Hormones: Adrenal, thyroid and sex—and how they all work together

by Elysian Magazine

ELYSIAN’s OptimalSelf Health Column with Dr. Katherine Birchenough

There are more than 50 of these potent chemical messengers in the human body, and life would not be the same without them. They control waking, sleep, hunger, thirst, love, sex… You name it, and there’s probably a hormone involved.

Over a lifetime, the intricate interplay of hormones controls our physical and emotional growth and development, maintains metabolism, and has a big influence on how we interact with and experience the world.

They control everything from the emotions we feel to our blood sugar levels, how fast we grow and develop, our body weight, and how we age. When working well, our hormones, bodies, and minds are synchronized. When deficient or out of balance, they can cause physical discomfort, emotional distress, increase our risk of disease, or even death.

Some hormonal deficiencies are easily detected and can be life-threatening. For example, take the hormone insulin. We know and accept that giving insulin to someone with Type 1 Diabetes is a necessity, and we don’t think twice about it. Another example is a child with growth hormone deficiency. Without daily injections, that child will remain small. However, many people (and doctors) still have some confusion, fear, or mixed feelings about replacing estrogen, progesterone, or testosterone when levels have dropped significantly, even when symptoms are severe.

The balance of adrenal, thyroid, and sex hormones is very important, and in my practice, I address all of these to achieve the best results, but here I will focus on the Big 3.

ESTROGEN is the main sex hormone in women, but men also have it in smaller amounts. It is responsible for innumerable things, including softer skin, breast development, and ovulation in females. But did you know it also keeps cholesterol in control, protects bone health for women and men, and positively affects brain function, the immune system, heart, skin, and connective tissue?

We are all familiar with the classic symptom of menopause, especially hot flashes. But what many people don’t know is when estrogen declines, some women also experience memory loss, problems focusing, mood swings and irritability, insomnia, extreme stress, anxiety, and depression. They are also at increased risk for cardiovascular issues, such as heart attacks and strokes. In the first 5-10 years after menopause, the rate of bone loss accelerates and results in osteopenia and osteoporosis. The estrogen depletion that comes with menopause decreases hydration and elasticity in the skin. Estrogen depletion can cause the lining of your urethra to become drier, thinner, and less elastic, which can lead to the need to urinate more often, an increased risk of urinary tract infections, and leaking of urine when coughing or laughing, as well as painful sex.

PROGESTERONE, widely known as the pregnancy support hormone, is more than that. Receptors for this hormone are also found in the brain, breasts, blood vessels, and bones of both sexes. Progesterone is the natural balancer to estrogen and has significant anti-anxiety and relaxing effects on the body.

TESTOSTERONE, the main sex hormone in men, is responsible for all things masculine: facial and body hair, muscles, a deeper voice. Women have small amounts that contribute to energy and a sense of well-being. When men’s testosterone starts to decline, the change has similar symptoms to menopause: hot flashes, mood changes, anxiety, depression, fatigue, and more. What we don’t talk about enough is the increased risk of heart disease, stroke, high cholesterol, osteoporosis, and loss of cognitive function. Testosterone replacement therapy can dramatically improve quality of life and can increase lean body mass, decrease visceral fat mass (that “beer belly”), decrease total cholesterol, and improve glycemic control.

Ultimately, hormone replacement therapy may not only add life to your years, but years to your life. I don’t know about you, but I’ll take it.


Katherine Birchenough was the fourth MD in the state of South Carolina to be certified through the Institute for Functional Medicine. A South Carolina native, Dr. Birchenough is a University of South Carolina School of Medicine graduate, board-certified in pediatrics and emergency medicine, and has recently devoted herself full-time to her wellness practice. Dr. Birchenough practiced traditional medicine for more than 12 years, diagnosing and treating diseases but not really getting to the root cause. Over the years, she watched as unhealthy environments and poor lifestyle choices affected the health of her peers and her patients, at one point even herself, and knew that something had to give. She realized the pursuit of health, beyond just the absence of disease, is a specialty in and of itself but wasn’t available to traditional medical students. This realization brought her to a new career path in functional medicine and has fueled her passion to treat the patient, not just the symptoms.


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