Reading the Signs of Our Hormones

Dr. Suzanne Fenske practices gynecology with the well-known idiom “you can’t see the forest for the trees” in mind. “If you view a woman by her body parts rather than looking at her as a whole, you will miss the picture,” says Dr. Fenske, who is double board-certified in obstetrics and gynecology, and board-certified in integrative medicine. “I look at nutrition, exercise, sleep, stress management skills, social parameters, sex, and, most importantly, a woman’s needs, goals, and wants.”

A certified North American Menopause Society provider and trained in functional medicine, Manhattan-based Dr. Fenske founded her integrative gynecology practice TārāMD to change how women’s healthcare is delivered. She empowers women to take control of their own health and well-being. Utilizing traditional, integrative, and functional modalities, Dr. Fenske’s approach enables her to tailor a woman’s care according to her needs. It teaches women how to rē-evaluate hormonal care as part of their bigger health picture along the way.

Many internal factors — including other hormones, for that matter — can be affected by hormones. “Thyroid health affects sex hormone health and vice versa. Adrenal hormones affect sex hormones and vice versa. Metabolic illnesses such as polycystic ovarian syndrome and diabetes can dramatically affect hormonal health,” says Dr. Fenske, who points out that genetic factors must also be taken into consideration. But hormonal health is usually multifactorial, she says. This means that it is not genetics alone that typically causes issues. 

A host of external factors also affect hormonal health, including nutrition, stress (also considered an internal factor), and endocrine disruptors — manufactured chemicals that affect the endocrine system and hormone levels in the body. “They can mimic our hormones, block hormones, affect hormone receptors, or impact endocrine glands responsible for making hormones,” notes Dr. Fenske, listing off some of the top offenders, such as BPA (a chemical used in plastic, receipts, and consumer goods), dioxins (a toxic byproduct from chemical and herbicide production), phthalates and plasticizers (chemicals that make plastic more soft or pliable) and flame retardants (found in furniture and children’s pajamas).

Understanding hormonal balance includes not just looking at numbers and ratios but also the metabolism of our hormones, too. This, in turn, allows us to zero in on the root causes of some of the problems plaguing women. “Several women’s health issues are based on inherent issues with hormones, such as endometriosis, fibroids, premenstrual syndrome, premenstrual dysphoric disorder, and perimenopause. But by understanding the inherent hormonal issue, we are able to treat the problem more effectively,” says Dr. Fenske.

A woman’s menstrual cycle, for example, can offer a lot of insight into her hormones. “If she has debilitating periods, that is abnormal and can be a sign of endometriosis, adenomyosis, or fibroids. Suppose she experiences premenstrual syndrome or worsening premenstrual syndrome. In that case, this is a sign of a hormonal imbalance,” says Dr. Fenske. She notes that cycle length and bleeding patterns are excellent parameters to evaluate hormonal health. The same is true for skin, mood, energy, and sleep changes.

Knowledge is power, especially when it comes to inherently understanding our own health. By paying attention to your body, whether intuitively or with a diary or an app, individuals can begin to make connections and feel empowered to take control of their health and well-being. “Understanding your body and knowing your body allows you to be an advocate for your health and a partner with your physician,” says Dr. Fenske. “Trusting that you know your body best and paying attention allows an issue to be identified earlier. Being able to provide your physician with answers to her/his questions empowers you to be a part of your healthcare and to get better care.”