Menstrual dysfunction is something we see regularly in the clinic and is unfortunately very misunderstood.
Menstrual conditions are all very different.
Not all of them include pain; however, each one is highly connected to something in the immune system.
PCOS is not painful, but presents with ovarian cysts, irregular periods, weight gain, and light periods in the teens, twenties, and thirties. In these women’s forties, they can see a dramatic change where they have intense heavy bleeding for weeks at a time each cycle.
PMDD presents with extreme mood changes before the period starts, but doesn’t present with pain like endometriosis or adenomyosis.
Infertility is also a menstrual condition, but just seen as a hormone problem or egg problem, but has a strong connection to the immune system.
Endometriosis and Adenomyosis are the most commonly mentioned painful, menstrual conditions.
Common symptoms considered to be menstrual dysfunction include:
- pain (even out of period or pms),
- heavy period pain,
- clotting,
- suspected IBS,
- bloating,
- irregular periods,
- mood changes (especially pre-menstrually/PMS),
- pain during intercourse, and
- vaginal bacteria issues such as thrush, utis, and bacterial vaginosis.
From approximately age 38-40, hormones start to shift, presenting more of an oestrogen dominance picture. During this time, gut microbiome changes occur peirimenopausally, along with changes to mood, and more dysregulation and irregular periods become common.
What is endometriosis?
While endometriosis is viewed as a female hormone reproductive issue, emerging research shows the root cause of endometriosis stems from:
- A dysfunction of our immune system, where immune cells called macrophages are not recognising endometrial tissue that has escaped the uterus.
- Microbes and inflammatory response from bacteria in the gut.
- The endometrial tissue produces aromatase enzyme, which converts testosterone to oestrogen, leading to excess oestrogen.
- Excess mast cells produced as a response from endometrial tissue is histamine producing.
- Oestrogen and the excess oestrogen are also histamine producing.
- Mast cells increase inflammatory cytokines, which are associated with excess pain and inflammation.
What happens in the Gut Microbiome?
Microbes from the gut and/or vagina can migrate to the peritoneal cavity, leading to excess inflammation. There is an increased ratio of opportunistic microbial activity causing inflammation and pain.
Bacteria, whether good or opportunistic, produce chemicals:
– Good bacteria produce the right chemicals for proper hormonal balances.
– Opportunistic bacteria produce chemicals associated with inflammation, excess pain, and mental state changes.
– There is a link between opportunistic bacteria and anxiety, depression, PMS, and potentially mental health disorders.
Polycystic Ovarian Syndrome (PCOS)
The main symptoms associated with PCOS include:
- Excess hair growth
- Weight gain
- Irregular menstrual cycles or no menstrual cycle
- Bloating
- Changes to mental health (being snappy, angry, sad, anxious)
- Acne
- Heavy bleeding
- Low iron
- High androgens
- High testosterone
- Insulin resistance
- Low or High Oestrogen (not normal levels – either or)
The typical PCOS picture shows facial hair, potentially thickened hair, excess weight around the mid-section, and skinny arms and legs. This mid-section weight gain occurs because with insulin resistance, cells become too full of carbohydrate, leading to fat storage around the midsection.
Oestrogen and Hormonal Balance
There are three different types of oestrogen: E1, E2, and E3.
Blood tests can only detect E2, making salivary or urinary hormone tests necessary for a complete picture.
Signs of oestrogen dominance include:
- Breast tenderness and swelling
- Constipation around ovulation
- Diarrhoea around menstrual onset
- Period pain
- Moodiness
- Menstrual clotting
- Weight gain
- Fluid retention
- Puffy eyes
Cytokines drive oestrogen dominance and are associated with allergies, itchy skin, seasonal allergies, runny nose, watery eyes, headaches, and in some cases, new allergic reactions.
How to put Menstrual Conditions into Remission
Treatment must focus on both symptoms and underlying causes.
The menstrual cycle acts like a monthly report card – symptoms often worsen with poor diet, excess alcohol, lack of exercise, and high stress, while improving with healthy lifestyle choices.
A comprehensive treatment approach includes:
- Assessment of conditions and symptoms
- Review of blood work and pathology
- Addressing gut dysbiosis
- Hormone regulation
- Inflammation reduction
- Working with conventional doctors when necessary
- Supporting immediate symptom relief while addressing root causes
Treatment must focus on both symptoms and underlying causes.
The menstrual cycle is our monthly report card.
Symptoms intensify with a weakened immune system, gastrointestinal dysfunction, or (puberty/pre-period/peri-menopause) changes in hormones that have a downstream impact on inflammation.
Most women have only learnt about their period problem from the lenses of hormones, but don’t understand what has caused it and how they can not only decrease symptoms, but put their condition into remission.
It’s why we put together a special new very detailed webinar on the Immunology of Menstrual Dysfunction. I did this webinar privately to help women really understand what’s happening to their bodies. You can watch the full webinar here: https://naturalhormonebalance.co/free-immunology-menstrual-dysfunction/
If you are ready to get help and resonate with the information here and want to by-pass the video and get treatment, you can organise an introductory consultation here: https://calendly.com/nz-naturopathy/intro-consult
