Dr. Brittany Schamerhorn, ND
Episode Summary
What does “hormonal imbalance” actually mean, and do symptoms such as PMS, acne, unwanted hair growth, weight changes, fatigue or irregular periods mean your estrogen, progesterone, testosterone or cortisol need to be tested and “balanced”?
In this episode of Girls Gone Wellness, Jeanette and Victoria speak with Dr. Britt Schamerhorn, ND, a naturopathic doctor focused on women's health and hormones, about hormonal imbalance, polycystic ovary syndrome (PCOS), premenstrual syndrome (PMS), insulin resistance, estrogen dominance, cortisol, hormone testing, perimenopause, birth control pills, hormonal IUDs, nutrition, seed cycling, cycle syncing, supplements such as DIM and indole-3-carbinol (I3C), and common hormone-health misinformation. Rather than dismissing women's symptoms, Dr. Schamerhorn explains why identifying the specific symptom, diagnosis or underlying driver is often more useful than simply labelling everything a hormone imbalance.
The conversation starts with a basic question: what are hormones? Dr. Schamerhorn describes hormones as chemical messengers that communicate throughout the body. Estrogen, progesterone, testosterone, insulin, cortisol and thyroid hormones all have different functions, which is part of why the blanket phrase “balance your hormones” can be misleading.
The episode explores situations where measurable hormone abnormalities do matter. In PCOS, for example, elevated androgens such as testosterone may be clinically relevant, while insulin can also contribute to the broader metabolic and reproductive picture. But Dr. Schamerhorn stresses that “hormonal imbalance” itself is not a diagnosis. Symptoms may also be affected by sleep, stress, nutrition, energy intake and other health conditions.
Nutrition is another major focus. Is there a special hormone-balancing diet? Should women eat low-carb or keto? Are carbohydrates helpful for PMS? Dr. Schamerhorn emphasizes basic nutrition first: eating enough food, adequate protein, fibre, fruits and vegetables and drinking enough water. She discusses the Mediterranean-style diet as a broadly useful pattern while explaining why carbohydrate needs may differ between someone with worsening PMS from restriction and someone managing insulin resistance.
The episode also examines seed cycling and menstrual cycle syncing. Dr. Schamerhorn questions whether seed cycling meaningfully “balances hormones,” while acknowledging that adding seeds may increase fibre, fatty acids, calories and awareness of the menstrual cycle. Similarly, she argues that women do not need to avoid high-intensity interval training (HIIT), running or strength training simply because of a particular menstrual-cycle phase. Performance may fluctuate, but exercise should remain practical, enjoyable and individualized.
A substantial section focuses on oral contraceptive pills and hormonal IUDs. Dr. Schamerhorn challenges the idea that using birth control is automatically a failure to address the “root cause.” For conditions such as heavy periods, painful periods, endometriosis or PCOS, symptom suppression may sometimes provide meaningful relief while other health factors are addressed. She also discusses why symptoms appearing after stopping birth control do not necessarily mean the pill caused PCOS, infertility or the underlying condition.
Hormone testing is examined through a simple question: Will the result change the diagnosis or treatment? Dr. Schamerhorn discusses progesterone testing in fertility, testosterone testing for PCOS and situations where hormone testing may be more useful, while questioning routine estrogen, progesterone or perimenopause testing when results will not change management.
Finally, the episode tackles cortisol testing, “cortisol belly,” estrogen dominance, DIM, I3C and hormone supplements. The recurring message is to define the clinical outcome first: What symptom are you trying to improve? What would make a supplement worth taking? How long should it take to work? And does changing a laboratory value actually make the patient feel or function better?
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What does “hormonal imbalance” actually mean, and do symptoms such as PMS, acne, unwanted hair growth, weight changes, fatigue or irregular periods mean your estrogen, progesterone, testosterone or cortisol need to be tested and “balanced”?
In this episode of Girls Gone Wellness, Jeanette and Victoria speak with Dr. Britt Schamerhorn, ND, a naturopathic doctor focused on women's health and hormones, about hormonal imbalance, polycystic ovary syndrome (PCOS), premenstrual syndrome (PMS), insulin resistance, estrogen dominance, cortisol, hormone testing, perimenopause, birth control pills, hormonal IUDs, nutrition, seed cycling, cycle syncing, supplements such as DIM and indole-3-carbinol (I3C), and common hormone-health misinformation. Rather than dismissing women's symptoms, Dr. Schamerhorn explains why identifying the specific symptom, diagnosis or underlying driver is often more useful than simply labelling everything a hormone imbalance.
The conversation starts with a basic question: what are hormones? Dr. Schamerhorn describes hormones as chemical messengers that communicate throughout the body. Estrogen, progesterone, testosterone, insulin, cortisol and thyroid hormones all have different functions, which is part of why the blanket phrase “balance your hormones” can be misleading.
The episode explores situations where measurable hormone abnormalities do matter. In PCOS, for example, elevated androgens such as testosterone may be clinically relevant, while insulin can also contribute to the broader metabolic and reproductive picture. But Dr. Schamerhorn stresses that “hormonal imbalance” itself is not a diagnosis. Symptoms may also be affected by sleep, stress, nutrition, energy intake and other health conditions.
Nutrition is another major focus. Is there a special hormone-balancing diet? Should women eat low-carb or keto? Are carbohydrates helpful for PMS? Dr. Schamerhorn emphasizes basic nutrition first: eating enough food, adequate protein, fibre, fruits and vegetables and drinking enough water. She discusses the Mediterranean-style diet as a broadly useful pattern while explaining why carbohydrate needs may differ between someone with worsening PMS from restriction and someone managing insulin resistance.
The episode also examines seed cycling and menstrual cycle syncing. Dr. Schamerhorn questions whether seed cycling meaningfully “balances hormones,” while acknowledging that adding seeds may increase fibre, fatty acids, calories and awareness of the menstrual cycle. Similarly, she argues that women do not need to avoid high-intensity interval training (HIIT), running or strength training simply because of a particular menstrual-cycle phase. Performance may fluctuate, but exercise should remain practical, enjoyable and individualized.
A substantial section focuses on oral contraceptive pills and hormonal IUDs. Dr. Schamerhorn challenges the idea that using birth control is automatically a failure to address the “root cause.” For conditions such as heavy periods, painful periods, endometriosis or PCOS, symptom suppression may sometimes provide meaningful relief while other health factors are addressed. She also discusses why symptoms appearing after stopping birth control do not necessarily mean the pill caused PCOS, infertility or the underlying condition.
Hormone testing is examined through a simple question: Will the result change the diagnosis or treatment? Dr. Schamerhorn discusses progesterone testing in fertility, testosterone testing for PCOS and situations where hormone testing may be more useful, while questioning routine estrogen, progesterone or perimenopause testing when results will not change management.
Finally, the episode tackles cortisol testing, “cortisol belly,” estrogen dominance, DIM, I3C and hormone supplements. The recurring message is to define the clinical outcome first: What symptom are you trying to improve? What would make a supplement worth taking? How long should it take to work? And does changing a laboratory value actually make the patient feel or function better?
Frequently Asked Questions
What does “hormonal imbalance” actually mean?
“Hormonal imbalance” is not a specific medical diagnosis. Dr. Britt Schamerhorn explains that individual hormones can absolutely be too high, too low or clinically relevant in conditions such as PCOS, but simply saying someone's hormones are “out of balance” does not explain which hormone is involved, why it is happening or what should be treated.
Can PCOS cause a true hormone imbalance?
Yes, PCOS can involve measurable hormonal abnormalities, including elevated androgens such as testosterone in some patients. The episode also discusses insulin as a hormone that can contribute to the broader PCOS picture, particularly when insulin resistance is present.
Can stress make PMS or hormone-related symptoms worse?
Yes. Dr. Schamerhorn discusses stress, sleep, food intake and other lifestyle factors as potential contributors to how someone experiences PMS and other hormone-related symptoms. Her point is not that the symptoms are “just stress,” but that hormonal symptoms occur within a larger physiological context.
Is there a specific diet that balances hormones?
There is no single hormone-balancing diet that Dr. Schamerhorn recommends for everyone. She prioritizes basic nutrition—adequate total food intake, protein, fibre, fruits and vegetables and hydration—and discusses a Mediterranean-style pattern as a reasonable general foundation.
Is a low-carbohydrate or keto diet good for hormones?
It depends on the individual. Dr. Schamerhorn discusses how excessive carbohydrate restriction may worsen PMS for some women, while monitoring carbohydrate intake may be useful in someone dealing with insulin resistance or related metabolic concerns. The episode emphasizes individualized nutrition rather than universally prescribing keto or low-carb diets.
Can eating more carbohydrates help PMS?
For some women, adequate carbohydrate intake may improve how they feel around the menstrual cycle. Victoria shares her own experience of PMS improving after reintroducing carbohydrates, while Dr. Schamerhorn emphasizes that this does not mean carbohydrates are a universal treatment for PMS.
Does seed cycling balance hormones?
The episode does not establish evidence that seed cycling directly “balances hormones.” Dr. Schamerhorn notes that seed cycling may increase fibre, fatty acids, calories and awareness of the menstrual cycle, all of which could influence how someone feels without proving that the seeds themselves are regulating estrogen or progesterone.
Should you change your workouts based on your menstrual cycle?
You do not necessarily need to cycle-sync your workouts. Dr. Schamerhorn acknowledges that energy or athletic performance may fluctuate across the menstrual cycle, but argues that women should not be told they cannot perform HIIT, CrossFit, running or other intense exercise during specific phases. Adjusting expectations, recovery, sleep or nutrition may sometimes be more practical.
Does HIIT raise cortisol and “wreck your hormones”?
Dr. Schamerhorn does not recommend avoiding high-intensity exercise simply because it temporarily increases physiological stress. She discusses exercise as a potential tool for managing stress and emphasizes recovery, sleep, overall training load and whether the person actually enjoys and can sustain the activity.
Can birth control pills be used for PCOS, endometriosis or painful periods?
Yes. Dr. Schamerhorn discusses oral contraceptive pills as one possible tool for managing symptoms including heavy or painful periods and symptoms associated with PCOS or endometriosis. She emphasizes informed decision-making rather than treating hormonal contraception as either universally good or universally bad.
Does the birth control pill cause PCOS or infertility after you stop it?
The episode does not support the claim that birth control pills cause PCOS. Dr. Schamerhorn explains that hormonal contraception may suppress symptoms from an underlying condition that was already present, meaning those symptoms can become noticeable once the medication is discontinued. It can also take time for the menstrual cycle to resume its previous pattern after stopping hormonal contraception.
When should hormones be tested?
Hormones should ideally be tested when the result is expected to change the diagnosis or management. Examples discussed include testosterone testing when evaluating PCOS and progesterone testing in some fertility situations, while routine estrogen or progesterone testing may add little when the result will not change treatment.
Can a blood or urine hormone test diagnose perimenopause?
Routine hormone testing often cannot reliably determine whether someone is in perimenopause because reproductive hormones fluctuate substantially during this transition. Dr. Schamerhorn discusses exceptions in people who cannot use menstrual patterns as a guide, such as some patients with an IUD, previous endometrial ablation or hysterectomy with retained ovaries.
Should you test cortisol if you already know you are stressed?
Not necessarily. Dr. Schamerhorn questions the value of routine cortisol testing when somebody already clearly identifies significant stress and the test will not change management. She distinguishes this from situations where a clinician suspects a specific medical disorder affecting cortisol.
Do DIM and I3C “detox estrogen” or balance hormones?
Dr. Schamerhorn argues that supplements such as diindolylmethane (DIM) and indole-3-carbinol (I3C) should not automatically be prescribed simply because a hormone pathway can theoretically be changed. She recommends first defining the symptom or clinical outcome being treated, the expected timeframe and how the clinician and patient will determine whether the supplement is actually helping.
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This transcript has been edited for clarity and readability while preserving the substance of the conversation.
Victoria
Hi, Dr. Schamerhorn. Welcome to Girls Gone Wellness.
Dr. Britt Schamerhorn
Thanks for having me.
Victoria
We are so excited to have you today.
This is a huge topic. Every time Jeanette and I ask our audience what they want to hear on the podcast, everyone asks us about hormones.
We knew we needed an episode where we could basically go back and forth with questions and have someone who's an expert in this space help us make sense of them.
We're so happy to have you.
I want to start by having you give us some background on how you got into naturopathic medicine and, specifically, your work with hormones.
Dr. Britt Schamerhorn
I started, I think, like a lot of naturopathic doctors.
I was in undergrad heading toward some form of healthcare or medical school. I was doing a biochemistry major, and basically everyone in my very small cohort was going to medical school.
I remember looking around and thinking, “I don't want to be here. This isn't where I want to be.”
I terrified my parents.
In my fourth year, I decided I wasn't going to finish the degree in the way I'd originally planned and started taking courses I actually enjoyed—psychology, nutrition, anatomy and physiology.
In one of my nutrition classes, somebody mentioned a naturopathic doctor.
It was a light-bulb moment.
I thought, “This is it. This is where I can do all the things I like.”
I finished the lecture, immediately looked into the schooling and figured out what I needed to apply.
From that moment on, that was the direction.
I wasn't originally planning to go into naturopathic medicine, but when I found it, it felt like the right fit.
Interestingly, when I was in fourth year, I remember thinking, “I don't want to do hormone therapy. Women's health is boring.”
Now it's basically all I want to do.
That shift happened because I love working with women.
Everyone has their own stories, and women do so many cool things.
I can't do everything for them, but what I can do is help them feel their best so they can go do everything they want to do.
I also saw that women weren't getting the support or education they needed.
Most of us just want to feel better and be able to show up in our lives.
If I can facilitate that, I'm happy.
Jeanette
I love that story.
I actually have a similar one.
I didn't really know what a naturopathic doctor was before I got into CCNM.
Somebody mentioned naturopathic medicine, I Googled it and thought, “Wow. This is exactly what I've been looking for.”
Your story about women's health and hormones is inspiring too because so many women are left trying to figure out who to trust for accurate, evidence-based information.
There's so much hormone information on the internet.
Dr. Britt Schamerhorn
Thank you.
Jeanette
Today's episode is all about hormones.
On the internet, “hormones” gets thrown around as this general term, but people are usually talking about sex hormones like estrogen, progesterone and testosterone.
There are obviously many other hormones in the body.
Let's start with the basics.
What are hormones, and what is their job?
Dr. Britt Schamerhorn
At the most basic level, hormones are messengers.
They're coming from one place and communicating throughout the body.
If we look at classic examples like estrogen and progesterone, they're largely being produced by the ovaries during the reproductive years, and their effects aren't limited to the ovaries.
They're communicating with the brain, skeletal muscle and other systems.
The same idea applies to cortisol from the adrenal glands or thyroid hormones from the thyroid.
Their actions aren't simply local.
They have effects throughout the body.
That's part of why hormones become confusing.
Each hormone can have many different roles.
But generally, they're messengers telling the body what to do.
Victoria
It definitely gets confusing.
Right before recording, we were actually looking up how many hormones there are because we only talk about a few of them most of the time.
Before we jump into the biggest question, I almost want to give a disclaimer.
We do a lot of debunking on this podcast, and I don't want women listening to feel like we're saying what they're experiencing isn't real.
That's not what we're debunking.
It's just not always as simple as putting the label “hormonal imbalance” on everything.
There may be other areas we need to look at.
I don't want us to put all our eggs in one basket.
Dr. Britt Schamerhorn
Exactly.
We hear phrases like “hormone imbalance” or “balance your hormones” all the time.
Patients will come in saying, “My hormones are out of whack.”
My first question is: what does that mean for you?
What is actually happening?
What are your symptoms?
Your hormones could theoretically look “out of balance” on a piece of paper and you could feel completely fine.
So how is this actually affecting you?
When I have this conversation with women, we're not dismissing them.
We're actually saying, “We care enough that we want to understand what is really happening.”
We want to know what is impacting you rather than simply marketing something to you.
The goal is for you to feel better and understand what your body is supposed to be doing.
Victoria
We're labelling everything as hormonal imbalance now.
Somebody gains weight and suddenly it's, “That's your estrogen. Your hormones are imbalanced.”
Then we have something like hirsutism with PCOS where we think, “Okay, maybe there actually is something hormonally relevant happening here.”
That's what I want to educate people about today.
When we look at conditions such as PMS, fibroids or PCOS, are there situations where hormones are genuinely abnormal?
Dr. Britt Schamerhorn
Yes.
PCOS is a good example.
Depending on the diagnostic picture, testosterone or other androgens may actually be elevated.
Where I struggle with the word “imbalance” is that it makes me picture two hormones sitting on opposite sides of a scale, with one higher than the other.
In reality, it's more like a symphony.
With PCOS, for example, we can ask what elevated testosterone is doing downstream.
Then insulin may also be elevated or someone may have insulin resistance.
Insulin is a hormone too.
If insulin is high, there can be downstream effects.
But then the next question is why.
Is insulin elevated as part of the underlying condition?
What role are stress, sleep, nutrition and other factors playing?
There may absolutely be a diagnosis such as PCOS with elevated testosterone.
But hormonal imbalance itself is not the diagnosis.
That's where I think the phrase gets used as a tagline.
Women know when something doesn't feel right.
We've all had that experience of thinking, “Something feels off.”
Hormones feel like an obvious place to look because we have menstrual cycles and experience these changes every month.
I call periods and PMS “annoying opportunities.”
Once a month, your body gives you an annoying opportunity to see a bigger picture of what is happening.
If your PMS is suddenly much worse, that might highlight how stress, sleep or another factor is affecting you.
It may feel like your hormones are “out of balance,” and in a sense your body is telling you something isn't right, but the primary issue may not simply be the hormones themselves.
Victoria
That's a great way of explaining it.
Jeanette
It's such a nuanced topic.
It's confusing even for healthcare practitioners, so I definitely don't blame somebody without medical training for hearing something on social media and thinking it sounds true.
Dr. Britt Schamerhorn
Exactly.
Sometimes when you dig into the pathophysiology, the statement isn't completely wrong.
It's just not being communicated with full accuracy.
Take the classic phrase “estrogen dominance.”
During some stages of perimenopause, ovulation can become inconsistent.
Progesterone production may therefore be lower at certain times while estrogen can still be relatively high.
You can see where the phrase came from.
That doesn't mean the term is necessarily the best or most accurate framework.
Then people start applying “estrogen dominance” to every condition—including situations where it doesn't fit at all.
Women are desperate for an explanation.
The conventional healthcare system is doing the best it can, but women don't always get the answers they're looking for there either.
Then they go somewhere else and find somebody on the internet who gives them a very confident explanation.
It sounds like it finally answers their question.
Victoria
What you said about insulin is really important.
In naturopathic medicine, we're constantly talking about the “root cause,” yet sometimes we immediately give supplements to change a hormone rather than asking whether stress, food, sleep or insulin is contributing to the symptoms.
Dr. Britt Schamerhorn
Totally.
It also comes back to the patient's immediate goal.
Sometimes we genuinely need to manage symptoms first because whatever is happening has become too disruptive.
Think about a headache.
If you actively have a terrible headache, sometimes we just need to make it go away.
Take the Advil.
Longer-term, maybe we look at nutrition, sleep, stress and everything contributing to the headaches.
But while you're in severe pain, you don't care.
You need to feel better now.
I think about PCOS similarly.
If acne or unwanted hair growth is causing so much distress and anxiety that it is worsening somebody's overall stress, maybe we treat that symptom directly.
Then we can work on everything else at the same time once the person is feeling a little better.
Natural approaches can work really well.
They can also sometimes take time.
I'm impatient as a person.
Sometimes I want someone to feel better faster.
Victoria
It's the power of integrative medicine.
Let's talk about therapeutic diets for hormones.
We hear that low-carb diets can be helpful.
Then someone else says carbohydrates are helpful for PMS.
Are there therapeutic diets that you find useful for hormone-related conditions?
Dr. Britt Schamerhorn
That's a great question because everybody wants that answer.
If I had to pick one general pattern, a Mediterranean-style diet is probably the one where I would say, “This is a pretty reasonable place to start.”
But before we get into specialized diets, I think about a nutrition pyramid.
Are you eating enough protein?
Are you drinking enough water?
Are you eating enough food?
Let's cover the foundation before we worry about all the little things at the top.
The same goes for organic food.
If someone isn't eating enough protein because meat is expensive, I don't necessarily want them spending all their food budget on organic fruit.
Let's cover the basics first.
Then we personalize from there.
Carbohydrates are a perfect example.
For some women, limiting carbohydrates too aggressively can worsen PMS.
Those women may feel better eating more carbs.
Someone with insulin resistance and weight concerns may benefit from paying more attention to carbohydrate amount and quality.
That doesn't necessarily mean “go low-carb.”
It means the individual picture matters.
We're desperate for simple answers, so we grab onto one piece of information.
“My neighbour did this and it worked, so it should work for me.”
But you and your neighbour may have completely different health pictures.
There isn't one therapeutic diet that fixes all of hormone health.
I would love women to eat enough, eat enough protein and have a healthy relationship with food.
The stress around food itself matters too.
Victoria
I used to think I had the worst PMS in the world.
Then I started eating carbs again and it basically went away.
That isn't the cure for everyone, but it was very relevant for me.
Dr. Britt Schamerhorn
Exactly.
Look at keto or even intermittent fasting.
A lot of women try it and a couple months later we're saying, “So, how's it going?”
And they're like, “Yeah, we're back on bread.”
It's similar with vegetarian or vegan diets.
I feel like every naturopath goes through a vegetarian or vegan phase.
Then a year or two later, ask us about our iron.
Meanwhile, the vegans are on one side of the internet and carnivores are on the other side, and both are saying they have the perfect answer.
How are patients supposed to navigate that?
It's overwhelming.
So the short answer is no, I don't think there is one magical therapeutic hormone diet.
Start with good basic nutrition.
Get enough protein, fibre, fruits, vegetables and water.
Then personalize.
Jeanette
We hear the general guideline that meals should include protein, fat and fibre.
Is that a reasonable place to start?
Dr. Britt Schamerhorn
Yes.
With many patients, I'll start even simpler and say, “Let's have protein with every meal.”
Start there.
Then maybe we work on adding a vegetable or fruit.
Breakfast is often the meal where people are least likely to have produce, so if you miss it there, you may not catch up throughout the rest of the day.
Small changes add up.
If you change the main component of the meal—for example, moving from just toast to a breakfast centred around eggs—other parts of the meal often shift too.
We have to make it easy.
Nobody needs another complicated nutrition book.
Jeanette
Quick side note: seed cycling.
Is there evidence that seed cycling actually balances hormones, or is somebody potentially benefiting because they're adding calories, fibre and other nutrients?
Dr. Britt Schamerhorn
I honestly haven't gone back and looked at the seed-cycling research recently enough to give you a definitive evidence review.
I remember writing about it when I was newer in practice, and now I'm thinking, “What exactly did I cite back then?”
So I don't want to pretend I know whether there is good evidence now.
My bigger question is: why?
What are you getting from it?
You're getting fibre.
You're getting fatty acids.
Those things may absolutely be beneficial.
If you want to seed cycle and you enjoy it, go for it.
You're adding fibre and healthy fats.
It's probably not harming you.
But would it be where I start? Probably not.
It's relatively expensive and complicated.
Victoria
I did seed cycling.
I've done everything.
Half the month was something like flax and pumpkin seeds, which was manageable.
Then the other half was sesame and sunflower seeds, and I would dread it.
I'd be thinking, “How am I going to eat these every day?”
Dr. Britt Schamerhorn
One thing I do like about seed cycling is that for some women it creates awareness of their cycle.
They start paying attention to where ovulation is and what phase they're in.
Maybe that awareness is part of why they feel better.
Maybe they're thinking more about their nutrition.
Maybe they're adding seeds to yogurt or a salad and suddenly they're eating more fibre or more nutrient-dense food.
There are so many variables.
What I don't want is somebody stressing about seed cycling.
Absolutely not.
At one point I remember hearing the advice, “Just mix all four seeds together and eat a couple of tablespoons.”
Honestly, that makes more sense to me than making somebody obsess over which seed belongs to which day.
Victoria
We talked about how seed cycling may help somebody with hypothalamic amenorrhea simply because they're adding more calories.
Flax is nutritious too.
But that doesn't necessarily mean it's “regulating hormones.”
Dr. Britt Schamerhorn
Exactly.
That's the problem with nutrition research and nutrition changes.
What else changed at the same time?
If someone says, “I went low-carb and felt better,” was it really because they cut carbohydrates?
Or did they stop eating doughnuts every day?
If someone started seed cycling, did they increase total calories?
Did they add healthy fats or fibre?
What actually shifted?
Then we ask whether there's an easier way to accomplish the same thing.
Jeanette
That's where informed consent matters.
If we're saying, “This may help you increase calories, fibre or healthy fats,” let's phrase it that way.
Don't tell somebody, “This will balance your hormones,” when that isn't what we actually know.
Dr. Britt Schamerhorn
Exactly.
I like to believe that most practitioners recommending these things genuinely think they're making the best choice.
Sometimes we just need to ask a second question: why are we doing this?
Healthcare practitioners also have to be willing to look back and say, “I was wrong,” or, “I could do this better.”
That's difficult.
Patients have put their trust in you.
It takes putting your ego aside and putting the patient first.
Our practices should change as we learn more.
Jeanette
Let's move into exercise.
On social media there's a lot of conversation around cycle syncing workouts—doing lower-intensity exercise during some menstrual phases and more intense training during others.
We also hear that HIIT or CrossFit can “wreck your hormones.”
Do you recommend cycle syncing?
Dr. Britt Schamerhorn
My first answer is: let's just exercise.
Let's not make this harder than it needs to be.
If somebody is struggling to get any movement at all, I do not care what menstrual phase they're in.
I want them to find something they like and bring movement into their life.
We can worry about the smaller details later.
I don't want to raise the entry barrier by saying, “This week you need hard exercise, then this week you taper, then this week you do something else.”
Will performance sometimes change across the cycle?
Absolutely.
If I go for a run right before my period or on day one, sometimes I think, “Why was that so hard? Why can't I keep my usual pace?”
Then I realize where I am in my cycle.
Your body may not perform exactly the same way every day.
That doesn't mean you can't give it the opportunity to exercise.
Let's not tell women they can't do HIIT or sprint right before their period because they're going to destroy their hormones.
That creates guilt, and women don't need more guilt.
Do what feels good.
There is another side, though.
Maybe we can use cycle awareness to ask, “How can I support myself better right now?”
Maybe I need more carbohydrates in the luteal phase.
Maybe I need to hydrate better.
Maybe I need to protect my sleep more.
If I want to perform similarly, maybe I need to change how I'm fuelling.
Or maybe I just accept that today's run is going to be easier.
That doesn't mean I'm losing progress.
It comes back to the individual.
Sometimes someone is an extreme overachiever and genuinely needs permission to back off.
But I also sometimes wonder whether we've swung so far into “listen to your body” that we've lost some of the self-commitment of showing up even when we don't feel like it.
There's nuance.
Jeanette
My next question was actually about stress and cortisol in relation to exercise.
Dr. Britt Schamerhorn
I love Emily Nagoski's work. She wrote Come as You Are and Burnout.
One idea she discusses is completing the stress cycle.
Exercise is one of the situations where we intentionally enter a heightened physiological stress state and then get the opportunity to deliberately come back down.
You exercise.
Then you stop exercising.
Your body practises moving through that cycle.
Of course, I'm also guilty of finishing a workout class, skipping the cooldown and running out the door into the next stressful thing.
But if you actually give yourself the opportunity to come down, exercise can be a beautiful stress-management tool.
So when somebody says, “Exercise raises cortisol,” we have to ask what that actually means.
Yes, exercise is a physiological stressor.
But that doesn't automatically make it harmful.
Again, take the piece of information and ask why it matters to you.
Sometimes it matters.
Sometimes it doesn't.
Jeanette
That's where social media creates another stressor.
Maybe someone's favourite stress outlet is OrangeTheory or CrossFit.
Then they see somebody saying HIIT raises cortisol and ruins hormones.
They think, “Maybe this is why I feel bad,” stop the workout they love and start forcing themselves into yoga classes they hate.
Dr. Britt Schamerhorn
Exactly.
I have two young kids and I currently go to OrangeTheory.
They have a 5:15 a.m. class.
Yes, that's early.
But for me, the accountability works.
I've signed up, and if I don't show up they charge me.
Apparently I need that.
Because I'm getting up early, I also go to bed very early.
I spread out the harder sessions.
I'm doing around three classes a week rather than smashing myself every day.
Then I might do an easier run or walk on other days.
I do it every week of the month because that's what works in my life right now.
I don't have the mental bandwidth to plan my entire schedule around exactly where I am in my menstrual cycle.
Sometimes I only realize where I am in my cycle because I think, “Why am I acting like this today?”
Then I look and think, “Oh. That makes sense.”
Victoria
My problem with cycle syncing is that some people market it as though women are incredibly fragile and can't do anything while they're menstruating.
That's not true.
Even if performance changes, sometimes the question is just, “How can I feel better today?”
And exercise itself can help painful periods.
Telling women they can only do yin yoga while bleeding feels ridiculous.
Dr. Britt Schamerhorn
Exactly.
The Olympics just happened.
How many Olympic athletes do we think said, “Sorry, I can't perform today. I have my period”?
Absolutely not.
There may be individual factors, symptoms or performance changes, but that doesn't mean women can't show up.
Sometimes showing up through those phases makes us more capable, not less.
Victoria
Let's shift to hormonal contraception—the oral birth control pill and hormonal IUDs.
You're a naturopathic doctor practising in British Columbia, where you have prescribing rights.
Are those options you actually use in your naturopathic practice?
Dr. Britt Schamerhorn
Yes, and that surprises some people.
At an initial visit, I tell patients that part of my job is to lay out all of their options—even the ones I know they probably didn't come to me for.
Somebody may come in specifically because they don't want the birth control pill.
I'll still say, “The birth control pill is an option. You get to decide whether you want it. I'm assuming it isn't your first choice, but let me explain why somebody may have offered it to you.”
Here's what the conventional practitioner may have been thinking.
Here are the goals.
Here are the other things we can do.
If someone has extremely heavy periods or severe cramps, the birth control pill may work faster than some of our naturopathic approaches.
Sometimes time matters.
I had a patient who experienced a significant flare of an autoimmune condition every time she ovulated and menstruated.
I didn't know exactly why that was happening, but it was causing enormous distress.
Nobody had offered her the birth control pill.
I asked whether she wanted to become pregnant right now.
She said no.
So we discussed suppressing those hormonal fluctuations for a period of time.
Then we could work in the background on stress, nutrition, sleep and everything else.
For two and a half weeks out of every month, she was too symptomatic to meaningfully work on those foundations.
It doesn't have to be either/or.
Sometimes we can strategically use the pill to quiet things down while addressing other factors.
The same could apply in PCOS or endometriosis.
If somebody has completed their family and their main goal is symptom management, maybe they don't want to spend a week or two every month being incapacitated by their period.
They have jobs.
They have children.
They have lives.
Let's not make women feel guilty for wanting symptom relief.
That doesn't mean everybody has to use birth control.
If you don't want it, that's completely valid.
The important part is understanding how and why it's being used.
And obviously contraception itself is also a valid reason to use contraception.
When I was in school, I had an IUD and loved not having a period.
I was busy.
Getting pregnant was absolutely not on the priority list.
It made my life easier.
There's no reason to shame a woman for her contraception choice or for choosing something that makes her life easier.
Victoria
I've done a complete 180 on this.
I used to think, “Birth control pills are just a Band-Aid. They're shutting down your hormones.”
Now I'm like: yes, sometimes they are suppressing the cycle, and sometimes that's exactly what somebody needs.
Dr. Britt Schamerhorn
Exactly.
The bigger problem is when somebody goes to their family doctor and the only thing they're given is the pill without understanding what the clinician thinks is happening or why they're prescribing it.
For many women's-health concerns, primary-care physicians may have limited conventional options before you're talking about more specialized interventions or surgery.
They're not necessarily trying to dismiss you.
They may have a very short appointment and know that several different symptom patterns lead to the same treatment option.
That's why the conversation in between matters.
If we're considering the pill, why?
What are we trying to improve?
What else can we work on if you choose this treatment?
Sometimes simply understanding why they're being offered the medication changes the patient's experience.
There's also not just one birth control pill.
We have different estrogen types, different progestins and different doses.
The options are extensive.
If you don't feel good on one pill, that doesn't automatically mean every formulation will feel exactly the same.
On the other side, we can't dismiss women who say they felt terrible on it.
If somebody's mood worsened or they had unacceptable side effects, we need to take that seriously.
Maybe they don't want to try another one.
Maybe we consider a different formulation.
Different progestins have different side-effect profiles.
Some may be more relevant for acne or androgen-related symptoms than others.
The point is that if hormonal contraception is what somebody wants, we can spend time trying to make it the right option for that person.
Victoria
That's really interesting because patients will say, “I can't take birth control. I tried it once and my depression got worse.”
I didn't even realize how many formulation options there were.
Dr. Britt Schamerhorn
Exactly.
And that's also asking a family doctor to be an expert in every possible contraceptive formulation when that may not be their specific area.
OB-GYNs have deeper expertise, but they're also overloaded.
There's an opportunity for practitioners who have the time to provide education and help patients understand what questions to bring back to their prescribers.
Victoria
Another claim we hear is that birth control makes your natural hormones imbalanced after you stop.
People say, “I came off the pill and now I can't get pregnant because it ruined my fertility,” or, “The pill gave me PCOS.”
I've seen so many patients who think their birth control caused their PCOS.
Does the pill cause hormonal problems?
Dr. Britt Schamerhorn
I think the problem comes when birth control is used without enough education and becomes a Band-Aid without anyone understanding what was happening beforehand.
The pill didn't necessarily fix whatever caused the cramps.
It suppressed the cycle and often removed the symptoms.
If somebody had endometriosis before starting the pill, they probably still have endometriosis.
The medication may simply have made it less symptomatic.
A lot of these patients started birth control when they were teenagers.
You're 16 or 17.
You're not thinking, “What does this menstrual pattern mean for my future fertility?”
You want to live your life.
Maybe you're starting the pill for contraception.
Then nobody has another conversation about the symptoms that were present before you started it.
Years later, you stop the pill because you want to get pregnant, and suddenly the old problem becomes visible.
It may have been there all along.
We also know it can take a little time after stopping hormonal contraception for the body's usual cycle to restart and settle into its pattern.
That doesn't automatically mean the pill damaged you.
The difficulty is that we often don't know what would have happened anyway.
Was the condition there beforehand?
Would it have manifested during those years even if you weren't using contraception?
We don't always know.
That's why education before and during contraception matters so much.
Jeanette
Exactly.
Girls are started on the pill very young, and they often aren't getting an hour-long discussion about why they're being prescribed it or what condition their symptoms might represent.
Then 10 or 20 years later, they come off and experience something they don't remember ever being told about.
The pill becomes the obvious thing to blame because that's the only thing they know changed.
Dr. Britt Schamerhorn
And more broadly, we haven't done a good job educating women about their menstrual cycles.
Many patients don't understand what happens throughout their cycle until they decide they want to become pregnant.
They don't know when they're most fertile.
They don't know how hormones change through the month.
I'm hopeful we're in a generation where we'll do better with our daughters.
That's actually one piece of cycle-syncing culture that I do appreciate.
Maybe we've taken it too far on social media, but educating women about the follicular phase, luteal phase, ovulation and how hormones change across the month is valuable.
Women are so hungry for education about their own bodies that they're grabbing onto whatever information they can find.
Jeanette
Let's talk about hormone testing.
There are so many ways to test hormones.
Should everyone test their hormones?
If you have symptoms, should you test them?
When does it make sense?
Dr. Britt Schamerhorn
My first question is always:
What are we hoping to gain from the test?
If we're testing something, the result should change how we diagnose or treat you.
There should be a reason.
Take progesterone.
If somebody doesn't want to become pregnant, I may not care what their “day 21” progesterone level is.
In fertility, progesterone may provide useful information.
But if the patient's goal is simply to have better PMS and feel better, will that progesterone number change how I treat them?
If it won't, why am I making them spend money on it?
The same can happen with estrogen.
Three people could have exactly the same serum estrogen level and feel completely different.
So what am I going to do with that number?
PCOS and testosterone can be different because androgens can play a role in diagnosis.
That information may actually change the clinical picture.
Hypothalamic amenorrhea is another example where looking at an overall low-hormone pattern may help us understand what is happening.
But for the average person with PMS or general concerns, routine hormone testing often isn't giving us the answer people expect.
I understand why they want it.
People want an explanation.
But we have to ask whether that test is actually necessary.
Jeanette
What about perimenopause?
Dr. Britt Schamerhorn
Perimenopause is another big one.
There are now even consumer urine tests marketed for screening perimenopause.
The problem is that perimenopause is a time when hormones fluctuate dramatically.
They're supposed to fluctuate.
Testing one moment doesn't necessarily tell you where you are in the overall transition.
There are situations where hormone testing can be more useful.
If somebody isn't menstruating for another reason—for example, they have an IUD, they've had an endometrial ablation or they've had a hysterectomy but still have their ovaries—we don't have a menstrual pattern to look back on.
Testing may then provide additional information in the right clinical context.
But for most people, there's no single hormone test that simply tells us, “Yes, you are in perimenopause.”
I'll have women come in saying they had their labs done and everything was “normal,” therefore someone told them they couldn't possibly be in perimenopause.
Then we spend time talking to them and their symptom pattern is very consistent with the transition.
That validation matters.
So I'm not saying hormone testing is never useful.
I'm saying we probably don't need to automatically start there.
Ask what information you're trying to gain and how it will change what happens next.
Victoria
It's confusing even for us.
Patients come in saying, “I want to see what my hormones are doing.”
Even in fibroids, which are hormonally sensitive, having fibroids doesn't necessarily mean your blood estrogen is sky-high.
We already know the fibroids are present.
Why do I need an estrogen level before I can move forward?
Dr. Britt Schamerhorn
Exactly.
Let's go very naturopathic for a second.
If you're planning to “support estrogen metabolism,” would that one lab value actually change what you're going to do?
Probably not.
I say the same thing about routinely testing cortisol for stress.
If you already acknowledge that you're extremely stressed, then we probably need to support the stress.
Unless we're concerned about an actual cortisol-related pathology, what is the test changing?
If you're already asking, “Is my stress affecting me?” it probably is.
Victoria
That's my next question.
Everybody knows the word cortisol now.
We hear “cortisol belly,” “cortisol face,” inflammation from cortisol—the word is everywhere.
Obviously there are actual disorders involving very high or low cortisol, such as Cushing's syndrome or adrenal insufficiency.
But for general everyday stress, should people be testing cortisol and then treating the number with herbs and supplements?
Dr. Britt Schamerhorn
Again: what will it change?
There are occasional patients where I might use testing as a tool.
Somebody can be sitting in front of me looking incredibly stressed and saying, “I'm totally fine.”
They may be the type of person who needs to see something on paper before they'll take their stress seriously.
If we've discussed the limitations and they really want the test, that's a different conversation.
But generally, what am I going to do?
Am I going to say, “You've just told me you're extremely stressed, but your cortisol test looks fine, so I'm not going to help you with stress”?
Of course not.
We live in a very stressed society.
Then somebody hears “cortisol belly” and thinks cortisol itself is the whole explanation.
Maybe somebody is extremely stressed, so they're skipping meals.
Then they're crashing and craving sugar because their body doesn't care about optimizing health five years from now.
It cares about getting through the next five minutes.
Now there are a bunch of downstream symptoms.
We can say “cortisol” and feel like we found an answer, but what does that actually mean?
What is the person doing because they're stressed?
How are they sleeping?
How are they eating?
What support do they need?
There can absolutely be roles for herbs.
Something like ashwagandha may help some people with parts of that stress picture.
But again, the question is why we're using it.
Jeanette
This is a lesson for everyone.
I want to end with supplements because this ties everything together.
Someone comes in saying they have a hormonal imbalance.
They get blood work.
Then they get sold a supplement.
We hear about I3C, DIM and other nutrients marketed to “detox estrogen” or increase progesterone.
Can these supplements meaningfully change hormones?
Could that ever be harmful?
How should people think about them?
Dr. Britt Schamerhorn
The question is still:
What are you trying to treat?
Are you trying to change an arrow in a biochemical pathway because theoretically you can?
Or are you trying to improve a symptom and the person's overall health?
There's definitely a role for supplements.
I don't agree with the opposite extreme where somebody says supplements never work either.
But we need a purpose.
What are we hoping to get from this?
How long does the person need to take it?
What dose are we using?
When do we decide it isn't working?
What is the expected outcome and timeframe?
Those questions matter.
With hormone-related symptoms, sometimes you may need a few months before you can fairly evaluate whether something is changing.
It's also very easy to build a practice around giving everyone I3C, DIM or another supplement because a test appears to tell you to do it.
That's simple.
But I think we can do better.
Naturopathic medicine already has a reputation for being expensive and giving people a bucket of supplements.
The financial side matters too.
If a patient is spending hundreds of dollars on supplements, should we also be talking about a medication that may be covered and may achieve their goal more reliably?
That conversation needs to be on the table.
In naturopathic medicine, especially when we're newer, there can be a bias toward “supplements good, pharmaceuticals bad.”
Why can't we use both when appropriate?
Why can't we just be smart about what we're using?
Sometimes working on stress, sleep or nutrition may be more relevant than targeting one tiny part of an estrogen pathway.
Zoom out and look at the bigger picture.
Victoria
We've talked about this before.
Are you changing a laboratory value, or are you changing the clinical outcome?
Let's say DIM lowers somebody's estrogen.
Okay.
Do they still feel terrible?
If so, changing the number hasn't necessarily achieved what we wanted.
Dr. Britt Schamerhorn
Exactly.
There are some people—particularly in longevity or biohacking spaces—who genuinely care about achieving a specific laboratory value.
That's a different goal, and that's fine.
But we need to be clear about the goal.
What outcome do we actually want?
That matters.
Victoria
This was amazing and so helpful, even for us.
Let's end with a quick round of rapid fire.
I'll give you a statement, and you say myth, truth or “it depends.”
First:
If your hormones are out of balance, they need to be treated.
Dr. Britt Schamerhorn
It depends.
Victoria
High stress can negatively impact estrogen and progesterone.
Dr. Britt Schamerhorn
One hundred percent.
High stress messes with everything.
Jeanette
There's the sound bite.
Victoria
Mic drop.
Last one:
Estrogen dominance causes increased belly fat.
Dr. Britt Schamerhorn
What do you mean by “estrogen dominance”?
That's my question.
Ask the question back.
Victoria
Trick question.
Dr. Britt Schamerhorn
Exactly.
Let's not automatically accept the premise.
Ask what the term actually means.
Victoria
Is there one myth in the hormone space you'd like to debunk once and for all?
Dr. Britt Schamerhorn
I'm going to say this, even though it sounds almost like it goes against the whole conversation:
Your hormones do matter.
If you think your hormones are affecting you, they probably are—just maybe not in the way social media has told you.
You're not crazy because your labs came back “fine.”
We can dismiss patients when we only search for a laboratory abnormality.
How your body responds to hormonal shifts throughout the month can absolutely affect how you feel.
Your hormones matter.
We may just need to look at them differently than social media leads you to believe.
Jeanette
That was incredible.
Thank you so much for coming on today.
We know you're very busy.
Can you tell our listeners where they can find you and where people in British Columbia can book with you?
Dr. Britt Schamerhorn
You can find me on social media at Dr. Britt Schamerhorn ND.
I'm happy to support patients in British Columbia.
You can find me at Okanagan Women's Clinic locally in Kelowna, BC, or virtually throughout British Columbia.
Jeanette
Amazing.
Thank you so much for coming on.
We really appreciate it, and we learned so much.
Dr. Britt Schamerhorn
Thanks for having me, guys.
Victoria
Thank you.
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I became a naturopathic doctor because I was tired of watching women be told that their suffering was “just part of getting older.”
You know the script:"You’re just stressed."
"That’s normal for your age."
"Your labs look fine."
"Let’s just wait and see."But what if you’re exhausted no matter how much you sleep?
What if your period now comes with cramps that stop you in your tracks—or doesn’t come at all?
What if you’re noticing weight gain, brain fog, low moods, or unpredictable cycles... and no one seems to take it seriously?The patients I saw—and the stories I kept hearing—were all too familiar:
• Periods that hijack your life
• Fatigue that no amount of sleep fixes
• Mood swings, night sweats, and irritability that feel like they came out of nowhere
• Being told to "wait it out" until menopause
• And deep down, feeling dismissed and alone in your symptomsIf you're nodding along right now, you’re exactly why I do this work.
I knew there had to be a better way.
A way to listen first, investigate with care, and treat the whole woman — not just her symptoms, not just her hormones, and definitely not just her lab results.Because you’re not broken — you just haven’t been supported in the way you need.