Women’s Heath and the HPA and HPG axes: Functional assessment, case studies and integrated working

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This short course...

  • is delivered: As an online on-demand-video from a live two- day course
  • is for: Nutrition practitioners, other health care providers and final year nutrition students interested in applying functional medicine approaches to health and well being (i.e. exploring how nutrients, other foods and lifestyle factors influence the function of the body and how to  apply findings in a person – centred manner that recognises individuals’ unique differences)
  • is with: Dr Nina Fuller-Shavel
  • spans: 10 hours recording time
  • provides: BANT CPD 10 hours

Women often seek nutritional and lifestyle support for a range of symptoms including fatigue, insomnia, brain fog, burnout, PMS/PMDD, PCOS, endometriosis and difficult menopause transitions. Appropriately exploring, assessing and addressing HPA (adrenal) and HPG (gonadal/sex hormone) imbalances and how these relate to other systems in the functional medicine matrix is essential in developing recommendations. It can be difficult to ascertain which tests are necessary and cost-effective, how to structure personalised plans to address any imbalances, when to re-test and when to refer. There are often challenges in effectively communicating with medical and other health practitioners and in understanding investigation and treatment options within the NHS. 

This course looks at how dysregulation within the HPA and HPG axes and their complex interplay with other systems can manifest as different physiological symptoms and patterns of dysregulation. It provides new ideas for how to spot particularly relevant information in your client’s story and how to assess testing options, including blood, salivary and urinary, e.g. DUTCH hormonal assessment, nutrigenetics and other options.  The course also reviews current literature regarding possible nutrition, supplementation and lifestyle interventions in specific contexts, including specific oestrogen, progesterone and testosterone-related patterns and supporting menopause management.  Finally, it helps practitioners understand more about what conventional treatments a client might be on, e.g. HRT options, how to integrate with the wider team safely and effectively and what can be helpful to ask NHS clinicians to investigate.



What will I learn?

By the end of the recording you will be able to:

  • Review and critically evaluate the potential common patterns of dysregulation within and between the HPA and HPG axes and evaluate their significance in person-specific contexts based on history taking, test results and other forms of assessment
  • Critically apply your knowledge around a range of testing options; nutrition and lifestyle recommendations, potential supplements and related approaches to develop clinically effective and cost-effective personalised and staged recommendations
  • Critically plan how best to monitor your client’s progress and maintain motivation when a long-term approach might be required
  • Work more effectively alongside GPs and other healthcare professionals through understanding NHS investigation and treatment options; when and how to refer and how to successfully communicate your approach.

What will be covered?

Session 1 (approx. 1hr 15 minutes))
HPA axis dysregulation: Options for assessment and implications across the functional medicine matrix

  • Disordered HPA axis physiology within specific clinical contexts
  • Recognising the inter-relationships of HPA axis dysfunction with other systems in the functional medicine matrix
  • Case study reflection
  • HPA axis assessment - tests and analytes to use to assess diurnal cortisol (including salivary cortisol, DHEA, cortisol : DHEA ratio and CAR); key patterns that may arise and how to interpret them
  • Session key points
  • Q and A

Session 2 (approx. 1hr 15 minutes)
Developing personalised and staged functional medicine recommendations to support HPA axis dysregulation

  • Common patterns of HPA axis dysfunction - three stages (adaptation, early and late decompensation) and a flattened HPA axis
  • Appropriate nutrition, supplementation (including adaptogens), lifestyle and mind-body recommendations
  • Tailoring your approach in different clinical scenarios - how to order and prioritise your recommendations
  • When and how to refer
  • Case study reflection
  • Monitoring progress using testing and clinical assessment and modifying your plan accordingly
  • Session key points
  • Q and A

Session 3 (approx 1 hr 15 minutes)
HPG (gonadal/sex hormone) axis dysregulation: Options for assessment and implications across the functional medicine matrix

  • Disordered HPG axis physiology within specific clinical contexts
  • Recognising the inter-relationships of HPG axis dysfunction with other systems in the functional medicine matrix
  • Case study reflection
  • Options available in the NHS for specific women’s health conditions including blood tests, imaging, related NHS guidelines and when to refer
  • HPG axis testing in the private setting - assessing hormone levels, metabolites and adjunctive system testing to consider, e.g. insulin resistance, GI testing
  • HPG axis and nutrigenetics - options available e.g. Lifecode Gx and DNA Health, their utility in clinic and deciding on which profile to use in different clinical contexts
  • Session key points
  • Q and A

Session 4 (approx. 1 hr 15mins)
Applying HPA axis and HPG axis disordered physiologies to the hormonal web and wider systems

  • How HPA and HPG dysfunction patterns affect each other and their relationship with thyroid function, blood sugar regulation and other hormone profiles.
  • Case study reflection
  • Digging deeper into the relationship between HPA and HPG axis dysfunctions and  other systems across the functional medicine matrix
  • Session key points and key takeaways for clinical practice
  • Q and A

Session 1 (approx. 1hr 15 minutes)
Developing personalised and staged functional medicine recommendations for specific oestrogen, progesterone and testosterone-related patterns

  • From menarche to menopause – pattern overview with a focus on oestrogen and progesterone
  • Managing oestrogen-progesterone balance and supporting healthy hormone metabolism
  • Case study reflection
  • Managing testosterone patterns in women
  • Monitoring progress using testing and clinical assessment and modifying your plan accordingly
  • Session key points
  • Q and A

Session 2 (approx. 1hr 15 minutes)
Developing personalised and staged functional medicine recommendations for managing the menopause

  • Common themes in menopause management – nutrition, lifestyle and mind-body interventions and considerations around HRT, including recent evidence
  • HRT options (synthetic, body identical and bio-identical) – what’s the difference; which are available on the NHS and how best to support clients access these
  • Sexual health and contraception around perimenopause
  • Case reflection
  • Important considerations in post-menopausal health, including neglected areas such as addressing increased risk of cardiovascular disease and  certain cancers and cognitive support
  • Session key points
  • Q and A

Session 3 (approx. 1hr)
Practical applications:  HPA-HPG axis case studies

This session will bring our earlier learning to life, looking at case studies in HPA-HPG axis management from the award-winning Synthesis Clinic. We will cover timeline and matrix consideration in each case and management plans, including nutrition, supplementation, lifestyle and mind-body approaches, as well as integrative medicine options.

  • Case study 1
  • Case 1 Q &A
  • Case study 2
  • Case 2 Q&A

Session 4 (approx. 1hr)
Complex women’s health cases and extended care team working

This session will cover different options in women’s healthcare, including medical, psychological and integrative modalities and potential indications for additional input. We will discuss how to work more effectively within extended care teams to support your client and successfully communicate your approach to GPs and other healthcare professionals.

  • The role of different professionals in women’s health and when/how to refer
  • Working with medical professionals effectively and guidelines for communication
  • Case study 3
  • Case 3 Q &A

Who is leading the course?

Dr Nina Fuller-Shavel MB BChir MA Hons (Cantab) IFMCP DipIM PG Cert DipION RYT200

Dr Nina Fuller-Shavel is a Functional and Integrative Medicine doctor with degrees in Medicine and Natural Sciences from the University of Cambridge, alongside further qualifications in nutrition, health coaching (FMCA), Functional Medicine (IFMCP), herbal medicine, integrative medicine, yoga and mindfulness.

Dr Fuller-Shavel is a Fellow of the College of Medicine, Vice Chair of the British Society for Integrative Oncology and the Director of The Synthesis Clinic, an award-winning multidisciplinary Functional and Integrative Medicine practice in Hampshire. Synthesis Clinic focuses on managing women’s health and hormones, gut health and mental wellbeing with a team of functional medicine doctors and nutrition, health coaching, psychology and physiotherapy professionals. Dr Nina specialises in complex multisystem women’s health cases and integrative support for women with breast and gynaecological cancers. Dr Fuller-Shavel also lectures, mentors and supports medical and nutrition professionals in the areas of women’s health (including hormones, mental wellbeing and gut health) and integrative oncology, alongside her work in precision health research.

For more information please see here

How will I be taught?

ION’s short courses reflect best practice for online teaching and learning practice. This is an edited recording of a live course that ran over two days. It contains presentations interspersed with anonymised case study data, individual reflection exercises and recorded Q&A sessions.

How much does it cost and what’s included?

The course price is £178.00. 

  • PDF of presentation 
  • Approx. 10 hours edited recording
  • A clinical desktop guide to support you
  • Viewing access for a least 90 days. You can access the course up to 10 times
  • BANT CPD 10 hours

Important information

About this On Demand Recording

  • Dr Fuller-Shavel is not present on this recording and you will not be able to ask questions but you will be able to see the recorded Q and A sessions.
  • The course has been developed as a two day course- it is not possible to only purchase one day
  • This course was recorded in June 2021. All recordings are removed approximately one year after they are recorded so that we can ensure our courses contain up to date information.
  • Dr Fuller-Shavel also runs mentorship and education programmes for nutrition and medical professionals. This course is still suitable for those on Dr Fuller Shavel’s mentoring programmes because it provides a structured learning opportunity for diving deep into the HPA and HPG axes and their interconnection beyond case-based discussions


  • Please check you have read ION’s FAQs including our cancellation and refund policy before booking
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  • Ensure you are booking for the "series", which will cover the two days, rather than a single day

Registration links and materials

  • You will be automatically sent a link to the course when you register. Please do not share this with anyone. This is set up to only allow entry to the first user that clicks it. Further links cannot be generated.
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  • To download the course materials, click the HANDOUTS button in the video player (situated between the VOLUME and QUESTIONS buttons). 
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  • Participation in an ION CPD course forms part of a practitioner's or individual's ongoing learning. It does not qualify a non-clinically trained practitioner or individual to work in a clinical setting. Individual’s boundaries of safe work, advice or practice are primarily determined by their formal qualifications and related personal insurance.
  • This on-demand recording is recognised by BANT for 10 hrs CPD  (applicable to BANT members only)
  • Non BANT registered practitioners may use this course for their CPD depending on the requirements and guidance of their professional body.

If you have a queries, please email [email protected]