A few weeks ago I started a series on what's causing hormonal symptoms like painful cramping and heavy periods. You can read the first installment on the liver’s role in hormonal imbalances in a blog post here.
This week we’re continuing the conversation but turning our attention to BLOOD SUGAR (a personal fave of mine, as you know!).
Blood sugar imbalances can impact MANY different systems from our thyroid, to immune system, stress reliance and sleep, cognitive health and of course, sex hormones! Sex hormones tend to be what we think of when we talk about “hormones”: estrogen, testosterone, and progesterone.
Blood sugar has a major impact on sex hormones, in part because blood sugar itself is controlled by hormones (and hormones can “compete” or disrupt each other, as you'll soon learn!). The hormones primarily controlling blood sugar are insulin and cortisol.
Insulin
Blood sugar imbalances means we’re frequently spiking blood sugar, and when blood sugar spikes it means insulin is high too. Insulin helps our body use glucose and bring glucose into the cell to be turned into energy. However, we don’t want insulin levels to be too high, too long, or too frequently. This can lead to physiological changes in how our bodies communicate in other ways, like with our sex hormones.
In women, high insulin increases testosterone production from the ovaries. This is part of how PCOS works, but even those without a PCOS diagnosis still experience insulin raising testosterone levels because of how the ovaries respond to insulin levels [NHS].
High testosterone is then converted into estrogen by a process called “aromatization”. This conversion from testosterone to estrogen can happen in both men AND women. So higher levels of testosterone, due to ovaries over-producing in a high insulin environment, turns into high levels of estrogen.
High estrogen is one of the driving factors of painful, heavy, symptomatic periods. Estrogen tells the uterine lining to grow more. A thicker uterine lining can lead to more intense cramping, and more shedding or bleeding as a result.
Cortisol
Another key hormone to consider with hormonal symptoms and blood sugar imbalances is cortisol.
Cortisol is often thought of as a “stress” hormone, but it’s involved in blood sugar regulation too. When our blood sugar levels get too low, like after a spike in glucose, our bodies over-correct with high insulin and we end up with too little glucose in the bloodstream.
Our brain detects low blood sugar levels and sends out an alarm. Low glucose is a BIG deal to the body, and it responds with a cascade of stress hormones to release glucose that’s stored in the liver and muscles in order to raise blood sugar back up to safe levels.
The problem is that the wave of stress hormones used to raise blood sugar can disrupt other communication happening in the body. Cortisol and adrenaline are “priority” hormones in the body. When cortisol is pumping, other systems are de-prioritized. Things like our sex hormones and fertility, certain aspects of the immune system, thyroid function, and sleep are all de-prioritized until the body reaches balance again.
Cortisol also increases inflammation, which is a big driver of intense PMS and painful, heavy periods as well. In smaller amounts cortisol is anti-inflammatory and kicks off the healing process, however in our modern “chronic stress” lives prolonged exposure to high levels of stress and cortisol lead to chronic inflammation.
Inflammation is controlled by compounds called prostaglandins, which are the same compounds that are released to initiate cramping to shed the uterine lining. Higher levels of prostaglandins are associated with more severe cramping and period symptoms [Mayo clinic].
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Avoiding glucose spikes is important to minimize the impacts of high insulin, but it’s also important to avoid the lows because of what we know cortisol does to our hormones.
The good news is that by minimizing the highs, we often prevent the lows too!
Let’s talk strategy to support blood sugar in the kitchen:
Protein with every snack or meal (and no, a handful of cashews or a crumble of feta on your salad probably doesn’t meet your protein needs!)
Protein + veggies should be the biggest part of your plate, with a smaller ~½ cup serving of starches rounding out a balanced plate
Start your meal with veggies and end it with the starches or sweets. This isn’t a fool-proof way to “cancel out” a big bowl of pasta or a large ice cream cone - but this can help soften the spike of the modest amount of complex carbs (see #3 above) you are eating, like starchy veggies, fruit, legumes or whole grains
Avoid eating starches and sweets on an empty stomach (granola bar, muffins, ice cream, bagel, juice, etc.)
Start with those basics! If you can nail those, you’re well on your way to reaping the benefits of stable blood sugar: steady energy, deeper sleep, less brain fog, reduced inflammation and puffiness, and brighter skin.