So many aspects of a woman’s health are kept in balance by hormones. Understanding what’s going on hormonally in a woman’s body can be key to understanding why her period is irregular, why she cannot have a baby, why she feels pain during menstruation, as well as the activities of many other systems not directly involved with reproduction, including her mental health.
Hormones are like musicians in an orchestra, and the brain is like a conductor, balancing and controlling the music that they play. While each hormone has its own distinct part, the overall performance depends on their harmonious interaction. If one musician refuses to play or if a number of performers are out of sync, illness and disease can be the result.
There are profound differences between women based on the interplay of hormones in their bodies. The influence of hormones on a woman’s overall wellbeing can be especially apparent during a time such as menopause, when the lack of hormones can bring on hot flashes, stress, and anxiety. Factors such as stress can conversely interrupt the brain’s normal hormone release patterns, preventing the body’s normal control of the menstrual cycle and causing missed periods and other related symptoms.
Of course, hormones are most intimately involved with the reproductive system, and they are directly responsible for nurturing the ovarian reserve—the cache of eggs in each woman’s ovaries. It’s the role of hormones to oversee the caretaking of these eggs, making sure that only the best quality among them pass the bar and go on to present themselves for fertilization.
A Question of Balance
You could say that a woman’s health is controlled nearly 70–80% by hormones. This means that the modern science of women’s health is largely concerned with hormone control, therapy and testing to ensure everything is in balance. Advanced knowledge of how hormones play their roles has given doctors the unprecedented ability to influence this system, often giving them the power to restore the balance when things get out of kilter. In recent years, Ob-Gyn doctors have become so confident in the safety and effectiveness of hormone therapy that it is now a recommended treatment for disorders such as endometriosis, ovarian cysts and uterine fibroids, which were previously resolved by surgery.
Hormone Replacement Therapy – East vs West
I often give hormone replacement therapy for women who have premenopausal symptoms. These aren’t related to reproduction, but symptoms such as hot flashes, insomnia, joint pain, and so on. So just with a relatively straightforward course of hormone therapy, all those out-of-tune musicians will be silenced. The symptoms vanish, they can sleep well, and they feel happy again.
Although hormones are the one factor that most directly affect women’s health, the will to control and balance the body’s hormones is very different between people. In my own practice, I have observed that foreign women who consult with me often accept my advice to use medication to control their hormones. For example, patients with endometriosis, which causes pain every time they have their period, are often willing to use medication to control the length of their menstrual cycle or to stop their period altogether. They understand that no period means no pain, and want to avoid the effect that pain has on their lifestyle—so they use contraceptive pills to hush the hormonal signals that induce periods.
My Vietnamese patients are generally much more hesitant to use such medication. I have found that if I prescribe a hormone pill to make their cycle longer—so that they will not need to endure pain every time they have their period—they will quite often not accept my prescription. I have often been told by Vietnamese patients that they prefer to deal with the pain rather than interfere with their natural cycle.
The Wash Up
As a doctor I have to listen to my patients’ thoughts about hormone pills. I have often found, however, that patients who view this therapeutic method as unnatural often base their opinions on stories about side effects read online. Sadly, these stories are often inaccurate. The health benefits of using hormone medication for those who need it usually far outweigh any negative side effects, which can often be reversed by switching to a different course of treatment.
I ask my patients to decide which is the better alternative—to treat the pain and inconvenience of a hormone-related condition, or to endure it for fear of minor side effects (such as putting on weight) that may never happen and can be easily resolved?
I always try to persuade my patients that using pills or other medication to control hormones is a safe and well-advanced medical technique that can really make their lives better. This medicine is very commonly used outside of Vietnam with excellent results.
A serious and intelligent physician with a flair for academic medical science, Dr. Tran Phuong Linh worked as an infertilitist and gynecologist before joining Family Medical Practice HCMC to enhance our services to women. She is the founder of the NGO project “Under the Tree”, dedicated to teaching English to children.