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The Female
Hormone Panels
The ovaries are a very important part of the female reproductive organs.
The ovaries are located on the right and left side of the pelvic cavity
next to the uterus. Each weighs about 15 grams. The human female is born
with immature ovaries which gradually mature until the start of
menstruation signals a fully functional reproductive system.
The Cyclical Pacing of the Ovaries
The human ovary releases its hormones in a cyclical manner which is
referred to as the menstrual cycle. The average cycle is about 26-30
days. The timing and pacing of hormone release is governed by GnRH,
FSH & LH, hormones from the hypothalamus and pituitary gland in
the brain. The two major classes of ovarian hormones released during
the menstrual cycle are Estrogens and Progesterone, which are known
as female steroid sex hormones. The major and most active Estrogen
released is Estradiol, while the major Progestin is Progesterone.
The female cycle has 3 physiologic phases (see Figure 1):
- The follicular phase starts with the onset of menstrual blood
flow and is of variable length. This phase is normally
characterized by both low Estrogen and Progesterone output.
- The ovulation phase is 1 to 3 days long and the human ovum
(egg) is released in this phase. This phase is characterized by
high estrogen levels.
- The luteal phase is rather constant in length, 12-14 days,
and ends with menses. Compared to the follicular phase, the
luteal phase is characterized by high Progesterone concentrations
and a moderate increase in Estrogens.
Functions of Female Sex Hormones
Estradiol and Progesterone affect several target organs involved in
a successful conception and pregnancy. Additionally, these hormones
maintain a number of secondary sexual characteristics such as reduced
bodyhair, soft skin texture, a higher voice pitch, possible release
of certain pheromones, etc..
Target Organs of Estrogen & Progesterone
- The Uterus
Estradiol prepares the uterus for conception and produces a 3-5 fold
increase in the thickness of its inner lining, and also promotes
uterine gland development and mucus secretion. Progesterone causes
a swelling of the uterine lining, an increase in glycogen (a complex
sugar) content, and an increase in the mucus secreted by the uterus.
If conception does not occur, the uterine lining is shed, resulting
in the menstrual flow.
- Fallopian Tubes
Sex hormones stimulate the fallopian tubes to move the egg toward
the uterus. The fallopian tubes also secrete nutritious fluids that
nourish the egg, the sperm and ultimately the embryo when fertilization
occurs.
- Vagina
Estrogens promote the thickening of the vaginal lining and increase
its secretions, which makes the lining more resistant to infections.
- Breasts
Before puberty, the breasts grow only in proportion to the rest of
the body, but under the influence of Estradiol and Progesterone during
puberty, the breasts develop to maturity. During the menstrual cycle,
excess Estradiol causes breast swelling and tenderness.
- Bones
In the adult female, Estradiol and Progesterone play an important role
in the inhibition of osteoporosis and improve the incorporation of
calcium and magnesium into bone. This is why doctors prescribe Estrogen
for menopausal women.
- Kidney
Estrogens cause the body to retain sodium which results in fluid buildup.
Conversely, Progesterone causes a loss of excess sodium and retained
fluid. Before the period begins, there may be a relative excess of
Estrogen over Progesterone which commonly leads to several of the PMS
associated complaints.
- Liver
Estradiol has stimulatory effects on liver proteins which may reduce
thyroid hormone availability and increases the risk for cardiovascular
disease. Estradiol also slows the process of liver detoxification of
various harmful substances.
- Miscellaneous
Estradiol can elevate blood sugar in certain susceptible individuals.
Progesterone can increase the appetite and has a general calming effect
on the nervous system, especially at night.
What We Test
The FHP is a simple, non-invasive test. Eleven saliva samples
are collected during specified time periods throughout the menstrual cycle.
The FHP, for the first time in routine medical practice, will allow
both patient and doctor to actually view the profile of Estrogen and
Progesterone simultaneously (See Figure 1). Diagnostic guesswork is minimized,
and hormonal balance evaluation and customized treatment becomes a reality
with the FHP.
In addition, we report the cycle average for Testosterone and DHEA.
The expanded eFHP also includes 5 FSH & LH measurements to see
if brain control and stimulation of the ovaries is optimal.
Applications of the Female Hormone Panel
- Detection of Luteal
Phase Defect
There are at least three luteal phase defect patterns which are
characterized by a reduced output of Progesterone that leads to
Estrogen dominance. This imbalance is usually associated with PMS,
infertility, fibroids and other female hormonal problems and can
be readily detected by our panels.
- Hormonal Imbalance
and PMS
Many women suffer from hormonal imbalance in the Estrogen to
Progesterone ratio. Our panels can objectively evaluate the hormonal
state with great accuracy which, in turn, provides specific
insights for appropriate intervention or treatment to relieve
hormonal imbalance and PMS related symptoms.
- Customized Hormone
Therapy
Presently, female hormone therapy is not individualized to the
needs of each woman because current diagnostic tests do not provide
sufficient data. Consequently, most women are empirically treated
without regard to their individualized physiology and specific
needs. The FHP, for the first time, will allow a clinician
to customize therapy to each female patient.
Other Applications
The FHP can also be used to detect & monitor the following:
- Functional infertility
- Influence of lifestyle (diet, exercise, etc.) on the cycle
- Menstrual problems originating in the brain
- Early pregnancy problems - spontaneous miscarriage
- Cycle irregularities, following the use of birth control pills
- Dysmenorrhea, i.e. painful and heavy periods
- Migraine headaches
- Endometriosis and cystic ovarian disease
- Early Osteoporosis
Advantages of the FHP
- Convenience: requires no blood draws, therefore no repeated
clinic visits and avoids the inconvenience of the 24 hour urine
collection.
- Economy: the fee for the 11 sample test is less than that of
2 blood determinations or a urine analysis for Estrogen and
Progesterone.
- Physiological Accuracy: research has demonstrated that the
free hormone fraction predominates in saliva. Hormones can be
found free or bound to protein. The free hormone fraction is very
important to ascertain because it is the bioactive fraction that
most significantly influences living cells. The salivary female
hormone levels correlate at 93% with the free hormones in the
tissues.
- One or two blood determinations or a 24 hour analysis of urine
for these hormones cannot give an idea of the ovaries' hormonal
productivity. The FHP gives a good approximation of the
ovarian capacity over a whole cycle.
Do you need the FHP?
To determine if the FHP is the appropriate test for your female related problems, consult with your physician or health care provider.
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