Endocrine System

Available treatment options

We are fortunate to have a vast array of highly effective treatments. For blood sugar management, Metformin (also available as branded Glucophage ) remains my gold-standard first-line treatment.

For those needing extra support, combination tablets like Competact , Janumet , or Jentadueto are excellent, while Diamicron helps stimulate the pancreas. Recently, Mounjaro has emerged as a revolutionary injectable option, and I am seeing incredible dual results for both glucose control and weight loss.

For menopause and HRT, we have fantastic options. Transdermal oestrogens like Oestrogel , Evorel patches, and Estraderm MX are my preferred starting points due to their safety profile, though oral options like Elleste Solo and Zumenon suit some women better.

If you still have your womb, you must take a progestogen alongside oestrogen to protect the lining. I frequently prescribe body-identical Utrogestan , but Provera and Norethisterone are also widely used.

For convenience, combined HRT products like Femoston , Femoston Conti , Kliovance , Kliofem , Novofem , Indivina , and Trisequens offer both hormones in one. Livial is a unique, steroid-based alternative that works beautifully for some postmenopausal women, while topical Estriol is unmatched for localised vaginal dryness.

For thyroid support, Levothyroxine is the cornerstone of treatment. For menstrual regulation or polycystic ovary syndrome (PCOS), contraceptives like Noriday and Qlaira offer great cycle control, and I frequently use Spironolactone off-label to combat hormonal acne and excess hair growth.

What to expect from treatment

Hormonal treatments require patience. Your body needs time to downregulate and upregulate its receptors. With HRT, I always warn my patients about the "3-week dip". You might feel fantastic in week one, terrible in week three as your body adjusts, and then finally balanced by week six.

Please do not abandon your treatment at week three!

With thyroid medication, the absorption is notoriously finicky. Even a splash of milk in your morning coffee can reduce the absorption of your medication by up to 30%.

Taking it strictly on an empty stomach with water is non-negotiable for stable energy levels.

Self-care and prevention

Medication is only half the puzzle. Your endocrine system is exquisitely sensitive to stress. High levels of cortisol (your stress hormone) actively block the function of insulin and disrupt the production of sex hormones.

I cannot overstate the clinical importance of sleep and stress management.

• Prioritise protein: Starting your day with a high-protein breakfast stabilises your blood sugar curve for the entire day.
• Protect your sleep: Just two nights of poor sleep can induce temporary insulin resistance.
• Move daily: Muscle tissue is a metabolic sink for glucose. A brisk 15-minute walk after dinner dramatically reduces blood sugar spikes.