The level of this protein tells us a lot about your stress condition, your insulin condition and the effectiveness of your hormones. Finally, undernourishment, as seen in anorexia nervosa, and estrogen or thyroid hormone treatment can cause higher than normal SHBG levels in women. Compared to men, women naturally have higher levels of SHBG. The age of menopause is reduced and menopausal symptoms, such as hot flashes, are more common among smokers Celentano et al. A health effect is a lowered risk of endometrial cancer , and another is an increased risk of systemic lupus erythematosus. Similarly, SHBG measurement may be of value in fine-tuning suppressive TSH therapy for patients with nodular thyroid disease or treated thyroid cancer. Estrogen has been traditionally thought to be cardioprotective while androgens have been considered to be atherogenic, and the finding of increased levels of androgens in smokers suggests that smoking increases cardiovascular risk in multiple ways. The transdermal route bypasses the liver allowing a lower dosage of estrogen to be used, and this route should be considered in women who are unable to stop smoking Mueck and Seeger, SHBG makes sure that these hormones are transported throughout your body and are available for the tissues that need them. The common downstream mechanism for all of these, including the effect of thyroid hormones  was downregulation of HNF4, hepatocyte nuclear factor 4. Normalization of SHBG precedes, and may be predictive of, future normalization of reproductive function. Low SHBH is often associated with polycystic ovarian syndrome.