Women’s Hormonal Wisdom Through Life Stages

# Women's Hormonal Wisdom Through Life Stages
### Dr. Erin Stokes, ND — Rancho La Puerta

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## Women's Hormonal Health Has Been Left Behind

**Dr. Erin Stokes:**
Thank you for joining me on this big topic around women's hormonal health through the ages. One thing I wanted to start with is the conversation around women's health and hormonal health. Whether you're talking about whatever decade you're in, this subject really has not gotten a lot of attention. I can see a lot of nodding heads. It's definitely been in the back seat.

But the good news is that this conversation is shifting. Have you all started to notice — starting with Oprah, Halle Berry, and many more — great doctors and healthcare practitioners of all kinds, and influencers, really bringing this to the forefront? Because this is a conversation we need to have.

Part of my intention in bringing this to Rancho La Puerta is to move this conversation forward and to give us an invitation to take it out of the back seat and into the front seat. You might ask, "Well, how do I do that? How do I influence policy?" And I think a big part of that is putting ourselves front and center — whatever that means, however it looks. We're all at different places, phases, and stages of life. But I think often, as women, social and cultural norms have kept us in the back seat.

So I just invite you — as you're here this week in contemplation, reflection, and stress reduction — to think of ways you can put your whole health, and particularly your hormonal health, first.

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## About Dr. Erin Stokes

I'm Erin Stokes. I'm a naturopathic doctor, and I have been for over 20 years. I had a private practice for many years, and my specialty was very much around women's health — a broad topic. I worked with a lot of women postpartum, through perimenopause, through all different stages.

Over time, I started using my voice more and more out in the world to educate. I was an instructor at Southwest Acupuncture College. I started speaking regularly, and I realized that what I'm supposed to do is use my voice to help people — with both the knowledge and the inspiration to make healthy changes in their lives.

So today we're going to talk about wisdom through life stages. A couple of people have said to me, "Well, I'm not really cycling anymore — how is this going to be impactful for me?" And I want to share one important point right off the bat.

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## Hormones Don't Stop at Menopause

When we go through menopause, we don't completely stop making hormones. *(Pause for show of hands.)* Okay. When we go through menopause, we stop having our cycle. And it's through our cycle that — we're going to talk about this in a moment. Understanding this may be a review for many of you, but the past informs the future.

Through cycling, our ovaries are producing a follicle and then the corpus luteum. When that stops, I remember the first time my doctor said: "You can produce testosterone for up to a decade after you go through menopause." I looked more into it — the adrenals start taking over. And when you look at the fact that the basis for all steroid hormones — and I promise no full chemistry lesson today, but a little bit of science — is actually cholesterol, and that we can make estradiol from testosterone, there are all kinds of fascinating things happening. So I want you to keep that in mind.

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## How the Brain Controls Hormonal Balance

We're going to take a little journey through how these three hormones are created. And this is going to connect directly with how stress and sleep impact hormonal balance, because it all starts in the brain.

It all starts in the brain. So we're thinking about our ovaries — "How are my ovaries doing? Do I have enough hormones?" — but it actually all starts right up here. And this connects with what we talked about yesterday.

*(For those of you who were in the session yesterday — I see some familiar faces.)*

It all starts in the brain, including with stress, because perception is reality. It starts with the hypothalamus — this ancient part of our brain that is literally pea-sized. Think about a pea-sized area of your brain controlling thermoregulation, sleep-wake cycles, and sending messages that control hormonal balance throughout your entire body. There is a pulse that comes from your hypothalamus, and from there, signals travel to another tiny part of your brain called the anterior pituitary. And that's what sends messages to your ovaries.

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## Stress, Cortisol & the HPG/HPA Axis

So why is this important? And why is it especially important as we go through perimenopause and menopause?

There's a really interesting fact: when you experience stress — and yesterday we talked about the stress response and how it's designed to protect us — that acute stress response where you quickly react to something, whether it's a close call on the highway or your dog running into the street — it's amazing what we can do in that moment. The thing is, we're supposed to react to a stressor, come back to baseline, react to another stressor, and come back to homeostasis, which the hypothalamus is regulating. But instead — and I include myself in this — we may react to a stressor, ruminate, relive it, and just keep going, going, going.

Who's heard of cortisol? *(Everyone in the room raises their hand.)* I love that. Okay. What's cortisol about? Just to get your brains working — what do you think of? *(Audience shares responses.)* Yes, excellent. Cortisol is connected to stress. It's the longer-term stress hormone. The initial response is adrenaline — you know that feeling where your heart's racing, you're alert and ready, and sometimes it feels kind of good, like before a race. But when it goes on and on and on, cortisol stays elevated in your body.

And that has implications for everything. There is this elegant, ancient system — the **hypothalamic-pituitary-gonadal (HPG) axis** — and cortisol literally suppresses it. It suppresses the message that travels between the hypothalamus and the pituitary. It is well established that chronic stress will actually suppress that system and lower your hormone production.

So think about that for a moment: if you're under chronic stress in your 20s, 30s, 40s, 50s, 60s — what does that mean for your hormones over time? And particularly when you're going through perimenopause and your hormones are all over the place, or through menopause, when you're really relying on your adrenals to produce some of that testosterone and some of that estrogen. After menopause, you're going to have very little progesterone — because of the corpus luteum. So I want to plant that seed around cortisol.

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## Sleep Is Hormone Replacement

The other piece is sleep — and cortisol and sleep are intimately connected. I was reading something this morning in preparation for this talk. The phrase I came across was: *sleep is hormone replacement.* And I thought, "Wow — that's fascinating."

This is based on science — PubMed research articles. When we get enough sleep — and not just hours, because we all know we can lie in bed for eight hours and it may not lead to high-quality sleep — it has an incredible regenerative capacity. It supports our adrenal system. And remember, post-menopause, our adrenals are kicking in to pick up some of that hormone production. Getting quality sleep also supports our whole endocrine system.

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## The Menstrual Cycle: Estrogen, Progesterone & Testosterone

Now, knowing that many of us — myself included — may be beyond our cycling days, let's talk about the menstrual cycle briefly and how it connects with everything. I like to think about our menstrual cycles alongside the seasonal cycles. Many of us attended the fall equinox events yesterday — it was the fall equinox — and talked about fall as the season of shedding. As we shed what's no longer needed, we create space for the new. And maybe that's something you're all exploring this week.

As women, we've experienced a really interesting monthly cycle of shedding — we shed our uterine lining. That's when we bleed. Building and shedding, building and shedding. In the menstrual cycle, estrogen is most dominant in the **follicular phase**, or the first phase of the cycle. What does estrogen do? Because I think we throw around "estrogen" and "progesterone" without always knowing what they mean.

**Estrogen** is important for developing and maintaining all of our reproductive tissues. It regulates our cycle when we have one. It's important for bone density, for mood, and for cognition — our brain.

**Progesterone** prepares the uterine lining for pregnancy. And even for someone who has never been pregnant, this is still part of the cycle we go through. It helps maintain early pregnancy if a woman does become pregnant. And interestingly, progesterone and estrogen being in balance matters — progesterone has more calming effects. You'll often hear that progesterone is important for sleep quality and for balancing the estrogen-progesterone ratio.

**Testosterone** — we often don't talk about testosterone in women's hormones, but it really matters. It's very important for muscle mass, bone strength, energy, mood, and libido. And as I mentioned earlier, depending on the woman and the health of her endocrine system, she can still be producing testosterone for 10 to 20 years after menopause. These hormones and the roles they play are so important.

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## Herbal Support: Vitex, Black Cohosh & Beyond

Now, when we talk about hormonal support and herbal support, a lot of people are looking for an herb that acts almost like a direct parallel to a hormone. What I mean is: a lot of people might think, "Well, I've heard of **Vitex** — has anyone heard of chaste tree berry? — and that it may help support progesterone." It does really help support the endocrine system in general. And **black cohosh** may be beneficial in supporting estrogen. But it's really a lot more nuanced than that.

So regardless of where you are in your cycle, and whether or not you're taking hormone replacement therapy — a couple of you have mentioned that — there's something we don't talk about nearly enough. We've discussed the production of hormones and how stress and lack of sleep literally, directly inhibit that production. That's one of the main takeaways I want you all to have from today.

*(And as we talked about yesterday, we have a sampling of some of those stress-support herbs and sleep support formulas for you to try, if you'd like to explore our herbal tinctures.)*

You have to put yourself back in the front seat. You have to decide: how I am living my life, how I am managing stress, and how I am getting quality sleep — these things matter. Because **I matter.** Because this is important for the rest of my life, for healthy aging, and for longevity.

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## Liver Health & Hormonal Clearance

One of the things we don't talk about — and I know we're spending a lot of time here before getting to products, but this is just as important as hormonal production — is clearance. Anyone want to guess where I'm going? *(Audience: "Nutrition... exercise...")*

Yes — nutrition, absolutely. Exercise, absolutely crucial. And herbs that can support **clearance**.

Our liver — our amazing, incredible liver — processes and detoxifies all of our hormones, and many other things as well, including alcohol and other substances we're exposed to. This is a really important and often overlooked part of the conversation.

Part of the reason I bring it up is that as Medical Director at WishGarden Herbs, when you look at our herbal blends, you're going to see liver-supporting herbs in there — like **burdock root**. Our founder and formulator, Catherine, is with us today, and Catherine understands that it's not just a one-to-one relationship. It's about the whole picture — how we process and detoxify our hormones.

Regardless of whether they're your body's own endogenous hormones or whether you're on hormone replacement therapy, the function of your liver is really important. Our livers do a beautiful job through Phase 1 and Phase 2 detoxification. There are supportive herbs like burdock root and **milk thistle** — a classic that many of you know — that can support this process. We need to support our liver health as women, for our hormonal health.

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## Digestion & Elimination Matter Too

And then, what's the other part of clearing out these lovely hormones that do so many important jobs?

Your digestion.

Did you know that if you're constipated, you can have recirculating endogenous hormones and hormonal breakdown byproducts? Daily elimination matters.

It's funny — I had a great podcast interview with a younger woman where we were talking about cycle syncing and menstrual health. It was on The Everygirl Podcast — I see some people nodding. It was such a lightbulb moment to talk about liver health and GI health, because she said, "I never thought about that. I was only thinking about, 'Am I making enough estrogen? Am I making enough progesterone?'" But it's the full circle. It's the full cycle.

And I want to bring that up here too, because when you're going through perimenopausal or menopausal changes — including hot flashes, which we'll talk about in a moment with our **Hot Flash Tamer** tincture — all of that is part of the same picture.

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## How Herbs Work with Your Body

So this morning I was thinking about how to make this really relevant for all of you. I wanted to cover how we produce hormones and the powerful impacts of stress. I feel like I'm on a campaign for people to take stress resilience seriously and to honestly look at how we're living our lives.

Because I think sometimes as women, we just barrel through — we just keep doing what we're doing — and sometimes things start to catch up. So be thinking about how you're living, how you're sleeping, and how that impacts your hormonal health.

How can herbs come into the picture? By working with your body, not against it. And that means supporting your body not just through hormonal phases and stages, but through what your body genuinely needs.

I've heard so many people here saying, "Gosh, I feel like I'm finally catching up on sleep. I feel like I'm finally resting." And I want to emphasize: **Your body knows how to heal when you give it what it needs.** That's the regenerative power of adrenal health and hormonal health.

Addressing the root cause — not just the symptoms — is a core tenet of naturopathic medicine. That's why I walked through the hypothalamic-pituitary axis, because it matters to understand those root causes.

I also believe in providing gentle, sustainable support, however that looks for you. Someone was asking me: "I'm using hormone replacement therapy recommended by my doctor — do herbs have a place in my life?" And the answer is absolutely yes. Of course, check in with your doctor — but say you're still having trouble sleeping. You can use a formula like **Sleepy Nights** to gently support relaxation into sleep. Skullcap, passionflower, hops — these gentle herbs. As a naturopathic doctor, I don't believe it has to be either/or. It's both/and. How can we keep working together toward optimal health?

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## WishGarden Herbs Products for Each Life Stage

So let's talk about immediate and long-term support.

For women who are still cycling, we have **Cycle Vitality 1** for the follicular phase — supporting healthy estrogen levels, which is important in the first half of the cycle. **Cycle Vitality 2** is for the luteal phase, supporting women through that second, more progesterone-dominant part of the cycle. We also have formulas for PMS emotional and mood support.

**Cycle Changes** is really designed for one of the most profound transition times in a woman's life: perimenopause leading up to menopause. There's not enough conversation about this, and part of the reason we're here is to open that conversation and provide the herbal support women need during that time.

So we have **PMS Emotional** for women who are still cycling — it contains gentle nervines for times when hormones can be erratic. We also have **Cycle Changes** for that perimenopausal transition.

And then there's **Hot Flash Tamer**. Who here has experienced hot flashes? *(Hands go up around the room.)* Okay, a lot of you. We brought Hot Flash Tamer for you today to give you an opportunity to experience herbs in the moment. Like a lot of our stress-support formulas, it's designed to work more immediately — as opposed to our longer-term hormonal support formulas, which, given the intricacy of how hormonal systems work, are designed to be used over time. Nourishing and supporting hormonal balance as well as the systems of hormonal clearance.

WishGarden Herbs has formulas across the full spectrum — depending on whatever stage or phase you're in, including pregnancy, postpartum, perimenopause, and menopause — that can offer real support. They do contain herbs like Vitex and black cohosh that many of you are already familiar with, and are elegantly formulated to support the whole endocrine system.

When I say "endocrine system," I mean the **hypothalamic-pituitary-gonadal (HPG) axis** — the pathway to the ovaries — as well as the **hypothalamic-pituitary-adrenal (HPA) axis**. And as we've talked about, that HPA axis is very intimately connected to how you are experiencing and responding to stress.

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All right. Thank you so much, everyone.

*(Audience applause)*

Thank you. That's so kind. Thank you.