You made it! Beyond forty years of age and still kicking. Here’s hoping that you experienced more good days than bad days, and more joy than, well, less joy. As you look at where you are and where you would like to be, occasionally you may find that some of that special stuff that made you who you are, has seemed to slip recently.

No, you are no less of a woman. No less of a person and certainly of no less of value. You are however, the result of the sum total of the work, energy and emotional giving you have manifested over the years of your life.

Picture yourself back in high school gym class. Yes, of course, ugly uniforms and all. The class is instructed to perform the dreaded arm circles exercise! You start out well, making those concentric circles in tight spirals. Then after a time your arms tire. They ache, weaken, and begin to drop lower. Glancing at the teacher you sneak your arms even lower until they dip below the half-way point. Just as you feel some relief, what happens? The gym teacher bellows at you to “get those arms back up!” Thwarted, you return to the seemingly unending achy, painful, and fatiguing exercise.

That’s a bit like life, right? Weekends or evenings that should be restful and restorative end up with children, family, and work activities. Never a moment of peace to let your body, emotions and yes, your hormones come back into balance.

During the fight or flight response of a zebra chased by lions, stress hormones are released in a surge, and then the surge stops and levels return to normal within ten minutes. Why? Because in that ten minutes the zebra has either escaped or become lunch. Ouch! Likewise the lion either loses or captures lunch. The question to my patients is often, “How many minutes a day do you run from the lions?” The answer varies from a knowing smile, to tears.

Negative effects on overall hormonal imbalance and neurotransmitters can happen as a result of everyday, lifelong stressors. These imbalances do not require severe trauma. Adrenal glands, which sit astride each kidney, release cortisol during stress. Cortisol breaks down protein to provide energy for a stress response. This includes keeping you alert but robbing you of sleep, as well as contracting muscles but leaving you with muscle spasms.

This constant fueling of cortisol takes its toll by increasing weight and tearing down the body. Guess what? Cortisol is made from progesterone! That same hormone that comes from ovulation and balances estrogen provides the raw material for a stress hormone. It’s no wonder as your stress mounts, and cortisol rises and progesterone falls, that you begin having symptoms of too much estrogen.

Reduced progesterone to estrogen ratios have been linked to menstrual pain, spotting, bleeding, and excessive clotting. Also swollen/tender breasts, insomnia, irritability, mood swings, low self-esteem, low libido, and fluid retention may be symptoms of reduced progesterone. Many times people attribute these symptoms as a “normal” part of life, but it doesn’t have to be!

Hormonal imbalances of progesterone, estrogen, and cortisol also may often exhibit symptoms that may appear as depression. This is not to say that treatment by a professional for depression may not be warranted. However, it makes sense that an evaluation of hormonal balance by a trained professional should also be added to any evaluation of depression in women and men over forty.

When working with a knowledgeable professional, hormones can be measured, and a treatment plan complete with monitoring can be established. Coupling this with diet, exercise and stress modification strategies, allows you to return to an enjoyable and enriched life.

Roger Spahr, M.D.

Advanced Integrative Physicians


11350 N. Meridian Street, Suite 220, Carmel, IN 46032


Phone: 317-200-3840

Fax: 317-870-1013

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