Evidence check: SHBG in the context of Wechseljahre

SHBG (sex hormone-binding globulin) is often included in hormone panels like the MyBody-X Body-Balance Check. During menopause, estrogen declines while testosterone remains relatively stable, leading to a relative androgen excess. SHBG is increased by estrogen and decreased by androgens, so the free androgen index (FAI) often rises postmenopausally. Low SHBG is associated with metabolic syndrome, insulin resistance, and increased cardiovascular risk. However, SHBG alone is not diagnostic for menopause or for guiding hormone replacement therapy. The evidence is based on observational studies, not RCTs. MyBody-X tests provide hints, not medical diagnoses. For symptoms or treatment decisions, clinical evaluation with lab tests (e.g., estradiol, FSH, testosterone) is required. Caveat: SHBG levels vary diurnally and are affected by medications (e.g., oral contraceptives, antiepileptics).