1. What are the types of hormones in the female body?

Most of the hormones secreted in a woman’s body are related to reproductive function either directly or indirectly. Those that are directly linked to reproductive function are called the sex hormones. A woman’s  ovaries produce hormones like oestrogen and progesterone and their precursors and by-products directly contribute to female reproductive function. It may be surprising to note that a woman also produces testosterone and its byproducts.  These are typically male hormones. The interplay of the adrenal gland and the ovary results in the male set of hormones. Luteinising Hormone and Follicle Stimulating Hormone are produced by the Pituitary gland. This gland is actually the Master Conductor of the orchestra of the hormonal play and replay in the female body where every hormonal note has to be synchronised to allow a smooth functioning of the female reproductive system. The sudden increase in height, development of breasts and pubic hair heralds the initiation of the prepubertal girl into a beautiful woman. There are some other distinctive hormones which are  linked to the female reproductive system indirectly. These are Thyroid Stimulating Hormone, Prolactin and Cortisol. Their interplay allows this synchrony to be achieved for events like the initiation of the first periods, the rhythm of the menstrual cycle, the process of ovulation, fertilisation and implantation of the embryo, the early pregnancy and its continuation to labour, lactation and the postpartum period. These hormones even control the woman’s mood!  So if a woman refuses sex with her husband saying, “Not tonight darling - I have a headache,” we can blame it on her hormones! There are important pregnancy hormones  Human Chorionic Gonadotropin (hCG), Oxytocin and Vasopressin. hCG helps the early embryo to implant and its further secretion allows the pregnancy to proceed smoothly. Oxytocin is important for the initiation of labour and is often called the ‘Love hormone!’ It  is linked to life satisfaction levels and a woman’s happiness. The other happiness and reward hormones are Dopamine and Serotonin. Endorphins reduce feelings of pain and sadness. These increase following exercise and that is why we feel very satisfied and happy after a good workout.

Hormones like Insulin are very important in maintaining weight and the equilibrium in a woman’s body. Other hormones like leptin, Adiponectin, and Ghrelin play an important role in hunger, satiety and weight gain or loss.

2. How do female hormones impact the menstrual cycle?

Estrogen is the female hormone that fluctuates over the course of a woman’s menstrual cycle. In the follicular phase of the cycle there is a gradual increase in the levels of estrogen  which allows the uterine lining to build up every month in preparation for pregnancy, Progesterone usually rises after ovulation. If implantation occurs both oestrogen and progesterone rise. In the absence of a pregnancy these hormones dip. The uterine lining is no longer supported. It thins down and sheds, resulting in menses.This cycle is repeated most of the times like clock work and results in a period every month. In fact some women say that they can can set the calendar to clock work precision based on the onset of their periods!

3. Describe how hormones are impacted during follicular phase, Ovulation, Luteal phase and menstruation?

Follicular Phase: This is the longest phase of the menstrual cycle. It lasts from 14 to 21 days. During this phase, FSH from the pituitary stimulates the ovaries & the oocytes start maturing. Due to the complex interplay of hormones, only one oocyte is released during ovulation. The end of this phase heralds the fertile period.

Ovulation: When the level of estrogen is sufficiently high, it produces a sudden release of LH, usually around day 13 of the cycle. This LH peak triggers a cascade of events within the follicles that result in the final maturation of the egg and follicular collapse with egg extrusion. Ovulation takes place 28 to 36 hours after the onset of the LH surge and 10 to 12 hours after LH reaches its peak.

Luteal Phase: The second half of the menstrual cycle, begins with ovulation and lasts approximately 14 days — typically 12 to 15 days. The ovulated follicle forms the corpus luteum.During this period, changes occur that will support the fertilized egg. The hormone responsible for these changes is progesterone, which is manufactured by the corpus luteum. Under the influence of oestrogen and progesterone, the uterus begins to create a highly vascularized bed for the fertilized egg.

If a pregnancy occurs, the corpus luteum produces progesterone until about 10 weeks of gestation. If no embryo implants, the circulating levels of hormones decline with the degeneration of the corpus luteum and the shedding of the lining of the uterus (endometrium), This results in bleeding.

Menstruation: Menstruation is driven by hormones. In the absence of a pregnancy, steroid hormone levels begin to fall due to the declining corpus luteum function and ultimately its demise. The lining of uterus breaks down and sheds. Menstruation is triggered by falling progesterone levels and is a sign that pregnancy has not occurred. It has been described poetically as ‘the weeping of the uterus.’

4. What are some measures that can be taken to balance the hormones during the menstrual cycle?

A hormonal imbalance can cause the absence of ovulation or a delayed ovulation. The cycles may also be irregular due to weight gain or weight loss. Mental stress increases the stress hormones like prolactin. The increased levels of Prolactin can cause irregular cycles. Excess of LH and some male hormones like testosterone can make the cycles irregular and anovulatory and predispose the woman to a breakout of pimples around the period time. These can also contribute to increased hair around the face, chin, breasts and the abdominal area. Some hormonal imbalances can be temporary while others can become chronic.

While many hormonal imbalances are not always preventable, there are certain things one can do to optimize overall health and also reproductive health. Medical interventions like hormonal therapy, anti-diabetic medication, ovulation enhancing medication may be recommended.  Eating a balanced, healthy diet, maintaining a healthy weight, exercising regularly, managing your stress levels, getting enough good quality sleep, managing any chronic health conditions, quitting smoking or tobacco products, maintaining strong friendships and bonding with family and friends all help. A loving partner can contribute tremendously to a woman’s reproductive health. In life, don’t sweat about the small things, instead express gratitude and be compassionate to yourself.