What role does SHBG play in Wechseljahre?

SHBG (sex hormone-binding globulin) binds estradiol and testosterone in the blood, regulating their free, bioactive fractions. During menopause, ovarian estrogen production declines sharply, often accompanied by a drop in SHBG, which can lead to a relative increase in free testosterone. Low SHBG levels are associated with a higher risk of metabolic syndrome, insulin resistance, and weight gain – common issues in menopause. However, measuring SHBG alone is not diagnostic for menopausal status; it is typically used as part of a broader hormone panel (e.g., free androgen index). The evidence for direct clinical utility of consumer blood tests measuring SHBG in menopause management is weak. Many factors – diet, exercise, liver function, and genetic variants (e.g., in the SHBG gene) – influence levels. Therefore, SHBG should not be interpreted in isolation. For menopausal symptoms, a physician-led hormone assessment is more appropriate than a self-test.