Men's health·Research·Women's health

sex-hormone binding globulin and hormone/metabolic imbalance

Women’s health concerns are becoming more and more prominent.
In clinical practice, naturopathic doctors see both imbalances with estrogen and progesterone, and estrogen and testosterone.
The availability of these hormones on the body’s tissues is dependent on carrier or binding proteins. Sex-hormone binding globulin is the protein to carry both estrogen and testosterone. Elevated levels of the protein causes a decrease in bioavailable estrogen and testerone, while decreased levels causes an increase. Most doctors do not test this protein on routine, and instead measure ‘free’ hormone.
However, many factors can contribute to an elevated or decreased SHBG. The birth control pill is one of them. The research demonstrates that OCP use increases SHBG. However, there are no studies on the long-term effects, i.e. will the body then under-produces SHBG after a certain amount of time to compensate for the increase? These questions require further research.
Here are some other factors that influence SHBG
1) the lower the fat content of one’s diet the higher the SHBG levels and vice versa.
2) increased levels may be seen in liver disease, hyperthyroidism, eating disorders
3) decrease levels with PCOS, hypothyroidism, acne, obesity, excess androgens
4) low fat vegetarian diet is associated with increased SHBG and decreased dysmenorrhea and PMS (2)
5) there is an inverse relationship between SHBG and insulin in women, therefore, a diet low on the glycemic index with less insulin spikes increases SHBG. (3)
6) SHBG may serve as predictive marker for insulin resistance in women, especially who show hyperandrogenic symptoms (4)
J Sex Med. 2006 Jan;3(1):104-13.

Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction.


Department of Endocrinology, Boston University Medical Center, Boston, MA, USA.



Oral contraceptives (OCs) have been the preferred method of birth control because of their high rate of effectiveness. OC use, however, has been associated with women’s sexual health complaints and androgen insufficiency. OC use is associated with a decrease of androgen ovarian synthesis and an increase in the production of sex hormone-binding globulin (SHBG). There have been limited studies assessing SHBG values after discontinuation of OC use.


To retrospectively investigate SHBG levels before and after discontinuation of OC use.


Sex hormone-binding globulin values were compared at baseline, while on the OC, and well beyond the 7-day half-life of SHBG at 49-120 (mean 80) days and >120 (mean 196) days after discontinuation of OCs.


A total of 124 premenopausal women with sexual health complaints for >6 months met inclusion/exclusion criteria. Three groups of women were defined: (i) « Continued-Users » (N = 62; mean age 32 years) had been on OCs for >6 months and continued taking them; (ii) « Discontinued-Users » (N = 39; mean age 33 years) had been on OCs for >6 months and discontinued them; and (iii) « Never-Users » (N = 23; mean age 36 years) had never taken OCs.


Sex hormone-binding globulin values in the « Continued-Users » were four times higher than those in the « Never-User » group (mean 157 +/- 13 nmol/L vs. 41 +/- 4 nmol/L; P < 0.0001). Despite a decrease in SHBG values after discontinuation of OC use, SHBG levels in « Discontinued-Users » remained elevated in comparison with « Never-Users » (N = 26; P < 0.0001 for >120 days).


In women with sexual dysfunction, SHBG changes in « Discontinued-Users » did not decrease to values consistent with « Never-Users. » Long-term sexual, metabolic, and mental health consequences might result as a consequence of chronic SHBG elevation. Does prolonged exposure to the synthetic estrogens of OCs induce gene imprinting and increased gene expression of SHBG in the liver in some women? Prospective research is needed.

(1) Thijssen JH. Ann N Y Acad Sci. 1988;538:280-6. Review. Hormonal and nonhormonal factors affecting sex hormone-binding globulin levels in blood.

(2) Barnard ND, Scialli AR, Hurlock D, Bertron P.Obstet Gynecol. 2000 Feb;95(2):245-50. Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms.

(3) Strain G, Zumoff B, Rosner W, Pi-Sunyer X.J Clin Endocrinol Metab. 1994 Oct;79(4):1173-6.The relationship between serum levels of insulin and sex hormone-binding globulin in men: the effect of weight loss.

(4) Eur J Endocrinol. 2007 Oct;157(4):499-507.Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome.


2 réflexions au sujet de « sex-hormone binding globulin and hormone/metabolic imbalance »

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