BY TRACY McCUBBIN, MD, ABOIM, ABEM
Get your mind out of the gutter! This month, we will break down a number of sex hormones and talk about their role and significance.
As their name implies, sex hormones are responsible for our sexual desire and fertility. What you may not know is that they are responsible for so much more. Acting as a messenger to communicate with all organs, these hormones have widespread influence on our bodies. These levels fluctuate with age, lifestyle and diet. We are most familiar with hormone changes during menopause and the associated physiologic changes we experience.
Menopause is a 10 year process as the production of estrogen and progesterone decline. It can be a turbulent time in a woman’s life as hormones fluctuate widely during this decade. However, I also see many young women whose hormones are out of balance, too. There are many reasons for this imbalance occurs in both aging and younger women. Traditional birth control pills will cause suppression of testosterone. Alarmingly, toxins on our produce, in our skincare products, in our cookware have been found to be endocrine disruptors. Stress from our jobs, lack of sleep and poor diet contribute to adrenal dysfunction which can lead to sex hormone imbalance. A partial hysterectomy can result in hormonal deficiency even though the ovaries are left in place. And having a baby late in life tends to push mom into perimenopause.
It is worth noting that men experience andropause (male menopause) but it is generally mild since testosterone declines in a linear fashion. However, those same toxins in the environment can affect men’s hormones as well.
Before we consider treatment of any hormonal condition, it is important to have a baseline knowledge of that particular hormone and how it functions in our body. We will begin with the 4 big ones; estrogen, progesterone, testosterone and DHEA.
Estrogen
Estrogen is a hormone primarily produced by the ovaries. Your body has receptor sites for estrogen everywhere: such as brain, bone, muscle, gut, uterus, ovaries, vagina, breast, eyes, heart and lung to name a few. It turns out that estrogen is about more than just reproduction. Hormone replacement therapy (HRT) is available to you but needs to be customized. It is important to use bioidentical estradiol in a topical application for the safest and best results.
Here are a few important functions of estrogen:
• Decreases risk of heart disease by 40-50%
• Aids in the formation of neurotransmitters in your brain which stabilizes emotions
• Helps maintain your memory
• Maintains bone density
• Decreases wrinkles
• Maintains collagen in your skin
• Increases water content in your skin (plumpness)
Progesterone
Progesterone and estrogen work together and proper balance of these two hormones is critical. An imbalance in the ratio of progesterone to estrogen can lead to numerous clinical conditions. Progesterone plays a role in menstruation, ovulation and pregnancy. Always use a bioidentical or natural form of progesterone if considering HRT. There are many unwanted side effects of synthetic progesterone (progestins) and they are not well tolerated.
Some functions of Progesterone:
• Balances estrogen
• Helps prevent anxiety, irritability, and mood swings
• Helps you sleep
• Relaxes smooth muscle in your gut so that your body and can break down food and absorb nutrients.
Testosterone
This hormone is often associated with male characteristics. However, women make testosterone as well in small but significant amounts. It has an impact on our libido but does so much more. Testosterone gives us a sense of direction and purpose, helps us get through our list of things to do. This important hormone gives both sexes a sense of well-being and helps preserve our memory. Some of the main functions of testosterone include:
• Increases sexual interest
• Increases sense of emotional well-being
• Increases muscle tone
• Decreases bone deterioration
• Helps maintain memory
• Decreases excess body fat
DHEA
DHEA is an androgen that is a precursor to testosterone. It is made in the adrenal gland. Some call it the hormone of youth. This hormone peaks in our late 20’s and slowly declines with age. Some important functions of DHEA include:
• Decreases formation of fatty deposits
• Helps your body repair itself and maintain tissues
• Increases lean body mass
• Reduces spikes on blood sugar
• Supports your immune system
The thing about our sex hormones, they need to be balanced and in proportion. Like Goldilocks, our bodies need them to be “just right.”. Let’s talk about how that is achieved.
Sex Hormone Binding Globulin (SHBG)
The name says it all. SHBG binds up our sex hormones.
The vast majority of hormones in your body are bound to proteins in the bloodstream. This helps stabilize the hormone so it can get to the targeted receptor cells all over the body. While it is bound, it is inactive.
In order for the hormone to be active, it must break away from this protein. This “free” hormone can then enter the cells and turn on cellular function. The amount of free hormone in the bloodstream is much smaller than the amount of “bound” hormone. This protein binding is one of the ways our body regulates hormone levels.
SHBG levels naturally increase as we age. Even small changes in SHBG can cause substantial symptoms and problems.
Follicle Stimulating Hormone (FSH)
Physicians use this hormone to diagnose menopause. As levels rise above 25, you are on the 10 year path to menopause. FSH is a message from the brain telling the ovaries to make follicles which mature into eggs that are released during ovulation. When the ovaries get tired and run out of eggs, FSH levels begin to rise.
A recent study published in the journal Nature found that mice with very high FSH levels suffered more cancer and earlier death. In these mice, removing the ovaries or giving estrogen prevented disease and early death. We monitor FSH levels during HRT.
An important thing to remember about hormones is that they operate like a symphony. They all have a role and when playing their part, together and in balance, the music is beautiful. However, If you knock out the percussion section, the music does not sound quite as nice. If you would like to check your hormone levels and get everything in balance, call or email us. At Radiance Functional Medicine, our goal is to help you shine!