Every person assigned female at birth (AFAB) experiences fluctuating hormones — the chemicals that control most of your body’s functions. The hormonal changes that naturally occur with certain life events, such as menstruation, pregnancy and menopause, are hard to ignore. But those aren’t the only reasons hormones become unbalanced.
Recognizing the symptoms of a hormonal imbalance when they happen can provide the clues you need to identify an underlying issue and get relief. Here’s what you need to know about dysfunctional hormones:
What is a hormonal imbalance?
Your body has more than 50 types of hormones that function like instruments in an orchestra. Even a small change to those instruments or how they play can throw off an orchestra’s balance.
Your organs and tissues release hormones into the blood. They travel throughout your body, regulating and controlling the systems that affect your:
- Growth
- Metabolism
- Mood
- Reproduction
- Sexual function
If your body produces too little or too much of a particular hormone, it can impact any of those functions.
What causes hormonal imbalance?
Certain times and events in life naturally affect the hormones of people AFAB. Age can affect hormone production and how well hormones work. Other life stages, such as puberty, can also affect hormonal levels.
Other causes of a hormonal imbalance may not affect everyone. Conditions that tend to disturb hormones include:
- Addison’s disease, which affects the adrenal gland and its ability to make hormones
- Anorexia and other eating disorders that cause hormonal changes
- Congenital adrenal hyperplasia (CAH), which can cause abnormal levels of cortisol (stress hormone) and testosterone (male hormone)
- Cushing's syndrome, associated with high cortisol levels
- Diabetes, which affects insulin (the hormone that regulates blood sugar)
- Polycystic ovary syndrome (PCOS), which causes people AFAB to produce unusually high levels of male hormones
- Thyroid disorders, which affect your thyroid’s ability to make hormones
You can also experience hormonal changes due to:
- Cysts and tumors
- Drugs such as birth control or cancer treatments
- Environmental exposure to chemicals
- Stress
Hormonal imbalance symptoms
It can be challenging to identify a hormonal imbalance because the symptoms vary depending on which hormones are affected and how. People AFAB with a hormonal imbalance may experience:
1. Menstrual changes
There are many reasons your monthly period can change, but hormonal imbalance often plays a role. Changing hormone levels can cause your period to be unusually:
- Absent
- Frequent
- Heavy
- Irregular
Most hormone-related menstruation changes have to do with fluctuating estrogen levels. But your period can also change because of diet, exercise, mental health and other underlying conditions.
2. Hair issues
Hormones affect hair’s natural cycle and structure. If your hormones are unbalanced, you’ll likely notice it in your hair. For example, people often experience thicker, fuller hair when their hormones change due to pregnancy.
Both hair loss and excessive hair growth (hirsutism) can be signs of hormonal imbalance. If coarse hair grows on your face and chin, your body may be producing too many male hormones. If you’re losing hair, you may have a thyroid issue.
3. Skin problems
A hormonal imbalance can cause changes to your skin’s color and texture. If you’re experiencing increased progesterone — which occurs with pregnancy — you may notice more acne on your face, chest and back.
Changes in hormones, including estrogen and progesterone, can also cause hyperpigmentation — dark patches on the skin. It’s most likely to occur on the neck, groin and under the breasts.
4. Sex-related symptoms
If your estrogen levels change — which happens with age — you may notice signs in the bedroom, such as:
- Low libido
- Pain during sex
- Vaginal dryness
A hormonal imbalance can also cause vaginal atrophy — inflammation and thinning of your vaginal walls. It tends to happen after menopause when estrogen levels are low.
5. Weight changes
Weight gain or sudden, unexplained weight loss is always a cause for concern. But those issues may indicate a hormonal imbalance. Weight gain is typical after menopause because of decreased sex hormones.
But weight issues are also associated with hormone-related conditions such as:
- Thyroid disorders
- PCOS
- Cushing’s syndrome
6. Mood and sleep issues
When estrogen levels drop, so does your body’s serotonin — the chemical that helps stabilize mood. When those levels are low, the brain and nervous system don’t always communicate as they should, causing:
- Anxiety
- Depression
- Irritability
Those mental health issues can interfere with sleep. A hormonal imbalance can also affect sleep by causing you to experience:
- Night sweats
- Trouble falling or staying asleep
7. Digestive distress
Your sex hormones, estrogen and progesterone, play a significant role in your metabolism and help regulate your gastrointestinal tract. When those hormones aren’t balanced, your gut function suffers, causing digestive issues such as constipation or diarrhea.
Research suggests that hormonal imbalance in people AFAB may be related to irritable bowel syndrome. Gastrointestinal issues commonly relate to hormonal changes in blood associated with menstruation.
What to do if you think you have a hormonal imbalance
Hormonal imbalances aren’t always easy to detect — no single test evaluates all hormone levels. There are various home testing kits available to measure specific hormone levels. But your best action is to share your symptoms and concerns with your primary care physician (PCP). They consider your entire health and can perform assessments that may get you one step closer to treating your symptoms.
Diagnosing a hormonal imbalance can involve:
- Physical exam and review of health history to detect an underlying condition
- Evaluation of medications and supplements taken
- Lab tests to measure hormone levels in your blood, urine or saliva
- Pelvic exam to feel for cysts or tumors interfering with hormone production
- Ultrasound, which can examine your uterus, ovaries, thyroid or pituitary gland
There are several ways to treat hormonal dysfunction, including:
- Anti-androgen drugs if the problem is higher-than-normal male hormones
- Hormonal birth control to balance sex hormones
- Hormone therapy, which uses artificial hormones to increase low estrogen or thyroid hormones
- Vaginal estrogen, a topical treatment that relieves vaginal dryness and pain
There are also natural remedies that may boost estrogen. Talk to your PCP before trying those options.
