What Are Hormones and Why They Matter

Hormones are your body’s internal messengers (tiny but powerful chemicals that help regulate everything from your energy and mood to metabolism, sleep, fertility, and immune function). When they’re in balance, your body tends to feel steady, resilient, and responsive. But when even one hormone falls out of sync, it can ripple across multiple systems and leave you feeling tired, anxious, inflamed, or just not like yourself.

Many people think of hormone imbalances as something that only happens during major life transitions like puberty, pregnancy, or menopause…but the truth is that hormone shifts are happening all the time. Daily stress, sleep disruptions, blood sugar swings, and even gut health can all influence your hormonal rhythm.
Here are just a few of the critical roles hormones play in your body:

  • Growth and development: Hormones regulate physical growth, sexual maturation, and cognitive development.
  • Metabolism: Thyroid hormones control how your body processes and uses energy.
  • Reproductive health: Estrogen, progesterone, and testosterone influence menstrual cycles, fertility, and pregnancy.
  • Mood and mental health: Hormones like serotonin and cortisol impact emotional balance and stress response.
  • Immune function: Some hormones help modulate inflammation and support the body’s healing response.

Over the next few sections, we’ll walk you through how important hormones function, what symptoms to watch for, and how a functional approach can help you restore balance at the root.

wellness-1

Key Hormones and Their Functions

Hormones act like internal messengers, carrying instructions to nearly every organ system in your body. While each hormone has its own role, they operate in a delicate balance. Here’s an overview of the key hormones we evaluate in practice, grouped by their primary functions.

Reproductive Hormones

Estrogen1

Estrogen is best known for its role in regulating the menstrual cycle, supporting ovulation, and preparing the uterine lining for pregnancy. But its influence goes far beyond reproduction. Estrogen helps maintain bone density by slowing bone resorption, reducing the risk of osteoporosis as women age. It supports cardiovascular health by improving blood vessel flexibility and promoting healthy cholesterol levels. In the brain, estrogen contributes to mood stability, memory, and cognitive function. It also plays a role in maintaining healthy skin and hair by enhancing collagen production, improving skin elasticity, and supporting moisture retention.

When Levels Are Too High or Too Low:

  • Excess Estrogen: can lead to ‘estrogen dominance’ with symptoms like bloating, breast tenderness, mood swings, and/or weight gain.
  • Low estrogen: hot flashes, night sweats, vaginal dryness, decreased bone density (common in menopause or overtraining).

Progesterone2

Progesterone plays a key role in maintaining a healthy menstrual cycle by balancing the effects of estrogen and preparing the uterine lining for implantation. After ovulation, progesterone levels rise to support early pregnancy by preventing uterine contractions and maintaining the endometrium. Outside of reproduction, progesterone has a calming effect on the brain, acting on GABA receptors to support sleep, reduce anxiety, and promote emotional resilience. It also supports thyroid function and helps regulate fluid balance in the body.

When Levels Are Too Low:

  • Irregular or heavy periods
  • Premenstrual anxiety or insomnia
  • Infertility or difficulty sustaining pregnancy

Testosterone3

Testosterone is often thought of as a male hormone, but it’s essential for both men and women. It supports muscle mass, strength, motivation, confidence, and sexual desire. In men, testosterone drives sperm production, promotes facial and body hair growth, and influences deepening of the voice during puberty. In women, it contributes to libido, energy, and metabolic stability. It also helps maintain bone density and supports red blood cell production. Imbalances can affect mood, body composition, and sexual health—and symptoms often vary based on whether levels are too low or too high.

When Levels Are Too High or Too Low:

  • Low testosterone (men): reduced libido, fatigue, muscle loss, brain fog, low motivation
  • Elevated testosterone (women): acne, facial hair growth, irregular cycles (commonly seen in PCOS)
  • Low testosterone (women): low sex drive, poor muscle tone, reduced vitality

Metabolic Hormones

Thyroid Hormones (T3, T4)4

Thyroid hormones control your body’s metabolic rate: how efficiently you burn energy, maintain body temperature, and support brain, gut, and cardiovascular function. T4 is the storage form, while T3 is the active form that your cells actually use. Even subtle shifts in thyroid function can lead to symptoms ranging from fatigue to weight gain or anxiety. These changes are especially common in women, particularly during times of stress, postpartum, or perimenopause.

When Levels Are Too High or Too Low:

Hypothyroidism (low thyroid): fatigue, weight gain, constipation, dry skin, cold intolerance, hair thinning
Hyperthyroidism (overactive thyroid): anxiety, rapid heartbeat, heat intolerance, weight loss, insomnia

Insulin5

Insulin helps move glucose out of your bloodstream and into your cells to be used for energy or stored as glycogen. It also plays a major role in fat storage and metabolic regulation. When the body becomes resistant to insulin (often due to chronic stress, inflammation, or poor diet) it compensates by producing more. This can lead to energy crashes, weight gain, and eventually prediabetes or type 2 diabetes if left unaddressed. To learn more about insulin and metabolic health, visit our ‘Complete Metabolic Health Resource.’

When Levels Are Too High or Too Low:

  • Insulin resistance (high insulin): weight gain (especially around the belly), sugar cravings, fatigue, increased blood sugar, prediabetes, type 2 diabetes.
  • Low insulin: typically seen in type 1 diabetes or advanced type 2; may cause high blood sugar and unintentional weight loss.

Stress Hormones

Cortisol6

Cortisol is your body’s main stress hormone. In healthy doses, it helps regulate your sleep-wake cycle, manage inflammation, and boost energy in response to short-term stress. But chronic physical or emotional stress can push cortisol out of balance leading to wide-ranging effects on mood, energy, metabolism, immunity, and hormone production across the board.

When Levels Are Too High or Too Low:

  • Elevated cortisol: anxiety, disrupted sleep, belly fat, sugar cravings, high blood pressure, feeling “tired but wired.”
  • Low cortisol (adrenal dysfunction): exhaustion that doesn’t improve with rest, dizziness, low motivation, frequent illness, low blood sugar.

Common Signs and Symptoms of Hormonal Imbalance

Hormonal imbalances don’t always show up as a diagnosis. More often, they appear as clusters of symptoms that don’t quite go away even when you're doing everything "right.” Because hormones influence nearly every system in the body, the signs can be wide-ranging, subtle, or mistaken for something else. Here are some of the most common symptoms we see when hormones are out of balance:

Energy & Sleep

  • Persistent fatigue, even after a full night’s rest
  • Feeling “wired but tired,” especially at night
  • Trouble falling or staying asleep
  • Midday crashes or a strong need for caffeine to function

Mood & Cognition

  • Anxiety, irritability, or emotional sensitivity
  • Low motivation or lack of drive
  • Mood swings, especially around the menstrual cycle
  • Brain fog or trouble focusing
  • Feelings of depression or apathy that seem cyclical

Menstrual & Reproductive Health

  • Irregular, painful, or heavy periods
  • Premenstrual symptoms that feel overwhelming
  • Low libido or vaginal dryness
  • Fertility challenges or trouble sustaining pregnancy
  • Hot flashes, night sweats, or sleep disruption (even before menopause). 

Metabolic & Weight Changes

  • Unexplained weight gain or difficulty losing weight
  • Increased belly fat, despite good nutrition and exercise
  • Sugar cravings or irritability between meals
  • Muscle loss or reduced exercise tolerance

  • Sluggish digestion or frequent bloating

Skin, Hair & Body Composition

  • Hair thinning or increased shedding
  • Adult acne, particularly around the jawline or chin
  • Dry or sensitive skin
  • Increased joint pain or inflammatory flares

The Impact of Stress on Hormonal Balance

Stress is one of the most common (and most underestimated) drivers of hormone disruption. Whether it stems from emotional strain, overtraining, lack of sleep, or blood sugar instability, chronic stress sets has the ability to set off a hormonal chain reaction that can affect nearly every system in your body.

The central player here is cortisol, your body’s main stress hormone. In healthy doses, cortisol helps regulate inflammation, manage energy, and keep you alert. But when cortisol remains elevated for too long, or drops too low after prolonged strain, it can throw other hormones out of balance.

This process is regulated by what’s known as the HPA axis which is the communication loop between your brain (hypothalamus and pituitary) and your adrenal glands. When the HPA axis is overactivated, it can cause ripple effects throughout the endocrine system, including:

  • Thyroid function: Elevated cortisol can reduce the conversion of T4 to T3 (your active thyroid hormone), slow metabolism, and contribute to hypothyroid symptoms, even if your labs appear within range.7
  • Progesterone levels: Chronic stress can disrupt the hormonal signals that trigger ovulation, leading to lower progesterone levels in the second half of the cycle. This can contribute to premenstrual mood changes, sleep disturbances, and irregular or symptomatic cycles.8
  • Blood sugar and insulin: Chronic stress raises blood sugar and insulin levels, which can drive fatigue, cravings, and metabolic disruption.9
  • Estrogen and testosterone: Stress can impair how your body produces and clears these hormones, contributing to potential imbalances. Multiple studies have shown that chronic stress can significantly reduce testosterone synthesis, while chronic stress and elevated cortisol may also decrease estrogen levels, potentially resulting in symptoms like irregular periods, fatigue, and mood imbalances.10

Over time, this pattern can contribute to what’s often referred to as adrenal or HPA axis dysfunction, a state where your stress response becomes dysregulated. While not a formal diagnosis, it's a real pattern we see in practice, often marked by persistent fatigue, sleep issues, hormone imbalances, and poor stress tolerance. That’s why any comprehensive hormone workup should include a look at your stress load. Not just emotionally, but physically and metabolically as well. In the next section, we’ll dive deeper into how this impacts the thyroid, one of the most stress-sensitive systems in the body.

Thyroid Health and Hormonal Balance

Thyroid hormones regulate metabolism, energy production, temperature control, digestion, mood, and even menstrual regularity. When your thyroid is underperforming or occasionally overactive, it can throw off multiple systems at once.

The thyroid produces two main hormones: T4 (thyroxine), which is inactive, and T3 (triiodothyronine), which is the active form your cells use. T4 must be converted into T3 in order to support energy, metabolism, and brain function. This conversion can be affected by things like stress, inflammation, gut health, and nutrient status (especially selenium, zinc, and iron).

Common Signs of Thyroid Imbalance

  • Fatigue or sluggishness
  • Weight gain (or inability to lose weight)
  • Brain fog or forgetfulness
  • Constipation or slow digestion
  • Dry skin and hair thinning
  • Irregular or heavy menstrual cycles
  • Feeling cold when others are comfortable
  • Anxiety, heart palpitations, or heat intolerance (more common with overactive thyroid)

Thyroid symptoms can be broad and easy to miss especially when standard lab work shows your TSH (thyroid stimulating hormone) in the “normal” range. In functional medicine, we often see patients with subclinical hypothyroidism, where symptoms are present even when labs appear borderline or technically normal.

It’s also important to distinguish between the two main types of thyroid dysfunction:

  • Hypothyroidism (underactive thyroid): This is the most common pattern, especially in women. Symptoms include fatigue, weight gain, depression, cold sensitivity, constipation, and heavy periods. Many cases are autoimmune in nature, most often due to Hashimoto’s thyroiditis (see below) though this is often overlooked or undiagnosed.
  • Hyperthyroidism (overactive thyroid): Less common, but important to recognize. Symptoms include anxiety, rapid heartbeat, heat intolerance, weight loss, and insomnia. It can be caused by autoimmune conditions like Graves’ disease, or arise temporarily postpartum or during perimenopause. 

In Hashimoto’s thyroiditis (an autoimmune condition that attacks the thyroid) people may swing between hyper- and hypothyroid symptoms, making the picture even more confusing. Identifying thyroid antibodies through testing can help clarify what’s really going on and prevent misdiagnosis.

How the Thyroid Interacts with Other Hormones

Your thyroid is closely connected to other key hormone systems:

  • Cortisol: Chronic stress can suppress thyroid function and reduce the conversion of T4 into active T3 as mentioned above.
  • Sex hormones: Estrogen and progesterone influence how thyroid hormones are used in the body, and fluctuating levels across the menstrual cycle or menopause can affect thyroid needs.11,12
  • Insulin: Blood sugar dysregulation can impair thyroid hormone function, and low thyroid function can in turn worsen insulin resistance.13,14

Because of these connections, it’s important to assess thyroid health in the context of your full hormonal picture, especially if you're dealing with persistent fatigue, mood changes, or symptoms that don’t resolve with surface-level interventions.

Hormone Health for Women

Hormonal patterns in women shift naturally across life stages from puberty to menopause. But when those shifts become exaggerated or disrupted, they can lead to symptoms that impact everything from mood and metabolism to fertility and  even long-term health.

Hormonal Patterns Across Life Stages

Adolescence and Early Adulthood

During puberty and into the early reproductive years, the body establishes regular ovulation and menstrual cycles. It’s common for teenagers and young adults to experience:

  • Irregular or heavy periods
  • Acne related to elevated androgens (testosterone)
  • Mood fluctuations tied to estrogen and progesterone shifts

Conditions like polycystic ovary syndrome (PCOS) often surface in this stage, marked by irregular cycles, acne, and signs of insulin resistance. Conventional treatment for PCOS often involves prescribing birth control pills to regulate periods or improve acne. While this can help manage surface-level symptoms, it often doesn’t address the underlying root causes such as insulin resistance, inflammation, or stress-related hormone disruptions that contribute to the condition in the first place.

Reproductive Years (20s–Early 40s)

In the reproductive years, many women experience more regular cycles, but some may still struggle with PCOS or other hidden imbalances. A common pattern we see in functional medicine is: low progesterone paired with high cortisol sometimes driven by chronic stress, under-eating, over-exercising, or poor sleep.

This combination can lead to:

  • Premenstrual mood symptoms (anxiety, irritability)
  • Irregular or heavy periods
  • Fertility challenges or miscarriage risk
  • Fatigue and disrupted sleep

During this stage, we also commonly see conditions like endometriosis, marked by painful periods and pelvic discomfort, often alongside mood and energy challenges related to hormone imbalance.

Perimenopause (40s–Early 50s)

Perimenopause is the transition phase leading up to menopause. While we commonly think of it affecting women in their mid-40s and 50s, for some women it can begin as early as their mid-30s. This phase can last anywhere from 2 to 10 years, with hormonal patterns becoming less predictable as estrogen and progesterone fluctuate.

  • Fluctuating estrogen: sometimes high, sometimes low
  • Consistently low progesterone: due to more frequent anovulatory cycles
  • Cortisol dysregulation: either elevated or depleted

Symptoms may include:

  • Hot flashes and night sweats
  • Mood swings or increased anxiety
  • Sleep disruption
  • Brain fog or memory lapses
  • Increased belly weight gain

This is often the stage where thyroid issues also show up or worsen, especially when compounded by chronic stress and nutrient depletion.

Menopause (After 12 Months Without a Period)

After menopause, both estrogen and progesterone levels remain low. Testosterone may also decline. These hormonal changes increase risks for:

  • Osteoporosis
  • Cardiovascular disease
  • Vaginal dryness or discomfort
  • Mood changes and cognitive shifts

Common Hormone-Related Conditions in Women

While hormonal shifts are part of life, certain conditions tend to show up more often at specific stages:

PCOS: Often identified in adolescence and early adulthood; linked to irregular cycles, acne, hair growth, and insulin resistance.
Endometriosis: Typically presents in reproductive years; involves painful periods and potential fertility challenges.
Thyroid Dysfunction: Common in all life stages but especially perimenopause and postpartum; affects mood, metabolism, and energy.
Perimenopause: A term used to describe fluctuating hormone symptoms before menopause fully sets in.
Adrenal or HPA Axis Dysfunction: Often seen as chronic fatigue, mood shifts, and sleep disruption tied to cortisol imbalance.
Postmenopausal Osteoporosis and Metabolic Changes: Directly related to sustained low estrogen levels.

Hormone Health for Men

While testosterone gets a lot of attention when it comes to men’s hormonal health, it’s not the only hormone that matters. From energy and mood to metabolism and reproductive health, hormonal balance is essential to how men feel and function at every age. In clinical practice, we often see men navigating hormonal shifts in patterns that follow natural life stages, in addition to also being influenced by stress, sleep, nutrition, and environmental exposures (at any life stage).

Hormonal Patterns Across Life Stages

Young Adulthood (Late Teens - 30s)

Testosterone levels peak in a man’s late teens and 20s. Testosterone supports:

  • Muscle mass and strength
  • Energy and motivation
  • Libido and sexual performance
  • Mental focus and confidence

During these years, men are often at their physical prime. However, hidden imbalances like cortisol elevation due to stress or insulin resistance (often tied to poor nutrition) can already start affecting hormone balance, especially in men with demanding lifestyles.

Midlife and Andropause (Late 30s - 50s)

As men move into their late 30s and beyond, testosterone production naturally begins to decline. This process is sometimes called andropause (a gradual reduction in testosterone) rather than a sharp drop like menopause in women.

Common signs of low testosterone during this stage include:

  • Reduced libido or sexual performance
  • Fatigue or lower energy
  • Loss of muscle mass or increased belly fat
  • Mood changes, irritability, or low motivation
  • Cognitive shifts like brain fog or slower processing speed

Later Life (60s and Beyond)

In later years, maintaining hormonal balance continues to influence:

  • Bone density and fracture risk
  • Cardiovascular health}
  • Mood stability and cognitive resilience

  • Metabolic health and blood sugar regulation

Common Hormone-Related Conditions in Men

While low testosterone is one of the most well-known concerns, men’s hormone health involves multiple hormones and systems. Common issues we address include:

  • Low Testosterone (Andropause): Gradual decline in testosterone tied to aging, stress, nutrient deficiencies, or metabolic issues.
  • Erectile Dysfunction: While ED is more common in older men due to declining testosterone and vascular changes, it is also becoming increasingly prevalent in younger men. Contributing factors may include chronic stress, toxin exposure, insulin resistance, and poor vascular health, not just hormone levels.
  • Thyroid Dysfunction: While hypothyroidism is less common in men than women, it can be an issue for some men which ultimately impacts metabolism, mood, and energy.
  • Adrenal/ HPA Axis Dysfunction: Chronic stress may lead to either elevated or depleted cortisol levels (both problematic) which can affect sleep, energy, and motivation.
  • Metabolic Syndrome and Insulin Resistance: Increased risk for type 2 diabetes and cardiovascular disease, often tied to hormonal shifts.
  • Reproductive Health Concerns (Fertility, Sperm Count): Low sperm count or fertility challenges may stem from hormonal imbalance, pituitary issues, or testicular dysfunction.

Functional Medicine’s Approach to Hormone Health

In functional medicine, we understand that hormonal shifts are not just a result of aging but often a response to deeper imbalances in the body. Our approach looks beyond surface-level symptoms to uncover root causes that may be disrupting hormonal function, including nutrition, gut health, blood sugar regulation, stress physiology, sleep quality, and environmental exposures.

Hormones operate within a delicate and interconnected system. When one hormone is off, whether it's cortisol, insulin, thyroid, or sex hormones, it often signals a broader systems-level imbalance. That’s why functional medicine doesn't treat hormones in isolation. Instead, we ask:

  • Why is this hormone out of range?
  • What upstream systems are contributing to the dysfunction?
  • What are the most efficient and sustainable ways to restore balance?

This root-cause mindset is paired with individualized care. Every person’s hormonal story is different (affected by genetics, life stage, health history, and lifestyle). Functional medicine practitioners use a combination of thorough health histories, lifestyle assessments, and targeted testing to identify which systems need the most support.

We also recognize the impact of endocrine disruptors such as chemicals found in plastics, personal care products, household cleaners, and even food packaging that can mimic or block natural hormone signaling.

By taking a systems approach, we aim to restore hormone balance not just through treatment, but by helping the body regain its natural rhythm and resilience. Testing and treatment strategies will vary from person to person and that’s what the next two sections will explore in more detail.

Hormone Testing in Functional Medicine

Accurate hormone testing is a cornerstone of effective care.We use hormone testing not just to confirm a diagnosis, but to map out a clearer picture of what’s driving symptoms like fatigue, mood swings, irregular cycles, sleep issues, or low libido.

Types of Hormone Tests

The right type of testing depends on the hormones being evaluated, life stage, symptoms, and whether someone is using hormone replacement therapy (HRT).

  • Blood (Serum): The most common testing method in conventional medicine. Useful for evaluating thyroid hormones, insulin, sex hormones (estrogen, progesterone, testosterone), LH/FSH, DHEAS, and more. Some markers like total testosterone and thyroid antibodies are best assessed via serum.
  • Saliva: Often used to measure free (active) cortisol over a full day, giving insight into HPA axis function. Some tests also assess sex hormones via saliva, though this method is best used alongside other data.
  • Urine (e.g., DUTCH Test15): Offers a detailed look at hormone metabolites, including how the body is processing and clearing estrogen, progesterone, testosterone, and cortisol. It also includes melatonin and certain nutrient markers. This type of testing is especially helpful for understanding hormone detoxification and adrenal patterns. However, it’s not always reliable for monitoring certain types of hormone replacement therapy (HRT). In those cases, we may recommend a different form of testing, such as blood or saliva, depending on the specific situation.
  • Combination Testing: For complex hormone cases, it may be beneficial to combine types of testing to get the most complete picture.

Hormones Commonly Assessed

Depending on your symptoms and health history, we may test:

  • Sex Hormones: Estradiol, estrone, progesterone, testosterone (total and free), DHEAS, LH, FSH
  • Stress Hormones: Cortisol (single or 4-point), cortisone, ACTH
  • Thyroid Hormones: TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies (TPO, TgAb)
  • Metabolic Markers: Fasting insulin, glucose, HbA1c, leptin
  • Additional Markers: SHBG, prolactin, melatonin, pregnenolone (in certain cases)

Timing Matters

Hormone levels naturally fluctuate throughout the day and across the menstrual cycle, so choosing the right timing for your test is essential to get accurate, meaningful results.

  • For menstruating women:
    • Sex hormone testing is typically done in the mid-luteal phase (around days 19–22 of a 28-day cycle), when progesterone is expected to peak.
    • If cycles are irregular, we may use ovulation predictor kits to identify the best window.
  • If on HRT or birth control:
    • We adjust testing protocols depending on the form and timing of hormone delivery (e.g., oral, transdermal, vaginal), as these can influence test results.
    • Certain lab types (like serum vs. urine) are better suited for specific forms of hormone therapy.

When Imaging May Be Recommended

In some cases, lab testing is paired with imaging to further evaluate hormone-related conditions:

  • Transvaginal or pelvic ultrasound: May be used when PCOS, fibroids, or endometriosis are suspected.
  • Bone density scans (DEXA): Especially relevant for postmenopausal women with estrogen deficiency.
  • MRI or pituitary imaging:  May be considered in rare cases of suspected pituitary dysfunction.

Treatment Approaches in Functional Medicine

The goal of functional medicine is to address hormonal imbalances with a comprehensive, root-cause approach. This imay include but is not limited to nutrition, lifestyle, targeted supplementation, and mind-body interventions. By taking a systems approach, the hope is not just to manage symptoms, but rather to restore hormone balance and support long-term health.

Nutrition for Hormone Balance

A foundational part of hormone health is a nutrient-dense, anti-inflammatory diet. This may include the following strategies help support optimal hormone function:

  • Whole foods: Focus on unprocessed or minimally processed foods to stabilize blood sugar and reduce inflammation.
  • Healthy fats: Include avocado, olive oil, nuts/seeds, pasture-raised eggs, and fatty fish to support hormone production.
  • High-fiber foods: These foods support hormone detoxification and gut health.
  • Quality protein: Protein helps stabilize blood sugar and provides building blocks for hormone production.
  • Colorful polyphenols: Found in foods like berries, pomegranate, and green tea, they reduce oxidative stress and support hormone pathways.
  • Minimize processed foods, sugars, and alcohol: These foods can disrupt hormone signaling, increase inflammation, and impact liver detox pathways.
  • Nutrients that support hormone health: Magnesium, zinc, B vitamins (B6, B12, folate), vitamin D, selenium, iodine, choline, calcium-D-glucarate, chromium.16–18

Lifestyle Strategies

  • Exercise: Regular movement, especially strength training and moderate cardio, helps regulate cortisol, boost testosterone, and additionally improve insulin sensitivity.
  • Sleep: Quality sleep is critical for hormone regulation which includes melatonin and cortisol rhythms.
     → [For a deeper look at sleep and hormone health, check out this blog.]
  • Circadian support: Morning light exposure and regular sleep-wake cycles are powerful regulators of hormonal rhythms.
    Stress Management: Chronic stress may disrupt cortisol, progesterone, thyroid, and blood sugar regulation. Supporting the nervous system is important for hormone balance.
     → [Explore 10 Ways to Manage Stress for Hormone Health.]

Mind-Body Therapies

  • Breathwork: Breathwork can calm the nervous system and support HPA axis recovery.
     → [Try our guided breathwork class to get started.]
  • Other modalities: Acupuncture, meditation, journaling, or nature exposure can reduce the impact of chronic stress and support emotional resilience.

Targeted Supplements and Botanicals

In addition to lifestyle and nutrition, we may recommend specific supplements tailored to each individual’s needs. These may include:

  • Adaptogens like ashwagandha, rhodiola, or holy basil for adrenal support.
  • Herbal therapies such as Vitex or DIM for reproductive hormone balance.
  • Nutrient repletion for common deficiencies such as magnesium, B vitamins, vitamin D, omega-3s, or other common hormone supporting nutrients mentioned above. 

The goal of these additional strategies are for them to be personalized as well as adjusted over time as symptoms and lab values improve.

Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT), including Bioidentical Hormone Replacement Therapy (BHRT), can offer meaningful support for both women and men with proven hormone deficiencies or specific clinical needs. In functional medicine, HRT is considered an individualized option (used appropriately and in conjunction with lifestyle care) to restore quality of life without replacing root-cause work.

Potential Benefits of HRT

For Women (Peri-/Postmenopause)

  • Relieves vasomotor symptoms (e.g., hot flashes, night sweats) and improves sleep quality. Research consistently shows better symptom relief when HRT is started early in perimenopause or menopause.19
  • Supports mood and emotional balance, reducing anxiety and depressive symptoms related to estrogen and progesterone fluctuations.19
  • Prevents bone loss and fractures, especially when initiated within 10 years of menopause, supporting bone mineral density and reducing osteoporosis risk.20
  • Improves vaginal health and sexual function, including reduced vaginal dryness, increased lubrication, and improved libido.21
  • Cardiometabolic protection when started early: evidence shows reduced risk of coronary heart disease and all-cause mortality when initiated within a decade of menopause.22

For Men (Testosterone Replacement Therapy, TRT)

  • Enhances libido, sexual function, and erectile performance, particularly in those diagnosed with hypogonadism.23
  • Increases muscle mass and bone density, improving body composition and reducing age‑related metabolic decline.24
  • Improves mood, cognitive clarity, and energy, especially in men with confirmed low testosterone.25

Potential Risks of HRT

While many benefits are supported by research, HRT is not risk-free. A balanced discussion is essential:

  • Breast cancer risk: Slightly elevated in longer-term users, especially with combined estrogen-progestin therapy and in women older than 60 or beyond 10 years post-menopause.26 Bioidentical progesterone may carry lower risk, though data are still emerging.27
  • Increased risk of blood clots and stroke, particularly with oral estrogen. Transdermal (patch or cream) forms carry significantly lower clotting risk.28
  • Endometrial cancer risk: If estrogen is used without progesterone in women with a uterus. Progestogen reduces this risk when incorporated appropriately.29
  • Other potential risks for women: Rare increases in ovarian cancer, gallbladder disease, and cognitive risk in women beginning therapy after age 65.30
  • Potential risks for men: Cardiovascular risk with TRT remains an area of ongoing research. Some studies suggest that properly monitored testosterone replacement therapy does not significantly increase cardiovascular risk and may even improve certain cardiometabolic markers, particularly in men with confirmed hypogonadism. However, other studies have raised concerns about potential increased risk in certain populations, especially older men or those with preexisting heart disease.31

Ready to Feel Like You Again?

Join our Hormone Clarity Program to get personalized care, expert lab testing, and support from our women’s health team.

Prefer to talk first? Book a free call to find your best next step.

Take the first step toward feeling like yourself again

FAQs on Hormone Health
[The nutritionist] is one of the most intelligent and well rounded nutritionists I have ever worked with and known. She is so good with explaining things in a very easy to understand way. I value our time together so much and would highly recommend anyone work with her. 

Mara Kalow

You can take control of your health. We can help.

 

Join Patient Membership