Expert advice on how to harness your hormonal health for overall well-being.
Agora Health is a platform dedicated to women’s health with the aim to empower women to be their own health advocates. Founded by a mother and daughter who both went through their own hormonal and gynaecological health struggles, Cristina (the mother) had a full hysterectomy and early menopause and Grace (the daughter) suffers from fibroids.
The platform provides accessible, reliable and functional health information bridging the latest scientific research and holistic approaches to provide support for women. They have a diverse team of female experts and offer health test kits to encourage regular testing, they’re also creating a community for women to come together through events and connect, share and learn on all topics related to women’s health and wellbeing.
Each expert at Agora Health is passionate about empowering women and helping them find health solutions. They all agree that being in tune with your hormonal rhythm can significantly enhance your overall well-being.
Introducing:
It’s important to understand that hormonal fluctuations can be a natural course, explains Dr Theshanka Hibbert (Medical GP, MBBS, BSc, MRCGP): “For everyone with a womb, your levels of oestrogen and progesterone will fluctuate every day. Especially if you are at an age where you are having periods, the amount of oestrogen hormone and amount of progesterone you have varies a lot throughout each menstrual cycle (and each menstrual cycle is usually about 21-35 days). The big exception is HRT in menopause, whereby you can build up a person’s oestrogen levels by giving doses of the hormone oestrogen. Our oestrogen levels drop as we get into the perimenopause and beyond."
Clinical Nutritionist with a background in psychology, Stephanie Smith adds, “You can do a lot for hormonal health through nutrition. Fibre is really important for hormone health, specifically in the menopause and lots of people are just not getting enough fibre. It's really important for gut health and for stabilising your blood sugar, all which have an impact on hormone health. Examples of fibre rich foods are whole grains, oats, different types of grains, quinoa, couscous, bulgar wheat, rye.
Protein is really important, specifically as we get into the menopause. Women typically don't meet their protein requirements, especially because our protein requirements change throughout our life and with our training.
We also want to be really maximising on healthy fats. I think the low fat craze that was massively peddled in the 80s and 90s has really stuck with women, which is a real shame, because fats are the building blocks of hormones. This should include Omega-3 or extra virgin olive oil which is literally liquid gold. Plant based fats like nuts, seeds, avocados, oily fish. It's really important, especially going into the menopause because you have to look after your heart, your brain and your gut to try and mitigate some of the risks that come at the time of the menopause and all of these things which are part of a balanced diet.”
Dr Theshanka suggests that undiagnosed food intolerances such as coeliac disease may influence your fertility process…
“A lot of women have undiagnosed coeliac disease, so wheat allergies. So it's worth considering getting tested. The average age of diagnosis is around 50, so it's better to check early, just in case you have it.”
The impact of stress can cause hormonal levels to fluctuate, which can have a negative impact on trying to conceive, explains Dr Theshanka:
“Stress impacts several hormones released in various parts of our body, especially our brain.” Hormones such as cortisol affect our stress levels and impact our sleeping pattern which can impact the ability to conceive if you are trying. “And actually, in my practice, I've noticed that when women sometimes take a break from work, try to get a sabbatical, reduce the hours, it has helped. It doesn't always work. It's not a magic pill, but it's something to consider.” So keeping an eye on your stress levels is key to improving your chances to get pregnant.
Hormonal imbalance can impact our mental health. The Agora Health experts urge women to seek support and help when they have any related symptoms.
Stephanie Queen, MA, BACP (Reg.), Integrative Psychotherapist explains… “Hormonal shifts can often have a noticeable impact on our mental health. If you notice that you're experiencing low mood, anxiety, mood swings, particularly if these are paired with some of the common physical symptoms linked to hormone related conditions like acne or irregular periods, it may be worth a conversation with your GP and thinking about getting some of those levels tested.”
From puberty and periods to perinatal and menopause, there can be very tangible spikes in mental health during hormonal periods, shares Stephanie Queen:
“75% of women struggle with premenstrual symptoms, whether those are mood symptoms or physical symptoms, 25% struggle with severe PMS, and then we have PMDD, which is premenstrual dysphoric disorder. And this is a rarer condition. It affects about 5% to 8% of women, but it can be really debilitating, and it is a serious mood disorder, and so often it gets missed and misdiagnosed. The average woman has 450 periods in their lifetime, so if you're struggling with mood symptoms somewhere in the one to two weeks before your period, you don't have to be a mathematician to work out that is a lot of time spent struggling."
“We live in a society that normalises stress and busyness. In fact, it often praises it. I see it all the time in the clinic, this addiction to stress, where clients are taking on more and more and more in order to feel like themselves, never returning to their baseline and this has really serious implications for both physical and mental health. It's really hard, but there's something about taking responsibility, actually taking a look at your lifestyle, being honest with yourself about your relationship to work and stress, looking at your sleep hygiene, thinking about whether you're moving your body, your diet, and whether or not you need additional support, whether that's from loved ones or perhaps a therapist” shares Stephanie Queen.
We can get used to living a high-stress existence and then be perpetuating our own problems
Stephanie Queen says, “There is a strong link between stress, hormonal imbalance, and mental wellbeing. So if you are living your life in chronic stress, cortisol is constantly flooding through your body, and it's going to impact your wellness. High levels of cortisol can affect other hormones and create an imbalance that “can, in turn, cause or exacerbate symptoms such as fatigue, low mood, anxiety, and hormonal imbalance and stress can get into this kind of negative feedback loop where one exacerbates the other.”
Rachele Louise (Women’s Fitness and Nutrition Coach) talks about cycle-syncing with exercise:
“Adapting our training to the hormonal shifts is absolutely vital. Research around fitness has predominantly been done on men, and it’s only recently women are finally being researched around fitness. With research showing that there are sex differences around training, women have a physiological shift which affects their ability to produce power and ability to recover at certain times of their menstrual cycle. And therefore cycle-syncing (although research is still being done) has been an effective way for female athletes to align their training with their hormonal shifts in order to train at their heaviest when their hormones are balanced, providing a greater ability to recover from this training stress too. And then to pull back, when their hormones are having an impact on training output and ability to recover, therefore this provides them with a natural de-load.”
Consider switching up our training at various ages and life stages, says Rachele…
“From the age of 30, you start to lose bone density and muscle mass, and this just becomes greater as we age, especially as we go through menopause. So strength training should always be a part of everyone's training regime.”
“For women in menopause, strength training, plyometrics and High Intensity Interval Training (HIIT), Sprint Interval Training (SIT) work will be the most beneficial methods for creating positive body composition changes, as it creates the appropriate stimulus to encourage the body to adapt to the training stress and adapting means building and increasing bone and muscle mass. It also has a positive impact on a cellular level, which can positively impact menopause symptoms, to help with brain fog, hot flushes and depression.”
Hormones are a complex network that can cause potential gynaecological conditions, often going undiagnosed, explains Dr Adanna Okeahialam (OBGYN Doctor and Pelvic Health expert)
“If we look at the hormones themselves, our brain and our reproductive organs are constantly having a conversation with one another to be able to bring about our oestrogen and progesterone. However we've also got other organs that are interrupting that conversation which includes your thyroid, adrenals and pancreas and therefore your thyroxine, cortisol and insulin can impact your oestrogen and progesterone levels, causing potential problems.
There are three most common conditions that we see in gynaecology: one out of 10 women will have endometriosis, and we know that is oestrogen dependent. Two out of three women will have fibroids in their lifetime. And again, traditionally, we know that it's oestrogen dependent, but also it can be dependent on progesterone as well. Then you have polycystic ovarian syndrome which is very common. One in 10 women will experience it.”
“Now oestrogen is very important to pelvic floor function as there are receptors present in the bladder, urethra, vagina, and pelvic floor muscles” Dr Nicola Adanna dives deeper into pelvic floor dysfunction,
“Oestrogen is also important in collagen production. So periods of reduced oestrogen levels can contribute to pelvic floor dysfunction, for example following childbirth and during breastfeeding, also most commonly during the menopause. Pelvic floor dysfunction is a term used to describe when there is abnormal functioning of the pelvic floor. Now the pelvic floor is a muscle which helps support the bladder, vagina and rectum. So with pelvic floor dysfunction, the pelvic floor muscle can be too weak, too strong or work in-coordinately. This may lead to symptoms such as involuntary urinary leakage, involuntary stool leakage, prolapse, difficulty passing urine, difficulty emptying your bowels, chronic pelvic pain and sexual dysfunction.”
“The research evidence surrounding the use of oestrogen, for example creams to apply to the vagina is conflicting regarding how effective it is in improving symptoms of pelvic floor dysfunction. However, with urinary symptoms such as bladder that is overactive or urinary incontinence, research is promising and this is commonly used in clinical practice. Pelvic floor symptoms are complex and multifactorial, but the use of vaginal oestrogens can be used in combination with lifestyle changes and physiotherapy to improve symptoms of pelvic floor dysfunction.
The Agora Health experts are passionate about empowering women to be proactive about their own hormonal health needs…
Agora Health co-founder, Grace Shaw, says “Mum's Italian. I was born and raised in the UK, and already there's a big cultural difference, because initially, from the moment you get your period in Italy, you are sent to go and see the gynaecologist. Here, I had to beg my GP in order to go and see a gynaecologist, and after feeling overlooked by medical professionals and resorting to a private consultation, it was revealed that I had fibroids. I believe it’s so important that we try to educate young people on gynaecological conditions, and that we really try and break down this stigma, because I think it's really important to be seen by a gynaecologist, not just when there's a problem, but also as a mode of prevention.”
Dr Nicola Adanna Okeahialam says “I think the difficulty is from when we're at school, the only time that we're told about our gynaecological issues is towards our periods and reproduction and childbirth, but it's so much more than that. And if you're not educated about yourself and what's normal for you, you'll never know where and when to seek help. There's already a gender health gap, but then adding the problems of being an ethnic minority, having a disability, your cultural background, your health literacy, but then also simply your postcode as well will impact the healthcare you receive. So there are so many potential barriers that can cause disparities in healthcare. So simply taking charge and being well educated about your gynaecological health will really prevent any significant disparities that you may experience.”
Halloween is almost here but one thing you shouldn’t feel scared of is having treatment! We spoke to a Dr to get the ultimate guide on what to look out for...
Are you experiencing itchy skin? Well, it could be a symptom of menopause!
While many of us are enjoying watching Wimbledon and treating ourselves to a few Pimm's cocktails, PAUSE Live would like to talk about how Tennis could help women suffering from menopause.
Hey, wait!
Before you go.....
Let's stay in touch, pop your details here and we'll send our editor's hand-picked updates on your fave subjects.