Hormonal disorders: assessment and care in Munich

In the first half of the cycle, a follicle matures under the influence of oestrogen and the uterine lining builds up. After ovulation, the corpus luteum produces progesterone. It prepares the lining for a possible pregnancy and has a balancing effect. If no pregnancy occurs, the progesterone level falls and the period begins. This cycle is controlled by the brain, via the hypothalamus and pituitary gland. The thyroid, adrenal glands and metabolism also play a part. If one link in this chain falls out of rhythm, it can show in different ways: as cycle disorders, symptoms before your period, mood swings or difficulty getting pregnant.

We speak of oestrogen dominance when, relative to progesterone, too much oestrogen is acting. This does not necessarily mean that the oestrogen level is high. Often it is progesterone that is lacking, for example when ovulation does not occur or the corpus luteum is working too weakly (corpus luteum insufficiency). This is particularly common in the years before the menopause, but also under stress. Typical symptoms are breast tenderness, water retention, heavy or irregular bleeding, irritability and sleep disturbance. The term oestrogen dominance comes mainly from integrative gynaecology. In guideline-based medicine, people speak rather of corpus luteum insufficiency or cycles without ovulation. Among other things, Prof. Dr. Schulte-Uebbing has published “Hashimoto's thyroiditis, oestrogen dominance and progesterone deficiency” (ZAEN, 2012).

A cycle is not the same length in every woman, and small variations are normal. Cycle disorders show up in very different ways: as bleeding that is too frequent, too rare or absent, as very heavy or long bleeding, or as intermenstrual bleeding and spotting. The causes are varied. They include stress, major changes in weight, intense exercise, thyroid conditions and raised prolactin levels. Polycystic ovary syndrome (PCOS), fibroids, polyps and the transition into the menopause are also possible. That is why we do not start with a therapy but with the search for the cause. Prof. Dr. Schulte-Uebbing describes approaches from Traditional Western Medicine in “Integration of Traditional Western Medicine (TWM) into modern gynaecology (Part 2): examples of cycle disorders, hypomenorrhoea, amenorrhoea” (Journal of Applied Complementary Medicine, 2023).

The thyroid is closely linked to the female hormones. An underactive thyroid can bring cycle disorders, exhaustion, weight gain, low mood and difficulty getting pregnant. A common cause is Hashimoto's thyroiditis, an autoimmune inflammation of the thyroid. Prof. Dr. Schulte-Uebbing has worked for many years on the interplay between Hashimoto's, progesterone deficiency and oestrogen dominance. Among other things, he published “Depressive moods, tiredness, reduced performance – Hashimoto's disease: an often overlooked important (partial) cause” (gyn, 2014). That is why thyroid values are part of our hormone assessment. You can read more on our page on Hashimoto's.

Some substances from everyday life and the environment can act like hormones or disrupt the hormonal system. Experts call them endocrine disruptors. They include, for example, certain plasticisers (phthalates) in plastics and cosmetics, some fragrances, pesticides and heavy metals. Prof. Dr. Schulte-Uebbing has studied their possible role in hormonal conditions for many years. Among other things, he published “Hormonally active substances in drinking water and their effects on the female hormonal system” (gyn, 2018). Another article is called “Phthalates as endocrine disruptors” (Gyn-Aktiv, 2019). For this reason, our practice is also nicotine-free and perfume-free. In your consultation, we discuss how you can reduce unnecessary exposures in everyday life.