10/15/2026
If your hormones had a traffic report, would it say:
🚧 backed up
⛽ running on empty
↪️ taking the wrong exit
⏰ completely off schedule?
In practice, I use four working patterns to organize the investigation. Most people overlap, but one pattern may deserve first place in the workup.
1️⃣Overloaded Clearance
I review liver and gallbladder history, bowel habits, medications, alcohol, and hormone exposure. Clues worth discussing include constipation, jeans that fit at 8 a.m. and pinch by lunch, breast tenderness 7 to 10 days before bleeding, heavy or clotty periods, and one glass of w**e causing next-day mutiny. Symptoms alone cannot confirm a clearance problem.
2️⃣Deficiency and Depletion
Cycles may stretch past 38 days or disappear. Hair collects near the shower drain. Libido goes quiet. Workouts take days to recover from. I assess energy availability, iron status, thyroid function, prolactin, nutrition, stress, sleep, and medication effects. Coffee and willpower are poor raw materials.
3️⃣Traffic Misdirection
This is the mixed picture: jawline acne or new chin hairs alongside scalp shedding, breast tenderness, bloating, or unpredictable moods. I look at ovulation, androgen activity, insulin signaling, thyroid function, medications, PCOS, and life stage. Mixed symptoms need a broad workup.
4️⃣Dysregulated Rhythm
Think awake at 2:47 a.m., dragging at 7, crashing at 3, then oddly alert at 9:30. Cycle length may swing from 26 days to 39. I review light exposure, shift work, sleep disorders, meal timing, training, and ovulatory patterns.
These patterns organize clinical questions. They do not diagnose the cause. Bring me the weirdly specific timeline. It is usually more useful than ‘my hormones are a mess.’
