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

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:
- Optimising diet to improve insulin sensitivity through encouraging low-carb nutrition which helps improve insulin resistance a cornerstone driver of the condition.
- 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.
- 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.
- Minimising stress through lifestyle tweaks like meditation and yoga which help support the parasympathetic rest and digest nervous system.
- 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:
- 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.
- 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.
- 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.
Cancer
GSK ovarian and womb cancer drug shows promise in early trial

GSK said its ovarian cancer drug shrank or cleared tumours in more than 60 per cent of patients in an early trial as CCO Luke Miels pushes faster development.
The company said that in an early-stage trial, Mocertatug Rezetecan, known as Mo-Rez, shrank or eliminated tumours in 62 per cent of patients with ovarian cancer after chemotherapy had failed, and in 67 per cent of those with endometrial cancer.
Hesham Abdullah, GSK’s global head of cancer research and development, said: “Treatment of gynaecological cancers remains a major challenge, with a pressing need for new therapies that offer improved response rates.
“With Mo-Rez we now have compelling evidence of a promising clinical profile.”
GSK acquired the Mo-Rez treatment, an antibody-drug conjugate, from China’s Hansoh Pharma in late 2023 and has trialled it in 224 patients around the world, including the UK, over the past year.
Only a few patients needed to stop treatment because of side effects, the most common being nausea.
It is given every three weeks by intravenous infusion, meaning directly into a vein.
Combined with data from a separate intermediate trial in China, the results have given the British drugmaker the confidence to go straight to late-stage trials, with five clinical studies planned globally in the next few months, including on patients in the UK.
Speaking to journalists before the conference, Abdullah described Mo-Rez as a “key asset” in the company’s growing cancer portfolio.
It is expected to be a blockbuster drug, with peak annual sales of more than £2bn, which GSK hopes will help it achieve its 2031 sales target of £40bn.
A few years ago GSK did not have any cancer drugs on the market, but it now has four approved medicines and 13 in clinical development.
Last year, oncology generated nearly £2bn in sales, up 43 per cent from 2024, with sales of its endometrial cancer drug Jemperli rising 89 per cent.
News
Self-employment linked to better cardiovascular health outcomes in Hispanic women

Self-employment is linked to lower rates of high blood pressure, obesity, diabetes, poor health and binge drinking in Hispanic women, research suggests.
The findings, published in the peer-reviewed journal Ethnicity & Disease, suggest work structure may be related to cardiovascular disease risk among this group.
Dr Kimberly Narain is assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, senior author of the study, and director of health services and health optimisation research for the Iris Cantor-UCLA Women’s Health Center.
She said: “Hispanic women experience a disproportionate burden of heart disease compared to non-Hispanic women. This is the first study to link the structure of work with risks for heart disease among this group of women.”
The researchers examined 2003 to 2022 data from the Behavioral Risk Factor Surveillance System to assess the association between self-employment, cardiovascular disease risk factors and health outcomes for Hispanic women.
The data included 165,600 Hispanic working women. Of those, about 21,000, or 13 per cent, were self-employed rather than working for wages or a salary.
Overall, the researchers found that self-employed women were less likely to report cardiovascular-disease-associated health problems.
They were also about 11 per cent more likely to report exercising compared with their non-self-employed counterparts.
Specifically, they found that self-employed Hispanic women had a 1.7 percentage point lower chance of reporting diabetes, roughly a 23 per cent decline.
They also had a 3.3 percentage point lower chance of reporting hypertension, roughly a 17 per cent decline.
The study also found a 5.9 percentage point lower chance of reporting obesity, roughly a 15 per cent decline.
It found a 2.0 percentage point lower chance of reporting binge drinking, roughly a 2 per cent decline.
It also found a 2.5 percentage point lower chance of reporting poor or fair overall health, roughly a 13 per cent decline.
The relationship between heart disease risks and the structure of work among Hispanic women was not driven by access to healthcare or differences in income, Narain said.
In fact, the decrease in high blood pressure linked to self-employment was nearly as large as the decrease in high blood pressure linked to being in the highest income group.
The study has some limitations.
The researchers relied on self-reported outcomes, which might be less reliable among ethnic and racial minorities and those from a lower socioeconomic background.
In addition, the researchers’ definition of poor mental health does not entirely match the accepted definition in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
They also did not have data allowing them to examine the specific types of occupations held by the women.
The study design also cannot prove any causal relationship between self-employment and cardiovascular disease risk, which is a subject the researchers will explore.
“The next step in the research is to conduct studies that are able to better assess if the structure of work is a cause of higher heart disease risks among Hispanic women.”
Narain said this.
Study co-authors are Lisette Collins, who led the research, and Dr Frederick Ferguson of UCLA.
Grants from the Iris Cantor-UCLA Women’s Health Center-Leichtman-Levine-TEM program and the UCLA National Clinician Scholars Program supported the research.
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