If you’re like most women, your menstrual cycle can cause your Lyme disease symptoms to skyrocket each month. Many women with Lyme disease, regardless of their age, have a hormone profile that resembles a woman in or approaching menopause — with low levels of estrogen, progesterone, and even testosterone. Some women with Lyme even experience cessation of menstruation, or amenorrhea, due to low hormone levels. When I was first tested, my doctor was surprised to hear I still had a period given my low levels of estrogen.
When it comes to Lyme disease and hormones, many Lyme-literate doctors (and female Lyme patients) seem to agree that supplementing and regulating their hormone levels during Lyme disease treatment can help support overall healing and recovery. If you decide to supplement, you have three options — synthetic hormone replacement therapy, compounded bioidentical hormones, or natural therapies. All have some possible side effects, so be sure you do your research and talk with your doctor before deciding which approach is right for you.
Lyme Disease and Hormones
1. Synthetic hormone replacement therapy
Synthetic hormones are widely available with a prescription from your doctor and are usually covered by insurance. They have been studied more thoroughly than the other options listed here (for postmenopausal women, not for Lyme patients), and they are proven effective at raising hormone levels and lessening some of the symptoms of menopause. Many doctors who use this approach to hormone replacement therapy (HRT) recommend taking the lowest dose of hormones for the shortest amount of time required to alleviate symptoms. When used at the onset of menopause, synthetic HRT may be a safe and effective option for you.
2. Compounded bioidentical hormones
Many Lyme specialists will prescribe compounded bioidentical hormones (this is what I use) as an alternative to synthetic. Bioidentical hormones are made from plant estrogens, and use chemicals identical to the ones found in the human body. They can be individually formulated to avoid ingredients that may cause allergies.
When I began taking compounded hormones, it was a bit of a process to find the right dose. At first I felt like a raging teenager. My doctor informed me this was normal, that it takes some experimentation to find what works for each unique body. Eventually we got it right.
Be aware that compounding pharmacies are not overseen by the FDA, and bioidentical hormones, like herbs, have not been widely studied for their efficacy, alone or in comparison to synthetic hormones. Be sure you and your doctor trust your compounding pharmacy if you go this route. Also, consider that compounded hormones may not be covered by insurance.
3. Herbal therapy
Some women may want to consider using supplements to balance hormones, and herbal therapy provides a third option that fits the bill. Herbal hormone therapy is considered a gentler approach, with possibly less side effects than either synthetic or compounded hormone replacement therapy.
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Most herbs for hormone regulation contain phytoestrogens, which mimic the actions of naturally-occurring estrogens in the body. My doctor told me that herbs tend to bind to hormone receptors less strongly than naturally-occurring hormones or drugs, and that some herbs even have an adaptogenic effect on hormones – helping to lower those that are too high and lift those levels that are too low. Herbs are also less expensive than compounded hormones.
I’ve listed four herbs for balancing female hormones below. Unfortunately, there isn’t a whole lot of scientific research on the topic. There is, however, a long history of their use in traditional herbal practices and a wealth of anecdotal evidence to support their effectiveness. Though some side effects are listed for pregnant or breastfeeding women or for those with hormone related cancer risk, generally these herbs are considered very safe. Many of them have similar properties, so if you choose to use them, talk with your doctor about which ones are best for your unique situation, and consider retesting your hormone levels after a period of time to make sure the herbs are working for you.
- Black Cohosh: Black cohosh, like all of the herbs below, contains phytoestrogens. The phytoestrogens support and regulate low estrogen levels in the body. Beyond supporting estrogen levels (or perhaps because of it), herbalists claim black cohosh helps to ease menstrual cramps, lessen insomnia, regulate menstrual cycles, reduce hot flashes and ease pain due to polycystic ovarian syndrome (PCOS).
- Red Clover: Red clover also contains phytoestrogens. One study showed that red clover may be effective at lessening bone loss due to low hormone levels. Another study showed red clover to be effective at raising collagen levels, thus decreasing skin aging and vaginal dryness. Where red clover has limitation, however, is with its ability to reduce hot flashes; research demonstrated that it was no more effective than a placebo in lessening this annoying symptom.
- Rhubarb Root: Rhubarb root is another plant containing phytoestrogens. It has been clinically proven to reduce hot flashes with minimal to no adverse effects. On a personal note: My mother has taken rhubarb root for well over twenty years, since perimenopause. It eliminates her (very intense and frequent) hot flashes, and she has never experienced side effects. If she stops taking it, the hot flashes return.
- Chaste Tree Berry: Chaste tree berry may stimulate the production of progesterone, as well as helping to normalize estrogen levels, though, more research is needed to determine its effectiveness. Folklore suggests it was used to lower sex drives in men in the Middle Ages, hence its name. But now a days, herbalists use chaste tree berry in women to normalize irregular menstrual cycles and ease pain during menstruation. Additionally, it may mitigate painful breasts, as well as reduce the size of uterine fibroids.
With any luck, as Lyme resolves, female hormones will begin to self-regulate and hormone replacement therapy of any kind will no longer be necessary, at least until menopause. Until that time, there are multiple options for balancing and regulating hormones in order to support the process of healing Lyme disease. For me, the silver lining of this particular aspect of Lyme treatment is that I won’t have to do any additional research when I hit menopause! I already know all my options.
Shona Curley lives and works in San Francisco. She is co-owner of the studio Hasti Pilates, and creator of the website www.redkitemeditations.com. Shona teaches meditation, bodywork and movement practices for healing Lyme disease, chronic illness and pain.
Atkinson C, Compston JE, Day NE, Dowsett M, Bingham SA. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. The American Journal of Clinical Nutrition. February 2004; 79(2): 326-333. doi: 10.1093/ajcn/79.2.326
Chaste Berry (chastetree). University of Rochester Medical Center Health Encyclopedia Website. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=19&contentid=ChasteTree
Matthew J. Leach, Vivienne Moore. Black cohosh (Cimicifuga spp.) for meno pausal symptoms. Cochrane Database of Systematic Reviews. 2012 Sep; 2012(9): CD007244. doi: 10.1002/14651858.CD007244.pub2
Vollmer F, Papke A, Zierau O. Treatment of menopausal symptoms by an extract from the roots of rhapontic rhubarb: the role of estrogen receptors. Chinese Medicine. Feb 2010. doi: 10.1186/1749-8546-5-7