Keeping our hormones balanced is such a critical component of our health and wellbeing. Our hormones function as messengers between systems helping to regulate so many bodily functions, from our physiology to our behavior, digestion, metabolism, respiration, tissue function, sleep, stress, reproduction, and even our moods. Everyone can experience a hormonal imbalance at some point in their lifetime. Disrupted hormones can cause weight gain, menstrual cycle disturbances, skin-related issues, mental health issues, and a poor quality of life. If you are experiencing hormone fluctuations, it may be time to look into hormone testing. It's important to note that all things in the body are connected. When dealing with an imbalance in the body, a multifaceted approach is vital for it to work in harmony with itself.

We spoke to Alannah Slingsby, CEO of Moment Health, a virtual healthcare clinic that tests and treats hormones from a whole-body-whole-person approach from the comfort of your own home. Alannah talks to us about the benefits of bioidentical hormones and how her clinic's formulas differ from traditional products out there. She also shares how hormonal support can be critical for those going through different stages of life, how your thin skin and wrinkles may be related to hormonal imbalances, and she gives us her top wellness hacks we can incorporate to support our overall hormonal health. 

Tell us a little more about Moment Health and the type of services you offer. 

MOMENT turns aging on its head. It is a protocol used by women to solve hormone imbalances and health. Being human means facing life's inevitable ups and downs, even when it comes to hormones. Each stage brings potential issues. For some, it's fatigue and mental fog; for others, it's hot flashes and irritability. But you don't have to suffer alone. We can solve many of these issues with natural and effective hormone solutions, plus a personalized care plan that focuses on the whole person because you are more than just your hormones. 

Every woman deserves to feel empowered, healthy, and ready to pursue all the wonders of life throughout her life. And that's why we built MOMENT, to give women the tools they need to live life to the max. What makes us different is we achieve hormone balance through proven at-home tests, safe hormone solutions, nutrition and lifestyle support, anti-aging solutions, and cancer prevention techniques. 

What are bioidentical hormones, and who is a good candidate for them? 

Bio-identical hormones are compounds that exactly match the natural hormones in your body. It describes the biologically identical molecular formula born by bio-identical hormones. It is a term that makes the critical distinction between bio-identical hormones and non-biologically identical or synthetic hormones. 

All bio-identical hormones used are chemically similar to human hormones. Women with some sort of hormone imbalances tend to benefit the most from this hormone replacement. However, not all hormones are the same. Replacing the body with biogenetical progesterone is different from bioidentical estrogen. Working with a practitioner who understands these nuances is vital to utilize this cutting-edge therapy properly. Women seeking recovery from PMS, irregular periods, heavy periods, endometriosis, fibroids, estrogenic cancers such as breast, ovarian, and uterine, fibrocystic breasts, weight gain, postpartum depression, thyroid nodules, menopause, and perimenopause, tend to be good candidates for bioidentical hormone therapy. 

How do the hormone formulations you offer differ from others out there? 

Our hormone formulations do not use added color dyes. Some inactive ingredients in Prometrium (bioidentical progesterone) include D&C Yellow No. 10 and FD&C Red No. 40. Red dye 40 is an artificially produced product made from petroleum and oils. It blends with foods to add a red color. It is one of the most common food additives in the US, and some people can experience adverse reactions to food additives, even in amounts considered safe. 

Red Dye 40 has been associated with migraines, worsening attention-deficit/hyperactivity disorder (ADHD) symptoms, and a possible risk of cancer. Research suggests that an immune hypersensitivity to chemical components of artificial food dyes could be the underlying cause of the behavioral symptoms that some children with ADHD experience associated with consuming these dyes. 

Also, MOMENT does not use peanut oil in our treatments. One of the adverse effects of peanut oil is that peanuts are a highly allergenic food. Furthermore, in studies, a high fructose (sugar) diet with peanut oil (high omega-6) led to fatty liver and dyslipidemia (Nature 2018). We use custom formulations. Not every woman is the same or has the same symptoms, so we customize each treatment plan and hormone therapy to precisely the dosage a woman needs to match a physiological level that can help her symptoms. 

How can hormonal support help women who are going through menopausal symptoms? 

Almost all women will experience some symptoms during menopause. However, the duration and the severity of the symptoms you experience will vary. During menopause, there are a number of hormonal changes that occur that can influence hot flashes, including: 

• Less progesterone and estrogen production. Menopause means that ovarian production of estrogen declines to levels that do not induce a menstrual cycle. Estrogen is still getting made in skin cells and fat cells. In the US, it is typical for women's progesterone production to be near zero at least six to eight years before actual menopause. It's all about ratios! When the ratio of progesterone to estrogen is off, the entire body is off. 
• A decline in thyroid function. 
• Lower testosterone production. 

Bioidentical hormones can help to balance the hormones, especially the ratio of estrogen to progesterone. Bioidentical hormone replacement therapy can effectively replace the hormones that your body is not producing anymore. By balancing out these depleting hormones, the woman's body can effectively offer relief from the negative symptoms that might be occurring. Bioidentical hormone replacement therapy can increase hormone levels in a woman's body. This means that this type of hormone therapy can reduce other health risks or conditions, such as the reduction of colon cancer and diabetes. 

What are the top ways to support postpartum hormonal imbalances? 

Many women face the postpartum hormone crash, but many clinical experiences show this can be treated effectively. 

The first step is measuring your hormones. Without measuring the actual hormone changes associated with pregnancy and postpartum and the behavioral symptoms that ensue, there is no way to recognize or treat postpartum withdrawal syndrome or syndromes. Measuring your hormones is essential to understanding your body and should not be ignored. 

Here are a few other tips that may help solve postpartum changes: 

• Bioidentical progesterone supplementation may help. Many women benefit from 100mg 2x a day and are taken at times that correlate with the menstrual cycle, i.e., after ovulation. 
• Eating enough calories. 
• Eating nutrient-dense foods. 
• Targeted supplementation like zinc, magnesium, and vitamin D. Zinc deficiency and high copper levels are commonly associated with postpartum depression, anxiety, emotional instability, racing mind, insomnia, low libido, blood sugar dysregulation, inability to engage in relationships, and blunted emotions and perception. 
• Daily and regular sun exposure for mood elevation. 

What is the connection between hormonal imbalance and wrinkles? How can we support this?

Our skin is not an independent organ. The product of hormones in the skin impacts our health, including the immune system! 

Thinning and wrinkled skin is a sign of lack of hydration in the skin. It is common in peri– and postmenopausal women and is often a sign of hormone depletion. 

Transdermal natural progesterone can be used as a skin moisturizer. When used as a skin cream, progesterone is well absorbed and can help restore skin hydration. Many patients notice a more youthful appearance and reduced presence of wrinkles. 

Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women show "…

that topical 2% progesterone acts primarily in increasing elasticity and firmness in the skin of peri- and postmenopausal women. These effects, combined with good tolerability, make progesterone a possible treatment agent for slowing down the aging process of female skin after menopause,” (Br J Dermatol 2005). 

Testosterone is also linked to improved skin appearance. "…The male hormone, testosterone, has a rejuvenating or ameliorative effect when applied to aging human skin,” (Effect of Topical Hormones on Aging Human Skin). 

DHEA may also improve the skin. Rats were treated for nine months with local topical application of DHEA compared with oral conjugated equine estrogens. The rats treated with DHEA showed "significant changes in all skin layers,” (Horm Mol Biol Clin Investig 2010). 

Another study noted, "…it is well known that the skin undergoes regressive changes after menopause and that these changes are mainly related to a loss of skin collagen content. The potent stimulatory effect of topical DHEA reflected by an increase in the number and size of dermal fibroblasts and the expression of procollagen types 1 and 3 suggest the possibility that topical DHEA could be a useful antiaging agent in the skin,” (BR J Dermatol 2010). 

The skin and hormones are intimately tied and human skin even produces and metabolizes sex hormones. Given all the functions hormones play regarding the skin, it makes sense that it could be related to hormone production when the skin is acting up. Furthermore, hormones may be considered a treatment for specific skin issues, including aging. 

How is hair loss connected to hormonal imbalances? 

Patients with hair loss often have excess levels of the stress hormone cortisol. Cortisol is an emergency stress hormone. In stress, almost all our hormonal precursors go into the production of cortisol, and there are fewer precursors for the production of the hormones that promote hair growth, including progesterone, testosterone, and DHEA. Cortisol and prolactin both increase during stress. 

When progesterone levels fall, the body often responds by increasing the production of corticosterone and androstenedione, which are both implicated as causative factors in hair loss. Stress hormones can cause hair follicle stem cells to stay in an extended resting phase without regenerating tissue. 

In addition, Robert Smart, a North Carolina State University researcher, reported that the female hormone estrogen could harm hair follicle growth. 

That said, estrogen is a hormone that stimulates cell division (mainly in the breast, uterus, prostate gland, and pituitary gland) and is normally produced in a monthly surge at the time of ovulation and during pregnancy. Women normally have higher levels in their blood than men do. 

The hormone estrogen was found to be elevated in those with pattern baldness [7]. Another "EFA" breakdown product, prostaglandin E2, increases the activity of the enzyme aromatase, which makes new estrogen [8]. Additionally, free fatty acids, mainly when unsaturated, facilitate the entry of estrogen into cells, possibly by lowering levels of sex hormone-binding globulin (SHBG), [9,10] whose function is to bind and keep estrogen out of cells and in the blood. Estrogen also increases the pituitary hormone, prolactin [11,12], which slows the metabolic rate [13], is associated with baldness [14], and is involved in many other problems. In one study, prolactin mimicked "androgen-induced skin symptoms,” [15]. 

When progesterone levels are raised by bioidentical progesterone, the androstenedione level will often gradually fall, and normal hair growth eventually resumes. Since hair growth is a slow process, it may take four to six months for the effects to become apparent. 

Five clinical studies showed positive effects of a topical melatonin solution in treating androgenetic alopecia in men and women while showing good tolerability. An observational study involving 30 men and women showed a significant reduction in the severity of alopecia after 30 and 90 days. 

One animal study showed topical T3 dramatically stimulated hair growth. Mice that received 3.8 microg of T3 had 42% more hairs per millimeter and hair length that was 1,180% longer. Topical thyroid is a known safe and effective therapy for other ailments in the body, and may be considered for hair loss treatments. 

How is high estrogen responsible for mental health-related illnesses? 

Many researchers believe hormonal imbalance is an under-recognized cause of low mood and depression. 

High estrogen levels in the body may be responsible for mental health-related illnesses. Estrogen is a hormone related to the development of breasts and the menstrual cycle, but is also linked to cell proliferation and cancer at high levels. 

One study showed that estrogen amplified the stress response in areas of the brain most closely identified with depression and other stress-related mental illnesses (J Affect Disord, 2003). 

Why? Because estrogen may increase stress sensitivity (Mol Psychiatry, 2004). This animal study states, "Female rats were impaired by lower doses than males during proestrus (high estrogen), but not during estrus (low estrogen). Similarly, ovariectomized females showed increased stress sensitivity only after estrogen replacement. These results suggest that estrogen amplifies the stress response in PFC, which may increase susceptibility to stress-related disorders." 

Furthermore, several other studies show estrogen-treated females are impaired at extinguishing a previously conditioned fear response (Toufexis et al. 2007), an effect that has also been reported in cycling women (Milad et al. 2006). 

High exposure to estrogen may explain why women are twice as likely to suffer from depression as men. 

Can you explain what the thyroid-estrogen connection is? 

Healthy thyroid levels are crucial to progesterone production because it actively converts cholesterol to pregnenolone. Pregnenolone is the precursor to progesterone. 

If estrogen is too high, it can prevent the thyroid from secreting the thyroid hormone and can inhibit the conversion of T4 (the inactive form of the thyroid hormone) to T3 (the active form of the thyroid hormone). High blood levels of estrogen signal to the liver to increase the production of thyroid-binding globulin (TBG). This inhibitor protein binds to the thyroid hormone, reducing the amount of T3 and T4 available for use by cells (Silva, J. Biology of Reproduction). 

Why would the thyroid be low in the first place? Studies show the more stress an organism is under, the more thyroid dysfunction (Ranabir, S. Indian J Endocrinol Metab. 2011). As we age, we encounter more stressors. The thyroid will go down when a person is stressed because the metabolism needs to reserve energy. This is an adaptation and protection mechanism. 

Another strategy to solve low thyroid is with a replacement thyroid solution of both T3 and T4. Thiamine has also been shown to support thyroid levels. Thiamine deficiency among thyroid sufferers is rampant. Thiamine deficiency tends to go hand in hand with individuals with thyroid problems. It’s one of the B vitamins known as B1. 

What are your top wellness hacks we can all practice today to support our hormonal health?

1. Eat nutrient-dense foods. Cholesterol is the raw material for all sex steroids. Without healthy cholesterol levels, our body cannot make hormones. This also helps keep a healthy body weight which is imperative to keep estrogen at normal levels. 
2. Go outside! Progesterone and testosterone tend to be lower in the winter, insinuating the major role sunlight plays in synthesizing hormones. I cannot stress the numerous benefits of getting adequate sunlight to improve hormonal synthesis, circadian rhythms, and sleep patterns and instantly (as soon as the sun hits the retina of your eye) IMPROVE ENERGY. This is the most effective way to start your day when you wake up. 
3. Keep stress low. Cortisol can be elevated due to stress in relationships, excessive cardio, under-eating, trauma, illness, financial worries or concerns. Consider natural progesterone and magnesium. Magnesium deficiency is directly linked to low thyroid production and low energy. 

When thyroid hormone conversion is low, it results in increased cortisol production, which further depletes your body of magnesium, and further robs you of energy. 

4. Measure your hormones! If you don't measure your hormones, you can't manage them.

References: 

Holzer G, et al. Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women: results from a double-blind, vehicle-controlled, randomized study. Br J Dermatol. 2005 Sep;153(3):626-34.

Shors T, Leuner B. Estrogen-mediated effects on depression and memory formation in females. J Affect Disord. 2003 Mar;74(1):85-96. 

Shanksy, R et al. Estrogen mediates sex differences in stress-induced prefrontal cortex dysfunction. Mol Psychiatry. 2004 May;9(5):531-8.

Silva, J. Thyroid hormones and female reproduction. Biology of Reproduction, Volume 99, Issue 5, November 2018, Pages 907–921.