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STRESS AND SEX HORMONES: SIGNAL, NOT STEAL HOW CHRONIC STRESS LOWERS PROGESTERONE AND TESTOSTERONE — AND WHAT DUTCH CAN SHOW Psychological stress · poor sleep · under-eating for your training · weight loss · illness · inflammation BRAIN Hypothalamus + pituitary run both systems "Is this a safe time to reproduce?" CRH · ACTH ↑ ADRENAL GLANDS: CORTISOL ↑ Made in its own layer, from its own pregnenolone LONG-RUNNING CORTISOL EFFECTS ↑ Blood glucose and insulin resistance ↑ Visceral fat storage ↓ Sleep when evening cortisol runs high ↑ Inflammation as tissues stop responding to cortisol's brake ↓ Immune defences GnRH · LH · FSH ↓ OVARIES / TESTES ↓ Less signal in, less hormone out WHAT YOU MAY NOTICE ✗ Fewer ovulations → low progesterone ✗ Irregular or missed periods ✗ Lower testosterone (men + women) ✗ Low libido · poor recovery ✗ Difficulty conceiving Extreme form: functional hypothalamic amenorrhoea WHY NOT A "STEAL"? Each hormone-making cell makes its own pregnenolone and uses it there. Cortisol and DHEA come from different layers of the adrenal gland. Progesterone and most testosterone come from the ovaries and testes. There is no shared pool to raid. DHEA also falls with age — read it against age and cortisol WHAT TO DO WITH IT 1 · TURN DOWN THE SIGNAL Sleep · stress load · nervous system work Eat enough for the training you do 2 · CHECK OTHER CAUSES Thyroid · prolactin · iron Polycystic ovaries · perimenopause 3 · THEN SEX HORMONES If still low, decide on treatment with your doctor, on its own evidence DUTCH Plus shows the cortisol pattern, DHEA, progesterone and androgen metabolites on one collection day. It shows the pattern. It can't show a steal, because there isn't one to see. SOURCES: ENDOTEXT ADRENAL ANDROGENS (NBK278929) · WHIRLEDGE & CIDLOWSKI 2013 · ENDOCRINE SOCIETY FHA GUIDELINE 2017 DETECTIVE HEALTH · STEPHEN DUNCAN MSC FDN-P · DETECTIVE-HEALTH.COM