Hypothalamic dysfunction in women is an epidemic following what I call the “exercise revolution” that began about 1980 and the dramatic change in athletics for women in U.S. schools about that time. Women now feel ashamed if they don’t engage in some high-level sport, where just a few years prior, they were not expected to be involved in sports. The latter attitude was present for the 100 million years leading up to 1980. In addition to the dramatic increase in fertility issues it creates, low estrogen causes all the major psychiatric issues for women: PMS, migraine headaches, depression anxiety, ADD, bipolar etc. etc. This is a huge problem in our world.

The sensitization to stress seems to be permanent. Certainly, everything done to decrease stress brings the physiology back toward normal, but still needs some help. Almost every woman with this problem needs supplemental estrogen to feel normal. Amenorrhea is the dramatic example, but the vast majority of women suffering from this have very subtle ovulation and menstrual changes resulting in 30-32-day cycles, something that is seen as normal by almost all physicians including reproductive medicine physicians. Only the amenorrheic patients are getting any press in the medical literature and they are few and far between. In the exercise world, these are the marathoners and the triathaletes. The keto diet relieves any nutrtitional stress that is present, i.e. hypoglycemia.

Michael D. Fox, MD