Women's health

Two hormones share the cycle: oestrogen builds up, progesterone calms down. Their ratio in the second half of the cycle is the real information — a single value on the wrong day tells you little.

On top of that come the things that shift the cycle from outside: sustained strain, the thyroid, an iron deficiency. And the flora that lives on oestrogen.

Analysen

What is measured here

7 Analysen · €75 bis €325

Whole Blood Mineral Analysis – Figure 1 of 5

Kapillarblut

VollblutmineralanalyseIron, zinc, selenium, copper and magnesium inside the cell. With heavy bleeding, iron is the most common bottleneck.

Eisenintrazellulär

€75,00 Ansehen

Speichel

Cortisol-TagesprofilCortisol in the morning, at midday and in the evening, plus DHEA. The value that the stress axis in step 01 hangs on.

3 MesspunkteDHEA

€155,00 Ansehen

Speichel

Women's hormone profileOestradiol, progesterone, testosterone, cortisol and DHEA from one sample — taken in the second half of the cycle, where the ratio can be read.

Oestradiolprogesterone2nd half of cycle

€160,05 Ansehen

Abstrich

Vaginal microbiomeMake-up of the flora, share of lactobacilli and detection of the most common problem organisms.

LaktobazillenpH-Milieu

€193,21 Ansehen

Vaginal flora with aromatogram – Figure 1 of 4

Abstrich

Vaginal flora with aromatogramThe same analysis of the flora, plus testing of which essential oil inhibits the organisms found.

FloraAromatogramm

€193,21 Ansehen

Kapillarblut

OM VitalTSH and ferritin together with hs-CRP, homocysteine, B12, selenium and zinc — the values that belong alongside the hormone axis in a work-up.

TSHFerritinhs-CRP

€205,00 Ansehen

Kapillarblut

Prevent 36075 values from one sample, among them oestradiol, testosterone, DHEA, TSH, ferritin and 18 amino acids.

75 Werte120 µl

€325,00 Ansehen

Figure 1 · The duo

A duo, two phases

Each hormone has its time in the cycle. Only measured together, and on the right day, do they add up to a picture.

Build-up phase Östrogen

Activity Rules the first half of the cycle (follicular phase).

Effect Builds up the lining of the womb and stimulates ovulation.

Body & mind Brings good mood, drive and firm skin.

Measurable Oestradiol in saliva, in the women's hormone profile and in Prevent 360.

Quiet phase Progesteron

Activity Dominates the second half of the cycle (luteal phase), after ovulation.

Effect Remodels the lining and secures the implantation of an egg.

Body & mind Has a calming effect, promotes sleep and relaxes the nervous system.

Measurable Progesterone in saliva, in the women's hormone profile — sample around cycle day 19 to 23.

What “oestrogen dominance” means — and does not

—What gets described is breast tenderness, water retention, irritability before the bleed and heavier bleeding.

—These symptoms can have other causes — thyroid, iron deficiency and strain are on the list too.

—What is informative is measuring both values on the right day, not a single oestrogen value.

—The term itself does not appear in the guidelines. It describes a ratio, not a diagnosis.

—With an absent cycle, very heavy bleeding or a wish to conceive over a longer period, the assessment belongs in a gynaecological practice.

Figure 2 · Stress axis

Why strain reaches the cycle

The pathway has been described and runs through control in the brain, not through the ovaries. Four steps, and at the end of them the progesterone phase is missing.

Step 01 Sustained strain Physical or psychological, over weeks. The stress axis stays active instead of switching between tension and recovery.

Daily cortisol profile

Step 02 Control is throttled back In the hypothalamus the pulsatile release of GnRH is inhibited — the described mechanism of functional hypothalamic disorder.

Cortisol

Step 03 Ovulation shifts Less signal to the ovary means later ovulation, or none. The cycle becomes longer or irregular.

Estradiol

Step 04 The quiet phase is missing No ovulation means no corpus luteum and so hardly any progesterone. Oestrogen then carries on without a counterpart.

Progesterone

The role of cortisol

The “pregnenolone steal”

—Cortisol and progesterone go back to the same biochemical origin.

—Under lasting stress the body produces cortisol by preference.

—On this model, the available progesterone level then falls.

The everyday effects

—A state like oestrogen dominance arises — too much oestrogen relative to progesterone.

—Typical signs are sleep problems, strong PMS symptoms, inner restlessness and an irregular cycle.

Both hormones go back to pregnenolone as a shared precursor. The term “pregnenolone steal” describes a model for this link; as a mechanism in humans it is not conclusively evidenced. Both values can be measured — cortisol in the daily profile and progesterone on the right day of the cycle.

The cycle gets longer The first phase drags on, ovulation comes later. Cycle length varies more than usual.

Cycles without ovulation They can look unremarkable — a bleed happens, but there was no ovulation and so no progesterone phase.

Progesterone low On the measuring day in the second half of the cycle the value comes out low, although oestrogen is within range.

Under very high strain Being underweight, very intensive training or sustained stress can stop the cycle — a reason for medical assessment.

GnRH throttled back The described mechanism In functional hypothalamic amenorrhoea the pulsatile release of GnRH is reduced. Triggers are energy deficit, strain and intensive training — singly or together.Endocrine Society, Clinical Practice Guideline 2017

3.7 to 20 % Luteal phase deficiency in fertility problems The range is the real message: in reviews it runs from 3.7 to 20 per cent, in single analyses up to 31 per cent — because there is no uniform definition. A second half of the cycle under twelve days counts as shortened; the ASRM sets the limit at ten days.OBG Management 2017, review; ASRM 2021

5 % Shortened luteal phase without a fertility problem A short second half of the cycle occurs in about five per cent of ovulatory cycles, including in women who menstruate regularly. A single unusual cycle is not a finding.OBG Management 2017, review

Figure 3 · Vaginal microbiome

Lactobacilli, pH value and what disturbance does

The flora lives on glycogen, which oestrogen brings into the mucosal cells. Lactobacilli turn it into lactic acid — hence the acidic pH that keeps other microbes away.

State 1 Stabil

Laktobazillen

dominant

pH-Wert

pH 3.8 to 4.5

Lactobacilli dominate the environment and produce lactic acid. The low pH keeps other organisms out.

lactic acidglycogen from oestrogenH₂O₂ production

State 2 Übergang

Laktobazillen

vermindert

pH-Wert

pH 4.5 to 5.0

The range of other organisms widens, without there necessarily being any symptoms. Often after antibiotics, or varying with the cycle.

possible without symptomsunstableworth rechecking

State 3 Gestört

Laktobazillen

niedrig

pH-Wert

pH above 5.0

Anaerobic bacteria predominate. Discharge and odour are typical — the picture of bacterial vaginosis, which is treated by a doctor.

Gardnerella among othersmedical treatmenthigher risk of infection

What shifts the environment

AntibioticsDouching and intimate washesFalling oestrogenSmokingFrequent change of partnerSustained stressLittle sleep

3.8 to 4.5 pH value in a stable environment Lactic acid from lactobacilli holds the pH in this range. Values above it are taken as a sign that the flora has shifted.Specialist literature on the vaginal microbiota

most common cause Bacterial vaginosis with discharge Bacterial vaginosis is the most common cause of altered discharge in women of childbearing age. It is diagnosed and treated by a doctor.Guidelines on bacterial vaginosis

Oestrogen as the basis Why it tips during the menopause Oestrogen fills the mucosal cells with glycogen — food for the lactobacilli. When oestrogen falls, they lose their basis and the pH rises.Specialist literature on vaginal atrophy

Figure 4 · Aromatogram

Which essential oil inhibits the microbe

A test method modelled on the antibiogram: instead of antibiotics, essential oils are tested against the cultured microbe.

01 Swab The sample is taken from the vaginal lining. With our set you take the swab yourself at home.

02 Culture The microbes are grown in the laboratory. That needs living microbes — which is why this test takes longer than sequencing alone.

03 Testing As in a classic antibiogram, it is checked which essential oil inhibits the growth of the microbes most strongly.

04 Result The lab report serves as the basis for an individually made-up preparation.

What a result looks like

Tea tree

strongly inhibiting

Thyme (thymol)

strongly inhibiting

Oregano

inhibiting

Lavender

weakly inhibiting

Rose geranium

barely inhibiting

An illustrative sample report, not values from an actual test. Which oils appear in the report depends on which microbes were cultured.

Where we stand on it

—The aromatogram is a test method, not a treatment. It says which oil inhibits the cultured microbe in the laboratory.

—What inhibits on the plate need not do the same in the body. The two are not equivalent.

—Whether a preparation is right for you, and in what form, is something you discuss with our expert network.

—With symptoms involving fever or pain, or during pregnancy, the assessment belongs first in a gynaecological practice.

Quellen

Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline, 2017.
Luteal phase insufficiency, Gynäkologische Endokrinologie, Springer.
Diagnosis and treatment of luteal phase deficiency — a committee opinion, ASRM 2021.
Luteal phase deficiency: What we now know, OBG Management 2017 — prevalence ranges and definition of luteal phase length.
Reviews of the vaginal microbiota: lactobacilli, pH value, oestrogen and glycogen.
Guidelines and reviews on bacterial vaginosis.
Specialist literature on the aromatogram as a test method modelled on the antibiogram.

Questions and answers

Common questions

Free initial consultation

Why does the day of the cycle matter for the test?

Progesterone is only produced in any relevant amount after ovulation. In the first half of the cycle the value is naturally low — measuring there tells you nothing about the second half.

The window is about five to seven days after ovulation, so around day 19 to 23 in a 28-day cycle. With a different cycle length it shifts accordingly.

Is oestrogen dominance a diagnosis?

No. The term describes a ratio: oestrogen within range or raised, progesterone too low in the second half of the cycle. It does not appear in the guidelines.

The symptoms described can also come from the thyroid, from iron deficiency or from sustained strain. TSH and ferritin are in OM Vital and in Prevent 360; fT3, fT4 and thyroid antibodies are not available from us as a self-test — they can be tested at a medical practice, so ask our expert network about them.

How is stress connected to the cycle?

Sustained strain damps down the pulsed release of GnRH, the controlling hormone, in the hypothalamus. Ovulation then shifts or fails to happen — and without ovulation there is no progesterone phase.

Cortisol and progesterone also share pregnenolone as a common precursor. The term “pregnenolone steal” describes the idea that under lasting stress the body favours making cortisol, leaving less progesterone available. As a mechanism in humans this is not conclusively established — both values can be measured.

What is a vaginal aromatogram?

A laboratory test that works out which essential oils inhibit the growth of the organisms found. After a swab, the organisms are cultured and tested against a range of oils.

With our kit you take the swab yourself at home. Because culturing needs living organisms, this test takes longer than sequencing alone. The result serves as the basis for an individually prepared formulation — whether and in what form is something you discuss with our expert network.

Does this replace the gynaecologist?

No. These tests give you measured values with the laboratory's reference range. A diagnosis is made by a doctor.

A cycle that stops, very heavy bleeding, trying to conceive over a longer period, and symptoms with odour, burning or pain all belong in a gynaecology practice.

Your Partner in Health

All figures are study results and describe groups, not individual cases. An absent cycle, very heavy bleeding, a wish to conceive over a longer period and symptoms with odour, burning or pain belong in a gynaecological practice.