“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.
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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/.
Most women that I see in my Ottawa practice who are in their reproductive years suffer from premenstrual syndrome (PMS) to some extent. Actually, about 75% of women in this demographic experience PMS (Medline Plus, 2016). Does that make it normal? While a low level of discomfort can be expected (after all, there are huge hormonal changes occurring all at once within the week before your period), in many cases, more severe symptoms are pointing to underlying hormone imbalances or deficiencies that should be addressed.
What Is PMS?
PMS is generally defined as a group of symptoms that comes and goes cyclically based on where a woman is in her menstrual cycle. They usually will start in the second half of the cycle (at least 14 days after the start of a period in a woman with a textbook 28 day cycle), and will go away 1-2 days after menstruation starts (Medline Plus, 2016).
Typical PMS symptoms can include one or more of the following:
-Bloating and/or increased gas
-Changes in bowel movements, such as constipation or diarrhea
-Mood changes, such as heightened emotions, irritability, anxiety, or depression
-Skin changes, such as cyclical acne
Paying attention to these sometimes subtle changes can give you a clue about what imbalances you may have.
The 4 Main Types Of PMS
PMS is classified into 4 main types. If you fit primarily into one of these 4 main types, your naturopathic doctor will be able to gain valuable insight just from your symptoms!
1) PMS-A (Anxiety): This type of PMS is characterized by symptoms of increased anxiety, irritability, and emotional lability.
What it means: PMS-A is usually associated with a high estrogen to progesterone ratio. Think of progesterone as the calming hormone between the two. If you don’t have enough of the calming hormone, estrogen will trigger the release of the more stimulating hormones, cortisol and adrenaline, which will make you feel more on edge. As well, if you’re on or have taken birth control pills in the past, you may have excess estrogen in your system, which can worsen these symptoms.
Treatment options: Using natural strategies to increase progesterone (such as the herb Chaste Tree), get rid of excess estrogen, and decrease stress is very helpful for PMS-A sufferers. Increasing magnesium intake can also be helpful. If you have severe PMS-A symptoms, and especially if you are peri-menopausal, you may benefit from cyclical use (post ovulation) of bio-identical progesterone cream (which I can prescribe).
2) PMS-C (Cravings): If you experience strong cravings the week before your period, especially carbohydrate cravings, then you are probably suffering from PMS-C. You may also crave stimulants and chocolate, get heart palpitations, and you may get headaches and energy highs and lows from fluctuating blood sugar levels.
What it means: These symptoms are thought to be due to changes in the way insulin binds. As a response to blood sugar in your bloodstream, your body produces insulin as a signal to bring the sugar into the cells. However, in the days leading up to a period, a woman’s cells become less sensitive to this insulin signal, leading to imbalances in blood sugar regulation. Giving in to sugar cravings can actually make PMS-C symptoms worse, since the body can’t deal with this influx of sugar properly.
Treatment options: Stabilizing blood sugar with a high protein diet low in refined carbohydrates is really important if you suffer from PMS-C. These blood sugar imbalances can also show up as acne in the skin, since high sugar in the blood can lead to more breakouts. Eat small and frequent meals, and avoid alcohol.
3) PMS-D (Depression): If you feel really down before your period, you don’t feel like participating in your regular social activities, you feel grumpy, angry, or have crying spells before your period, you may suffer from PMS-D. If you have pre-existing depression, you might feel like your symptoms are worse leading up to your period. Another feature of this type of PMS is that it may be associated with premenstrual acne.
What it means: The etiology of this type of PMS is like the reverse of PMS-A, with elevated progesterone levels, and low estrogen levels. While progesterone decreases anxiety, too much progesterone relative to estrogen can depress the nervous system, leading to symptoms of depression. As well, the happy neurotransmitter serotonin is decreased when estrogen levels are low, worsening feelings of depression. There also may be elevated testosterone levels, which can lead to increased acne.
Treatment options: Some foods and herbs with phytoestrogenic activity can be used to balance estrogen levels. As well, if you have elevated androgens (hormones such as testosterone and DHT), these can be balanced using natural therapies. Including foods high in tryptophan (the precursor to the feel good hormone, serotonin) can help with mood: sour cherries, turkey, cottage cheese, and oats are all high in tryptophan (Pope, 2016).
4) PMS-H (Hyperhydration): If you routinely gain a few pounds before your period, your abdomen feels swollen, or your breasts get more swollen and tender, you are likely suffering from PMS-H. Rings on your hands may feel tighter if it also affects your extremities.
What it means: The increased extracellular fluid which leads to symptoms of fluid retention is due to higher aldosterone levels. Aldosterone is a hormone produced by the adrenal glands that helps the body retain fluid. This can be compounded with lower dopamine levels typical in the days leading up to the period.
Treatment options: Eating foods high in salt makes the body retain more water, so decreasing your salt intake and processed foods can help decrease the fluid retention. Increasing magnesium intake can also help reduce aldosterone levels and improve symptoms.
What’s A Girl To Do?
If you are tired of dealing monthly with your PMS symptoms, there is a better way than just pushing through it. Prominent PMS symptoms are signs for you to pay attention to the subtle imbalances in your body. The above treatment options will work for some but must be adapted to your particular case. Naturopathic doctors can help you balance your hormones with tools such as liver supporting and hormone balancing herbs, nutritional supplements, dietary changes, and acupuncture. In more complicated cases, we may need to run hormonal testing (blood or salivary) to find out exactly what we’re dealing with.
If you want to get to the bottom of your PMS, I’d love to help. You can get in touch here.
Image from: http://www.123rf.com/profile_rodimovpavel'>rodimovpavel / 123RF Stock Photo
Kaslow JE (2016). Premenstrual Syndromes. Jeremy E. Kaslow, MD. Retrieved from http://www.drkaslow.com/html/premenstrual_syndromes.html.
Pope N (2016). Naturopathic Infertility Treatments Timed With Cycle Charting. Webinar May 15, 2016.
White CD (2016). Premenstrual Syndrome. Medline Plus. Retrieved from https://medlineplus.gov/ency/article/001505.htm.
Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.