The Female Hormone System: The Five Organs Involved

The female hormonal balance is complicated. In this article, Dr. Morstein will discuss the main glandular organs that are actively involved in producing and secreting hormones that help a woman feel her best, balanced, vital and thriving.

There are five main hormonal glands that inter-connect in the female body: hypothalamus, pituitary, thyroid, adrenals and ovaries. If any one or several of these glands are not functioning normally, they can cause female imbalance and also have a negative impact on how the other glands themselves work.

The Hypothalamus

The hypothalamus is located in the brain, and sends signals to the pituitary, detailing what hormones it wants the pituitary to produce. The two main hormones produced by the hypothalamus are: cortisotrophin releasing hormone (endpoint: adrenals), thyroid releasing hormone (endpoint: thyroid).

The hypothalamus is affected by other signals it receives from the body. When hormones are being produced exactly as it dictates, the hypothalamus “down-regulates” its signals, releasing less of its hormones. When it senses the targeted hormones are not in production to the level the hypothalamus feels is required, it will “up-regulate” its hormones, secreting more signal hormones to ensure those endpoint hormones are where they should be.

Many factors can affect hypothyalamus functioning. For example, if a person is under a great deal of stress for a long time, the hypothalamus may tend to lose its ability to signal the adrenal hormones, and adrenal fatigue, the lack of hormonal capacity can occur.

The Pituitary

Once the hypothalamus has sent its signals out, the pituitary is the next gland in line to process the messages and react accordingly. The pituitary consists of anterior and posterior sections. In the posterior pituitary oxytocin and antidiuretic hormone are produced, which are not pertinent to this article.

However, the hormones produced in the anterior pituitary are vital for female hormonal health. These are the hormones produced by the pituitary:

1. Thyroid stimulating hormone: Stimulates the thyroid gland to produce thyroxine, T4, and a little triiodyione, total T3.
2. Adrenocorticotropic hormone (ACTH)—stimulates the adrenal gland to product cortisol.
3. Follicular stimulating hormone: Stimulates the ovaries to produce estrogen.
4. Luteinizing hormone: Stimulates the ovaries to produce progesterone.
5. Prolactin: Although it has many uses in the female body, it is mainly used to produce breast milk after birth.

Sometimes the pituitary can be unhealthy and not produce one or many hormones, or the pituitary can also overproduce a hormone or two, causing problems with the end organ gland or the body as a whole. Pituitary tumors, many of which are benign, can be a cause of that, and so can trauma to the skull. To analyze the pituitary functioning a full hormonal panel of all those listed above would be drawn via blood.

The Thyroid

The thyroid produces mostly thyroxine, known as T4, and a little triiodothyronine, also know as T3. The T4 and T3 may be bound to a protein and inactive, or “free”, not bound, and then active in the body. T4 is converted into T3 in body cells, with selenium, and with the help of Vitamin A and cortisol, directs energy production.

If the thyroid is underperforming and a woman has hypothyroidism, this can have serious problems on her cycle; it can come too frequently, be too heavy and cause more discomfort, such as more water retention, breast pain, or cramping.

Hypothyroidism may be due to a lack of iodine, insulin resistance (such as in prediabetes or diabetes), elevated cortisol from the adrenals, or, commonly, Hashimoto’s thyroiditis, an auto-immune disease where a woman’s own immune system attacks and destroys parts of the thyroid molecule (anti-thyroglobulin antibodies) or the enzyme that helps add iodine to the thyroid molecule (anti-thyroid peroxidase enzyme).

An overactive thyroid, known as hyperthyroidism, and also, Grave’s disease, can also affect a woman’s cycle. Any change, then, in a woman’s cycle requires a full thyroid panel through the serum: Total and Free T3, Total and Free T4, TSH, Autoimmune antibodies, and perhaps Reverse T3. Reverse T3 is a type of T3 that is not active in the body; it is the throw-away form of thyroid. If it is elevated, it shows some sort of stress is occurring to the women’s body, or that there is low selenium.

Mastering hypothyroidism and hyperthyroidism is an involved process for a physician, and Dr. Morstein can be considered an expert on this complicated organ.

The Adrenals

The adrenal gland, little almond sized glands sitting on the kidney, contains the medulla and cortex. The medulla produces epinephrine and norepinephrine, which are not pertinent to this article. The adrenal cortex produces a small amount of reproductive hormones, but mainly cortisol and DHEA. These are called “glucocorticosteroids”.

When cortisol is under-produced, it can cause problems with T3 conversion in cells, and when it is over-produced it can interfere with the original secretion of T4 in the thyroid, both of which can cause hormonal problems in a woman. So, when the thyroid seems to be causing signs and symptoms, and the thyroid lab panel is fine, or, if a woman has been suffering significant stress, or, if the woman suffers from continual fatigue, then analyzing the adrenals makes sense.

As for DHEA, Dr. Morstein is mostly concerned when DHEA levels are elevated, as that is an indication a woman may have Polycystic Ovarian Syndrome, a condition whereby she skips many periods, and may suffer from hirsuitism (excessive hair growth on the face), or hair loss on the scalp), and ovaries that have many cysts on them.

Dr. Morstein measures these two hormones via a convenient and easy to do salivary test the woman does at home.

The Ovaries

The ovaries produce four hormones: estrogen, progesterone, testosterone, and DHEA, although mainly estrogen and progesterone.

Estrogen is produced throughout the entire cycle but is high in the first half as it causes the uterus to build-up up a bloody lining to immediately begin feeding a fetus if pregnancy occurs. Estrogens also signal an ovarian egg to come to maturation and be released from the uterus. From that area, called the corpus luteum, progesterone is secreted. There are three main estrogens: estradiol, estrone and estriol.

Progesterone is designed to extend the cycle out longer, another 11-12 days, to allow fertilization of the egg with a sperm and its deposition into the lining of the uterus. When that doesn’t occur the uterine lining blood starts getting a little “old”, so the body stimulates a large increase in estrogen again, signaling the body to shed the that unused lining, thus the woman has her period, and begins rebuilding a new fresh lining. This is the basics of the female monthly cycle.

If the estrogens and progesterone are not in good normal balance, the woman may become “estrogen dominant” and have signs and symptoms of too much estrogen in her body and in her mental/emotional system. This can happen if the estrogen levels are high and the progesterone is normal or low, or if the estrogen levels are normal and

the progesterone levels are low. Foreign environmental estrogens, from environmental chemicals in pesticides, herbicides, plastics, phthalates and other toxins can also
increase estrogen effects in the female body. An estrogen dominant female might have frequent, heavier periods, and bad premenstrual symptoms such as irritability, weepiness, breast pain, mirgraines, cramping, acne, water retention, and other negative events.

During the perimenopausal time, a woman may not “pop out” an egg during ovulation, and thus will not produce much progesterone. Without this signals to reduce estrogen production, this can cause dysfunctional uterine bleeding, very significant, at times life threatening, heavy constant bleeding. When a woman goes through menopause, her estrogen production falls drastically and the period cycling stops. The lower amount of estrogen can cause many post-menopausal problems: hot flashes and night sweats, migraines, vaginal dryness, rapid aging of skin, increase risk of insulin resistance, easier weight gain around the tummy, voice changes, loss of bone mass, and mood changes.

When the ovaries produce too much testosterone, it can also indicate Polycystic Ovarian Syndrome, with the same signs and symptoms as can elevated DHEA. PCOS develops when insulin resistance is present as that will upset the ovaries and they will erroneously reduce estrogen production and increase the production of both testosterone and/or DHEA.

One other hormone associated with the female reproductive hormones is Sex Binding Globulin Hormone (SHBG), which binds to both estrogens and testosterone, and is produced in the liver. When those hormones are bound, they cannot be used; only “free” hormones can be used.

When SHBG is lowered in females, which occurs, for example, in insulin resistance, hypothyroidism, there is more free testosterone levels, which is a keynote lab for PCOS.

When SHBG is elevated, it is associated with: elevated estradiol production, hyperthyroidism, birth control pills, anorexia nervosa (with weight loss), cigarette smoking, liver detoxification problems, pregnancy, elevated cortisol.

Since the adrenals make some little bit of reproductive hormones, post-menopause, if they are under-performing, they may have a little impact as well on how the woman handles menopause.

Ovarian labs include:

1. Estradiol and estriol
2. Progesterone
3. Free and Total Testosterone
4. DHEA
5. Sex Hormone Binding Globulin

As you can see, the female hormones are complicated and interwoven. You always want to find a physician who understands the complex nature of hormone regulation when your hormones are not working in balance. Dr. Mona Morstein excels in treating women in all phases of their life: menstrual, perimenopause and post-menopause. If you have any imbalance at any time of life, please contact Dr. Morstein for a comprehensive work-up and treatment plan to bring you, and all your hormones, back to balance!

Next, check out Dr. Morstein’s article on BioIdentical Female Hormonal Replacement!

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