The ovaries are a major component of the female reproductive system. The ovaries are located on the right and left side of the uterus in the pelvic cavity. Each weighs about 15 grams. The human female is born with immature ovaries which gradually in stages until the start of menstruation, which signals a fully functional reproductive system.
The Cyclical Pacing of the OvariesThe human ovary releases its hormones in a cyclical manner which is referred to as the menstrual cycle. The average cycle is 26-30 days. The timing and pacing of hormone release is governed by GnRH, FSH and 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 Progestin, also known as the 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 ovulatory phase is 1 to 3 days long and the human ovum (egg) is released in this phase. This phase is preceeded by high estrogen levels.
The luteal phase is rather constant in length, 12-14 days, and ends with menses. In contrast to the follicular phase, the luteal phase is characterized by high Progesterone concentrations and a moderate increase in Estrogens.
Functions of Female Sex HormonesEstradiol 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 body hair, soft skin texture, a higher voice pitch, possible release of certain pheromones, etc.
Target Organs of Estrogen and 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 TestThe 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 and LH measurements to see if brain control and stimulation of the ovaries is optimal.
Applications of the Female Hormone Panel™Detection of Luteal Phase Deficit
There are at least three luteal phase deficit patterns which are characterized by a Progesterone/Estrogen imbalance. This imbalance is usually associated with PMS, infertility, ﬁbroids and other female hormone related 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 define the hormonal state with exquisite 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 ApplicationsThe FHP™ can also be used to detect and monitor the following:
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
Cystic ovarian disease
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, 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 gives only an idea of the ovaries’ hormonal productivity. The FHP™ provides a view of the ovarian capacity over a whole menstrual cycle.
Do you need the FHP™?To determine if the FHP™ is the appropriate test for your hormone related problems, consult with your physician or healthcare provider.
If either infertility or PMS are of concern to you, ask your doctor about the Expanded Female Hormone Panel™
Our expanded panel not only reveals any hormonal imbalances but also accurately indicates the basis of the problem
Hormone balancing is reduced to simple scientific principles using our well structured report and recommendations.
The Male Hormone Panel™ (MHP™) allows the clinician to assess male hormone functionality affecting vigor, vitality and virility using a non-invasive saliva collection. The aging process is inevitable, but restoring lost male vitality is within reach. The Male Hormone Panel™ (MHP™) evaluates the androgen pathway by measuring the free fractions of 6 hormones: Androstenedione, Testosterone (T), Dihydrotestosterone (DHT), Estrone (E1), Progesterone (P), and DHEA/DHEA-S. The expanded Male Hormone Panel™ (eMHP™) contains all the tests in the MHP™ plus FSH and LH.
Traditionally, age-related male hormone changes were not considered problematic because fertility in men persists until an advanced age. In contrast, women undergo ovarian function failure and require multiple hormone replacements. More careful evaluation in males shows progressive age-related changes including:
Decreased muscle mass & strength
Decreased vigor, low energy
Nervousness & Depression
These changes usually begin in the fourth and fifth decades and point towards hormone imbalances and deficiencies which may be considered the male equivalent of menopause, i.e. the Andropause.
What you can do about male hormone imbalance
Optimal health is dependent on the balance of hormones, and not just a single hormone. Currently, men with low androgen hormones can benefit from hormone replacement therapy. Also, men with imbalances in their androgen to estrogen and progesterone can also be hormone supplemented to achieve balance.
Supplemental hormones can be given by mouth, by injection, by skin patch, or by implant. Androgen supplementation, in states of deficit, improves fitness and produces a feeling of well being, with a reduction in abdominal fat and enhanced lean body mass.
Testosterone production in males is mainly a testicular function. Pituitary sex hormones (FSH & LH) stimulate and regulate this function. Specifically, LH (Luteinizing hormone) stimulates testosterone production in the testicles. This process is under negative feedback, meaning that testosterone levels regulate LH secretion. FSH (Follicle Stimulating Hormone) and testosterone stimulate sperm production.
Why measure male hormones?
Measurements of hormones can be used in two general ways.
To estimate the body's own production-baseline test
To measure levels of hormones after supplementation-therapeutic monitoring
Baseline measurements will show normal and abnormal levels of six distinct hormones shown in boxes (See Diagram 1). If levels are too low, too high or hormone ratios are outside of expected limits, an objective treatment plan can be developed for the individual. Symptoms are not a substitute for measuring hormone levels because many symptoms may involve non-hormonal factors.
Using appropriate tests for monitoring hormone therapy is crucial in establishing the appropriate dosing regimen. This reduces the chance of undesirable side-effects and maximizes beneficial effects. For example, excessive use of androgens (testosterone, androstenedione, DHEA and testosterone derivatives) can activate subclinical prostatic tumors which are androgen-dependent. Monitoring is especially important in older males. By the age of 70, at least 50% of men have subclinical prostate cancer. These are especially susceptible to growth stimulation by androgens.
The roles of the six hormones we test are highlighted below:
DHEA - Is the precursor for both male and female hormones. Also, it is an anti- stress hormone produced by the adrenal glands. Unmonitored intake can easily alter the delicate balance between male to female hormones.
Androstenedione - Is a weak male hormone (androgen) and a precursor of both male & female hormones. Unmonitored intake in men can cause excessive female hormone production with minimal male hormone production. In women, unmonitored intake usually causes excess male hormone production with body & facial hair stimulation.
Testosterone - Is the main testicular androgen and is a precursor to the highly potent dihydrotestosterone male hormone. Excessive amounts of testosterone promote hardening of the blood vessels, aggression, prostate problems and increase in total cholesterol.
Dihydrotestosterone (DHT) - Is made from testosterone in certain tissues. The rate of its production is controlled by the level of free active progesterone. Excess DHT causes prostate enlargement and thinning of scalp hair.
Progesterone - This hormone is important in both sexes. It is a natural calming agent to our nervous system. It also keeps in check excessive DHT production and counterbalances the effects of excessive estrone. Unmonitored intake can lead to breast enlargement, depression and weight gain.
Estrone - Is an estrogen that both sexes produce in the fat cells. The more fat, the more estrone which in turn itself promotes fat deposits. It is produced from androstenedione and excess of estrone can cause breast enlargement and contributes to prostate enlargement. In males, a certain low level of estrone is mandatory to balance the androgens.
What we test & what it tells you
Using your saliva sample, the regular MHP™ panel measures six hormones: DHEA, Androstenedione, Testosterone, Dihy-drotestosterone, Estrone & Progesterone. The eMHP™ panel measures these six hormones plus FSH & LH.
The hormone levels in saliva reflect the active tissue concentrations, while blood contains mostly protein bound hormones, whose active levels can only be estimates at best. Urine contains both the active hormones and numerous metabolites and can only be used to gain gross estimate of hormone production over time.
Active fraction measurements from saliva are superior to blood and urine total hormone levels in diagnosis and treatment.
This test is for you if you are...
Middle aged and having:
baldness and/or extremity hair thinning
fat accumulation around the waist
urinary symptoms: pain and/or frequency; urgency; interrupted stream
change in sleeping habits
lack of enthusiasm for life
increase in bad cholesterol, decrease in good cholesterol
your Dr. tells you that you have osteoporosis
Young and having:
inability to lose weight