In women estrogen falls in waves from the mid-40s, in men testosterone slowly from 30. What that does to sleep, weight, muscle and mood, when hormone therapy makes sense, what strength training and sleep deliver hormonally and which values to have measured.
In short
- Perimenopause often begins at 45 with sleep disturbances, mood and cycle changes, years before the last period.
- Hormone replacement therapy is safe and effective by current evidence with symptoms and a start under 60, with individual weighing.
- Testosterone falls in men by one percent a year; belly fat, sleep deprivation and alcohol lower it further, strength training and sleep raise it.
- Muscle, bone and mood hang on hormones in both sexes; strength training is the best hormone therapy without a prescription.
Women: perimenopause
Menopause does not begin with the last period but years before, often from 45: estrogen and progesterone swing in waves, cycles become irregular, and the first signs are rarely hot flashes but sleep disturbances, mood swings, joint complaints, palpitations, concentration problems and weight gain at the belly. Many women are examined for depression, thyroid or burnout in this phase before anyone thinks of hormones. Menopause, the last period, sits on average at 51.
Hormone replacement therapy today
The fear of hormones stems from the WHI study of 2002, whose results were later classified as exaggerated: it studied older women with synthetic preparations. Today applies: a therapy with body-identical estradiol through the skin and progesterone, started before 60 or within ten years of menopause, is effective with symptoms and the risk is low for most women; bone, sleep, mood and probably the heart benefit. With a history of breast cancer or thrombosis risk it takes alternatives. The decision belongs to a gynecologist with experience, not to a forum.
Men: testosterone
Testosterone falls from 30 by about one percent a year, slowly and without a clear break. It falls much faster through belly fat, which converts testosterone into estrogen, through sleep deprivation, which throttles nightly production, through alcohol and chronic stress. Signs are lack of drive, muscle loss, belly fat, loss of libido, mood. A value under 12 nmol/l in the morning, measured twice, with symptoms, justifies a conversation about therapy. For most men lifestyle raises the value by 10 to 30 percent: ten kilos less belly fat, seven hours of sleep, strength training, less alcohol.
What lifestyle delivers hormonally
Strength training acutely raises testosterone and growth hormone and long-term preserves muscle and bone, which both hormones otherwise protect. Sleep is the main production time for testosterone, growth hormone and the regulation of cortisol; a week with five hours lowers testosterone by 15 percent. Belly fat is a hormone disruptor in both sexes. Alcohol lowers testosterone and amplifies menopause symptoms. Protein, omega-3, vitamin D and zinc are building blocks of hormone production.
Which values to measure
Women: with symptoms estradiol, FSH, progesterone by cycle day, thyroid, ferritin, vitamin D. Men: total and free testosterone in the morning fasting, twice, SHBG, thyroid, blood sugar, vitamin D. Both: blood pressure, blood lipids and bone density from menopause or from 70, because the hormone drop raises heart and bone risk.
Try it
Fitness Age CalculatorResting heart rate, push-ups, one-leg stand, flexibility and grip strength: how old your body is functionally, in years.Blood Test CheckCholesterol, LDL, HDL, triglycerides, glucose, HbA1c, vitamin D, ferritin, TSH, CRP, blood pressure: each value with a traffic light and explanation.Sleep CalculatorWhen do you have to get up? The best bedtimes by 90-minute cycles, or the other way round: when you should wake up.Frequently asked questions
Are plant hormones an alternative?
Soy isoflavones, black cohosh and red clover show small effects with mild symptoms, none with strong ones. They replace no hormone therapy but usually do no harm.
Do I have to replace testosterone?
Only with repeatedly low values with symptoms and after lifestyle, sleep and weight have been exhausted. Testosterone therapy without need has risks for heart, prostate and fertility.
How long does menopause last?
Perimenopause four to eight years, hot flashes seven years on average, in some longer. The hormone deficiency afterwards stays and acts on bone and heart, which is why strength training, calcium, vitamin D and screening count.
This article is general information and not medical advice. If you have symptoms or existing conditions, or before changing any medication, talk to your doctor.
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