WHY ARE ALL MY HORMONES SO LOW AT 41? DHEA, THYROID & PERIMENOPAUSE EXPLAINED

“What are your thoughts on DHEA? All my hormone levels are low – estrogen, testosterone, and progesterone. My TSH is high too (but still in ‘normal’ range). Could my thyroid be caused by all my other hormones being low? I’m only 41. Why is everything so low?!”

I get these kinds of questions all the time, and honestly? These are great conversations we need to be having about women’s health in our 40s.

Because the truth is, women in their early 40s are routinely being dismissed, misdiagnosed, and told they’re too young for perimenopause.

Or their period’s still regular, so it can’t be perimenopause.

Or a lot of the time, it’s that we think we’re too young for perimenopause. Because perimenopause is a short period of time that only women well over 50 go through. Right?!

So if you’ve ever left a doctor’s appointment feeling more confused than when you walked in, thinking “if it isn’t perimenopause, what is it then?!” and clutching blood test results that don’t really explain why you’re feeling the way you are, because “everything’s fine,” then stay with me, this blog’s for you as much as it is for the person who asked me the question above!

“WHY IS EVERYTHING SO LOW?!”

If you’re 41 and your estrogen, progesterone, and testosterone levels are all low, it’s very likely you’re in perimenopause.

I know, it feels “too young” to be in perimenopause. But remember that perimenopause can last for 2-12 years! And with the average age of menopause being 51, if we do some simple maths (51-12) we see that perimenopause hormone shifts can start in your late 30s. I wrote more about the phases or stages of perimenopause in this blog.

Having said that, 41 is on the younger side for menopause to strike. I wrote more about early menopause and why it happens in this blog. If you’re under 45 and your cycles are already starting to stretch out (say, you’ve only had one in the past 3-6 months), which is a sign of being in mid to late perimenopause, then I recommend speaking with your doctor about whether hormone therapy is appropriate to protect bone and cardiovascular health.

One thing that I haven’t talked too much about in the other blog is the impact of stress on perimenopause. In particular, the impact of stress in the lead up to perimenopause, but I have talked about it in this blog - Symptoms of stress: high cortisol and your body.

So yes, this phase can start earlier than most people realise (late 30s is common), and it brings with it a whole range of hormonal shifts that don’t always show up clearly on blood tests.

Which brings us to…

WHY HORMONE TESTING ISN’T ALWAYS THAT HELPFUL

Female hormone testing is a snapshot of one moment in time. It doesn’t always reflect what’s happening in the messy reality of perimenopause, especially if your cycle is 24 days one month and 48 the next, or you skip a period entirely, testing becomes unreliable. Why? Because

• Progesterone is best tested on day 21 of your cycle

• Estrogen is typically tested on day 3,

and most doctors don’t tell you that anyway!

This is why I don’t often use female hormone testing as a starting point in my clinic - it’s too hard to get an accurate picture unless you’re testing multiple times or investigating a specific issue. In most cases, the cost of hormone testing just doesn’t offer enough insight to justify it—especially when the results are so dependent on timing and cycle variation. Your symptom picture is far more reliable, and in Australia, it’s still considered the clinical gold standard.

➡️ That’s exactly why I created The Perimenopause Decoder to help you decode your symptoms and spot the patterns that blood tests often miss.

Don’t get me wrong, I do love blood test results, as they can be used to give us loads more info about what’s happening for you. It’s just female hormone tests I don’t do regularly for the reasons outlined above, and in this blog about how perimenopause is diagnosed.

If you are looking at your blood test results it’s super important to use ranges that are optimal for women’s health (normal just isn’t good enough to help you feel great).

I also like to do a functional analysis of your blood biochemistry so I can really get a deep understanding of what’s happening in your body, why you’re feeling the way you are, and what we need to do about it. By using functional blood chemistry analysis, we can use mostly ‘standard’ blood tests to find out more about how other systems of your body are functioning, as well as track subtle changes in your body's biochemistry, for a comprehensive view of your health and what’s behind how you’re feeling. I LOVE doing these for my clients in The Chaos to Calm Method.

WHAT’S THE DEAL WITH DHEA?

DHEA is a hormone made by your adrenal glands and acts as a precursor to both estrogen and testosterone. It’s what our brain and heart use to make estrogen when we’re in menopause, so they can function more effectively.

DHEA naturally declines with age, so as demand rises in perimenopause, supply drops. That gap gets even wider if you’ve been under ongoing stress, under-slept, or under-eating (sound familiar?). That’s why DHEA can be low — not because your body is broken, but because it’s been running on empty.

But DHEA is also very sensitive to stress.

Because it’s not just about how old you are, it’s about how you’ve been living. Especially in our 40s and 50s, as we hit perimenopause and menopause. We can’t expect to flog ourselves doing all the things that modern mum life requires in the 10 years before perimenopause, and expect to then sail through the experience. It just isn’t physically possible, because our body systems are so intricately intertwined.

Low DHEA may be a signal that your HPA axis is dysfunctional, your stress response system is overwhelmed and no longer adapting well.

So when I see low DHEA in women in their 40s, I don’t just ask, “Should we supplement?”

I want to know what’s behind it’s low level. What’s driving the problem.

I would encourage you to always think this way, as it’s what gives you long term resolution of your symptoms, rather than just having to rely on supplements or medications to suppress them. (Note that DHEA is restricted in Australia, only available on doctor’s prescription, so I’d be supplementing with herbs or nutrients to help support your body’s production.)

Now, let’s have a chat about the stressors in your life that may be messing with your hormone levels.

WHAT COUNTS AS STRESS?

(SPOILER: IT’S NOT JUST DEADLINES + DRAMA)

Stress isn’t just about how busy your week is. It includes both physical and mental load.

PHYSICAL STRESSORS:

• Late nights (especially 1am bedtimes)
• Overexercising
• Skipping meals or eating in a rush
• Under-eating or restricting carbs
• Nutrient deficiencies (more on that in a sec)
• Food intolerances
• High sugar, alcohol, or caffeine intake
• Illness or chronic conditions

MENTAL/EMOTIONAL STRESSORS:

• Work pressure
• Parenting teens
• Budget anxiety
• Relationship tension
• The never-ending mental load
• Rushing, multitasking, being “on” all the time

If you’ve been running hot for the past 10+ years, your body doesn’t just bounce back like it used to. It adapts… until it can’t. And that’s when symptoms start to pile up and you may see changes on your blood test results.

COULD MY THYROID BE BEHIND MY LOW HORMONES OR ARE MY LOW HORMONES MESSING WITH MY THYROID?

Let’s look at the next part of the question asked:

“Could my thyroid be caused by all my other hormones being low?”

In this case, it seems like it’s a perfect storm of perimenopause, stress, and a body that’s had enough of being pushed to the bottom of the priority list.

Here’s what’s likely happening:

• As progesterone drops (which happens early in perimenopause), your stress resilience declines.
• Your brain becomes more sensitive to stress, your HPA axis (the part of your brain and adrenal system that manages your stress response and hormones) becomes more reactive, and over time, this can start to impact your thyroid function too, because it is also controlled by the HPA axis.
• At the same time, lower progesterone = less control over your immune system. And that’s often when autoimmune thyroid issues (like Hashimoto’s) start to bubble up, or get worse.

When your stressors are high, your cortisol and HPA axis may be upregulated - driving your female and thyroid hormones up. If you’re in burn out and your HPA axis is dysregulated and cortisol levels are low, this may drive your hormone levels down.

It’s not just one system acting alone. Your female hormones, your thyroid hormones, your nervous system, they’re all interconnected, and influencing each other, all the time. When the HPA-axis is dysregulated, there will also be dysregulation in the other organs it looks after too.

Your brain and body are brilliant, they really are, but they just aren’t ready for life as we live now. Technology moves quickly, so do our lives; but the human body evolves relatively slowly.

Many nutrients are needed to build the enzymes and molecules that build our hormones, and then detoxify and eliminate them from our body. Nutrient insufficiencies or actual deficiencies in these can quietly chip away at hormone production long before anything shows up on bloods.

Which is why we always need to zoom out and look at the whole picture, not just look at one test result, or even just at your blood markers individually. And a reminder that only testing TSH doesn’t give us a full picture of your thyroid function - we want to know all of your thyroid hormones free T4, free T3, antibodies, and even reverse T3 (though usually we can assume this is high, depending on your symptoms and stress levels).

Without more answers, I of course can’t make a definitive statement! It isn’t always clear cut, or that simple, because we have complex systems and biochemistry, that are inter-connected.

🧭 SO WHERE DOES THAT LEAVE YOU?

You don’t need to rush out and buy a DHEA supplement.

And you don’t need to panic if your TSH is slightly elevated but still within range. Focus on addressing what you think might be driving it, and then retest in a few months to track how things are shifting.

What you do need is a better understanding of what your body is doing, why it might be struggling, and how to start supporting it in a way that aligns with this phase of life.

If you’re wondering whether this is perimenopause, The Perimenopause Decoder is a great place to start.

It’ll help you be more informed about what’s happening in your body as you understand if it is perimenopause, what phase you’re in, how much longer it may last for, and start making decisions that are based on you and your phase of life.