Hormones play a critical role in every system in the human body. Consequently, when hormones are imbalanced, those systems may not function properly, and troubling symptoms and serious health issues may result. As a woman, it’s important to be mindful of the symptoms of hormone imbalance, take them seriously and advocate for yourself when seeking guidance from a health practitioner. Here’s what you need to know.
What are hormones?
Hormone receptors are found in every cell in our bodies. In Greek, the word hormone means “that which sets in motion” or “to impel or urge on.” Hormones act as chemical messengers, travelling from one part of the body to another in order to “set in motion” and help control how different cellular systems and organs function.
When hormones are imbalanced, meaning your body either produces more or fewer hormones than you need, those chemical messengers (hormones) can’t do their jobs properly. They are unable to “impel” the various cellular systems into action, and that’s when symptoms of hormone balance arise and disease can result.
Hormone imbalance can occur at any age
Most people think about hormone imbalance as something that occurs in the stages leading up to and following menopause. While it’s true that women typically produce less estrogen and testosterone as they age (yes, women need testosterone, too), many younger women also suffer from hormone imbalance.
For one, women with eating disorders may stop ovulating and produce less estrogen than their bodies need. Poor gut health, nutrient deficiencies, obesity, stress, chemical exposure and environmental toxins can also lead to hormone imbalance, affecting women of all ages.
High or low levels of testosterone in women are associated with a variety of health issues. For example, women with PCOS (polycystic ovary syndrome) tend to produce higher levels of testosterone than normal, which can disrupt menstrual cycles and lead to infertility, acne, excess hair and many other issues.
What are the symptoms of hormone imbalance?
Many of the symptoms related to hormone imbalance in women occur during the three stages of menopause—perimenopause, menopause and postmenopause. These symptoms tend to be associated with flagging estrogen or testosterone levels or both. However, as noted above, hormone imbalance can occur at any age and for a variety reasons.
In addition, many of the symptoms of hormone imbalance can be attributed to other health conditions or lifestyle habits. A medical practitioner who specializes in hormone imbalance and functional, integrated medicine can help determine the root cause of your specific health concerns.
14 common symptoms of hormone imbalance
1). Low libido: Estrogen and testosterone both play a role in sexual desire. When those hormone levels drop—which naturally occurs as women age—it isn’t unusual for a woman’s libido to suffer as well. Many women find estrogen and testosterone hormone replacement therapy with pellets very helpful for addressing low libido.
2). Hot flashes and night sweats: Also known as vasomotor symptoms (VMS), research suggests that hot flashes and night sweats may be associated with declining estrogen levels that make the hypothalamus (the body’s thermostat) more sensitive to changes in body temperature. Hot flashes are one of the most common symptoms of menopause (pre- through post-) and are generally described as a sudden feeling of warmth in the upper body that may cause flushing, sweating and the chills. Night sweats are hot flashes that occur at night, which may disturb sleep.
3). Urinary incontinence and other urinary tract symptoms: While incontinence and urinary tract infections can occur for a number of reasons, low estrogen often plays a role. Estrogen deficiency following menopause is known to cause atrophy of the urinary tract and genitals and may be associated with symptoms such as “frequency, urgency, nocturia, urgency incontinence and recurrent infection. These may also co-exist with symptoms of urogenital atrophy such as dyspareunia, itching, vaginal burning and dryness.”
4). Vaginal dryness, painful sex: As mentioned above, low estrogen levels also contribute to vaginal dryness, which can lead to discomfort and pain during sex, known as dyspareunia. This symptom may arise during perimenopause and continue after menopause. Many women find relief from estrogen therapy and vaginal lubricants.
5). Irregular periods: According to the National Institutes of Health, between 14 and 25 percent of women experience irregular menstrual cycles, where periods are heavier or lighter than usual and last longer than 35 days or shorter than 21 days, along with other issues, like abdominal cramps. Changes in the levels of the hormones that regulate the menstrual cycle—progesterone and estrogen—can cause menstrual irregularities. As noted earlier, increases in testosterone levels related to PCOS can also affect the menstrual cycle.
6). Breast tenderness, pain and swelling: Many women experience cyclical breast pain associated with the monthly fluctuations in estrogen and progesterone associated with menstruation. The pain tends to occur a few days prior to menstruation, causing the breasts to swell and feel tender, painful or even lumpy. According to Harvard Medical School (HMS), “Cyclical pain may worsen during perimenopause, when hormones can surge and drop erratically, and linger into menopause, especially in women who use oral contraceptives or hormone therapy.” No studies have linked cyclical breast pain to hormone abnormalities, per HMS.
However, if you experience ongoing or “non-cyclical” breast pain it’s important to speak with a healthcare practitioner to check for breast cancer and other health conditions. In addition, testosterone plays an important role in breast health. As Dr. Terri DeNeui, DNP, APRN, ACNP-BC, explains in her book, “Hormone Havoc, Dispelling the Myths about Hormones in Women & Men”, research shows that “not only is testosterone protective of the breast, it also should be investigated as a preventive strategy for breast cancer.”
7). Insomnia, fatigue: Low estrogen is widely known to be associated with insomnia. If you have trouble falling asleep or staying asleep, wake up frequently during the night, feel tired and irritable in the morning and throughout the day, and have difficulty concentrating, you may have insomnia—and the fatigue that goes along with it. Keep in mind, insomnia is a symptom associated with many health conditions, as well as lifestyle factors, including stress, anxiety, depression, substance abuse, caffeine, nicotine and more.
8). Mood disorders: Imbalanced hormones have been linked to mood swings, anxiety and depression. In fact, according to Johns Hopkins Medicine (JHM), the same hormones that regulate the menstrual cycle (estrogen and progesterone) also influence serotonin, the chemical that promotes feelings of happiness and wellbeing. Poor sleep, which may be tied to hormone imbalance (see above), also increases the likelihood of depression by 10X, per JHM. In addition, research shows that both high and low levels of testosterone have been linked to depression in women.
9). Memory loss, cognitive issues: If you’re approaching or past menopause and experiencing memory issues, you may want to talk to your practitioner about estrogen therapy. As Dr. DeNeui details in her book, an abundance of research shows the critical importance of estrogen for brain health. Numerous studies cited by NIH also support the use of estrogen for promoting brain health, including the use of estrogen therapy to reduce the risk of dementia and Alzheimer’s disease.
10). Reduction in bone density: It is well known that estrogen is critical for bone health. Since we produce less estrogen as we age, keeping an eye on bone density, especially as you approach and surpass menopause, is critical. While calcium and other nutritional supplements can promote bone health, many women benefit from hormone therapy. Further, research shows that testosterone provides an additive effect on bone density improvement, when added into continuous estrogen therapy using subcutaneous pellets.
11). Changes in skin health, texture, dryness: Estrogen receptors exist in every layer of the skin, the largest organ in the body. Consequently, estrogen plays a vital role in both the skin’s appearance and its wound healing capabilities. According to research cited by Dr. DeNeui in “Hormone Havoc”, correcting hormone imbalance of all deficient sex hormones—estrogen, testosterone and progesterone—enhances the benefits of hormone therapy on the skin. Based on clinical observations, improvements in skin thickness, hydration, wrinkles and elasticity, as well as would healing and anti-inflammatory benefits, have been shown, per Dr. DeNeui.
12). Weight gain, belly fat: Imbalances in both estrogen and testosterone can have an influence on a woman’s ability to maintain a healthy weight and figure. For one, research has shown that both premenopausal and postmenopausal women who are overweight had higher free testosterone levels than “normal weight women.” Other studies show that the accumulation of belly fat many women experience as they age, along with overall fat mass, can be addressed with estrogen therapy, which may also improve insulin sensitivity and reduce the risk for type-2 diabetes.
13). Hair loss or growth: Imbalanced testosterone levels can contribute to both excess hair growth and hair loss. Androgen (testosterone) hormone receptors are found throughout the skin, so when a surge or plunge in testosterone levels occurs, changes to hair production can result. Such is the case in women who suffer from PCOS, as heightened testosterone levels and excess hair growth are both associated with this condition.
14). Acne: An imbalance of the sex hormones estrogen, testosterone and progesterone can trigger an over production of sebum, an oily substance that helps protect the skin and keep it hydrated. When too much sebum is produced, acne can become an ongoing issue. (Conversely, low sebum production due to hormone imbalance can lead to dry skin.) Acne is a common symptom women experience due to the hormone fluctuations associated with puberty, menstruation and pregnancy, as well as PCOS.
How can I find out if I have a hormone imbalance?
The best way to find out if you have hormone imbalance is to ask your practitioner to perform lab tests to check your hormone levels. Along with the sex hormones we focused on in this blog, your practitioner can also order tests for other important markers related to hormone balance and overall health.
Testosterone, estrogen and progesterone are but a few of the many vital hormones the body needs to function optimally. Your practitioner should also evaluate thyroid, cortisol, insulin and growth hormone function (among others) when evaluating hormone balance and total body health.
How should I talk with my practitioner about hormone imbalance?
First of all, you shouldn’t assume your primary care physician or OB/GYN will automatically order tests to check sex hormone levels when you schedule a physical and have lab tests done. Many practitioners won’t automatically order those tests unless the patient requests them.
If you are concerned about hormone imbalance and the related symptoms discussed above, you should be clear and direct about your concerns. Should you find your practitioner doesn’t take your concerns seriously or seem knowledgeable about hormone therapy, seek out a medical practitioner who specializes in hormone imbalance.
Take a proactive approach to hormone balance and overall health
Functional, integrated medical practitioners focus on uncovering the root cause of disease, whether it be hormone imbalance or other health issues. They can explain how hormone therapy works and prescribe nutritional supplements and other therapies to help support your health goals. If you have questions about hormone imbalance, hormone replacement therapy and other integrative medicine therapies, contact an EvexiPEL Certified Provider near you to discuss next steps.
