Hormones
Hormones are the chemical messengers that finely regulate the female cycle and thus create the conditions for fertility and menstruation every month. Changes in hormone levels influence not only ovulation and the uterine lining, but often also mood, energy, and general well-being. In case, you have any personal questions about reproductive aging or if you think, you might experience signs or symptoms of early reproductive aging or early menopause – I am happy to offer a personal and thorough online-consultation.
Purpose of Hormones
Hormones regulate almost all important functions in the female body – from the control of the menstrual cycle and fertility to mood, energy levels, and metabolism. A balanced hormonal equilibrium is essential for physical and emotional well-being. However, many women experience cycle disorders, irregular or absent periods, PMS symptoms, or hormonal imbalances that can impair everyday life.
Cycle disorders can have many causes: hormonal imbalances such as PCOS or thyroid disorders, stress and lifestyle factors, as well as anatomical changes. Thorough diagnostics help to identify the cause and initiate targeted treatment.
Cycle Disorders
The most common cycle disorders include irregular cycles, absence of menstruation (amenorrhea), frequent bleeding (polymenorrhea), heavy or painful periods, and premenstrual complaints (PMS/PMDD). These can be triggered by hormonal imbalances such as progesterone or estrogen deficiency, elevated androgens in PCOS, or thyroid disorders. Stress, weight changes, intensive exercise, and anatomical factors also play a role.
Diagnostics begin with a detailed discussion of cycle patterns, symptoms, and lifestyle. Hormone tests are then carried out at different phases of the cycle in order to precisely assess the hormonal status. Ultrasound examinations of the ovaries and uterus, and additional tests if necessary, help to identify the cause of the disorder.
What You Will Find Here
Menstrual Cycle Disorders
Disorders of the Menstrual Cycle
Hormonal Imbalance
Hormonal Imbalance
With too little estrogen, the mucous membranes can become too thin and dry and thus be more prone to infections. As a result, bladder problems and recurrent inflammations (urinary tract infections) can occur. Estrogen deficiency can also have a negative effect on mood and on interest in and enjoyment of physical intimacy (libido).
With too little progesterone (for example when ovulation does not occur, luteal phase defect), menstruation often starts late and bleeding becomes noticeably heavier and more prolonged. This should be clarified and treated. An excess of male hormones, as found in the common polycystic ovary syndrome (PCOS), in certain genetic conditions (congenital adrenal hyperplasia), or in other rather rare diseases, often leads to cycle disorders and more or less pronounced cosmetic problems (acne, oily hair, hair loss, increased hair growth especially in atypical areas – hirsutism).
Over time, this can also lead to relevant general medical problems – elevated blood lipids (cholesterol), vascular problems, and arteriosclerosis. Elevated male hormones also frequently cause ovulation disorders and thus difficulties in becoming pregnant. A systematic evaluation and optimization of the hormonal situation is therefore very important – also to prevent chronic health problems. In case, anything like this sounds familiar and you wish to talk about options of improvoement – just get in touch with me, so that we can arrange an online consultation.
Ovarian Aging - Reproductive Aging
Ovarian Aging - Reproductive Aging
Ovarian reserve continuously declines until menopause – the last menstrual bleeding regulated by the ovaries. The timing varies greatly between women: some can still become pregnant relatively easily and have children in their mid-forties, while for others this can already be difficult or impossible in their early thirties. Around one in 20 women reaches menopause (the permanent cessation of ovulation and menstrual bleeding) before the age of 45, and for years beforehand, pregnancies are hardly possible. If you have any questions of reproductive aging, or if you have a feeling, that you might experience signs of symptoms of early reproductive aging, I am happy to offer a personal and throrough online consultation.
In principle, reproductive age depends on many factors, including family-genetic influences, lifestyle (smoking, diet, body weight, medications), and general illnesses, and these should be taken into account where appropriate.
You might also refer to the sections “Premature exhaustion of ovaries” and/or “protecting fertility for medical reasons.”
Premature Exhaustion of the Ovaries
Premature Exhaustion of the Ovaries
In Western countries, the average age at menopause (the permanent cessation of ovulation and menstrual bleeding) is about 51 years. However, nearly one in 20 women experiences menopause before the age of 45, and in about 1 in 100 women, menopause occurs at or before the age of 40. This is also referred to as early or premature menopause; the medical term is premature ovarian insufficiency. In most affected women, pregnancies have hardly been possible for several years beforehand.
Regardless of family planning, careful medical evaluation and management of this situation is of great, immediate, and long-term health importance. The chronic hormone deficiency has many health effects and, without appropriate countermeasures, accelerates aging processes in the entire body. If you are interested in details, you may also refer to the sections short term complaints as well as long term health risiks of menopause.
Especially when there is still a desire to have children, time is crucial, and every month counts: as many follicles as possible in the ovaries should be stimulated to mature, the eggs should be retrieved and fertilized, or frozen unfertilized. When this situation affects relatively young women, it has the advantage compared with women close to natural menopause that each egg has a very high developmental potential and therefore high chances of pregnancy.
What is essential in every case is rapid, goal-oriented diagnostics and, if necessary, the planning of further steps regarding any incomplete family planning. If you have evidence or just suspect to experience advanced ovarian aging/premature exhaustion if your ovaries – or if you think, you might experience signs or symptoms of early reproductive aging or early menopause – I am happy to offer a personal and thorough online-consultation.
In addition, you might want to refer to “Protection of fertility for medical reasons”).
FAQ
Hormones are chemical messengers that control almost all important functions in the body - from the regulation of the menstrual cycle and fertility to mood, energy levels, and metabolism.
Cycle disorders include irregular or absent periods, heavy bleeding, PMS symptoms, or hormonal imbalances. Causes can include hormonal imbalances, PCOS, thyroid disorders, stress, or anatomical changes.
A healthy lifestyle with a balanced diet, regular exercise, sufficient sleep, and stress management can positively influence your hormonal system. For hormonal disorders, you should seek medical advice.
Hormones are chemical messengers that control important body functions including metabolism, growth, reproduction, sleep-wake rhythm, and mood. They are produced in glands and transported through the blood to target organs.
Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of childbearing age, characterized by cycle disorders (often absent ovulation and periods), elevated male hormones, and metabolic changes.
A hormone test can be useful for otherwise unexplained symptoms such as cycle disorders, severe acne, hair loss, increased body hair, hot flashes, vaginal dryness, or mood changes.
A thorough diagnosis includes cycle observation, hormone tests (FSH, LH, estrogen, progesterone, thyroid hormones), ovarian ultrasound, and if necessary further investigations to identify the cause.
Depending on the cause, hormonal treatments, lifestyle changes, medications for cycle regulation, treatment of underlying conditions (e.g., thyroid, PCOS), or in severe cases surgical measures may be considered.
Chronic stress can significantly affect hormone levels and lead to cycle disorders. Stress reduction through relaxation techniques, exercise, and adequate sleep can help regulate the cycle.
Yes, hormones have a strong influence on mood. Fluctuations can lead to irritability, depressive moods, or feelings of anxiety. A balanced hormonal balance contributes to emotional well-being.
Regular exercise, a balanced diet rich in vegetables and healthy fats (Mediterranean diet), adequate sleep, and stress management can help regulate hormones naturally. Manifest symptoms should be medically evaluated.
The ring molecule 17-beta estradiol is predominantly produced in the ovaries. The diverse effects of this endogenous, "natural" estrogen are mediated by binding to the estradiol receptors alpha and beta, and these receptors occur in varying degrees in all possible regions of the body and in numerous tissues. This explains the diverse effects of estrogen on a wide range of physical and psychological functions. In addition to 17-beta estradiol, there are a number of other endogenous, i.e., "natural" estrogens (estrone, estriol, etc.), which differ in their potency and binding behavior to estrogen receptors as well as in other detailed properties (metabolism, inactivation, etc.). The dosage and method of application—i.e., administration as a tablet, cream, patch, vaginal ring, or spray—also have a significant influence on the various effects of estrogens. In addition to the body's own estrogens, there are also chemically modified estrogen-like substances that differ from the body's own bioidentical estrogens in terms of inactivation, binding behavior, and stimulation of estrogen receptors. These special properties can sometimes be used for specific medical conditions, such as in contraceptive pills or for diseases that benefit from a partial inhibition of the estrogen effect (e.g., endometriosis, breast cancer). Another important sex hormone produced naturally in the bodies of sexually mature women is progesterone. It is produced predominantly in ruptured (ovulated) follicles and therefore mainly in the second half of the cycle, and it plays a key role in preparing the uterine lining for implantation of the embryo and early pregnancy. Progesterone binds to and stimulates the two main forms of the progesterone receptor (PR-A and PR-B) – and this is also achieved in sometimes different forms by chemically produced progesterone-like hormones – the so-called progestogens. While progesterone binds almost exclusively to PR-A and PR-B, the different types of progestogens can also bind, stimulate, and in some cases inhibit other hormone receptors (estrogen, androgen, aldosterone, and hydrocortisone receptors). In fact, choosing the "right" progestin in a specific clinical situation can have very favorable, but possibly also unfavorable, additional effects compared to natural, bioidentical progesterone. In addition, sufficient duration and dosage of progestin administration is of great importance, especially in menopausal hormone therapy. In fact, too little or too short a course of progesterone or other progestogens can lead to bleeding disorders and even an increased risk of cancer of the uterine lining. The correct method of application and adequate dosage are particularly challenging for bioidentical progesterone, as this progestogen requires particularly high doses in tablet form to achieve sufficient effective levels, and it is not possible to achieve sufficiently safe effective levels through the skin.
In summary, the medicinal use of bioidentical 17-beta-estradiol has several pharmacological advantages and fewer side effects than chemically modified estrogens. The latter are mainly considered for special indications where "nature-identical" estrogens are not effective or not sufficiently effective.
The primary "nature-identical" progestogen—progesterone—can only be absorbed in sufficient concentrations via the gastrointestinal tract in relatively high doses in order to protect the uterine lining from degeneration in the long term. When administered through the skin – i.e., as a patch or cream – progesterone is almost always insufficiently dosed, meaning that such formulations carry an increased risk of endometrial cancer. Accordingly, chemically modified progestogens are used in hormone patches to achieve sufficiently safe concentrations for the uterine lining. In addition, chemically modified progestogens have additional effects that offer significant advantages over progesterone for some women, such as a reduction in the effects of male hormones (androgens) or diuretic effects (anti-aldosterone effects). To make prudent use of these progestin side effects while avoiding the possible risks and side effects of individual progestins, you should seek the advice of a specialist gynecologist.