“Doc, I think I have a hormone imbalance.” The majority of the women I see in my practice first come in with some form of hormone-related concern. If they are in their reproductive years, they may suffer from PMS, spotting between periods, painful periods, PCOS, cyclical acne, or irregular periods. In their pre-menopausal years, their period may still come but irregularly, accompanied with hot flashes, insomnia, lowered thyroid function, and other symptoms. Once in menopause, women still experience symptoms related to changes in their hormones.
Resolving those imbalances can seem complex and overwhelming at times, but never underestimate the power of what you put at the end of your fork: your food. One of the first dietary tools that I recommend to patients to help balance hormones is called seed cycling. I have seen this alone have a positive impact within 3 months in patients who do just that! Of course, most cases are much more complex and necessitate a multi-pronged approach. But the effectiveness of this simple and low cost therapy as a starting point should not be overlooked.
What is Seed Cycling?
Seed cycling uses specific estrogen-balancing and progesterone-balancing seeds at different times of your menstrual cycle in order to help shift and improve hormone imbalances. It is as simple as incorporating a total of 2 Tbsp of the specific seed(s) (I usually recommend a raw form) once a day, switching seeds halfway through your cycle, around ovulation.
Why do we switch seeds? The beginning of your menstrual cycle is the first day of your period (Day 1). From Day 1 until ovulation (typically around Day 14 IF you have a textbook 28 day cycle), the predominant hormone is estrogen, which helps build up the lining of your uterus (the endometrium) after your period. Flaxseeds and/or pumpkin seeds help to balance estrogen levels and are therefore used in this first half of the cycle.
From ovulation until your period starts is the second half of your cycle, in which progesterone is more predominant. This is why we switch to the progesterone-balancing seeds, sesame and/or sunflower seeds.
A typical cycle will look like this:
-Day 1-14 (follicular phase): 2 Tbsp (total) of freshly ground flaxseed (or whole pumpkin seeds) – estrogen balancing
-Day 15-28 (luteal phase): 2 Tbsp (total) of sesame or sunflower seeds – progesterone balancing
You can use a combination of the seeds (1Tbsp of each), or just stick to 2Tbsp of one kind in each category.
If your cycle is not 28 days, and/or you have no clue when you ovulate, then you will need to start charting your cycle (using markers such as cervical mucous +/- basal body temperature), in order to find out your particular pattern and whether it falls within the normal range. I like the Kindara App to help with tracking this, but there are many other apps out there, or you can you good old pen and paper charts too!
How Does It Work?
You might be asking yourself if taking these little seeds daily can really have an impact on your hormones. After all, if you go to your medical doctor to try and “balance hormones”, you will usually be recommended some form of birth control. This actually does not balance your hormones at all, but it suppresses your natural production of hormones in order to try and prevent the process of ovulation, fertilization, and make the uterus lining inhospitable to embryo implantation. Furthermore, the birth control pill sets you up for specific vitamin and nutrient deficiencies, as well as imbalances in your gut flora (the good bugs that help regulate your immune system). Therefore, if your goal is to balance hormones, the birth control pill is not your answer.
Although there are no studies of the seed protocol itself, we do know from studies of the individual seeds how they may be gently nudging our hormones in the right direction.
Most women tend to have estrogen dominance, too much of the hormone estradiol, which can manifest as fibroids, endometriosis, mood swings, hair loss, breast tenderness during PMS, and even an increased risk of estrogen-positive cancers such as breast and ovarian cancer. Flaxseeds are considered a “phytoestrogen”, but they don’t directly boost all estrogens as the name might lead you to think. They actually decrease the production of the more harmful estrogen form of estradiol, as well as shift the balance of estrogen metabolites (breakdown materials) from the more harmful 16-hydroxy-estrone towards the less harmful 2-hydroxy-estrone. What they are actually “boosting” is the more beneficial estrogen metabolites… Win-win! Ground flaxseeds have been shown to be helpful for premenstrual breast tenderness and to decrease estrogen-dependent cancer risk.
-> Pumpkin and Sesame Seeds
Similarly to flaxseeds, pumpkin seeds also have phytoestrogens which have shown potential in decreasing estrogen-dependent cancer risk, but they have not been studied as extensively as flaxseeds.
Zinc is high in both pumpkin and sesame seeds, and indirectly helps increase your production of progesterone. The corpus luteum (the “shell” that is left over in your ovaries from the egg that is released during ovulation) becomes the main producer of progesterone in the second half of your cycle, but only if you ovulate. Zinc increases progesterone production by stimulating the hormone FSH, which is needed for proper ovulation to occur.
-> Sunflower Seeds
Sunflower seeds are high in selenium, magnesium, Vitamin B6, Vitamin E, and also contain a decent amount of zinc. These nutrients are needed for proper progesterone production and hormone metabolism.
How To Get Started
If you are dealing with some female hormone imbalances and would like to get started with this dietary intervention, you can start at any time! Just make sure to find out what phase of your cycle, follicular (1st half) or luteal (2nd half) phase, you are in, and start consuming the seeds for that phase until it’s time to switch. As these seeds are high in fibre, make sure to have them with plenty of water so that you don’t get constipated. As well, some people experience bloating when they start eating these amounts of ground flaxseeds – if this is you, cut back and start small, working your way up, or try pumpkin seeds instead.
If your case is more complicated or you have irregular cycles, it might be worth it to get a proper evaluation. You may need an in-depth hormone assessment through bloodwork, salivary hormone testing, or dried urine testing (DUTCH test) to really find out what is going on. Naturopathic doctors have many tools to help you balance your hormones, including dietary and lifestyle changes, botanical medicines, nutritional supplementation, and acupuncture.
As always, I would love to help you get to the bottom of your hormone troubles so that you don’t have to fear that time of the month anymore. Make an appointment at my Brampton office to get started.
Haggans CJ, Travelli EJ, Thomas W, Martini MC, Slavin JL. The effect of flaxseed and wheat bran consumption on urinary estrogen metabolites in premenopausal women. Cancer Epidemiol Biomarkers Prev. 2000 Jul;9(7):719-25.
Images from 123rf.com.
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Mojgan Mirghafourvand, Sakineh Mohammad-Alizadeh-Charandabi, Parivash Ahmadpour, Yousef Javadzadeh. Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial. Complementary Therapies in Medicine; Volume 24, 2016: 90-95.
Richter D, Abarzua S, Chrobak M, Vrekoussis T, Weissenbacher T, Kuhn C, Schulze S, Kupka MS, Friese K, Briese V, Piechulla B, Makrigiannakis A, Jeschke U, Dian D. Effects of phytoestrogen extracts isolated from pumpkin seeds on estradiol production and ER/PR expression in breast cancer and trophoblast tumor cells. Nutr Cancer. 2013;65(5):739-45.
Sicilia T, Niemeyer HB, Honig DM, Metzler M. Identification and stereochemical characterization of lignans in flaxseed and pumpkin seeds. J Agric Food Chem. 2003 Feb 26;51(5):1181-8.
Wzelaki, Magdalena. Seed Cycling to Balance Pre and Post Menopausal Hormones. Dr. Jolene Brighten. 2009-2019. Accessed Jan 22, 2019: https://drbrighten.com/seed-cycling-menopausal-hormones/.
I am very excited to announce that I will be integrating bio-identical hormone replacement therapy (BHRT) into my Ottawa practice very soon! I am getting additional training at the end of February at a bio-identical prescribing conference in Toronto, where I will learn clinical pearls from leading integrative medical doctors and naturopathic doctors.
So, what is all the fuss about bio-identical hormone therapy? Let me clarify a few things for you.
What is bio-identical hormone replacement therapy?
BHRT is the use of biologically and structurally identical hormones to those naturally found in the human body for the purposes of replacing hormones that are found to be lacking. BHRT is most commonly used in women to help with the symptoms of peri-menopause and menopause. However, imbalances in estrogen and progesterone are found in younger women as well, and these women can also benefit from bio-identical hormone replacement therapy carefully timed to their menstrual cycle.
Who can benefit from BHRT?
Women with the following symptoms and hormonal imbalances may benefit from BHRT:
-Sleep disturbances that are hormone-related
-Polycystic Ovarian Syndrome (PCOS)
-Depression, anxiety, and mood swings
I heard that hormone replacement therapy is dangerous. How would bio-identical hormone replacement be any better?
The well-known Women’s Health Initiative study (WHIS), which was published over 10 years ago, highlighted the dangers of conventional replacement therapy, with increased risks of heart disease, stroke, blood clots, and dementia in those taking a combination of Premarin® (conjugated equine estrogens) and Provera® (synthetic progestins). This study looked at the use of non-bio-identical hormones that resemble but are not identical to our human estrogen or progesterone. That is key. Premarin® is a mix of conjugated horse estrogens (extracted from the urine of pregnant mares), only 50% of which are identical to human estrogen. The other 50% are not well recognized by our body. Provera® is a synthetic progestin, which is structurally different from progesterone. The lowest risk in the WHIS study was in those who were treated with Premarin only. This may be because Premarin contains 50% bio-identical estrogens.
But, we can do better! We can use 100% bio-identical hormones. We can also have the exact amount you need compounded for you based on your levels, which makes it a very individualized process. Furthermore, we now know that giving estrogen as a cream (transdermally) is much safer than giving it orally. Because bio-identical hormones cannot be patented, funding for large studies is harder to find. While there are no very large trials of bio-identical hormone replacement yet, we are seeing more studies with hundreds of participants confirming that BHRT appears to be effective and substantially safer than conventional hormone replacement.
How do you determine what’s going on with my hormones?
Before starting bio-identical hormone replacement therapy, I will do a full naturopathic assessment, and look at the roles that your diet, lifestyle, adrenal glands, thyroid, and liver play in keeping your hormones in balance. If these underlying aspects are not addressed, you may not see as big of an improvement as one would expect from bio-identical hormone replacement therapy.
We will also need to do a baseline assessment of your hormones, usually using salivary hormone testing. I will then work with a compounding pharmacist to prepare an individualized bio-identical topical cream or vaginal suppository, based on your needs. Once we start treatment, we will monitor your hormones periodically and make changes as needed.
BHRT is only one part of the puzzle
Don’t forget that health is multi-faceted. Replacing one or two deficient hormones can be extremely helpful, but supporting the health of your entire body is vital for enduring health. As I mentioned earlier, addressing underlying causes and supporting the function of the liver, adrenal glands, and the thyroid are extremely important for lasting hormone balance.
If you are interested in pursuing BHRT to help with your hormone imbalance symptoms, I invite you to make an appointment with me starting March 1st, 2016. Just call either of my locations (Nepean 613-225-3339 or Orleans 613-837-8885), and we’ll get you set up!
Gillson, G., & Marsden, T. (2004). You’ve Hit Menopause: Now What? Calgary, AB: Rocky Mountain Analytical Corp.
Image from 123RF: Copyright: <a href='http://www.123rf.com/profile_AnaBGD'>AnaBGD / 123RF Stock Photo</a>
Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.