The life stages of women are based on their reproductive cycle – beginning with menstruation and continuing through to menopause.1 Specific symptoms like cramps, weight gain, hot flashes, mood swings, night sweats, etc., often mark the different life stages, and to understand this better, you have to start with biology and genetics.
Dr Sarah Gottfried, an obstetrician-gynaecologist and clinician with more than 20 years of experience in hormone health and longevity in men and women, speaks to the importance of early understanding of hormones in women.
In an episode of the Huberman Lab podcast titled “How to optimise female hormone health for vitality and longevity,” Dr Gottfried spoke about the importance of women understanding their genetics. Gottfried said that knowing your mother’s, grandmother’s and even great-grandmother’s experience with hormones, not just about pregnancy, child-rearing and childbirth, is essential. “Certain female conditions like endometriosis and fibroids have a strong genetic component,” she said. From puberty through to menopause, many of those symptoms are linked to your genetics.
Understanding hormones through the different stages
Estrogen, progesterone and testosterone are the most influential hormones throughout a woman’s life. From the first signs of puberty to menopause and beyond, hormonal changes are universal, but their effects are deeply personal.
Puberty
Typically beginning between the ages of 8 and 13, this is when estrogen and progesterone levels ramp up, and the dance between them is important. In the teen years is also when, Gottfried advises, having cortisol levels tested. Stress plays a big part in the development of the adrenal glands, and young women are more likely to skip periods in this stage, especially due to stress. Nutritional tests can also be carried out in the teen years.
20s
Micronutrients play a huge role in terms of hormone production; for example, magnesium is hugely involved in getting rid of estrogen. Good nutrition and an increased intake of vegetables is not only important for hormonal balance but can prevent future risk of breast cancer.
According to Dr Gottfried, if estrogen is dominant in this phase, you have a greater risk of fibroids, endometriosis, and breast pain. Testing your estrogen, progesterone, and testosterone is important in this phase, and the best time to test is on day 21-22 of your menstrual cycle – about a week before your period. The best and cheapest test is a blood test, but you can also test using saliva and dried urine, Gottfried said.
30s
Having a basic understanding of your hormones in your 30s is essential. The more you know about your hormones in your 30s, the more you set yourself up for the future, especially regarding estrogen, thyroid, and progesterone levels. Even though men make as much or more than 10 times more testosterone, testosterone is the most abundant (biologically) hormone in the female system. For women as early as 28, testosterone levels decline by about 1% per year.
40s
At age 40, is when a massive change happens in the female brain, where most women will experience something Gottfried describes as “slow brain energy”. This stage – perimenopause – is the period of time before your final menstrual cycle and is usually when you start having your cycle closer together (from 28 days to 25 days) – this can happen in your 30s or 40s. “Many symptoms that occur in perimenopause are not driven by the ovaries; they are driven by the brain”, she said.
By age 45, Gottfried said, women should do a coronary artery calcium (CAC) score and sooner if they have premature heart disease. The test is usually done through a CT scan of the chest. It is also essential – for men and women – to know their Adverse Childhood Experiences (ACE) score as a baseline for how much trauma their system has endured since they were a child. Studies show that trauma maps to disease in middle age and that trauma and intergenerational trauma affect the endocrine system, especially cortisol. You don’t have to wait until your 40s to have this test done; you can do your ACE score test as a teenager.
50s
Constipation is far more common in women and is usually a signal to a larger set of problems. While there isn’t any data to confirm the exact age, Gottfried said that a colonoscopy for females at 50 is essential. “The gut is about 10 feet longer in women compared to men, and women suffer from digestive issues at more than 10 times the frequency that men do,” she said.
During the different stages, it is important for women to not just test their blood, but urine and microbiome tests can also be used to get a clear understanding of their hormone status, not just at present, but also where the trajectory of their hormones is taking you.
