Your Guide to Hormones

Maybe I’m living in a bubble, but it seems like everyone in the wellness space is talking about hormones right now. Low energy? It’s your hormones. Weight gain? Hormones. Poor sleep? You get the point. I want to explain to you what hormone are, their functions in your body, and the most common ones you need to know about (and optimize! We’ll get to that later).

The most basic definition is that a hormone is a chemical messenger that goes from one place in your body to affect an action in another place. When the hormone reaches its intended site of action, it binds to a hormone receptor like a key in a lock. When the key (hormone) binds to the receptor (the lock), it triggers certain actions in the cell and can even go so far as to change the ways our genes are expressed.

Over 50 different hormones have been identified in humans, and you’ve probably heard of most of them: insulin, growth hormone, cortisol - even vitamin D is actually a hormone. Hormones are classified by how far they have to travel to exert an effect, but the hormones we care most about are the “endocrine” hormones, which means that they enter the bloodstream and travel to another organ before they exert their effect.

As an aside, it’s common to confuse hormones with neurotransmitters like dopamine and serotonin. The difference is in how far they each have to travel. Hormones travel much farther than do neurotransmitters, and their actions generally can persist much longer. Neurotransmitters don’t travel very far – usually just from one nerve ending to another – and their duration is limited.

So now that you know what a hormone is, why have they become the scapegoats for everything that ails us? Simply because they regulate many different processes in the body, from digestion to metabolism, reproduction, sleep, growth, mood…the list goes on. And because many of them decline with age, we certainly can feel the effects.

If we went over all 50 hormones, this blog would go on forever, so let’s just focus on the three that commonly go out of whack with aging, what they do, and how to know whether or not you could be deficient.

Testosterone

Testosterone is an important hormone for both males and females. It has many effects beyond reproduction – I tell my patients that it’s the hormone that “makes effort feel good.” Testosterone is protective for our brain, our joints, and our bones, and it significantly improves our energy and quality of life. It’s produced in the testicles in men and the adrenal glands and ovaries in women.

In men, testosterone declines by about 1% per year over age 30 (1), but a man’s overall health status can significantly affect testosterone. Chronic diseases of aging (like hypertension, diabetes, obesity and heart disease) can drastically lower a man’s testosterone, and low testosterone has even been found to correlate with all-cause mortality (2). It is estimated that testosterone deficiency is as high as 38.7% in males over 45 years old (3). Testosterone is protective against Alzheimer’s disease, cardiovascular disease, osteoporosis, diabetes, and muscle loss.

Females have about a tenth of the testosterone as men do, and we lose about 50% of our testosterone by age 40. Most people are surprised to learn that testosterone is actually the most abundant sex hormone in women, with testosterone levels 3-4 times higher than estrogen daily. Testosterone in women has been shown to be protective against osteoporosis, dementia, menopausal symptoms, diabetes, cardiovascular disease, and breast cancer (4, 5).

Symptoms of Testosterone Deficiency:

• Brain fog

• Decreased libido

• Joint pain

• Low energy

• Difficulty maintaining muscle mass

• Disrupted sleep

• Weight gain

• Irritability

Estrogen

When people think of female hormones, most of us think of estrogen. Estrogen is primarily secreted from the ovaries but can also be made from testosterone and from peripheral fat. Estrogen acts mainly on the reproductive organs and plays a central role in a woman’s menstrual cycle and maintaining pregnancy.

In men, estrogen is converted (or “aromatized”) from testosterone. In both sexes, estrogen has protective effects on the heart, bones, immune system, gastrointestinal tract, and the brain.

The largest swings of estrogen in a woman’s life are during pregnancy (when it rises) and during menopause (when it falls). Menopause is defined as the absence of a period for 12 months, and occurs at an average age of 51. Menopause signals the loss of the ovarian production of estrogen. If a woman does not menstruate at baseline (because of birth control or a uterine ablation, for example), there are certain laboratory tests such as FSH (follicle stimulating hormone) that can also be indicative of menopause.

Symptoms of Estrogen Deficiency In Women:

•  Irregular or absent periods

• Hot flashes

• Mood swings

• Vaginal dryness

• Poor sleep

• Breast tenderness

• Headaches or worsening migraines

• Depression/anxiety

• Frequent UTIs

Progesterone

Progesterone is another important hormone produced from cholesterol in the adrenal glands, the ovaries, and secreted by the corpus luteum during pregnancy. It primarily acts on the uterus, breast, vagina, blood vessels, and brain. Like the other hormones, progesterone also decreases with age and can drop precipitously during menopause when ovarian production ceases. Progesterone increases metabolism, balances blood sugar, reduces anxiety, helps with sleep, and can help moderate PMS symptoms.

Symptoms of Progesterone Deficiency in Women:

• Weight gain

• Depression

• Heavy menstrual bleeding

• Irregular periods

• Headaches

• Anxiety

• Poor sleep

• Decreased libido

• Infertility

• Severe PMS

There are many other hormones – thyroid hormone being one of them – that could be affecting your quality of life, but these “big three” are what people usually mean when they say that declining hormones are contributing to your symptoms of generally feeling poorly. Fortunately, there are many ways to optimize your hormone profile and get your vitality back. Since everyone is different, I recommend finding a provider (like me, if you live in Colorado!) who will check your levels and customize a plan for you.

Hope that was helpful!

In good health,

Gina

 References:

1)    Feldman HA et al. Age trends in the level of serum testosterone and other hormones in middle-aged men. J Clin Endocrinol Metab 2002;87:589-598.

2)    Shores et al. Low serum testosterone and mortality in male veterans. Arch Intern Med 2006;166:1660-5.

3)    Mulligan et al. Prevalence of hypogonadism in males aged at least 45 years: the HIM sudy. Int J Clin Pract 2006;60:762-9.

4)    Glaser et al. Testosterone therapy in women: myths and misconceptions. Mauritas 2013;74(3):230-4.

5)    Glaser et al. Testosterone and breast cancer prevention. Maturitas 2015;82(3)291-5.