Hormonal Health

Each decade after age 25-30 we start to lose hormonal function. The symptoms may be very subtle at first. The signs that your hormones are out of balance may masquerade as sleep or energy issues. They can even mimic or cause cognitive or mood issues. There’s a reason the divorce rate is the highest for menopausal women and andropausal men. Yes, I’m saying that getting a divorce might a symptom caused by two people who simply have hormonal issues. How to know if your hormones are out of whack? Have a thorough medical history with lab  testing by a qualified anti-aging specialist. I can do this in my sleep. And over the years, I’ve heard “the same story” over and over again from people who are mystified that I can so easily diagnose what is wrong with them even before I have their labs back. If you think you have hormonal issues, see if you fit into a typical “by-decade” pattern.

Age 30-40

We start to lose melatonin by the time we hit 30 so as early as our 30’s we can start having sleep issues. Loss of melatonin is worsened by our poor sleep hygiene habits of having TV’s, computers, tablets and bright lights in the bedroom. Symptoms can include having trouble falling asleep, staying asleep, or just awakening feeling unrefreshed. Make sure that you have good sleep hygiene to keep your natural melatonin levels up and then supplement when you think you need to. If you need a review on  what’s best for you then read about the best natural sleep aid or aids.

Mid 30’s

Human Growth Hormone (HGH)

In our mid 30’s, we can start to see a drop in Human Growth Hormone (HGH). This is often not dramatic, but sometimes, we can indeed start to see these changes in our mid to late 30’s:

  • Increase in body fat
  • Increase in wrinkles and the beginning of sagging, thinning skin
  • Less of a feeling of well being
  • Sagging of muscles and breasts- but this usually doesn’t start until the late 40’s
Age 30-40 in Women

Progesterone deficiency

Progesterone deficiency is the great masquerader. It can cause sleep issues which then decrease your energy levels. It can decrease serotonin levels which make you crabby 1/2 the month, or you can feel anxious (low GABA)  and/or depressed. You can have some minor memory issues such as name recall, and some concentration issues. Peri-menopause may start as early as 25! Mood swings and PMDD may be other symptoms. However, typically this starts around 40.

Drops in testosterone in women are often responsible for a decreased sex drive and tend to occur after we see a drop in progesterone; usually when you are in your 40’s but possibly prior.

If you feel you have a progesterone deficiency, then the hormone pregnenolone, with its breakdown product of progesterone, will help you sleep better and have improved cognition and mood. It also staves off low progesterone- constipation issues. (Yes, low progesterone decreases gut motility and can cause constipation). The pregnenolone can be taken in doses up to 200 mg at bedtime and is often a good substitute for progesterone until close to menopause. 5-HTP can be taken to elevate serotonin levels and for anxiety, pharmagaba can be use to elevate GABA levels.

Age 40-50 (but can start in late 30’s) in Men

Testosterone deficiency

“Low-T” can be caused by a variety of factors. Real “andropause” is typically is a drop in testosterone occurring usually in men in their 50’s, but it can occur earlier. However non-andropause induced “low-T” needs a bit of investigation.

Low testosterone levels can be caused by rough sports with knocks to the head or groin. It can be caused by previous use of testosterone for body-building purposes with disruption of the normal pituitary-testicular axis. It can be caused by testicular tumors or varicoceles. It should nevertheless be evaluated by a Specialist; not a counselor in a “hormone mill.” signs that your hormones are out of balance

Testosterone deficiency can also cause memory issues, mood issues, and sleep issues, usually resulting in unrefreshed sleep.

Energy is also impacted as well, with an all-day feeling of sluggishness, which includes lack of drive, inability to “get going” on an exercise regimen, and loss of muscle mass.

Libido is down of course and erectile dysfunction is possible but (believe it or not) usually not due to having a low level of testosterone. If you have “E.D.” it’s more often from vascular disease and/or a high glucose level-so get that checked out.

IMPORTANT NOTE: If you are experiencing the symptoms described above, there is the remote possibility of a testicular nodule that may or may not be serious. If you feel one, seek medical help immediately. I’ll discuss testosterone replacement below.

Age 40-50 in Men and Women

By our mid 40’s, we are seeing the need for progesterone in women and sometimes; we see early menopause which I’ll go into details about in a moment. With the passage of time, we notice the effects of having less HGH (human growth hormone). Have you noticed how injuries heal more slowly than in years past? That’s why.  And as mentioned we sometimes see testosterone levels decrease in both men and women.

Age 50ish in Women- When you see definite signs that your hormones are out of balance

how to know if your hormones are out of whackIn our early 50’s, women will be experiencing irregular periods, hot flushes, a definite drop in libido, and vaginal dryness. All of these symptoms, other than the libido drop (due to a loss of testosterone levels), are due to estrogen loss. There are other hormonal “disasters” which occur and contribute to what I call the “menopause 25 pounds” and the menopausal belly fat. All of these hormonal changes are treatable-meaning 100% reversible.

One quick word about hot flushes/flashes or whatever you’d like to call them.

Adrenal fatigue, with its high cortisol levels, is sometimes associated with hot flushes.

So if you have energy issues which are not diagnosed and hot flushes too- don’t assume this is due to low estrogen. Check out the articles in this website about adrenal fatigue and see if you “see yourself.”

Note: If your adrenal fatigue is severe enough to cause hot flushes, you will not just “get better on your own.”

Estrogen deficiency

Now back to the “usual” cause of hot flushes: estrogen deficiency. Please do not even consider taking a synthetic estrogen pill prescribed by your regular doctor: Look up the reasons why I’m making sure to tell you this. Synthetic estrogen is associated with breast and uterine cancer as well as Alzheimer’s, yes, Alzheimer’s! Why is this still on the market? Your guess is as good as mine.


Treatment is with a combination of Estradiol and Estriol creams or pellets (bioidentical hormones). Even if you have had a hysterectomy, you need bio-identical progesterone to protect breast tissue, as well as for sleep and immune function.

During the period of time before menstruation stops fully, women’s adrenal glands try to “pick up the slack” by producing estrone, which functions like estradiol (neutral) and estriol (healthy), with one huge exception.

Many studies on breast and uterine cancer make a correlation between estrone (the “bad estrogen”) and cancers. The problem appears to be with the  metabolites of estrone. However, these can be modified to transform into the good metabolites which come from the breakdown of estradiol and estriol. You can supplement to shift bad estrogen/estrone to metabolites of good estrogens with products that contain “DIM.”

Age 50-60 in Men

In our 50’s, most men definitely go through through “andropause”, much the same as women go through menopause. Testosterone levels drop causing a drop in energy, motivation, mood, libido, sometimes causing erectile dysfunction, as well as unrefreshed sleep. The optimal treatment is an easy, self-administered once weekly injection of bio-identical testosterone.

The vast majority of testosterone topical preparations are not strong enough and, at some point (probably related to hair follicles), men stop absorbing topical testosterone.

Another Important Note of Caution:

If you are a man getting testosterone from your general doctor, he/she is most likely unaware that testosterone converts to estrogen, and therefore, most men require an “estrogen-blocker“. So, please, have testosterone, free testosterone, and estradiol measured. And do find a specialist!

How to know if your hormones are out of whack by the time you are Age 60-70

In our early 60’s, cortisol levels start creeping up. It is quite common for people to experience a drop in energy and attribute it to age. There is no reason energy or cognition should fall off at 60. We have cortisol which can be lowered and mitochondria which can be amped up. Don’t settle for “feeling older” when it’s totally un-necessary. I haven’t mentioned insulin levels but I HOPE you have them under control by the time you hit 60. Insulin is a great marker for inflammation and it’s easy to get it down to 2 IU/ml, where it needs to be. If it isn’t and you’re 60, it’s time to take control of your health.

Age 70-100

There are some “forgotten” hormones that can diminish as we age. Those are parathyroid hormone and calcitonin, both needed for bone health and other “odds and ends.” And something “no one” seems to look for- hypothyroidism that is due to a diminution of TRH- thyrotropin releasing hormone. Doctors measure the pituitary TSH and the thyroid hormones T3 and T4 (free T3 and free T4 are correct) but no one seems to consider TRH. My dad 92 year-old dad was “visibly” hypothyroid and his regular doctor plus a Specialist told me he was fine. I then ordered the correct tests and yes, now my dad is fine, on bio-identical thyroid hormone prescribed by me.


I have always found that if someone thinks something is “out of whack”, it is. Don’t let your doctor tell you the sky is pink when you know it’s blue. If you have a problem that is being scoffed off as “depression” or “moodiness” or “stress” and you know there’s “something wrong”; listen to your instincts and find someone who will take you seriously.

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