The Oestrogen Shift

Global flatness, low mood, dry everywhere, patchy response to everything

Before menopause, your sex hormones are made in the ovaries and delivered everywhere.

The process starts with cholesterol – yes, the same cholesterol that medicine has spent decades demonising. Cholesterol is the raw material from which every steroid hormone in your body is built.​ It moves along a production line:

Cholesterol → DHEA → Testosterone → Oestrogen

Most of this conversion happens in your ovaries, and your adrenal glands contribute a smaller amount of DHEA to the same supply chain.​ Oestrogen is released into your bloodstream in the carefully timed monthly cycle. It travels everywhere at once: the same strong signal reaching your brain, bones, skin, vagina, heart and immune system simultaneously.​ Think of it as a central factory that makes a finished hormone and sends it out by courier to the whole body, every month, on schedule. Your tissues receive the delivery. They open the package. They use what’s inside. They do not need to make anything themselves.

After menopause, the ovarian factory closes and oestrogen production shifts to the tissues.

Your adrenal glands – which have been contributing DHEA to the production line all along – now become the sole supplier. Every day, they produce DHEA and release it into the bloodstream.​ DHEA then travels directly to individual tissues: bone, brain, skin, vagina, muscle and fat.

Each tissue has its own local enzyme machinery — a small set of molecular tools that can convert DHEA into whatever hormone that tissue specifically needs. Those enzymes need specific nutrients to work. The enzymes your body uses – specifically 3β-HSD, 17β-HSD, Aromatase, and 5α-Reductase – determine exactly what hormones are produced locally. When one of these specific enzyme pathways struggles or becomes overactive, you experience a “cluster” of related symptoms

Global flatness, low mood, dry everywhere, patchy response to everything

This is the woman who says, “I just don’t feel like myself any more.” – not in one dramatic way, but in a dull, spread-out way.

Your mood is low. Your drive has gone. You feel drier in more than one part of the body – skin, eyes, vagina, mouth, sometimes all of them. Your resilience is down. Things that should be helping only seem to help a bit, or not for long. You try eating better, sleeping more, exercising, taking supplements, and nothing seems to land properly. Your body feels as though it is only half responding. It’s a whole-body pattern of flatness.

Where it’s happening:
This pattern is less about one specific tissue and more about the whole precursor system – the adrenals, the liver, the bloodstream, and then every tissue downstream that depends on DHEA and DHEA-S arriving in a form it can actually use.

In other words, this sits further upstream than the other clusters.

Before the brain can make better local use of hormones, before the vagina can maintain healthy tissue, before the skin can keep itself supple, before the joints and muscles can respond well, the body first needs a decent circulating pool of raw material to work from

What the tissue is making:
This is not mainly about one tissue making one final hormone. It is about whether the body is maintaining a healthy supply of DHEA and DHEA-S in circulation, and whether those precursors are then being delivered, stored, recycled and converted properly.

If that upstream supply is low, unstable, or poorly handled, every tissue further down the line has less to work with.

So this row is really about the body’s ability to keep a good background supply going – enough precursor in the system for tissues to make what they need locally.

Pathway:

  • DHEA and DHEA-S act as part of the circulating precursor pool
  • DHEA can be turned into androstenedione via 3β-HSD
  • DHEA can also be turned into androstenediol mainly via AKR1C3 / 17β-HSD5

From there, different tissues can take those precursors in different directions depending on their enzyme machinery

So the main issue here is not, “Is one final hormone low?”
It is, “Is the body keeping the whole precursor stream going well enough for tissues to do their local work?”

If that stream is weak, poorly sulphated, poorly stored, badly recycled, or simply not reaching tissues well, everything further downstream starts to feel patchy.

Wider support:
This whole layer is easily thrown off by the kind of things that chip away at the system day after day.

Poor sleep. Chronic stress. Alcohol. Ultra-processed food. Oxidative stress. Under-eating. Blood sugar swings. A liver that is not keeping up well with storage and recycling. Too much pressure on the adrenals for too long.

This is why I think of this as a foundation pattern rather than a tissue-specific one.

When this level is underpowered, every other cluster becomes harder to shift. You can support the brain, the vagina, the joints, the skin – but if the upstream supply is weak and the body is not handling it well, the results often stay partial.

Support options:

  • Vitamin C – useful because the adrenal glands are rich in vitamin C and use a lot of it. I think of it as support for adrenal function and adrenal resilience, especially where stress has been high for a long time.
  • B3 (niacinamide / nicotinamide) – useful because it supports the NAD/NADP pool that underpins this redox chemistry. This is one of the key nutrients here.
  • B2 – useful alongside B3 as part of the wider redox support the pathway depends on.
  • Vitamin B5 – helpful as part of the broader machinery of steroid hormone production.
  • MSM – useful as a possible support for the body’s sulfate pool, which feeds sulphation, the store-and-release side of hormone handling.
  • Magnesium glycinate – helpful where poor sleep, nervous system tension and long-term stress are dragging the whole system down.
  • Omega-3 fish oil – useful as broader support for membrane quality and inflammatory tone.
  • Folate – useful as background support for the wider metabolic terrain.
  • Iron, if deficient – only if labs suggest low iron or low ferritin – which many women have after heavy blood loss in perimenopause. Iron matters for heme-based enzyme systems more broadly, but it is not something I would add routinely in menopause.

When this underperforms or tips the wrong way:

Everything feels dimmer. The brain feels duller. Mood drops. Dryness shows up in more than one place. Energy and resilience go down. Even sensible interventions only seem to help halfway, because the body has not got a strong enough upstream supply of raw materials to work with.

This is often the pattern underneath the woman who says, “I’m not terrible in one specific way. I just feel flat everywhere.”