Know Your Body: Hormones & Mental Health Podcast Episode

Mothers talking to their daughters about the gift and privilege of being a woman, of being able to be a life giver. You know, whether you have children or not, I think as godly women, we are made fearfully and wonderfully, and we have the opportunity to promote that. Welcome, everyone, to Breaking Bread, the podcast brought to you by Apostolic Christian Counseling and Family Services.

Wonderful as always to have you along. You know, a verse that we often cite in this podcast because it comes up so frequently is we are fearfully and wonderfully made. And I think today’s topic is going to illustrate that in more beautiful ways and with me to have this conversation is Kathy Knochel.

Thanks for being here, Kathy. And Lynn Streitmatter. Lynn, thanks for being here. It’s a privilege. We know Kathy already. Lynn, please introduce yourself, share a little bit about the work that you do, and then we’re going to get into our topic. So, my name is Lynn Streitmatter from Sarasota, Florida. I’m married to Jeff. We have four sons ranging in age from 29 down to 21. One of our sons, Gabe, is married to Haley from Detroit, and they gave us our first grandchild about two weeks ago. So, we’re delighted to have that gift of extended family. I was a NICU nurse in my early singlehood, and worked in the OB first, women’s health, and then moved to neonatal ICU.

And then after I met my husband Jeff, I was a stay-at-home mom. And then as my children were getting older, I had the privilege to go back to school. And what I thought was just to complete my bachelor’s, actually God led me into my master’s, family nurse practitioner. And then he gave me the gift of working in a women’s health clinic.

Being able to work and get a fellowship into an area that used to terrify me, which was balancing women’s hormones. School gave me great instruction, fellowship, and that is how I currently practice in women’s health, GYN, with a specialty in hormone balancing for women. Thanks for that, Lynn. And I think our listeners will see how apt she is to be here for our conversation.

Kathy, this is a conversation you’ve actually raised. And that’s really about our bodies and knowing our bodies because it impacts our physical well-being, our mental well-being, and overall health in so many ways. Yeah, I see it so often with a lot of the women I work with in the counseling world. The more they can understand how their bodies were designed and how God created them and what’s actually happening throughout their monthly cycle.

How much of that does impact their overall well-being, physical well-being, mental well-being? And I’m so excited to have Lynn here to give us all the medical end of things. Lynn, you mentioned hormones. Yeah. That’s a lot of the work that you do. Is that right? That is. I think hormones are incredibly mysterious.

I’m capping out my biology education now. One class in college might be, might be my cap and then pretty poor student attention in junior high. So, anyway, that’s where I am right now. But I do know hormones are a big thing. Right? Correct. Hormones are huge but yet they’re mysterious.

Can you give any clarity, Lynn, on what hormones are. Yeah. So, absolutely. So, hormones are the chemicals God gave us. And I love the verse you started out with; we are fearfully and wonderfully made. I think anybody that’s had the privilege of working in the medical community has been able to see that if they have their eyes open to it.

So, let’s consider the thyroid. Our hormones affect every part of our body system. So, the thyroid sort of is the master gland. If it’s not balanced, it can affect our heart, it can affect our neuromuscular system, our GI system. If the thyroid isn’t balanced, it can affect our whole health. Blood pressure.

There are just a lot of symptoms that can come from an imbalanced thyroid gland, the master gland of the body. Kathy, what kind of things do we see even in the counseling room that we might think it’s a matter over here, but turns out it’s a thyroid matter? Yeah, I think Matt, a lot of times what feels like anxiety or depression or those sorts of things, understanding that there can be medical reasons for it.

And so, as part of an intake with somebody, we’re talking about how is your physical health doing? Tell me all the things that are going on with your mental health. Because you want someone to be able to have knowledge of what’s happening medically in their body as well as the things that are increasing mental health symptoms.

And teasing out what is a spiritual matter, what is an emotional matter, and what is a biological matter is a task. Right. But it’s important to sort those things out because they can be conflated. Yes. And because it usually can be some of all of them, right? Because when there is something going on with the thyroid, it’s going to manifest as various things.

Yes. Depression. You’re going to feel these symptoms and that’s going to affect you spiritually. And so, part of all of this and part of the heart behind this podcast is you have to know all parts of yourself. You have to understand your body. You have to understand medically, spiritually, physically, all of those things.

I think knowing your body is a really important charge. And that’s really what we’re talking about. And I know the context and examples are female, but males have hormones too. And we see that, but I’m still fascinated Lynn, with what these chemicals are doing. So, the thyroid is the command center, and it dispatches hormones.

And then what are they doing? Are they message senders? Yeah. So, hormones are message senders. That would be layman’s term. Well, that’s what I am. And they direct. I’m kind of impressed to actually pull that out. They direct the body what to do. Okay. So, the basic hormones of a female are estradiol, E two, and that is made by the ovaries primarily in your childbearing years.

So, when you’re having cycles, that is your primary hormone. Estriol is the primary hormone of pregnancy. And it is made by the placenta, largely. It’s a weaker hormone. And then, Estrone is made primarily in post menopause. How you manage it or how you metabolize it can be challenging. It’s the one hormone that can cause problems in the postmenopausal period because elevated estrones can cause inflammation in the body and can lead to cancer.

What does it mean to metabolize it? So, how you metabolize or break it down depends on the genes you were given by both sets of parents. So, cruciferous vegetables like broccoli, cauliflower, dark leafy greens, bok choy. Those things help us to do it, but a lot of times that’s not enough.

And especially for people that would maybe be taking hormone therapy, especially oral. They tend to have elevated estrogens without realizing it. So, it’s just something that you want to make sure your provider is looking at. This is really interesting. Okay. Now we’ve touched on some things which I can tell is going to become important like diet.

Exactly. Okay. So, that’s good. That’s the big reveal. Maybe we’ll come back to diet. I’m still really fascinated about what hormones are doing because they are giving some sort of marching orders to the body. Correct. So, each month they change. So, you start out with a typical cycle of 28 days.

Okay. For most people it starts around the age of 12, but 12 to 16 is a range. The start of your period is day one. Most cycles are typically five to seven days. After that, from day 1 to 14, the prominent hormone is FSH, follicle stimulating hormone. That’s a brain hormone that talks to the ovaries and tells them, oh, it’s time to mature an egg. Around day 14 is when you ovulate. So, FSH has told the LH, luteinizing hormone, to raise. And when it raises, you have ovulation where one of those cells has matured. Our Creator designed this for conception. When we ovulate, that’s the ideal time for conception. The luteinizing hormone matures and causes the egg to expel ovulation or fertilization of the ovulation, usually happens within 36 hours.

You’ll have a basal body temperature rise, and that’s how people can know they’re primed for fertilization. Okay, after estrogen goes down a little bit, you have the LH surge. So incidentally, that is what the home pregnancy tests are checking, is that for LH surge. So, for people having challenges with conception, sometimes they’re not ovulating. So, that would be a lab test you would want to look at. Day 15 to 28 is called the luteal phase. So, that’s when you have a decrease of LHFSH and a rise of the progesterone, and so progesterone rises, that’s what would maintain a pregnancy if there’s a fertilized egg, and estrogen rises some, but then decreases when there’s no fertilization. That’s when you have your menses, which you’re back at day one.

Okay, so for people that have problems with conception, it can be that they don’t ovulate, no rise of the LH, or it can be low progesterone where they can’t maintain the pregnancy. So, those are things that your OB would want to check if you’re having problems with fertility. So, it sounds to me that hormones are very much centered upon reproduction.

Is that true? I would say our master Creator made it that way. Yes, and I know your explanation there is female, but males would be as well, right? Testosterone is the male hormone. Prominent hormone, right? Which women do create it as well. Okay, and so the first is this kind of high level. Is that true across the board? Every hormone in the human body is attentive to conception and reproduction and the life stage of a person. I believe so. That’s my understanding. The gift of life. That’s really interesting. I didn’t know that until now.

So, some hormones, like the ones made by the adrenal gland, are more about managing stress. So, that would be like your serotonin, your dopamine, those rise and fall, that’s sort of our fight or flight. You know, the adrenal glands are nut size and set on top of our kidneys. They’re responsible for fight and flight, managing stress, decreasing stress, getting us excited when we need to be excited. So, yeah, the way we are created is fearful and wonderful. And so, the hormones are very much attuned to life, giving of life, and then preserving of life.

It sounds like. Kathy? I’m learning right alongside of you, Matt. This is so wonderful. I wonder, Lynn, you talked a lot about estrogen at the beginning of this. Help a female understand what they might be experiencing if estrogen levels are not going the way they should be going in her life.

Yeah, so that’s a really good question. It manifests different ways. So, estrogen is responsible for our heart, our skin, rebuilding our bones. So, people who go through early menopause or primary ovarian insufficiency, the way it would characterize in their life is the inability to get pregnant. And typically, what we see. So, menopause by definition is one complete year without a cycle. The time leading up to that is perimenopause. We used to think it was a shorter time, but now evidence-based research says it’s like 7 to 10 years. It can be 7 to 10 years before the actual cessation of our cycle.

Common symptoms that people would feel, if that’s your question, are hot flashes, night sweats, vaginal dryness, pain with intimacy, decreased libido, interrupted sleep, go to sleep fine but wake up at 2 a.m. and can’t get back to sleep. For some people it’s fatigue, brain fog, anxiety, depression. You know, there’s a new book out that sheds light on this. The highly recommend reading it, called The New Menopause by Dr. Mary Claire Haver. And it actually talks about things like frozen shoulders, that we usually thought were just part of getting older but actually are related to lower estrogen.

So, in childbearing years, I think what I see is the rise and fall of some anxiety and depression linked to some of that. And that’s what you’re saying. Absolutely can be. Yes. Absolutely. One thing I have noticed within this is I feel like there can be two ditches and that is we either ignore the hormone cycle piece of it and just think there’s a few days every month that are kind of bad and I’m going to be irritable and moody and kind of get out of my way, right? And then the other ditch I think is everything gets blamed on hormones. I think what I can see there are individuals who have an existing anxiety or depression diagnosis, they can experience the PMS symptoms on more extremes.

And then individuals who do not have that co-occurring, there are still the shifts in moods, which is the estrogen piece, but that is just the natural rise and fall of the body. It’s something to be stewarded more than something to be concerned about. Yeah, correct. So average PMS affects like 26% to 31%. Okay. One out of three. Yes. Whereas PMDD affects a much smaller group, 3 to 8%. What is PMDD? Premenstrual dysphoric disorder. PMS, premenstrual syndrome, is a common thing that we may feel the last week before our cycle where there’s extreme depression, mood instability, there may be hunger, cravings, tired, bloating, joint pain.

Those are common symptoms you may not necessarily feel every month. Lynn, can I ask you something about that? So, if they are experienced to more extreme, that is likely an indicator that something isn’t balanced outright or that you maybe are not taking care of your body in the way that it needs to be taken care of.

Would that be correct? That would be accurate. And back to the metabolizing thing that you had mentioned, probably. Yeah. Right? How is your body? Well, and sleep. So, one of the most important things is during that time, if you’re having challenges, we recommend keeping a diary of your emotions throughout your cycle of what you’re feeling, your emotions, cravings, nutritional, because that all plays into it.

And you would probably find those type of diary rhythms helpful too, Kathy. Yes, absolutely. Because, again, that goes back to our earlier conversation of teasing out what the emotion is. What is medical and what is more emotional health based? And so, any female client of mine has likely heard me say lots of times, are you tracking all month long because you start to learn and understand your body during this phase. Lynn talked through all the phases.

During this phase, this is typically what I experienced with sleep, with eating, my social battery, all of those things. Tracking is important for sure. Absolutely. So premenstrual dysphoric disorder is like PMS in a more extreme and you would want to just do everything you can to manage that with good nutrition, make sure you’re getting your rest during that time.

And then there are some medical things we can do as well that you should see your provider for. And that’s like usually doing a low dose progesterone during that time that week before or the second part of that cycle. I think it’s good to think about the PMDD. You said it, but it’s severe or extreme. And I would say that from a mental health perspective, when that is diagnosed, we really are seeing that in big extremes, participating in work, participating in things at home is almost impossible during that certain cycle, that certain phase of the cycle. And I would say there’s definitely an increase in depression.

If somebody already has anxiety, there can be an increase in intrusive thinking. For the individual diagnosed with this, I see more suicidal ideation during that time. This is the extreme with the PMDD. Yeah. And what I’d want to add is what we’re seeing with postpartum depression. It is a real thing. We used to call it the baby blues, but it is a real thing. And people who have anxiety and depression prior to pregnancy tend to have higher risk of postpartum depression also with perimenopause and menopause symptoms. So, I definitely highly recommend getting medication and getting that managed if at all affects any of our population.

Let’s linger a little bit more with that postpartum, what’s happening in the body hormonally and how that might manifest itself. So, after you deliver, I mean, the way God made us is so amazing. The hormone that we use to induce, Pitocin, Oxytocin, when you deliver, that same hormone is what causes the uterus to shrink to keep women from hemorrhaging.

That same hormone is released when a mom’s looking at her baby. Oxytocin also is what causes milk to let down for those who choose to breastfeed. And when that happens, it also continues to shrink the uterus. So, the way God made us is just so amazing and fascinating. So, when you’re postpartum, you have these shifting of hormones, your estrogen, progesterone, oxytocin, other hormones that affect your body changing. It’s going through shifting from nurturing a pregnancy to trying to return it back to normal. We know that takes up to six weeks, maybe even longer. So, with those hormone shifts women who are overjoyed at having the gift of life, sometimes they surprisingly feel thoughts that scare them, like with thoughts of harming the child and fatigue plays into this, trying to take care of yourself.

If you have other children, your family, the fatigue of a newborn, having to feed a newborn, all that can really play into giving you feelings of hopelessness, of guilt. Absolutely. Yeah. Intrusive thoughts of harming my baby or all kinds of things. The amount of guilt that comes with that then, what I’ve experienced with others, is it drives them to secrecy about it versus just like that ability to say God designed my body beautifully and this is the hormones doing their thing.

I can get help and support around this and talk about it. These are experiences that happen. It’s become such a common issue that we now screen our mothers at one to two weeks. We have them come back to our OBGY to see if they need help. It’s become a routine check.

Speak to that listener who is dealing with it, whether in herself or in her family. Rest, first and foremost, I tell all new moms, you need to sleep when the baby’s sleeping. Rest and nutrition are important, especially for breastfeeding. You know, I think it’s important for moms to have mother groups. You know, other women, it’s wonderful to have that support at home, but I think women need women, they need to talk, and probably after they realize that a lot more people experience this than they thought before, and are able to talk about, they’ll find out that they have a lot of friends out there who have also experienced that it’s more common than we believe.

Is there a certain length that you can like, hang on, it’s going to be this long. I’m sure there’s not a hard and fast rule there, but what do you see in terms of the duration of postpartum? Is this a two-year deal or is this a one-month deal? For some people it’s up to a year. So, medically what we would do in our practice is primarily if there were no allergies we would do a low dose SSRI.

Zoloft is a common one, low dose Zoloft, and that would be managed for a year or as long as the patient needed it. Yeah, I would say those things Lynn is talking about are certainly the things that I find myself talking about with new moms. How are you taking care of your health? Are you sleeping? What kind of support do you have? I think sometimes it can be what kinds of boundaries are you setting? What are your expectations? Sometimes it is all overwhelming But then also knowing some of the skills and tools like healthy thinking styles or some more helpful ways of thinking about yourself and your body, those sorts of things.

Also, I will do some behavioral activation work with somebody who is having some postpartum, which is what we do for depression and that is like when you need rest, what is the schedule you’re following? Also, how are you getting up and getting moving and is that done with support? Those sorts of things. When it is moderate to severe, I do recommend the use of medications. Like you said, the SSRI.

I think that’s super! It can be helpful and important to just help an individual get to the point where they can see up and over the fog of postpartum. This is really enlightening, and I’m still really struck by the power of hormones. I’m still stuck on this hormone thing. They give marching orders to the body. Am I right? And even as I hear you explain that, again, we’ve been very concentrated on the female body because in some ways, dare I say it, you’re more wonderfully made and complex because your body, in a month’s time, goes through this cycle where the male doesn’t although that’s another question.

I want somebody to answer what cycles does a male enter. Yeah. I can’t speak about that issue, but it is a real one. I was going to say, let’s take that one away. Yeah, I mean because we have to be very in tune to our bodies as well. And we have hormones as well. And they are giving us marching orders.

Right. And so, parsing this out between what my hormones are telling me I should be doing right now and trying to have a connection with God, and we want God to be telling us what to do. You know what I mean? I can see how these can become conflated sometimes when we get unhealthy. Is that a fair observation?

I would agree. So, I think that’s why it’s important to be in the Word and know the Word. And if what your hormones are telling you to do doesn’t line up with the Word, then you need to think about it. Someone made the statement once, the Bible does not say, have the fruit of the Spirit when hormones are in balance or during a certain phase of your monthly cycle.

And I think that’s true. While hormones make a lot of changes in us, we have to continue to be stewarding them in a way that allows us to be living in the Word and being godly. Lynn, what questions should a young lady be asking her mother? Or maybe what information should a mother be thinking they should be passing along to her daughter?

So important factors are, when did she start her cycle? What were her cycles like? When did she go into perimenopause, menopause? Because that can be an important factor. How about bone density? For people who have osteoporosis, it can be genetically driven. There’s a lot we don’t know about, but there is some evidence pointing out that some of these challenges can be also genetically related.

So, I think Mom being really transparent with how it was for her and relating that to her daughters is really important. And I’ll say dads to sons as well. But I know that I’m finding I’ve got more questions as I’m growing older to older men. Like, is this what you experience? Help me understand life in stages of life, because there’s no way of knowing it unless it’s in the rearview mirror, right?

And so anyway, I think that’s really important. And I think it’s a larger concept that we can take as sons and daughters and mothers and fathers. And I think it is so good for moms to talk with their girls like how we started out talking today of the beauty in how God designed your body.

If it’s not talked about that way, it can become such a negative in a female’s life. I know it’s really easy in the hard, stressful years of teenagers to be able to see positives when they’re in that PMS stage or when PMS symptoms would be likely. And it’s easy to be to shoot that at them like, you are hormonal right now.

And really, if based on all the things you said, we’re hormonal all month long. And so being able to give better language for it and better tools and resources to navigate those days versus okay, stop, this is just hormones. I think it’s a wonderful conversation to have with teens. And mothers talking to their daughters about the gift and privilege of being a woman, of being able to be a life giver. Whether you have children or not I think you know as godly women we are fearfully and wonderfully made and we have the opportunity to mentor other young women, whether they’re our daughters or not. We also have the privilege and opportunity to complement men.

And it’s just a beautiful gift we’ve been given. And I think it’s wonderful to promote that rather than put it in a negative light. Indeed, we are fearfully and wonderfully made. Lynn and Kathy, as we talked about that, it just became more and more evident and to take a couple steps back, I don’t think we can help or get out from underneath it as humans to divide things up into categories.

The human body, from the emotion, from the spiritual walk, from worship. You know, we have all these compartments that we think of things in, and I dare say Jesus sees them much more integrated. Would you agree with that? And that our bodies are not only fearfully and wonderfully made, but our worship is done in our body.

We worship God via our body. It houses us and is going to be resurrected, right? I mean, it blows our minds. We can’t quite get our minds all the way around that, but I think what you’ve done is elevate the body to a sense that, no, it’s not just biology and physical things. These are very instrumental in how we live our life. And how we worship God, and our hormones are very much a part of the picture of loving God and loving others and living well with ourselves. Is that fair to say?

And so, knowing ourselves, whether we’re female or male, knowing our bodies and their intricacies is a really high calling and it’s very motivating. I think it’s something we all should step into. Thank you, Lynn, for your expertise. You shared a lot. So, for our listeners, we do have our show notes and we’re going to have a couple of links there. Those have some graphs, some of the terms that we were used, some of the acronyms so that we can use those as references.

Thank you for bringing clarity to that. Kathy, as always, thanks for elevating this topic and allowing this to be heard by our audience. It’s so important. And to each one listening, I hope you have been educated but also inspired by what God has done in all of us.

Thanks to each one for listening.