control, you’re taking synthetic estrogen and progesterone and not ovulating,” explains Dr. Steelsmith. “It doesn’t stop natural hormone production entirely, but it does shut down a lot of it, so that you maintain even levels throughout your cycle.” That’s precisely why you have super regular periods and are much less likely to PMS when you’re on the pill.
But if you feel like your hormones are out of whack and want to try to regulate matters without meds, there are plenty of alternatives. Various nutrients, botanicals, and herbs from Chinese medicine can be very helpful, says Dr. Steelsmith, while Dr. Hoppe adds that B vitamins are also hugely beneficial for alleviating PMS symptoms. Your best bet? Keep a detailed log of your symptoms and where they fall throughout your cycle, then talk to your OBGYN to determine the best course of action for you.