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There is a direct link between the stress response and sex hormone imbalances. Under times of stress when the HPA axis is activated or upregulated, the reproductive axis is inhibited by the HPA axis for the sake of saving energy. You just need to look at the increasing numbers of stressed out women and couples turning to IVF to understand that our modern stressful lifestyle is having an effect on our fertility. Environmental chemicals can also play havoc with our sex hormones, impacting fertility levels and producing more female babies.

There are documented links between several conditions and HPA axis dysregulation. Polycystic ovary syndrome (PCOS), anorexia nervosa, and pregnancy in the third trimester are all characterized by HPA axis activation. In contrast down regulation or what’s also called stage 3 HPA axis dysregulation has been implicated in post-partum depression.

Steroid hormone production is linked via biochemical pathways, meaning that depletion of cortisol and DHEA will damage levels of the female hormones progesterone and estrogen, as well as the predominant male hormone, testosterone. In both men and women, hormonal symptoms such as mood swings, irritability, sweet cravings and headaches can be related to the failure of the HPA axis to adapt to stress.

Female hormone symptoms such as menstrual cramping, infertility, night sweats and hot flashes can also be HPA axis related. Many women feel they are on an emotional roller coaster with their female hormones, yet rarely is the role the adrenals play in female hormones explored. Testosterone levels in men also suffer as a result of weak adrenal output. Since sex hormone levels drop as cortisol and DHEA levels drop, sex drive diminishes in both men and women.


As levels of cortisol and DHEA start to plummet, your energy levels will also plummet. If you’re like most people you will reach for a coffee or a sugary hit like a pastry, a piece of cake, or chocolate. This just sets your blood sugar on a roller coast ride, resulting in HPA axis dysfunction and sex hormone imbalances. Correcting sex hormone imbalances with bio-identical hormones will only be effective if you control your blood sugar. Eating low Glycaemic Index foods together with relaxation techniques are essential in any adrenal and sex hormone repair programs.

Correcting adrenal and sex hormone imbalance with natural Bio-Identical hormones can;

  • Improve fertility
  • Help with endometriosis, fibroids, polyps, irregular periods, heavy bleeding and out-of-control cycles
  • Increase libido
  • Increase energy levels
  • Decrease risk of cancers from synthetic hormone replacement
  • Improve depression and anxiety symptoms
  • Help with insomnia
  • Decrease headaches
  • Help with PMS and PCOS
  • Support transition through menopause
  • Slow or stop osteoporosis


Historically the sex hormones have been measured via blood tests. This is not an entirely accurate way to measure the sex hormones as it only tests the hormones in the blood that circulate bound to a protein such as sex hormone binding globulin (SHBG). The problem with only measuring the bound levels is that you are missing crucial information on the level of available hormone and also how you are clearing the hormones after they have been used, known as the metabolites. You will also miss out on information regarding the methylation of the sex hormones.

The Dried Urine Test for Comprehensive Hormones (DUTCH) test will you give more information that could change your treatment protocol and results. The DUTCH test will not only give you valuable information around the sex hormones but also the adrenal hormones cortisol and DHEA.

Blood (serum) testing is also adequate for the sex hormones. The one area where the DUTCH test does outperform blood tests for sex hormones is in the evaluation of the metabolites. Testosterone and Estrogen are metabolized (broken down) via certain pathways which can be measured on the DUTCH test. Certain metabolites of the sex hormones are more dangerous than other types. When the androgens favour the more damaging pathway then the following signs may appear;

  • Excess facial hair growth
  • Scalp hair loss
  • Acne
  • Irritability
  • Oily skin
  • Prostate issues and increased cancer risk in men

When we look at estrogen metabolites, elevated levels in men can cause :

  • Weight gain
  • Breast development
  • Mood swings
  • Cardiovascular problems
  • Prostate issues and increased risk of cancer

In women when estrogen is metabolized down the more potent, carcinogenic pathway then there is an increased risk of developing breast cancer.

For these reasons we believe the DUTCH test to be a better measure of your sex hormones, together with cortisol, DHEA and melatonin making it a comprehensive way to check hormonal levels in women and men. 

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