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Hormones and menopause

What do you mean by “hormones”?

The term “hormone” comes from ancient Greek (ὁρμᾶν hormān) and means “to drive, to excite”. In medical terms, the term was coined by Ernest Starling in 1905:

Hormones are the body's own messenger substances, which come from a hormone gland into the bloodstream are released in order to achieve a specific effect in other organs. (A special form is the so-called “Neurohormones” that are produced by nerve cells and released into the blood.)

So there are 3 characteristics of hormones:

  • Messenger substances that are produced in the endocrine glands
  • Are transported to their place of action in the blood
  • Specifically change the activity of the target cells


What are the functions of hormones?

Hormones regulate a variety of physiological mechanisms and behavioral activities, such as::

  • Growth and puberty
  • Metabolism
  • Body temperature
  • Sleep / biorhythm
  • Water balance
  • Memory
  • Blood pressure / heart rate / blood lipids
  • Energy balance (blood sugar)
  • Sensations/moods/feelings/stress
  • Sex / Reproduction / Pregnancy

Each hormone has its own, distinctive biochemical structure and works according to the “key and lock principle”.


What types of hormones are there?

3 hormone classes:

  • Amino acid derivatives
    • T3 and T4 from the thyroid, adrenaline and norepinephrine from the adrenal gland, melatonin (“sleep hormone”), serotonin (“feel-good hormone”)
  • Protein & polypeptide hormones
    • Are broken down in the intestine - therefore no oral administration possible
    • Examples: TSH, ACTH, FSH, LH, insulin from pancreas
  • Steroid hormones (Steroids are ring-shaped molecules that belong to the fats and are part of the cell membrane; are all derived from cholesterol)
    • Lipophilic (“fat-soluble”) – are bound to globulins and transported in the blood
    • Examples: estrogens, progesterone, androgens, aldosterone
    • Sites of synthesis of steroid hormones:
      • Cortisol (“stress hormone”): adrenal glands
      • Testosterone (“male hormone”): testes (80%)/ovaries (50%), adrenal glands
      • Estrogens (“female hormones”): testes/ovaries & placenta, fatty tissue, adrenal glands
      • Progesterone (“pregnancy hormone”): testes/ovaries & placenta, brain, adrenal glands
      • DHEA (“Good-Aging Hormone”): testes/ovaries, brain, adrenal glands (90%)


Focus on adrenal hormones

The adrenal gland is the key organ for optimal stress processing. It produces the following hormones:

  • Aldosterone --> Regulation of sodium, potassium and fluid amounts
  • Cortisol --> Regulation of blood sugar, anti-inflammatory, stimulation of the central nervous system, normalization of the stress reaction
    • Inhibition of HDL cholesterol and increase of LDL cholesterol
    • Anti-inflammatory (inhibition of the transcription factor NFkB)
    • Humoral immune response (Th2 shift), antiallergic
    • Suppresses cellular immune response à reduced infection and tumor defense
    • Cortisol antagonists are progesterone and DHEA
  • DHEA --> Formation of sex hormones, regulation of the amount of cortisol, “anti-aging”
    • DHEA levels decrease significantly over the course of life: increase up to approx. for the 20th year of life, then halved to approx. for the 50th year of life and at the end of life (~80 years) approx. 10% of the initial mirrors
    • DHEA can control negative effects of excessive cortisol release
    • “Character image” DHEA: anabolic and immunizing
      • Athero- and cardioprotection
      • Anti-diabetic (increase insulin sensitivity, glucose utilization and lipolysis)
      • Osteoprotection (reduces osteoclast activity and increases bone density)
      • Increase vitality (mental and somatic)
      • Immunoprotection (modulated towards normalization Th11-Th2 shift, increase in natural killer cells, anti-inflammatory)
      • Improves muscle-fat ratio
      • Dermaprotection (improves skin thickness, elasticity, oiliness and moisture)
    • Optimal target range DHEAS:
      • Women: 2000-2800 ng/ml
      • Men: 4000-5000 ng/ml
    • Adrenaline, noradrenaline --> reaction to fight or flight situations

Possible symptoms of adrenal insufficiency

  • Constant tiredness despite adequate sleep
  • Feeling dizzy after getting up quickly
  • Lower tolerance threshold / higher susceptibility to stress
  • Increased menstrual cramps
  • Craving for salt or salty food
  • Poor memory (“scattered”)
  • Lack of energy (lethargy), reduced performance
  • Depressive phases
  • Significantly decreasing libido
  • Improvement of well-being v.a after dinner


thyroid and adrenal hormone control circuit

  • The thyroid and adrenal glands influence each other
  • The pituitary hormones TSH and ACTH activate the thyroid thyroxine in the brain via a control circuit. the adrenal gland produces cortisol.
  • To put it simply, the division of roles is as follows:
    • The thyroid provides energy in the body and regulates it (via T3 and T4)
    • But the adrenal glands have to be strong enough to handle this metabolic energy.
    • This can result in “poorly controlled hypothyroidism,” which shows little progress even with therapy.
  • When adrenal exhaustion occurs, the following “vicious circle” arises:
    • Pituitary gland also reduces ACTH --> exhausted adrenal gland leads to lower cortisol production
    • TSH is reduced --> Subclinical hypothyroidism (adaptation of the body to the cortisone deficiency)
    • Caution: If this hypothyroidism is treated with L-thyroxine, the pituitary gland requests the adrenal gland to produce more cortisol via ACTH release. But if the adrenal gland is already exhausted, then the symptoms of adrenal fatigue really become apparent. In the case of hypothyroidism, adrenal fatigue should always be clarified as a possible actual cause!
  • Excursus Hashimoto (source: Schulte-Uebbing 2012):
    • There is a connection between the occurrence of Hashimoto's thyroiditis and estrogen dominance (pregnancy improves Hashimoto's).
    • When additional progesterone is administered to replace thyroid hormones, anti-TPO decreases (30-50% within 2-6 months).
    • Sleep, mood as well as physical and mental resilience often improve with this combination therapy.
    • It is important to simultaneously compensate for a common zinc, selenium and vitamin D3 deficiency



Focus estrogen and progesterone



  • “Character image” estrogen: feminine, soft and moisturizing
  • There are 3 different estrogens in the body:
  • Estrone (E1) = the storage form
  • Estradiol (E2) = the “main estrogen” (the most potent estrogen)
    • “Make the woman a woman”
    • Stores fat, stores water
    • Slows metabolism by inhibiting thyroid function
    • Reduces the overall risk of heart disease by 40-50%
    • Improves mood and increases the brain's memory capacity
    • Slows down bone loss by inhibiting osteoclasts
    • Promotes the cell development of the uterine lining and the breast in the 1st week. Half cycle
  • Estriol (E3) = the “mucosal estrogen” (but only has approx. 10% of the biological activity of E2)
  • Ideal ratio E1 : E2 : E3 is 10 : 10 : 80 to 20 : 20 : 60
  • Typical estrogen deficiency symptoms:
    • Depressed mood
    • Cosmetic aspects such as: Crow's feet or vertical mouth wrinkles
    • Mucosal atrophy, dystrophic breasts
    • Difficulty sleeping through the night
    • Slim, petite, perfectionist



  • Occurs in women and men
  • Precursor of testosterone
  • 20% of the receptors are in the brain
  • “Character image” Progesterone: balancing and energizing
    • Natural antidepressant – the “feel-good hormone”
    • Neuroprotective
    • Important role in fat burning
    • Drains (antimineralocorticoid effect)
    • Improves thyroid function
    • Protects against breast pain and cysts
    • Apoptosis promotion v.a in the uterus, ovaries, breast and prostate
    • Stimulates bone formation via osteoblasts
    • Normalizes blood sugar levels, lowers insulin levels
  • Typical progesterone deficiency symptoms:
    • Headaches and migraines, especiallya premenstrual
    • Myoma formation
    • Spotting, hypermenorrhea (including iron deficiency anemia)
    • Difficulty falling asleep
    • Aggressiveness, inner restlessness
    • Chronic fatigue
    • Increase in abdominal fat (“pear type”)
    • Lack of libido


The “hormone triangle” of estradiol/progesterone/testosterone

All hormones interact with each other to form the individual “hormone orchestra”. If one of them is increased or decreased, it will influence all other “players”.

  • For example, the physiological estradiol/testosterone ratio is 1:6 in women and 1:10 in men.
  • The physiological estradiol/progesterone ratio is 1:100 – 1:200 across genders.

There are also hundreds of genes whose promoters are controlled by estrogen/progesterone. This affects more gene segments than was thought for a long time. If estrogen/progesterone is missing, disruptions in gene control occur. This explains the multitude of possible complaints that are associated with estrogen/progesterone deficiency. Therefore, hormonal supplementation is not about “rejuvenation”, but rather about a therapy that is as causal as possible.


What can disrupt the hormonal balance?

  • Age-related à Menopause (seeu)
  • Chronic stress
  • Sleep disorders
  • Hormonal contraception (pill, coil, ring, patch)
  • Surgery (uterus, ovaries)
  • Thyroid disease
  • Disorder of the pituitary gland
  • Anorexia/eating disorders
  • Environmental toxins (plasticizers – v.a BPA)
  • etc.


The “menopause”

What are the typical “menopause” symptoms for women and men?


  • Hot flashes
  • Sweats
  • Sleep disorders
  • Luxury
  • Dry mucous membranes, painful sex
  • Depression
  • Nervousness
  • Irritability
  • Memory impairment
  • Hair loss
  • Increase in body fat
  • Joint problems
  • Loss of muscle mass
  • Skin aging / wrinkle formation
  • Osteoporosis
  • Bone pain
  • Joint pain
  • Heart racing
  • Cardiac arrhythmias


  • Decreasing sexual desire
  • Potency disorders
  • Depression
  • Sleep disorders
  • Irritability
  • Luckiness
  • Memory impairment
  • States of exhaustion
  • Increase in body fat
  • Loss of muscle mass
  • High blood pressure
  • Elevated cholesterol levels
  • Skin aging / wrinkle formation
  • Osteoporosis
  • Bone pain
  • Joint pain
  • Heart racing
  • Cardiac arrhythmia
  • Sweats


What happens on a hormonal level during the “menopause” (climacteric)?

“Estrogen deficiency myth” for menopausal symptoms:

The prevailing opinion is that menopausal symptoms result from a lack of estrogen. Accordingly, therapy is carried out with “estrogens”.

Estrogen is still produced, however, in smaller quantities and not in the ovaries, but predominantly in the fat cells from the male hormones androstenedione and testosterone (with the help of the enzyme aromatase).

But the problem is that the balance between estrogen and progesterone is no longer correct, as the progesterone level falls much faster than the estrogen level:

During menopause, estrogen levels drop to below 25 ng/l in the first half of the cycle and below 80 ng/l in the second. The progesterone level is very low, tending to zero. The FSH (follicle stimulating hormone - is produced in the pituitary gland and influences the female menstrual cycle and is responsible for the proper functioning of the reproductive system in women), on the other hand, increases to levels of over 12 IU/l.

D.H Contrary to popular belief, at the beginning of menopause it is not the estrogen deficiency that is responsible for the estrogen/progesterone hormonal imbalance, but rather the progesterone, which falls even more sharply in relation to estrogen! Because it is not absolute values, but rather ratios that decide this well-being. The physiological progesterone/estrogen ratio in women is 1:100 to 1:200. At the beginning of the menopause, this ratio deteriorates significantly to the detriment of progesterone.


  1. Phase of the climacteric: Loss of progesterone
  • Irregular cycle from the 45th Year of life
  • Weight gain
  • Water retention
    à Therapy: Progsterone – no estrogen/progesterone


  1. Phase of the climacteric: Loss of estrogen
  • Hot flashes
  • Sleep disorders
  • Joint pain
  • Dryness all over the body (genital, eyes)
  • Muscle pain
  • Hypercholesterolemia
  • Labile blood pressure
  • Irregular heartbeat/palpitations
  1. Phase of the climacteric: Loss of androgens
  • Stimulates metabolism
  • Strengthen the connective tissue
  • Important for psyche
  • Important for libido
  • Starting material for the synthesis of other hormones
  • Weight problems in the abdominal area
  • Enlarging breasts
  • Chronic fatigue

Important: Male hormones are also important for women! And female hormones are also important for men!



Deficiency-associated complaints

  • Progesterone
    • Depressed mood
    • Restlessness, irritability
    • Anxiety
    • Irregular / shortened cycles
    • Bleeding disorders, hyperplasia
    • Mastodynia, mastopathy
    • Edema, labile hypertension
    • Osteopenia
  • Estrogen
    • Sweats
    • Mood lability
    • Sleep disorders
    • Vaginal dryness
    • Prolonged menstruation
    • Joint pain
    • Incontinence
    • Osteopenia
  • Androgens (v.a testosterone)
    • Libido reduction
    • Reduced vitality
    • Chronic fatigue
    • Low-fat skin
    • Anemia
    • Atrophies (tissue, muscles)
    • Fat accumulation



Therapy of or during menopause

  • Symptomatic
    • Antirheumatic drugs
    • Antihypertensives
    • Antidepressants
    • Bisphosphonates
    • Sleeping pills
    • Pain relievers
    • Synthetic hormones
  • Holistic
    • Nature-identical hormones
    • Dietary supplement


What are hormones made from?

  • Synthetic hormones
    • Urin from pregnant mares
    • Chemical
  • Bioidentical hormones
    • : Progesterone from yam root (Dioscorea vilosa)
    • Identical to the body's own hormones
    • Same spectrum of effects
    • No increased risk of cancer


Effects of synthetic hormones

  • Foreign substances for the body (different chemical structure)
  • Cancer risk increased up to 80% (see.u)
  • Ultimately unknown effect
  • Biological structures change
  • Relieve only a few symptoms
  • Promotes conversion processes in the body


How synthetic hormones can trigger breast cancer

“Vienna. Scientists at the Institute of Molecular Biotechnology (IMBA) of the Austrian Academy of Sciences have clarified the connection between the intake of synthetic sex hormones and an increased risk of breast cancer. (…) Only a small proportion of those affected have inherited the predisposition; the tumor is usually acquired through external influences. (…) The factors that promote breast cancer include taking synthetic progesterones (gestagens) as part of hormone replacement therapy or for hormonal contraception. (…) Original work: Osteoclast differentiation factor RANKL controls development of progestin-driven mammary cancer (Schramek et al.) Nature AOP, 29.92010, doi:10.1038/nature09387; Source: RANK Ligand mediates progestin-induced mammary epithelial proliferation and carcinogenesis
(Gonzalez-Suarez et al.) Nature AOP, 29.92010, doi:10.1038/nature09495


Risks of synthetic hormones

Source: Breast cancer data according to Fournier et al. 2005 and Clavel-Chapelon et al. 2005/2006 in 69,647 women (in Europe): No increased cancer risk can be seen with natural estrogen and progesterone.


Difference between bioidentical hormones and synthetic hormones (= medications with hormone effects) – using progesterone as an example:

  • In the 1930s, progesterone was first extracted from the pig ovary and then from the placenta of women.
  • In 1939, progesterone was produced from the diosgenin of the yam root (the development of the contraceptive pill in 1951 in the USA was also based on this discovery), causing the price of progesterone to drop from over $100/gram to a few cents.
  • But this meant that natural progesterone became uninteresting for the pharmaceutical industry, since natural substances cannot be patented. As a result, “progestogens” were developed – i.e.H Drugs with hormonal effects
  • The difference between hormones and drugs with hormone effects is the changed biochemical structure:
    • Bioidentical hormones have an identical structure to the body's own hormones, i.e.H they trigger original metabolic processes and fit into the natural synthesis pathway.
    • Synthetically modified hormones, on the other hand, are foreign bodies!
  • No natural hormone causes side effects at the dose the body knows.

Hormones in comparison:



Which micronutrients are useful for menopausal symptoms?  

  • Yam as a source of diosgenin. Diosgenin is very similar to progesterone (the corpus luteum hormone) produced naturally by the ovaries.
  • Red clover and hops
    • Belong to the phytoestrogens (3 groups: isoflavones (includinga soy, hops, red clover), lignans (e.g. linseed) and coumestans (e.g. black beans or alfalfa sprouts)
    • Blocking of the proliferative ER-alpha receptors: breast, uterus, liver
    • Estrogen-like effect via apoptotic ER-beta receptors: bones, vessels, brain, bladder
    • Antioxidant effect and strengthening of the immune system
  • Chasteberry:
    • Strengthens the progesterone side / has a diuretic effect
    • Decreases prolactin and increases progesterone levels in 2. Half cycle
    • Key symptoms: mastodynia, premenopausal cycle and bleeding disorders, premenstrual depressive mood, premenstrual edema
  • Cordyceps: In TCM, cordyceps is used for menopausal symptoms because it strengthens kidney energy. This is said to relieve both hot flashes and cold symptoms.
  • Valerian: a study with 60 postmenopausal women examined the influence of valerian on unpleasant sweating - with the result that valerian was able to significantly reduce hot flashes compared to placebo (cf.
  • Iron: Men and women after menopause lose about one milligram of iron every day. Since women often have long and heavy bleeding, especially at the beginning of menopause, iron deficiency often occurs.
  • Vitamins B6, B9 (folic acid) and B12: In combination with vitamin B12 and folic acid, vitamin B6 is essential for breaking down the cell toxin homocysteine. This occurs to a greater extent in the blood due to the reduced estrogen levels during menopause. Vitamin B6 and B12 also support the production of the “feel-good hormone” serotonin.
  • Melatonin: increases the body's estrogen sensitivity


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