Why hormones matter with Dr Nicky Keay

Hormones are chemical messengers produced by endocrine glands (including ovaries, testes, thyroid, pituitary and adrenal) that have far reaching effects throughout the body.

Some of the most important include thyroid hormones and sex steroid hormones

Low oestrogen and progesterone, as seen in menopause or functional hypothalamic amenorrhoea (loss of periods with no medical cause) which can lead to:

• Loss of bone mass 

• Increased risk of osteoporosis & bony stress fractures

• Higher cardiovascular disease risk

• Mood changes due to altered neurotransmitter production

There are also other hormones that play a role in bone health and adaptation to exercise such as insulin-like growth factor-1 (IGF-1)

The importance of hormones 

Sex steroid hormones, oestrogen and progesterone for women and testosterone for men, are key for reproductive health. 

These hormones also influence other systems of the body such as:

• Body strength 

• Cardiovascular health 

• Neurotransmitter production 

• Exercise adaptation

When a dancer has an energy deficit, hormone production is reduced to conserve energy.

This can result in multiple issues including: 

• Loss of menstrual cycles due to functional hypothalamic amenorrhoea 

• Low IGF-1 due to suppression of the brain-hormone system that regulates growth, recovery & metabolism

• Impaired bone health 

• Reduced ability to adapt to training 

Impacts of hormonal treatments 

Hormonal treatments such as the oral contraceptive pill (OCP) contain oestrogen and progesterone to prevent ovulation.

They produce regular withdrawal bleeds however these are not menstrual periods, and it is therefore not recommended in cases of REDs as it can mask internal hormone suppression. 

Studies have also shown the OCP to  play a detrimental role in bone health,  decreasing levels of active, unbound IGF-1. 

Hormonal treatments such as Hormone Replacement Therapy, also known as HRT have been shown to improve bone mineral density. These involve transdermal oestradiol and cyclic micro-ionised progesterone. 

This can be utilised short term but it is crucial that the wider issue of LEA is addressed in cases of REDs. 

How can dancers help their hormones 

There are several ways dancers can help their hormones. Firstly, it is important for dancers to keep themselves adequately fueled throughout the day. Recognising periods of high energy demand and adapting fuelling and recovery needs around these is also key.  Prioritising sleep and rest for your hormones to drive positive adaptations as well as strength training which can help reduce injury risk

Understanding your hormones is the first step. Protecting your health is the next.