By Dr. Francesca Testa 

Have you ever noticed how your body seems to change the rules on you every few years? One moment, you’re thriving on green smoothies and HIIT classes, and the next, you're exhausted, bloated, and wondering why your skin is suddenly breaking out again in your 30s, or why sleep feels elusive in your 40s.

The truth is: our hormonal landscape as women is constantly evolving. From our first period to pregnancy, postpartum, and eventually perimenopause and menopause, our bodies undergo profound metabolic and endocrine shifts. And with each new chapter, our nutritional needs shift too.

It’s not just about tracking calories or eating clean. It’s about learning how to fuel our bodies to support complex, delicate systems—systems that regulate everything from fertility and energy to bone density and brain clarity. Whether you’re trying to conceive, managing perimenopausal symptoms, or simply seeking more energy and less anxiety, what you eat can either nourish or stress your hormones.

And while there are unique micronutrient needs at every life stage, there’s one universal truth: adequate energy intake is the foundation. If we don’t eat enough to meet the demands of our everyday life (plus the extras of stress, movement, or caregiving), the body begins to prioritise survival—often at the expense of hormone balance, muscle maintenance, and long-term health.

Today we break down how a balanced diet can support you—and your hormones—at every age and stage.

The Power of a Truly Balanced Diet

When we hear “balanced diet,” we often think of plates divided neatly into thirds. But this goes far deeper than just ratios: it’s about variety, abundance, and nourishment.

A truly balanced diet includes all three macronutrients:

• Carbohydrates, our body’s primary energy source, are especially important for women because they play an important role in women’s health by indirectly supporting cortisol balance and supporting serotonin levels—two major players in hormonal and emotional health.

Carbohydrates can be broadly divided into two main types:

1. Complex Carbohydrates
   These include starches found in foods like rice, pasta, oats, and potatoes. Wholegrain or "brown" versions are also rich in fibre—a non-digestible carbohydrate that doesn’t provide energy to us directly, but plays a vital role in nourishing the gut microbiome and supporting healthy digestion.
   
   

2. Simple Carbohydrates
   These are found in fruits, honey, and refined sugars. While they’re quickly metabolised and can provide a fast source of energy, it’s important to be mindful of the source and quantity, especially when balancing blood sugar and mood.
   
   

• Fats are essential for hormone production. Cholesterol, often vilified, is the precursor to our sex hormones like oestrogen and progesterone.  While our bodies naturally produce cholesterol, we also get it from our diet. Interestingly, when dietary intake increases, the body typically compensates by producing less, helping to keep overall levels within a healthy range.

Fats come in different forms, each with a distinct impact on our health:

• Unsaturated Fats: found in foods like avocados, nuts, seeds, olive oil, and oily fish like salmon, unsaturated fats are considered the most beneficial for cardiovascular health. They support hormone production, reduce inflammation, and help maintain healthy cholesterol levels.
  
  

• Saturated Fats: primarily found in animal-based products such as butter, full-fat dairy, and the visible fat in meat, saturated fats can be part of a balanced diet but are best consumed in moderation, as excessive intake may contribute to elevated cholesterol and increased cardiovascular risk in some individuals.
  
  

• Protein is vital for tissue repair, immune function, and building and maintaining muscle—especially important as we age and naturally lose lean mass.
  
  

• Eggs, meat, fish, lentils, tofu, chicken, Greek yoghurt, hemp seeds, and tempeh.
  
  

But macronutrients are just the start. A diverse, colourful diet ensures that we get the micronutrients—vitamins and minerals—that help our enzymes and hormones work properly. Think:

• Iron and B12 for energy and blood health
  
  

• Magnesium for mood and muscle relaxation
  
  

• Zinc for immune and reproductive function
  
  

• Calcium and vitamin D for bone health
  
  

And then there's fibre, often the unsung hero of hormonal health. Found in fruits, vegetables, whole grains, legumes, nuts, and seeds, fibre supports a healthy gut microbiome—which, as recent research has shown, plays a role in metabolising oestrogen and regulating inflammation. The gut microbiome doesn't just affect digestion—it plays an active role in recycling oestrogen and regulating its levels in the body, which is crucial for hormonal balance.

Your gut, in other words, is not just your digestion centre— but it’s also been suggested that it could be your hormonal ally.

What Happens When We Don’t Eat Enough: The Hidden Cost of Low Energy Availability (LEA)

In a world obsessed with dieting, “clean eating,” and high-output fitness, many women are unknowingly under-fuelling—eating too little or skipping carbs, while pushing themselves through high-intensity workouts or long days of stress.

This state of low energy availability (LEA) happens when the energy you consume isn’t enough to support both your physical activity and all body functions. And the body responds accordingly: by conserving energy for essential survival tasks and switching off what it deems non-essential, including:

• Reproductive function
  
  

• Bone building
  
  

• Muscle repair
  
  

• Metabolic efficiency
  
  

In LEA, hormonal pathways across the body are affected: menstrual cycles can become irregular or stop, oestradiol drops, bone becomes fragile, metabolism slows, and muscle growth is impaired.

Here’s what this can look like in real life:

• You’re exercising regularly but not getting stronger or seeing results.

• Your menstrual cycle becomes irregular—or disappears entirely.

• Difficulty concentrating or staying focussed

• Slower digestion and/or constipation

• Low mood or lack of motivation

• You feel cold often, even in warm environments.

• Your libido drops.

• You’re tired but wired at night, and foggy during the day.

• Bone loss and increased risk of fractures and osteoporosis 

• Impaired fat metabolism, leading to fat buildup in arteries (risking heart disease)

• Worsened insulin sensitivity, increasing the risk for blood sugar dysregulation and type 2 diabetes

This is your body in a stress state, with elevated cortisol contributing to disrupt hormonal communication from the brain.

In pre-menopausal women, LEA disrupts the hypothalamic-pituitary-gonadal axis—a key regulator of reproductive hormones. When this axis is disrupted, the production of oestradiol and progesterone from the ovaries decrease. The disruption of this important hormonal axis can lead to Irregular menstrual cycles (oligomenorrhoea) or lack of menstrual cycle (amenorrhoea).

The Thyroid and Muscle Connection

In LEA, not only does oestrogen suffer—so does the thyroid. Low energy intake and decrease body fat lower leptin, the hormone that signals the brain that you’ve eaten enough. Low leptin impacts the hypothalamic-pituitary-thyroid axis, reducing T3, the active thyroid hormone.

With lower T3:

• Your metabolic rate slows, meaning you burn fewer calories at rest and how you store carbohydrates and protein is also affected

• You may feel sluggish, struggle with weight gain, and feel cold or mentally foggy
  
  

Muscle growth is also impaired due to reduced IGF-1 (insulin-like growth factor 1). This matters not just for fitness goals, but for long-term health: less muscle = lower metabolism, greater risk of insulin resistance, and less protection against ageing.

This is especially critical during:

• Postpartum recovery, when muscle mass and nutrient reserves are already depleted
  
  

• Perimenopause and menopause, when lean mass declines rapidly if not actively maintained with proper nutrition and strength training
  
  

Practical Takeaways for Every Life Stage

No matter your age or hormonal phase, these habits support your health:

Eat enough—and regularly: Especially during busy or stressful periods. Skipping meals, intermittent fasting, or overly restricted eating can disrupt your hormones even if you're eating “healthy” foods.

Make fibre your friend: Aim for 25–30g per day from whole foods. Add ground flaxseeds to yoghurt, swap white rice for brown rice, snack on hummus and carrots, or enjoy lentil stews and vegetable soups.

Include carbs and healthy fats with each meal: They’re not your enemy—they’re your hormone fuel.

Tune into your symptoms: Fatigue, irregular cycles, dry skin, hair thinning, or brain fog are not just “normal”—they’re signs your body may need more nourishment.

Seek professional help: If these symptoms are ongoing, it’s important to seek guidance from a trusted medical or nutrition professional. These signals are your body’s way of asking for support, and addressing them early can prevent deeper imbalances down the line. You deserve care that listens, investigates, and responds with solutions tailored to you.

Support your gut: A thriving microbiome helps regulate inflammation, stress, and hormone detoxification. Fermented foods like sauerkraut, kimchi, kefir, and miso can be supportive, alongside plenty of plant diversity.

Real Food, Real Balance

A balanced and varied diet is the cornerstone of both metabolic and hormonal health. It’s not just about eating “clean”—it’s about consistently providing your body with the fuel it needs to function, adapt, and thrive.

When we don’t meet our energy or carbohydrate needs—especially during demanding seasons of life—we can slip into a state of low energy availability. This can quietly disrupt our reproductive health, weaken our bones, slow our metabolism, and alter our body composition in ways that don’t serve our long-term wellbeing.

On the flip side, ensuring a fibre-rich, diverse diet supports not only digestion and controls our blood sugar but also the health of our microbiome—a key player in hormonal balance, immune function, and even mental clarity.

Every meal is a chance to nourish the systems that carry us through life. The more we honour our changing needs, the more we create a foundation of strength, stability, and true vitality.  If you find yourself feeling confused, stuck, or unsure of what your body truly needs, know that you don’t have to figure it out alone. Working with a qualified medical or nutritional professional can offer the clarity, personalised guidance, and support you deserve. 

REFERENCES

• https://pmc.ncbi.nlm.nih.gov/articles/PMC9687867/

• https://pubmed.ncbi.nlm.nih.gov/33095376/

• https://pubmed.ncbi.nlm.nih.gov/38936255/

• https://pmc.ncbi.nlm.nih.gov/articles/PMC10780928/

• https://pmc.ncbi.nlm.nih.gov/articles/PMC377492/

• https://www.ncbi.nlm.nih.gov/books/NBK500006/

About Dr Francesca Testa

Dr Francesca Testa (BSc (hons), MBBS, MSc) is a practising medical doctor, registered associated nutritionist (ANutr), certified health coach, personal trainer, and the founder of Core Health and Wellness.

She is currently working in clinical medicine, research and in medical weight loss services. Her research interests include low energy availability and relative energy deficiency in sport (REDs).

With a career spanning clinical practice, teaching, research, management consulting and health-tech, she has a unique understanding of the distinct challenges to wellbeing experienced across different industries. Being an ex-gymnast and now a keen endurance runner, she has a deep appreciation of the physical and emotional demands of training (as well as the rewards that come with it).

Francesca is passionate about a holistic approach to health, rooted in balanced nutrition, whole-body movement, and mindset shifting.

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life –– The SABI is changing the narrative around our hormones from one of taboo, embarrassment, and loneliness to awareness and even, pride. As more than a wellness brand, The SABI offers a carefully-crafted line of products to carry you through your hormonal journey, including rituals, supportive tools, and ancient herbal remedies that have been tested time and time again by women and now come backed by medicine. The SABI is a blend of science and nature conceived by women who have experienced the joys and deep struggles of bringing a child into the world, the pains of a heavy, difficult period, miscarriage, and difficulty conceiving.

We invite you to get to know your body and its cycles better –– to really understand what is going on inside. Learn to use your hormones to your advantage no matter your stage of life, and know that you can support and balance your hormone levels. We are here to help with the information, understanding and natural tools to support your body and the emotional process along with it.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation.