Women's Health
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November 18, 2024

Functional Medicine Obstetrics and Gynecology: Essential Lab Tests for Women's Health

Medically Reviewed by
Updated On
November 21, 2024

Women's health issues are often complex and deeply interconnected, leading to prolonged struggles with symptoms like fatigue, hormonal imbalances, and reproductive challenges. In recent years, the functional medicine approach in obstetrics and gynecology has gained traction for its focus on personalized, root-cause-focused care. By using comprehensive lab testing, this method moves beyond symptom management to uncover underlying imbalances that affect women's health.Β 

This article explores the essential lab tests that functional medicine practitioners use to enhance diagnostic accuracy, create tailored treatment plans, and, ultimately, transform outcomes for women.Β 

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Understanding Functional Medicine in Obstetrics and Gynecology

An obstetrician/gynecologist, or OB/GYN, is a healthcare professional who specializes in female reproductive health. Taking a functional medicine approach to obstetrics and gynecology means looking beyond immediate symptoms to address the underlying causes of women's health issues.

Traditional OB/GYN practices often center on symptom management and treating diseases as they present. Functional medicine, on the other hand, seeks to identify and address the root causes of health problems, promoting overall wellness and preventing future issues.

Comprehensive, functional lab testing helps identify underlying causes of women's health issues that might remain hidden in traditional assessments. These tests provide objective data that inform personalized treatment plans, ensuring that interventions are targeted and effective.

Key Functional Medicine Labs for Obstetrics and Gynecology

Functional OB/GYN utilizes a variety of lab tests, each designed to evaluate different aspects of a woman's health.Β 

Thyroid Panel

A thyroid panel assesses thyroid gland function. The thyroid produces hormones that regulate metabolism.

Components of the Test

A comprehensive thyroid panel includes the following biomarkers to evaluate the hypothalamic-pituitary-thyroid (HPT) axis:Β 

  • Thyroid-Stimulating Hormone (TSH): Indicates how well the thyroid is functioning
  • Free T3 and Free T4: Measure the active thyroid hormones
  • Reverse T3: Helps assess thyroid hormone conversion
  • Thyroid Antibodies: Detect autoimmune thyroid conditions

Clinical Applications in Women's Health

Thyroid disease affects one in eight women and can have significant impacts on women's health. Thyroid disease can cause:

When thyroid dysfunction is diagnosed, it can be corrected through pharmaceutical and natural means:

  • Levothyroxine (synthetic T4) is the first-line therapy for replacing deficient thyroid hormone in hypothyroidism.
  • Hyperthyroidism may be treated with antithyroid medications (methimazole or propylthiouracil), radioactive iodine therapy, or surgical removal of the thyroid gland (thyroidectomy).
  • A nutrient-dense diet (rich in selenium, zinc, and iodine), adequate sleep, effective stress management, and anti-inflammatory practices can help improve thyroid function (17).Β 

Test Examples

Cardiometabolic Panel

A cardiometabolic panel evaluates factors that influence cardiovascular and metabolic health, including cholesterol levels, blood sugar, and inflammation markers.

Components of the Test

  • Lipid Panel: Assesses cholesterol and triglyceride levels
  • Fasting Glucose and Insulin: Evaluates blood sugar control and insulin resistance
  • Hemoglobin A1c (HbA1c): Provides an average blood sugar level over three months
  • C-Reactive Protein (CRP): Measures systemic inflammation

Clinical Applications in Women's Health

Metabolic syndrome (MetS) is a cluster of conditions, including abdominal obesity, dyslipidemia, hypertension, and insulin resistance, which collectively increase the risk of type 2 diabetes mellitus and atherosclerotic cardiovascular disease (ASCVD).

Women with MetS have a higher prevalence of cardiovascular complications compared to men (42).Β 

Postmenopausal women are particularly vulnerable to MetS due to hormonal changes that exacerbate insulin resistance and fat accumulation.Β 

Cardiovascular risk can be lowered by bringing cardiometabolic biomarkers into optimal ranges through heart-healthy lifestyle changes, targeted medications, and supportive nutraceuticals.

Test Examples

Female Hormone Panel

A female hormone panel measures sex hormones that regulate the female reproductive system.Β 

Components of the Test

  • Estrogens: Responsible for the development and regulation of the female reproductive system and sex characteristics. Estradiol (E2) is the primary estrogen in premenopausal women. Estrone (E1) is the primary estrogen post-menopause. Estriol (E3) is produced during pregnancy by the placenta.
  • Progesterone: Prepares the uterus for implantation of a fertilized egg and maintains pregnancy.
  • Testosterone: Is converted to estradiol and plays a role in libido, bone strength, and muscle mass.
  • DHEA-S: An androgenic hormone produced by the adrenal glands that acts as a precursor to other sex hormones.
  • Sex Hormone-Binding Globulin (SHBG): A protein that regulates the availability of sex hormones.

Clinical Applications in Women's HealthΒ 

Hormonal imbalances can lead to symptoms like irregular periods, infertility, mood swings, and decreased libido. Common imbalances include:

  • Estrogen Dominance: Estrogen levels are elevated in relation to progesterone. This is associated with painful and heavy periods, PMS and PMDD, fibrocystic breasts, headaches, reproductive cancers, endometriosis, and fibroids. (12)Β 
  • Progesterone Deficiency: Low progesterone symptoms include abnormal uterine bleeding, irregular periods, frequent miscarriages, and PMS.
  • Hyperandrogenism: Androgen excess refers to elevated levels of testosterone and DHEA. It is associated with polycystic ovary syndrome (PCOS), irregular periods, acne, weight gain, hirsutism, alopecia, and infertility.Β 

Test Examples

Adrenal Stress Profile

An adrenal stress profile assesses adrenal gland function by measuring the hormones involved in the stress response and energy metabolism.

Components of the Test

  • Cortisol: Often called the "stress hormone" because the adrenal glands produce it to support the body in adapting to a stressful trigger
  • DHEA: Reflects adrenal hormone production

Clinical Applications in Women's Health

Chronic stress activates the hypothalamic-pituitary-adrenal (HPA) axis, resulting in sustained cortisol elevations. Over time, this overactivation of the HPA axis disrupts the natural diurnal rhythm of cortisol, leading to symptoms like insomnia, anxiety, and fatigue.Β 

Chronic elevations in cortisol also interfere with the signaling pathways controlling thyroid and ovarian function, perpetuating additional hormonal imbalances. This can manifest as fatigue, weight gain, depression, and menstrual irregularities. (68)Β 

Abnormal adrenal stress profile results necessitate the importance of stress management through techniques like a healthy diet, quality sleep, adaptogenic herbs, and mind-body therapies.Β 

Test Examples

Micronutrient Test

A micronutrient test assesses levels of essential vitamins, minerals, antioxidants, and other nutrients within the body, offering a complete picture of nutritional health. This type of testing is valuable because it can identify nutritional imbalances that might not yet present as obvious symptoms but could impact immune function, energy levels, mental clarity, and hormonal health.

Components of the Test

Micronutrient tests will assess the status of 30+ vitamins, minerals, antioxidants, amino acids, and fatty acids. Examples of nutrients that are especially relevant to women's health include:

  • Calcium: Supports strong bones and teeth and plays a role in muscle function and cardiovascular health. Postmenopausal women are particularly at risk of osteoporosis.
  • Vitamin D: Necessary for calcium absorption, vitamin D also supports immune health, mood regulation, and hormone balance.Β 
  • Iron: Integral to oxygen transport in the blood. Women of reproductive age need more iron due to menstrual blood loss, with deficiency leading to anemia, fatigue, and impaired cognitive performance.
  • Folate: Important for cell growth and DNA synthesis, folate is especially critical for women who are pregnant or trying to conceive, as it helps prevent neural tube defects in the developing fetus.
  • Magnesium: Supports muscle and nerve function, energy production, and mood regulation. It also aids in hormone balance and can relieve PMS symptoms.

Clinical Applications in Women's Health

Detecting suboptimal and deficient nutrients helps OB/GYNs make targeted dietary, supplemental, and lifestyle recommendations to optimize nutritional health and alleviate ailments.

For example, menstruating women deficient in iron will benefit from eating more iron-rich foods and supplementing with iron (either by oral or intravenous administration). Exposure to sunlight and supplements can be recommended to optimize vitamin D levels.Β 

Test Examples

Comprehensive Stool Analysis

A comprehensive stool analysis examines the health of the gastrointestinal tract, including gut microbiota, digestive function, and markers of inflammation.

Components of the Test

  • Microbiome Composition: Diversity and balance of gut bacteria
  • Digestive Function Markers: Enzyme levels, macronutrient absorption
  • Inflammation Markers: Calprotectin, lactoferrin, white blood cells
  • Microbial Metabolites: Short-chain fatty acids (SCFAs), beta-glucuronidase
  • Pathogen Screening: Presence of harmful bacteria, parasites, or yeast

Clinical Applications in Women's Health

The estrobolome is a collection of gut bacteria that plays a role in regulating estrogen metabolism within the body. A balanced estrobolome maintains balanced estrogen levels by breaking down estrogen metabolites and preparing them for excretion from the body. An imbalance in the estrobolome can lead to estrogen dominance by excessively recycling estrogens into circulation.

A comprehensive stool analysis can identify dysbiotic patterns in the gut microbiome that may contribute to systemic women's health issues, such as PCOS, cancers, bone diseases, Alzheimer's disease, and obesity.Β 

Recognizing dysbiosis allows healthcare providers to target specific imbalances with personalized interventions, such as probiotics, dietary adjustments, and lifestyle changes, to restore a healthy microbiome and potentially mitigate the risk or severity of these conditions.

Test Examples

Vaginal Microbiome Analysis

Vaginal microbiome analysis assesses the microbial composition of the vaginal environment.

Components of the Test

  • Lactobacillus spp.: Beneficial bacteria that maintain a healthy vaginal environment and protect against infection protect against pathogens.
  • Pathogens: Presence of harmful organisms like Gardnerella or Candida.

Clinical Applications in Women's Health

Vaginal dysbiosis leads to increased vaginal mucosal inflammation and epithelial disruption, compromising the vaginal barrier and immune defenses that predispose a woman to vaginal infections (4).

Chronic bacterial vaginosis is associated with poor obstetric and gynecologic health outcomes, including an increased risk of acquiring sexually transmitted infections, pelvic inflammatory disease, preterm birth, and low birth weight (2, 47).

Restoring a healthy microbiome promotes vaginal health and reduces the risk of complications.

Test Examples

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Key Takeaways

  • Integrating functional medicine lab tests into obstetrics and gynecology practices offers a comprehensive approach to women's health.Β 
  • A holistic approach to women's health and OB/GYN care involves assessing hormone levels, nutrient status, adrenal function, gut health, and more.
  • By leveraging lab testing, healthcare providers can enhance diagnostic accuracy, tailor treatments, and promote women's health.Β 
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Jaime Cloyd
Author
Dr. Jaime Cloyd ND
Naturopathic Physician based in the greater Seattle area
Medically Reviewed by
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Clinical Infectious Diseases
Peer Reviewed Journal
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Brain
Peer Reviewed Journal
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The Journal of Rheumatology
Peer Reviewed Journal
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Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
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Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
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Hepatology
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The American Journal of Clinical Nutrition
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The Journal of Bone and Joint Surgery
Peer Reviewed Journal
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Kidney International
Peer Reviewed Journal
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The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
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Annals of Surgery
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Chest
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The Journal of Neurology, Neurosurgery & Psychiatry
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Blood
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Gastroenterology
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The American Journal of Respiratory and Critical Care Medicine
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The American Journal of Psychiatry
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Diabetes Care
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The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
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The Journal of Clinical Oncology (JCO)
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Journal of Clinical Investigation (JCI)
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Circulation
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JAMA Internal Medicine
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PLOS Medicine
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Annals of Internal Medicine
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Nature Medicine
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The BMJ (British Medical Journal)
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The Lancet
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Journal of the American Medical Association (JAMA)
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Pubmed
Comprehensive biomedical database
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Harvard
Educational/Medical Institution
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Cleveland Clinic
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Mayo Clinic
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The New England Journal of Medicine (NEJM)
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Johns Hopkins
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