Connect with us

Insight

From PCOS to thyroid troubles- an exploration of women’s hormones

By Dr Haleema Sheikh, a specialist in integrative women’s health and bioidentical hormone balancing for the Marion Gluck Clinic

Published

on

Dr Haleema Sheikh, a specialist in integrative women's health and bioidentical hormone balancing for the Marion Gluck Clinic

Hormones are our bodies’ communication messengers. They are chemicals that are released by one organ/tissue that are carried in the blood and impact another organ/tissue and thus coordinate different functions in our body.

These signals tell your body what to do and when to do it and cause significant issues when there is hormonal imbalance.

Hormonal balance is very often related to our lifestyle. The environment we bathe our genes in impacts which genes are switched on and off.

Our body is always trying to be balanced and so our hormones adapt to try to create balance within the body and are a reflection of environmental and mental inputs.

Unlike men who have a 24hr testosterone cycle with testosterone peaking in the morning, the female menstrual cycle requires a complex dance of hormones to interplay to release an egg monthly.

This includes building up the lining of the womb in preparation for a fertilised egg and if there is no pregnancy to allow the lining to break down and start the whole process again.

This roughly 28-day cycle can be easily unbalanced by a number of factors, including poor nutrition, suboptimal movement, disturbed sleep, excess stress, poor relationships and high toxic burden from environmental toxins.

Reproductive hormonal symptoms can show up in a variety of ways including painful and/or heavy periods, infertility, altered cycle and PMS.

PCOS is a common (one in five to 10 women) but often poorly understood whole body hormonal/metabolic disorder that affects women of reproductive age.

The defining feature of PCOS is irregular/anovulatory cycles and the over-production of male type hormones- androgens. The increased androgens can lead to acne, oily skin and hirsutism.

Many women with PCOS also struggle with weight gain, particularly in the abdominal area.

The irregular cycles can interfere with getting pregnant and so balancing the hormones is key to restoring fertility.

There are genetic predispositions for PCOS which had a survival advantage in the past when food was scarce, and we had to fight predators.

It has been said that women with PCOS have the genes of warrior princesses and this is why it has perpetuated.

Women with this condition are struggling in today’s modern society because we are often sitting at work for hours at a time and then sitting in front of screens in the evening.

Our genes expect movement in the day and to follow natural rhythms and the sedentary nature of modern day life results in a mismatch and health issues.

The name arises from the multiple follicles seen on ultrasound of affected women- these are not true cysts.

Many young women will have these appearances and should not be automatically diagnosed with PCOS unless they have the androgen excess symptoms and irregular periods.

Women suffering from PCOS have hormonal imbalance that has a few root causes including blood sugar regulation (insulin resistance), inflammation and poor gut health. Addressing these areas is foundational to managing and reversing PCOS symptoms.

The conventional medical model is focussed on managing symptoms of PCOS and will often result in putting women on the pill to regulate periods and reduce androgen symptoms, but this is not dealing with the root cause and bringing the body back into balance.

When women have difficulty getting pregnant, they are given drugs to try to induce ovulation or referred for IVF. These are useful options to explore when lifestyle interventions have not been fruitful and should remain a reserve option.

The functional medicine approach to PCOS focuses on:

  1. Optimising diet to improve insulin sensitivity through encouraging low-carb nutrition which helps improve insulin resistance a cornerstone driver of the condition.
  2. Supporting gut health to reduce inflammation which is another key factor. Pre and probiotics can support the gut microbiome which modulate hormone balance and detoxification.
  3. Reducing exposed to toxic ‘endocrine disrupters’ in the environment like BPA in plastics because they’ve been shown to disrupt the hormonal system by altering the way in which hormones interact with their receptors and how they are used/ metabolised within the body. Thesexenoestrogens can be found in plastic bottles/containers and in many skincare products/makeup which get absorbed through the skin so it is important to use ‘clean’ products and work on minimising exposure.
  4. Minimising stress through lifestyle tweaks like meditation and yoga which help support the parasympathetic rest and digest nervous system.
  5. Using targeted supplements and herbs to support hormones further, including magnesium, which improves insulin sensitivity and is anti-inflammatory, omega 3 fatty acids, inositol and zinc.

We can also use natural bioidentical progesterone to help women with PCOS kick start a regular ovulatory cycle.

Progesterone is released in the second half of the cycle after ovulation.

Professor Jerilyn Prior has been a pioneer in her work on the use of cyclical natural progesterone for two weeks on and two weeks off to help trigger ovulation in women who are not ovulating, and this helps correct the hormonal imbalance. This can fully explored in a bioidentical hormone clinic.

Thus, in the example of PCOS we can see the far-reaching, whole-body consequences of reproductive hormone balance.

Interestingly, women are also five to eight times more likely than men to have thyroid hormone problems, with one in eight women developing a thyroid disorder during her lifetime.

The thyroid is a butterfly-shaped gland at the base of the neck that produces hormones (thyroxine) essential for regulating metabolism, body temperature, energy, heart rate, menstrual cycle, mood, and hair and nail growth.

Essentially, it serves as the body’s thermostat controlling how fast things happen in the body by its actions on different organs/tissues.

There are two main categories of thyroid problems hypothyroidism (an under-active thyroid) and hyperthyroidism (an overactive thyroid).

In the case of hypothyroidism, the body literally slows down and causes symptoms like weight gain, brain fog, constipation and sluggishness.

The thyroid is not producing enough of the thyroid hormones – triiodothyronine T3 (active form) orthyroxine T4 or both.

The thyroid is a sentinel gland assessing the environment and ensuring the body adapts appropriately.  It requires a number of nutrients to function optimally and lack of these can cause it to under function. These nutrients include selenium, zinc, vitamin A, iron and iodine.

Reversing these deficiencies can help the thyroid improve its functioning.

In addition, the immune system can become muddled and produce autoantibodies which mark the thyroid for destruction by the white cells of the immune system. This is called Hashimoto’s disease an autoimmune condition which is more common amongst women.

There is a triad of genetic predisposition, increased gut wall permeability which allows the immune system to be more activated and a trigger e.g. stress/gluten exposure which ignites the whole process resulting in the production of antibodies which label the thyroid as foreign and for attack.

The conventional medical model works on trying to reduce the symptoms of hypothyroidism by giving replacement thyroxine support.

This can help the situation but does not address the immune activations and high levels of antibodies causing the thyroid to be attacked. Patients will feel a bit better, but it certainly does not bring vitality and full wellbeing to the majority.

In the functional medicine world patients are often given replacement hormone but there will also be emphasis on addressing the root cause by:

  1. Improving gut health and reducing gut permeability. This requires working on the gut microbiome and nutrition. 85 per cent of patients with Hashimoto’s do better on a gluten-free diet because there is molecular mimicry between the gluten molecule and the thyroid and in individuals with a genetic predisposition the immune system reaction against gluten ingested can also target thyroid tissue.
  2. Working on the other pillars of health sleep, relaxation and movement can also help bring the body back into balance and help the immune activation.
  3. Ensuring there are not nutritional deficiencies impacting the gland.

Women in the perimenopause and menopause are more at risk of thyroid disorders as there are oestrogen receptors on the thyroid and at this time there is hormonal fluctuations which can trigger thyroid dysfunction.

During the menopause, as a result of the lack of estrogen, thyroid function can be suboptimal and this can contribute to the menopausal weight gain around the middle that happens and the deterioration in lipid panels.

We can see how endocrine glands interact with each other; the body has a complex web of interconnection which help keep the body in balance.

When we are seeing hormonal dysfunction symptoms is important not only to look at symptoms control but to look at deeper root causes driving the issues.

Careful consideration to the environment we are bathing our genes is key to optimal hormonal health and this is best done with a medical professional who understands the importance of hormonal health.

To find out more, visit the Marion Gluck Clinic.

News

Bridging the metabolic wealth gap: The telehealth platform bypassing insurance to democratise care

Published

on

As weight-loss treatments remain locked behind prohibitive paywalls, a new direct-pay initiative is cutting costs in half for low-income patients, and it could provide a new blueprint for health equity.

It is one of the most persistent, frustrating paradoxes in modern healthcare: the medical innovations most capable of addressing widespread chronic conditions are overwhelmingly priced out of reach for the populations most vulnerable to them.

Nowhere is this more evident than in the current landscape of metabolic health and weight management.

As state governments and insurance providers increasingly restrict coverage for advanced weight-loss medications due to skyrocketing costs, a stark dividing line has emerged. Clinical need is no longer the primary factor in who receives treatment. Affordability is.

This financial barrier disproportionately impacts women, who not only face high rates of metabolic conditions but also frequently serve as the primary caregivers in their households.

For a single mother managing childcare, grueling work hours, and the relentlessly rising cost of living, personal well-being is often the first casualty of a tight budget.

These patients are forced into a holding pattern, watching their conditions progress year after year while highly effective, life-changing treatments remain separated from them by a paywall.

Now, a telehealth platform called Amble Health is attempting to dismantle that wall by bypassing the traditional insurance apparatus entirely.

A Structural Shift for Access

Today, Amble Health announced the launch of the Amble Cares Program, a national initiative designed to cut the cost of medical weight-loss treatments in half for low-income Americans.

The programme arrives at a critical inflection point.

Today, roughly one in eight U.S. adults have utilized advanced metabolic medications, according to a recent KFF Health Tracking Poll.

This surge in adoption has driven a fundamental shift in preventative care, but the distribution of that care has been deeply uneven.

Through the Amble Cares Program, eligible patients can access comprehensive medical weight-loss programmes, which may include prescription medications if clinically appropriate, at up to 50 per cent below standard rates.

To ensure the discounts reach the intended demographic, eligibility is determined by an independent, third-party verification partner, based on verified financial need.

The programme explicitly prioritises individuals and families with limited disposable income, including parents and guardians whose financial flexibility is tied up in providing for dependents.

Once verified, patients are connected directly to licensed clinicians to begin treatment immediately, stripping away the friction of waiting periods.

“Healthcare should not be a luxury item,” said Joey Stiver, CEO of Amble Health. At Amble, we believe that a patient’s zip code or income shouldn’t dictate their metabolic health outcomes.

“The Amble Cares Program is our direct response to the cost of living crisis, moving beyond talk of ‘affordability’ to actually delivering it to the people the traditional system has left behind.”

The Direct-Pay Trade-Off

However, this rapid, lower-cost access comes with a significant structural trade-off.

To achieve these price reductions and eliminate the administrative delays, denials, and red tape associated with traditional healthcare, Amble Health operates strictly as a direct-pay platform.

This means participants cannot use outside coverage. The programme does not accept Medicaid, Medicare, commercial insurance, or even HSA/FSA funds.

For some patients, being entirely locked out of utilizing their existing health benefits may present a new kind of hurdle.

But for those who have already found themselves abandoned by traditional coverage networks, facing outright denials, unnavigable prior authorisations, or insurmountable deductibles, the direct-pay model offers a predictable, transparent alternative to a broken system.

Ultimately, the Amble Cares Program is making a bold bet: that the most efficient way to deliver equitable healthcare to disenfranchised populations isn’t to fix the traditional insurance system, but to innovate entirely around it.

Continue Reading

News

UK report warns against ‘financial half measures’ for women’s health

Published

on

The Women and Equalities Committee (WEC) has warned against “financial half measures” on women’s health as the government published its response to the report.

Ministers launched the renewed Women’s Health Strategy in April after the committee’s March report concluded it was not convinced that the menstrual and gynaecological needs of young women and girls had been sufficiently prioritised in wider healthcare reforms.

It followed the committee’s 2024 “medical misogyny” report, which found women with painful reproductive health conditions such as endometriosis, adenomyosis and heavy menstrual bleeding were frequently finding their symptoms “normalised” and their “pain dismissed” when seeking help.

In both reports, MPs called on the government to recognise the benefits of increased investment in early diagnosis and treatment of women’s reproductive health conditions and provide additional funding needed to transform the support available to millions of women.

In its response, published on 26 May as a command paper, the Department of Health and Social Care outlined action on reducing gynae waiting times, ensuring procedures are conducted with women’s full consent and adequate pain relief, and improving access to contraception for menstrual healthcare in line with the committee’s recommendations.

It said: “The government agrees with the committee’s overarching findings and recommendations for improving women’s health outcomes and experiences.

“We acknowledge the impact that menstrual health conditions can have on women’s lives, relationships, and participation in education and the workforce.

“We recognise that more needs to be done to support women with menstrual health conditions, particularly around listening to women, improving information and education, and enhancing patient experience.”

However, there was no commitment to increase school nurse provision, no measurable actions and targets on countering online misinformation, no new commitments to end inappropriate censorship of women’s online health content, and no further initiatives on tackling racial discrimination or understanding the menstrual wellbeing needs of young disabled and Deaf women.

The response comes after analysis by The Times suggested the government is allocating 60 per cent more funding to its men’s health strategy than to its renewed strategy for women’s health.

Sarah Owen, chair of the Women and Equalities Committee and Labour MP, said: “WEC’s 2024 ‘medical misogyny’ report warned 18 months ago of women in unnecessary pain and undiagnosed for years and called on the Government to recognise the benefits of increased investment in early diagnosis and treatment.

“Our follow up report this March cautioned girls’ and women’s health are not being sufficiently prioritised in system-wide NHS reforms, while initiatives which have proven to be successful in reducing waiting lists and improving women’s healthcare access, such as women’s health hubs, risked being scaled back or discontinued.

“While it’s welcome to see a focus on tackling ‘medical misogyny’ in April’s renewed Women’s Health Strategy and an emphasis on women’s voices being heard, this must be backed by adequate funding, not financial half measures, particularly when compared to men’s health.

“Significant questions remain following today’s response publication over the adequacy of investment being provided, including for workforce training, menstrual health education in schools, research and additional ring-fenced funding for women’s health hubs to deliver services within the emerging neighbourhood health framework.

“There are both opportunities and risks when it comes to increasing use of technology in women’s healthcare.

“As the Committee’s report set out, social media companies should be held to account for inappropriate and disgraceful ‘shadow banning’ censorship of important women’s health content and there should be a rigorous approach to tackling the risks from ineffective, unsafe and exploitative for-profit FemTech apps.

“The Government should take the problem of ‘shadow banning’ more seriously.

“A strategy which does not fully address the concerns set out in WEC’s report, alongside measurable actions and timescales, will only scratch the surface of the issues facing women’s health.

“WEC will keep a close eye on progress and continue to push for long overdue tangible change for women and girls.”

Continue Reading

Insight

Early PET scan could chemo response in aggressive breast cancer – study

Published

on

An early PET scan after one cycle of chemotherapy may help predict how aggressive breast cancer responds to treatment, a study suggests.

Research led by The Institute of Cancer Research, London and King’s College London suggests that an early scan taken after one cycle of chemotherapy could help predict how well a patient’s cancer will respond to treatment.

The study focused on patients with triple-negative breast cancer (TNBC), an aggressive form of the disease in which cancer cells lack receptors for the hormones oestrogen and progesterone, as well as the HER2 protein.

Patients with TNBC are usually treated with chemotherapy prior to surgery. While many respond well, residual disease at surgery, typically around six months later, is associated with a significantly poorer prognosis. Identifying people sooner who are unlikely to respond remains a major clinical challenge.

The research explored whether using PET imaging shortly after treatment begins, rather than relying only on MRI scans later in the treatment process, could provide earlier insight into how a patient’s cancer is responding. Twenty-two patients were recruited, with fourteen undergoing FDG-PET scans before treatment and after the first cycle of chemotherapy.

The findings, published in Clinical Cancer Research, showed that changes seen on PET scans after just one cycle of chemotherapy were strongly associated with subsequent response, including whether there was no detectable cancer, known as a complete response, by the end of treatment. Importantly, early PET response showed stronger associations with treatment outcomes than standard mid-treatment MRI scans in this study.

Being able to identify patients who are not responding well at an early stage could allow clinicians to adjust treatment sooner or consider alternative approaches. These findings may also support future strategies to better tailor treatment intensity to individual patients.

The study also compared two types of PET tracers, FDG and FLT, to determine which was most suitable. While both met the study’s technical criteria, FDG-PET was selected for further evaluation due to its better image quality, greater consistency and wider use in clinical practice.

The research also explored how imaging changes after just one cycle of chemotherapy relate to the body’s immune response to treatment. Biopsies taken before and after the first cycle of chemotherapy showed that an increase in immune cells within the tumour was strongly associated with both early PET changes and improved treatment outcomes.

The researchers emphasise that these findings now need to be validated in larger studies. Future work will aim to confirm these results in broader patient groups and explore more accessible imaging approaches, such as ultrasound, alongside PET and MRI.

Sheeba Irshad, professor of cancer immunology at King’s College London and lead of the Breast Cancer Now KCL Research Unit, said:

“In patients who had PET scans both before treatment and after the first cycle, we found that this early scan could predict whether they were likely to achieve a complete response by the end of treatment. These findings highlight the potential of early imaging to guide treatment decisions, and now need to be validated in larger, modern clinical trials.”

Andrew Tutt, professor of breast oncology at The Institute of Cancer Research, London, said:

“Research that helps us determine early who is already benefitting from standard neoadjuvant chemotherapy and who might benefit from clinical trials to find better treatments is vital. This study shows that FDG-PET may have great value in this regard. We hope to be able to design studies that further investigate and validate these findings.”

The study was supported by funding from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, Breast Cancer Now, Cancer Research UK, and Guy’s and St Thomas’ Charity.

Continue Reading

Trending

Copyright © 2025 Aspect Health Media Ltd. All Rights Reserved.