Navigating your hormone-based symptoms across your 30s, 40s, and 50s--from insomnia and irritability to period changes and hot flashes--can leave you feeling dismissed, confused, and exhausted.
On top of the revolving door of medical care and the 3268 things on your plate, you often have to wade through a mountain of well-crafted marketing, internet fear-mongering, and wellness-industry grifting to get real answers about your health, which is even more exhausting.
I really want us all to feel well and thrive. Developing agency over your health is not only a personal act; it is a powerful, political tool for shaping a healthier world. Having energy and building physical capacity is what allows us to show up and do that work. I want us all to step into whatever roles we can for our own dreams and to support the lives of others. Right now, this matters A LOT!
So, I thought I'd compile a little list to help you move through the online space with a bit more information, science, and real talk. I would much rather you spend your resources on YOU and what YOU NEED, versus handing those over to someone without regulations who's using marketing techniques to help themselves out (all healthcare professionals have regulators and colleges making public safety a priority!).
Consider this your hormone health guide whether you're in perimenopause, have period problems, are on the pill, or are super stressed out. Here are the 12 hormone truths you need to know to navigate the wild, wild webs of the internets (find the podcast version here):
Your lived experience is your best data point, and it's often far better data than a $500 lab test.
Hormones fluctuate constantly throughout your cycle and your lifespan. What’s usually happening in perimenopause, PMS, and PMDD is that your body is responding to the very natural fluctuations in hormone levels. You have a sensitivity to hormone change that is influenced by many factors (think: genetics, upbringing, medical history, circumstances, age, etc.) that affects HOW you experience hormone change. This is why there's a spectrum in signs and symptoms in perimenopause. Not only that, we often cannot draw a straight line from a hormone level to a particular symptom, which means that testing doesn’t help us understand what’s going on, guide treatment, or monitor progress. There’s a time and place for testing, which is typically done through bloodwork, but it’s not always relevant. A high-priced salivary or urinary hormone panel are not evidence-based or necessary.
Your daily signs and symptoms tracked over time ARE data points. We track these changes and we listen to you, how you're feeling, and then we offer you treatment. Period.
I actually did a whole TEDx talk on this! (Have you seen it? Watch it here!)
"Cortisol face" is an internet wellness buzzword.
Cortisol is a vital hormone required to keep you alive, not a villain; it goes up and down naturally as you go through life. It’s NOT the cause of your stress, it’s around when you are stressed (there’s a difference!).
There are very real autoimmune cortisol disorders someone can have, but social media trends urging women to shrink their lives and abandon high-intensity exercise to "protect their hormones" are misleading. Your fatigue and nervous system dysregulation isn't caused by a failure or fatigue of your adrenal glands, but by being under-resourced in a stressful world (some of which is beyond our control, like geopolitics).
The goal is NOT to avoid cortisol ups and downs or to avoid stress entirely. The goal is to increase your resilience and capacity and broaden your boundaries through adequate fuelling and balanced nutrition, physical activity, rest, sleep, fun, social connection, and any individualized support you need. And, yes, this includes high-intensity exercise, which has immense benefits to your cortisol, heart, and brain in the long run.
Weight is a complex interplay of biology, genetics, and environment (think: upbringing, mental health, access to resources, education, nutrition, etc.), meaning your willpower is not to blame (despite what the rest of the internet says!).
People come in all shapes and sizes, and what they look like does not often tell you about their actual health status. With the rise of meds like semaglutide and tirzepatide, there’s a lot of body-shaming on the internet, which is sad because this is the most we’ve known about obesity medicine and just how complex it is.
Yes, there is benefit to weight loss, particularly decreasing waist circumference, since visceral fat around the organs increases the risk of high cholesterol, diabetes, high blood pressure, poor pregnancy outcomes, cancer, heart disease, etc. However, there’s no one-size-fits-all solution here, and these risks can be improved upon with a small amount of weight/waist size decrease, like 5-10%.
Fibre matters far more for your hormone and heart health than protein. They’re both important, but high-fibre diets are consistently associated with lower risk of heart disease, certain cancers, cognitive decline, and hormonal symptoms in PMS/PMOS/perimenopause/endometriosis.
While wellness media remains hyper-fixated on protein consumption, most people hit the minimum target of protein. Most North Americans (yup, women included) consume LESS THAN HALF of the recommended 25 to 30 grams of daily fibre.
The minimum target of protein is 0.8g per kg of body weight per day, but most of us should be getting a bit more especially if you're active and want to preserve muscle mass. This changes the target to 1.2 - 1.4g of protein per kg of body weight per day.
Leaking urine when you sneeze, cough, or jump is incredibly common, but it is not normal. Society routinely normalizes pelvic floor dysfunction, chronic bladder leaks, severe period pain, and painful sex as "just part of being a woman," but these are treatable medical concerns.
Kegels are not a universal fix-all because pelvic floor muscles can be tight, loose, and/or uncoordinated. A pelvic physiotherapist can be an important medical team member.
The birth control pill does NOT cause infertility, but it frequently masks (and treats!) underlying hormonal conditions for years.
The pill remains an invaluable, life-changing tool for family planning and reproductive autonomy (and many symptoms). However, it’s often prescribed without a full assessment so if you have something brewing under the surface (think endometriosis, adenomyosis, PCOS (now PMOS)), it can be a rude awakening when you come off the pill, especially if pregnancy is now the goal. This and the lack of discussion about how it works (by suppressing your menstrual cycle and ovulation) is why the pill gets such a bad rap. If you’re prescribed the pill to "fix" adult acne, severe period pain, or irregular cycles, it is helping to treat and manage those symptoms but not the metabolic or structural issue underneath.
You can learn more about the pill, how it works here, and how to make a decision about it here.
Rampant online fear-mongering regarding seed oils and trace food additives creates unnecessary orthorexia and food anxiety.
Craving convenience foods or a cookie is a normal response to corporate food engineering and their lobbying dollars (while nutrient-dense foods become more and more expensive), and not a personal moral failure!
Focus on adding nutrient-dense whole foods where you can, and leave room for flexibility without the side of guilt. Not only that, the processing status of a food does not always tell you about nutrients (protein powders, fruit yoghurts, potato chips, and gummy worms are all in the UPF category!).
Nutrition is the long game and we want to focus, as much as possible, on whole foods and lots of plants with a dash of flexibility. Here's a longer-form blog post on ultra-processed foods and how they can be part of a healthy diet.
Alcohol is a carcinogen, and even moderate drinking raises your lifetime breast cancer risk (and upper digestive tract, liver, and prostate too!).
While outdated myths falsely claim that soy products cause cancer (when human trials show that soy is actually protective and can help with symptoms of PMS and perimenopausal change), alcohol is the real driver that disrupts sleep and increases cancer risk. Many people with breasts will be afraid of mammograms but not of their very regular alcohol consumption even though one saves lives and the other does not. There is no safe amount of alcohol. Period.
The menopause transition or perimenopause can begin many years before your final period, so yes, you can be in perimenopause in your late 30s and early 40s.
Even though perimenopause is defined by changes in menstrual bleeding, earliest symptoms are often mood and sleep disturbances. Hormone Therapy (or Menopausal hormone therapy, MHT) is a highly safe, effective, and valid first-line option to preserve your quality of life, NOT a dangerous last resort that you have to suffer enough to "earn." There are other options as well. Obviously, lifestyle modification should always be part of the plan.
Heavy menstrual bleeding or heavy flow (categorized medically under Abnormal Uterine Bleeding or AUB) means losing over 80mL of blood per cycle, bleeding past 8 days, or regularly passing clots larger than a quarter. Flooding through products, needing to double up on tampons and pads, or waking up in the middle of the night to change protection, chronically being iron-deficient are all red flags. A sudden, significant shift from your personal baseline matters too–if your period jumps from a light 20mL to a heavy 70mL, that dramatic change warrants medical investigation even if it technically sits below the textbook 80mL diagnostic limit.
Here's a podcast on what a normal period can look like.
Many hormone-based conditions are reduced to their reproductive impact alone, but this is far from the truth. They have effects beyond your fertility and reproductive system and they also affect your future health. You can read about the name change of PCOS to PMOS here, but part of the discussion was the fact that this is beyond ovaries--it's about metabolism. These conditions are associated with low-grade inflammation and increased long-term cardiovascular risk.
You cannot out-supplement a broken lifestyle foundation, a chronic lack of sleep, or an under-fuelled body. Before spending thousands of dollars on adaptogens, green powders, or thyroid support supplements, you’ve gotta make sure you’re eating enough, getting your bloodwork done, getting good quality sleep, engaging in rest and fun, connecting with others, and moving your body. Millions of women suffer from chronic under-fuelling, sleep apnea, vitamin D deficiency, or iron deficiency (low ferritin) that can lead to fatigue, irritability, headaches, low mood, hair loss, and daytime sleepiness. We won’t get too much into the invisible load women carry, the constant low-grade climate anxiety, cost of living crisis, and geopolitical strife for now (but obviously those play roles too!).
There you have it! 12 truths to help you with your hormone health. If you're looking for an audio or video version, check out my Phase to Phase: The Hormone Health Show episode on the topic.
As always, if you're looking for a naturopathic doctor in Ontario (virtual, the Newmarket area in East Gwillimbury, or the south Barrie area in Innisfil), feel free to reach out or book an appointment. If you're not in the province, then check out the podcast and my book, The Period Literacy Handbook.
