Hormonal imbalances are a complicated host of symptoms that can manifest in the body in a myriad of ways. Signs and underlying drivers of hormonal imbalances may include blood glucose imbalance, systemic inflammation, adrenal fatigue, HPA-axis dysregulation and insulin resistance to name a few.
As we’ll explore in this article, hormonal imbalances can affect both men and women's health.
When we’re talking about hormone imbalance, we’re discussing the sex hormones –estrogens, progesterone and androgens¬– and how these key hormones interplay and balance each other out and how they connect with endocrine organs and systems.
A hormone imbalance may manifest as heavy and painful periods for women, mood swings, vaginal dryness, low libido, acne, infertility, unexplained weight gain, hair loss, fatigue, brain fog, stress and anxiety.
This article is going to break down the symptoms of hormone imbalance and what you can do from a natural and holistic approach to restore balance and harmony to hormone health.
Table of Contents
The Signs of Hormonal Imbalance in Women
As women, we’re classically and stereotypically labelled “hormonal”. But what does this even mean and why does it occur? What are the signs of hormone imbalance? There are many. First of all, PMS and painful periods are common, they’re not normal.
PMS and painful periods are driven by imbalances in sex hormones and the ratios of estrogens, progesterone and androgens.
Estrogen is a trio of female steroid hormones. We have E1 – Estrone, E2- Estradiol and E3 – Estriol.
Estrone is the dominant estrogen during menopause. It comes from the ovaries, adipose tissue and adrenals.
Estriol E3 is prominent and elevated during pregnancy and is a weak estrogen supporting pregnancy (also what tends to be measured in a pregnancy test).
Estradiol is the main estrogen in reproductive aged women. It’s also the estrogen that will either drive PMS and painful period symptoms through its conversion.
Estradiol is the “strongest” estrogen. It is released from the ovaries (specifically the follicles) and is converted to either 2-OH (2-Hydroxyesterone) the protective, “good” and weaker version, 4-OH (4-Hydroxyestrone) the inflammatory version or 16OH (16a-Hydroxyesterone), the symptomatic version that promotes tissue proliferation and estrogen activity.
The way we live our lives, the food we eat, the amount of sleep we get, and how we manage stress will determine which pathway Estradiol is shuttled down. And thus, if we experience enjoyable and surprise periods, or painful, debilitating ones.
Estradiol, especially 4OH and 16OH, also drive PCOS (Polycystic Ovary Syndrome), endometriosis and additional gynaecological conditions.
Estrogen is the main anabolic hormone for women's health. It builds and protects bone health, fortifies collagen in the skin, regulates cholesterol, increases BDNF (brain derived neurotrophic factor), improves mood and cognition and increases serotonin uptake in the brain.
With this list, we can see many of the important functions healthy estrogen levels produce in the body and contrarily, how symptoms of low estrogen levels may manifest into symptoms of hormonal imbalance.
There are estrogen receptors in every single one of our cells. When estrogen binds to cells, they influence gene expression; hence why sex hormones influence so much of our physiology (eg cramps - muscles, mood - brain, appetite - digestion).
Only “free” estrogen can bind. If it’s bound up with SHBG (sex hormone binding globulin) it won’t be able to exert it’s potential (this is a good thing).
Because when there is an excess of estrogen in the body, which is quite common for most women, you might experience these symptoms:
- Heavy, clotty, painful periods
- Breast tenderness
- Anxiety and worry
- Mood swings
- Fluid retention
- Fat pockets specifically on the back of arms, hips, thighs and butt
- Depression and mood swings
- Headaches and migraines around our cycle
- Deep vein thrombosis and varicose veins
Progesterone is released from the corpus luteum which happens after ovulation and keeps our uterine lining juicy and ready for a pregnancy.
Progesterone balances estrogen. These two hormones act like a see-saw with each other. When there is an imbalance in one, there is an imbalance in the other. Signs of low progesterone and estrogen can be seen in menopause, perimenopause and amenorrhoea (absent period).
Progesterone is naturally anti-anxiety, anti-depressive, increases GABA pathways that act like a calming neurotransmitter. Generally, progesterone deficiency is more common than in excess and symptoms associated a deficiency include:
- Estrogen dominant symptoms
- Mid cycle spotting
- Light, scant or absent periods
- PMS at ovulation
- Painful ovulation
- Testosterone dominant symptoms
Then we have the androgens, which, like estrogen, are a family of steroid hormones with testosterone being the predominant one within women and males.
Healthy testosterone levels are just as important for women's health as they are for men.
Women naturally release small amounts of testosterone from the ovaries and adrenal glands. Testosterone is used to support healthy skeletal muscle mass, improve cognition, support healthy libido and bone density (1).
An excess in testosterone levels may manifest into symptoms such as:
- Hormonal acne specifically around the jawline
- PCOS (Polycystic Ovary Syndrome) / PCO
- Insulin resistance and type 2 diabetes
- Visceral fat around central organs
- Missed, scant, light periods
- Anger and irritability
Low hormones amongst all three looks like:
- Menopause / andropause
- Hot flashes
- Slowed recovery time
- Disrupted sleep
- Imbalanced moods
Heavy or Painful Periods
Heavy or painful periods are driven by menstrual cycles with an excess of estrogen levels, specifically 4OH and 16OH estrogen, that’s driving inflammation, thickened uterine lining and associated symptoms. Menstrual cycles with dark blood, clotty blood, heavy long bleeds with cramping, breast tenderness and any of the above estrogen dominant symptoms all point to an excess in estrogen levels.
Estrogen levels may be elevated due to a number of reasons. Higher than normal stress levels are one and quite possibly the main cause.
A lack of progesterone or xenoestrogens in our personal care products, a diet high in pro-inflammatory sugars and oils, pre-exposure through utero, an overburdened liver and gut inflammation / leaky gut / dysbiosis may all contribute to high estrogen levels.
We’ll explore how to actually balance sex hormones further below.
The current approach within conventional medicine is to use contraception (birth control) to suppress symptoms and shut down the communication between the brain and ovaries. But unfortunately, symptoms of hormonal imbalance will appear again whenever you choose to come off birth control because the underlying imbalance is still there. It’s just being alleviated and masked by the synthetic hormones in the birth control contraception.
Additionally, working with a health professional is advantageous to restoring balance to your hormones and supporting estrogen detoxification.
Low libido is another key symptom caused by hormone imbalance. Once again, stress is a major factor.
When the body is stressed out it diverts all its attention, energy and nutrients to surviving. It will shut down reproduction because it’s the least important system at that time.
The body wants to survive more than it wants to reproduce. The body is intelligent enough to know it’s unable to have a baby and support a healthy pregnancy when we’re stressed out.
Low libido has been linked to a decrease in testosterone, estrogen and progesterone levels. All three are responsible and required for a healthy sex drive.
I’d also like to mention that as humans and women, we’re designed to have a libido. Women were designed to want to have sex and have sexual desires because our biological purpose is to reproduce. When we don’t have that desire it weaves into deeper levels of emotional, psychological and physical blocks. Low libido is often a symptom of something that has not been addressed and I feel there’s a lot of shame, stigma and stereotypes surrounding a low sex drive in women.
Choosing to work with a health professional whether it’s from an emotional, psychological or biological standpoint to uncover the reasons for a low libido can also be explored. Also, consider trying a natural libido boosting product.
Plus, sexual pleasure and orgasms are scientifically shown to reduce stress and blood cortisol levels and increase immune function. During sex, serotonin, dopamine and endorphins are released, we bond and feel connected, seen, cherished and it’s a natural part of being a hedonistic human.
Poor Quality Sleep
Poor sleep and hormone imbalance are not often connected but the two are intrinsically and reciprocally linked.
We see it play out or hear about it throughout perimenopause and menopause, with night sweats, hot flashes, poor disrupted sleep and insomnia becoming common due to a decline in sex hormones.
Sex hormones influence sleep regulation. Estrogen and progesterone receptors are in many areas of the brain that regulate our sleep/wake cycles (2).
Both low estrogen and progesterone are directly associated with disrupted sleep, poor sleep quality and difficulty falling asleep (3, 4).
Studies on mice showed that after being sleep deprived to 6 hours of sleep (sleep deprivation being categorised as 7 hours or less), they were then treated with estradiol and progesterone. The results demonstrated the rats that received the additional hormones had a larger increase in REM sleep but less NREM (deep) sleep than those who were untreated (5).
Interestingly, when both female and male mice had gonadectomy, there were no differences in their sleep-wake cycle. This conveys how important the sex hormones are for influencing sleep patterns.
Adult acne (Acne vulgaris) appears as a hormone imbalance specifically along the jawline, signalling an excess in androgens.
Androgens stimulate the sebaceous glands within the skin to make additional oil (sebum) and thus, increase the amount of oil produced. This process increases the chances of the follicle being blocked therefore, developing acne and driving break outs.
As mentioned above, an excess in androgens produced by the ovaries and adrenals are the key sex hormones responsible for driving adult acne. Balancing and increasing SHBG (sex hormone binding globulin) is how you may help support and decrease adult acne.
SBHG acts like a mop soaking up additional androgens helping them safely detoxify and be eliminated via the liver and GI tract.
Natural ways to increase SHBG levels include nettle root, Pine Pollen extract, flaxseeds, fermented organic soy (because of the lignans and phytoestrogens), exercise, intermittent fasting and caffeine.
Infertility issues and difficulties getting pregnant can be a broad complex topic with our sex hormones at the centre. We need healthy levels of estrogens, progesterone and androgens to conceive and maintain a pregnancy.
Progesterone in particular plays a key role in pregnancy and gestation. Progesterone helps hold the uterine lining in enabling an egg to attach and thus, a foetus to grow.
Estrogen is an anabolic hormone that assists the growth of the uterine lining and the blood vessels that feed into the uterus, which brings nutrients to these cells. When either of these hormones are out of balance, it may be difficult conceiving.
It would also be criminal to not mention the role of stress hormones and their impact on sex hormones and fertility. The adrenals produce DHEA (dehydroepiandrosterone), the grandfather hormone that is converted into cortisol, progesterone, estrogens or testosterone.
When we’re stressed out, DHEA converts into cortisol to buffer the perceived stressors which lowers the production of sex hormones.
Additionally, chronic stress and cortisol release throws off blood sugar balance, slows down metabolism, liberates key nutrient stores, increases weight gain, disrupts a healthy functioning gut and imbalances mood. All of this factor into having a healthy pregnancy.
The HPGA – hypothalamus-pituitary-gonadal-axis is the feedback loop from the brain, adrenals and ovaries. Chronic stress inhibits reproduction signalling that it’s not safe for the body to reproduce (6).
Vaginal dryness is a symptom of low hormones– estrogen particularly and progesterone.
Estrogen again being that anabolic, lubricating hormone enables a thick, juicy uterine lining and the production of fluid to support a healthy vaginal microbiome and also sex.
Consider getting your hormones tested through a health practitioner and/or by ordering a DUTCH test to assess your hormone levels. This is highly advantageous as blood serum markers aren’t the most reliable or best way to measure hormone imbalance, especially considering it’s just a snapshot in time rather than a comprehensive month-long saliva and urine test.
In some situations, testing thyroid hormones and/or hormone replacement therapy might also be beneficial if advised by a licensed practitioner.
Mood swings are the most stereotypical symptom of a hormone imbalance, but also have some truth and science behind it.
Both estrogen and progesterone are naturally anti-depressants. These hormones begin to drop pre-period week, mood dips, emotions bubble up, energy levels decrease, and all the additional physical symptoms begin.
The brain is loaded with estrogen and progesterone receptors that influence how our mood, emotions, cognition and memory all function and operate. Additionally, progesterone stimulates the GABA pathway–our calming neurotransmitter. When women have lower progesterone levels, many find they’re unable to calm down and switch off, or they over think, worry, feel anxious and emotionally exhausted.
We may help support and increase progesterone levels by taking Cordyceps mushrooms, oats (gluten free and uncontaminated where possible), flaxseeds, quinoa and wholegrains, pumpkin seeds, seafood and cacao. Additionally, it’s important manage stress and get optimal sleep.
The Signs of Hormonal Imbalance in Men
Hormonal imbalance in men manifest as weight gain around the chest, hips and thighs and a decrease in muscle mass and tone. Hormone imbalance also cause low libido, erectile dysfunction, low sperm count and bouts of over thinking, anxiety and depression.
These changes are contributed to either an increase in aromatisation – the biological pathway where enzymes convert testosterone to estradiol and thus, changes occur in physical composition and adipose tissue being in those real estrogen dominant areas.
5-alpha reductase enzymes also convert testosterone to DHT (dihydrotestosterone) – the more active and “stronger” male androgen. An excess in DHT may accelerate a receding hair line and male pattern baldness.
Experiencing Erectile Dysfunction
Erectile dysfunction (ED) may be attributed to lower levels of free testosterone in the blood and body.
Aside from the role testosterone plays, biologically speaking, chronic stress (physical, mental and/or environmental) and inadequate sleep also impact healthy testosterone levels and may cause erectile dysfunction.
Sex hormones are just one factor contributing to ED. High blood pressure, early stages of atherosclerosis, obesity and metabolic disease also contribute to ED symptoms.
Consider working with your health care professional for a full evaluation and find the underlying hormone imbalance causing ED, be it physical, emotional or psychological.
Lower levels of Body Hair Growth
Testosterone is the primary driver behind body hair growth.
A decrease in the conversion of DHEA to testosterone whether due to stress or high levels of SHBG (sex hormone binding globulin) will be contributing to a lack of hair growth.
We can also see this in reverse. As men age, they tend to get hairier because the hair follicles have been exposed to testosterone since puberty, transforming once hair (fine hair) into thicker hair.
Low Sperm Count
A decrease or lack of DHT (dihydrotestosterone) in the body may cause a decrease in sperm production.
DHT regulates semen volume and viscosity. Lower testosterone levels in men have shown to not impact sperm function, rather, causing low libido and erectile dysfunction.
One particular study draws attention to exogenous testosterone functioning as a contraception that inhibits the release of follicle stimulating hormone and luteinizing hormone – the two hormones that stimulate sperm production within the testes. (7-9)
Reduced Sex Drive
Reduced sex drive may be contributed to numerous factors with low testosterone levels being a hormonal driver.
Low testosterone may occur due to an unhealthy lifestyle and increased aromatisation from alcohol, stress, medications and drugs, an overburdened liver, systemic inflammation, obesity, type 2 diabetes and accelerated aging (10).
Natural Ways to Balance Hormone Levels
Balancing hormones requires a holistic and long-term approach to address the root cause.
These are six major factors that must be considered to balance hormone levels–balance and manage stress levels, improve sleep, movement and exercise, a reduction in sugar and processed foods and lowering inflammation.
1. Try and Balance Stress Levels
Stress informs the body that it doesn’t have the time, energy or priority to reproduce safely. When the body is overly stressed it shuts down the reproductive system which naturally leads to a decreased desire for sex.
Stress is experienced through four keyways:
- Physical stress – over-exercising.
- Emotional stress – difficult or manipulative relationships, or the pressures from societal expectations.
- Psychological stress – financial strain, loss of a loved one.
- Environment stressors – exposure to pollution, contaminants and toxins in food water, hygiene products and workplaces.
Combatting stress is a multi-approach. There are many ways to reduce stress levels including:
- Movement and moderate exercise
- Walking the dog
- Having sex
- Breath work
- Spending time in nature
- Setting boundaries and communicating
- Having authentic conversations and interactions
- Doing what we love and feel passionate about
- Include key adaptogenic herbs and other products to balance hormones into our diet
- Adding in supplements such as Magnesium and Activated B Vitamins
2. Improve Sleep Quality
Sleep is such an underrated form of medicine to help restore hormone imbalance.
One night of sleep restriction was associated with lower testosterone levels in men. This makes sense because testosterone is released by the hypothalamus to the testes during the hours of 11 pm-1 am each night. If you’re awake during this phase you’re missing out on that key release and function that occurs when we’re asleep. (11, 12)
Try these healthy sleep time habits to improve sleep quality and symptoms of hormonal imbalance such as hot flashes and night sweats:
- Set a regular bedtime and wake up time. The body thrives on routine.
- The optimal sleeping temperature in the bedroom is 18 degrees Celsius (64 Fahrenheit).
- Have a warm shower before bed.
- Start winding down at least 30 minutes to one hour before bed–limit screen time and turn off all phones, TV and other electronic devices.
- Empty your brain by writing down tomorrow’s to-do list.
- Use natural sleep supplements before bed to calm the mind and nervous system. Try magnesium, Reishi Mushroom and other sleep-promoting herbs such as passionflower, zizyphus, Pearl powder, chamomile, Schizandra berry, kava root and valerian.
3. Reduce Inflammation Levels
Inflammation is one of the key driving forces behind hormonal imbalance.
There’s many ways to reduce inflammation–improve sleep quality, manage stress better, exercise, switch to a healthier diet, eat more foods rich in antioxidant and take natural supplements such as omega 3’s found in fish oil.
Fish oil is probably the most extensively researched supplement to help lower inflammation levels.
However, it’s important to understand that not all fish oils are created equal and this is often reflected in the price.
A lot of low-quality fish oils on the market (cheaply priced) are not beneficial for your health. Low end products are often cut with soybean and pro-inflammatory plant oils. Instead of wild caught cold water fish, poor quality fish oil products use farmed fish fed GMO corn and soy feed that don’t even contain the essential Omega 3 fatty acids that’s intended to help reduce inflammation.
If you choose to incorporate fish oil into your diet, select good quality brands with certificates of analysis that source wild caught fish from clean waters.
4. Eliminate Sugar From Your Diet
Sugar is a key inflammatory driver and as we’ve discussed inflammation is the underlying reason for hormonal imbalance and the symptoms that are associated.
Reducing processed and refined sugars that will be present in processed foods will see a reduction in insulin resistance, imbalances in blood glucose, weight gain, cellular aging – all of which decrease testosterone levels.
We live in an era where we have access to so many amazing replacements and alternatives to sugar.
Try consuming sugar in its whole form such as in fruit and berries. Or, instead of using unnatural processed sugar, opt for the natural sugars in honey, pure maple, dates and coconut sugar. You can also try other low glycemic sweeteners such as stevia, thaumatin or monk fruit.
By limiting our daily sugar intake or eliminating sugar from our diet altogether, in a period of time we can get our hormones back on track and restore hormonal balance.
5. Limit Toxicity From Products You Use
Personal hygiene products and home cleaning products are full of endocrine disrupting ingredients such as parabens and phthalates that mimic xenoestrogens in the body. These nasty imposters get into our systems and drive hormonal imbalances and increase inflammation.
Reassess the ingredients list of your personal hygiene and cleaning products at home.
Make a conscious effort to choose natural deodorants, shampoo, soap, toothpaste, condoms, lubricants cleaning sprays etc. Throw out those old toxic hormone-sabotaging products and select non-toxic replacements to help restore balance to hormone health.
6. Keep Exercise Regular
Time and time again, exercise has been shown to improve testosterone levels and hormone health. Moderate regular exercise works as a positive feedback loop.
Within the muscle, testosterone stimulates protein synthesis and inhibits the degradation of protein and muscle. In turn, testosterone levels are increased directly after heavy resistance training, forcing the body to adapt and release more testosterone to increase resilience (13).
Additionally, regular exercise improves metabolic markers; blood glucose, insulin and leptin sensitivity, reduces inflammation, improves cardiovascular function and blood flow, and reverses erectile dysfunction.
Further, movement and exercise influence and improves a positive mental state, wellbeing and self-confidence which naturally leads to enhancing libido and sexual desire.
Talk to a healthcare professional
As always, we recommend consulting with your doctor or healthcare professional to address any of the symptoms and states we’ve mentioned in this article or if hormone replacement therapy is necessary. Everyone is different and unique and therefore, the information provided in this article is intended for informational purposes only and is not to be taken as treatment advice.
Commonly Asked Questions
How to Know if You Have a Hormonal Imbalance?
You may have a hormonal imbalance if you’re experiencing any physical symptoms such as heavy or painful periods, low libido and sex drive, acne, poor sleep quality, mood swings, weight gain, breast tenderness, erectile dysfunction, infertility issues and other symptoms discussed in this article.
What Causes Hormonal Imbalance?
Hormonal imbalances may be caused by eating a diet high in processed sugar and inflammatory foods, excessive alcohol intake, a lack of exercise, increased toxic load, an overburdened liver, chronic stress levels and poor-quality sleep.
What are Natural Ways to Address Hormonal Imbalance?
Natural ways to address hormonal imbalance is to exercise regularly, reduce sugar and processed foods, eat more wholefoods, manage stress better, improving sleep quality and include natural supplements and adaptogens in your diet such as Reishi Mushroom and Cordyceps Mushroom.
Signs of hormonal imbalance are vast and complex but also very specific. Hormonal imbalances can be linked to libido, skin, mood, body composition, weight gain, sleep and fertility. Symptoms of hormonal imbalance could also be associated with thyroid hormones.
For both men and women, improving hormone health and restoring balance requires a long-term holistic approach that will enable us to feel happy, vibrant and energised for a lifetime.
If you suspect imbalances in your hormones, seek guidance from a health care professional and begin adopting the necessary changes to your lifestyle immediately.
Take the lessons from this article and proactively learn new sleep habits and stress reduction techniques, eat healthier foods, drink better quality water and include natural supplements, medicinal mushrooms and adaptogens into your diet to restore balance and get back your healthy hormones.
Written by Eliza Hedley
Eliza is a health, mindset and abundance enthusiast obsessed with helping millennial's experience living at a higher level.
Her relaxed new age approach and understanding of nutrition and wellness sees her empowering and coaching individuals to understand that their health is the ultimate asset. Upon experiencing first hand the power and place of tonic herbalism and medicinal mushrooms in everyday life, Eliza’s become an adaptogen fangirl and feels their utilisation in today’s world is essential for abundance and wellbeing.
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- Sleep in Women Across the Life Span https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045782/
- When does estrogen replacement therapy improve sleep quality? https://www.sciencedirect.com/science/article/abs/pii/S0002937898705393
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- Glucocorticoids, Stress, and Fertility https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547681/
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- Dihydrotestosterone regulation of semen in male pseudohermaphrodites with 5 alpha-reductase-2 deficiency https://pubmed.ncbi.nlm.nih.gov/8045956/
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- Cross-sectional analysis of sleep hours and quality with sex hormones in men https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376994/
- Testosterone Physiology in Resistance Exercise and Training https://link.springer.com/article/10.2165/11536910-000000000-00000