By naturopath Margaret Jasinska

Approximately three quarters of patients with autoimmune disease are women. Why is that? Researchers think that female hormones play a significant role.

Women are at higher risk of developing an autoimmune disease following childbirth. Some autoimmune diseases fluctuate in intensity throughout the month, depending on the phase of a woman’s menstrual cycle. They tend to be worse in the week leading up to a period. Some autoimmune diseases go into remission during pregnancy, while others intensify markedly.

Oestrogen and progesterone are the main female sex hormones. Women also produce male hormones (called androgens), such as testosterone, albeit in much lower quantities than men. Oestrogen is predominantly produced during the first half of the menstrual cycle. It stimulates thickening of the endometrium, preparing it for pregnancy. Progesterone is produced in the second half of the menstrual cycle, following ovulation.

Oestrogen tends to have a bad reputation because in some situations it can promote the development of endometriosis, uterine fibroids, painful breasts, heavy menstrual bleeding, breast cancer and PMS. An imbalance between oestrogen and progesterone is extremely common and this is known as oestrogen dominance. There is too little progesterone in relation to oestrogen. Any medical condition that inhibits ovulation will also produce a progesterone deficiency. Polycystic ovarian syndrome is the most common example. Stress can also inhibit ovulation, and the lack of ovulation can aggravate an existing autoimmune disease.

The sex hormones are known as steroid hormones because they have a steroid like structure and are closely related to cholesterol and cortisol. Steroids are commonly given to patients with autoimmune disease because they reduce inflammation. Prednisone is the most common example.

Steroid hormones have anti-inflammatory effects and this is also true for progesterone. This is not surprising when you consider that progesterone and cortisol are both manufactured from cholesterol, and progesterone is just one step further down the production chain.

Women with autoimmune disease commonly experience an aggravation or flare in the second half of their menstrual cycle if they are not producing adequate progesterone. This can be ameliorated well with the use of a natural bio-identical progesterone cream. You can also support progesterone production by ensuring your diet contains sufficient vitamins and minerals and healthy fats (since progesterone is mostly made of fat). However, if you have an autoimmune disease and are low in progesterone, you should experience faster improvements in your wellbeing with a bio-identical progesterone cream. This cream requires a doctor’s prescription.

Symptoms of progesterone deficiency

If you are suffering with an autoimmune disease and you experience several of the following symptoms, you may benefit from progesterone:

  • Heavy menstrual bleeding
  • Painful periods, especially if the pain lasts more than 24 hours
  • Irregular menstrual periods
  • Endometriosis
  • Uterine fibroids
  • Adenomyosis (thickening of the uterine muscle)
  • Endometrial hyperplasia (excessively thick uterine lining)
  • Premenstrual syndrome (PMS)
  • Polycystic ovarian syndrome (PCOS)
  • Postnatal depression
  • Scalp hair loss or thinning
  • Breast pain or lumpy breasts
  • Insomnia in the week before menstruation

Other hormone deficiencies

People with autoimmune disease often suffer with low levels of certain hormones. Low levels of adrenal gland hormones are common in people with adrenal gland exhaustion. We often discover low levels of the hormone DHEA (dehydroepiandrosterone), and sometimes the patient greatly benefits from the prescription of bio-identical DHEA.


Pregnenolone is a steroid hormone made in your body from cholesterol. It is considered a mother hormone because your body uses it to produce a large range of other hormones. It can be used to produce progesterone, androgens (male hormones), oestrogen and hormones made by the adrenal glands. Pregnenolone helps to reduce inflammation in your body. It has similar actions to cortisol.

Long term illness, stress, exhaustion and nutrient deficiencies can create a deficiency in this hormone, and this is typical in autoimmune patients. Taking pregnenolone in supplement form can help to reduce aches and pains and improve energy and stamina. It has many of the benefits of steroids such as prednisone, without the harmful side effects, as long as it’s used in an appropriate dose. Pregnenolone requires a doctor’s prescription and needs to be made by a compounding pharmacy.


Oestriol is a type of oestrogen. Women actually produce three different types of oestrogen in their bodies: oestriol, oestrone and oestradiol. Oestriol is the mildest form. Some women with autoimmune disease suffer with prematurely low levels of oestrogen, and supplementing with this hormone can offer improvements for some conditions.

Research conducted on women with multiple sclerosis showed that taking oestriol can reduce the risk of flare ups of the disease. This is because oestriol is able to reach the brain and protect brain cells from damage. Multiple sclerosis is one of those autoimmune diseases that usually improves significantly while a woman is pregnant, and then worsens after she gives birth. This is partly because oestrogen (and progesterone) levels become very high during pregnancy. Taking a small amount of oestriol and progesterone long term may offer women some of these benefits. Oestriol requires a doctor’s prescription.

As you can see, the role of sex hormones in autoimmune disease is very complex. Women experience far greater fluctuations in hormones than men, and this can have a significant impact on disease symptoms.

For more information see the book Healing Autoimmune Disease: A plan to help your immune system and reduce inflammation.

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