by Alannah Slingsby
When my grandmother was pregnant with my mother, she was given a drug that would change her life forever. She was given DES, a potent synthetic estrogen that was given to women to prevent miscarriage. The marketing campaign for DES was aggressive and was sold as a “wonder drug.” It turns out, DES actually caused miscarriages. Not only that, DES has been linked to cancer, anatomical problems, infertility, and cardiovascular disorders. These side effects did not just impact the mother, but the baby. As a result, my mother had severe scoliosis, dealt with infertitly, never had two periods in a row, and is at a higher risk of developing cancer. The research is still ongoing on the side effects of the granddaughters of women given DES.
This was all caused by invisible messengers. Hormones are not actually visible to the human eye or to a microscope. And yet this microscopic messenger can change the state of our health drastically.
The term hormone comes from the Greek meaning, “set in motion” and was introduced by scientists in the 1900s to describe a chemical substance that travels around the body influencing physiology and behavior. I imagine Ernest Starling, the professor of physiology, who first used the word “hormone” had amazing intuition about the human body because that’s just what hormones do — set your health in motion.
Hormones are chemical messengers that are produced in the body by glands and can be transported by the blood to a target organ. Hormones are used to communicate between organs and tissues and control almost all tasks in the body relating to regulation. A subset of hormones, sex hormones (also known as sex steroids), are hormones that interact with vertebrate steroid hormone receptors. Sex hormones are not just made by the ovaries or testes, but also in skin cells and fat cells. Steroid hormones are hormones derived from cholesterol. These include testosterone, estradiol, and even cortisol.
Two major classes of steroid hormones include:
- Glucocorticoids: Cortisol
- Progestogens: Progesterone, a protective hormone involved with many functions but known to support fertility
- Androgens: Testosterone, a hormone with many functions but is known to facilitate male characteristics
- Estrogens: Estradiol, a hormone with many functions but known to contribute to female characteristics
- There are several other estrogens including estriol and estrone
Males and females make all the sex hormones, just in different amounts. For example, it’s commonly known that women produce more estrogen than men and men produce more testosterone than women.
How can these invisible messengers change our health so drastically? It’s about amounts, ratios, and the effects of the hormones themselves.
The body can over-secrete sex hormones, causing a multitude of issues. When a blood hormone test is done, the level of hormones in the blood are compared against the optimal range of hormone production.
For example, take estrogen. If estrogen levels are below or above the range 51–302 pg/mL (Premeno-luteal), then there could be contributing to many health conditions.
Cancer: It is estimated that over 70% of breast cancers are related to hormones. A 1994 publication reported that there are four hormonal features in women with breast cancer. (1) Diminished adrenal androgen production, probably genetic, in women with premenopausal breast cancer; (2) ovarian dysfunction (luteal inadequacy plus increased testosterone production) in breast cancer at all ages; (3) increased 16 alpha-hydroxylation of estradiol in breast cancer at all ages; and (4) evidence that prolactin is a permissive risk factor for breast cancer, and that the pregnancy-induced decrease in prolactin levels may account for the protective effect of early pregnancy against breast cancer.
Another study looked at forty-one women with breast cancer and 119 controls. During the follicular phase of the menstrual cycle, one overnight urine specimen was collected. During the luteal phase, urine and blood specimens were obtained. 17 beta-Estradiol, sex hormone-binding globulin, progesterone, and prolactin were measured in plasma, whereas estrogen metabolites (estrone, estradiol, and estriol) and pregnanediol were assessed in the urine. Breast cancer was associated with high-plasma estradiol and prolactin and with low progesterone.
PCOS: Polycystic ovary syndrome or PCOS is one of the most common causes of infertility among women of reproductive age. It is an endocrine disorder with inflammatory aspects leading to a lack of ovulation. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries.
PCOS is often related to the balance of estrogen and progesterone and multiple studies have demonstrated that estrogen administration in females can reliably induce obesity and PCOS.
In one study comparing PCOS to endometrial cancer, Dr. Rungruang states, “With PCOS you have a relative increase of estrogen relative to the levels of progesterone, which is the other female hormone and this causes thickening over time of the endometrial lining.”
Furthermore, in one animal study, the induction of PCOS can be induced with an “injection of 4 mg of Estradiol valerate for 28 days.” Progesterone opposes estrogen, which makes supplementing progesterone an effective option.
Endometriosis: Endometriosis affects an estimated 2 to 10 percent of American women between the ages of 25 and 40. One recent study noted, ”…Since endometriosis is an estrogen-dependent disease, treatment approaches still rely on mechanisms to suppress estrogen action. But this approach has the considerable disadvantage of affecting fertility and producing menopausal-like side effects.”
It’s not just about the amounts of hormones, but their ratios. The hormones in our body are all dancing together in a beautiful choreography. If a woman has normal levels of estrogen, but very low levels of progesterone, she may experience significant negative symptoms. This ratio is often termed “estrogen dominance.” and is something many physicians use when a woman suffers from hormonal symptoms, yet their lab results appear to be within the “normal” range. Progesterone opposes many of the negative effects of estrogen, so without adequate levels, health issues can ensure. Consider progesterone an estrogen-antagonist. This relationship is illustrated during a woman’s menstrual cycle. Estrogen in healthy women should only be dominant for a few hours each month, not sustained dominance. Ideally, progesterone, which surges from the corpus luteum after ovulation, lowers estrogen and its effects by eliminating it from cells. Therefore, when progesterone is at healthy levels after ovulation, PMS usually isn’t reported or is minimal. However, if estrogen is high relative to progesterone, side effects if it’s not balanced by its opposing hormone.
What other conditions can secretion levels and ratios of hormones affect the body?
- Fertility and pregnancy
- Skin health
- Immune system
- Brain health
- Muscle growth
- Heart rate
- Menstrual cycles
- Wake and sleep cycle
To be clear, no hormone is “bad.” In healthy amounts, hormones really do keep our body “in motion.” But we must live in reality and understand that when hormones are off, our health is off.
The good news is there are solutions. At-home hormone testing has never been easier. A simple blood prick on the finger can give amazing insight into your hormone levels. Keep in mind, that all testing has its limitations. For example, blood measurements don’t capture the hormones made in the fat cells. A biopsy is invasive, expensive, and typically only done during a cancer diagnosis. However, the blood is the so-called “highway” for the hormones and can be a great starting point as a diagnostic marker.
About the author
Alannah Slingsby is the CEO and founder of Moment, a health femtech startup focused on testing and treating hormone imbalances with a whole-person approach — from the comfort of your own home.