Hormone Imbalances 101

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Medically reviewed by Dr. Stacy Hengisman MD and Felice Ramallo MSRD.

Anyone who has been diagnosed with a hormonal imbalance knows how frustrating and challenging it can be. The ‘why’ behind what triggers a hormone imbalance, why some people struggle with their hormones, and how to resolve a hormonal imbalance are all common questions someone may have when they first start researching symptoms. But what are hormones and what are the various symptoms that could hint at a hormone imbalance? These are questions we’ll be covering in this post. Let’s dive into everything you need to know if you suspect you have a hormone imbalance. 

Defining the term “hormones” 

Hormones are chemical messengers produced by endocrine glands that communicate certain things to different organs and systems in your body. Commonly known hormones include estrogen, progesterone, testosterone, FSH and LH.  Hormones control everything from your reproductive system, to your metabolism, to your mood, and beyond. So despite being invisible to our own eyes, and quietly traveling throughout our bodies with little ceremony, hormones are incredibly powerful players in both our daily biology and our long-term health

What is a hormone imbalance?

Essentially, a hormonal imbalance is what it sounds like: your internal chemistry (for unknown or known reasons) is off, and it can cause physical and emotional problems. For instance, in the case of women who have PCOS, they have too-high levels of testosterone - which can prevent ovulation and cause irregular or absent periods, as well as excess hair growth on the body and face, acne, and potential thinning of hair on the head. In some cases, women with PCOS can also have estrogen excess. Johns Hopkins has a particularly useful resource, which lists the different hormones and their role in the functioning of the human body, which you can find here. Ultimately, though, a hormone imbalance boils down to the following, per the Cleveland Clinic: “A hormonal imbalance happens when you have too much or too little of one or more hormones, your body’s chemical messengers. It’s a broad term that can represent many different hormone-related conditions.”

Note how a hormone imbalance is in itself not a diagnosis: there are several conditions that your doctor can run tests for, which are in and of themselves hormonal imbalances, but having a hormonal imbalance is more a catch-all term for a set of more specific conditions that each will require their own unique treatment plan. For instance, both PCOS and hyperthyroidism (an overactive thyroid) involve an imbalance of hormones on some level, but they require vastly different approaches to manage, from medication, to lifestyle recommendations, to root causes and more.  

Symptoms of a hormone imbalance 

The below list isn’t exhaustive: it won’t encompass all possible symptoms of a hormone imbalance - because there are many - and they can include physical, emotional, and psychological symptoms of all different degrees, ranging from mild to quite severe. 

That being said, these are some of the most common symptoms of a hormone imbalance: 

  • Physical 
  • Unintentional or uncontrollable weight gain
  • Unexplained weight loss
  • Fatigue
  • Aching, stiff, weak muscles
  • Painful or stiff joints 
  • Sweating 
  • Increased thirst 
  • Hunger 
  • Excessive sweating
  • Infertility 
  • Thinning or brittle hair 
  • Dry skin
  • Puffy face 
  • Decreased sex drive
  • Increased or decreased heart rate
  • Emotional 
  • Depression
  • Anxiety
  • Irritability
  • Nervousness

There are many more symptoms beyond this, but it would be difficult to list all of them on one page. 

Keep in mind that some of these are “nonspecific” symptoms, meaning they might not be related to a specific hormonal health condition. For instance, we’ve all had days where we feel a little more irritable than others, or where we’re extra anxious, but if you notice physical or emotional changes you can’t account for, it is extremely important to raise your concerns with a trusted physician as soon as possible. Don’t convince yourself it is nothing or you’re being silly: it’s always best to err on the side of caution when it comes to your health. 

Getting tested for a hormone imbalance  

Depending on symptoms you raise with your doctor, your doctor may order specific testing in order to narrow down potential diagnoses, as well as eliminate others. But just know that there is no one single test that can diagnose a hormone imbalance. It is often through a set of symptoms, multiple tests, evaluating your family history, and considering lifestyle considerations, medications, and other factors that your doctor may diagnose a hormone imbalance - or more specifically, a particular disorder (such as PCOS, hypothyroidism, hyperthyroidism, Hoshimoto’s, and so on) that falls under the umbrella of a ‘hormone imbalance.’

In the case of PCOS and other disorders, some symptoms (such as weight gain) could also be indicative of a thyroid problem or something else going on in the body that needs to be investigated. Indeed, there are also cases when two disorders are found together, such as an autoimmune condition and a hormone disorder. Because of how complex the human body is, and how many potential blood tests that could be taken, your doctor may decide to order more common tests - such as a testosterone test to see if you have too-high levels of androgens in your body - and let those tests inform further testing. No matter what though, it’s important that you: 

  1. Find a doctor that you trust
  2. Tell your doctor as much information as you can! This includes symptoms, when they started, when they peak and trough, as well as your family history and any other events from your recent history or in your current life that could be informing symptoms. The more information you can supply them with, the better. 
  3. Feel your doctor can support you: if this means getting the help of a specialist, such as a doctor that specializes in reproductive health or endocrine health, then this may also be an avenue worth exploring, or your primary care physician may even refer you to a specialist in some cases. 

Questions your doctor may ask 

Don’t worry if you don’t know the answers to some of these, we’re just including this list since it may be helpful in preparing for an appointment with a doctor in order to understand what may be going on internally. 

  • When was your last period?
  • Are you trying to get pregnant? (If yes, how long have you been trying to conceive?)
  • Are there stressful events going on in your life right now?
  • Approximately when did your symptoms start?
  • Is there anything else you’d like to share with me?

Common tests used to figure out if you have a hormone imbalance

Common tests (though this list is by no means exhaustive) for figuring out if there is a hormone imbalance at play may include: 

  • LH test
  • LH stands for luteinizing hormone, and this hormone is made by your pituitary gland. In women, LH is responsible for things like the menstrual cycle (including ovulation), and this test can help determine everything from causes of infertility, to when ovulation occurs, to the underlying reason for missed or irregular periods.
  • FSH test 
  • FSH stands for follicle-stimulating hormone, and this hormone is made by the pituitary gland as well. FSH plays an important role in regulating the menstrual cycle, in particular the growth of eggs in the ovaries. FSH levels change during the stages of a woman’s menstrual cycle, peaking before an egg is released by the ovary around the time of ovulation. Too low levels of FSH can cause menstrual irregularities and even infertility in women. 
  • Testosterone test
  • Often ordered as a result of physical symptoms, such as abnormal hair growth on the face or body, androgenic alopecia (hair loss that manifests primary in the center of the hairline and a thinning around the temples),  deepening  voice,  and acne (particularly the hormonal, cystic type) can all be noted and used as a reason to pursue testosterone testing.

There are plenty of others, especially if you are trying to get pregnant for a period of time but have not been successful, or if your symptoms may also indicate an autoimmune disorder, but your doctor will take all this information into account and order initial testing using their expertise. 

Note: check out Allara’s Guide To Hormonal Testing for more blood tests and what they involve!

Next steps 

If you think you have a hormone imbalance, it is important that first and foremost you schedule an appointment with your primary care physician, as soon as possible. From there, it can also be helpful to:

  1. Make notes of your symptoms, if possible, noting when symptoms flare up and when they recede 
  2. If you have a period, keep track of beginning and end dates
  3. Try to reduce your stress levels where possible: if you are someone whose job often demands overtime, try and scale back your hours where feasible (although we know this unfortunately isn’t always an option for people); ask for support from friends and family where needed; and go easy on yourself - when your health suffers, life can feel even more challenging and upsetting. Prioritizing speaking kindly to yourself and being gentle with your feelings can go a long way. 
  4. Finally, researching your symptoms can equip you with follow up questions and help you understand this is absolutely not your fault - a hormone imbalance is something many people struggle with for a multitude of reasons, and what is most important is getting you back to feeling your best self again. 

Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.

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