It’s not just puberty and menopause: Women experience hormonal changes throughout their lives. New research shows the onset of menopausal symptoms is often linked to the modern Western lifestyle, including nutrient-poor diets of refined foods, alcohol consumption, smoking, chronic stress, depression, lack of exercise, and exposure to endocrine-disrupting toxins found in common household products.

The good news about symptoms is that "women get a wake-up call," says Marcelle Pick, RNC, MSN, a Yarmouth, Maine–based ob-gyn nurse practitioner. "When the body is out of balance, it really screams at them. Men have heart attacks. Women have an opportunity to get really healthy." Making smart lifestyle changes—especially before peak transition times—can help smooth out symptoms, says Alicia Stanton, MD, an Enfield, Connecticut–based integrative physician and coauthor of Hormone Harmony (Healthy Life, 2009)

Pregnancy Years

"Hormones tend to be more stable when women are in their 20s and 30s, unless they have a boatload of stress," says Pick, who cofounded Women to Women, an integrative clinic that serves women both online and in person. Ordinarily, estrogen is high in the first half of your cycle; in the second half, estrogen comes down and progesterone goes up. Then they both plunge right before your period.

But many women—Stanton estimates as many as 80 percent—have a condition known as estrogen dominance, an imbalance believed to be triggered partly by excess body fat, poor diet, stress, and exposure to estrogenic factors in the environment, such as those leached from most plastics. "Either there’s too much estrogen in the system or not enough progesterone to balance the estrogen," says Jennifer Johnson, ND, clinical faculty member at the University of Bridgeport College of Naturopathic Medicine.

POTENTIAL PROBLEMS

PMS. Johnson says symptoms during the pre-period hormone drop may be worse for women with estrogen dominance. Common symptoms include headaches, breast tenderness, irritability, depression, bloating, and cravings.

Infertility.  If you’ve ruled out structural problems (such as blocked fallopian tubes)—as well as issues with your male partner—and still can’t get pregnant, you may have low progesterone levels in the second half of your cycle.

Cysts or fibroids. "Estrogen is the proliferative hormone," explains Erin Lommen, ND, a practitioner based in Clackamas, Oregon, and author of Slim, Sane, and Sexy (Fountain of Youth, 2009). That means it helps grow the uterine lining to prepare for pregnancy, but it also grows cysts, fibroids, and cancers. "Progesterone is the antiestrogen, or the balancer."

HORMONE HELP

Try a natural progesterone cream. You can pick this up without a prescription, but first be sure your progesterone levels really are low. Your doctor can do a saliva or urine test to find out. Look for a low-dose (2 percent) topical cream and check the ingredient list for USP progesterone rather than wild yam, which the body cannot metabolize into progesterone. Apply about ¼ teaspoon (providing 20 mg of progesterone) to the neck, face, chest, or inner arms; rotate the application site daily. Bio-identical progesterone is safe for women when used as directed, says Pick, but a health care provider should monitor any woman using hormones. Women with breast cancer or a history of breast cancer should not use progesterone cream.

Try supplements. Clamp down on crankiness with a B-complex that has at least 50 mg of B6. Take 500 mg per day of krill oil, or 2,000–3,000 mg of high-quality fish oil each day, with meals, to reduce inflammation and cortisol demand. Johnson also suggests evening primrose oil, 1,200–1,500 mg per day with meals, to ease cramps and help with other estrogen-dominance symptoms. Dandelion (both root and leaf)—100–200 mg, or 1/2 teaspoon of tincture, or two or three cups of tea daily—minimizes bloating and helps the liver eliminate excess hormones; it may not be safe for people on diuretics, Johnson cautions. For fertility issues, try vitex, or chasteberry, 300–400 mg daily unless you are already taking prescribed fertility hormones or are undergoing in vitro fertilization, she says.

Avoid environmental and dietary estrogen sources. These include many plastic water bottles; canned foods with BPA in the lining; personal care products with potentially hormone-disrupting chemicals, such as parabens, phthalates, triclosan, and many fragrances; and nonorganic