Your Hormones Are Changing
Your Hormones Are Changing so Your Approach to Health Should Too.
Throughout a person’s life, there are times when the body experiences dramatic changes. Biology is shifting from one phase of life to another. Many traditional cultures had rituals and celebrations to mark these major life shifts so we gained an appreciation that these are a natural part of being human. From an Ayurvedic perspective, puberty — which is a period of a decade or so — marks a transition from childhood (the kapha time of life) to adulthood (the pitta time of life). We understand that there are very specific, natural, and universal changes that occur during this transition, beginning with a increase in production of specific hormones that then signal other biological changes. There is another transition from later in life from adulthood into what I refer to as ‘the wisdom years’ (the vata time of life). This is also a decade or more of gradual and natural changes in our biology. Of course, as Ayurveda is a personalized approach to health, there is an understanding that although there are commonalities to our experience of these shifts, they are also very unique to each individual. As a physician, I believe it is important to understand the basic physiology of these changes, from a medical as well as an Ayurvedic perspective, so we can understand our unique needs throughout life.
For everyone, around age 10-12, the natural biological clock in our physiology triggers changes in the expression of a master gene regulator, known as the KISS1 gene. The turning on of this ‘master switch’ results in the production of proteins that start a cascade of communications through the hypothalamus and pituitary glands which then results in a rise in hormones such as estrogen, progesterone, and testosterone. There are changes at every level of the physiology and in every organ of the body, and is why we experience changes in our sleep, our appetite, our emotions, and the old body is traded in for a new model!
While there are changes that occur in all people, there are unique expressions in female versus male physiology. In female biology, an obvious expression of these rising hormones is the beginning of menstrual cycles, known as menarche. At the other end of this phase of life, there is a natural and gradual decline in hormone levels, often with fluctuations that create irregularities in menstrual cycles that were once predictable, as well as changes in sleep, energy, moods, and another remodel in the body. This many-year shift is known as peri-menopause and at the cellular level begins around age 35. This phase also lasts many years and can involve any number of changes in the body, until the hormone levels decline to a point where ovarian hormone production and menstruation stop, known as menopause. Until we reach this new baseline, post-menopause, hormonal levels go up and down unpredictably and can make a person feel as if they are on a hormonal and biological roller coaster. At times it is hard to accept the new changes and society would have us think these changes are a ‘disease’ or ‘not natural’. However, these shifts are all part of being human. And the good news is that we can have an influence over how we experience these natural transitions in life.
Hormones do not function in isolation. They are part of a complex, interconnected system influenced by our environment, stage of life, the health of our organs and tissues, our individual mind-body constitution, and lifestyle choices related to stress, sleep, nutrition, and movement. Moving through the various stages of life can be less turbulent when we make the best choices for that time of life.
One of the foundational teachings of Ayurveda is that nature moves in cycles, and so do we. Our physiology is not meant to remain exactly the same throughout our lives. From puberty, through menstrual cycling, perimenopause, menopause, and into healthy aging, our hormones shift as we move through the different ‘seasons’ of life.
Rather than resisting these changes, understanding them allows us to ask a much more useful question:
What does my body need at this stage of my life?
Hormones Are Part of a Larger System
Hormones are chemical messengers that travel through the bloodstream and help regulate many essential functions in the body, including reproduction, metabolism, sleep, mood, energy, growth, and our response to stress. They also communicate with one another. This is why hormonal health cannot always be understood by looking at a single hormone or symptom. Our endocrine/hormonal system is connected to the health and function of many other organs and tissues throughout the body.
Ayurveda has approached health through this interconnected lens for thousands of years. Rather than separating the body into individual systems, Ayurveda looks at the whole system together and through the physiological patterns of the doshas. The three doshas, Vata, Pitta, and Kapha, are mind-body principles that describe different qualities and functions in nature and within our physiology. All three are present within us, although in different proportions, and their influence changes throughout the stages of our lives. Just as there are predictable changes in the weather throughout the seasons, there are certain predictable changes through the seasons of life. And when we prepare for the changes by making more supporting choices, we can experience more ease through these transitions.
Understanding these patterns gives us another way to recognize why our needs may change over time and why the same diet, exercise routine, or wellness practices may not serve us equally well at every age.
Healthy Cycles: Learning to Read the Signals
For people who menstruate, the monthly cycle provides valuable information about overall health. Throughout a healthy menstrual cycle, hormones rise and fall in a coordinated rhythm that prepares the body for ovulation, menstruation, and potential pregnancy.
Ayurveda also recognizes different energetic qualities throughout the menstrual cycle and how the doshas influence these natural rhythms. When there is imbalance in one of the doshas, the body often communicates with us through symptoms. Changes in the timing or quality of the menstrual cycle, significant discomfort, digestive changes, mood shifts, changes in energy, and other symptoms can all be reasons to pay closer attention and, when appropriate, seek professional guidance.
This is where lifestyle becomes important. Food, movement, sleep, stress management, herbs, and mind-body practices can all play a role in supporting healthy cycles. The specific recommendations will vary depending on the individual, specific symptoms, and the root cause of the imbalance.
This is an important distinction. Ayurveda is not about giving every woman the same list of foods, herbs, or supplements. It asks us to understand the individual first. Rather than teaching simply how to manage a period, we can help a person understand what influences their cycles, why it changes throughout the month, and how to begin recognizing the messages their bodies are giving them.
Perimenopause Is a Transition, Not a Disease
Perimenopause is receiving much more attention today, and I am glad we are talking more openly about it. But I also think we need to be thoughtful about how we frame this stage of life.
Perimenopause is not a disease. It is a natural physiological transition that occurs as reproductive hormones begin to shift on the way toward menopause. That does not mean the transition is always easy. For some women, changes may be subtle. For others, symptoms can significantly affect sleep, mood, energy, menstrual cycles, temperature regulation, and quality of life.
From a medical perspective, understanding these hormonal changes helps us evaluate symptoms and determine what support may be appropriate. This can certainly include prescription hormones or medications, but from an Ayurvedic perspective also includes addressing sleep routine, nutrition and digestion, the balance of activity and rest, stress and emotions, and a person’s underlying nature. Food, herbs, physical activity, restorative practices, and other lifestyle approaches can all provide support during this transition when appropriately individualized.
But Ayurveda also offers something beyond symptom management. It gives us a different perspective on this transition time itself. Rather than viewing perimenopause only as something to get through or something to fear, we can recognize that the body is moving us toward another stage of life. Often the habits that served us at 30 are not what our bodies need at 45 or 50. It may be OK to slow down a bit, not as a sign of failure but as an honoring of your needs.
This transition is asking us to pause, listen to our bodies, and care for ourselves differently.
What About Hormone Therapy?
Any conversation about perimenopause and menopause today will eventually include questions about hormone therapy. Hormone therapy may be appropriate for some women, depending on their symptoms, medical history, risk factors, and individual circumstances. This is a conversation that should happen with a qualified healthcare professional who can help evaluate the benefits and risks for you personally.
Integrative medicine does not mean choosing between conventional medicine and Ayurveda. We can look at all of the options available and choose what is best for each individual. Lifestyle practices can provide support, and herbs or other complementary approaches may be appropriate as well. Sometimes medical treatment is needed. And we can use several approaches together. It’s important to tell your healthcare provider about any herbs or supplements you are taking, particularly if you are also using prescription medications or hormone therapy. Natural substances are physiologically active and are not automatically appropriate for every person.
The goal isn’t to choose a side. The goal is to use the tools available to us thoughtfully and safely, and finding educated and experienced practitioners to help.
Menopause and the Wisdom Years
Menopause marks another significant transition as menstrual cycles cease and we enter a new phase of life. And while there is often considerable discussion about the symptoms leading up to menopause, I believe we need to talk just as much about what comes afterward.
Women may spend decades of their lives in the postmenopausal stage. This becomes an opportunity to shift the conversation from managing a transition to supporting long-term vitality. Ayurveda has always recognized aging as a distinct stage of life with its own beneficial qualities and unique needs. How do we maintain strength and mobility? How do we nourish our tissues? How do we support cognitive, cardiovascular, metabolic, and emotional health as our body changes? How do our needs for food, movement, sleep, recovery, and connection change as we age?
The goal is not to resist every change associated with aging or attempt to make our bodies behave exactly as they did decades earlier. We can accept that our physiology changes while continuing to actively support our health. In Ayurveda, this is the vata stage of life and we can stay healthy in this stage of life by having more consistent routines in sleep, meals, and activity. We may need to eat differently, such as eating more warm, cooked foods, to support a changing digestion. We may need more mind-body practices such as meditation and breathing to regulate a more sensitive nervous system, which results in better sleep, brain health, and mood.
Food, movement, herbs, restorative practices, meaningful relationships, purpose, and connection all remain important tools for maintaining vitality and wellbeing as we age.
Healthy aging is not about staying young forever. It’s about staying engaged with our health and our lives and maintaining vitality and contentment with life. As we have more lived experience, we can then share that wisdom with others.
Your Health Routines Should Evolve With You
There is no single wellness routine that will serve us perfectly from puberty through our 70s and beyond. Our bodies are more intelligent and dynamic than that. The practices that support us need to evolve as we do.
This is why understanding our hormonal and physiological shifts matters. Not because we need to control every physiological change, but because greater understanding allows us to understand the changes that are happening, ask the correct questions, and make more informed choices about our health.
Ayurveda gives us additional perspectives on these natural cycles of life. Just as seasons throughout the year have different dosha qualities that dominate, we also experience shifts in the expression of doshic qualities throughout our lives.
As we move through each stage of life, perhaps the goal is not to hold onto the body we once had, but to become more deeply connected to the body we have now. Our relationship to ourselves becomes healthier along the way.