Hormonal Imbalance in Women: Types, Causes, Signs, Solutions & Treatments

Hormones lie at the very heart of our mental, physical and emotional wellbeing.

Our body’s chemical messengers, hormones travel through the bloodstream to organs and tissues. They have a profound, fundamental role in coordinating many complex bodily functions.

As such, when your levels of these molecules are out of sync — even by a small amount — a wide range of signs and symptoms may present themselves.

Many women begin to pay more attention to their hormonal health as they enter the menopause. And whilst menopause-induced hormonal imbalance is the most commonly discussed and the type we’re probably most familiar with since it affects all women at some point in their lives, hormonal disorders can be relevant to women of any age.

So, how can I tell if I’m struggling with a hormonal imbalance, and why might this be the case? What steps can I take?

What is hormone imbalance?

Hormones are chemical messengers. When there is too much or too little of one of these crucial signaling molecules in the bloodstream, we can experience symptoms of a hormonal imbalance: this may include weight gain, acne, low mood, period problems, excessive hair growth, fatigue and more.

Hormonal imbalance is most commonly associated with the menopause, thyroid problems and polycystic ovary syndrome (PCOS).

What are hormones?

Secreted by our endocrine glands, hormones are chemicals that travel through our circulatory system, helping our tissues and organs to communicate. There are around 50 different types. Hormones work progressively over time to facilitate and impact wide-ranging, important bodily processes.

Hormones play a role in:

• Digestion
• Sleep
• Mood
• Metabolism
• Stress
• Reproduction
• Sexual function
• Movement
• Respiration
• Tissue function
• Growth and development
• Sensory perception
• Excretion

The endocrine system is responsible for creating, monitoring and feeding back on the hormones in our body.

This system is made up of a number of major endocrine glands:

• Pancreas
• Pituitary gland
• Pineal gland
• Thymus gland
• Thyroid gland
• Adrenal glands
• Ovary (in women)
• Testis (in men)

Given the fundamental role that hormones play in many bodily functions, an imbalance can understandably produce noticeable, sometimes troublesome signs and symptoms.

What are the signs and symptoms of hormone imbalance in women?

With many types of hormones in our body, there are a number of different ways that an imbalance can occur. A hormone imbalance can cause a huge range of different signs and symptoms, including adult acne, fatigue, low mood, period problems, headaches and more.

Many of the most commonly-reported symptoms of hormonal imbalance are related to oestrogen and progesterone. Other hormones of significance include those of the thyroid, androgen hormones as well as the follicle-stimulating hormones and luteinising hormone.

These symptoms are nonspecific and having any of them does not necessarily mean you have a hormone imbalance. Make sure to consult your doctor if you suspect you may need help with your hormonal health.

Adult acne, dry skin & other skin problems

Our skin’s health is inextricably linked to our hormones — women struggling with adult acne may wonder whether their hormones are playing a role.

One very common hormonal condition that can lead to skin problems is polycystic ovary syndrome (PCOS). It is characterised by a higher-than-normal presence of ‘male’ hormones, like testosterone, that can increase sebum and skin cell production, leading to acne.

PCOS affects around 1 in 10 women in the UK, with most discovering they have it in their 20s and 30s. Remarkably, around 70% of women are actually unaware that they have it. It is the most common type of hormonal imbalance in women of reproductive age.

The menopause — with its drastic hormonal fluctuations — can also cause itchy or dry skin. Oestrogen keeps our skin supple; shifting oestrogen levels can leave your skin slightly more prone to redness, irritation and bumps. As a result of decreased gland secretion, an underactive thyroid can also be to blame for dry, scaly skin.

If you think your skin problems may be caused by a hormonal imbalance, be sure to consult your doctor as soon as possible.

Unexplained weight gain

Our thyroid gland — a small butterfly-shaped gland in the neck — produces thyroid hormones that boost your metabolism and help your body to burn fat.

An underactive thyroid is a hormonal issue more commonly affecting women, occurring at any age, but most commonly in those over 60. Also known as hypothyroidism, it is characterised by low levels of thyroid-producing hormones, such as triiodothyronine and thyroxine. This can change the way the body stores fat and can result in an unexplained increase in weight.

There’s no known way to prevent the development of an underactive thyroid — at present, it’s thought to be largely genetic, caused by the immune system attacking and damaging the thyroid gland.

The menopause can also be to blame for weight gain — fluctuating oestrogen levels can cause an increase in abdominal fat storage. Falling oestrogen levels can also make it harder for us to sleep, leading to us feeling more fatigued and therefore less likely to exercise.

Menopause fatigue can also lead to sugar cravings, which is understandably a potential contributory factor to weight gain. Polycystic ovary syndrome (PCOS) is another hormone-related condition that is known to cause unexplained weight gain, related to the body’s inability to use insulin properly.

If you have completely unexplained weight gain that you think is related to a hormonal imbalance, be sure to consult your doctor and discuss the possibility of thyroid problems or ovarian cysts.

Mood swings, depression and anxiety

Oestrogen is a female sex hormone that works closely with serotonin, a mood-boosting neurotransmitter in the brain. There is strong scientific agreement on the direct impact of oestrogen on our mood.

During the menopause, which begins between the ages of 45 and 55 for most women, levels of this hormone drastically fluctuate and become imbalanced, placing these women at a higher risk of developing mood disorders or depression.

An underactive thyroid — where the thyroid gland does not produce sufficient thyroid hormones — is also implicated in depression.

Hot flushes & night sweats

Hot, burning sensations and profuse sweating are quintessential menopause symptoms primarily caused by depleting oestrogen levels in the body. A low level of oestrogen is also known to cause lower-than-normal levels of norepinephrine, a hormone that helps our body to regulate its temperature.

Insomnia, fatigue & sleeping troubles

Did you know that two key female sex hormones — oestrogen and progesterone — play a crucial role in the quality of our sleep? They help to metabolise neurotransmitters like serotonin that regulate our sleep wake cycle. Both of these hormones fluctuate and become imbalanced during the menopause — this can result in those forty winks being slightly harder to come by.

Tiredness can also be caused by a thyroid imbalance; too little of the thyroid hormone can result in us feeling rather drained. If you suspect you may have an underactive thyroid, get in contact with your GP.

Painful periods and abdominal pain

An oestrogen imbalance can also occur when there is too much of the hormone. During our reproductive years, you might experience symptoms like painful periods, lower back pain, tummy pain and constipation.

These are all common symptoms of non-cancerous growths around the womb called fibroids. Occurring most often in women aged 30–50 years, around one in three women will get them, with those of African-Caribbean origin more susceptible. They are related to an increase in the levels of oestrogen in the body. Usually, fibroids do not need any treatment — they shrink naturally, particularly after the menopause.

Discussing treatments to target the symptoms with your doctor may be helpful. If the fibroids are particularly troublesome, there are medications that can help to shrink them.

Irregular (and heavy) periods

Polycystic ovary syndrome (PCOS) affects a woman’s hormone levels. Women with PCOS usually produce a higher-than-normal amount of ‘male’ androgen hormones and lower levels of progesterone, resulting in an imbalance; this can cause the body to skip menstrual periods. PCOS is also associated with periods being heavier than usual when they do occur.

Lower sex drive

Although a ‘male’ hormone, women naturally produce small amounts of testosterone. Together with oestrogen, these two sex hormones are responsible for our libido.

During the menopause, production of these hormones declines, leading to an imbalance that can have a profound impact on our sex lives. Additionally, other menopause symptoms — such as night sweats, tiredness and low mood — can contribute to this lack of lust for sex.

Headaches & migraines

Of course, headaches can have many, many conceivable causes, but a decrease in oestrogen is known to be a reason why you might experience a pounding head more often — a hormonal headache. Menstrually-related migraines are precipitated by a decline in the oestrogen hormone.

Hair growth on the face & body & hair loss

In women, excess hair growth on the body and face (hirsutism) and hair thinning on the head (androgenic alopecia) can be a tell-tale sign of a hormonal issue.

Polycystic ovary syndrome (PCOS) is a condition that is characterised by the body producing higher-than-normal levels of ‘male’ hormones. This hormonal imbalance can cause women to report baldness or unwanted hair growth on the face and body.

Declining levels of oestrogen during the menopause can also cause these ‘male’ hormones to have a greater effect, leading to hair thinning or hair loss.

Fertility troubles

As a result of natural hormonal changes, women’s fertility usually starts declining at age 35. Early menopause can harm your fertility, as can other hormone-related conditions, like polycystic ovary syndrome (PCOS).

High levels of follicle-stimulating hormones (FSH) also reduces our chances of becoming pregnant. Other types of fertility-related hormonal imbalance concern the luteinising hormone (LH) — when this is low, our ovaries receive less stimulation to release an egg and produce progesterone.

If you’re concerned about your fertility and think it might be related to a hormone problem, your doctor will be able to arrange blood tests to check your FSH and LH levels.

Diabetes

Around 70 percent of women who have polycystic ovary syndrome (PCOS) also have insulin resistance. PCOS is the hormonal condition characterised by increased levels of male hormones and a decreased level of progesterone.

As such, having diabetes is associated with also having a hormone imbalance — it is understood that the extra insulin production in diabetic people causes the ovaries to produce more male hormones.

A lump in the neck

One potential sign of a hormone imbalance is a lump in the front of the neck, also known as a goitre — an underactive or overactive thyroid can cause the gland to swell. This lump will move when you swallow. The size of the swelling differs from person to person.

If you notice a lump in your neck developing, be sure to get in touch with your doctor as soon as possible. A thyroid hormone imbalance is only one out of a number of other possible causes, some of which can be serious.

Vaginal dryness & discomfort during sex

During the menopause, levels of oestrogen fluctuate wildly and gradually decline. Low levels of this important female sex hormone are associated with a loss of lubrication in the vagina and a thinning of the vaginal cell walls.

Other oestrogen-related symptoms you might experience

The menopause process causes two key female sex hormones — oestrogen and progesterone — to decline in production. The resulting hormonal imbalance has the potential to produce a wide range of physiological changes and symptoms. As well as those already discussed, this can also include:

• Weak bones (osteoporosis)
• Body odour
• Water retention and bloating
• Lapses in memory
• Leg pain and restless legs.

What are the causes of hormone imbalance?

Oestrogen, progesterone, thyroid hormones, androgens, follicle-stimulating hormones and luteinising hormones are some of the key hormones implicated in hormone imbalance.

Our understanding of why imbalances in these hormones occur is not complete, but the menopause and genetics are known to be two causes.

• Menopause: In most women, the menopause process usually begins between the ages of 45 and 55. Levels of oestrogen and progesterone — two key female sex hormones — wildly fluctuate, leading to an imbalance that causes symptoms like hot flushes, insomia, low mood and low libido.
• Genetics: Common hormone-related conditions like polycystic ovary syndrome (PCOS) are known to run in families, with the exact causes not sufficiently clear. The cause of the condition that produces an underactive thyroid — Hashimoto's disease — is not yet completely understood, but is thought to be genetic, too.

Aside from family history being thought to play some role, the precise causes of hormonal disorders such as PCOS, fibroids and hypothyroidism are not fully understood at present.

If you have concerns about your hormonal health or you suspect you may have a hormone imbalance, make sure to discuss the problem with your doctor as soon as you can.

What can be done to test for and diagnose hormone imbalance?

If you think you have symptoms of a hormone disorder or imbalance, ask your GP or health provider for a test. This will measure the levels of hormones in your saliva, urine or blood.

For example, to diagnose a thyroid hormone imbalance, you will take a thyroid function test. A sample of your blood will be taken and analysed for levels of thyroid-stimulating hormone (TSH) and, if appropriate, for levels of triiodothyronine and thyroxine, both thyroid hormones. Testing may also include an ultrasound.

If you think you might have polycystic ovary syndrome (PCOS), your GP will be able to arrange a number of tests to find out whether a hormone imbalance is the cause of your symptoms. Your blood pressure will usually be checked in order to rule out other causes.

Talking with your GP will also help you to discover whether your hormonal imbalance symptoms are as a result of the menopause. You may want to explore treatment options with your doctor.

What are the treatments for hormone imbalance?

There are a number of different therapies and medications for hormonal imbalances in women — of course, the type of imbalance you have will determine which treatments are appropriate for you.

Some treatments, such as oestrogen therapy and thyroid hormone therapy, address the hormonal imbalances directly, thereby alleviating symptoms. Others concern themselves with treating only the symptoms.

Treatments for menopause-related hormonal imbalance

Hormonal issues caused by the menopause are most commonly and effectively treated with oestrogen therapy. Some women may prefer to not take HRT, either because they’re not suitable, have concerns about side effects, or want to explore ‘natural’ alternatives.

Hormone replacement therapy

Women experiencing hormone imbalance caused by the menopause may want to explore hormone replacement therapy (HRT). There are a number of different ways of taking HRT — oral tablets, skin patches, gels and even implants. HRT increases levels of the hormone oestrogen, thereby restoring balance and helping to alleviate troublesome symptoms of the menopause.

For sex drive

If your libido is a casualty of your menopause hormonal imbalance, consider discussing the issue with your doctor. They may recommend a testosterone gel to be included as part of your HRT.

For vaginal dryness, hormone replacement therapy is clinically shown to help, with a practical solution including the use of a water-based lubricating gel.

Alternatives to hormone replacement therapy: for minimising symptoms of hormonal imbalance

Not all women are suitable for HRT, or some may wish to explore other avenues for treating the symptoms of an oestrogen imbalance. For such women, there are a number of lifestyle, dietary and complementary and alternative treatments to HRT. These can include certain types of exercise, food, herbal remedies as well as other prescribed medicines.

Treatment for thyroid hormone imbalances

An underactive thyroid (hypothyroidism) is often treated with levothyroxine, a type of hormone replacement tablet. This provides your body with a supply of thyroxine, the hormone your body is not producing enough of.

Usually, you’ll begin on a low dose of levothyroxine and will take regular blood tests to ascertain the correct dose of the drug for your body. Thereafter, you’ll take annual blood tests to monitor your thyroid hormone levels.

The tablet is usually taken at the same time every day. There are no known side effects from the drug. The time for the treatment to take effect varies; some people find it works almost immediately, whereas others only report improvements several months down the line.

Sometimes, people may discover they have an underactive thyroid through a test, but not wish to take treatment if their symptoms are very mild.

Treatments for polycystic ovary syndrome

There is no known cure for PCOS, although symptoms can be greatly improved with simple lifestyle, healthy changes. Weight loss, in particular, has been clinically shown to improve symptoms of the hormone disorder — PCOS is exacerbated by obesity.

Depending on the PCOS symptoms you’re reporting, a number of treatments exist:

• Excess hair growth: There are several medicines available that work to control excess hair growth (hirsutism) and hair loss. They work by blocking the effect of the ‘male’ hormones.
• Fertility: Tablets, injections or IVF treatment may be recommended by your GP.
• Irregular periods: Women may be advised to take the contraceptive pill in order to induce regular periods.

Being in touch with your hormonal health

A good understanding of the role of your hormones can be very useful, particularly when it comes to spotting the signs of imbalance. If you think you might be struggling with a hormone disorder, be sure to consult your doctor as soon as possible.

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