What can I do to balance my hormones naturally?

One of the questions I’m frequently asked is, “What can I do to balance my hormones naturally?”

My answer may be a little different from what you expect.

During perimenopause and menopause, your hormones are supposed to change.

We aren't necessarily trying to “balance” them back to where they were when you were 30. Nor can a supplement, diet or herbal medicine stop ovarian ageing and make your ovaries continue producing premenopausal levels of oestrogen and progesterone indefinitely.

But that doesn't mean you have to sit back and do nothing.

There is actually quite a lot we can do to influence how well your body adapts to hormonal change, how troublesome your symptoms are and how we protect the areas of health that become more vulnerable as oestrogen declines.

First, let's change the goal

I think we need to move away from the idea that every woman needs to “balance her hormones”.

Menopause isn't a hormone imbalance in the traditional sense. It is a normal physiological transition.

During perimenopause, hormone production can become erratic. Oestrogen can swing high and low, ovulation becomes less predictable and progesterone production commonly declines. Eventually, ovarian oestrogen production falls substantially.

We can't supplement our way out of that process.

What we can do is ask a better question:

How can I support my body as my hormonal environment changes?

Phytoestrogens: food first, but there's an important catch

Phytoestrogens are naturally occurring plant compounds that can interact with our oestrogen receptors.

Two of the best-known food sources are flaxseed and soy, but they don't behave in exactly the same way, and your gut microbiome has a surprisingly important role in determining what happens next.

Why I often start with flaxseed

Ground flaxseed is probably the phytoestrogenic food I recommend most frequently.

Flax is particularly rich in plant lignans. Our intestinal bacteria metabolise these lignans into compounds called enterolignans, particularly enterodiol and enterolactone, which can then exert weak oestrogenic or anti-oestrogenic effects depending on the hormonal environment.

There is individual variation in how efficiently we make these compounds, but flaxseed brings other benefits to the table too.

It provides fibre, supports bowel regularity and can be a useful addition to a diet designed to support cardiovascular and metabolic health, all things that become increasingly important during and after menopause.

I recommend freshly ground flaxseed rather than whole seeds, as whole seeds can pass through the digestive tract relatively intact.

Soy is a little more complicated

Soy contains isoflavones, including daidzein. Certain intestinal bacteria can convert daidzein into S-equol, a metabolite with greater biological activity and a particular affinity for the oestrogen receptor beta.

Here's the catch:

Not everyone can make it.

Only around 20–30% of people in Western populations appear to be S-equol producers, compared with approximately 50–60% in many Asian populations.

Gut microbial composition appears to be important, and long-term dietary patterns may also contribute. Traditional Asian diets tend to contain considerably more fermented soy than Western diets, including foods such as tempeh, miso and natto.

Fermentation changes the form of the isoflavones and may influence their absorption and metabolism, but fermented soy itself doesn't automatically provide S-equol. You still need the right gut bacteria to make that final conversion.

This may help explain why one woman can respond beautifully to soy while another notices very little.

The soy isn't necessarily the whole story. The woman eating it matters too.

This is where supplements get interesting

If I'm specifically trying to utilise the equol pathway therapeutically, I'm more interested in a supplement that contains S-equol itself rather than simply providing soy isoflavones and hoping the woman's microbiome can make the conversion.

A standard soy isoflavone supplement contains compounds with biological activity, but conversion of daidzein into S-equol remains dependent on having the appropriate intestinal bacteria.

An S-equol-containing supplement provides the metabolite directly, bypassing that particular conversion step.

So don't assume that “soy isoflavones” and S-equol are interchangeable when you're reading a supplement label.

What about herbal medicine?

Herbal medicine gives us additional options, and the choice depends on the woman and the symptoms we're trying to address.

Some of the herbs and herbal extracts used during menopause include black cohosh, red clover, hops and rhubarb.

But I don't think of these herbs as simply “natural hormones”.

Different herbs have different mechanisms and may suit different symptom patterns. For one woman, hot flushes and night sweats are the priority. For another, it's sleep, anxiety or irritability.

This is why I don't believe in a universal menopause supplement.

And natural doesn't automatically mean appropriate for everyone. Medical history, medications and a history of hormone-sensitive conditions all need to be taken into consideration.

Not everything that helps menopause has to change your hormones

I think this is an important point.

Take hot flushes.

Changing oestrogen levels affect temperature regulation within the brain. The temperature range in which your body feels comfortable becomes narrower, so relatively small changes can suddenly trigger sweating and flushing.

Stress, poor sleep, alcohol and a hot environment can make symptoms worse for some women.

Breathing exercises, meditation, yoga and other nervous-system strategies aren't increasing your oestrogen, but they may still influence how you experience symptoms.

Sleep deserves particular attention.

Poor sleep can affect blood glucose, appetite, mood, stress tolerance, energy and cognition. And alcohol can further disrupt sleep and trigger hot flushes or night sweats in some women.

Sometimes changing the body's response is just as useful as trying to change the hormonal trigger.

Protect your muscle and metabolic health

As oestrogen declines, and as we age, body composition and insulin sensitivity can change.

This is why I encourage women to think beyond the scales.

What is happening to your muscle?

Muscle is metabolically active tissue and an important site for glucose disposal. It supports insulin sensitivity, strength, mobility and our ability to remain independent as we age.

Resistance exercise, and adequate protein become increasingly important during midlife. 

Add adequate fibre, colourful plant foods, essential fatty acids, hydration and good nutritional foundations and we start supporting much more than menopause symptoms.

This isn't technically “balancing your hormones”.

It's something I think is far more useful:

protecting your body against some of the downstream effects of hormonal change.

You don't have to “balance” menopause

Perhaps this is the message I most want you to take away.

Your body isn't failing because your hormones are changing.

And the goal doesn't have to be forcing your hormones back to where they were before menopause.

We can use phytoestrogenic foods intelligently. We can use herbal and nutritional medicine where appropriate. We can support sleep and the nervous system. We can build muscle, protect bone and improve metabolic health.

The goal isn't necessarily to “balance your hormones”.

It's to help your body adapt to hormonal change as well as possible, while protecting your health for the decades ahead.