SHBG and Surgical Menopause: What You Need to Know About Hormone Balance

When navigating surgical menopause, many women find that Hormone Replacement Therapy (HRT) is essential for managing symptoms and supporting long-term health. But one important factor that often gets overlooked in the conversation is Sex Hormone Binding Globulin (SHBG).

If you’ve never heard of SHBG before, don’t worry—you’re not alone. Let’s break it down and talk about why it matters, especially for women in surgical menopause.

What is SHBG?

SHBG is a protein made by your liver that binds to sex hormones like estrogen, testosterone, and dihydrotestosterone (DHT). Think of it as a "carrier" protein. While SHBG plays an important role in regulating hormone availability, it can also limit how much of your hormones are actually free (or bioavailable) for your body to use.

This means that even if your blood test shows a certain level of estrogen or testosterone, high SHBG levels might make those hormones less effective in your body.

Why SHBG Matters in Surgical Menopause

For women in surgical menopause who are on HRT, SHBG can significantly influence how well treatment works.

• High SHBG levels: More of your hormones are "tied up" and unavailable for your body to use. This often means you may need a higher dosage of HRT to get symptom relief.

• Low SHBG levels: More hormones remain free and active, which may reduce the amount of HRT needed.

This is why two women with the exact same prescription can have very different experiences with symptom relief.

What Causes High SHBG?

Several factors can increase SHBG levels, including:

• Oral estrogen therapy (taken by mouth rather than transdermally)

• High thyroid hormone levels

• Liver conditions

• Certain medications

• Genetic predisposition

For many women, switching from oral estrogen to transdermal estrogen (patch, gel, or cream) or subcutaneous injections can naturally lower SHBG and improve symptom control.

Natural Ways to Support Healthy SHBG Levels

If your SHBG is high, there are natural strategies that may help bring it down and improve your hormone balance. Always talk with your healthcare provider before making changes, but here are some supportive options:

1. Stinging Nettle Root

   • This herbal supplement may help reduce SHBG levels, making more hormones available for your body to use.

2. Boron

   • A trace mineral that has been shown in studies to lower SHBG and increase free testosterone. It may also support bone health—important for women in menopause.

3. Nutrition and Lifestyle

   • Maintaining healthy liver function through a balanced diet, reduced alcohol intake, and minimizing processed foods can also support optimal SHBG balance.

Key Takeaway

If you’re in surgical menopause and feel like your HRT isn’t working as well as it should, SHBG may be part of the puzzle. Testing your SHBG levels can give you and your doctor important insights and help you fine-tune your treatment plan.

By understanding how SHBG works—and supporting your body with both medical guidance and natural strategies—you can move closer to the balance your body needs.

Medical Disclaimer

This article is for educational purposes only and is not intended to diagnose, treat, or replace professional medical advice. Always consult with a qualified healthcare provider before making changes to your hormone therapy, supplements, or lifestyle.