Sex hormones are chemicals responsible for reproduction and sexual desire. Common female sex hormones include estrogen and progesterone, while testosterone is abundant in most males.
Sex hormones are produced by the ovaries, testes, endocrine system, and adrenal glands. Menstruation, age, and certain medical conditions can cause fluctuations in sex hormones. Females and males can balance sex hormones through hormone deprivation or replacement therapy.
This article will review sex hormone production, function, and ways to achieve hormonal balance.
Sex vs. Gender
This article uses the terms “male” and “female” as labels referring to a person’s chromosomal, anatomical, or biological makeup without regard to which gender or genders they identify with.
Where Are Sex Hormones Produced?
Females and males have different sex hormones. However, they do share some of the same ones but each with different functions.
Females
The main hormones that contribute to sexual health and desire in females are estrogen, progesterone, and testosterone. Although the ovaries are responsible for most female sex hormones, other tissues can also produce them. These include:1
- Estrogen (estradiol, estrone, estriol): Although made primarily by the ovaries, estrogen is also produced by the adrenal glands and adipose (fat) tissue.
- Progesterone: Besides the ovaries, progesterone is produced by the adrenal cortex, corpus luteum, and placenta.
- Testosterone: Although more abundant in males, testosterone is also essential in females. Testosterone is made in small amounts by the ovaries and adrenal glands.
Males
Androgens are the main sex hormones produced by males. Androgens are responsible for male characteristics and reproduction. Several types of androgens are made in the male body, which include:1
- Testosterone: Produced in the Leydig cells of the testes and small amounts in the adrenal gland.
- Dihydrotestosterone (DHT): In adults, about 10% of testosterone is metabolized into DHT by the enzyme 5-alpha reductase. A rise in DHT levels initiates puberty in younger males.
- Estrogen: This hormone plays a vital role in males. In addition to being produced by the testes, the enzyme aromatase converts testosterone into estrogen.2
Function of Each Sex Hormone
Sex hormones are not only responsible for sexuality and fertility but also are crucial for the growth and development of muscles and organs.1 Additionally, sex hormones help prevent medical conditions such as cardiovascular disease and bone deterioration.
Growth and Development
Estrogen is responsible for the sexual and reproductive development of females. Breast development, pubic and armpit hair, and the start of menstruation are all influenced by estrogen.1
Progesterone contributes to a healthy uterine lining for the implantation and growth of a fertilized egg.3 Progesterone is also essential for maintaining pregnancy and reducing bleeding and miscarriage.
Testosterone and DHT initiate puberty in young males.1 These hormones are responsible for penile and testicular growth, growth in height, and facial hair growth.
Arousal
Estrogen and testosterone are the main hormones affecting arousal and sexual desire. In females, the menstrual cycle causes fluctuations in sex hormones, resulting in feeling more aroused just before ovulation, when estrogen levels are at their highest.4
High levels of progesterone, however, can cause a decrease in sexual desire. Although testosterone may increase libido in some females, estrogen is the primary sex hormone linked to female sexual desire.4
In males, testosterone levels correlate to male libido. Age, obesity, and hypogonadism decrease testosterone, thereby reducing sexual arousal.
Organ Health
Estrogen and testosterone are important in preserving muscle strength as you age. In the first year of menopause, for example, about 80% of a female’s estrogen is lost, resulting in significant muscle loss and frailty.
Decreased estrogen levels can lead to osteoporosis (decrease in bone mass and density) and increased risk of cardiovascular events. Testosterone improves cachexia (complicated metabolic syndrome characterized by muscle mass loss) in cancer and other inflammatory-based conditions.5
Immune System
One study showcased how sex hormones influence immune system cells. Androgens (testosterone and DHT) and progesterone boost an immunosuppressive response (improving autoimmune disorders), while estrogen strengthens humoral immunity (the body’s ability to fight infection). However, more research is needed.6
Mood and Brain Function
Research continues to prove that sex hormones affect the entire brain. Depression, memory loss, brain plasticity, and mood disorders result from decreasing estrogen levels. Cognitive impairment during menopause has been shown to improve with estrogen treatment and may protect against stroke damage, Alzheimer’s disease and Parkinson’s disease.7
How Sex Hormones Fluctuate
Hormone fluctuation is normal in both sexes. Premenopausal females will experience hormonal changes throughout the menstrual cycle. Estrogen and progesterone levels are low just before the start of menstruation but are higher around ovulation. As females age, sex hormone levels drop, leading to menopause.8
In males, testosterone levels are highest in the morning and decrease throughout the day. Testosterone decreases at 1% to 3% yearly between 35 and 40.5
Sex Hormone Disorders
Sex hormone disorders can affect physical and mental quality of life. In some instances, they can even be deadly. Types of sex hormone disorders include:
- Premenstrual dysphoric disorder (PMDD): Due to falling levels of estrogen and progesterone 10 to 14 days before menstruation, severe depression and anxiety can be experienced by some females. PMDD affects approximately 5% of premenopausal females.9
- Menopause: Females 45 to 55 will begin to notice the inevitable symptoms of decreasing estrogen and progesterone levels. Brain fog, reduced muscle mass, and hot flashes are common symptoms of menopause.10
- Erectile dysfunction (ED): As testosterone levels fade with age, having and maintaining an erection can be difficult. ED usually occurs in men over age 50.11
- Hyperestrogenism (high estrogen levels): Too much estrogen can cause certain types of cancer, polycystic ovary syndrome (PCOS), and infertility.
- Hyperandrogenism (high androgen levels): Too much testosterone can cause PCOS, hirsutism, acne, male-pattern baldness, menstrual irregularities, infertility, and virilization.
Can You Balance Sex Hormones?
Understanding the cause of sex hormone imbalances is essential to creating a treatment plan. If the sex hormone imbalance is due to a medical condition, then treating that condition should be considered. If the hormonal imbalance is due to aging or there is no treatment for the cause, then the following options could help improve sex hormone imbalances.
- Lifestyle: Eating a well-balanced diet, exercising, maintaining a healthy weight, eliminating alcohol use, and getting enough sleep can impact hormone levels in a positive way.12
- Herbs and supplements: Some herbs and supplements claim to restore hormonal balance. Nigella sativa could increase estrogen levels, improving the symptoms of menopause.13
- Hormone therapy (HT): Replacing estrogen, progesterone, and testosterone with synthetic (human-made) forms can help increase low levels of sex hormones. HT can be given as oral medication, patches, creams, vaginal suppositories, subdermal pellets, or injections. Birth control is a form of hormone therapy. HRT is also a vital part of gender-affirming care.14
- Hormone deprivation therapy: Some medications block hormones, reducing the effects of having too much of a particular hormone. Aromatase inhibitors, for example, prevent estrogen production, and gonadotropin-releasing hormone analogs and antagonists are used to block estrogen, progesterone, and testosterone. Gonadotropin-releasing hormone analogs are used to pause puberty in youths undergoing gender-affirming care.14
If you’re experiencing symptoms of sex hormone imbalances, talk to a healthcare provider about having a sex hormone blood test done to help identify potential imbalances.
Summary
Estrogen, progesterone, testosterone, and dihydrotestosterone (DHT) are sex hormones in males and females. Sex hormones are important in reproduction, fertility, sexual desire, and overall health. Sex hormones fluctuate with the menstrual cycle and with age.
There are several ways you can balance sex hormones, including lifestyle changes and medications. Talk to a healthcare provider if you believe you’re experiencing symptoms of a sex hormone imbalance.
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