If you’ve ever felt inexplicably fatigued after months of hard training, noticed your menstrual cycle going missing from excessive cardio, or struggled with stubborn weight despite eating clean, your hormones may be sending you signals. As a naturopathic doctor, I often use the DUTCH Test (Dried Urine Test for Comprehensive Hormones) to gain a detailed picture of my patients' hormonal balance. This test provides invaluable insights into sex hormones (estrogens, progesterone, and androgens), adrenal hormones like cortisol, and their metabolites, revealing how your body produces, metabolizes, and detoxifies hormones¹. 

Why Hormonal Testing Matters for Exercise Choices 

Hormones regulate numerous bodily functions including metabolism, energy, mood, and recovery. Exercise itself influences hormone levels—boosting beneficial hormones like testosterone, growth hormone, and DHEA temporarily after workouts. However, excessive or inappropriate exercise can disrupt hormonal balance, especially in women². The DUTCH Test helps identify your unique hormonal status, enabling a personalized exercise plan that supports rather than stresses your endocrine system¹. 

Key Hormones from the DUTCH Test and Exercise Implications 

• Estrogens and Metabolites: The DUTCH Test reveals estrogen levels and how well your body detoxifies estrogens through phase 1 (hydroxylation) and phase 2 (methylation) pathways. Excess circulating estrogen is associated with symptoms sometimes described as estrogen dominance and may play a role in conditions like PMS and PCOS. Estrogen is a key hormone influencing muscle health in women, and its natural decline during menopause can significantly accelerate age-related loss of muscle mass and strength. Research indicates that lower estrogen levels impair processes essential for muscle maintenance, such as protein synthesis, satellite cell function, and mitochondrial efficiency, while also increasing inflammation and oxidative stress that further contribute to muscle breakdown and reduced regenerative capacity³.  
• Progesterone Metabolites: Progesterone balance is critical for menstrual health, mood stability, and fertility. Low progesterone or imbalances can worsen from excess stress and overtraining⁴. 
• Androgens (Testosterone, DHEA-S): Androgens influence muscle mass, energy, and libido. The test also shows if androgen metabolism favors the 5α-reductase pathway, linked to issues like acne and hair loss⁵. 
• Cortisol and Adrenal Hormones: Cortisol regulates stress response and energy. Chronic high cortisol from overtraining or stress can suppress sex hormones and impair recovery⁶. Low cortisol is associated with persistent muscle weakness, fatigue, and reduced exercise tolerance.  

Cortisol: The Double-Edged Sword of Stress and Movement 

Every workout you do sends messages to your hypothalamic-pituitary-adrenal (HPA) axis—a central command system for stress response, energy regulation, and hormone balance⁶. When your brain perceives stress (from a work deadline, an intense workout, or poor sleep), your hypothalamus releases corticotropin-releasing hormone (CRH), which signals the pituitary gland to secrete adrenocorticotropic hormone (ACTH). ACTH prompts your adrenal glands to release cortisol, your primary stress hormone. Cortisol boosts blood sugar for quick energy, suppresses non-essential functions, and regulates inflammation⁷. 

Cortisol isn’t inherently bad—it helps us wake up, fuels workouts, and regulates metabolism. But when stress is chronic, cortisol patterns can become disrupted. You might feel wired but tired, struggle with abdominal fat, or crash in the afternoons. Research shows that while short bursts of HIIT or heavy lifting spike cortisol temporarily, chronic or excessive exercise without adequate recovery can lead to dysregulated cortisol rhythms and symptoms of overtraining ^2,6,8. 

If your DUTCH test shows high or dysregulated cortisol, focus on: 

• Gentle movement (walking, swimming, restorative yoga) to calm the nervous system⁹ 
• Short, strategic HIIT (10-20 minutes, 2x/week max) to avoid overstressing adrenals^6,8 
• Morning sunlight + movement to reinforce a healthy cortisol awakening response¹⁰ 

If your DUTCH test shows low or dysregulated cortisol, focus on: 

• Focus on Low-Impact, Low-Intensity Activities: Gentle exercises such as walking, swimming, yoga, Pilates, tai chi, and barre are recommended. These activities are less likely to overwhelm your stress response and support recovery. 
• Emphasize Consistency and Enjoyment: Regular, moderate movement—like brisk walking or cycling for 30 minutes—can help your body gradually adapt to stress and maintain muscle health without overtaxing the adrenals. 
• Incorporate Mind-Body Practices: Yoga, tai chi, and Pilates combine movement with breathwork and mindfulness, which help calm the nervous system and may support a healthier cortisol rhythm over time. 

Research evidence suggests that excessive high-intensity exercise, particularly when not balanced with sufficient recovery, can disrupt normal cortisol rhythms and negatively impact overall health.  Alternating high-intensity days with restorative movement like yoga or walking is supported by evidence showing these activities lower cortisol and promote parasympathetic nervous system activity⁹. 

Estrogen, Testosterone, and the Strength Training Advantage 

Many women believe cardio is the holy grail for hormonal balance, but excessive endurance training can worsen estrogen dominance and suppress progesterone⁴. Moderate aerobic exercise helps the liver metabolize estrogen¹¹, while resistance training triggers increases in free testosterone, which is beneficial for both women and men^2,5. In patients with PCOS, combining strength training with lifestyle interventions improves insulin sensitivity more effectively than cardio alone¹². 

Sample protocol: 

• 2-3 days/week: Heavy compound lifts (squats, deadlifts) 
• 2 days/week: Moderate-intensity aerobic exercise (e.g., brisk walking) 
• 1 day/week: HIIT (short intervals) 
• Daily: 10-minute post-meal walks to lower glucose spikes 

The Blood Sugar Hack: Why Timing Your Workouts Matters 

For individuals with PCOS, prediabetes, or afternoon energy crashes, exercise timing is as important as the workout itself. A 2017 study by Reynolds et al. found that walking for just 10 minutes after meals significantly lowered postprandial glucose compared to a single 30-minute morning walk¹³. Muscle contractions activate GLUT4 transporters, shuttling glucose into cells independent of insulin¹⁴. Pairing post-meal walks with resistance training builds muscle and further improves glucose handling. 

The Recovery Paradox: Why Less Is More for Hormone Health 

Overtraining can disrupt thyroid hormones, blunt growth hormone release, and suppress progesterone, especially in women^6,8,15. Monitoring resting heart rate, prioritizing sleep, and ensuring adequate rest days are essential for hormonal recovery¹⁴. 

Special Considerations: Menopause and Thyroid Issues 

• Perimenopause / Menopause: Bone-loading exercises (e.g., jumping rope, heavy carries, plyometrics) are crucial to prevent bone loss¹⁵. 
• Hypothyroidism/Hashimoto’s: Short strength sessions and daily walking are generally easier to maintain and less likely to worsen fatigue than chronic cardio. These forms of exercise place less stress on the body’s energy systems and support recovery, making them more suitable for individuals experiencing low energy due to thyroid dysfunction³. 

Putting It All Together: Your Hormone-Balancing Exercise Prescription 

Test First 

• DUTCH test for cortisol/sex hormones 
• Fasting insulin + glucose if metabolic issues 
• Thyroid panel if fatigued 

Move Strategically 

• High intensity: 2-3x/week max 
• Strength training: 3x/week (focus on big lifts) 
• Daily walking: Minimum 30 minutes, ideally after meals 

Recover Like Your Hormones Depend On It 

• Sleep 7-9 hours nightly 
• Take 1-2 rest days weekly 
• Consider adaptogens (with professional guidance) for HPA support 

The takeaway: Exercise is a potent hormone modulator—but only when personalized. Start with testing, listen to your body’s signals, and remember: in hormonal health, consistency always beats intensity. 

References 

1. Precision Analytical Inc. DUTCH Test Clinical Guide. (2023). 
2. Hackney, A. C. (2020). Stress and the neuroendocrine system: the role of exercise as a stressor and modifier of stress. Expert Review of Endocrinology & Metabolism, 15(3), 227-236. 
3. Pellegrino A, Tiidus PM, Vandenboom R. Mechanisms of Estrogen Influence on Skeletal Muscle: Mass, Regeneration, and Mitochondrial Function. Sports Med. 2022;52(12):2853-2869. doi:10.1007/s40279-022-01733-9 
4. Williams, N. I., et al. (2015). Exercise and the stress system. Hormones and Behavior, 76, 1-15. 
5. Handelsman, D. J. (2017). Androgen physiology, pharmacology, use and misuse. Asian Journal of Andrology, 19(2), 134-140. 
6. Meeusen, R., et al. (2013). Prevention, diagnosis, and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 45(1), 186-205. 
7. Tsigos, C., & Chrousos, G. P. (2002). Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress. Journal of Psychosomatic Research, 53(4), 865-871. 
8. Duclos, M. (2008). Overtraining syndrome in athletes. Annales d'endocrinologie, 69(2), 116-121. 
9. Pascoe, M. C., & Bauer, I. E. (2015). A systematic review of randomised control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68, 270-282. 
10. Scheer, F. A., & Buijs, R. M. (1999). Light affects morning salivary cortisol in humans. The Journal of Clinical Endocrinology & Metabolism, 84(9), 3395-3398. 
11. Ennour-Idrissi, K., et al. (2015). Estrogen metabolism and breast cancer risk: a review. Breast Cancer Research, 17(1), 1-14. 
12. Hutchison, S. K., et al. (2011). Exercise improves insulin resistance and markers of cardiovascular health in polycystic ovary syndrome: a randomized controlled trial. Clinical Endocrinology, 74(5), 593-600. 
13. Reynolds, A. N., et al. (2017). Walking after meals: A systematic review and meta-analysis of randomised controlled trials. Pediatric Diabetes, 18(6), 664-675. 
14. Richter, E. A., & Hargreaves, M. (2013). Exercise, GLUT4, and skeletal muscle glucose uptake. Physiological Reviews, 93(3), 993-1017. 
15. Howe, T. E., et al. (2011). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database of Systematic Reviews, (7).