Your hormones aren’t the problem
Here is What Is.
If you’ve been scrolling health content lately, you’d be forgiven for thinking every symptom — from fatigue to mood swings to weight gain — comes down to your hormones. And yes, hormones matter enormously. But here is what most mainstream health content misses: in the vast majority of cases, hormonal imbalance is a symptom, not a cause.
As a Functional Medicine practitioner, I have seen this pattern play out many many times. Patients come in convinced their estrogen is too high or too low, progesterone or testosterone too low — and often upon running tests, they aren’t wrong.
But the deeper question should always be: why?
Why are the hormones out of balance? They usually don’t ‘just go’ (other than if you are a woman in perimenopause or postmenopause, when that indeed happens!). There is generally a reason WHY, and once addressing those root causes, more often than not, hormones will get back to balance without the need of adding in hormones, or at least not long term.
(Other than post menopause, where research is showing compelling evidence towards the benefits of HRT, if dosed appropriately. More on that here).
The answer almost always points to the same five root causes:
- Chronic inflammation
- Blood sugar dysregulation
- Chronic stress
- Nutrient imbalances, and
- Impaired cellular detoxification.
Get these under control, and hormones typically regulate themselves. Ignore them, and no hormone protocol will deliver lasting results. Let me break this down — including what this means for specific conditions you may be dealing with.
First, a quick hormone primer
Before we dive into root causes, let’s briefly recap what’s at stake hormonally.
Female hormones
- In women, oestrogen supports cardiovascular health, bone density, brain function, skin, hair, and mood.
- Progesterone balances oestrogen’s growth-promoting effects and supports sleep, fertility, and calm (partly through its role in GABA, the brain’s calming neurotransmitter).
- Testosterone — yes, women need it too — drives energy, focus, libido, and muscle tone. Low testosterone in women is chronically under-recognised and often written off as “just getting older.”
Male hormones
When one thinks of men and hormones, it is usually testosterone that springs to mind. For good reason, as it absolutely takes up the most important role in men. However, men also produce estrogen, just at much lower levels than women.
Testosterone helps a man feel ‘manly’, increasing drive, assertiveness, muscle tone and more.
Reduction in testosterone results in a number of physiologic changes that surpass what one might think. Many are familiar with reduced testosterone
- Altering body composition (decrease in lean body mass, increase in fat mass)
- Decrease in energy, mood and muscle strength
- Decreased libido (sexual desire) and erections.
However, less commonly talked about are an increased risk for osteoporosis, a reduction in cognitive function (R), a contribution to infertility with low or absent sperm counts, and other less suggestive symptoms such as a depressed mood, irritability and poor concentration (R). Additionally, below optimal testosterone levels in men have been linked to a heightened risk of cardiovascular disease (R).
This decline, sometimes also called ‘andropause’, can start as early as in the 30ies, but most commonly happens gradually throughout the 40ies, 50ies and later.
Often this andropause and slow decline in testosterone is coupled with a simultaneous increase in estrogen. Too much estrogen also contributes to cardiovascular disease risk in men, in addition to conditions such as obesity, gynecomastia (‘men boobs’), metabolic syndrome, type two diabetes, benign prostatic hypertrophy and prostate cancer (R, R).
And for everyone: thyroid hormone is our master metabolism regulator, influencing weight, energy, hair, and mood.
Thyroid
Another hormone many are familiar with is the thyroid hormone. It is our master metabolism hormone, and needed for (you guessed it) metabolism, such as weight management, but also hair health, energy levels, mood and more.
So yes — hormones are crucial. But why do they go out of balance in the first place?
However, as briefly mentioned earlier, hormones being out of balance in most cases is really just a knock on effect of the 5 factors creating problems, rather than a root cause in itself.
More often than not, it is chronic inflammation, blood sugar issues, stress, nutrient imbalances and a clogged up cellular cleanup that are to blame for hormonal disruptions. Once they are addressed, hormones generally return back to balance, and with that sense of wellbeing. Let me explain.
The 5 root causes behind hormonal disruption
1. Chronic inflammation
Inflammation is perhaps the most underappreciated driver of hormonal chaos. It upregulates aromatase, an enzyme that converts testosterone into oestrogen — contributing to oestrogen dominance in women and elevated oestrogen in men. It also upregulates alpha-reductase, the enzyme that converts testosterone into its more potent form, DHT. This matters enormously for conditions like PCOS, male pattern hair loss, and benign prostatic hyperplasia — all linked to elevated DHT. Rather than blocking alpha-reductase with drugs like finasteride (which carry significant side effects), Functional Medicine asks: what’s driving the inflammation in the first place?
2. Blood sugar dysregulation
Unstable blood sugar — driven by ultra-processed diets, skipped meals, stress, and poor sleep — creates a cascade of hormonal disruption. Insulin resistance, in particular, is a key driver of PCOS and of excess androgen production. It also upregulates both aromatase and alpha-reductase, compounding the effects of inflammation.
3. Chronic stress
Chronic stress elevates cortisol — and cortisol competes with progesterone at the receptor level, effectively suppressing it. This contributes directly to oestrogen dominance, PMS, cycle irregularities, and fertility issues. The body also deprioritises “non-essential” functions like reproduction when it perceives ongoing threat — meaning ovulation itself can be impaired under chronic stress.
4. Nutrient imbalances
Key nutrients are required at every step of hormone synthesis, signalling, and breakdown. Iodine, for example, is specifically implicated in fibrocysts and thyroid dysfunction. Zinc, magnesium, B vitamins, and vitamin D all play critical roles in the hormonal cascade. Deficiencies — common in modern diets — quietly undermine hormonal function.
5. Impaired cellular detoxification
Oestrogen that isn’t properly broken down and cleared by the body recirculates, driving oestrogen excess. This “clogged cleanup machinery” — impaired liver detox pathways and gut health — is a major contributor to conditions like endometriosis, fibroids, and hormonal acne.
What this means for common conditions
PCOS, male pattern hair loss, and benign prostate hyperplasia
These three conditions share more than most people realise. They are all linked to elevated DHT — the potent form of testosterone produced when alpha-reductase is upregulated. And what drives alpha-reductase? Inflammation and blood sugar dysregulation. Addressing these root causes — rather than suppressing DHT pharmacologically — is where functional medicine delivers one of its most compelling results.
Endometriosis, fibroids, and cysts
Beyond hormonal imbalance (often including elevated levels of estrogen AND high progesterone with the cells not responding to progesterone appropriately any longer, also called ‘progesterone resistance’), research points strongly to inflammation as a driver of endometriosis.
Fibroids and cysts are further linked to iodine deficiency and impaired oestrogen clearance.
These are nutrient and detoxification problems as much as hormone problems.
Perimenopause chaos
Erratic estrogen (which often initially increases, and eventually drops) and lower progesterone levels are natural — but the severity of symptoms is not inevitable. Women whose bodies are dealing with inflammation, blood sugar instability, and chronic stress will experience far more chaotic transitions.
Supporting the root causes doesn’t stop menopause, but it can make it significantly smoother. (More on perimenopause and its ‘chaos’ here).
Low testosterone (in both men and women)
Low T often has chronic inflammation, blood sugar imbalances and nutrient deficiencies (including, but not limited to, inadequate protein intake) at its core — alongside a sedentary lifestyle and poor sleep.
Worth noting: Testosterone is predominantly produced during REM sleep. Prioritising sleep quality is, quite literally, a testosterone optimisation strategy.
The bottom line
Hormones are a mirror and downstream result. When they are out of balance, it’s almost always a signal that something deeper is dysregulated. If you have been chasing hormone symptoms without addressing the underlying terrain — inflammation, blood sugar, stress, nutrients, detoxification — you are treating the smoke, not the fire.
The good news?
These root causes can be addressed. And when that is done systematically with a precise lab based root cause protocol and strategy, hormones (other than post menopause) typically follow.
Mirthe
It is my goal to empower you to become the CEO of your health trajectory, preventing and optimising with precision and science backed strategies to live your best life & thrive.
HI, I'M MIRTHE
It is my goal to empower you to become the CEO of your health trajectory, preventing and optimising with precision and science backed strategies to live your best life & thrive.
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