Symptoms, Dr. Neville’s Blog

Reproductive Hormone Health Matters at Every Age

September 22, 2020


Dr. Andrew Neville


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Almost all of my patients have educated themselves about their health challenges. If you’ve found this page, I bet you are one of them. Once your GP, endocrinologist, or gynecologist told you that you were menopausal, had low testosterone, high estrogen, or had one of the many reproductive hormonal dysfunctions, you were probably searching the internet the very next hour about how you feel, why you feel it, what you can do to take control of what’s happening in your body.

Symptoms of hormone dysfunction

As I said, many of my patients have “made the rounds” of other approaches, multiple treatments and numerous chronic fatigue or adrenal specialist doctors by the time they get to me. They have been on the “specialist merry-go-round” once or twice and are now ready to get off.

The reasons for this late arrival to our doorstep are many, but the primary three are a) a failure to look at the cause of a problem, as opposed to the symptoms b) our human desire for a quick fix to an unpleasant problem and c) the effectiveness of marketing strategies that exploit this desire for a quick fix.

Many younger female patients present with symptoms of ovarian hormone dysfunction but  have Adrenal Dysfunction as the underlying cause. The pattern is typically a problem with low progesterone and testosterone and relatively high estrogen.

The symptoms include premenstrual syndrome-type symptoms such as moodiness, irritability, acne, breast tenderness, insomnia, and anxiety. They also often complain of heavy bleeding, possibly spotting in between periods, difficult ovulation, a history of ovarian cysts or fibroids, and low sex drive.

Still other women come to me in their forties or fifties with issues they believe are linked to menopause, although they ultimately are caused by weakened adrenals. These symptoms include hot flashes, vaginal dryness, low libido, anxiety, insomnia and fatigue.

Most of my patients are women, but I see many men seeking answers to their unexplained fatigue, loss of interest in life, anxiety, insomnia, low libido, decreased sperm production, and erectile difficulties. (There are strong similarities in the symptoms of hormonal suppression between men and women.)

The internet and their doctors have told these men that all of these symptoms are the result of low testosterone…which may be true. But what these sources have failed to communicate? Their low testosterone is caused by overworked and weakened adrenals that absolutely need to be treated.

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What’s happening here?

Suppression is, again, the key word here with hormones, as it was with the thyroid and the digestive and immune systems. A stress response that was once life-saving in the short-term is now being overused and is causing suppression of every hormone, save your stress hormones.

By constantly activating your HPA-Axis and your fight-or-flight sympathetic nervous system through chronic stress, you suppress your parasympathetic or rest and digest nervous system (read more about this “seesaw” of physiology), which includes all your thyroid hormones and your ovarian (or testicular) hormones: estrogen, progesterone, and testosterone.

The normal ovaries

The ovaries work very much the same way as the thyroid and adrenals in a normal setting. The hypothalamus and pituitary are running the show. If the hypothalamus perceives a need for ovarian hormone (which occurs due to a woman’s monthly menstrual cycle), it acts to stimulate the pituitary to stimulate the ovaries to begin production of estrogen and progesterone.

The majority of the cells in the body have receptors for estrogen and progesterone; however, the tissues of primary importance here is the ovaries and the uterus, and they are stimulated once the ovarian hormones bind to these receptors. Upon binding and activation, the cells  begin the process of developing an egg within the ovary (as is the case for progesterone) or developing the lining of the uterus to receive the egg (as is the case for estrogen). This is to prepare the woman’s body for conception and pregnancy.

This system differs from that of the thyroid and adrenals primarily due to the monthly rhythm, as opposed to a daily rhythm with the adrenals and more of a need-base” rhythm for the thyroid.

How stress hormones directly hurt your fertility and ovaries

Problems with ovarian suppression occur in the same manner as with the thyroid. Upon elevation of the stress hormones during a stress response, cortisol is released which is carried in the blood to most cells in the body.

The cortisol that gets to the brain tells the hypothalamus to stop stimulating the pituitary, which then stops stimulating the ovaries because procreation, conception, and reproduction is now on the back burner. In addition, cortisol that reaches the ovaries then even further blunts the process by decreasing the sensitivity of these organs to estrogen and progesterone. The simplicity of this process is crucial to understand: the stress response directly tells your body not to reproduce.

The symptoms of ovarian suppression during the stress response in the short-term are again negligible, as with the thyroid, as this is a temporary response, putting us in fight or flight which lasts briefly, after which the ovarian axis is allowed to kick on again.

Symptoms that develop depend on the stage of life of the patient. If we were to look at a prepubescent Olympic level gymnast (a massive level of stress, by definition) we would see that puberty and the onset of a menstrual cycle itself is suppressed and, as a result, delayed for years.

But when this ovarian suppression occurs in women who are already menstruating the symptoms become more complicated.

Low progesterone

With low progesterone, there are symptoms of lowered ovarian and adrenal progesterone output.

This places the woman in “estrogen dominance,” where she develops symptoms of premenstrual syndrome, moodiness, irritability, breast tenderness, spotting and heavier bleeding. These symptoms are all due to a relatively lower progesterone level during the second half of her cycle, when it should be highest.

With low progesterone, the uterus becomes less stable, which can lead to spotting, earlier menstruation, and shorter periods. Also, more estrogen during this time causes mood swings, irritability, anxiety, and insomnia. The low progesterone can lead to infertility issues; the pro-gestational hormone is low. In some women who manage to conceive during times of stress and low progesterone, the risk of miscarriage is elevated.

Low testosterone

The primary symptoms of low testosterone, both from the ovaries as well as the adrenals, is lowered libido in women. It is rare that a woman with Adrenal Fatigue has much of a sex drive at all.

Low “everything”

Some women will see lowered ovarian and adrenal output of ovarian hormones overall which can lead to lighter or missed periods and infertility.

In women around the age of menopause and perimenopause, this leads to the symptoms we associate with menopause. The epidemic of menopausal symptoms in our society is not only an ovarian problem; it is a problem of Adrenal Dysfunction. By the time menopause occurs in most women, the adrenal system has been so overtaxed from life, that this is one job that the adrenals simply cannot handle.


The treatment for these issues is basic, although it must be individualized.

The good news is that if you treat the adrenals properly,  the thyroid and sex hormones usually follow suit on their own. In the majority of men and women, I never need treat their ovaries or testes (or the thyroid, for that matter). Overall treatment of Adrenal Fatigue and the balancing of the stress response system is the only treatment most of my patients need in order to see their sex hormones balance naturally during the course of their adrenal recovery.

If necessary, I will engage in more specific treatment of the sex hormones, but only after I am sure we have adequate adrenal support. If the adrenals are not supported, the results from any other treatment of hormonal symptoms are only temporary at best, and harmful at worst.

A word about BHRT

For those women who really require a boost in this direction. I am not against the use of this type of hormone therapy, however, I am in favor of working to treat it on a deeper more curative level first as much as possible.

In no way does taking a static oral dose (or cream) of a hormone compare to the dynamic, cyclical nature of our own hormone production; the effort is primarily in the restoration of that process first and foremost.

There can be a lot involved regarding this treatment: what to take, what to avoid, what to eat, what not to eat, or whether to take hormones. Starting with a basic philosophy and understanding of treatment is key here. Once that is established, then we can easily fill in the holes as needed on an individual basis in a treatment program.


Dr. Andrew Neville


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