We’re going to talk all about hormones. This is starting to get a little bit of traction in female strength sports due to a variety of factors, whether it’s diet or over-training or under-recovery, women are starting to notice that they’re having hormone imbalances. It’s becoming a huge issue and it’s something that I’ve been studying for years because I noticed a link between my own intense training and shifts in my menstrual cycle and energy levels.
First, I want to take you through a common scenario, so see if this sounds like you:
- You know something isn’t right.
- You’re tired; actually, you’re exhausted.
- Your training sessions are getting harder and harder to get through.
- You can’t function without coffee in the morning and can’t train without a pre-workout supplement loaded with caffeine.
- You have zero energy for social events
- You end up binging like crazy on the weekends, and not because you’re just out having fun at a restaurant, because you’re like, “Food! I want more food.”
- Or even if you just stick to your plan perfectly, you’re just noticing that you’re not really making any progress (whether you were trying to gain weight, lose weight or just maintain to get strong), whatever your goal was, you’re not making any traction.
- You may even notice missing or irregular periods.
What I’m describing are symptoms of a hormone imbalance. A lot of times, that’s brushed off as over-training or under-recovery or a combination, or you just think that you’re under a lot of stress. As a female strength athlete, there aren’t a lot of resources out there for us to detect and to treat these hormone imbalances that come up as a result of heavy training and dieting, and even if you haven’t dieted a lot in the past, just heavy training alone can cause hormone imbalances, which is something that is completely overlooked. No one really looks at how intense training can affect your hormones, and it kind of flies under the radar.
A lot of times people will go to their doctor and say “,I’m really tired, I’m having trouble losing weight. These things are happening…,” and if you have a really astute doctor, they might go, “Oh, it kind of sounds like you might have a low functioning thyroid,” but then, nine times out of 10, the thyroid tests will come back normal.
Before we get into what a hormone imbalance is, we have to talk about what a hormone is and what a hormone does. Hormones are chemical substances in all animals. They’re often referred to as chemical messengers because they carry information and instructions from one group of cells to another. In the human body, hormones influence almost every cell, organ, and function. Our bodies produce and secrete over 50 hormones. The regulate our growth, development, metabolism, tissue function, sexual function, reproduction, the way our bodies use food, and the reaction of our bodies to emergencies and even our moods. They’re the messengers that tell our tissues, our brain and everything else how to respond. However, the main hormones that we’re going to be discussion today are the sex hormones and then one other: progesterone, estrogen, testosterone, and cortisol. These hormones are made from cholesterol. Cholesterol is a precursor for sex hormones, which is why we need cholesterol in our bodies. Every cell in your body produces cholesterol. Your liver alone makes 75% of the cholesterol in your body – even if you have a low cholesterol diet, your liver makes 75%. It’s an integral part of our cell membranes.
Let’s first dive into a brief overview of each hormone and then we will piece it all together at the end.
Progesterone is a hormone that’s made in the ovaries and the adrenal glands. It’s responsible for regulating your menstrual cycle, getting your uterus ready for pregnancy, and then maintaining that pregnancy, and it also counteracts some of the effects of estrogen. A lot of women think that it’s awesome if they stop getting a period, but it’s not, because maintaining menstrual cycles, which is the function of progesterone, is important during childbearing years. Unopposed estrogen without progesterone increases your risk of endometrial cancer.
Symptoms of low progesterone include:
- Mood changes, including anxiety or depression
- A low sex drive, hot flashes, and irregularity in your menstrual cycle (shortening, lengthening or absence of).
Estrogen is a common name for three different hormones which, for our purposes, we do not need to distinguish between. We’re just going to lump them all together and call it estrogen. It’s responsible for the growth and development of female sex characteristics and reproduction. It’s produced in the ovaries and also the adrenal glands, just like progesterone, but it’s also produced in our fat tissue. This is one reason that women can experience hormone imbalances when people have really low body fat. it’s also the reason that women with an excess amount of adipose/fat tissue are more susceptible to estrogen related cancers.
In women, estrogen circulates in the bloodstream. It binds to estrogen receptor cells in targeted tissues, and it affects all sorts of things, such as breast tissue, uterus, brain, bone, liver, heart, and some other tissues. It’s an important hormone.
Declining or low levels of estrogen can cause physical symptoms, which include:
- Hot flashes
- Night sweats
- Vaginal dryness.
- All of the above are symptoms of menopause.
Symptoms of excessive estrogen are the same as symptoms of low progesterone, because we talked about how the progesterone counteracts some of the effects of estrogen. Therefore hormone testing is really important. You can’t always go off of symptoms alone. You’ve got to do some sort of testing so you know exactly what you’re dealing with, because you may deal with them in different ways.
Women do produce testosterone, but in lower level than men, it’s produced in the ovaries and the adrenal glands. It serves many vital functions. Testosterone is actually really important for women, because we need it for bone strength, development of lean muscle mass and strength. It also contributes to an overall sense of well-being and energy levels, and it plays a super important role in a woman’s sex drive.
Cortisol is referred to as the stress hormone. It’s produced within the adrenal gland. It’s released in response to stress and low blood sugar. It helps control blood sugar levels, regulates metabolism, helps reduce inflammation and it assists with memory. It also has a controlling effect on the salt and water balance in our bodies, too, which is important for regulating blood pressure.
What’s really important for us, as athletes, is that cortisol is a strong anti-inflammatory. Your circulating levels of cortisol are a key factor in controlling the level of inflammatory reactions in your body. So for us, it’s really important to have cortisol circulating through our body. The harder your adrenal glands have to work, the more fatigued they become and the less cortisol they produce.
The Root of the Problem – Adrenal Fatigue
If you noticed, every one of the hormones mentioned above, is produced, at least in part, by the adrenal glands. The adrenal glands can become fatigued due to the stress of training (and other life stressors) but really for us as athletes, it’s the heavy training that sets us up for something called adrenal fatigue. This is a condition that most medical doctors are not trained in. A large part of the medical community ignores this condition out of lack of knowledge and understanding about sub-clinical conditions, and it’s done a really big disservice to particularly women that are experiencing some of these problems.
There are some medical doctors who practice what’s called functional medicine, and they do diagnose and treat adrenal fatigue. Some naturopaths and chiropractors are also able to treat and diagnose adrenal fatigue, but the thing that most medical doctors will look at if you talk to them about low functioning adrenal glands is actually a disease called Addison’s disease. In the case of Addison’s Disease, which is life threatening, the adrenal glands have shut down and are no longer producing any cortisol, so people who have been diagnosed with this disease have to be on corticosteroids for life. That’s not what we’re talking about here.. We are talking about adrenal fatigue, which is curable. As more women get involved in competitive sports, I really hope that medical schools begin to teach and recognize about adrenal fatigue, because it’s a serious issue.
The definition of adrenal fatigue was written by the doctor who literally wrote the book on adrenal fatigue, Dr. James Wilson, a naturopath, chiropractor, and PhD, and he writes:
“Adrenal fatigue is any decrease, but not failure, in the ability of the adrenal glands to carry out their normal functions. The chief symptom of adrenal fatigue is fatigue, but is also accompanied by many other signs and symptoms. Adrenal fatigue occurs when stress from any source, physical, emotional, mental, or environmental, exceeds, either cumulatively or in intensity, the body’s capacity to adjust appropriately to the demands placed upon it by stress. When this happens, the adrenals become fatigued and are unable to continue responding adequately to further stress.”
Symptoms of Adrenal Fatigue
You do not have to have all of these symptoms to be experiencing Adrenal Fatigue. A combination of some of them can mean that you may have adrenal fatigue and it’s worth looking into.
- Difficulty getting up in the morning, despite getting a good night’s sleep
- You still feel tired when you wake up
- You just don’t really feel like you’ve woken up until about 10 a.m. A lot of times, you’ll hit an afternoon low around 3-4 p.m., and then feel better around 6 p.m. or after dinnertime and feel pretty good for the rest of the night until about nine, and then kind of crash again and if you stay up late enough, you may get a second wind at about 11, and you could actually be really productive from like 11 p.m. to 1 a.m.
- Craving salty foods
- Having a lack of energy, basically everything seems like a chore, even the things that you used to enjoy.
- You have an increased effort to do everyday tasks. Everything seems to require 10 times as much energy as it should.
- You have a decreased sex drive
- Decreased ability to handle stress, and little things that never used to bother you start to get to you.
- You’re irritable
- You have constant anxiety, yelling at your kids or your partner, compulsive eating.
- Increased time to recover from illness or injury
- Feeling lightheaded when you stand up quickly
- Mild depression
- Less enjoyment or happiness with life
- Not much seems to interest you anymore
- Work and relationships feel empty
- You almost never do anything just for fun
- Increased PMS symptoms
- Thoughts are less focused and more fuzzy
- Lose tracks of your train of thought
- Difficulty making decisions, even about little things
- Slight memory problems
- Decreased productivity
- Frequent upper-respiratory infections
All of the symptoms, or combination of symptoms, get worse if you skip a meal. If you’re noticing that you’re getting hangry (hungry+angry) often, you might have something going on with your hormones.
There’s not a lot of research out there on adrenal fatigue and female strength athletes. Here’s the crazy thing, when you research hormone imbalances in the female athlete, you’re going to find everyone talking about the female athlete triad, which is menstrual dysfunction, low energy availability, and decreased bone density, which is usually talked about in endurance athletes and athletes with eating disorders, and I just don’t think this fits the bill for us. That does not describe what I think is happening with female strength athletes. Experts typically will point to a caloric deficit as the culprit, but honestly, I respectfully and professionally disagree with that, at least for the population of women that I work with, which is strength athletes. I think that a lot of these symptoms are underlying adrenal fatigue.
The Adrenal Glands, Hormones and Adrenal Fatigue
Let’s talk a little bit about what your adrenal glands are. The adrenal glands are a small, pyramid-shaped organ that sits on top of each kidney, and the role of the adrenal gland is to produce hormones. Specifically, it produces the hormones that regulate fight or flight response, tissue repair, anti-aging, blood sugar, immune response, central nervous system stimulation, stress reaction normalization, regulation of sodium, potassium, and fluid volume, as well as produce a portion of the sex hormones.
In the case of adrenal fatigue, the sex hormone levels are often decreased because the adrenal glands are too taxed to manufacture adequate levels of the hormones. So I want to be really clear about this, because I know I’m repeating myself, but what I’m saying is as a female strength athlete, we are prone to hormone imbalances, specifically imbalances in the sex hormones. This is generally, not always, but generally, due to our adrenal glands being too tired from everything we expect of our body to produce adequate level of hormones.
My research has led me to believe that adrenal fatigue is a huge issue for female strength athletes. First off, intensive exercise can lower progesterone. That in and of itself can cause irregular periods or missed periods. Secondly, intense exercise puts a huge amount of stress on your body. This stress causes your adrenal glands to release more cortisol, and then balancing everyday life on top of training is stressful. If you add on an injury, surgery, relationship or work stress, you have a recipe for adrenal burnout or adrenal fatigue. What this means is that your body has been producing cortisol at such a high rate for long enough that it simply can’t continue and it stops producing adequate amounts of cortisol.
A lot of times, people that do realize that there’s a link between female athletes and hormone problems, point to a caloric deficit or low body fat for bringing on these hormonal changes. That absolutely can happen, but if you listened to an episode we did on Empowered by Iron, “Eating for health and gains,” we talked about how women need 30% of their calories to come from fat. This is why. Remember we talked about these hormones are made from cholesterol? If you’re following a diet that’s consisting of 20% or less of your caloric intake coming from fat, and you are experiencing hormone troubles, your problems might be more diet related and maybe not so much adrenal gland, but if it goes on long enough your adrenal glands can start to suffer. What I’m recognizing is that it’s not just diet that causes this, however, the way you solve part of the problem, is changing up your diet a little bit.
But what about stress? It’s the cumulative stress on the body that initiates these hormone imbalances, and that’s what leads to missed periods and all these other issues. So here’s the piece that as a nutrition coach and an athlete really terrifies me: When cortisol is low, which is the case in adrenal fatigue, your liver has a more difficult time converting glycogen, which is stored sugar, into glucose, which is the usable sugar for energy. So the foods that you eat, which are normally converted to glucose to be used for energy, cannot be converted. This means that when your body is demanding energy, there’s no usable energy available. Your body cannot convert the stored energy source into usable energy, so that leads to low blood sugar, clouded thinking, decreased muscle strength and fatigue. It’s almost like you didn’t eat, despite the fact that you’ve eaten your pre-workout meal, your body is unable to meet its energy needs during training and throughout the day, because the hormone you need to convert your food is not in ample supply. [highlighted for extreme emphasis in blog post]
So many of us, and rightly so, focus on getting our nutrition spot-on to fuel our training and our goals, and if your adrenal glands are taxed, your body cannot adequately use that food for fuel.
Thyroid and Hormone Imbalances
80% of those suffering from adrenal fatigue also have a lot of symptoms of low thyroid. For female strength athletes, I believe much of this is due to the fact that low progesterone, which is caused by adrenal fatigue, blocks the action of thyroid hormones, and that leads to hypothyroid symptoms. This is why your thyroid tests will come back normal. The hormones are there and circulating, but they’re not allowed to work effectively.
So in order to fix these issues and recover, we have to get an accurate diagnosis, and that’s performed through hormone testing. We will put some links at the end of this post so that you can find someone that can do the appropriate form of testing, because these hormones need to be looked at all together, not just individually. I really like saliva testing for this. Blood testing only measures the amount of hormones that are circulating, not the hormones inside of the cells. It’s the hormones inside of the cells that matter.
Adrenal Fatigue and Diet
We can make some really impactful diet changes, so recovery from Adrenal Fatigue totally possible if you are making really targeted changes for your specific hormone profile. You can begin to see improvement in a week to three weeks, and then depending upon the severity of it, you might be able to completely recover in three months. If things are really severe, maybe a year or if you just have a lot of stress in your life that you can’t get rid of, it might take a little bit more time.
Click HERE to learn how to fuel your body for athletic performance.
Find a Functional Medicine practitioner or Naturopathic doctor:
Hormone testing through Fiercely Fueled Nutrition:
Hormones & The Female Strength Athlete – Empowered by Iron Podcast Episode: