What causes Premature Hormone Decline 

premature hormone depletion Dr Agnes Ryu

Nowadays premature hormone decline is a real phenomenon in both men and women. Sperm decline is well recognized. My article on the epidemic of low testosterone is found here

For women, the levels of both Oestrogen and Progesterone start progressively and significantly to decline between the ages of 30 and 35, which is long before the menopause and typical menopausal symptoms manifest.

Some encounter the ‘change of life’ too early. After years of suffering vague symptoms and discomfort, some women get diagnosed with hormone imbalance and depletion in their 20’s and 30’s. Patients who have been struggling with fertility issues are often found to be already within the menopausal range of hormones.  If diagnosed with very low Oestrogen with sky-high FSH, this is beyond devastating. My articles on High FSH diagnosis is here and Premature Ovarian Failure (POF) is here.


Females tend to go through the transition of hormones in the following patterns:

  • progesterone deficiency
  • a fluctuating Oestrogen level which eventually declines
  • relative androgen excess
  • that is followed by androgen deficiency. 



Progesterone is typically the first hormone to decline and missing progesterone secretion results in PMS or perimenopause symptoms in mid-thirties and early forties. It can cause the Luteal Phase Defect. Fertility problem and pregnancy loss can result due to abnormal endometrium development and ensuing implantation failure.  

Progesterone level of cycling women:

beginning of the cycle 1 ng/mL or under
middle of the cycle 5 to 20 ng/mL


Progesterone levels rise throughout pregnancy. 

first trimester 10 to 44 ng/mL 
second trimester 19 to 82 ng/mL
third trimester 65 to 290 ng/mL



Irregular ovulation and a resulting deficiency in progesterone expose women to relatively high Oestrogen that is unopposed by Progesterone for typically 8-10 years. This condition, elevated oestradiol to progesterone ratio is called Oestrogen Dominance, a term coined by Dr. John Lee, a pioneer in the study and use of the hormone progesterone. I recommend all his books for those interested in learning how hormones work and how to achieve hormone balance for men (prostate health) and women (fertility, menopause, breast cancer to name a few).  Oestrogen Dominance manifests itself in female hormone imbalances making women vulnerable to many symptoms and diseases such as fibroids, hyperplasia and Oestrogen dependent tumours such as breast cancer, etc. 

Nowadays I witness many more cases of Oestrogen deficiency among my patients. Young ladies with irregular or absent periods and fertility issues often revealed to be Oestrogen declined prematurely. 

Age-specific reference values for serum Oestradiol levels:

Age Oestradiol levels (pg/mL)
20 400
25 350
30 300
35 200
40 150
45 100
50 50
60 40 or less
75 20 or less


Although testosterone is called the male hormone, its role is just as important to women’s health as oestrogen and progesterone. Actually women make 10 times more testosterone than they do the main oestrogen – estradiol. It is an important anabolic and sexual hormone for women and the female testosterone deficiency can cause premature ageing with various physical and mental signs of regression.  


What accelerates the natural age-related decline in female hormone production long before menopause? 

  • The use of the birth control pill will always have consequences as it suppresses the hypothalamus -pituitary – ovary axis. The true nature and impact of birth control pills and many synthetic hormones is very concerning. These pseudo-hormones attach to hormone receptor but they do not exert intracellular effects like real hormones do and benefit women. The natural cycle and hormone production are dampened in those who are on birth control pills long term with ensuing numerous side effects such as insulin resistance, blood clotting and depletion of vital nutrients. Nowadays the concept of post birth control syndrome is recognized. 
  • Pregnancy often takes such a toll that many women, after giving birth, never recover the level of hormone they produced prior to pregnancy and they age prematurely.
  • Women who have a history of induced abortion or uterine tubal ligation also have reduced production of female hormones.
  • Men who engage in intensive sports deplete testosterone and sperm production whilst those women who engage in intensive sports frequently miss ovulation and produce less oestrogen and progesterone. This is often seen in athletes and in those who exercise intensively to lose weight on low-calorie diets. This Hypothalamic Anovulation (HA) is often confused with Polycystic Ovarian Syndrome (PCOS).
  • Poor quality and quantity of sleep is often the hallmark of hormone deficiency and accelerates further hormone depletion and ageing. It also increases insulin resistance, all-cause mortality and halts brain regeneration.
  • Obesity and metabolic disorder affect HPO axis and ovulation and steroidal hormone production.
  • Toiletries and personal care products contain endocrine disruptors which mimic the hormones in the body and disrupt natural hormone function. These chemicals with various environmental toxins are found in the breast milk and umbilical cord, affecting epigenetics of the offspring with long term consequences.
  • Stress eats up the hormone. In turn, the state of the hormone depletion causes a pathological stress response. It is a vicious cycle.
  • Malnutrition and processed food consumption do not facilitate reproduction. High-calorie malnutrition is rampant in industrialized society.
  • The Low-fat campaign has caused a disastrous effect on general health. Low-fat, low-cholesterol diet, still recommended by official guidelines, is based on flawed science.
  • Low-protein and low-fat intakes, low-calorie diets can cause anovulation and oestrogen deficiency in women and testosterone deficiency in men.
  • Avoiding nutrient-dense animal food that leads to a deprivation of quality protein, good fat, vitamins and minerals, therefore, decreases hormone production. Sex hormones are made from cholesterol. Cholesterol is very relevant in the maintenance of male and female fertility. Animal proteins and fats are the keys to countering a deficiency in any of the sex or adrenal hormones, which include oestrogen, progesterone, testosterone, DHEA, aldosterone, pregnenolone, and cortisol. For hormone/immune/nervous system restoration, Dr.Ryu recommends low-carb, Paleo diet as a basic dietary template.
  • A high carbohydrate diet with grains and starches dysregulates blood sugar and causes insulin surges which put sex hormones out of balance.  A high sugar, high carb diet promotes yeast and fungal bacteria proliferation in the gut and wreaks havoc with the hormone and immune systems.
  • Consuming a large amount of fibre, especially from cereal grain, can decrease hormone levels.
Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

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