I want to talk to you about ovulation and the importance of ovulation beyond reproduction, but for your overall health.
Why do women ovulate? Is it good for them or a stress for nature to try to prepare a woman's physique for pregnancy?
Undoubtedly ovulation from the evolutionary point of view is for reproduction. But the reason ovulation is important even if we don't make a baby is that through ovulation hormones are produced.
Let's make a comparison: the testes produce sperm and testosterone. But testosterone is not only for making a baby, we know very well that testosterone has numerous other benefits, and not only for men. So for women, the production of estradiol and progesterone in the ovaries is of crucial importance. Let's see why.
Let's start by talking about estradiol, a very powerful hormone even at very low dosages: we measure it in pg toward the ng of progesterone.
Estrogen is important for metabolism: in fact, estrogen is anabolic, that is, it stimulates the formation of adequate muscle mass; this is why women who do strength training are particularly powerful e.g., in lifting heavier weights in the follicular phase, that is, in the first 2 weeks of the cycle when a lot of estrogen is formed, a period when muscle mass is particularly stimulated.
Think estrogen stimulates the metabolic flexibility, a true metabolic superpower. What happens. Metabolic flexibility encourages cells through their mitochondria to switch from using glucose to using ketones to get the energy they need. This is a crucial point for a healthy metabolism. In menopause, when we lose estrogen, insulin resistance increases precisely because we lose that metabolic superpower given to us by estrogen.
Estrogen plays an important role in the brain. I had once read a quote from a scientist who said that estrogen is like chocolate for the brain: it acts as a mood enhancer, which is why some women before ovulation are euphoric and extroverted. Do you find yourselves?
Estrogen is an appetite suppressant: in fact in the pre-ovulatory phase, when estrogen is high, the woman is more outgoing, wants to get out of the house, fasri beautiful, and is not interested in eating.
Progesterone, is definitely different, is produced by the corpus luteum after ovulation and is the hormone that prepares and maintains pregnancy: beneficial to the fetus and uterine lining. In addition to this progesterone is a beneficial immunomodulator with marked anti-inflammatory effects.
In perimenopause, which is the 5-8 years before women enter menopause, they lose progesterone before they lose estrogen, in when they have cycles in which they do not ovulate. So you also lose the immunomodulatory benefits of progesterone-that's why women in their late 30s and early 40s are more vulnerable to autoimmune diseases, Hashimoto's thyroiditis. The other phase of a woman's life where she is at risk for autoimmune diseases is the postpartum phase, when there is a collapse in progesterone production. Let me remind you that during pregnancy the placenta produces huge amounts of progesterone (you know that feeling of indifference and total well-being when you were pregnant?). so the immune system is particularly sensitive to progesterone.
An important metabolite of progesterone is allopregnanolone, a neurosteroid with a GABAergic effect in the brain: the effect is calming, stimulating sleep as well as appetite.
What does ovulation and, specifically estrogen spikes do for women?
Women benefit from 35 to 40 years of age from ovulatory cycles, not only for fertility, but especially to prevent cardiovascular disease, osteoporosis, dementia, and cancer, including even breast cancer: progesterone, in fact, is quite different from the progestins of HRT and contraceptive pills, and has distinct protective characteristics toward carcinoma.
It is right to consider each and every ovulatory cycle as a deposit into the bank account of long-term health: in doing so we build healthy muscles, healthy bones, healthy insulin sensitivity, healthy brains. And to do this over the decades we need ovulatory cycles that deposit hormones into the bank account!
Why don't some women ovulate?
There are dozens of potential causes for a failure to ovulate. First, hyperprolactinemia or thyroid disease must be ruled out. Think of ovulation as your monthly health report card: since ovulation is difficult to do as it is an energy-consuming process, if we are able to do it on a monthly basis, that means we are well, so we ovulate well and menstruate: menstruation is a sign of good health.
Very frequently at the basis of ovulation failure we find the contraceptive pill suppressing ovulation, polycystic ovary syndrome, steadily increasing and hypothalamic amenorrhea, due to under/malnutrition. Hypothalamic amenorrhea is not to be considered a malfunction but a defense of the body: because no you get enough nutrition, you are unable to cope with pregnancy. Hypothalamic amenorrhea is often misdiagnosed as PCOS.
