Related post: Why All Women Should Take the Dutch Hormone Test
Since the DUTCH (Dried Urine Test for Comprehensives) technology came out, I’ve ordered many of these tests, including for myself. I recently retested my own Dutch from last year, and saw some interesting changes for the better. It inspired me to write a bit more about why I use this test, who I use it for, and why it’s useful to retest later.
The Dutch test is for any woman with hormone problems. Here are three examples:
1. Getting pregnant with PCOS
Polycystic Ovarian Syndrome (PCOS) is one of the most common reasons for “infertility.” Most PCOS women I work with do not know they have it, although others already have the diagnosis. PCOS usually comes with irregular menstrual cycles, hormone imbalances, and inconsistent or no ovulation. Hence these women often have trouble conceiving.
Often these women get rushed onto medications like Metformin (a diabetic medication), and assisted reproductive technology like insemination or IVF. Conventional medicine doesn’t have a great toolbox for PCOS, and education about it is lacking. I love helping women with PCOS resolve underlying hormone imbalances, regulate their cycles, and conceive naturally!
Note that PCOS spans a wide spectrum, with many nuances and types. I will write more about this soon, as women with this condition make up a large part of my practice, and it’s one of my pet specialties.
With the Dutch test and PCOS, we get answers to these crucial questions:
- Are your “male” androgen hormones (DHEA and testosterone) too high?
- Is your progesterone too low?
- Do you have estrogen dominance?
- Are there obstacles to getting rid of (breaking down, metabolizing, detoxifying) bad or excess hormones?
When we get this information, we can nail the treatment so that we get results – regular cycles, ovulation, and conception.
2. Perimenopause symptoms
Perimenopause means before menopause. This period of time can begin as early as your late 30s, or in your 40s. It’s a natural time of life, not a disease. However; some women experience uncomfortable symptoms. Fortunately, it is possible to manage your symptoms so they disappear or aren’t a big deal.
Symptoms include short overall menstrual cycles, such as having a period every three weeks instead of every 28 days. You may have PMS symptoms such as sore breasts, bloating, irritability, anxiety, or headaches. Your periods can be heavier, more painful, and exhausting. Sleep can tank. Hot flashes or sweating may emerge.
With perimenopause symptoms I always like to do the Dutch test. Then we can tell:
- • Is your progesterone low?
- • Are estrogens metabolizing properly, so that estrogen dominance is reduced?
- • Do you make enough melatonin?
- • How are your adrenal hormones functioning?
With these answers, we can find out if your perimenopausal symptoms are driven by adrenal dysfunction or HPA-D. Adrenal health is crucial for a healthy perimenopause. As sex hormone production from your ovaries declines, your adrenals take over, and produce small amounts of sex hormones.
It’s natural for women to experience estrogen dominance during perimenopause, and I will write more about this topic later. However, for some women estrogen dominance is trouble! Too much estrogen, from what you produce and what you absorb from the environment, can wreak havoc on hormone balance. It can set you up to grow fibroids, endometriosis, and reproductive cancers that are fed by estrogen.
Making sure that you metabolize and detoxify estrogen properly is essential. The single most important part of the Dutch hormone test for all women, in my opinion, is to find out about your estrogen metabolism.
3. Stressed out, anxious, tired, and insomniac
How is this related to sex hormones? This is when the adrenal portion of the Dutch test really comes into play. Adrenal hormones, primarily cortisol and DHEA, get disrupted with chronic stress (including emotional), inflammation, and even excess weight.
Sometimes the origin of adrenal disruption is old trauma. Or, it can be from perpetual daily life stress. There is also good stress, that you may thrive on and seek out, like the thrill of skiing down a mountain. It can also be chronic, like the busy entrepreneur who loves her work but never stops. Your body doesn’t necessarily know the difference between positive or negative stress. When stress becomes chronic, your adrenal hormones will take a hit.
This can cause fatigue, anxiety, and poor sleep. Adrenal hormonal disruption effects all other hormones in the interconnected endocrine web. This includes blood sugar and insulin (you may have have heard how high cortisol causes abdominal weight gain), thyroid problems, and reproductive sex hormone imbalances. For these reasons, checking out adrenal status is important when any hormone system is out of whack.
To read much more about stress and its effects, check out this blog series.
For people experiencing adrenal-related symptoms, the Dutch test can reveal:
- Is total cortisol high, low or just right?
- What is your cortisol curve – is it normal or is it backwards or disrupted?
- Are you producing the right amount of DHEA, which can be low with adrenal disruption?
When we get this information, we know exactly how to intervene. Otherwise it’s just guesswork. Symptoms like fatigue, insomnia and anxiety can be from high or low cortisol! We can put the cortisol information together with the sex hormone information to nail down the most effective treatment.
My recent Dutch retest results
My cortisol diurnal curve in 2016 was one of the worst I’ve seen. Cortisol was way too high, and my diurnal curve was backward! I did a course of focused treatment to restore my adrenal function, which always involves working with the nervous system as well. Adrenals don’t have their own intelligence, they are instructed by signals from the brain, specifically the hypothalamus and pituitary glands. Check out my 2016 messed up diurnal cortisol curve:
I’m happy to say that in 2017 my retest shows that I managed to fix my diurnal curve. There is still some work to do with the overall test results, but I’m happy to get my cortisol rhythm straightened out. It’s definitely reflected in how I feel: I am sleeping well and have good energy during the day – which was not the case when I did the test in 2016. Check out 2017:
Big hormone changes such as menopause, pregnancy and puberty, are when our endocrine systems can take a hit. Girls and women often develop thyroid, weight, or sex hormone problems during these times. Sometimes the immune system acts up, and autoimmune diseases appear. Other times it’s the nervous system that is most affected during hormone upheaval. Taking the Dutch test can prevent downward patterns and trends that we see before pregnancy or menopause, which will help you glide through these periods with much greater success.