Hormones: a quick tutorial

Everyone seems to be talking about hormones these days, with more and more people discussing topics like hot flashes, perimenopause, irregular periods and weight gain. There is also a lot of confusion floating around, so I thought it might help to break down the science behind some of the major hormones.

Background

Hormones are chemical messengers that travel throughout the body to help regulate various functions. They are extremely bioactive — meaning a little goes a long way — and can take some time to adjust, which is why doctors typically test levels every few months.

There are many different kinds of hormones, and it can get complicated to learn about each one. To keep things simple, I’ll just stick with the ones people are most familiar with.

Note: All of the hormones discussed below exist in both males and females. Some are naturally higher in males, while others are naturally higher in females. Depending on the symptoms you’re experiencing or the conditions you’re concerned about, it may be helpful to have all of these areas checked — regardless of your gender.

Estrogen

There are actually three different kinds of estrogen: estrone, estradiol and estriol. The most bioactive type is estradiol, and it’s generally the one being referred to when people mention estrogen.

All forms of estrogen play a role in regulating the female hormone cycle, but they also affect multiple areas of the body. There are estrogen receptors in the lungs, intestines, and even the brain. Estrogen has an effect on cholesterol levels, blood sugar, bone and muscle mass, circulation and cardiovascular health, collagen and skin health, and focus and memory, among many others.

Estrogens are crucial in balancing the reproductive system, menstrual cycle, fertility and pregnancy. Along with progesterone, its decrease is one of the main reasons women feel such a wide range of symptoms during menopause.

• Estrone (E1): Relatively low throughout most of life, but becomes the major estrogen available after menopause
• Estradiol (E2): The strongest and most active form during reproductive years
• Estriol (E3): The main estrogen active during pregnancy

Progesterone

I tend to describe progesterone as the sister to estrogen. Together, they perform a carefully choreographed dance throughout the menstrual cycle and have multiple functions related to reproduction and pregnancy.

Outside of direct hormone balance, progesterone also supports areas such as thyroid function, mood regulation and sleep. Low levels of progesterone can appear as irregular menstrual periods, infertility, insomnia, anxiety, depression and fatigue. If you’re experiencing any of these, ask your primary care provider to check your progesterone and estrogen levels to help rule out a hormonal connection.

Testosterone

Testosterone is another hormone present in both males and females, though it is naturally higher in males. Testosterone plays a major role in puberty, but it also affects red blood cell production and bone health.

Many people assume testosterone stays at the same level all the time, but it actually fluctuates for various reasons. Levels start out low in early life, rise around puberty and decline again with age. They also tend to be higher in the morning and lower in the evening.

I check testosterone levels if I suspect a female patient may have PCOS. Along with other symptoms — such as acne, excess body hair and irregular periods — these patients often have elevated testosterone.

In males, I check testosterone when symptoms like low energy, depression, infertility or weight gain appear. Low testosterone can also be a marker in patients with type 2 diabetes, so it may be helpful to ask your provider whether your levels are within range.

Prolactin

Produced in the pituitary gland, prolactin is typically increased during pregnancy and breastfeeding. However, elevated levels can also be associated with irregular periods, infertility, or erectile dysfunction, so it’s worth checking if you’re experiencing any of these.

Prolactin also has hundreds of other functions throughout the body. It can affect metabolism, immune system function and even behavioral and stress responses.

LH and FSH 

These lesser-known hormones, LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone), are also produced by the pituitary gland and stimulate the ovaries and testes to produce testosterone, estrogen and progesterone.

In males, they stimulate testosterone and support sperm production. In females, they work together to regulate estrogen and influence ovulation and the timing of the menstrual cycle.

Because of their relationship with other hormones, I often check LH and FSH when working with hormone-related symptoms or conditions, such as PCOS or irregular periods. It may also be helpful to check these levels in both partners if you’re experiencing fertility issues.

A starting point

If all this feels overwhelming, don’t worry, there’s no exam!
Educating the community about how their bodies work is something I deeply value. This information is meant to help you feel more empowered and confident in taking an active role in your health.

Feel free to read it again, bring it to your health practitioner and use it as a starting point to learn more.

Learn more about Dr. Ayanna Quamina and her practice at www.drayannaq.com.

Email her directly at info@drayannaq.com.