Nutrition For Hormonal Balance

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Nourish to Flourish: Ancestral Principles and Bio-Individual Nutrition for Women’s Hormonal Health

The female body is a study in hormonal complexity and rhythm. When this system is supported, wom­en’s bodies are incredibly adaptive; when it is dis­rupted, the consequences can be far-reaching and deserve careful examination. Unlike men, whose hormonal pat­terns tend to remain relatively stable, women’s biochem­istry is inherently dynamic, shifting across life stages and fluctuating day to day throughout the menstrual cycle. This biological variability has been met with oversimplified, one-size-fits-all guidance that may work reasonably well for men but often fails to help women. Importantly, the impact of sex hormones extends far beyond reproduction: estrogen and progesterone play central roles in metabolic regulation, gut health, bone remodeling, brain function and cardiovascular health. As such, hormonal balance is not a niche concern but rather a foun­dational determinant of women’s health, well-being and longevity.

In the 1930s, during his global studies of traditional societies, Dr. Weston A. Price not only documented the robust health of ancestral populations but also observed the relative ease and regularity of pregnancy and childbirth, as well as overall health and vitality, among women consuming their native diets. He described a visible contrast between women nourished by traditional foods and those increasingly affected by what he termed the “displacing foods of modern commerce.”¹ Fast forward to the modern woman—emotional burnout, stubborn weight changes, infertility struggles and metabolic illnesses have become increasingly common. A legacy of institutionalized dietary advice that lacks critical nutrients for female hormonal and metabolic stability has left many women depleted of vitality and resilience, some living with life-altering suffering driven by hormonal imbalance.

FOUNDATION FOR HORMONAL HEALTH: NOURISH THE HPO AXIS

Female clients frequently express frustra­tion with what feels like an unfair reality: they adopt dietary interventions such as intermittent fasting, ketogenic diets applied without regard to hormonal phenotype or other highly restrictive, low-calorie, diet-and-exercise plans, only to experience outcomes that differ markedly from those of their male partners. Whereas men may see at least short-term improvements in weight, body composition and perceived energy, women often report that the same approach backfires. Common consequences include unfavorable shifts in body composition despite weight loss on the scale, worsening metabolic and hormonal markers and heightened stress responses often reflected in dysregulated cortisol on testing panels.

These sex-specific differences are largely explained by the hypothalamic-pituitary-ovari­an (HPO) axis (see Figure 1)—a communication system that links energy availability (“Am I getting enough food?”), nutrient building blocks (“Am I getting adequate dietary fat, glucose and micronutrients?”) and other perceived stress­ors with female reproductive and metabolic function.

The key takeaway for women is that the HPO axis is highly sensitive to nutritional status. Unlike the male hor­monal environment, which is relatively resilient to short-term energy stress, the female HPO axis quickly shifts away from reproduction when nutrient availability is insufficient. An inadequate or imbalanced intake of calories, fat, protein, carbohydrates or key micronutrients can disrupt this communication, reduce ovulatory function and contribute to broader hormonal and metabolic disturbances.^2,3

THE BURDEN OF MODERN DIETS

The standard American diet—high in refined carbohydrates, inflam­matory seed oils, neurotoxic monosodium glutamate (MSG) and other chemical additives—does little to support female hormonal health. With nearly half of U.S. adults estimated to fall along the diabetes–prediabetes spectrum,⁴ blanket high-carbohydrate patterns that are too low in healthy fats and adequate protein are a poor fit for metabolic vulnerability, pro­moting insulin resistance—the hallmark of poor metabolic health.

MSG, added to most ultra-processed foods, has been shown to dam­age the arcuate nucleus of the hypothalamus, a key center for appetite and energy regulation.⁵ Used as a flavor enhancer to increase palatability and reward signaling, MSG disrupts normal hunger and satiety cues, increas­ing the likelihood of overeating and subsequent obesity. This modern dietary pattern quietly reshapes female hormonal signaling, promoting unfavorable sex hormone balance, disrupting appetite-regulating hor­mones and ultimately undermining female resilience.^6-9

When metabolic regulation is impaired, it directly affects hor­mone balance. Chronically high insulin lowers sex hormone–binding globulin (SHBG), a liver-made protein that acts like a hormone buffer by controlling how much testosterone and estrogen are freely active in the bloodstream. When SHBG drops, testosterone and estrogen can rise beyond healthy ranges (see Figure 2). Excess body fat adds another layer by converting androgen hormones into estrogen. Together, these shifts can disrupt the menstrual cycle, interfere with ovulation and contribute to patterns seen in polycystic ovarian syndrome (PCOS), a condition closely tied to metabolic health.^7,8

TWO ENDS OF THE MODERN HORMONAL LANDSCAPE

In clinical practice, I tend to see two ends of the spectrum. On one end are women still bearing the burden of historically misguided dietary guidelines, chronically low in healthy fats and excessively high in refined grains and industrial seed oils, culminating in the ultra-processed “Fran­kenfoods” that now dominate the modern food supply. These women often present with features including dysregulated blood sugar, chronic low-grade inflammation and excess body fat, all of which are associated with reduced fertility and a higher prevalence of androgen-dominant conditions such as PCOS, as well as—ironically—estrogen-dominant patterns.

On the other end of the spectrum is the highly health-conscious woman, often in­fluenced by Instagram-era wellness trends. Combining low-fat, low-carbohydrate and low-calorie patterns can drive body fat levels below what is physiologically protective for women. Research consistently shows that body fat levels below approximately 20 to 22 percent are as­sociated with impaired ovulation,¹⁰ increased rates of anovulatory cycles (no ovulation) and, in more severe cases, complete menstrual ces­sation, hallmarks of functional hypothalamic amenorrhea (FHA) and relative energy defi­ciency in sport (RED-S).

Excessively low body fat can create its own risks for postmenopausal women. After ovarian estrogen production declines, body fat becomes an important site of estrogen production and storage. Estrogen supports vascular, bone and muscle health; very low body fat may, therefore, increase risk of conditions including sarco­penia and osteoporosis through both reduced mechanical loading on bone and diminished estrogen signaling.¹¹

Women’s bodies are highly sensitive to both excesses and inadequacies in macronutrient balance—protein, fat and carbohydrate—as well as micronutrient depletion. These risks be­come increasingly likely when diets move away from the ancestral nutrient density so clearly documented by Weston A. Price in Nutrition and Physical Degeneration.¹ Thus, this article serves as a bridge between ancestral wisdom and modern understanding of female physiology as it intersects with nutrition.

MACRONUTRIENTS: MODULATORS OF CELLULAR SIGNALING

The following framework helps women adjust macronutrient intake—the balance of protein, fats and carbohydrates—to support their individual hormonal needs. Why is this necessary, one may ask? A whole-foods diet prepared according to ancestral principles is always the foundation, but most modern women are not beginning with the metabolic resilience common in preindustrial societies. Decades of processed foods, environmental exposures, chronic stress, circadian disruption and epigen­etic influences have left many with underlying metabolic dysfunction.

While returning to traditional, nutrient-dense foods is the bedrock, restoring hormonal balance may require thoughtful macronutrient refinement based on individual physiology. The goal is not rigid long-term tracking, but building awareness so sustainable adjustments can be made. For women unfamiliar with their baseline intake, a brief tracking period can be illuminating. Simple nutrition app tools can calculate nutrients automatically, keeping the focus on learning what balanced intake looks like in real meals.

For example, a higher-fat diet consisting of 60 percent or more calories derived from fat (Figure 3) does not inherently require meals swimming in added fats. Pasture-raised eggs cooked in butter with cheese and sauerkraut, or wild salmon with vegetables dressed with butter, can naturally fall near this range because fat provides roughly 9 kcal per gram compared with only 4 kcal per gram for protein and car­bohydrates. A pattern closer to 45 percent fat, 20 percent protein and 35 percent carbohydrate (Figure 4) might center on a protein-anchored plate of meat or fish, vegetables, fruit or roots and moderate amounts of traditional fats—still abundant and satisfying.

It is worth noting that macronutrient per­centages cannot be translated into exact uni­versal food quantities because caloric needs vary widely—from roughly 1,800 kcal for a smaller, sedentary woman to over 3,000 kcal for a highly active athlete—making fixed prescriptions misleading. After gaining context, most women can return to intuitive, real-food eating guided by physiological feedback rather than numbers.

PRIORITIZING PROTEIN

Protein, derived from the Greek proteios, meaning “of first impor­tance,” is a foundational component of the diet. Unlike fats and carbohy­drates, which serve as primary energy sources, protein provides structural building blocks for hormones, neurotransmitters, tissues and enzymes.

Adequate protein intake supports several foundational physiological processes. Protein helps regulate appetite through production of hormones that influence satiety, and it slows digestion in a way that reduces post-meal blood sugar swings.^12,13 Together, these effects play an important role in metabolic stability and female hormonal regulation.^9,14

As estrogen declines with age, particularly during perimenopause and menopause, women experience greater difficulty maintaining muscle mass. Sufficient dietary protein is, therefore, essential for stimulating muscle protein synthesis, preserving lean body mass and supporting metabolic health across the lifespan.¹⁵

Protein quality is as important as quantity. Complete proteins provide the essential amino acids needed for effective metabolic signaling. While some plant foods qualify as complete proteins, animal-derived proteins generally offer more favorable amino acid availability^16,17—and uniquely supply compounds such as creatine, which is increasingly recognized as relevant to female hormonal health.

Evidence from an NHANES (National Health and Nutrition Exami­nation Survey) analysis highlights the hormonal relevance of creatine intake. Women consuming less than 13 mg/kg of body weight were 26 percent more likely to require hormone replacement therapy, 33 percent more likely to report irregular menstrual cycles, 42 percent more likely to undergo hysterectomy and 68 percent more likely to experience pelvic infection.¹⁸ These findings underscore the fact that adequate protein, and its associated bioactive compounds, is not solely an athletic concern but a determinant of hormonal and reproductive health.

With that said, female protein needs vary across the lifespan and depend on many person­al factors, including genetics, digestive capacity, activity levels and hormonal status. Protein absorption often declines with age as stomach acid decreases, a common consequence of low-grade inflammation, gut imbalance and subtle nutrient deficiencies (such as too little salt). Protein needs also shift during key life phases such as pregnancy, lactation, periods of stress or injury and through hormonal transitions like perimenopause and menopause, when changes in estrogen can reduce insulin sensitivity and accelerate lean mass loss.^19-21

A practical intake range that respects bio-individual needs is approximately 1.2–1.8 g/kg (0.55–0.82 g per pound of body weight), with the higher end often being appropriate during pregnancy, lactation, recovery from illness or injury, for those who have high exercise de­mands and during major hormonal transitions, where adequate protein helps preserve muscle and metabolic resilience.²² For a woman weigh­ing one hundred sixty pounds (seventy-three kg), this equates to roughly eighty-five to one hundred thirty grams of protein per day. In practical terms, this may look like three meals daily each containing a palm-sized portion of protein-rich foods (approximately three to four ounces cooked meat, fish or shellfish, provid­ing twenty-five to thirty grams of protein), with additional protein from eggs or dairy as needed to reach the daily total.

It should be noted that when higher protein intake is warranted, ensuring adequate vitamin A from foods such as butter, cod liver oil and liver becomes especially important to help maintain levels of this critical fat-soluble vita­min—which would be depleted with high intake of lean protein sources as opposed to protein balanced with adequate animal fats—needed for robust metabolic and hormonal health.

At the same time, more is not always bet­ter. The current trend toward very high protein intakes (often at or above 2.0 g/kg or 0.9 g per pound indiscriminately) can unintentionally crowd out other nutrient-dense foods, espe­cially when protein is obtained primarily from powders or highly processed products rather than whole foods. This may reduce intake of key minerals and fat-soluble vitamins that are essential for long-term hormonal health.

Additionally, historical accounts from indigenous populations of the Canadian Arctic and Alaska, as well as explorers and fur traders of the late nineteenth and early twentieth centu­ries, described a condition termed rabbit starva­tion. This occurred when diets relied heavily on very lean wild game without sufficient dietary fat or carbohydrate. Individuals consuming this pattern developed nausea, profound fatigue, loss of appetite and signs of physiological starvation despite consuming large quantities of meat.²³

This phenomenon, a state of functional ammonia toxicity, is a consequence of rely­ing on protein as a primary energy source in the absence of adequate fat or carbohydrate. When protein is used for fuel rather than for structural and functional roles, its nitrogen must be removed and converted to urea in the liver through the urea cycle. This process has a finite capacity. Very high intakes of lean protein in­crease the nitrogen load placed on the liver, and when elimination cannot keep pace, the constel­lation of symptoms described historically can emerge.²³ For this reason, it is very important to pair muscle meats with natural fats such as butter and cream, and collagen-rich foods such as bone broth, skin-on meats and connective tissue cuts, thus helping balance amino acid intake, support metabolic processing, and pro­mote long-term resilience.

WHY FATS MATTER FOR FEMALE PHYSIOLOGY

Decades of low-fat dietary guidance, de­spite limited evidence of cardiovascular benefit, have coincided with rising metabolic dysfunc­tion that profoundly disrupts female hormonal health.^4,6,24 Dietary fats are essential for the production of sex hormones and their precur­sors, including estrogen, progesterone, DHEA and testosterone, synthesized from cholesterol via the parent hormone pregnenolone. Evidence shows that insufficient fat intake impairs female hormone function. A recent systematic review found that lower-fat diets were associated with a higher risk of bone stress injuries in women, likely reflecting reduced estrogen production resulting in impaired bone remodeling.²⁵ Ear­lier feeding studies, which often restricted fat further than more contemporary studies looking at fat intake and hormone production, similarly demonstrated reductions in circulating estrogen, progesterone and luteinizing hormone with low-fat diets.^26,27

Dietary fat supports metabolic stability by slowing digestion and helping keep post-meal blood sugar steady, which in turn supports insulin sensitivity and healthy HPO axis sig­naling. Fat is also essential for the absorption of fat-soluble vitamins (A, D, E and K2) and essential fatty acids, which play key roles in immune function, inflammation balance and ovarian and endometrial health.²⁸

For women, fat quality matters as much as fat quantity because ovarian and hypothalamic signaling are highly sensitive to inflamma­tory inputs. Industrial seed oils are a relatively recent addition to the human diet, becoming widespread in the early twentieth century with the rise of hydrogenation and shelf-stable fats such as Crisco.²⁹ Although industrial trans fats have largely been removed from the food supply—due in large part to the pioneering work of Dr. Mary Enig—non-hydrogenated polyunsaturated seed oils remain ubiquitous in modern diets.³⁰ In female physiology, these pro-inflammatory fats promote conditions in which inflammation plays a central role, such as PCOS and excessive menstrual pain and cramping. Inflammation can also disrupt how the body processes estrogen, shifting it toward less favorable pathways, sometimes referred to as “dirty” estrogen metabolites. This imbalance is often linked to stronger PMS symptoms, stub­born weight gain and mood swings.³¹

Prioritizing ancestral, minimally processed fats (such as grass-fed butter, pastured animal fats like tallow and lard, olive oil, avocados and traditional tropical oils), while eliminating seed oils high in omega-6, is critical for supporting women’s hormonal and metabolic health.21 Dur­ing the luteal phase, metabolic signaling shifts toward greater fatty acid oxidation, and insulin sensitivity temporarily decreases.^32,33 For this reason, some women feel and function better with an increase in dietary fat during the second half of the cycle.

For many women, a practical lower thresh­old for dietary fat intake may fall to around 45 to 50 percent of total calories. This level sup­ports hormone production and ensures adequate intake of fat-soluble vitamins, while still allow­ing sufficient protein and whole-food-based carbohydrates to sustain thyroid function and reproductive stability.

In practice, the women who do well on fat intakes below 45 percent—and they are the exception rather than the rule—are typi­cally highly insulin sensitive, with excellent metabolic and gut health, relatively low stress levels and high activity demands that often re­quire ready access to glycogen stores provided through higher carbohydrate intake.

In the context of insulin resistance, blood sugar instability and PCOS, higher fat intakes (often 60 percent or more within a well-formulated low-carbohydrate approach) may be particularly effective for stabilizing blood sugar, reducing excess androgen (including testosterone) production and supporting the menstrual cycle.^9,34

CARBOHYDRATES AND FEMALE HORMONAL PHYSIOLOGY

Carbohydrates—sugars and starches used for readily available energy—may be the most “Goldilocks” of the three macronutrients. Both excess and inadequate intake can carry meaningful metabolic and sex-hormone conse­quences for women. Accordingly, carbohydrate intake should be individualized to a woman’s personal carbohydrate threshold—the level that supports micronutrient sufficiency, gut func­tion and hormonal balance, while remaining below the threshold that promotes blood sugar dysregulation.

Whole-food carbohydrate sources con­tribute not only glucose but also vitamins, minerals, phytochemicals and dietary fiber that supports the gut microbiome, including the es­trobolome—the subset of microbes involved in estrogen metabolism in part via β-glucuronidase activity.³⁵ Dietary fiber from whole-food carbo­hydrate sources is also associated with improved blood sugar stability and more favorable lipid profiles.³⁶

Although carbohydrates are not technically essential, small-to-moderate intakes may play a regulatory role in female endocrine signal­ing. Very low-carbohydrate or ketogenic diets have been shown to reduce circulating free T3, the active thyroid hormone, particularly in the context of low-calorie diets.³⁷ While this may reflect adaptive signaling rather than overt hy­pothyroidism, reduced thyroid output is known to suppress hypothalamic activity and thus may negatively impact the menstrual cycle in susceptible women. This underscores biochemi­cal individuality: women with lower thyroid output, low or borderline low body fat or higher energy demands may benefit from slightly higher whole-food carbohydrate intake, while those with excess body fat, insulin resistance or PCOS often fare better with carbohydrate restriction, commonly less than 20 percent of total energy intake.³⁸

CARB CAUTIONS: ENERGY AVAILABILITY AND METABOLIC CONTEXT

Indiscriminate promotion of high-carbohydrate diets to “support hormones” is no more appropriate than universal carbohydrate restriction. When carbohydrate intake exceeds an individual’s personal carbohydrate tolerance, the resulting poor blood sugar control can cre­ate hormonal imbalance. In a prospective study of nearly eight hundred women attempting to conceive, even mildly elevated “high-normal” blood glucose levels were associated with lower conception probability per cycle and longer time to pregnancy.³⁹

Very high-carbohydrate patterns, especially when applied to an insulin-resistant individual, may also provoke reactive hypoglycemia, trig­gering compensatory cortisol release which can dampen reproductive function.^40,41 Insulin sensi­tivity fluctuates across the menstrual cycle and declines during the second half (luteal phase), making carbohydrate quality of utmost impor­tance.^32,42 Carbohydrates should be drawn from whole-food, ancestrally appropriate sources (with proper preparation of grains and legumes when consumed) and balanced with fat and protein to limit excessive blood sugar swings.

Metabolically healthy, moderately active women may thrive at 30 to 45 percent of calo­ries coming from carbohydrates, while athletic women with high training demands may even require 45 to 55 percent. Still, for reproductive-aged women, during the luteal phase, when fat is more readily used for fuel and blood sugar control declines slightly, prioritizing fat and protein while including smaller amounts of high-quality carbohydrates can help stabilize blood sugar while still providing enough car­bohydrate to support the monthly building of the endometrial lining, a glycogen-rich tissue.⁴³

For metabolically compromised or seden­tary individuals, carbohydrate intake around 20 to 30 percent of total calories often supports metabolic improvement. More therapeutic ke­togenic approaches (less than 15 to 20 percent or less than 50 g per day) can offer additional benefit in some PCOS phenotypes. In practi­cal food terms, keeping carbohydrate intake under fifty grams per day would allow for ap­proximately one modest serving of traditional starch (such as one medium sized potato or one to two slices of properly prepared sourdough bread), which would comprise the majority of the daily carbohydrate allotment. However, individuals with more severe insulin resistance may not experience optimal blood sugar stabil­ity with concentrated starches and may instead tolerate considerably larger volumes of low-glycemic carbohydrates—such as several cups of leafy greens, properly prepared cruciferous vegetables, zucchini, carrots, berries or other non-starchy produce—within that same carbo­hydrate range.³⁸

COMMON HORMONAL DISRUPTION PATTERNS

Women rarely experience hormonal imbal­ance in isolation. Instead, patterns of metabolic stress, under- or over-fueling, environmental burden and lifestyle strain can disrupt the HPO axis in predictable ways. Functional testing (see Table 1) does not replace clinical judgment, but it can help illuminate the physiological drivers behind symptoms.

 

In the following sections, I describe three common hormonal disruption patterns along with the testing categories that often provide insight, and nutrition and lifestyle interventions that can help to reestablish hormonal balance.

 

1. Estrogen dominance and imbalance
2. Polycystic ovary syndrome and the metabolic syndrome con­nection
3. Functional hypothalamic amenorrhea

CASE ONE—EMILY:

THE METABOLICALLY STRESSED WOMAN

(ESTROGEN DOMINANCE AND IMBALANCE)

Estrogen, particularly estradiol (E2), is a critical hormone during the reproductive years, facilitating female sexual development, conducting the orchestra of monthly follicle development and playing an all-star role in metabolic, bone and brain health. Yet excess estrogen, unfavorable estrogen metabolite patterns or a relative imbalance between estrogen and progesterone can disrupt this finely tuned system, creating a wide range of symptoms.³⁵ This pattern, often referred to as “estrogen dominance,” is multifactorial in origin and increasingly common in modern women.⁵⁹

Emily was a thirty-eight-year-old mother of three who came to me frustrated by steady midsection weight gain over the previous few years. Despite approaching her forties, her PMS symptoms seemed to worsen rather than improve. She experienced recurring headaches, anxiety throughout her cycle and increasingly painful breast tenderness. Sleep had become a nightly struggle. Emily often lay awake for hours, only to rise before her five oʼclock alarm to “burn calories” at the gym.

Emily felt she was eating healthfully, choosing lowfat cereals, skin­less meats and non-dairy creamers, yet she frequently craved sugar and relied on caffeine to get through the day. Her typical diet before interven­tion was as follows:

• Breakfast: Cereal with skim milk and orange juice
• Snacks: Pretzels or fruit
• Lunch: Chicken salad with romaine lettuce and canola oil dressing
• Dinner: Whole wheat pasta with store-bought sauce (high in seed oils)
• Beverages: Multiple caffeinated diet sodas throughout the day

Emily’s environment further contributed to her hormonal burden. She regularly used plug-in air fresheners, scented dry­er sheets and plastic food containers—sources of endocrine-

disrupting chemicals that can increase estrogen­ic load. Her high-stress job likely compounded hormonal imbalance by suppressing progester­one production and elevating cortisol. Table 2 shows Emily’s key test findings.

 

Emily’s nutritional plan (Table 3) empha­sizes metabolic stability, adequate protein and traditional fats alongside whole-food carbohy­drates to support blood sugar regulation, estro­gen clearance and HPO-axis resilience. The plan follows a moderate, protein- and fat-anchored pattern (approximately 55 percent fat, 20 per­cent protein, 25 percent carbohydrate) within approximately two thousand calories per day.

 

Maintaining a healthy body weight is important for estrogen dominance, as excess adiposity can increase estrogen production in fat cells. Traditional nutrient-dense foods sup­port Phase I and II liver detoxification required for estrogen conjugation (preparing estrogen for elimination), while traditionally fermented foods help nourish the estrobolome—the gut microbial component involved in regulating estrogen metabolism and circulation.

As for beverages, kombucha can be a par­ticularly useful addition, providing glucuronic acid along with other organic acids and micro­bial metabolites that support liver clearance pathways and healthy estrogen elimination. Beet kvass is another traditional beverage that can be especially supportive, as it contains betaine, which aids Phase II liver detoxification, along with compounds that gently promote bile flow, both important for effective estrogen metabo­lism and clearance.

Emily worked hard to implement the recom­mended dietary changes—as well as making key lifestyle upgrades—and within a few months she reported reduced anxi­ety, improved PMS severity and that her clothes fit better despite lower-intensity workouts. She also slept more soundly with fewer awakenings.

CASE 2—JENNIFER:

THE INSULIN-RESISTANT, ANDROGEN-DOMINANT WOMAN (PCOS AND THE METABOLIC SYNDROME CONNECTION)

PCOS affects an estimated 8 to 15 percent of women worldwide and is one of the most common causes of female hormonal dysfunction.⁶⁰ It is a leading contributor to irregular or absent menstrual cycles, infertility and a broad range of metabolic disturbances, including insulin resistance, prediabetes and type 2 diabetes, dyslipidemia, hypertension, obesity and increased long-term risk for cardiovascular disease and cognitive decline.⁶¹

Jennifer had long sensed that something was “off” with her hor­mones, even though she had never received a clear diagnosis of PCOS. She did not meet the classic ultrasound criteria for ovarian cysts, a com­mon experience among women with PCOS, but her body was sending consistent signals that something deeper was out of balance. Over time, Jennifer noticed thinning hair at her temples, increased facial hair, and persistent acne along her chin that worsened before her period. She also struggled with stubborn midsection weight gain, low energy and a sense that her body was no longer responding the way it once had. During her annual wellness exam, her doctor noted rising blood sugar levels and less-than-ideal cholesterol ratios (high triglycerides and low HDL), further confirming Jennifer’s concerns.

Jennifer worked as a nurse in a fast-paced hospital environment, often pushing herself through long shifts with little time for rest or regular meals. Her irregular schedule disrupted her sleep and circadian rhythm, while chronic stress and reliance on convenience foods quietly compounded her hormonal and metabolic strain. She had no consistent exercise routine and as­sumed that the physical demands of her job were enough to sustain her health. Her typical diet before intervention was as follows:

• Breakfast: Often skipped; a sweetened cof­fee on the way to work
• Snacks: Processed snack foods, sugary drinks, occasional fruit
• Lunch: Café meals such as pizza, burgers or salads with industrial seed-oil dressings
• Dinner: Prepackaged meals or fast-food options after long, demanding shifts

 

A hormone panel revealed elevated free testosterone, low SHBG and low progesterone. Her menstrual cycles were irregular and often stretched beyond thirty-five days, reflecting disrupted ovulatory rhythms and hormonal signaling (see Table 4).

 

Jennifer’s nutritional plan (Table 5) uses a lower-carbohydrate, higher-fat approach (approximately 70 percent fat, 20 percent protein, 10 percent carbohydrate) within an ap­proximately two thousand kcal per day intake to improve insulin signaling and help reduce androgen excess.

 

Stabilizing blood glucose and lowering diet-driven inflammation are central to restoring metabolic flexibility, as these factors directly influence insulin dynamics and ovarian an­drogen production in insulin-resistant women. This macronutrient pattern emphasizes nutrient-dense fats and adequate protein to promote satiety and hormonal stability while minimiz­ing glycemic (blood sugar) volatility that can perpetuate hyperinsulinemia and PCOS-related symptoms.

As for beverages, homemade bone broth is an ideal beverage for a female with PCOS and/ or insulin resistance. It provides amino acids that support the synthesis of key metabolic-regulating hormones (including insulin, leptin and glucagon), along with bioavailable minerals that help nourish and restore metabolic function. The addition of sea salt helps maintain electro­lyte balance, which can take time to reestablish when transitioning to a lower-carbohydrate approach.

Jennifer soaked up all the information she could to understand how her processed foods diet was creating insulin resistance, which was worsening her hormonal imbalance. After following the recommended interventions, she happily reported that her lipid ratios (specifically HDL-to-triglyceride balance) and blood sugar parameters were much improved on her next wellness exam. Additionally, she felt more energized throughout the day and had improved her body composition.

CASE 3—OLIVIA: THE UNDER-FUELED, HIGH-PERFORMING WOMAN (FUNCTIONAL HYPOTHALAMIC AMENORRHEA)

Functional hypothalamic amenorrhea (FHA) is one of the clearest examples of a disturbance within the HPO axis. It is diagnosed when menstruation ceases completely for three to six months and is considered a diagnosis of exclusion, meaning other causes (such as PCOS, hypothy­roidism, pregnancy and structural abnormalities) must first be ruled out. Of note, many women experience partial hypothalamic suppression, ir­regular or anovulatory cycles without complete amenorrhea, which may affect a significant proportion of active or dieting women.⁶²

Olivia, a former college athlete, came to me with concerns that had gradually become impossible to ignore: hair loss, anxiety, persistent fatigue, poor exercise recovery and ongoing digestive issues, all despite following what she believed was a very healthy lifestyle. As we explored her history more deeply, Olivia told me that her menstrual cycles had become infrequent, sometimes disappearing for months at a time. Her years as a competitive swimmer had shaped a mindset of discipline and endurance, where pushing through physical strain felt normal rather than problematic.

Olivia maintained a high level of physical activity but underestimated the physiological cost of chronic training combined with restricted food intake. Her identity as an athlete and her exposure to cultural messaging around leanness and discipline reinforced patterns of under-eating and over-exercising. Psychological stress, performance pressure and fear of weight gain further compounded hypothalamic suppression (Table 6).

A closer look at her diet revealed chronically low caloric intake, a strong emphasis on lowfat foods and an unusually high fiber intake. While high fiber can be helpful in cases of estrogen excess, it can further suppress estrogen signaling in women already at risk for FHA. In Olivia’s case, her nutritional pattern was quietly reinforcing an under-fueled physiological state. Her typical diet before intervention was as follows:

• Breakfast: Often light or delayed; low-calorie foods such as fat-free yogurt with fruit
• Snacks: High-fiber foods such as fruit and veggies without an added fat or minimal intake between meals
• Lunch: Large salads, lean proteins, lowfat meals
• Dinner: Modest portions with limited di­etary fat and carbohydrates

Overall, Olivia’s diet appeared “clean” and nutrient-conscious but was insufficient in total energy, fat, carbohydrate and micronutrients to meet her metabolic and activity demands.

Olivia’s nutritional plan (Table 7) prioritizes energy availability through a higher-calorie in­take (about twenty-five hundred kcal/day) and a balanced macronutrient pattern (approximately 45 percent fat, 20 percent protein, 35 percent car­bohydrate) to help restore menstrual signaling and overall metabolic safety. Establishing meta­bolic safety is key to recovering from impaired HPO-axis signaling, as seen in FHA and other menstrual irregularities such as anovulatory cycles and oligomenorrhea.

While dietary fat is essential for steroido­genesis—the production of sex and adrenal hormones—adequate room is intentionally made for moderate carbohydrate intake to ensure consistent glucose signaling to the hypothalamus, support thyroid hormone recov­ery (as glucose facilitates T4-to-T3 conversion) and allow for a modest increase in body fat, which is often necessary to help an FHA patient rise above about 22 percent body fat.

Whole raw milk is an ideal beverage for a female with FHA, as it supports hypothalamic safety by delivering a balanced combination of energy, fat, protein and carbohydrate that signals adequate fuel availability to the HPO axis. It also provides critical nutrients, including fat-soluble vitamins and calcium, that help restore bone mineral density, which is negatively impacted by menstrual disruption.

When Olivia began to understand that menstrual suppression can affect not only fertility but also bone health, cardiovascular function, mood and energy, she realized that her symptoms were not isolated is­sues but signals from a body in need of restoration. Within three months of intervention, Olivia had reduced anxiety symptoms, increased hair growth and, most importantly, a restored menstrual cycle.

PUTTING IT ALL TOGETHER

In summary, modern food environments present women with many hormonal challenges. Returning to ancestral nutrition principles, so clearly articulated in the work of Dr. Weston A. Price, alongside thoughtful macronutrient balance grounded in modern physiology, offers a practical and empowering framework for hormonal restoration. This foundation helps correct common disturbances and supports a return to balance and resilience.

 

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SIDEBARS

ALL-STAR NUTRIENTS: LOW IN MODERN DIETS, ABUNDANT IN ANCESTRAL FOODS

While no single nutrient operates in isolation, certain micronutrients play particularly influential roles in the regula­tion of female physiology. Notably, many of these nutrients are commonly under-consumed in modern diets and may be inadequately emphasized within standard dietary guidance.3 In contrast, these nutrients, alongside many others, are naturally abundant in traditional, ancestral food patterns, particularly those aligned with the principles outlined by the Weston A. Price Foundation. Some key examples are highlighted below.^44-56

VITAMIN A (RETINOL)—A MASTER REGULATOR OF FEMALE PHYSIOLOGY: Rich dietary sources of preformed vitamin A include liver, shellfish, eggs, cod liver oil, grass-fed butter and full-fat dairy—foods traditionally valued in ancestral diets for supporting female health across the lifespan.

• Supports healthy ovulation and follicle development by guiding granulosa cell growth (act like bodyguards around the develop­ing egg—forming a protective and nourishing environment that shields it) and differentiation within the ovary.
• Antioxidant properties protect developing eggs from oxidative stress.
• Plays a role in thyroid hormone signaling and metabolic regulation.
• Supports skin health and tissue turnover.

VITAMIN D—A HORMONE-LIKE SIGNAL FOR FEMALE METABOLIC AND REPRODUCTIVE HEALTH: Key dietary sources include shellfish, egg yolks, butter, full-fat dairy, poultry liver and lard from pasture-raised pigs—foods traditionally valued in ancestral diets but often avoided due to outdated cholesterol concerns.

• Acts more like a steroid hormone with receptors throughout the female reproductive axis, including the ovaries, endometrium, hypothalamus and pituitary gland.
• Supports ovulatory function and hormonal signaling, contributing to more regular cycles, balanced reproductive physiology.
• Enhances insulin sensitivity and metabolic regulation, with particular relevance for women with insulin resistance or PCOS.

VITAMIN K2 (MENAQUINONE)—A DIRECTOR OF CALCIUM AND CARDIOMETABOLIC HEALTH: While vitamin K1 is abundant in leafy green plants, vitamin K2 is found in animal and fermented foods traditionally valued in ancestral diets. Dietary sources include egg yolks, butter and full-fat dairy (especially from grass-fed animals), poultry fat and liver (particularly goose liver), aged and fermented cheeses and natto—a traditional fermented soybean food that is especially high in the MK-7 form of K2.

• Contributes to bone strength by activating osteocalcin, which helps bind calcium into the bone matrix—especially important during periods of growth, such as adolescence when peak bone mass is established, and during hormonal transitions including menopause.
• Supports long-term cardiovascular health by helping prevent calcium from depositing in the arteries, which is particularly important for women as estrogen declines post-menopause.
• Plays a role in metabolic health, with research suggesting involvement in glucose regulation and improved insulin sensitivity.
• Works synergistically with vitamins A and D to support proper mineral metabolism and hormonal signaling.

CHOLINE—A STRUCTURAL AND METHYLATION NUTRIENT FOR FEMALE HORMONAL HEALTH: Rich dietary sources of choline include egg yolks and organ meats, with additional contributions from shellfish, beef, poultry and fish.

• Supports cellular structure and signaling by providing phospholipids that form the foundation of healthy cell membranes, es­sential for nutrient transport, hormone signaling and cellular communication.
• Supplies methyl groups critical for methylation pathways, influencing estrogen metabolism, liver detoxification and overall hormonal balance.
• Plays a role in fertility and reproductive health, with particular importance for neural tube development if conception occurs.
• Supports estrogen metabolism across the female lifespan, becoming especially relevant as endogenous estrogen production shifts in perimenopause and menopause.

HEME IRON—A FOUNDATIONAL MINERAL FOR FEMALE ENERGY AND REPRODUCTIVE HEALTH: Heme iron from animal foods is significantly more bioavailable than non-heme iron from plant sources, which is often blocked by phytates and requires vitamin C for enhanced absorption. Rich dietary sources of heme iron include liver, red meat, shellfish and dark poultry.

• Supports oxygen delivery and mitochondrial energy production, influencing stamina, cognitive function and overall vitality.
• Contributes to healthy thyroid hormone conversion and metabolic signaling, with low iron status often associated with fatigue and reduced metabolism.
• Plays a role in fertility and reproductive health, as adequate iron status is necessary for optimal ovarian function and pregnancy outcomes.

ZINC—A CATALYST FOR OVULATION, HORMONE PRODUCTION AND CELLULAR RESILIENCE: Rich dietary sources of zinc include oysters, beef, lamb, poultry and eggs.

• Serves as a critical cofactor for enzymes and structural proteins involved in female reproductive function, hormone signaling.
• Helps maintain mitochondrial function within ovarian tissue, supporting cellular energy and resilience.
• Modulates oxidative stress and inflammatory signaling, factors that can influence ovulatory quality and hormonal balance.
• Bioavailability is highest from animal foods, while plant sources are often limited by phytates that reduce absorption.

 

THE DYSLIPIDEMIA OF INSULIN RESISTANCE: THE DIABETIC CHOLESTEROL PATTERN

Most readers will already be aware that total cholesterol has proven to be a poor surrogate for cardiovascular risk. In fact, some evidence suggests that—particularly in older women—when total cholesterol declines, all-cause mortal­ity may actually increase. This was one of the key observations from the well-known Minnesota Coronary Experiment (MCE), which replaced traditional saturated fats with polyunsaturated vegetable oils. In a later reanalysis of the MCE data published in BMJ, researchers found that for each 30 mg/dL reduction in serum cholesterol, there was a 22 percent increase in mortality risk.⁵⁷

What clinicians who focus on metabolic health often observe, however, is a distinct pattern of dysregulated lipid ratios that serves as a telltale sign of insulin resistance. This pattern is typically characterized—and apparent on a basic cholesterol test—by lower-than-ideal HDL (high-density lipoprotein) and elevated fasting triglycerides.

Why does this pattern occur? The explanation has very little, if anything, to do with dietary fat intake and every­thing to do with excess carbohydrate intake and the development of insulin resistance. This metabolic state is driven primarily by diets high in processed carbohydrates, compounded by inflammatory seed oils and often exacerbated by a sedentary lifestyle (exercise is a powerful sink for glucose disposal).

The ingestion of highly refined carbohydrate foods quickly raises blood glucose, and the liver works hard to convert this sugar into glycogen, the storage form of glucose. But when insulin remains high and glycogen stores become replete, the liver then uses de novo lipogenesis (DNL)—the creation of new fat from sugar—to turn excess glucose into fatty acids, which are then assembled into triglycerides for storage in fat tissue. Additionally, insulin itself acts as a signal for DNL, and thus the hyperinsulinemic state seen in metabolic syndrome is like a switch constantly flipped to the “on” position, even in a fasted state. These triglycerides tend to transfer onto HDL particles, making them unstable and more rapidly cleared by the liver—hence the reliably predictable pattern of elevated triglycerides and lowered HDL. It is, therefore, plausible that the reason many studies have found an association between higher HDL and lower cardiovascular risk in women has much to do with its representation of strong metabolic health—marked by healthy glucose and insulin metabolism—and its favorable impact on inflammatory status.⁵⁸

While the standard triglyceride reference range is under 150 mg/dL, metabolically focused practitioners usually prefer to see fasting triglycerides under 100 mg/dL. For women, an HDL level above 60 mg/dL is often considered a sign of strong metabolic health. And how does one improve HDL and triglyceride levels? By focusing on the advice outlined in this article: consuming healthy fats, including saturated fats and natural sources of omega-3 oils; removing ultra-processed foods from the diet; maintaining healthy body fat levels—neither too high nor too low; and engaging in exercise one enjoys to help metabolize glucose.

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