Female Hormone Problems & Functional Medicine: What Your Doctor Won’t Tell You {Could Mean Years of Frustration & Pain}

Which of these female hormone problems do you have - and how can you get help?

Imagine being free of your hormonal symptoms for good, taking back control of your life, and doing it naturally, without strong medications with unwanted side effects?

In severe female hormone issues, the huge fluctuations in mood and pain can really be all consuming, reaching into every aspect of your life, including your personal confidence, relationships, work life and career, and even your ability to have children.

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The Coho Functional Medicine approach to female hormone problems can help.

Hormones are responsible for regulating various bodily functions, including mood, cognitive function, metabolism, and reproductive health.

Any disruption in the delicate balance of your hormones can have a complex knock on effect, leading to a wide range of diseases and conditions.

Even worse, many of the hormone problems experienced by women are ‘hidden’ – brushed under the carpet, ignored as ‘just one of those things’ and women are basically expected (and left) to just get on with things (in addition to everything else).

That’s not ok with us.

Unfortunately – as you might have experienced yourself by now – current conventional medicine options are a huge let down in many female hormone conditions, and it can be so difficult to find a solution that actually works for you.

The good news is that we’re vastly experienced in helping women just like you to find relief from hormone disorders that are negatively impacting your quality of life, even where medication has been ineffective.

Table of Contents

Common female hormone conditions

Every week in our Functional Medicine clinics, we help women just like you to solve their female hormone problems.

Often, these female hormone problems have been slowly getting worse for quite a few years and clients come to us frustrated and out of hope that anything can be done.

Even worse, many female hormone problems can appear as part of a complex constellation of other (and seemingly unrelated) health problems.

Here are a few examples of the most common conditions we help women with in our clinics, although there are many others:

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PCOS & the Coho Functional Medicine approach to female hormone problems

PCOS is the most common endocrine (hormone) disorder to affect women after puberty and is the leading cause of infertility globally (1).

That’s a shocking statistic.

The symptoms of PCOS and the side-effects from prescribed hormone medications, can lead to women with this condition also experiencing mental health issues.

The syndrome can present differently in different women, and the root cause of PCOS is multifactorial, but often involves insulin resistance and inflammation (2). 

Diagnosis isn’t always straight forward; the current diagnostic criteria means that women don’t need to have the classical ovarian cysts (seen on a scan) but can be diagnosed based on symptoms and hormone test results (3).  

Common PCOS signs and symptoms include;

PCOS Symptoms Infographic Girl with Various Symptoms

Hopefully you can already see that PCOS is related to a wide range of other problems.

Medical options for treating PCOS are limited.

PCOS infographic showing the difference between healthy and poly cystic ovaries
PCOS infographic showing the difference between healthy and poly cystic ovaries

The oral contraceptive pill is often prescribed and, in some cases, metformin, a diabetes medication is used since one of the main drivers of PCOS is insulin.

In fact, 40% of affected women suffer from insulin resistance and are subsequently predisposed to developing type 2 diabetes (6).  

PCOS is a complex disorder with multiple factors, and therefore really benefits from a natural, comprehensive Functional Medicine approach to female hormone problems that focuses on the drivers of this condition, which includes:

The Coho Functional Medicine approach to PCOS can help to improve:

If you want to discover more about how we help women manage and overcome their PCOS problems, read our in-depth article here:

Endometriosis & the Coho Functional Medicine approach to female hormone problems

The World Health Organization (WHO) estimates that around 10% of women in the general population suffer with endometriosis, that’s a staggering 190 million women globally (7).  

And it is estimated that endometriosis affects around 50% of women struggling with infertility (8, 9, 10).

Endometriosis symptoms can be mild, having minimal impact on quality of life, but can be extremely severe, causing debilitating pain.

Common symptoms include:

Endometriosis happens when the lining of the uterus, called the endometrium, grows outside of the womb, attaching to other organs such as the ovaries or fallopian tubes.

The endometrial tissue outside of the uterus causes inflammation and scarring.

Endometrial tissue isn’t just found in the reproductive system, the cells can migrate and be present in different locations in the body, such as around the digestive system and the bowel, where it can cause pain, bloating or constipation.

Oestrogen dominance, where there is a relatively higher amount of oestrogen compared to progesterone, is a feature of endometriosis.

Endometriosis is also an inflammatory condition (11) and responds extremely well to a Functional Medicine anti-inflammatory approach targeting the root causes of inflammation.

Conventional treatment for endometriosis includes pain medications, hormone medications or surgery

While this can provide benefit, none of these approaches are addressing the root causes of endometriosis, and we don’t think it’s right that so many women are only given these limited options when far more effective natural solutions exist.

If there is benefit in taking medication, and it’s helping, a Functional Medicine approach alongside conventional treatment can provide significant additional benefits, including limiting the progression of the disease.

At Coho, we assess hormone levels accurately using advanced comprehensive hormone testing, and we also identify how the body is metabolising (detoxifying) oestrogen.

How the body is eliminating oestrogen is a vital factor in considering oestrogen levels in the body at any given time (please see below for more details).

This is a critical step in assessing endometriosis that is overlooked by conventional medicine doctors.

Menstrual issues & the Coho Functional Medicine approach to female hormone problems

Menstrual issues are a common concern among women, affecting your daily life and overall well-being.

Dysmenorrhoea, also known as painful periods, is one of the most prevalent menstrual issues, and can cause really severe discomfort and cramping.

This condition affects up to 95% of women of reproductive age (12) and is characterised by cramping pain in the lower abdomen.

That’s pretty outrageous!

Even more outrageous is that the general attitude that you just have to woman up and get on with it.

It simply doesn’t have to be that way.

This pain can range from mild to severe, and may radiate to the back and / or thighs.

The pain associated with dysmenorrhoea can be so severe that it interferes with your daily life – sometimes even your ability to get out of bed.

On the other hand, menorrhagia is another common menstrual issue characterised by heavy bleeding during menstruation.

This significant loss of blood can lead to anaemia, fatigue and low mood.

It can also make it impossible to go about normal daily activities when the flow is at its worst and worrying about ‘bleeding through’ can be so stressful.

For chronic menstrual issues, it’s so important to investigate the root cause underlying reasons, such as endometriosis or fibroids.

Unfortunately, we know only too well from our daily clinical experience just how often these simple to detect associated conditions are left unexplored.

Where there is no other diagnosis to explain these symptoms, it’s important to understand what specific imbalances are driving these symptoms.

Oestrogen dominance is associated with painful and prolonged menstruation and addressing the underlying causes of oestrogen dominance can help improve symptoms.

High Oestrogen - Oestrogen Dominance in Fertility

Key drivers of oestrogen dominance include:

Low Progesterone - Oestrogen Dominance

Balancing female hormones: the Coho Functional Medicine approach

People talk about ‘hormone balancing’ in very broad terms but what does is actually mean?

The hormone (endocrine) system is a complex network of interrelated hormones.

Hormones act as signals between cells in your body.

Female hormone signalling (or communication) all starts in the brain – in the hypothalamus

The hypothalamus then responds by sending signals to the pituitary gland, which then sends hormone signals to the ovaries. 

This is called the H-P-O axis (hypothalamus-pituitary-ovaries).

Other glands, besides the hypothalamus and pituitary, influence female hormone production and function.

Adrenal hormones and thyroid hormones also influence levels of oestrogen and progesterone.

Women have several hormone signalling pathways.

As there is so much ‘crosstalk’ between glands and hormones, when we are assessing a clients hormone levels, it’s important for practitioners and clients to understand the complete picture by assessing all hormones together.

It sounds so simple but we see it all the time – clients have only had a few hormones checked by their doctor, which is of little help finding and implementing an effective solution to female hormone problems.

Additionally, it is helpful to consider hormones at three stages:

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Hopefully it’s clear to see that if we’re only looking at the hormone levels being produced, we’re missing a huge part of the picture. 

If we don’t eliminate hormones very well, then we’re likely storing an excess amount of hormone – leading to hormone imbalances.

This is such a critical part of the hormone picture that is missed in conventional medicine, yet can be the root cause to so many hormonal imbalances, including oestrogen dependant disorders such as:

Achieving hormone balance means the level of hormones are within the optimal range and are in balance relative to each other.

For example, oestrogen in a blood test in the mid-luteal phase of a menstrual cycle might be at ‘normal’ levels, but if the progesterone is too low then there is a relative oestrogen excess, which is not optimal for that part of the menstrual cycle.

Low Progesterone - Oestrogen Dominance

Nutritional and lifestyle interventions can profoundly impact:

In the liver, we have enzymes which are responsible for detoxifying (metabolising) oestrogens, converting them into a form we can safely excrete through our stools.

The genes that code for these enzymes can be tested, which we routinely do, and we can check how efficient these oestrogen detox pathways are working, through our advanced hormone testing.

Oestrogen metabolising enzyme activity can be altered through nutrition.

For example, the CYP1A1 enzyme that metabolises oestrogen to a ‘healthy’ oestrogen metabolite (2-hydroxyestrone) can be supported by:

The CYP3A4 enzyme that helps reduce oestriol (a potent form of oestrogen) can be supported with:

The gut microbiome and an enzyme produced in the colon called beta-glucuronidase, determine to what extent oestrogen metabolites are eliminated from the body

This is a marker included in the comprehensive gut function and microbiome tests that we find extremely helpful in hormonal issues.

In fact, the microbiome plays such an important role in hormone balance that it has been called the ‘oestrobolome’, which is a collection of microbes capable of metabolising oestrogens (22).

This is just one reason why women who want great hormonal health shouldn’t be ignoring any digestive symptoms.

Another massively influential factor for hormone balance is xenoestrogens.

We are continuously exposed to synthetic xenoestrogens, which are oestrogen-like substances that haven’t been produced by humans, but that act on our oestrogen receptors, disrupting the delicate balance of hormones in the body. 

Chronic exposure to high amounts of synthetic xenoestrogens is a risk factor for many female hormone disorders, including breast cancer (23).

Xenoestrogens from plastics have been extensively studied, particularly in breast cancer (24).

Are some examples of known drivers of inflammation and immune system imbalances (25), that can subsequently cause havoc with our hormone levels, increasing the risk of hormone-related diseases.

Menopause: the Functional Medicine approach to female hormone problems

Since most women (85%) experience menopausal symptoms (26), it has become the norm, rather than the exception, to feel the effects of fluctuating and declining hormone levels. 

Menopause is inevitable for all women and can cause significant mental, emotional, and physical symptoms, such as:

Functional Medicine approach to menopause symptoms infographic showing the most common symptoms of menopause

Perimenopause encompasses the gradual change in ovarian function, and this period can last from anywhere between 6 to 13 years (27).

During perimenopause, ovarian hormone levels start to first fluctuate, and then secondly, decline.

Due to fluctuating and declining hormone levels, menstrual cycles can become irregular, heavier, or lighter.

Functional Medicine approach to menopause graph showing hormone levels during menopause transition

Declining hormone levels affect every cell, organ and system in the body and can accelerate ageing. 

This can explain why signs and symptoms can be so varied.

Understanding your hormones is key to the Functional Medicine approach to menopause.

We usually think of the sex hormones being important for fertility and libido, but these hormones are vital for many other functions.

Oestrogen alone has over 400 important functions in the body!

Higher oestrogen (relative to progesterone) and fluctuating oestrogen levels can trigger night sweats and increase appetite

Functional Medicine approach to menopause infographic showing hormones produced by the ovaries.

In late stage perimenopause, where oestrogen is low, the body begins to use energy differently.

The function of fat (adipose) cells changes, it becomes easier to gain weight, and there are changes in bone health and cardiovascular health (28).

The negative symptoms of menopause, and the risks associated with the menopause, are not inevitable.

Women can, and do, experience this transitionary period with positivity and with very few, or no, symptoms.

Female hormone problems: advanced testing options

Some hormones such as DHEA-S, testosterone and Sex Hormone Binding Globulin (SHBG), are useful to test via a blood sample.

But to get a detailed understanding of exactly what’s going on in the complex hormone system, we love the DUTCH hormone tests.

The DUTCH tests provide clear, meaningful results that help with effective protocol designs for our clients. 

We can understand levels of adrenal and sex hormones, their metabolites, liver detoxification pathways, and a range of additional markers including melatonin, oxidative stress, and functional levels of vitamin B12 and vitamin B6 (and more).

Another area we often take a deep dive into, to improve hormone health, is the gastrointestinal system and gut microbiota.

You might be wondering what the gut microbiota has to do with female hormone imbalances?

The gut microbiome influences hormone synthesis, breakdown and detoxification (29), and can often be the root cause (or at least one the root causes) of hormone dysregulation.

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The wrap...

While we only had time to cover a few of the many issues that women suffer with, hopefully you can see how the Coho Functional Medicine approach to female hormone problems can help you.

Female hormone related diseases are sadly affecting so many women globally, and cause significant pain, discomfort, mood changes and loss of quality of life.

Yet the conventional medical options are limited in most scenarios to pain relief medications, hormone medications or surgery – and we don’t think that’s anywhere near good enough.

Women deserve a comprehensive approach to solving their hormone related problems and that’s what nutritional and lifestyle medicine offers.

The Coho team have helped hundreds of women take back control and learn which tools are the most effective in their individual case, to put an end to hormone related symptoms that are impacting every aspect of their life.

Comprehensive testing and pinpointing underlying imbalances help the Coho team design an effective personalised protocol that targets the root causes behind your hormone imbalances, bringing about sustainable, long-term relief from symptoms and helping achieve optimal ‘hormone balance’.

To your optimised, healthy future,

Dee & the Coho Health team

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19.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302358/



















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