“Something is just not right.” How often has that been the “chief complaint” of one of my lady patients;) This can be so frustrating for the traditional patient-doctor relationship when oftentimes the “screening” blood work tells nothing about hormonal imbalances that are actively causing the “off” feeling that can be very hard for the woman to describe. Hormones are the communicators of the tissues in the body and they also work to provide homeostasis, therefore even slight levels being “off” can cause you to feel “off”. It is often not that something is too high or too low, it’s that the level is high/low relative to the other hormones in the communication pathway. And so many things affect our hormone production and utilization – it’s very complicated, but when it’s healthy and working for us it can be a beautiful thing, however when it goes awry, things can get real wacky real quick. 

I often point out that women start their menstrual cycle anywhere from 9 – 19 years of age – THAT’S A HUGE RANGE OF “NORMAL” – so to think that we shouldn’t start looking at hormone decline until you are 50 years old and have had no cycle for a full 12 months is just plain dumb to me. I mean, if you’re pregnant at 35 years old you are labeled “geriatric” so that qualifies you to be determined of a different state of health at the OB, but why not talk about hormonal balance at 35 years old even if you’re not pregnant? Moreover, it’s not fair to the female patient 40 years of age who says “something is just not right” but then is dismissed when the screening blood work is “perfect”! No one argues that PMS is a “thing” which we all know is the imbalance of estrogen and progesterone that is needed for menstruation to occur, so then why is it absurd to think that similar types of imbalances even other times of the month can have similar effects but could also be helped – first by identifying where the imbalance is. Instead, these issues are often masked with medications that only really improve the clinical symptoms because they in some way put back in what the hormonal imbalance has taken out — Estrogen modulates serotonin, Testosterone modulates dopamine and progesterone modulates gaba, so you can appreciate that healthy optimal balance of these communicators is paramount to overall cognitive function and well-being. All too often, I have patients tell me a course of events leading to multiple medications for things like anxiety, depression, add/adhd, pain etc., and when you look at the historical timelines, hormonal decline/shift occurred on or around the onset of the symptoms! Some of the conundrum is due to the fact that mainstream medical philosophy likes to have boxes to check to make a diagnosis to then qualify the patient for the medication. However, there are times when this algorithmic approach underestimates the complexities of the human body and ultimately suppresses our body’s natural adaptability – it’s about balancing the imbalance and supporting those communication pathways to work for you instead of giving mixed signals and then suppressing and overriding with pharmacological means. And trust me, I’m not saying that pharmaceuticals are all bad — there is often a place for them – moreover, when used, they can even work better if the communication pathways are optimized at the same time. So at the very least, if “something is off”, get your hormones tested — a comprehensive test looking at all of the sex hormone levels, thyroid, vit d, and adrenals. At the very least, you owe it to yourself to get back to yourself – and hormone balancing can oftentimes be a key to this… especially as we age – and you want your wellness regimen to evolve with you and support dynamic aging in longevity. Fixing the small imbalances can have very large positive effects on your day-to-day function and ultimately your overall well-being as the main communicators of your body are always trying their best to work for you! Sometimes, they just need to be given a little attention and a lot more credit in addressing the steps of balancing the imbalance:)