Estrogen, Hypothalamus Hormones and Brain Function – Part 3

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM

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Estrogen, Progesterone, and AFS

Hypothalamus hormones and reproductive hormones affect your adrenalsEstrogen dominance and AFS are closely related. Late stage AFS often is associated with estrogen dominance in the symptom presentation. In the earlier stages of AFS, as the adrenals are under considerable burden to output cortisol to fight the effects of stress, more and more progesterone is needed. Progesterone is a precursor to cortisol. The more cortisol is synthesized, the more progesterone is needed. Natural hypothalamus hormones work best for the body.

Since estrogen and progesterone work as a team, balancing each other, the situation described above sets the stage for relative estrogen levels to increase leading to estrogen dominance.

Lowering estrogen levels is a prime consideration in remediating AFS. Working to heal the adrenals will make more progesterone available, thus balancing estrogen. One way to heal the adrenals is to lower overall stress, thus relieving the burden on the adrenals.

Balancing estrogen with progesterone is best achieved with natural progesterone, provided that the body can tolerate it. The synthetic progestin is not a good substitute for natural progesterone for the reasons enumerated above.

Type of administration of hormones is important in remediating imbalances found in AFS. Orally administered synthetic estrogen is not the preferred pathway for this hormone. Reasons for this have been discussed above. Most women find the low-dose topical pathway the best. It’s both inexpensive and effective. Especially in cases of AFS, the right administration method is important.

Dosage is likewise important. The wrong dose or wrong timing of doses can increase the symptoms of AFS and possibly even bring about adrenal crashes. Even normal doses may be excessive for the person with AFS. Adrenal crashes can be triggered. The weaker the body, the greater the risk.

Those with systemic congestion at the liver or extracellular matrix are particularly prone to negative outcome. Hormone replacement, even natural forms, is not for everyone. Due to the severity of symptoms of estrogen dominance, it is tempting to rush administration of hormones. It’s much more efficient and effective to heal the adrenals first, then administer hormones. This gives the liver more time to heal as well so it can metabolize the hormones given.

How to balance your hypothalamus hormonesThe best way to administer natural progesterone is subject to some disagreement. Most women take the hormone by mouth because this comes as a prescription from their healthcare professional. The liver metabolizes about 80 percent of the hormone, so a significant dose must be taken in order to get a beneficial dose. These large doses will put extra stress on the liver.

People with AFS already have a low clearance state for progesterone with high reactive metabolite load. An overload of progesterone through the oral route will overwhelm the liver and possibly bring on an adrenal crash as mentioned before.

Because of this, the oral route of administration of progesterone side effects is not recommended for those with AFS unless properly supervised.

Testosterone is another of the hypothalamus hormones that become unbalanced with AFS. Lower levels of testosterone are related to decreased libido and sex drive in both men and women. This is also common in AFS. Replacement of testosterone can help. However, the administration of testosterone should not be too aggressive, because it can lead to overstimulation and adrenal crashes.

Hypothalamus Hormones Remediation Efforts

When menopause occurs, the symptoms sometimes become difficult to deal with. Women seek help to alleviate the symptoms, but in the recent past have been counseled not to use hormone replacement therapy.

Research has indicated that hormone replacement therapy is effective, but some hormone replacements have not proven effective. Bioidentical hormones have been shown to be effective due to their bioavailability, but the benefit is not universally evident. Hormone replacement of any kind needs to be personalized Careful measurement of hormone levels and continued monitoring are necessary.

Both men and women need testosterone to function optimally. Libido, endurance, and mood are all affected by testosterone levels. With AFS, the appropriate level of testosterone can alleviate some of the discomforts felt by both men and women. Excessive testosterone can trigger adrenal crashes due to the anabolic and stimulatory nature of this compound.

Progesterone is another of the hypothalamus hormones necessary for women to achieve relief from symptoms of both menopause and AFS if there is a state of estrogen dominance.

In cases of AFS, progesterone is often depleted in the production of cortisol. This leads to estrogen dominance and all of the symptoms of that condition. Progesterone is needed to balance estrogen in both menopause and AFS. Once again, dosage and type of administration are important.

A deficit of estrogen can be seen in the later stages of AFS as well, especially in those who are in catabolic state.

Supplementation will help women with their symptoms if this is the case. Care must be taken to monitor levels so as not to push them into estrogen dominance. The same situation is seen in menopause, as well.

Overall, remediation efforts directed at AFS with any kind of supplementation must be regarded with the entire set of body organ systems in mind. The most appropriate approach with which to do this is the NeuroEndoMetabolic (NEM) model of stress response.

Hypothalamus hormones are part of the hormonal circuit of the NEM stress response

Traditionally trained physicians typically view symptoms as set apart from all but possibly one or two organs in the body. This is their approach in which only the symptoms are dealt with. The root causes of the condition for which their patient is seeking relief are not assessed.

On the other hand, practitioners who use the NEM model look at the six major organ systems and their inter-relationships in order to fully address the issues brought to them by their patients. This model says what affects one of these major organ systems affects others as well, including hypothalamus hormones systems.

In the case of women in menopause with AFS, the hormonal system will be affected greatly by fluctuating levels of estrogen, progesterone, and testosterone. The symptoms arising in this system will lead to fatigue, infertility, hair loss, low libido, and irregular menses.

With AFS, estrogen dominance can easily become a significant issue. Increasing stress puts more burden on the adrenals to secrete cortisol, which requires progesterone for production. This lowers the level of the hormone needed to balance estrogen. More inflammation also results from estrogen dominance.

Inflammation is also a product of metabolic system issues in AFS. With leaky gut syndrome, the toxins that enter the bloodstream cause more inflammation and an immune system response. This disruption in the metabolic system leads to dyslipidemia, central obesity, and the development of Type 2 diabetes.


With more women reaching the age of menopause and living quite a few years afterward, the issue of hormone replacement therapy grows in significance. The WHI results led to a cessation of synthetic HRT. More current research and clinical practice have shown HRT, both synthetic or bioidentical, to be effective on hypothalamus hormones and have its place when used correctly. Not only will this approach help women deal with the issues related to menopause, it also addresses issues related to AFS. Careful consideration of whether or not to use HRT should be entered into by women and their healthcare professionals.

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© Copyright 2018 Michael Lam, M.D. All Rights Reserved.

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