What Does It Mean?
- Hypogonadism in females is a condition characterized by an imbalance in hormone levels, particularly estrogen, progesterone, and testosterone.
- This dysfunction can result from primary ovarian insufficiency, hypothalamic or pituitary dysfunction, chronic stress, or metabolic imbalances.
- Functional medicine seeks to identify and address the root causes, including nutrient deficiencies, inflammation, and endocrine disruption.
How Did We Get Here?
Root Causes & Contributing Factors:
- Chronic Stress: Disrupts the hypothalamic-pituitary-ovarian (HPO) axis, leading to hormone imbalances.
- Nutritional Deficiencies: Inadequate levels of zinc, magnesium, vitamin D, and essential fatty acids impair hormone synthesis.
- Inflammation & Oxidative Stress: Chronic inflammation contributes to endocrine dysfunction and impaired ovarian function.
- Metabolic Dysfunction: Insulin resistance and dyslipidemia impact hormonal regulation.
- Aging & Menopause: Natural decline in estrogen and progesterone can lead to hypogonadism.
Signs & Symptoms:
- Irregular or absent menstrual cycles.
- Low libido and vaginal dryness.
- Fatigue, mood swings, and depression.
- Loss of muscle mass and increased fat deposition.
- Hot flashes and night sweats.
Lab Test Findings
The following lab tests help evaluate female hypogonadism and its underlying causes:
| Lab Test Name | Expected Changes | Optimal Range |
| % Free Testosterone | Decreased | 1.60-2.20% |
| Arachidonic Acid : EPA Ratio | Altered | 3.7-40.7 |
| Arachidonic Acid (AA) | Altered | 8.6-15.6 µg/mL |
| Estradiol-E2 | Decreased | 24.00-39.00 µg/mL |
| Estrogen | Decreased | 80-250 pg/mL |
| Follicle-Stimulating Hormone (FSH) | Increased | 1.60-8.00 mIU/mL |
| Free Testosterone, Calculated | Decreased | 0.8-1.2 pg/mL |
| Linoleic Acid | Altered | 18.6-29.5 µg/mL |
| Luteinizing Hormone | Increased | 1.50-6.15 mIU/mL |
| Omega-3 total | Altered | 5.4-10 µg/mL |
| Omegacheck (EPA+DPA+DHA) | Altered | 5.4-50 µg/mL |
| Pregnenolone | Decreased | 125.00-200.00 ng/dL |
| Progesterone | Decreased | 0.20-0.90 ng/mL |
| Sex Hormone Binding Globulin | Altered | 40.00-46.00 nmol/L |
| Testosterone, Total | Decreased | 700.00-1100.00 ng/dL |
How Do We Treat It?
Treatment focuses on restoring hormonal balance, reducing inflammation, and optimizing metabolic function.
Supplement Protocol
| Supplement | Function | Dosage & Frequency |
| Femarin | Supports estrogen balance and ovarian function | 1 capsule with or without food, twice daily |
| Vita DIM | Aids in estrogen metabolism and hormonal detoxification | 1 capsule with or without food, daily |
Additional Lifestyle Interventions:
- Hormone-Supportive Nutrition: Consume cruciferous vegetables, flaxseeds, and phytoestrogens to support estrogen metabolism.
- Stress Management: Incorporate mindfulness, meditation, and adaptogenic herbs to balance cortisol levels.
- Healthy Fats & Omega-3s: Improve hormone synthesis and reduce inflammation with sources like fish, avocados, and nuts.
- Regular Strength Training: Helps maintain muscle mass and supports metabolic function.