Warning Signs of Hormone Imbalance in Women

There are many plagues in the world right now but I believe that one of the most sinister is that of hormone imbalance.

Why?

Because even small changes in your hormone levels can result in huge changes to how you are feeling.

And these changes can easily be dismissed or ignored (and they often are) by your doctor.

As a doctor, it’s easy to handwave away symptoms such as fatigue, joint pain, hair loss, and weight gain as a sign that you are getting older or provide some other excuse for their existence.

And, believe it or not, this happens commonly, especially among women!

There are many differences between men and women and one of those differences has to do with how small changes in hormone levels are perceived on a symptomatic level.

Women tend to have more tightly regulated hormone cycles (1) and levels compared to men (2), it’s just the way it is.

Men’s hormone levels can fluctuate hour to hour but are relatively stable when you look at them over a period of weeks to months.

Women, on the other hand, see significant changes day to day and even week to week.

This cyclical pattern is great because it allows for pregnancy and carrying a child but because the system is so regulated any small change can disrupt the balance and result in symptoms that YOU will feel.

This is because your hormones are the most powerful compounds in biology (3) and in your body.

And that’s exactly why we are talking about them. Today, you will learn:

Why your hormones are so important for regulating how you feel
Why small changes to your hormone levels can result in big symptoms
Why you need to trust yourself and listen to your own body when it comes to your hormones
Why doctors miss hormone imbalances and why they aren’t always the best option for treatment and therapies
How hormone imbalances present in women, what these symptoms mean, and how to use your symptoms to figure out which hormone imbalances you are struggling with

Let’s jump in…

When it Comes to Your Body, Trust Yourself

Before we talk about the symptoms associated with hormone imbalance, I need to make one very important point.

And that is that you know your body better than anyone else.

Because hormone levels can fluctuate from person to person, day to day, week to week, month to month, and even due to stress, it can be hard to pinpoint what “normal” is for you.

This often results in mismanagement or neglect by providers because your lab tests may not reflect how you are feeling symptomatically.

In other words, what’s “abnormal” for you may actually be “normal” for other people or vice versa.

Having said that, one sure way to know if you are having problems is to listen to your own body and to your own intuition.

No one knows your body better than you!

You’ve lived your life in your body for years and decades, you know how you should feel during certain times of your cycle, you know what’s normal for you in regards to food cravings, and you know when something is off.

Don’t let someone try to convince you that you are “normal” when you know you aren’t.

I’ve found that women are especially insightful about their own bodies. When they think something is off they are usually right.

They aren’t right 100% of the time but, for the most part, if you feel something is wrong then something is probably wrong, it’s just a matter of finding it.

Secondly, you have to understand that most doctors are not great at treating hormone imbalances, at least not the hormone imbalances we are going to be discussing today.

There are some major hormone imbalances that you definitely want to bring up to your doctor, but we aren’t talking about those.

You can find out if your doctor is the right person to treat your hormones by assessing a few different things:

#1. If your doctor’s solution for fixing your hormones is to put you on birth control then you know you are looking in the wrong place.

Birth control is often wielded as a one-size-fits-all all solution for women with sex hormone issues and sometimes it works but for most people, there are often much better solutions out there.

Birth control pills work to mask or hide the problem but they don’t solve or treat the underlying issue.

Try to avoid doctors who use birth control as the solution to all hormone-related issues.

#2. If your doctor is dismissive or ignores your symptoms then you know you are in the wrong place.

Look for doctors who are empathetic and sympathetic to your symptoms.

Doctors that will are willing to order tests, look for solutions, and ones that are available to answer questions and willing to work with you.

Lastly, before we talk about symptoms, you should know that there are two major groups of hormone imbalances that you should be aware of.

The first group is conditions that are often not missed by your doctor and include a group of conditions that are more serious and potentially life-threatening.

These conditions include things like Addison’s disease (4), hyperthyroidism, thyroid storm, and serious complications from diabetes like DKA (5).

These hormone imbalances are serious but, luckily, are typically not missed by most doctors.

The second group is a more sinister group because it is often missed by doctors.

This group includes minor to moderate hormone imbalances that result in serious symptoms for women but are often ignored by doctors.

Conditions in this group include PCOS, hypothyroidism, Hashimoto’s thyroiditis, early insulin resistance, estrogen dominance syndromes, and even menopause or perimenopause.

THESE are the conditions that are associated with the symptoms we are going to be discussing today and these are the conditions that are most often ignored by doctors.

9 Signs of Hormone Imbalance in Women

As you look at these symptoms, keep in mind that you do not have to have ALL of them or even MOST of them to have a hormone imbalance.

They often do go together, that much is true, but it’s quite possible for you to only experience 1 or 2 of these symptoms and still have moderate issues with your hormones.

#1. Weight Gain (Including Fluid and Fat Mass)

The first, and probably most important symptom of hormone imbalance for women, is weight gain.

And as you think about weight gain, I want you to think about the two major types of weight gain that can be associated with hormone issues.

The first is the type of weight gain that you are probably well familiar with and this weight gain is associated with an increase in fat mass.

Women who experience an increase in fat mass will not only see the scale go up but they will also see their clothing size increase and may see changes such as increased skin or cellulite.

Certain types of hormone imbalances can result in an increase in fat cell size which is separate from another type of weight gain that can occur from hormone issues.

This type of weight gain is associated with fluid shifts or water weight (6).

Weight gain from water weight will definitely still increase your overall weight on the scale, and may even change how your clothes fit, but this type of weight gain is much preferred over an increase in true fat mass and true fat cell size.

Hormone imbalances that cause water weight gain can be treated more easily because that extra weight can often be eliminated through the kidneys (via your urine) if the underlying hormone imbalance is fixed.

Hormone conditions which result in an increase in the size of your fat cells are a little more tricky to treat and take more time.

Many different hormones can result in weight gain but you can use this guide to help you figure out which hormone imbalance you are probably dealing with:

Gaining weight in your belly? This is probably a sign that you have an insulin issue or a cortisol problem.
Gaining weight on the back of your arms? This is probably a sign that you have a problem with testosterone.
Gaining weight in your butt or your thighs? This is probably a sign that you have an estrogen or progesterone problem.
Gaining weight evening over your entire body? This is probably a sign that you have a problem with your thyroid.
Gaining weight in the trunk of your body or on the back of your neck? This is probably a sign that you have a cortisol problem.

This guide isn’t always 100% accurate but it can definitely help direct you to your problem areas and may help you start down the right track.

These hormone imbalances are associated with a true increase in fat mass.

Changes to estrogen and progesterone, especially excess progesterone, may result in weight gain from water retention.

#2. Menstrual Irregularities (and Infertility)

As a woman, you should be aware that it is never normal to have any of the following symptoms (7):

PMS or excessive symptoms associated with PMS
Heavy flow or light flow
Migraines or headaches associated with your cycle
Cramping or pain with your cycle
Fatigue or low energy during your cycle
Irregular menstrual cycle or rapid menstrual cycle (cycles which occur longer than every 34 days or cycles which occur more frequently than every 22 days)
Or any other abnormal sign or symptom that you experience around the time of your cycle

In fact, you can kind of use your symptoms during PMS as a barometer for how balanced your hormones are.

If you breeze through your cycle without issues then you can say with some degree of confidence that your estrogen and progesterone levels are well balanced.

If, on the other hand, you barely make it through with mood changes, pain, changes in your flow, or any other symptoms, then you can confidently assume that something is off.

I’ve lumped infertility into this section because the same hormones that help to regulate your cycle are the same hormones that are associated with ovulation.

Because of this, issues with estrogen and progesterone not only lead to hormone irregularities but also may lead to infertility or difficulty in getting pregnant.

For instance, an irregular menstrual cycle is often associated with an anovulatory cycle (8).

An anovulatory cycle is a way to describe a menstrual cycle that isn’t associated with ovulation.

In other words, a cycle that would be incapable of producing a pregnancy.

The three primary hormones involved in regulating your menstrual cycle include thyroid hormone, estrogen, and progesterone.

If you are having menstrual problems then look to these hormones first!

#3. Fatigue.

It is not normal for you to not have the energy to get up and go!

Fatigue is a tricky one, though, because so many things can cause fatigue.

Conditions such as common illnesses to not getting enough sleep and everything in between.

The fatigue I’m talking about here is the unexplained type of fatigue.

In other words, if you find that you have fatigue and you don’t have any clear answer as to why you are fatigued then it may be related to your hormones.

If you have fatigue with a clear answer, such as not sleeping enough each night, then the cause of your fatigue isn’t a mystery.

The type of fatigue caused by your hormones exists despite doing everything right.

It exists even if you are sleeping well, eating well, exercising regularly, and so on.

If you have fatigue despite doing everything right then that may be a sign that your hormone levels are impacting your energy levels in some way.

The hormones in charge of helping to regulate your energy include cortisol, thyroid hormone, testosterone, and even estrogen/progesterone to some extent.

In terms of which are most common, low energy problems most frequently stem from cortisol dysregulation as well as thyroid problems but the other hormones can and often do play minor to moderate roles as well.

You can check these hormones in your blood to try and figure out which one is causing your fatigue.

Another alternative is to just supplement with an adrenal support supplement if you know that you’ve been under a lot of stress or if you believe that stress/cortisol is playing a role in your fatigue.

This works for many people simply because stress and cortisol dysregulation drive the majority of fatigue-related hormone problems and these problems tend to be associated with other hormone imbalances such as thyroid problems.

If you prefer to be more precise in your treatment and supplementation then you can and definitely should check your serum levels of all hormones listed above.

#4. Digestive Issues (Pain, Cramping, Bloating, Constipation/Diarrhea)

This set of symptoms is less well known compared to some of the others we will be discussing but it is absolutely the case that hormone imbalances can and do impact your gut health.

As they impact your gut health they may trigger a range of symptoms including:

Pain
Cramping
Bloating
Constipation
Diarrhea
Excess gas

Like fatigue, gut problems can be tricky in that many other problems can contribute to gut-related issues.

In fact, I would say that other issues such as a poor diet probably contribute more to gut-related symptoms than hormone imbalances do.

Having said that, hormone disruption is still important and should be evaluated in anyone who is experiencing gut issues.

Two of the biggest hormones that impact your gut include the thyroid and stress/cortisol.

Low thyroid is notorious for resulting in constipation which can trigger overgrowth syndromes such as small intestinal bacterial overgrowth (9) and even fungal overgrowth.

These syndromes can then lead to all sorts of abdominal issues such as gas, bloating, acid reflux, and more.

Another big one is stress (10).

Stress frequently contributes to diarrhea and abdominal pain.

Think about the last time you were nervous, did you feel butterflies in your stomach? Did it feel like you were going to throw up? Did it feel like you needed to use the bathroom?

This is that hormone complex in action on your gut (11).

#5. Skin Issues (Acne, Rashes, Swelling)

Your skin is the biggest organ on your body and it isn’t exempt from being impacted by your hormones!

As a general rule, it’s often best to think about your skin as a proxy for what is happening on the INSIDE of your body.

Most people think about problems of the skin as issues related to things that come into contact with the skin from the outside.

The truth is that your skin is most impacted by things from the inside that is then seen externally.

Among the many things that can impact the health and quality of your skin include your hormones.

I’ve included some examples of skin problems that can be caused by hormone imbalances and which hormones are often responsible below:

Acne – Usually caused by excess testosterone (12)
Rashes – Usually related to thyroid problems
Swelling – Usually related to thyroid or progesterone imbalances
Loss of subcutaneous fat – Often related to decreased estrogen (13)
Looking gaunt – Usually related to low estrogen/menopause
Eyebrow hair loss – Often related to low thyroid
Puffy eyes – Often related to low thyroid
Nail changes – Often related to low thyroid

#6. Hunger or Abnormal Food Cravings

It is normal for you to have cravings for foods periodically but it is not normal for you to feel like you don’t have control over the foods that you want to put into your mouth.

There’s a fine balance that must be maintained between the hormones that regulate your appetite and their impact or sensitivity on your brain.

If you feel like you are experiencing constant cravings for foods, especially unhealthy foods, or if you feel like your cravings are out of control then that is a good sign that there is an imbalance in that system.

In healthy individuals, the stomach should ‘talk’ to the brain when it gets distended or filled up with food.

This crosstalk between your stomach and brain is really what drives most of your feelings of satiety (or feeling like you’ve eaten enough).

But hormone imbalances such as leptin resistance, excess cortisol, and excess ghrelin or ghrelin resistance (14) can impact that system and drive you to eat more than your body needs.

And this is actually quite common, especially among people who are trying to lose weight.

Dieting, for instance, is known to increase ghrelin (15).

You can imagine that shooting up your hunger hormone after you’ve lost a lot of weight is not ideal and is thought to be a reason why people regain weight after dieting.

Leptin works in a slightly different way.

Dieting results in resistance to the hormone leptin at the level of your brain.

This tricks your body into thinking you starving which promotes an aggressive appetite and occurs while you are already overweight.

Cortisol imbalances often result in cravings for sugary or salty foods and stem from excess stress, decreased sleep, and/or reliance upon caffeine.

If you are having issues in regulating or controlling your appetite then look at these 3 players.

#7. Sleep Disturbances or Insomnia

Sleep disturbances such as insomnia have many causes but hormone imbalances can be among them, especially if you are going through menopause or peri-menopause.

As estrogen levels fall in your body it can trigger symptoms such as hot flashes which are notorious for causing sleep disturbances.

This typically occurs in women around age 45 to 55 but can be triggered even earlier in some individuals.

Other hormones such as cortisol also play a role in helping you to not only fall asleep but stay asleep by interfering with your circadian rhythm.

#8. Mood Changes (with or without Migraines)

I’ve included migraines with mood changes simply because both are associated with the brain/head area.

It is definitely the case that certain hormones in your body can and do impact your mood (16).

If you find that you are more irritable than normal, if your mood is changing dramatically throughout the day, if you are having issues with depression, anxiety, or even panic attacks, then your hormones may be responsible.

Hormones that can lead to changes in your mood include:

Low testosterone – Occurs with age but can be triggered by insulin resistance and weight gain
Excess estrogen – Often associated with PCOS and weight gain
Low progesterone
High or low thyroid – Both hypothyroidism and hyperthyroidism may contribute

Hormones that can lead to migraines or headaches include:

Changes to estrogen and progesterone

If you are experiencing headaches or migraines that tend to occur around your menstrual cycle then that is a good sign they are related to hormone imbalances.

#9. Decreased Sex Drive

It is certainly normal for sex drive and libido to vary quite dramatically from person to person.

This normal variance isn’t a problem.

But what I’m talking about here is a little bit different.

If you have noticed an abrupt CHANGE in your libido and sex drive that may indicate an underlying hormone imbalance.

And this can go both ways.

If you notice an increase in libido or a dramatic decrease in libido from whatever is normal for you, that is often an indication that something is off in your sex hormones.

Your sex hormones including estrogen, progesterone, and testosterone, all play together (17) to create your libido.

Of course, other factors play a role including sight, smell, and other stimuli, but these factors tend to be more important for the arousal state.

Your hormones set the framework and foundation which allow for your body to get aroused.

In other words, you could be seeing everything and smelling everything that would normally get you aroused but in the setting of hormone imbalance, your body won’t respond.

Decreased sex drive is actually a huge deal.

Regular sexual intercourse is associated with a huge amount of health benefits (18) that you really can’t get anywhere else ranging from benefits to your mood, your metabolism, and pretty much everything in between.

Treating issues related to libido have primarily been focused on men but there are still treatments available to women as well!

One of the most frequent hormones used to improve libido for women is low-dose testosterone but there are other topical medications that can be used to improve blood flow and heighten sexual arousal as well.

All three sex hormones play a role in regulating sex drive so it isn’t always as easy as taking some testosterone and calling it a day but that is usually the first place to start.

#10. Hair Loss in the Places you Want to Have Hair and Hair Growth in the Places you Don’t

Your hormones can cause several different types of hair-related problems including hair loss where you want to have hair and hair growth where you don’t.

There are many causes of hair loss in women but when it comes to your hormones thyroid, testosterone, and estrogen are the most important.

Both low and high thyroid can contribute to hair loss on the entire body including the eyebrows and the head.

Treating thyroid-related hair loss can be complicated and I have plenty of resources to help you solve that problem if you are suffering from it.

When it comes to testosterone, it can lead to both hair growth as well as hair loss.

Excess testosterone can cause something called hirsutism which results in dark hair growth on the chin, jawline, and upper lip.

On the flip side, high testosterone can also result in hair loss around the temples and at the hairline.

Estrogen usually results in hair loss and this hair loss typically occurs around the time of menopause and perimenopause as well as in the postpartum period when estrogen levels drop rapidly.

If you feel that your hair loss is related to your hormones then you will have to do some digging to figure out which hormone is the problem and if other factors may be contributing as well.

Your Next Steps

Okay, now for the important part:

What should you do if you are experiencing these symptoms?

The first place to start is always with a doctor.

The reason you want to see a doctor is simple:

You need to first ensure that you have a problem (by testing) and secondly, you need to make sure that your symptoms are not actually due to something more serious than a mild to moderate hormone imbalance.

Seeing a doctor first will ensure that you aren’t missing something big and allows you to get started on the right track.

As I mentioned previously, though, not just any doctor will do.

The best type of doctors to see for hormone imbalances include:

Doctors who specialize in functional medicine
Doctors who specialize in anti-aging medicine
Doctors who specialize in integrative medicine
Doctors who specialize in bio-identical hormone replacement therapy
Naturopathic doctors (if they can prescribe in your state)

These types of doctors are always best for treating mild to moderate hormone imbalances that don’t require drugs or surgery to fix.

These doctors will be more likely to help you balance your hormones with the use of medications, hormones, supplements, diet, lifestyle, stress, sleep, detox, and more.

Honorable mentions include some health coaches, nutritionists, and some chiropractors as well.

The only downside to the honorable mentions is that they are unable to prescribe medications to treat hormone imbalances.

But if you are someone that is trying to go the all-natural route (while avoiding prescription medications/hormones) to improve your hormones then it probably doesn’t matter if your doctor can prescribe medications or not.

It’s also worth pointing out that many (but not all) hormones can be purchased as over-the-counter supplements.

Hormones included on this list include DHEA, progesterone, some weaker forms of estrogen, T2 thyroid hormone, and pregnenolone.

If you can find a knowledgeable practitioner that is familiar with hormone supplements then you may be able to get by without the use of prescription hormones.

Doctors to avoid FIRST include:

Ob/gyns
Endocrinologists
Family practice doctors

You would think and hope that these types of doctors would be the best place to start but experience suggests that they are not.

These types of doctors are best at identifying the more serious and life-threatening hormone imbalances that can occur in your body but they are usually inexperienced at providing lifestyle and holistic recommendations.

The solutions that these doctors typically offer include birth control pills to mask your symptoms or a ‘stick-their-head-in-the-sand’ approach and pretend that your symptoms don’t exist or are from something else such as getting older.

If you have experienced this before please leave a comment below!

After you find a doctor your next step will be to get tested.

This is actually quite easy once you find a doctor willing to order the right tests (easier said than done, I know).

When you get to this step, here are the hormones you’ll want to get tested:

Complete thyroid hormone panel (TSH, free T3, free T4, TPO antibodies, and thyroglobulin antibodies)
Sex hormones including total testosterone, free testosterone, progesterone, and estradiol
Sex hormone binding globulin
8 am serum cortisol
Fasting insulin
Fasting leptin
DHEA-s
Pituitary and hypothalamic hormones (if necessary)
Inflammatory markers such as ESR and CRP (not required but can be helpful)