Could a Hormone Imbalance Be at the Root of Your Frustrating Symptoms?

Weight gain, irritability, bloating, fatigue, skin problems – they’re all just a normal part of being a woman. But are they really? Do you really have to accept them as your new “normal”?

The truth is that these frustrating symptoms are common, but that doesn’t mean they’re normal. What many women don’t know is that all these symptoms could have one common root cause: hormone imbalance.

In this article, we’ll discuss the different types of hormone imbalance and how achieving optimal balance can help you be a healthier and more joyful version of yourself.

What are Hormones?

Think of hormones as your body’s chemical messengers. Like little FedEx delivery trucks, your hormones carry signals and information from one group of cells in your body to another.

Your hormones are created and secreted by the glands (ex: thyroid and adrenal glands) that make up your endocrine system. Hormones manage literally hundreds of processes in your body, including:1,2

• Growth and development
• Metabolism
• Sexual function
• Reproduction
• Mood
• Homeostasis (internal balance), such as blood pressure and blood sugar levels
• Sleep-wake cycle

As you can see, hormones affect just about everything in your body. That’s why even minor imbalances can leave you feeling off.

Scientists have identified more than 50 hormones in the human body so far. Let’s go over the ones that cause the most hormone-related health problems in women.

Estrogen

Estrogen affects the development of the female reproductive system, your menstrual cycle, fertility and pregnancy, and menopause. But many women don’t realize that estrogen also affects your cardiovascular, central nervous system and bone health.3

Estrogen comes in three main forms – estradiol, estrone, and estriol.

Estradiol is the primary form of estrogen in premenopausal women, with an average level ranging from 15 to 300 pg/mL.

For postmenopausal women, estrone becomes the primary form of estrogen. The average level of estrone for postmenopausal women is 7 to 40 pg/mL, and estradiol drops to less than 15 pg/mL.4

Estriol is the primary form of estrogen during pregnancy, making up more than 90% of estrogen in the urine of pregnant women.5 It helps your uterus grow in preparation for childbirth and breastfeeding. Estriol levels that are too high or low may indicate problems with the fetus or pregnancy. Ranges of normal estriol levels vary between labs.

Your estrogen levels change with age. If you have low estrogen levels, you may experience:6,7

• Hot flashes or night sweats
• Mood swings
• Thinning skin
• Thinning urinary tract that may increase the frequency of urination
• Vaginal dryness
• Menstrual periods that are lighter, infrequent or that stop

Low estrogen levels also put you at a greater risk of developing osteoporosis and heart disease.8

But what if your estrogen levels are too high? Then you might have symptoms of what many people call “estrogen dominance,” such as:9

• Irregular periods, such as light or heavy bleeding
• Breast tenderness
• Weight gain
• Fibrocystic breasts (non-cancerous breast lumps)
• Fatigue
• Loss of sex drive
• Fibroids (non-cancerous tumors) in the uterus
• Acne
• Constipation
• Endometriosis and/or adenomyosis

Estrogen and progesterone (see below) work together to prevent your endometrium, or your uterine lining, from getting too thick. Your body becomes estrogen dominant if it doesn’t produce enough progesterone or has too much estrogen.

Progesterone

Progesterone is released by your ovaries. It plays important roles in maintaining pregnancy, preparing your body for pregnancy, and regulating your menstrual cycle.

Progesterone levels vary based on certain phases of your menstrual cycle and pregnancy. During the pre-ovulation phase and for postmenopausal women, the average progesterone level is less than 1 ng/mL; after ovulation, it rises to 5 to 20 ng/mL.10

Common signs of excess progesterone are:

• Increased feelings of stress11
• Low sex drive12
• Depression13

Symptoms of low progesterone include:

• New or increased migraine headaches14
• Bloating15
• Mood swings16
• Difficulty sleeping17
• Irregular or skipped menstrual periods18
• Infertility19
• Heavy menstrual bleeding

Learn more about progesterone through my blog “How to Naturally Boost Progesterone Levels.”

Thyroid Hormone

Every organ system in your body needs thyroid hormones, including your central nervous system, heart, and metabolism. In the human body, thyroid hormone exists in two main forms, thyroxine (T4) and triiodothyronine (T3).

Euthyroid is a term used to describe an optimally functioning thyroid. Unfortunately, experts estimate that more than 12% of the U.S. population will develop a thyroid condition during their lifetime. And up to 60% of those with a thyroid condition may not even be aware of it!20

Thyroid health is even more critical for women, as we’re 5 to 8 times more likely to develop thyroid problems than men are.21

So what are some signs that your thyroid isn’t functioning well?

Symptoms of an underactive thyroid (hypothyroidism) include:22

• Dry skin
• Weight gain
• Joint pain, stiffness, or swelling
• Thinning hair
• Constipation
• Increased sensitivity to cold
• Enlarged thyroid gland
• Impaired memory
• Depression
• Fatigue
• Puffy face
• Elevated blood cholesterol level
• Irregular menstrual periods or heavier bleeding than normal

If you have an overactive thyroid (hyperthyroidism), you may experience:23

• Mood swings
• Difficulty sleeping
• Muscle weakness
• Diarrhea
• Frequent urination
• Itchiness
• Loss of sex drive
• Nervousness, anxiety, or irritability
• Hyperactivity
• Persistent thirst

A thyroid stimulating hormone (TSH) test can be performed to measure the function of your thyroid. It serves as an “early warning system,” catching any abnormalities before the actual thyroid hormone levels are affected.

Labs generally place TSH values from 0.5 to 5.0 mIU/L in the normal range,24 but from my experience, this range is too broad. Many people begin to experience the early warning signs of low thyroid at ranges higher than 2.5 – 3.0 mIU/L.

Insulin

Insulin is a peptide hormone produced by your pancreas. It controls the glucose (sugar) levels in your blood and helps store them in your fat and muscle cells and your liver. It also regulates the breakdown of carbohydrates, proteins, and fats in your body.

Insulin resistance isn’t a deficiency. Rather, it means that insulin is being produced, but your body isn’t responding to it. In other words, your cells aren’t taking up the glucose from your blood. As a result, your pancreas is forced to make even more insulin to try to overcome the increasing blood glucose levels. Eventually, your pancreas won’t be able to keep up, and your blood glucose levels will keep rising. This puts you at risk of diseases like type 2 diabetes and prediabetes.

You may have insulin resistance if you experience the following signs and symptoms:25

• Sugar cravings
• A large waist
• Dark skin patches
• High blood pressure
• High fasting blood sugar levels
• Low high-density lipoprotein (“good” cholesterol) levels
• Resistance to weight loss
• Fatigue after eating
• Feeling jittery or shaky
• Increased thirst or appetite

Insulin resistance is a warning sign that your body needs intervention before diabetes develops. I suggest my clients aim for optimal insulin levels between 2-6 mIU/mL.

Cortisol

Cortisol is your body’s primary stress hormone and is secreted by your HPA axis. “HPA” stands for hypothalamic-pituitary-adrenal. The HPA axis is an eloquent set of pathways that connects your central nervous system to the critical glands in your endocrine system. Cortisol is critical to health, and even life. It helps maintain healthy blood sugar levels, inflammation, blood pressure, and muscle strength.26,27

Here are some symptoms that indicate you may have too much cortisol:28

• Obesity
• High blood pressure
• High blood sugar
• Acne
• Irregular menstrual periods
• Excess hair on your face and chest
• Fatty hump at the base of your neck
• Thin skin that bruises easily
• Pink or purple streaks on your stomach, thighs, or buttocks

If you suspect that you have high levels of cortisol, talk to your healthcare provider about testing for Cushing’s syndrome.

On the other hand, too little cortisol could be a sign of Addison’s disease, also known as primary adrenal insufficiency. Addison disease may cause these symptoms:29

• Weight loss
• Belly pain
• Low blood pressure
• Nausea or vomiting
• Diarrhea
• Dark patches on your skin
• Decreased armpit and pubic hair
• Low sex drive
• Muscle and joint pain

Cortisol is just one of four hormones secreted by your HPA axis. Your HPA axis tightly controls your stress response and many other processes that maintain balance in your body. When just one part of your HPA axis stops running smoothly, it can affect the rest of the pathway, leading to frustrating symptoms.

You may have heard of “adrenal fatigue,” a phrase used commonly to link chronic stress to low cortisol levels and other symptoms like lack of energy. The theory behind adrenal fatigue is similar to that of insulin resistance — chronic stress overworks your adrenal glands, which eventually “burn out.”

The concept of adrenal fatigue is likely an oversimplification. But it’s well-documented that HPA axis dysfunction, in which your adrenal glands don’t release enough cortisol, exists. And it has detrimental effects on your immune system.31

I recommend a salivary or urine adrenal test to identify HPA axis dysfunction in my patients. I’ve included a simple graphic below that illustrates how different cortisol levels are correlated with HPA axis function.