Eating for Hormonal Health: Does it work?

Written By Maria Miracle

Everyone wants to know: does eating for hormonal health actually work? TLDR it’s complicated but promising. HI Advisor Dr. Tosin Sotubo-Ajayi guides us through the intricate relationship between food and hormonal health.

Eating for hormonal health isn’t about incorporating one specific nut, seed, fruit, or vegetable into your diet. It’s about packing your plate with a diversity of nutrient-dense ingredients. Nutrition is emerging as a pivotal environmental factor shaping both the endocrinological landscape and reproductive health. By closely examining what occurs throughout the menstrual cycle, we can gain a better understanding of our nutritional needs.

Dr. Tosin Sotubo-Ajayi is a GP with established experience working in both primary and secondary care with a special interest in women's health, preventative medical care and health technology. She was selected as a UK NHS Clinical Entrepreneur in 2019 for her focus and interests on the intersection between healthcare and technology and its impact on healthcare outcomes. She has since had established experience working as a Medical Advisor and as a Clinical Lead across various digital health platforms, including serving as Senior Medical Advisor for Flo Health. She joined HI Foods in 2024 as a Founding Advisor.

THE CYCLE: A QUICK REVIEW
The menstrual cycle is notoriously variable, with the average cycle lasting 28 days, though a range of 21-35 days is considered normal. The menstrual cycle can be divided into two phases: the follicular phase and the luteal phase.

FOLLICULAR PHASE
The follicular phase typically lasts 1 to 14 days of a 28-day cycle, although this varies with the length of the cycle. The primary hormone during this phase is oestrogen, which gradually increases and peaks just before ovulation. Due to this rise in oestrogen, the follicular phase is often associated with a gradual increase in energy and mood.

Antioxidants
Antioxidants are molecules that protect your body from the effects of harmful molecules called free radicals. These molecules are crucial during the follicular phase, as they help reduce inflammation and support the immune system, which is important for ovulation. As oestrogen levels rise, the body’s need for antioxidants increases to protect cells from oxidative stress (an imbalance between the harmful free radicals and protective antioxidants in the body). Foods rich in antioxidants, such as berries, nuts, and a range of vegetables such as broccoli, spinach, carrots and sweet potatoes can be beneficial.

Macronutrients
Macronutrients are the main nutrients the body needs in large amounts for overall function. There are three main types of macronutrients: carbohydrates, proteins and fats.

Research has shown that during the follicular phase, the body favours carbohydrates for energy over fats or proteins whereas conversely later on in the menstrual cycle during the luteal phase there is a stronger preference for fat utilisation especially during periods of exercise. Complex, low-GI carbohydrates like whole grains, legumes, and vegetables provide sustained energy during this period and can also help regulate blood sugar levels. As oestrogen levels rise, it is also essential to maintain a diet rich in fibre to support oestrogen metabolism. Whole grains, legumes, fruits, and vegetables are all key in this process.

Iron 
Iron is an essential mineral required for everyday functions such as energy metabolism, cognitive function, immune health, and the production of red blood cells, which transport oxygen throughout the body. Women, particularly those of childbearing age, have nearly double the iron requirements of men. When blood is lost during menstruation, the iron within those red blood cells is also lost. A lack of iron means the body can’t make enough red blood cells to carry the oxygen and this can lead to iron deficiency anaemia,  resulting in feelings of  tiredness, weakness, shortness of breath and difficulty concentrating. Women who experience heavy periods are at an even greater risk of developing iron-deficiency anaemia. This is a problem experienced by women globally with menstruation being the most common cause of iron loss worldwide. A study in 2011 reported approximately 29% of non-pregnant women and 38% of pregnant women aged 15–49 were reported to be anaemic.


LUTEAL PHASE
The luteal phase, the second half of the menstrual cycle, starts after ovulation and lasts until the onset of menstruation. During this phase, the body prepares for a potential pregnancy, with progesterone levels rising. If pregnancy doesn’t occur, progesterone levels fall, triggering the shedding of the uterine lining, leading to menstruation. In simple terms, the luteal phase is when the body shifts towards either pregnancy or menstruation. Premenstrual syndrome (PMS) can commonly be experienced during this time with around 75% of women experiencing PMS during their reproductive years. PMS refers to the physical and psychological symptoms that a person may experience before their menstrual period, with common symptoms include bloating, breast tenderness, and mood changes.

During the luteal phase, nutritional needs are influenced by the increase in progesterone which can impact metabolism, appetite, and mood. Understanding specific nutrients that the body requires at this time can help support the body’s needs.

Omega-3s
The body’s metabolism increases during the luteal phase and there is a stronger preference for fat utilisation over carbohydrates. As progesterone levels rise to maintain the uterine lining, it is important to consume healthy fats like omega-3 fatty acids such as those from fish, nuts and other nutrient-rich foods.

Magnesium
Similarly to the follicular phase magnesium is also important during the luteal phase and it has been shown to help ease PMS symptoms like bloating, cramps, and fluid retention.

Vitamin B6
Vitamin B6 is an essential vitamin involved in regulating neurotransmitters (the body's chemical messengers) including serotonin and dopamine production, both of which are important for mood regulation. Some studies indicate that vitamin B6 might help reduce PMS symptoms and the NHS acknowledges this, but the findings are mixed, and more well-conducted research is needed to confirm its effectiveness. Foods rich in vitamin B6 include poultry, fish, bananas, potatoes, and fortified cereals.


MORE IS MORE
Understanding and addressing nutritional needs throughout the menstrual cycle and beyond is important for supporting hormonal health and overall well-being in women. Diet can be an essential modulating factor in reducing and managing PMS symptoms, and as research into female health progresses, we will continue to provide quality information to help women and girls make evidence-based decisions regarding the maintenance of their health.

References

  1. Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Blackman MR, et al., South Dartmouth (MA): MDText.com, Inc.; 2000

  2. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Peña-Rosas JP, Bhutta ZA, Ezzati M, Group NIMS. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16–25.

  3. Matsuda T, Ogata H, Kanno M, Ishikawa A, Yamada M, Sakamaki-Sunaga M. Effects of the menstrual cycle on oxidative stress and antioxidant response to high-intensity intermittent exercise until exhaustion in healthy women. J Sports Med Phys Fitness. 2020 Oct;60(10):1335-1341. doi: 10.23736/S0022-4707.20.10868-5. Epub 2020 Jun 18. PMID: 32550716.

  4. Rogan MM, Black KE. Dietary energy intake across the menstrual cycle: a narrative review. Nutr Rev. 2023 Jun 9;81(7):869-886. doi: 10.1093/nutrit/nuac094. PMID: 36367830; PMCID: PMC10251302.

  5. Zengul AG, Demark-Wahnefried W, Barnes S, Morrow CD, Bertrand B, Berryhill TF, Frugé AD. Associations between Dietary Fiber, the Fecal Microbiota and Estrogen Metabolism in Postmenopausal Women with Breast Cancer. Nutr Cancer. 2021;73(7):1108-1117. doi: 10.1080/01635581.2020.1784444. Epub 2020 Jun 26. PMID: 32590914; PMCID: PMC7875566.

  6. Gao M, Gao D, Sun H, Cheng X, An L, Qiao M. Trends in Research Related to Premenstrual Syndrome and Premenstrual Dysphoric Disorder From 1945 to 2018: A Bibliometric Analysis. Front Public Health. 2021 Apr 21;9:596128. doi: 10.3389/fpubh.2021.596128. PMID: 33968873; PMCID: PMC8096922.

  7. Cable JK, Grider MH. Physiology, Progesterone. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.

  8. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. PMID: 22069417; PMCID: PMC3208934.

  9. Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999 May 22;318(7195):1375-81. doi: 10.1136/bmj.318.7195.1375. PMID: 10334745; PMCID: PMC27878.

  10. NHS. (2023). Premenstrual syndrome (PMS). NHS. Retrieved September 10, 2024, from https://www.nhs.uk/conditions/pre-menstrual-syndrome/.

Maria Miracle