How to Calm Inflammation

By Suzanne Fenske, MD, FACOG, ABOIM, MSCP

How to Calm Inflammation

From an integrative and functional medicine perspective, we are always seeking to understand the root cause of symptoms and diseases that women experience. Often, inflammation is a piece of the puzzle. Then we want to take a step further to understand what drives inflammation. Is it lifestyle, diet, hormones, toxins, or a combination of factors?

Today’s article will explore inflammation, when we want it and when we don’t, and how to address lifestyle habits that may be contributing to silent inflammation. Keep reading as we explore:

• What is inflammation?
• Acute inflammation vs. chronic inflammation
• Inflammation and women’s health concerns
• Perimenopause as pro-inflammatory
• What causes inflammation?
• Integrative strategies for reducing chronic inflammation

What is Inflammation? Acute vs. Chronic Inflammation

Inflammation is a key physiologic process, the immune system’s response to injury or infection. Imagine you accidentally slam your finger in your car door. The immune system immediately sends resources to the area for healing, and you’ll feel the effects in the form of pain, swelling, heat, and redness. As the injury heals, inflammation subsides and shuts off. It’s an acute, short-term event that resolves itself, and this is precisely how we want inflammation to work.

Where we get into trouble is when the inflammatory process doesn’t shut off, and you experience persistent low-level chronic inflammation. Chronic inflammation may exhibit have the same signs and symptoms as the acute event; it may be brewing silently beneath the surface, contributing to disease.

Whereas acute inflammation is localized and beneficial, chronic inflammation is often systemic and detrimental.

Inflammation and Women’s Health

Chronic inflammation affects all aspects of health, including the menstrual cycle and women’s specific concerns, as well as the risk of chronic disease. Most uncomfortable symptoms and diseases have an inflammatory component. Any condition with “itis” in the name suggests inflammation of that part of the body.

Research suggests that 20 to 40% of reproductive-age women experience low-grade, silent inflammation, which is associated with a variety of conditions, including:

• Fertility challenges
• Pregnancy complications and miscarriage
• Polycystic ovary syndrome (PCOS)
• Endometriosis
• Uterine fibroids
• Chronic pain syndromes
• Migraines
• Interstitial cystitis
• Autoimmune diseases
• Premenstrual syndrome (PMS)

The menstrual cycle, including ovulation and menstruation, as well as other reproductive events such as labor and childbirth, demonstrates aspects of normal inflammation, where cells release inflammatory signals. Women’s health issues may occur when that inflammation does not resolve correctly. Inflammation in the reproductive organs can become inflammation elsewhere in the body.

For example, up to 80% of women experience PMS symptoms during the luteal phase of the menstrual cycle (before the period). Specific symptoms, including mood symptoms, pain, cramping, weight gain, bloating, and breast pain, correlate with a higher level of C-reactive protein (CRP), a biomarker of inflammation.

Perimenopause and Inflammation

In perimenopause, ovarian aging accelerates, and inflammation rises. Some characterize perimenopause as an inflammatory event. As estrogen declines, women lose its anti-inflammatory protection, and it becomes harder to “turn off” the cascade of inflammatory signals after an acute event. Women become more vulnerable to chronic inflammation.

Many perimenopausal symptoms are inflammatory in nature, such as PMS, joint pain, breast changes, depression, migraines, weight gain, and others.

Further, perimenopausal inflammation is a driver of chronic disease. After menopause, a woman’s risk for cardiovascular disease, metabolic disease, and neurodegenerative diseases increases. While we attribute these increased risks to the loss of estrogen (and progesterone), the rise in inflammation certainly contributes.

One study examined inflammatory markers, including CRP, LDL, and Lp(a), around the time of menopause and found that early inflammation correlated with cardiovascular events 30 years later. Managing inflammation in perimenopause is not only about symptoms; it’s an incredible opportunity to establish long-term health.

Other Causes of Inflammation

In addition to the hormonal changes of perimenopause that increase a woman’s vulnerability to inflammation, many environmental factors contribute to low-level, silent, and chronic inflammation in the body.

These include:

• Diet high in ultra-processed foods
• Diet high in processed red meat
• Elevated blood sugar
• Exposure to environmental toxins
• High stress and nervous system dysregulation
• Hidden infections, such as gut infections or chronic viral infections
• Gut barrier disruption (“leaky gut”)
• Excess body fat, especially visceral fat (fat around the organs)
• Alcohol and tobacco use
• Sedentary lifestyle

The good news is that many of the factors on this list are modifiable with good nutrition, lifestyle practices, and integrative medicine approaches. You can lower inflammation by addressing your contributing factors!

How to Reduce Inflammation

Reducing inflammation, the silent, chronic kind, comes down to identifying and adjusting your individual root causes. The individual aspect is why it’s crucial to work with a practitioner who understands inflammation and how to manage it, as we do at TārāMD. While much of it is personal, here are some general action steps to consider:

• Optimize nutrition. Reduce ultra-processed foods and opt for whole, nutrient-dense options that help you balance blood sugar and meet your nutrient needs. Key categories include colorful produce, healthy fats (olive oil, nuts, seeds), fish, legumes, soy, herbs, and spices. Think eating seasonally and with variety. This step may mean meal planning and dedicating more time to food preparation.

• Increase omega-3s. Omega-3 fats, especially EPA, are anti-inflammatory and often lacking in an American diet. These fats turn into SPMs – specialized pro-resolving mediators – in the body, which are literally anti-inflammatory messengers that help turn off the inflammation cycle. In addition to eating omega-3s from fish, you can consider supplementing with fish oil or SPMs themselves.

• Remove toxins. You can’t avoid every environmental toxin, but a few simple interventions such as filtering drinking water, purifying indoor air, choosing organic food, and avoiding toxins in personal care products, can significantly reduce your body burden and inflammation.

• Prioritize gut health. Ensure you are meeting your daily fiber needs, eating a variety of colorful plant foods, using fermented foods as condiments, and having daily bowel movements. For a more in-depth assessment, consider a comprehensive stool test to evaluate gut integrity, microbiome balance, and inflammatory markers.

• Adjust your lifestyle. Getting enough sleep, exercising, managing stress, and maintaining good relationships all inform your overall health and inflammatory status. Sometimes the foundations are the hardest piece, but you can’t skip over them. Shoot for consistency over perfection.

• Talk with your provider about medication. If hormone loss is driving inflammation, bioidentical hormone replacement therapy (BHRT) may help. Likewise, if excess body fat is driving inflammation and you’re facing weight loss resistance, a low-dose GLP-1 medication may be supportive for some individuals. From an integrative approach, we use all the tools at our disposal, including food, supplements, and medication.

Inflammation is the body’s natural response to injury or illness; if it shuts off. For many of us, there are environmental and lifestyle components that affect the body’s ability to fully shut off the inflammatory process and instead keep it burning under the surface. Chronic inflammation wreaks havoc on our health, and addressing health concerns requires getting a handle on inflammation. It’s not the only piece to consider, but it’s an important one. If you’re ready to dive deeper and experience a personal health transformation, please reach out.

References

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