Your Brain Runs Your Hormones: HPO, HPA Axis & the Progesterone Connection

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Alex, welcome to A Quest for Wholeness podcast. I'm your host. Lexi Burt, a fertility advisor and endometriosis advocate together, we're diving into the journey of understanding what it truly means to be a healthy, complete individual, biologically, psychologically, socially and spiritually. In solo episodes, I'll share my insights on fertility, holistic health and endometriosis, plus we'll have conversations with incredible guests, all exploring the same burning question, what does it mean to be a whole, healthy and satisfied person. I'm so grateful you're here. Hey, welcome back to the podcast. If you're new here, welcome. If you've been here before, welcome back. My name is Lexi Burt. I'm a fertility advisor and a women's health researcher here in Vancouver at BC Women's Hospital. This podcast goes over anything related to health. I believe that there are different facets of ourselves and our health that are important to consider, not just physically, not just mentally, but spiritually, socially, financially. We cover everything here. But today, I want to go over the recent episode that I did with Melissa dealey. She is an integrative health practitioner. Melissa has fantastic insights into women's health, hormone production and detoxing, so I wanted to put my little spin on her episode as well. Key takeaways of the last episode were the relationship between cortisol, estrogen and progesterone, the concept of progesterone steel, the role of stress in hormonal balance and overall health, the importance of detoxification in managing excess estrogen, and the differences between conventional and functional hormone testing. To give you a little bit of insight into my world as a fertility advisor, I would work with a clinic who supports women in restorative reproductive medicine. Have you heard of that before? I'm wondering if you have, because it's not something that's super common and knowledgeable and known about, I guess, but I would love to share with you a bit about it today. So again, restorative reproductive medicine or RRM, it's this belief and this branch of established science that if a woman is experiencing infertility, there's something at the root causing that infertility, and if we can identify what that root cause is, and fix it, her fertility and overall health can be restored. I always had this very specific view of fertility, which was related to baby making. Fertility is about if you can make babies or not, and that's the only time it really matters. But as we talked about in the last episode with Melissa, there's this very intricate relationship between our overall health and our Hormonal Health and our fertile health. This is something that I like to bust down, a myth I like to bust with the clients that I see, because I have some women who are young and are maybe experiencing painful periods, hormonal imbalances. Don't really care about baby making quite yet. And then I work with women who are in the midst of trying to figure out what is wrong with their fertility. Maybe they've had multiple unsuccessful IVF or IUI attempts, and they're really kind of had their last straw with their fertility. Fertility does not mean baby making. Our fertility is an indicator of how well our overall health is. And this was the first mistake that I made. I thought again, it was just related to baby making. So this is something we'll unpack throughout this episode today. First, I want to explain some anatomy and physiology. So I might be bringing you back to 10th grade biology class here. But bear with me. I think when we think about reproductive organs and our reproductive health, our periods, baby making, our fertility in general, we think about all of the organs that exist in the lower abdomen, right the uterus, the fallopian tubes, the ovaries, and how well those things are functioning, and we forget that there's an intricate relationship with the rest of our body, but more specifically, our brain. So our brain is what's controlling the production and functioning of our reproductive organs. So there is this pathway or axis called the hypothalamic pituitary ovarian axis. So the hypothalamus is a structure in the brain, and in our context, it's secreting g, n, r, H, or gonadotropin releasing hormone. On this hormone stimulates the pituitary gland to release LH and FSH, and if you've been on a fertility journey, you know about these hormones, FSH and LH, when released from the pituitary gland, are traveling through the bloodstream and are activating the ovaries to start their process of follicular development and resulting in, eventually ovulation and the creation of a corpus luteum, all things we will also cover. So we have this relationship right, establish a relationship for reproduction between the brain and the ovaries right when the ovaries they're going to secrete estrogen and progesterone, which will influence the uterus and the endometrium to start changing throughout the month, resulting in the four phases of the menstrual cycle, or better put, fertility cycle. But we also have this other axis, it's called the HPA axis. So this stands for hypothalamus, pituitary adrenal axis. So again, we have the HPO and the HPA. So the first two structures are the same in the axis, but the third, the A in the HPA axis, stands for adrenal glands. So again, the hypothalamus is stimulating the pituitary to stimulate the adrenal glands, which release cortisol or stress hormone. And if you aren't familiar, the adrenal glands are like tiny little bean like glands that sit upon our kidneys. And again, they have a role in cortisol and stress production, I think right now, especially if you are a person who is on Tiktok Instagram in the world, and you follow anyone who's in health and fitness, cortisol is getting a pretty bad rap. Everyone has high cortisol. It's the cause of all of their problems, but we actually need to have high levels of cortisol. Specifically in the morning when we wake up, there is a bi directional, or opposing relationship between melatonin and cortisol production. So in the morning, when we wake up, melatonin production is going to go down and cortisol production is going to go up. That's what causes us to have energy to get up and go throughout our day. As the day continues and we near nighttime, cortisol should start to go down and melatonin start to go back up, and this is establishes our circadian rhythm, or our sleep wake cycle. So I don't want to add to any myths here that high cortisol is a bad thing and is the result of your infertility and all of your problems, but it's important to know how it can affect our fertility. So as Melissa was talking about in our last episode, there's this idea of progesterone steel. So this involves the HPA, hypothalamic pituitary adrenal axis and the HPO, hypothalamic pituitary ovarian axis. And when I'm teaching my clients this, I can see this, like light bulb happen for them, and I ask them, and I invite you to think about this too. Why would the body steal progesterone inhibit the reproductive pathway in favor of the stress pathway? Well, let's think about it evolutionarily, it wouldn't have been safe if our bodies were in a high stress state to reproduce. Likewise, this is imperative energy that is going towards reproduction, and if we aren't safe in our environment, we actually need that energy to fight, flight, freeze or fawn. So when we take this into consideration, it makes sense how we can start to see infertility, hormonal imbalance appear, especially in people who are dealing with significant levels of stress. Okay? Lexi, I live in a super stressful environment. I'm working. I have all these responsibilities. We have a lot of economic uncertainty, political uncertainty.

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It's not looking great for the environment out there. How am I supposed to manage my stress? I don't have an answer for you. I have been told so many times to focus on managing your stress, your stress management skills. And look, this isn't all a waste of time to hear this. Managing our stress is important, but that's going to look different for everybody based on their ability. Ability to take the time to find stress management skills based on you know, their responsibilities that they have kids work, maybe two jobs. However, I do want to emphasize that finding time to take care of yourself, to reduce your stress, is going to be significant for whatever journey you're on right now, whether that's hormonal balancing fertility, but also longevity, and I know there can be some even guilt that comes along with self care. I hate to use the word self care, because I think that's something that should just be baked in, and we have really ran away with this concept of self care, which being bubble baths and maybe getting a mani pedi. But that's not the type of self care I'm talking about. I'm talking about the thing that actually fulfills your soul and gives you energy to continue to do these responsibilities. I have these conversations with my clients, specifically, who are our mothers. I don't have the time if I'm getting upset. I even feel like a bad mother if I have to step away to regulate myself when my kids need me. I'm not a mother. I don't know what that feeling is like, but I can empathize, and I like to remind my clients that during those times when they're feeling guilt for having to step away to regulate or yelling at their kids, in a quick snap of the moment you know responds that they aren't bad mothers. They're simply humans trying to exist on this planet. But also taking that moment to even co regulate with your kids explain what's happening, because even if you aren't telling them what's happening, they can feel it. They know what's happening. So taking a moment, whatever that looks like, right? If you can't step away, you know, saying I'm really upset right now, and I don't know what to do with my emotions, I'm having really big emotions, can be a significant step in doing the best that you can to manage your your stress, this will look different for everyone. So it's figuring out those tiny moments you can get to bring yourself back into your body and calm yourself. The last thing on this progesterone steal, I want to talk about how it can be impactful for women who are trying to conceive, they're on a fertility journey. But also for women who might have irregular cycles, it's interesting how low progesterone can appear in our cycles. Specifically, we see this in a case with a lot of women who have had frequent miscarriages or even unexplained I'm doing finger quotations, by the way, for those listening audio wise, because unexplained infertility is not a diagnosis, but often we see that there's an issue with low progesterone. Progesterone is significantly important in the second half of our cycle, or the luteal phase, to build the endometrium, if you're on a fertility journey, building the endometrium, ensuring you have healthy cell lining in the uterus with lots of healthy blood vessels, is important for A potential fertilized embryo to implant in the uterine lining. If you have low progesterone and you've had miscarriages, that could be an explanation for those who are on a women's health journey. Let's say they have irregular cycles. They're not sure what's happening. We can identify this on our charts, or the cycle charting that I do with clients. There's a couple ways we can identify low progesterone through the chart. For example, in the luteal phase, we like to see a very consistent period of 11 to 16 days. The research has established that that's a healthy range for women. So if you have a luteal phase that's under 11 days, that could indicate low progesterone. Well, what does low progesterone mean? Why is it important for someone who's maybe not even trying to have a baby? Right now, there's been some research showing a relationship between low progesterone and PMS symptoms. So if you're somebody who experiences PMS symptoms, maybe even a week to two weeks before the onset of your menstrual phase, low progesterone could be an indication. Yeah, also another way we can identify low progesterone in the chart. And really this goes for both women who are trying to conceive and women who are not, because it will come up the same in the chart. So we know a short luteal phase less than 11 days. And then also any pre menstrual spotting, or what we call tail end brown bleeding. So any days that you have more than two days of spotting or brown bleeding before your period actually arrives, is an indication that there's something happening with progesterone as well. So what can you do to identify if you have low progesterone Well, you could start cycle charting. That's one way to figure out the length of your luteal phase, so the time after ovulation to the onset of your next menstrual phase. You could start tracking any spotting you have before the onset of your menstrual phase, and then you could also do blood testing. We call it peak plus seven, or peak plus nine. So this is a way to get an accurate snapshot based on your individual cycle to see what progesterone levels are doing in the luteal phase. There's also another fantastic fertility tool, and I've partnered with them. They're called Mira. This is an at home hormone tracking device. I'm going to do a whole episode on Mira, because they have recently gifted me one. So you're able to analyze your LH, FSH, estrogen and progesterone yourself at home on an app, the app that we use in my practice as well chart Neo, you can link these so you can see all of your data on Chart Neo, along with the hormonal charts from Mira as well. We've covered a lot in this short little episode. And if you stuck with me through it, Hi. Thanks. I appreciate that. I wonder how many of you would you could send me a little message? I'd love to know if I'm speaking to the abyss or real humans. But to kind of recap, we talked about Melissa's past episodes. If you haven't even listened that to that one yet, go back to the previous episode. Give that one a listen. We talked about the idea of progesterone steel. We talked about the HPO and HPA axis. We talked about how progesterone can impact women's health and those who are trying to conceive on their fertility journey. We talked about ways that you can identify yourself at home to identify if you have low progesterone. And then I also mentioned a tool that you can use at home to track your hormones as well. Like I said, if you listen to this episode, I would love to hear from you to let's see if it's real humans that I'm speaking to. And if you have any questions, thoughts or comments about fertility, endometriosis, hormones, I would love to hear from you. Thank you so much for tuning in to today's episode. I hope you feel inspired and empowered to embrace your whole self in mind, body and spirit, if you're ready to take the next step in understanding your fertility or women's health needs, I would love to support you. Book a free consult with me, and Together, we'll explore how we can work towards your healthiest, most vibrant self until next time, take care you.