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Hormone Health
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What Are Hormones? 

Hormones are chemical messengers that travel through the bloodstream, helping to regulate nearly every function in the body. They influence how we feel, think, sleep, digest, and move, guiding systems like metabolism, memory, energy, and mood. Produced by glands in the endocrine system, hormones constantly signal tissues and organs to act in rhythm with what the body needs. While often linked to reproduction, hormones do far more. Oestrogen, progesterone, and testosterone are key sex hormones for women, but hormonal balance as a whole is essential for lifelong wellbeing. When things shift, even slightly, we often feel the effects in subtle or noticeable ways.

OESTROGEN

Supports brain function, bone strength, skin elasticity, heart health, and vaginal tissue. It plays a central role in the menstrual cycle and is key during puberty, pregnancy, and menopause. When oestrogen declines, we may notice changes in memory, mood, skin, sleep, and joint comfort, all signs of shifting hormonal rhythm.

PROGESTERONE

It helps regulate the menstrual cycle, supports restful sleep, and calms the nervous system. It works in harmony with oestrogen to prepare the body for pregnancy and helps maintain hormonal balance throughout the cycle. Falling progesterone can contribute to anxiety, poor sleep, irregular periods, and an overall feeling of imbalance or unease.

TESTOSTERONE

Often overlooked in women, testosterone plays an important role in libido, energy, muscle strength, and motivation. It supports bone health, cognitive function, and overall vitality. Levels decline gradually with age, but low testosterone can lead to fatigue, loss of strength, reduced confidence, or a drop in sexual desire and emotional resilience.

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Meet All Your Hormones

Women produce dozens of hormones, not just the “classic” sex hormones. Each plays a unique role in keeping the body balanced, supporting mood, energy, metabolism, sleep, reproduction, and stress response.

 

Hormones are made in several key hubs; the brain, ovaries, adrenal glands, thyroid, and pancreas, and work together in a complex network. Even small imbalances can affect wellbeing, from fatigue and low mood to digestive issues or disrupted sleep.

 

Understanding hormones as a whole system helps us see why changes in one area can ripple across the body. It’s not just about oestrogen and progesterone; it’s about total body harmony.

Sex Hormones

Oestrogen, progesterone and testosterone control reproduction, libido, bone health, and mood.

Gut & Digestive

Gastrin, secretin, and GLP-1 help digestion, nutrient absorption, and appetite control.

Stress Hormones

Cortisol and adrenaline regulate energy, inflammation, and how the body responds to stress.

Metabolic

Insulin, glucagon, and leptin manage blood sugar, energy use, and appetite.

Thyroid Hormones

T3 and T4 control metabolism, energy levels, temperature, and brain function.

Growth & Repair Hormones

Growth hormone and IGF support tissue repair, muscle, and cell renewal.

Sleep Hormones

Melatonin signals sleep and regulates circadian rhythms.

Understanding the Endocrine System

Our endocrine system is the body’s hormone communication network. It is made up of specialised glands that release chemical messengers called hormones directly into the bloodstream. These hormones travel throughout the body, helping regulate mood, sleep, metabolism, reproduction, immunity, and how we respond to stress. Unlike nerves, which act quickly, hormones work more slowly but their effects are deep, wide-reaching, and long-lasting.

 

At the centre of this system are the endocrine glands, including the hypothalamus and pituitary in the brain, the thyroid, adrenal glands, pancreas, and ovaries. These glands are designed specifically to produce hormones and coordinate signals between the brain and the body. They act as command centres, adjusting hormone output in response to internal and external changes.

 

However, modern medicine now recognises that the endocrine system extends beyond glands alone. Organs such as the gut, kidneys, heart, and adipose tissue (body fat) also release hormones and hormone-like signals. These organs influence appetite, inflammation, blood pressure, fertility, and oestrogen levels, particularly after menopause when fat tissue becomes a key source of oestrogen.

 

For women, this matters deeply. Hormonal shifts across the menstrual cycle, pregnancy, perimenopause, and menopause affect not one organ, but the entire endocrine network. Understanding this helps us see symptoms not as isolated problems, but as part of a connected system that deserves informed, compassionate care.

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The Endocrine System: A Whole-Body Hormone Network

The endocrine system extends far beyond individual glands. Hormones are produced not only by the brain, ovaries, thyroid, and adrenal glands, but also by organs such as the gut, kidneys, heart, and adipose tissue. Together, they form a whole-body hormone network that shapes mood, metabolism, stress response, fertility, and long-term health. Supporting this system thoughtfully can help restore balance, resilience, and wellbeing at every stage of life.

DID YOU KNOW?

All these things can affect your hormones

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How Trauma Rewires the Body

The biological imprint on hormones, digestion, and chronic illness.

Many women live with the long shadow of trauma, whether from a single frightening event or prolonged experiences such as abuse, neglect, or chronic stress. Trauma care has traditionally focused on psychological healing, thoughts, memories, and emotions. Yet modern research shows that trauma is not only held in the mind. It is deeply embedded in the body, the nervous system, and the hormonal networks that regulate safety, repair, and resilience.

 

Trauma activates the hypothalamic-pituitary-adrenal axis, the body’s central stress system. When stress becomes chronic, cortisol and adrenaline remain elevated or become dysregulated. This alters sleep, immune function, metabolism, and reproductive hormone signalling. The vagus nerve, which helps regulate calm, digestion, and emotional regulation, often becomes less responsive, reducing the body’s ability to return to a settled state after stress.

 

The glymphatic system, responsible for clearing metabolic waste from the brain during deep sleep, can also be impaired when stress and poor sleep persist. Over time, this contributes to brain fog, fatigue, and reduced cognitive resilience. The gut, rich in stress receptors and hormone signalling pathways, is particularly affected, helping explain strong links between trauma, irritable bowel syndrome, inflammation, and chronic pelvic or hormonal conditions such as endometriosis.

 

Understanding trauma as a whole-body experience allows healing to extend beyond talk therapy. Supporting the nervous system, hormones, sleep, and gut health creates space for deeper, more sustainable recovery.

Where Are You On The Hormone Timeline?

This is a general overview, not everyone will follow the same pattern. Hormone levels can be affected by many factors, including stress, medical conditions & treatments, hysterectomy, or induced menopause. Each journey is unique.

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Do You Know What You Are Taking?

Synthetic

Synthetic hormones are most commonly used in hormonal contraception, including the combined oral contraceptive pill, the progestogen-only pill, hormone-releasing intrauterine devices such as the Mirena, the contraceptive patch, injection, and implant. These products typically contain ethinylestradiol and synthetic progestogens known as progestins, which are structurally different from the hormones naturally produced by the ovaries.

 

Their primary role is to suppress ovulation and override the natural hormonal cycle. Because synthetic hormones do not behave identically to endogenous oestrogen and progesterone, they can affect the brain, liver, blood vessels, and metabolism in different ways. Commonly reported effects include low mood or mood instability, reduced libido, headaches, breast tenderness, nausea, and changes in bleeding patterns.

 

For some women, longer-term use is associated with increased anxiety, depressive symptoms, emotional blunting, or a sense of hormonal disconnection. Certain formulations are also linked to a higher risk of blood clots, raised blood pressure, insulin resistance, and altered cholesterol profiles, particularly in women over 35 or those with underlying risk factors.

 

Synthetic hormones can be effective and appropriate for contraception or specific medical indications. However, they are not designed to support hormonal balance or replicate the body’s natural endocrine environment, which is why they may not suit every woman, especially during hormonally sensitive life stages.

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Body-Identical

Body-identical hormones are chemically identical to the oestrogen and progesterone produced by the ovaries. In hormone replacement therapy, they are used to replace declining hormones during perimenopause and postmenopause in a way that closely mirrors the body’s natural endocrine environment. Oestrogen is most commonly delivered through transdermal patches, gels, or sprays, while progesterone is prescribed as micronised oral capsules.

 

In the short term, body-identical HRT can significantly improve common menopausal symptoms, including sleep disruption, low mood, anxiety, vasomotor symptoms, joint pain, vaginal dryness, and reduced energy. Because these hormones interact with receptors throughout the brain, cardiovascular system, bones, and immune tissues, many women also report improved emotional stability, cognitive clarity, and physical resilience.

 

Long-term, body-identical HRT offers important protective benefits. It helps preserve bone density, lowering the risk of osteoporosis and fractures. Transdermal oestrogen has a neutral or beneficial effect on blood clot risk and is associated with improved vascular health. When started within the menopause transition, there is growing evidence that it may also support brain health and reduce the risk of cognitive decline.

 

Body-identical HRT is not contraceptive, but it is a clinically evidence-based approach to supporting hormonal health, quality of life, and long-term wellbeing in midlife and beyond.

What Is Hormonal Dominance?

Hormones are meant to work together in balance. But sometimes, one becomes too dominant and disrupts the rhythm. This is called hormonal dominance. Oestrogen dominance is the most common form, especially in the years leading up to menopause, when progesterone begins to decline. This doesn’t always mean oestrogen levels are high, only that there’s not enough progesterone to keep it in check.

 

Hormonal dominance can also involve other key hormones, like cortisol or insulin. Long-term stress, poor diet, sleep issues or inflammation can all tip the scales. Even small imbalances in this system can lead to noticeable symptoms.

Signs of Hormonal Dominance

  • Heavy or painful periods

  • Bloating or weight gain 

  • Breast tenderness or swelling

  • Headaches or migraines

  • Trouble sleeping

  • Fatigue or low libido

  • Skin breakouts

  • Brain fog or irritability

Hidden Imbalance, Visible Effects

Dominance doesn’t always show up clearly on blood tests. Often, levels fall within the normal range, but the relationship between hormones is off. That’s why looking at symptoms is just as important as lab results. Hormonal dominance can affect the menstrual cycle, mood, weight, sleep and skin.

 

Bringing things back into balance often starts with gentle changes. Nutritional support, stress reduction, better sleep and targeted supplements or hormone therapy can all help. Awareness is the first step when we understand the signs of imbalance, we can take action that supports our long-term wellbeing.

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When Hormones Influence How We Feel

In puberty, rising oestrogen, progesterone and testosterone shape mood and sensitivity as the brain adapts. During the menstrual years, monthly hormonal shifts can naturally affect emotional rhythm.

 

After childbirth, hormone levels change quickly. Oestrogen and progesterone drop sharply in the first days after birth, while prolactin rises for breastfeeding and cortisol may increase due to stress and lack of sleep. This mix can affect mood, emotional stability and energy, contributing to postpartum anxiety or depression. These shifts are biological, not personal, and understanding them helps reduce self-blame.

 

In perimenopause, progesterone is often the first hormone to decline. Because it supports calmness and sleep, early signs can include night anxiety or disrupted rest, which naturally affects mood. As perimenopause progresses, oestrogen becomes more erratic, influencing serotonin and contributing to irritability, low mood or emotional sensitivity. In postmenopause, hormones settle at lower levels and many emotional symptoms ease.

 

Knowing how hormones shape mental wellbeing across each stage helps us recognise patterns and seek support that aligns with what our bodies need. 

It's All About Hormonal Balance
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Internal Imbalances

Our hormone levels naturally rise and fall across different life stages; puberty, pregnancy, postpartum and menopause. But sometimes, the internal systems that regulate hormones become disrupted. Ongoing stress, poor sleep, unstable blood sugar or chronic conditions like PCOS or thyroid disorders can all impact how hormones are made and used. When this balance is off, we may notice fatigue, mood changes, brain fog, skin issues, low libido or weight gain. These symptoms are not just a normal part of ageing. They are signs that the body is asking for support, and often responds well to gentle, targeted changes in lifestyle and care.

Why Balance Matters

Hormones are involved in nearly every system in the body from brain and bone health to sleep, energy, mood and metabolism. When they are balanced, the body tends to function with ease. When they’re not, we may feel flat, anxious, irritable or unlike ourselves. These changes are not always dramatic, but they are often deeply felt. Hormone balance isn’t just about managing periods or menopause it’s about supporting the foundation of our long-term wellbeing. Low or fluctuating hormone levels can also raise our risk of issues like osteoporosis, heart disease and cognitive decline. Understanding what affects hormone balance gives us more control over how we live, feel and age.

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External Disruptors

Hormone health can also be influenced by what we’re exposed to day to day. Endocrine-disrupting chemicals, found in some plastics, perfumes, makeup, cleaning products and pesticides, can interfere with how hormones work in the body. They may block hormone receptors, mimic hormones or disrupt how they are processed. Diet, alcohol, synthetic hormonal contraception and long-term medication use can also affect balance. While we cannot eliminate every exposure, we can make informed choices that help reduce this burden. Choosing natural skincare, limiting processed foods, and using safer cleaning products are small steps that can make a meaningful difference.

The Most Common Types of HRT / MHT 

Hormone Replacement Therapy (HRT), also called Menopausal Hormone Therapy (MHT), comes in several forms. Below are some of the options available in the UK & USA.

Oestrogen Gel (Oestrogel, Sandrena)

Usually applied daily to the skin, this clear gel delivers oestrogen through the bloodstream. It’s body-identical and easy to adjust based on symptoms.

Oestrogen Patches (Evorel, Estradot)

Worn on the skin and changed once or twice a week, patches release oestrogen steadily. A good option for those who prefer not to use gels or pills.

Micronised Progesterone (Utrogestan)

Taken orally or vaginally, this is body-identical progesterone used alongside oestrogen for those with a womb to protect the uterine lining.

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Combined Patches or Tablets (FemSeven Conti)

Contain both oestrogen and progestogen. These options may suit women who want a single product for convenience, though not all are body-identical.

Oestrogen Spray (Lenzetto)

A newer option, this spray is applied to the inner forearm. It absorbs quickly and suits those who want an alternative to gel.

Vaginal Oestrogen (Vagifem, Ovestin)

Used for local symptoms only, like dryness, burning or pain during sex. Available as a cream, tablet or soft capsule inserted into the vagina. It is not systemic HRT, it does not act as full body hormone replacement. See GSM (Genitourinary Syndrome of Menopause) for more details.

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Hormone Testing

What tests can tell us, when they help, and when they do not

Many of us reach a point where symptoms feel intense and unmistakable, yet hormone test results return as “normal”. This disconnect is especially common during perimenopause, when hormone patterns become highly unstable. Oestradiol levels do not simply rise and fall across the month, they can fluctuate dramatically from day to day. Research shows that short-term oestrogen surges of several-fold can occur, followed by sharp drops, with some studies describing three to ten times. In practical terms, this means hormone levels can rise hundreds of percent above a woman’s usual baseline, then fall again rapidly. A blood, saliva, or urine test taken on a surge day may therefore appear reassuring, while symptoms persist or worsen days later. Understanding this volatility is essential when deciding if testing is useful, how results should be interpreted, and why lived experience often tells us more than a single hormone value.

Blood Testing

Blood tests are the most commonly used hormone tests in the NHS. They are reliable for confirming menopause once periods have stopped for over 12 months, particularly using follicle-stimulating hormone levels. In perimenopause, however, blood oestradiol and progesterone levels can appear normal even when symptoms are severe, simply because the test reflects one moment in time. Blood tests are most useful for ruling out other conditions such as thyroid disorders or for monitoring hormone levels once HRT has been established.

Salvia Testing

Saliva tests measure free, biologically active hormones rather than total circulating levels. While sometimes used in private practice, saliva testing is not routinely recommended in the UK for menopause assessment due to variability in collection, limited standardisation, and inconsistent correlation with symptoms. Results can fluctuate significantly depending on timing, stress, sleep, and recent food intake.

Urine Testing & DUTCH Testing

DUTCH testing measures hormone metabolites in dried urine samples and provides insight into how hormones are processed by the body. It can offer useful information about oestrogen metabolism, cortisol patterns, and androgen balance. However, it does not diagnose perimenopause or menopause and should be viewed as a functional snapshot rather than a definitive assessment. In the UK, it is typically used in specialist or integrative settings rather than mainstream care.

At-home Hormone Monitors

Mira and similar devices are designed to track reproductive hormones like oestradiol and luteinising hormone across the cycle. They can help illustrate hormonal volatility and cycle disruption, which can be validating during early perimenopause. However, they are tracking tools rather than diagnostic tests and should not be used to rule symptoms in or out on their own.

Hormonal contraception suppresses natural ovarian hormone production, meaning tests do not reflect underlying hormone status. Oestrogen and progesterone measured while using synthetic hormones are not representative of endogenous levels. For this reason, hormone testing is generally unreliable while on combined contraception, progestogen-only pills, implants, or hormonal coils.

 

Across all testing methods, context matters. During perimenopause, symptoms often provide more clinically meaningful information than any single hormone value.

The Impact of Hormonal Contraception and Synthetic Hormones

Testosterone in Women

It's not just a “male hormone” testosterone supports energy, strength, mood, and overall wellbeing.

Testosterone is often labelled a male hormone, yet it has always been an essential part of women’s health. From the teenage years through early adulthood, women naturally produce significant amounts of testosterone. In fact, by daily production, women make more testosterone than oestrogen, highlighting how central it is to female physiology. This is not a minor or optional hormone, but one the body relies on throughout life.

 

Testosterone supports energy, muscle and bone strength, motivation, mental clarity, confidence and mood stability. It also plays a role in libido, joint health and physical resilience, while helping to reduce inflammation and support healthy mitochondrial function, which allows cells to produce energy efficiently.

 

As women move through their 30s, 40s and beyond, testosterone levels gradually decline. This drop often accelerates during perimenopause and menopause, or following medical treatments that affect hormone balance. When levels fall, symptoms may include fatigue, low mood, anxiety, reduced motivation, muscle loss, joint pain, hair thinning, weight gain or a general sense of feeling flat or disconnected from the body.

 

These symptoms are frequently treated with antidepressants, mood stabilisers or pain medications, yet testosterone levels are not always tested. If there is little improvement with treatment, it may be worth discussing testosterone testing with a doctor. A simple blood test can assess levels, and treatment is usually an easy, once daily gel applied to the skin. For many women, restoring testosterone can lead to meaningful improvements in mood, strength, energy and overall wellbeing.

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MICRONISED PROGESTERONE

Many women notice that sleep feels elusive, mood feels fragile, or hot flushes persist even when they begin hormone support. One of the key tools in menopause care is micronised progesterone, a body‑identical form of progesterone. It is typically made from plant-based sources, such as yams or soy, and matches the hormone the ovaries naturally produce. In the UK, this is usually prescribed as capsules such as Utrogestan or Gepretix, often taken at night because it can gently support sleep and calm the nervous system. When taken orally with food, it is absorbed systemically and can influence the brain, sleep quality, and emotional regulation.

 

Micronised progesterone is used in hormone replacement therapy to restore balance during perimenopause and postmenopause. Progesterone plays a vital role alongside oestrogen, particularly for women who still have a uterus, as it protects the endometrium and helps prevent complications linked to unopposed oestrogen.

 

The hormone can be taken orally, vaginally, or less commonly rectally. Oral capsules, best taken with food, are absorbed systemically, supporting emotional regulation and promoting sleep when taken in the evening. Food enhances absorption, which is why clinicians often advise taking oral progesterone with a meal containing some fat, such as avocado or peanut butter, to improve hormone uptake and reduce nausea. Vaginal administration delivers progesterone directly to the uterus and vaginal tissues, reducing systemic side effects and helping counteract oestrogen dominance, particularly in women with endometriosis. Rectal administration is an alternative for those who cannot tolerate oral or vaginal routes.

 

Micronised progesterone offers both short-term symptom relief, such as improved sleep, mood, and calm, and long-term benefits, supporting uterine health and helping balance oestrogen. Women should discuss with their prescriber the most suitable route and timing to match their individual needs and lifestyle.

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Medical suppression uses medication to temporarily reduce or switch off ovarian hormone production. It is commonly used for endometriosis, fibroids, adenomyosis, severe PMDD, or during IVF when doctors need to control the cycle. Treatments such as GnRH analogues or progestin-based therapies create a reversible, low-oestrogen state similar to temporary menopause. Symptoms can include hot flushes, low mood, poor sleep, brain fog and vaginal dryness because the hormonal change is sudden. Women should be fully prepared by their medical team, with a hormone support plan discussed and agreed before treatment begins to help protect mood, bone health and overall wellbeing.

Medical Hormone Suppression

  • Temporary

  • Uses medication (GnRH analogues or progestin therapies)

  • Often for endometriosis, fibroids, adenomyosis, PMDD or IVF cycles

  • Creates a reversible low-oestrogen state

  • Symptoms may include hot flushes, low mood, brain fog and vaginal dryness

  • Needs a hormone support plan agreed before starting treatment

  • Permanent

  • Caused by removal of both ovaries or loss of ovarian function after surgery or cancer treatment

  • Sudden and steep drop in oestrogen, progesterone and testosterone

  • Symptoms may be stronger than natural menopause

  • Long-term considerations for heart, bone and brain health

  • Needs a hormone support plan agreed before surgery

Surgical Menopause

Surgical menopause occurs when both ovaries are removed (bilateral oophorectomy) or stop functioning after certain operations or cancer treatments. This causes an immediate and permanent menopause with a much sharper drop in oestrogen, progesterone and testosterone than natural menopause.

Symptoms can be intense at first, and long-term risks relating to the heart, bones and brain may increase. Women should have a clear hormone management plan in place before surgery, tailored to their medical history and future health needs, so they feel supported and understand what to expect afterward.

When Medical Treatments Lower Hormones

The Female Brain & Hormones

It’s not in our head. We’re not imagining it. But it is happening in our head, because the female brain responds to hormones differently. Pioneering research from Dr Lisa Mosconi shows that oestrogen is a key protective hormone for the brain. It supports blood flow, helps regulate glucose (the brain’s main fuel) and supports the repair of neural connections.

 

This matters because women are at greater risk of Alzheimer’s and dementia, and hormonal changes across midlife are part of the reason. In perimenopause, fluctuating oestrogen can affect memory, focus and mental clarity, which is why brain fog is so common. After menopause, hormone levels settle at lower levels, and while symptoms often ease, long-term low oestrogen may influence, even accelerate brain ageing.

 

Understanding this connection helps us act early. Supportive habits, stress care, good sleep, targeted nutrition and HRT can all contribute to long-term cognitive resilience. To expand your knowledge further we recommend reading The Menopause Brain. 

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