Over the last few years, I’ve adopted Ayurveda, an ancient Indian healing system, as my main paradigm for maintaining my health. Of all the books I’ve read about Ayurveda, one has proved most helpful: Claudia Welch’s Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness through Ayurveda, Chinese Medicine, and Western Science.
When I first picked up Welch’s book, I was setting out to learn about Ayurveda, not hormones or Chinese medicine. Reading those other words in the book’s title, I just figured understanding them would be a side benefit of the book. But the more I read, the more captivated I became—it turns out that understanding hormones is key to understanding my ulcerative colitis and autoimmunity.
Welch’s thinking would become a primary lens through which I’d see my health from here forward. I cannot recommend her book highly enough, for everyone but especially for women.
The Modern Stress Epidemic
She begins with the thesis that modern society is experiencing a stress epidemic, perhaps especially among women. She describes the typical, stressed-out Western woman who is “doing too much while getting too little physical and emotional nourishment.”
Some of our stress is unavoidable, due to external circumstances like illness, deaths of loved ones, or challenges at work. But some of our stress is unconsciously self-imposed. Many of us are ambitious and overactive. Modern women tend to have an “overblown sense of responsibility and tremendous fear of impending doom,” Welch says, as if our slacking off will cause our entire lives to fall apart.
This all rang true for me. I could remember the franticness with which I’d often done things before my big health crisis in 2016—not only my work at work, but also my nonessential projects at home. Some women do need to work constantly to make ends meet, but Welch is especially talking about those who, like me, could make time to rest but still don’t.
Because external stressors are impossible to avoid, Welch says it’s crucial to learn to tamp down our stress levels when we can. After a major stressor, we must learn to relax again, taking advantage of lulls. If we never allow our bodies to relax, our stress becomes chronic. That wreaks havoc on our hormones.
Stress Hormones & Sex Hormones
While hormones are so complex that most doctors don’t even fully understand them, Welch asserts that laypeople need only understand a few basics.
First, hormones come in two broad categories: sex hormones and stress hormones. Both are important. Sex hormones—primarily estrogen and progesterone, in women—are not just about sexual function. They also help us to grow, help our reproductive organs to develop, and they’re found in every tissue in our bodies. Sex hormones are crucial to our general wellbeing throughout our lives.
Meanwhile, stress hormones—primarily cortisol and adrenaline—are meant to help us get through acute, urgent situations and “kick our bodies and minds into high gear.” But they can also be activated by any form of stress, including overwork, illness, upset, or even fasting.
Together, these two sets of hormones are supposed to maintain equilibrium in our bodies…but problems arise when our stress becomes chronic:
In the modern world, many of us find ourselves in a near-constant state of stress. When this happens, we have stress hormones like cortisol coursing through our bodies on a regular basis. The crunch comes when we don’t have enough of these hormones available to satisfy the huge demand for them. Then our bodies will find a way—any way—to get us more. One way to get more is to sacrifice some of our sex hormones by transforming them into stress hormones.
This piece is key: too much stress depletes our sex hormones. This happens because progesterone, though primarily a sex hormone, is also used by the body to manufacture both estrogen and cortisol. (“The reverse is not true: You cannot make progesterone from estrogen or cortisol.”)
That means when cortisol is in constant, high demand, progesterone becomes depleted—and when that occurs, there isn’t as much progesterone left over to make estrogen.
I had already known excess cortisol is generally bad, and that it compromises the immune system. But now, reading Welch, I learned that excess cortisol also depletes estrogen and affects the body’s tissues. This causes accelerated aging and breaks down everything, “including the bones, skin, muscles, and brain.”
How did my childhood stress affect my body?
Reading this part struck me profoundly. I believed I’d had elevated cortisol throughout my life—not just in adulthood like so many women, but also in childhood from the trauma of my dad’s alcoholism and depression.
I could even remember often deciding to cause myself stress in middle school. It felt as if I was addicted to stress, which I experienced as something similar to excitement. I figured I would be safest in life if I was ever-prepared for disaster, and so I trained myself to be vigilant against danger. Sitting in class, I’d imagine attackers surrounding my school, earthquakes occurring, or other dangers—always in vivid, shocking detail—then would picture how I might get away.
Addiction and trauma expert Gabor Maté writes:
For those habituated to high levels of internal stress since early childhood, it is the absence of stress that creates unease, evoking boredom and a sense of meaninglessness. People may become addicted to their own stress hormones, adrenaline and cortisol… To such persons stress feels desirable, while the absence of it feels like something to be avoided.
This had perfectly described me as a kid.
But now, reading Welch, I wondered how all my constant stress hormones had affected my young body. Did my natural slimness have to do with not only the airy vata nature I’d had from birth, but also with a lack of estrogen as I grew older? If I’d felt calmer and safer as a kid, might I have more body fat and a fuller figure? I couldn’t help but wonder.
Perhaps my slimness was “okay,” in general, as Ayurveda taught. But perhaps it was also rendered more extreme and unhealthy by my stress hormones.
What if shifting hormones caused my colitis?
I was also struck upon reading that women’s hormones change around age thirty-five. Again, I had generally known that the body changes around that age, which is why later pregnancies come with more risks. But I’d never thought about the specifics before, or what such changes might mean for my disease.
Welch explains that progesterone begins to decline around thirty-five. That means that as we age, we have fewer sex hormones to buffer the effects of our stress hormones. She points out that immune system disorders often appear around that age—and my colitis symptoms had begun, like clockwork, two or three months after my thirty-fifth birthday.
For years, I had attributed the timing of my colitis to changes in diet and lifestyle in the year before diagnosis. But that logic had never felt like the whole story to me—I hadn’t changed my diet that much.
Now Welch had given me a new explanation for the timing of my illness: I had aged. My progesterone had naturally begun to decline, and with that decline, the level of cortisol I’d been living with all my life had finally become too much for my system.
If this was true, then in a way, there was nothing at all I had done to cause my disease. Except keep on living with the same unhealthy diet and chronic stress I’d always had without health problems…and grow older.
Eastern concepts can help balance our hormones.
Reading Balance Your Hormones, Balance Your Life was sobering. I now had great clarity on how exactly my chronic stress—from childhood, from the pressure on modern women, and from my own habits—might have helped trigger my ulcerative colitis, creating a time bomb that went off when I aged.
But fortunately, the book was greatly comforting and uplifting as well. As Welch explains the workings of hormones in our bodies, she also offers a helpful paradigm through which to view them, and offers concrete practices that can bring them into balance at last.
This is where Ayurveda and traditional Chinese medicine (TCM) come in. Welch suggests we view hormones through an Eastern lens, because Eastern concepts are so helpful for understanding and balancing them.
Rather than focus on the Ayurvedic doshas I’d been reading about elsewhere—vata, pitta, and kapha—Welch writes about the broader concepts that Ayurveda and TCM have in common. The two philosophies go hand in hand, she says. Just as the same idea can be described in both French and Spanish, Ayurveda and TCM “are different languages that describe a reality they fundamentally see the same way.”
She specifically wants us to understand the concepts of qi and yin/yang. These are Chinese words, but Ayurveda has its own Sanskrit words that describe them, too: qi is prana and yin/yang are santarpana (or brmhana) and apatarpana (or langhana).
Understanding Qi (or Prana)
Qi (also spelled chi) is energy, but not the same kind of energy we think of in the West.
“Many modern women mistake the feeling of being under stress for having energy,” Welch points out, calling to mind my young fantasies of escaping attack. In the West, we seek energy by pumping ourselves up on adrenaline and caffeine, staying in shape through extreme workouts, and pushing through fatigue. The modern Western woman is “the human equivalent of the Energizer Bunny,” rushing frantically, trying to constantly do and be everything, but actually making herself fragile by depleting her reserves.
In Eastern medicine, qi is the life force. It’s something to spend judiciously and to nourish so that it doesn’t become depleted. The key to strong qi is balance; in China, multitudes of people practice tai chi and qi gong to nourish their qi and help it flow. Rest is important, too. Energy is related to peace of mind.
Reading about qi made me proud, because I had just started taking tai chi classes as part of my recovery from my health crisis. By now I had attended three classes and loved my new practice. I often came away feeling both calm and energized.
That feeling was the quieter, more vital energy of qi.
Understanding Yin and Yang
The other concept Welch teaches is yin/yang:
Ayurveda and Traditional Chinese Medicine both hold that there are two fundamental (and opposing) principles that invigorate and nourish life. Yang is the energizing, activating, and motivating principle of life. Yin is the nourishing and building principle.
…Yang is considered male energy, yin is considered female. Yang energy is hot, bright, fast, mobile, dry, energetic, and aggressive. Yin is cool, dark, slow, soft, substantial, stable, moist, and tranquil. Yang is daytime, yin is night. Yang is the movement of the wave crashing on the shore… Yin is the water that comprises the wave.
Welch says that from the Eastern perspective, stress hormones are considered yang and sex hormones are considered yin. Stress is mobile and energetic. Sex hormones, which build and nourish, are softer and more stable.
We need both yin and yang—both sex hormones and stress hormones. And thinking in terms of yin and yang can help us bring our hormones into balance.
Yin and yang can each be either good quality or bad quality, depending on the situation. Bad-quality yin comes from inactivity and poor-quality food, which both lead to sluggishness. Good-quality yin comes from healthy food, loving relationships, and taking time for contemplation, all of which lead to fulfillment and contentment. There’s a big difference between feeling heavy or lethargic and feeling full, whole, and content.
Meanwhile, bad-quality yang comes from too much stress, ambition, and busyness, which leads to agitation. But good-quality yang is supported by healthy exercise, inspiration, and mental stimulation, which can all motivate and energize us.
Bad-quality yang is the wired, frantic feeling you get from drinking too much caffeine or working too hard for too long. Good-quality yang is invigorating, like the energy of a stimulating conversation or a fun workout.
Reading about yin and yang, Welch’s descriptions instantly explained several mysterious cravings I’d had during my health crisis. For no reason I could explain at the time, I’d craved femininity and women’s books, overcast skies and dark rooms, solid things and the feel of stone. Now I realized I’d been unconsciously seeking the kind of balance Eastern medicine describes. I had been too yang during my crisis, and I’d sought yin things to balance myself out without even knowing I was doing so. Femininity, darkness, and solidity are all yin.
The Three Pillars of Health
Using these concepts of qi and yin/yang, Welch goes on to teach readers how to bring their own hormones into balance.
In the West, if we have a measurable hormonal imbalance, we’re often prescribed synthetic hormones. But those can be risky, and they don’t address the underlying problem that unbalanced the hormones in the first place.
Eastern philosophy frowns on synthetic anything, including hormones—hormone therapy for menopause, hormones in the form of birth control pills, etc. (Welch submits that if your hormones are healthy, the symptoms of menopause should be mild, and she recommends the book Taking Charge of Your Fertility for a safer, effective, natural form of contraception.)
In contrast to Western thinking, Ayurveda and traditional Chinese medicine aim to heal imbalanced hormones through diet, lifestyle, and stress management. Welch calls these the “three pillars of health.”
1. Diet
Welch cites an Ayurvedic proverb that illustrates the central role diet plays in promoting health: “When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need.”
Specifics on diet vary between Ayurveda and TCM, but both generally emphasize whole foods: whole grains instead of refined grains; legumes, vegetables, and fruits; healthy, whole spices (turmeric instead of turmeric supplements); and fermented foods like kimchi and miso. The key is to find foods that are as fresh and natural as possible, and to find what’s best for each individual body.
2. Lifestyle
Welch’s second pillar of health encompasses many of our habits and routines. She recommends the daily Ayurvedic ablutions, such as neti pot, tongue scraper, and other dinacharya, which help set our bodies on a good path at the start of the day. She emphasizes catering exercise to our body’s individual type and needs—as a slender person, I may need more moderate, gentle exercise than someone more robust. She also describes ideas for getting good sleep and reducing environmental toxins.
3. Stress Management
Welch says we must remove the “poisons” from our lives—poisonous foods, alcohol, caffeine, and other substances; but also poisonous relationships or other elements that get in the way of our health. “If we can’t do this all at once, we can at least address these issues one at a time.”
She also offers several practices for calming the nervous system. These are meditation, which I was already doing as I read her book, and two others I hadn’t yet tried: alternate-nostril breathing and a practice called abhyanga.
In her own role as a healer, Welch says these two practices have been incredibly effective for many of her patients, sometimes almost single-handedly seeming to reduce anxiety and bring calm. This made me eager to try them both.
Alternate-nostril breathing is described here, and abhyanga, the wonderful, self-massage with warm oil, is described here.
A New Understanding of Health
By the time I finished Welch’s book, I was sold on Ayurveda and on her general philosophy.
She’d given me a solid paradigm for understanding what had caused my disease and how it related to my chronic anxiety. My hypervigilance, which had first developed as a child, had chronically elevated my cortisol, which depleted my qi and stole from my body’s ability to produce enough estrogen. The imbalance had possibly stunted my growth in some ways, and, over the years, it had kept me always on the threshold of illness—which I hadn’t realized, because my Western mentality told me to keep pushing through pain and fatigue. My elevated cortisol contributed to general inflammation over the years, too.
And once my sex hormones began declining around age thirty-five, the cracks in my internal foundation became too much for my system to handle. My overtaxed immune system finally became confused and began attacking my colon.
To reach a place of optimal health now, I needed to cultivate my qi and nurture my yin. Whatever these terms technically meant for the inner, scientific workings of my body, they offered perfect imagery for how to approach my healing. The process would involve eating nourishing food, putting healthy lifestyle practices into place that fostered routine, focusing on gentle exercise that respected my delicate build, and spending time on calming practices.
Much of this I was doing already—I had instinctively gravitated to these healing practices after my health crisis. The book added to my repertoire of things to try, clarified how I saw my health, and gave me a road map to follow.
