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Hormonal Imbalance in Women: 9 Signs to Look For

At different points in life, your hormone levels will shift. These shifts may happen before or after your periods, during pregnancy, or during menopause. Let’s explore what causes a hormone imbalance, how to diagnose one, and how to regulate hormones.

What is a hormonal imbalance?

Hormones are chemicals produced by different glands and tissues, forming a part of the endocrine system.

Hormones travel to all of the body’s tissues and organs through the bloodstream. They give messages to these organs, letting them know what function to perform and when to do it.

Hormones help regulate a lot of processes in the body. Hormones manage appetite and metabolism, sleep cycles, heart rate, sexual function, general mood and stress levels, and body temperature. Because they affect so many functions, imbalances in certain hormones can lead to uncomfortable symptoms. 

A hormonal imbalance occurs when a person has too much or too little of a certain hormone, such as insulin, cortisol, thyroxine, androgens, estrogen, or progesterone. Even slight changes can have a significant effect on your body.

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Symptoms of a hormonal imbalance

A range of symptoms can result from female hormone imbalance. Hormonal imbalance symptoms depend on which hormones or glands are not working properly.

Some of the most common hormonal conditions in women cause the following symptoms:

Excessive weight gain

Fluctuating hormone levels are associated with weight gain and difficulty losing weight. High levels of estrogen, cortisol, and insulin and low levels of thyroxine can lead to extra belly fat.

Sweaty skin

A hormonal imbalance may cause excessive sweating, as some hormones control your body temperature. 

Excessive sweating can also result from endocrine changes in conditions like hyperthyroidism, hyperpituitarism, pheochromocytoma, and diabetes, as well as at stages of life like perimenopause and pregnancy. 

Decreased sex drive

A person’s desire for sex can be influenced by a variety of factors, such as physical and emotional well-being, past experiences, beliefs, and relationships.

A range of illnesses, physical changes, and medications can affect libido significantly. For example, your desire for sex may drop because of variations in estrogen and progesterone levels or health problems like diabetes or an underactive thyroid.

Hair loss

Most people lose some hair every day. But, starting to lose a lot of hair may signal a health issue. 

When you're dealing with hair loss, it’s important to treat the cause and not just the symptom. An imbalance of several hormones can play a role in hair loss:

  • Thyroid hormone: Low thyroid function can be one of the main reasons for hair loss.
  • Adrenal gland hormones: Cortisol is a stress hormone that comes from the adrenals. When its levels rise, the body experiences a state of stress.
  • Sex hormones: If you're entering menopause or perimenopause, or you're experiencing a hormone-related condition like PCOS, you may notice some hair loss.

Extreme fatigue

We all experience fatigue from time to time. But if you feel constantly tired, you might have an issue with your thyroid gland. Constant fatigue is related to problems with the thyroid hormone thyroxine. Also, a hormonal imbalance can cause a lack of sleep and more stress, leading to increased fatigue.

Persistent acne

A hormonal imbalance may explain acne that appears before your period. Hormonal changes trigger acne and can worsen skin concerns. High levels of androgens like testosterone are associated with acne problems.

Loss of muscle mass

The endocrine system plays an important role in regulating muscle metabolism. Hormones such as androgens, growth hormone, and insulin-like growth factor-I (IGF-I) influence muscle development and mass.

The lack of some hormones can also affect muscle strength:

  • Hyperglycemia and hyperinsulinemia can reduce muscle growth.
  • Low androgens and estrogens (for physiological, pathological, or medical treatment-related reasons) can affect muscle physiology. 
  • Changes in thyroid hormone metabolism can lead to altered muscle function.

According to some studies, a deficiency in vitamin D is also associated with muscle weakness.

Scientists at the University of Iowa found tomatoes and apples have compounds that can help reverse age-related muscle weakness, but more studies are needed to confirm this.

For some people, hormonal supplementation might help, but the efficacy and safety of this therapy haven’t been fully studied.

Digestive problems

Sex hormones (especially estrogen) affect the microflora in the gut, which alters GI tract functioning. This can lead to bowel discomfort, abdominal pain, bloating, constipation or diarrhea, and nausea before or during menses.

Estrogen’s impact on the gut may also explain why women are more prone to irritable bowel syndrome (IBS) than men.

Hot flashes and night sweats

One of the most common symptoms of perimenopause is hot flashes, which often coexists with night sweats. Almost 80 percent of people who are in perimenopause or transitioning into menopause have hot flashes. Also, most women who receive chemotherapy or undergo surgery to remove their ovaries will experience hot flashes.

Scientists know that hot flashes occur as a result of low estrogen levels. Each hot flash involves a sensation of heat that starts in the chest area and travels to the neck and the head. It can last for a few minutes and may cause sweating. Some women also develop a faster heart rate during hot flashes.

If a hot flash happens during sleep, they are called night sweats. Women who have night sweats often wake up in the morning feeling tired.

Some people experience redness along their neck and face during a hot flash. This is called a hot flush.

On average, each hot flash lasts for about three to four minutes. Hot flashes can occur for a few months to several years. In a few rare cases, some people had hot flashes for 10 years.

Other signs of hormonal imbalance include:

  • Constipation
  • Heavy or irregular periods, missed periods, frequent periods, or stopped periods
  • Vaginal dryness and itching
  • Hyperpigmentation of the skin
  • Puffy face
  • Decreased or increased heart rate
  • Weakened muscles
  • Pain in the muscles, tenderness, and stiffness
  • Pain and swelling in the joints
  • Depression
  • Infertility
  • Anxiety or irritability
  • Purple stretch marks

What causes a hormone imbalance?

There are lots of possible causes of hormonal imbalance in women. Just like the symptoms, causes differ depending on which hormone or gland is affected. Some of the most common reasons for a hormonal imbalance are:

  • Diabetes
  • Menopause
  • Pregnancy
  • Breastfeeding
  • Premature menopause
  • Primary ovarian insufficiency
  • PCOS
  • Hyperthyroidism
  • Hypothyroidism
  • Hypogonadism
  • Cushing syndrome
  • Benign or cancerous tumors
  • Eating disorders
  • Stress
  • Hormone therapy
  • Thyroiditis
  • Congenital adrenal hyperplasia
  • Medications
  • Cancer treatments

How is a hormonal imbalance diagnosed?

First, make an appointment with a health care provider for a physical exam. The health care provider will ask about your symptoms. Then, depending on your symptoms, they will suggest which hormone imbalance tests to do. These could be evaluations like:

  • Blood test: Estrogen, progesterone, testosterone, thyroxine, TTH, insulin, and cortisol levels can be detected in the blood.
  • Pelvic exam: A health care provider will search for any lumps or cysts.
  • Ultrasound: Images of your uterus, ovaries, thyroid, and pituitary gland can be obtained.
  • Biopsy
  • MRI (magnetic resonance imaging)

What are the treatment options?

Hormone replacement therapy (HRT) is one of the most common treatments of low hormone levels.

For people experiencing menopause, premature menopause, or primary ovarian insufficiency — as well as after oophorectomy (a surgery that removes the ovaries) or chemotherapy — estrogen therapy can offer some relief. Estrogen therapy alone is recommended for those who have had a hysterectomy. You can take estrogen in different forms, generally estrogen pills and estrogen patches.

Estrogen pill

Estrogen pills are the primary treatment for menopausal symptoms. Before starting to use these pills, a health care provider will explain the right dose for you. In most cases, estrogen pills are taken once a day.

Estrogen patch

Estrogen patches are put on the skin of the abdomen. Some patches can be worn for a week. Some people may benefit from patches that combine estrogen and progestin (a synthetic form of progesterone).

Vaginal estrogen

Vaginal estrogen comes in different forms, including a cream, a ring, or tablets. Vaginal estrogen is a common treatment for people who experience vaginal dryness, itching, or pain. A health care provider will help you find the right dosage, as it varies depending on the product. Vaginal rings contain estrogen and progestin and are changed every three weeks. Vaginal tablets and creams are used daily.

Estrogen/progesterone/progestin hormone therapy

Some people may need several different hormones instead of estrogen alone. This is called combination therapy because it offers doses of estrogen and progestin. This option is recommended for people with an intact uterus. Progesterone is added to estrogen therapy in order to protect women from endometrial hyperplasia and endometrial cancer.

Thyroid hormone therapy

Usually, hypothyroidism is treated with the synthetic thyroid hormone levothyroxine on a daily basis. This oral medication restores hormone balance while addressing the symptoms of hypothyroidism.

Levothyroxine stays in your system for a long time, so it can be taken just once a day, resulting in stable levels of thyroid hormone. Your health care provider will want to check your thyroid hormone and TSH levels periodically, even if you are feeling fine, to adjust the dose of thyroid hormone if needed.

PCOS treatment 

Combined hormonal birth control pills can be used for long-term treatment in people with PCOS who do not wish to get pregnant. Combined hormonal pills contain both estrogen and progestin. In addition to helping regulate your menstrual cycle, they also can reduce unwanted hair growth and acne.

Natural ways to balance your hormones

Most natural remedies for hormonal imbalance in females can be found in widely available supplements. Many people also experience relief from certain lifestyle changes, including:

Hormones have a great role in many processes in our bodies. As we’ve seen, disruptions of these hormones can cause a variety of symptoms. Sometimes, a hormonal imbalance can have several serious effects. If you seek treatment as soon as possible, you’ll have the best chance of managing any complications.

Martín, Ana Isabel et al. “Hormones and Muscle Atrophy.” Advances in experimental medicine and biology vol. 1088 (2018): 207-233. doi:10.1007/978-981-13-1435-3_9

Schlereth, Tanja et al. “Hyperhidrosis--causes and treatment of enhanced sweating.” Deutsches Arzteblatt international vol. 106,3 (2009): 32-7. doi:10.3238/arztebl.2009.0032

Lause, Michael et al. “Dermatologic manifestations of endocrine disorders.” Translational pediatrics vol. 6,4 (2017): 300-312. doi:10.21037/tp.2017.09.08

Oakley, Amanda. “Hyperandrogenism.” Hyperandrogenism | DermNet NZ, 2014, dermnetnz.org/topics/hyperandrogenism/.

“9 Medical Reasons for Putting on Weight.” NHS Choices, NHS, www.nhs.uk/live-well/healthy-weight/nine-medical-reasons-for-putting-on-weight/.

“Low Sex Drive in Women.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2020, www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554.

“Thyroid Hormone Treatment.” American Thyroid Association, www.thyroid.org/thyroid-hormone-treatment/.

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