Hormones can mess with your sleep? Oh yes, honey, and I wished someone would have warned me when I was younger. Hormones are involved in many processes in the body. In fact, the rise and fall of hormone levels have been known to affect sleep. Therefore, hormonal changes can have some unintended consequences on our sleep patterns. To better understand this, though, we must take a quick dive into the menstrual cycle.   

 Although the menstrual cycle is often taught to have four phases, scientific studies and research often divide it into two main phases: the follicular (includes menstruation) and luteal phases (includes ovulation).   

Follicular Phase (Phase I): Day 1 of menstruation to ovulation.  

During phase 1, the hormone estrogen rises in concentration until ovulation or the release of an egg from the ovaries. Estrogen during this time acts as an energy supplement. Think “I could go on an endless run right now” kind of energy. Luckily sleep disturbances are also much less common during Phase I of your menstrual cycle. You are on top of the world! Too bad it doesn’t last forever. 

Luteal Phase (Phase II): Begins after ovulation.  

At ovulation, estrogen has peaked, and progesterone starts to rise, which can raise your core body temperature. The increased temperature can lead to night sweats and decreased comfort, which can lead to poor sleep. So it’s got to get better from here, right?! 

I wish I could say that it does, but for some women, especially those with Premenstrual Syndrome (PMS) symptoms, the late Luteal Phase is the worst for sleep quality. Women with PMS are more than twice as likely to have insomnia before or during their periods. In addition, some studies have shown a decrease in the amount of melatonin in women with PMS symptoms which makes it harder to fall asleep during this part of the menstrual cycle. On top of that, the amount of time spent in restorative REM sleep for women having PMS symptoms can also decrease. Some of this change may be related to physical PMS symptoms such as cramping, bloating, or headaches, but mood changes caused by PMS are also thought to be involved.  

Menopause and Perimenopause 

Insomnia, poor sleep and overall fatigue are among the most frequent health complaints of perimenopausal women. Sure, our never-ending task list might have something to do with our lack of sleep, but it’s also our hormones. As we age, estrogen plummets, and I mean Tom Petty- Free Fallin’ type of plummet. In fact, after menopause, the body stops producing most of the estrogen and starts to only produce small amounts of estradiol and estrone. This is why estrogen replacement therapy (ERT) has become a major success for those who experience hot flashes, night sweats, insomnia, etc. It is believed that ERT improves sleep by alleviating vasomotor symptoms. In addition, estrogen has powerful effects on body temperature regulation, circadian rhythms, and stress reactivity. Research is still working through this, and many findings are speculative at the moment, but it is finally attracting attention. 

What can I do to fix my bad sleep? 

No matter what the cause of your poor sleep is, there are some generic things that you can do to help it get better! Improving your sleep hygiene is a crucial factor that you actually can control. This includes limiting caffeine, getting some sun, exercising regularly, reducing the light and noise in your bedroom, and developing a calming bedtime routine. If you are already doing all of this right and it isn’t helping, you may want to talk with a provider. Sometimes our hormones are to blame, and that perfect night’s sleep may only be one hormonal contraceptive or ERT away! 

 

References:

https://www.sleepfoundation.org/articles/6-sleep-problems-occur-during-your-period-and-what-do-make-them-go-away  

https://www.sleephealthfoundation.org.au/pdfs/Menstrual-Cycle-and-Sleep.pdf  

PMS and Insomnia | Sleep Foundation 

https://www.webmd.com/women/pms/features/why-pms-gives-you-insomnia  

https://www.webmd.com/sleep-disorders/features/women-hormones-sleep-problems 

Reproductive hormones, aging, and sleep – PubMed (nih.gov) 

Sleep and Premenstrual Syndrome – PubMed (nih.gov) 

Premenstrual dysphoric disorder: Different from PMS? – Mayo Clinic 

It’s no secret that our menstrual cycles are annoying.  But a frustrating symptom that no one talks about is Period Poops. The list of GI symptoms is endless and ever-expanding for some individuals, such as cramping, nausea, vomiting, diarrhea, and constipation. There’s no need to feel singled out here if any of this sounds like you because you’re not alone. But what is causing this? 
…Prostaglandins 

What are prostaglandins? 

Prostaglandins are a type of fatty acid hormone and are responsible for your inflammatory changes. Your body creates prostaglandins right before your period starts. Prostaglandins cause the muscles and blood vessels of the uterus to contract to shed the uterine lining or essentially have a productive period or withdrawal bleed. When levels of prostaglandins are high, they can enter the bloodstream and begin affecting nearby bodily systems. All that cramping can really get the bowels moving. On the first day of your period, the prostaglandins in your body are high, which is why your period poops are usually worse at the beginning of your period. This is why pain and cramping tend to get better after the first couple of days of your period. 

Wait, period constipation? 

Alternatively, progesterone, another hormone, may impose the opposite effect, constipation. This hormone is responsible for the growth and thickening of uterine walls. Progesterone levels tend to peak just before ovulation or a few days after. 

Suggestions to prevent period poops: 

So how do we combat these hormones and fatty acids responsible for making our periods terrible? First, we can try cleaning up our diets. Eating healthy foods with plenty of fiber can help to alleviate constipation. And if you’re dealing with diarrhea, keep drinking plenty of liquids to replace lost fluid and electrolytes. Throwing in some healthy fruits, vegetables, and leafy greens is always a good idea too! Although no one wants to hear it, light exercise such as walking can assist with helping everything move through your system. Maintaining a consistent sleep/wake cycle and reducing stressors may also help ease symptoms. Your cycle may not be your favorite “time of the month,” but with a bit of understanding and lifestyle changes, you might be able to make it less of a nuisance.   
 

*Disclaimer: If you experience diarrhea lasting more than 2 days, have blood in your stool, or suffer from severe physical or psychological symptoms, please seek medical attention. * 

 

Sources:

• https://health.clevelandclinic.org/why-you-get-diarrhea-constipation-or-both-during-your-period/ 
• https://www.medicalnewstoday.com/articles/diarrhea-during-period#causes 
• Vasopressin and Prostaglandins in Premenstrual Pain and Primary Dysmenorrhea – Strömberg – 1984 – Acta Obstetricia et Gynecologica Scandinavica – Wiley Online Library 

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To hormone… or not to hormone… that is the question. Since birth control was invented in the 1950s, many have questioned which is better: hormone or hormone-free. If we’ve said it once, we’ve said it a million times: birth control is not one-size-fits-all. Why? Because we are all unique with different expectations, tolerances, and overall goals. If you are willing to do the extra work and take on a little more risk, non-hormonal options might work great for you! If you are looking to ensure no surprises, IUDs or hormonal options might be your perfect fit. Regardless, it is important to learn and understand all your options so you can make an educated decision.  

What Is The Difference?

Hormonal contraceptives use synthetic hormones to prevent pregnancy or treat underlying health conditions, while non-hormonal contraceptives use no hormones and are strictly used to prevent pregnancy. At some point, a strange “beef” began among the hormonal vs. non-hormonal crowd.  This has led to individuals thinking they must pick a side, and to that, we say “hard pass.” 

Hormonal Birth Control 

So, let’s start off with hormonal contraceptives, because these little gems can work wonders for a lot of people. Hormonal contraception includes the pill (combined and progestin-only), the ring, the patch, the shot, implants, and some IUDs. I’m sure at this point, you’re even more overwhelmed now that you see all of those options. But, hold on, we’ve got you covered. Our team made this fancy chart comparing contraceptive options, so you can get a better idea of your options at a glance. Yes, honey, you are welcome.  

Non-Hormonal Contraceptives 

But what about non-hormonal options, including cycle tracking and barrier methods? Good news! We have already created an overview of each proven method (spoiler alert: seed cycling is still not on that list). You can find those options and their efficacy here.

Why Do Providers Always Go to the Pill? 

The big question: Why do so many providers “push” the pill? One of the reasons is that hormonal options tend to be more reliable at preventing pregnancy than the non-hormonal options, and they are seen as more of a safe bet. 

Another major reason is that many hormonal contraceptives have benefits in addition to preventing pregnancy. Hormonal contraceptives can help control cyst development, slow the growth of endometriosis, reduce the risks of some cancers, and lessen the amount of bleeding and pain women feel during their period. They are even often used by fertility doctors to prep the ovaries and eggs before invitro fertilization (IVF). Hormonal contraceptives are like a Swiss army knife with a lot of different uses. 

You wouldn’t suffer through a cold without some medication to ease your symptoms, so why would you suffer through a painful period? Providers want to offer you a proven solution to assist bad cramps and heavy bleeding while also reducing your risk of unplanned pregnancy.

Pick a Contraceptive to Fit Your Lifestyle 

Before settling on any method, you should ask yourself (and your provider) the following questions: 

1. How do you see contraception fitting into your daily routine? 
2. What is the level of pregnancy risk you’re willing to tolerate? (The answer to this may change throughout your life, and that’s okay.)
3. Do you have other underlying health conditions? 
4. What are your side effect deal breakers? 
5. How long do you need to use this method? One year, five years, longer? 

We understand that although most providers view hormonal birth control as the first choice, just because it works for many doesn’t mean it works for everyone. That is why we educate on both hormonal and non-hormonal options. Don’t think that you need to pick a “side” between the two options.  Both might be great options at different times or circumstances in your life. So don’t throw shade at one side, because you might need other options later! If your provider isn’t listening to you about your goals, tolerance to side effects, or overall expectations, then look for someone who will listen.

It’s time to take control of your body and customize your contraceptive plan. Between all the hormonal and hormone-free options available, the list of contraceptives can seem endless. Let OvaryIt help you meet your contraceptive match. Because you deserve to make an educated decision. And you deserve all the best options.  

Additional Resources:

• Barrier Methods of Birth Control – ACOG
• Fertility Awareness Based Methods of Family Planning – ACOG

Polycystic ovary syndrome (PCOS) is a hormone disorder. It is the most common endocrine condition in females of reproductive age in the United States (US). It is also one of the leading causes of infertility in women in the US. The exact underlying cause is still unknown; however, medical professionals have discovered a genetic component. Those with other known family members who have PCOS are more likely to also have the condition. Unfortunately, approximately 5 to 6 million women (about twice the population of Arkansas) in the US still live with undiagnosed PCOS.

Symptoms: 

Symptoms of PCOS often vary widely both in the physical ailments and the severity of those symptoms.   

• Excessive androgenic effects: This includes high blood testosterone level, acne, and excess hair growth. 
• Problems with ovulation: This may include having no menstrual periods, irregular menstrual cycles, and infertility.  
• Ovarian issues: Many develop enlarged ovaries with fluid-filled sacs (cysts), leading to pain and other issues.  
• Insulin resistance: This can cause an increased risk of diabetes and heart disease.   

Testing: 

If your provider believes you have PCOS, they might order labs and testing to investigate. Some of these primary labs include: 

• Testosterone: These values are typically elevated in PCOS.
• Sex Hormone Binding Globulin (SHBG): These levels may be reduced in PCOS.
• Anti-Mullerian Hormone (AMH): These values are often elevated in PCOS.

More information might be needed, so do not be alarmed if your provider orders further tests. Sometimes the tests below are completed at the same time as the tests listed above, and other times, they are ordered afterward. 

• Follicle Stimulating Hormone (FSH): Can be normal or low with PCOS.
• Luteinizing Hormone (LH): Will be elevated with PCOS.
• Estrogens: May be normal or elevated with PCOS.
• DHEAS: These values are often elevated in PCOS.
• Androstenedione: May be elevated in PCOS.

Treatment: 

Currently, there is no cure for PCOS. Medications and treatment options usually focus on a patient’s specific symptoms, other health issues, and family planning goals. Usually, weight loss and regulation are an important part of PCOS treatment. Still, it is important to acknowledge that PCOS can also cause insulin resistance, making weight loss very difficult. This can be rightfully frustrating for many women with PCOS. Therefore, it is important to find a provider that understands the challenges and works with you to help you succeed!

Today, long-term treatment often involves using combined oral contraceptive pills or progestins to regulate the menstrual cycle and treat other PCOS symptoms. Anti-estrogen medications, other hormones, and metformin may also be used. In addition, there is some evidence to suggest that a supplement called Ovasitol, which is made of myo-inositol and D-chiro inositol, may help improve ovarian function and possibly help fertility in women with PCOS. Although many women report success with Ovasitol, more studies are ongoing, and the jury is still out. If you have PCOS and are currently trying to conceive, please know that your process might take longer, and you may need to see a reproductive specialist to help you succeed.

Sending Cysters a Hug: 

PCOS is a life-changing diagnosis and an invisible disorder, but PCOS does not have to ruin your life. With early detection, lifestyle changes, and the right medications for those who need them, you can experience major improvements. Advocate for yourself, and work with a provider that listens to you to regain control of your cycle and live a happier and healthier life! 

Additional Resources:

• Polycystic Ovary Syndrome (PCOS) — ACOG  
• Polycystic Ovary Syndrome (PCOS) — Lab Tests Online 
• Which Hormone Tests for the Diagnosis of Polycystic Ovary Syndrome? — PubMed (nih.gov) 
• Polycystic Ovary Syndrome (PCOS) Diagnosis and Treatment — Mayo Clinic 
• Effects of Myo-Inositol in Women with PCOS: A Systematic Review of Randomized Controlled Trials — PubMed (nih.gov) 

When it comes to Urinary Tract Infections (UTIs), women, unfortunately, received the short end of the stick… or urethra anatomically speaking. So what’s the deal with UTI’s? Why do they happen? How do you treat UTIs? How do you prevent them? Let’s review.

The urethra is the tube responsible for carrying urine from the bladder to outside the body. The female urethra is substantially shorter in length compared to males. A shorter urethra increases the likelihood of harmful bacteria entering and traveling its way up to the bladder to wreak havoc. By definition, a UTI is an infection of the urinary system. It can affect the bladder and/or the urethra and, in severe cases, the kidneys too.    

UTI’s are nothing to be ashamed of, though! The potential causes are nearly endless, and they are both common and uncomfortable. Usually, bacteria from vaginal, genital, or anal areas can mistakenly enter the urethra. This often occurs during sexual intercourse as bacteria from your partner’s genitals, anus, fingers, or sex toys get pushed into your urethra. So be sure to go pee after sex! This forces a lot of the bad bacteria back out that may have gotten trapped in your urethra. 

Several STIs, including chlamydia and gonorrhea, can also cause UTIs. Females with a prior history of UTI are also more inclined to develop future UTIs. Also, females who are obese, have diabetes, use spermicides or diaphragms, or have kidney stones are more likely to get UTIs.    

If you think you may have a UTI, contact your provider for a urine test. This simple test can diagnose a UTI and help the provider decide on the most effective type, dose, and length of antibiotic treatment. Treatment typically depends on the specific bacteria causing the infection and your past medical history. In addition to antibiotic treatment, over-the-counter pain medications can help alleviate some of the discomforts.    

Preventing UTIs in the first place may not be foolproof; however, there are some strategies you can easily do at home to lower your risks.    

• Staying hydrated by drinking plenty of fluids, especially water, and using the restroom when you feel the urge rather than holding it in. 
• Wipe from front to back. Unfortunately, many women do just the opposite, and that’s a great way to introduce unwelcomed bacteria to the urethra.    
• We will repeat it, GO PEE AFTER PLAYTIME!  
• Maintain proper hygiene. Anything that touches or goes into the anus (fingers, sex toys, penis) must be washed adequately before encountering your vulva/vagina area.    

UTIs are common and easy to treat for the most part. Do yourself a favor and prevent them from occurring in the first place; both you and your bladder will thank us later.   

 

What is a Urinary Tract Infection? | Symptoms & Causes (plannedparenthood.org)   

How Much Does a UTI Test & Treatment Cost? (plannedparenthood.org)  

Ahhhh, clear skin. Something that we all strive for, but doesn’t always work out. So what’s the deal, can birth control help with your acne problem? Let’s review. 

Have you ever noticed that certain weeks are better than others iwht acne? If so, your acne pattern could be trying to tell you something? Our bodies have an interesting way of trying to communicate with us. Acne around the jawline can be caused by hormones, stress, diet, and other medications. Unfortunately, women are more likely than men to get acne along their jawline and chin… awesome.

But why does this occur, and when should we expect it? Well, it turns out that these breakouts are usually due to an increase in androgens, which stimulate the oil glands in our skin. Some women notice more acne around the time of their period or the days leading up to their period as their hormone levels shift.

Good news! The hormones found in combination birth control can actually help reduce acne, and some are even FDA approved to treat acne. YAY! This is because the combination pill reduces the hormone spikes and valleys that occur. These stabilized levels decrease the release and circulation of androgens, which in turn reduces the production of sebum, giving your clearer skin. *Boom*.

The U.S. Food and Drug Administration (FDA) has approved some combination pills for the treatment of acne; these include Beyaz, Ortho Tri-Cyclen, and Yaz. But this does not mean that these are your only options. Since all combination pills are known to level out hormones, most will have a positive long-term impact on acne. Things to remember or consider when looking to treat your acne with birth control:

• Some physicians are not comfortable in prescribing birth control. Why? It is complex and unless you are up to date with the most common practices, guidelines, screenings, and treatments, it can be extremely difficult to find your contraceptive match.
• If you have tried multiple types of combination pills, tell your healthcare provider what you liked or did not like about each. This might provide them a roadmap of what works best with your body.
• Tell your healthcare provider about any new goals or expectations that you may have about using the pill as an acne treatment.
• Since there are many different types of pills, tell your provider that you want a low androgenic option. This will decrease your body’s creation of sebum, often leading to a decrease in acne.

If your provider is comfortable prescribing birth control for acne treatment, this may be a great place to start. Be sure to tell them about your contraceptive history and goals. If you have an adverse reaction, don’t give up, and give your provider the feedback. If you get frustrated, remember that birth control is not a one-size-fits-all solution, and not all healthcare providers have the same level of knowledge on the subject. 

You are likely to get the best results if you find a healthcare provider that specializes in birth control and is willing to work with you to find your perfect fit.

https://www.healthline.com/health/jawline-acne#causes

https://www.mdedge.com/dermatology/article/132746/acne/oral-contraceptives-acne-treatment-us-dermatologists-knowledge

https://www.ncbi.nlm.nih.gov/books/NBK279209/