Women are rarely given the full picture when it comes to their hormones. Most are taught to fear menopause, blame everything on “low estrogen,” and accept symptoms as an inevitable part of being a woman.
For me this is personal. When my mother was pregnant, her doctor prescribed an estrogen drug, DES, to prevent miscarriage, unaware of its long-term consequences. My whole life I struggled with hormonal imbalances-I have never had 2 consecutive menstrual cycles in a row, had to go through fertility treatments, and in my 60’s underwent 16+ hours of back surgery for scoliosis, a condition tied to structural deformities that was caused by DES.
1. Estrogen is not the defining female hormone.
Yes, women need estrogen—but it’s only one part of a much larger hormonal network. Estrogen’s primary biological role is cell proliferation: it stimulates growth in tissues like the breasts, endometrium, and uterine lining, and rises dramatically in pregnancy to support rapid tissue expansion. Women naturally produce more estrogen than men because female physiology requires these growth responses.
But estrogen isn’t made only in the ovaries. It can be produced in fat tissue, the brain, skin, adrenal glands, and even within tumors. This is why “low estrogen” is rarely the sole cause of perimenopausal symptoms, and why simply replacing estrogen without considering the rest of the system can create new problems. Calling estrogen the female hormone has also driven harmful medical decisions in the past—like the widespread use of DES.
2. Most hormone symptoms can be traced back to stress and low thyroid function.
Because thyroid hormones influence everything in the body, including sex hormones, many hormonal issues are downstream from low thyroid function. In fact, the transition into perimenopause and menopause is heavily influenced by chronic stress and suboptimal thyroid function, not necessarily low estrogen. In addition, women are biologically more prone to thyroid slowing, partly because unopposed estrogen can suppress thyroid hormone activity (PMID: 11396440)
When thyroid function drops, everything feels harder: fatigue, temperature swings, anxiety, irregular cycles, heavy bleeding, brain fog, and weight changes.
3. Hormone replacement therapy is often misunderstood.
Many women are told they simply need more estrogen as they age. Yet conventional therapy often delivers far higher estrogen levels than what a healthy, cycling woman would naturally produce. Over time, some women actually become more sensitive to estrogen and end up needing higher and higher doses just to feel the same—creating a cycle that can be harmful, especially when it isn’t balanced with protective hormones like progesterone.
Real care should involve supporting the whole system—thyroid, adrenals, progesterone, and metabolism—not just increasing estrogen to mask symptoms.
4. Progesterone is the true stabilizing, protective hormone.
Progesterone is one of the most important hormones for a woman’s physiology. It supports thyroid function, steadies blood sugar, reduces inflammation, protects the brain, and keeps estrogen’s growth-promoting effects in check. It helps maintain normal cycles, supports fertility and pregnancy, and creates a sense of emotional stability and calm. When progesterone drops, even mildly, women can experience:
- menstrual cramps
- migraines
- breast tenderness
- bloating and water retention
- mood swings or anxiety
- postpartum depression
- irritability
- heavy or irregular periods
- sleep problems
- PMS
These symptoms aren’t inevitable parts of being a woman, but signs that progesterone is low relative to estrogen and that the system needs support.
5. Progestins are not the same as natural progesterone.
Progestins, synthetic compounds used in many forms of birth control, do not behave like bioidentical progesterone. Their chemical structure is different, and so are their effects.
In contraceptives, progestins were engineered to suppress ovulation, blunt the LH surge, thicken cervical mucus, and alter the uterine lining. These actions override the body’s hormonal rhythm rather than support it. And even when progestins are used outside of contraception, they still don’t reproduce the protective roles of real progesterone.
Natural progesterone stabilizes the luteal phase, supports thyroid function and metabolism, calms the nervous system, balances estrogen, and protects breast tissue.
Progestins can bind to progesterone receptors, but they send a different message—and many also activate androgen or estrogen receptors, which progesterone does not. This is why women may experience mood changes, fluid retention, breast tenderness, or clotting risk on synthetic versions.
Progestins don’t raise true progesterone levels, and they don’t restore normal cycle physiology. They’re functionally different compounds with different downstream effects.
6. Estrogen needs to be kept in balance.
Estrogen is a growth-hormone. It can promote the growth of all tissues, including cancerous tissue.
When it is unopposed (by progesterone and other protective hormones), the body shifts toward a more inflamed, reactive state. That’s when women start to see the classic signs of imbalance: fluid retention, breast tenderness, anxiety, PMS symptoms, heavier or clot-filled periods, and cycle instability.
The issue is estrogen without the hormones that normally keep its effects in check. No hormone is good or bad. We want everything to be in balance.