The human body can produce a number of hormones that all serve different functions, including oestrogen, progesterone, luteinising hormone, follicle-stimulating hormone, prolactin, cortisol and testosterone. They’re all really important, but sometimes one (or more) of these hormones can become unbalanced. Read on to find out more about hormonal imbalances and the impact they can have on your body.
What is a hormonal imbalance?
A hormonal imbalance is when you have too much or too little of a particular hormone. As a result, you may develop some signs and symptoms that show something isn’t quite right. The symptoms you might experience will likely depend on the severity of the imbalance, but also the type of hormone you’re lacking or overproducing.
What are the main signs of a hormonal imbalance?
The signs and symptoms of a hormonal imbalance will differ depending on the cause. Different hormones have different effects on the body. For example, if your body doesn’t produce enough insulin, it can cause diabetes. For the purposes of this article, however, we’ll focus on the effects of imbalances of female reproductive hormones - oestrogen and progesterone specifically. Generally, the main signs that you’re producing too much or too little of a particular female reproductive hormone include:
- Irregular periods or no periods
- Excess facial hair
- Weight gain
- Oily skin and hair
- Hot flushes
- Trouble sleeping
- Heart palpitations
- Dry and itchy skin
- Vaginal dryness
- Reduced libido
- Tiredness
- Muscle aches
- Nervousness
- Anxiety
- Mood swings
You likely won’t experience all of these symptoms, but if you do notice signs like these, it could be a signal that your oestrogen or progesterone isn’t in balance.
What causes a hormonal imbalance?
Imbalances of other hormones can be caused by a range of conditions, but we’re focusing on female reproductive hormones. The following conditions can cause an oestrogen or progesterone imbalance:
- Polycystic ovary syndrome (PCOS)
- Menopause or perimenopause
- Hypothyroidism
- Hyperthyroidism
- Hormone replacement therapy
- Cancer treatment (including chemotherapy)
We look at each of these in more detail to examine why they can cause an imbalance.
PCOS
The cause of PCOS is unknown, but it is thought to be a condition that’s related to unusual or imbalanced hormone levels in women. It’s been shown that women with PCOS usually have at least one of the following hormonal imbalances:
- High testosterone
- High luteinising hormone (LH)
- Low sex hormone-binding globulin (SHBG)
- High prolactin
It’s unknown why these hormones may be off balance, but it’s thought that it could be an issue that stems from the ovaries and the way they’re working, or from the part of the brain that controls hormone production.
Symptoms of PCOS include:
- Irregular periods or no periods at all
- Excess facial hair
- Weight gain
- Thinning hair
- Oily skin
- Acne
Menopause or perimenopause
As women get older, the amount of oestrogen they produce begins to drop. This process can start months or years before your periods stop and is known as the perimenopause. Once your periods have stopped altogether, this is known as the menopause.
Oestrogen production is controlled by the ovaries, but as the ovaries age, they begin to produce lower amounts of this hormone. Oestrogen production can also drop if you’ve had an oophorectomy (surgery to remove the ovaries) or a hysterectomy (surgery to remove the uterus).
It’s this reduction in oestrogen production that can begin symptoms of the perimenopause, which can include:
- Hot flushes, particularly at night
- Changes to your period
- Trouble sleeping
- Heart palpitations
- Headaches or migraines
- Muscle aches
- Joint pain
- Low libido
- Vaginal dryness
- Increased frequency of urinary tract infections (UTIs)
- Dry and itchy skin
- Weight gain
Underactive thyroid (hypothyroidism)
The thyroid produces the hormone thyroxine. This hormone is responsible for controlling your body’s metabolic rate (the amount of energy your body uses), and when you have low levels of thyroxine (also known as an underactive thyroid), it can cause some of your body’s functions to slow down.
Commonly, an underactive thyroid is caused by the immune system mistakenly attacking the gland, and is a condition known as Hashimoto’s disease. This attack can damage the thyroid and reduce its ability to produce thyroxine. It can also be caused by previous trauma, such as treatment for thyroid cancer or surgery.
The symptoms can be quite similar to those women experience during the menopause, such as:
- Tiredness
- Changes to your period
- Increased sensitivity to heat and cold
- Weight gain
- Dry skin and hair
- Brain fog
- Loss of libido
- Muscle aches
- Depression
Overactive thyroid (hyperthyroidism)
People with an overactive thyroid have the opposite problem to those with an underactive one - the thyroid produces too much of the thyroid hormones.
The most common cause of hyperthyroidism is an autoimmune condition called Graves’ disease, and is the cause of three out of every four cases of an overactive thyroid. The immune system begins to attack the gland, making it overactive (similar to the way in which Hashimoto’s disease makes it underactive). The actual cause of Graves’ disease is unknown.
Hyperthyroidism is more common in women and mainly affects young to middle-aged women.
Symptoms of an overactive thyroid can include:
- Nervousness and anxiety
- Mood swings
- Trouble sleeping
- Tiredness
- Weakness
- Heart palpitations
- Weight loss
- Twitching or trembling
Hormone replacement therapy (HRT)
HRT involves taking hormones that your body is producing limited amounts of to reduce the symptoms of the menopause, however, it can come with its own set of side effects and imbalances.
If you’re taking oestrogen as part of your HRT treatment, you may experience:
- Bloating
- Breast tenderness
- Nausea
- Headaches
- Leg cramps
- Vaginal bleeding
If you’re taking progesterone, your symptoms might include:
- Acne
- Headaches
- Mood swings
- Breast tenderness
- Back pain
These symptoms will usually go away within a few weeks of beginning the treatment.
Cancer or cancer treatment
If you have cancer or are undergoing a cancer treatment, you may experience a hormonal imbalance. Some types of cancer cells produce hormones, which can be the reason for an imbalance. If you’re undergoing treatment for cancer, such as chemotherapy, the treatment can also reduce the amount of hormones you’re producing or block the action of the hormones that are being produced. This is particularly the case if you’re being treated for breast or prostate cancer, and it’s usually the sex hormones that are affected (oestrogen, progestogen and testosterone).
Depending on which hormone is imbalanced, you will likely experience similar symptoms to the menopause, HRT or PCOS. These symptoms might include:
- Hot flushes
- Decreased libido
- Mood swings
- Tiredness
- Trouble sleeping
- Weight changes (usually weight gain)
Can contraceptives cause a hormonal imbalance?
If you take a hormonal contraceptive, such as the progestogen-only pill or the combined pill, you may be wondering whether they can cause a hormonal imbalance. As these things contain hormones (either oestrogen and progestogen, or just progestogen), they could cause certain temporary symptoms, such as mood swings, nausea and headaches. Such symptoms, however, will usually settle down after a few months as your body adjusts to the hormones.
How to treat a hormonal imbalance in females
Treatment of your hormonal imbalance will likely depend on the hormone your body is lacking or producing too much of. Below, you can find some ways to help manage the imbalance based on the cause.
How to manage a hormonal imbalance caused by PCOS
PCOS isn’t a curable condition, however, there may be some things you can do to reduce the impact of its symptoms.
Your doctor may recommend that you choose a contraceptive pill for contraception if you have PCOS. The contraceptive pill can be used to help manage the issue of irregular periods or having no periods. While the combined pill can help to introduce more regular periods and monthly bleeds, some progestogen-only pills can help to induce periods if you don’t get them at all.
Losing weight can also help to improve the symptoms of PCOS if you’re overweight. While it won’t make the symptoms disappear altogether, it’s thought that being overweight causes your body to produce more insulin. This in turn can cause the ovaries to produce too much testosterone and might make your PCOS symptoms worse. You should aim to have a well-balanced diet and exercise regularly to lose weight in a healthy way.
If you wish to control the symptom of excess facial hair, you can take certain medications which may help. If you have or think you have PCOS and want to help to manage the symptoms, visit your GP or pharmacist who will be able to offer you advice and support.
How to manage hormonal changes caused by the menopause
The main treatment for the symptoms of menopause is HRT, which can come with its own set of symptoms, as already discussed. However, the symptoms you experience with HRT are usually temporary and may improve those you experience with the menopause, enough to make the treatment worthwhile. A GP will be able to provide you with more information and advice.
HRT involves taking oestrogen. This can be in the form of a patch, gel, implant or tablet. You may also need to take progesterone as well, which can usually be provided as a tablet, intrauterine system or patch.
How to manage a hormonal imbalance caused by a thyroid issue
Treatment for an underactive thyroid may involve taking a tablet each day such as levothyroxine. This hormone makes up for the thyroid’s reduced production and could help to ease your symptoms. The dosage you will take depends on how low your levels of thyroxine are, and so you may need a few blood tests to determine when the correct dose has been reached.
To treat an overactive thyroid, you may be given a medication known as carbimazole. This prevents your thyroid from producing too much thyroxine. At first, you may experience some side effects, including nausea, headaches, an upset stomach and a high temperature, but these usually ease off after a couple of months. In some instances, surgery to remove the thyroid may be recommended, but this is only likely in severe cases or if you cannot have thionamides.
If you think you have any hormone imbalance or are concerned about your symptoms you should discuss this with your doctor or pharmacist who will be able to offer you advice and support.
Sources:
https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
https://www.nhs.uk/conditions/menopause/
https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/
https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/
https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/
https://www.pituitary.org.uk/information/hormones/
https://www.cancerresearchuk.org/about-cancer/coping/physically/sex-hormone-symptoms/sex-hormones
https://www.jneurosci.org/content/26/41/10332
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