Hormones

The ovaries are the primary endocrine gland that releases female hormones such as estradiol, progesterone, and testosterone.

Estrogens are the major female hormones. Estrogen is responsible for your sexual and reproductive development inlcuding menstruation, pregnancy, puberty and menopause. Estrogen plays a major role in your cardiovascular health, musculoskeletal system and brain development. The three major estrogens are estrone, estradiol and estriol. Estrone is an estrogen that we typically don't like to see elevated as research has shown its link to certain cancers. We assess the different estrogens based on your history and your age.

We test estrogen in both men and women to determine whether there is a deficiency or excess of that hormone. If estrogen is too low in women it can indicate:
- Primary or secondary amenorrhea
- Bilateral oophorectomy
- Hypogonadism (low-functioning ovaries)
- Premature menopause or menopause
- Chronic kidney disease
- Pituitary gland disorders
- Some autoimmune diseases
- Turner syndrome
- Eating disorders

If estrogen is too high in females it can indicate:
- Polycystic Ovarian syndrome
- Endometriosis
- Xenoestrogen exposure
- Obesity
- Stress
- Certain cancers
- Insulin resistance

Progesterone:
Progesterone is another hormone that is also produced by the ovaries. It is the hormone that is essential for ovulation, pregnancy and menstruation. Progesterone is important for a fertilized egg to be implanted in the uterus to maintain a pregnancy.
If progesterone is too low in women it can indicate:
- Hypothyroidism
- Anovulation
- Elevated cortisol
- Elevated prolactin levels
- Low cholesterol
- Menopause

If progesterone is too high in females it can indicate:
- Pregnancy with multiple babies
- Ovarian cysts
- Ovarian cancer
- Adrenal disorders

Testosterone:
While testosterone is considered a male sex hormone, women actually produce some testosterone in their ovaries and their adrenal glands. It's important to test this hormone in females as too much or too little could cause a slew of symptoms.

Signs of low testosterone in females include:
- Low libido
- Fatigue
- Muscle weakness
- Insomnia
- Fertility issues
- Weight gain
- Lack of motivation

Causes of low testosterone:
- Menopause
- Hypopituitarism
- Adrenal insufficiency

Causes of high testosterone levels may include:
- Polycystic Ovarian Syndrome
- Hirsutism
- Congenital Adrenal Hyperplasia

Signs of high testosterone in females include:
- Acne
- Facial hair
- Deep voice
- Increase muscle mass
- Changes in mood
- Irregular periods
- Thinning hair
- Oily skin

DHEA:
DHEA, also known as dehydroepiandrosterone, is a hormone that your body naturally produces in the adrenal gland. DHEA helps to produce other hormones like testosterone and estrogen. Higher levels of DHEA might cause lower levels of cortisol.

Symptoms of low DHEA:
- Unexplained weight loss
- Nausea and vomiting
- Dehydration
- Salt cravings
- Dizziness

Causes of low DHEA:
- Stress
- Diabetes
- Autoimmune Disease like Lupus
- Osteoporosis
- Adrenal Disorder

Symptoms of high DHEA:
- Amenorrhea
- Loss of body hair
- Acne
- Hair loss
- Infertility
- Baldness

Causes of high DHEA:
- Congenital Adrenal Hyperplasia
- Adrenal Gland tumor
- Adrenal cancer

If you are experiencing any of the above conditions or symptoms, it may be prudent to follow-up with your Physician to get some of these lab values further investigated.

The testes are the primary endocrine gland that releases male hormones such as testosterone. Males have other hormones, though, which include Estrogen, Progesterone, and DHEA. Oftentimes in men, it is important to also look at DHT, also known as Dihydroxytestosterone, Sex Hormone Binding Globulin (SHBG) and Total versus Free Testosterone.

As you may imagine, Testosterone is responsible for many essential functions in males. Normal testosterone levels are essential for muscle mass, energy, sperm production, bone mass, sex drive, better mood and healthy cardiovascular health.

Signs of low testosterone in men include:
- Fatigue
- Weight gain
- Low bone mass
- Depression
- Trouble concentrating
- Decreased libido
- Erectile dysfunction
- Decreased muscle mass
- Low sperm count
- Signs of high testosterone in men include:
- Hypertension
- Risk for cardiovascular disease
- Excess body hair OR hair loss
- Acne
- An increase in appetite
- Mood swings
- Insomnia
- Prostate enlargement
- Aggression
- Increased libido
- Headaches

Both free and total testosterone are often assessed because total testosterone can sometimes be interpreted as normal, however, if most of it is bound to a protein made by the liver called sex hormone binding globulin (SHBG), then there may not be a lot of free testosterone available that your body can utilize.

SHBG binds tightly to three sex hormones in men and women, specifically testosterone, estrogen and DHT. binds tightly to 3 sex hormones found in both men and women. These hormones are estrogen, dihydrotestosterone (DHT), and testosterone. SHBG carries these 3 hormones throughout your blood. If SHBG is too high, your tissues are unable to utilize all of your testosterone.

So if your labs show normal total testosterone, but you're still experiencing symptoms of low testosterone, it may be prudent to ask your Physician to assess SHBG and your free testosterone.

Causes of irregular SHBG include:
- Thyroid Disease
- Eating Disorders
- Pregnancy
- Birth control use
- Hypogonadism
- Obesity
- Diabetes
- Adrenal Disorders like Cushing Disease
- Polycystic Ovarian Syndrome

Normal testosterone levels will vary depending on age, as testosterone levels usually peak when a man hits puberty, and then begin to decline as a man gets older.

DHT or Dihydroxytestosterone:
DHT is a sex hormone that stimulates the development of male hormones. It is made through the conversion of testosterone in the testes and prostate in males. The amount of DHT often depends on the amount of testosterone you have. Typically when a male has higher levels of testosterone, more of it is converted to DHT. However, as both testosterone and DHT increase in a man, there is a signal to the pituitary gland to stop or slow the productuction of the hormone, LH, which in turn will reduce testosterone and thus DHT.

Symptoms of high DHT:
- Male pattern baldness
- Oily skin
- Acne
- Increased risk for prostate cancer
Symptoms of low DHT:
- Low libido
- Increased sweating
- Depression
- Reduced muscle mass
- Increased body fat
- Gynecomastia

Estradiol:
Estradiol, a type of estrogen, is a hormone that is present in both males and females. Testosterone can be converted to estrogen through an enzyme known as aromatase, which can be caused by several factors. It is important to assess this marker in men as increased estrogen in males can contribute to many symptoms but also put them at increased risk for breast cancer.

Signs of high estrogen in men include:
- Increased fat distribution
- Gynecomastia
- Infertility
- Weight gain
- Low libido
- Fatigue
- Decreased muscle mass
- Erectile Dysfunction

Signs of low estrogen in men include:
- Fatigue
- Depression / Anxiety
- Water Retention
- Hypersomnia
- Forgetfulness
- Osteoporosis

Progesterone:
Progesterone is often considered a female hormone, however, it is necessary in men for several reasons. Progesterone is produced by the adrenal glands and testes in men. Progesterone is actually necessary for the production of testosterone and helps to counteract the overproduction of estrogen.

Symptoms of low progesterone include:
- Gynecomastia
- Osteoporosis
- Impotence
- Low libido
- Hair loss
- Weight gain

Symptoms of high progesterone include:


DHEA:
DHEA is a hormone that is produced in your adrenal gland. DHEA helps to produce other hormones like testosterone and estrogen. Higher levels of DHEA might cause lower levels of cortisol.

Symptoms of low DHEA:
- Unexplained weight loss
- Nausea and vomiting
- Dehydration
- Salt cravings
- Dizziness

Causes of low DHEA:
- Stress
- Diabetes
- Autoimmune Disease like Lupus
- Osteoporosis
- Adrenal Disorder

Symptoms of high DHEA:
- Amenorrhea
- Loss of body hair
- Acne
- Hair loss
- Infertility
- Baldness

Causes of high DHEA:
- Congenital Adrenal Hyperplasia
- Adrenal Gland tumor
- Adrenal cancer

If you are experiencing any of the above conditions or symptoms, it may be prudent to follow-up with your Physician to get some of these lab values further investigated.