Symptoms of sex hormone imbalance can present in a multitude of ways. Absent or irregular periods, long or short cycles, heavy/painful periods, PMS, anxiety, depression, weight gain, mood swings, breast tenderness/swelling, acne, headaches, insomnia, fatigue, and cravings can all be due to imbalances in our hormones. Whew!
Hormonal conditions such as polycystic ovarian syndrome (PCOS), endometriosis, and fibroids also have hormone imbalances at their root. The underlying causes of endometriosis and fibroids are unknown, but estrogen can make these conditions worse.
To find out if your hormones are out of whack, you have to know what to look for. So let’s start by reviewing some of our key hormone players that I cover in my Hormone Balancing Guide and Cookbook and what it looks like for them to be in or out of balance.
Estrogen [source] and progesterone are the two primary female sex hormones. However, the other hormone that can be a major player in sex hormone imbalances is testosterone. We’ll go through each in detail below.
When estrogen is in balance:
When estrogen is produced in the proper amounts, it makes you feel happy and motivated by stimulating serotonin (the happy neurotransmitter) and dopamine (the motivation/pleasure neurotransmitter), increases sex drive, enhances your sensitivity to insulin which is important for metabolism and weight management, and benefits your bones, muscles, brain, and skin [source]!
When estrogen is too high:
- fibrocystic breasts
- weight gain, particularly in waist, hips, and thighs
- heavy or irregular periods
- painful periods
- uterine fibroids
- loss of sex drive
- breast tenderness and enlargement
- water retention
- headaches/migraines [source]
- mood swings and irritability
When estrogen is too low:
- Mood changes
- Less frequent or cessation of periods
- Hot flashes
- Skin dryness
- Sleep problems, night sweats
- Thinning of the vagina
- Decreasing sexual desire
When progesterone is in balance:
When progesterone is produced in the proper amounts, it reduces inflammation, builds muscles, promotes good sleep, relaxes muscles and calms your nervous system, and makes you more resilient to stress [source].
Low progesterone symptoms:
- Heavy or irregular periods
- mid-cycle or premenstrual spotting
- short luteal phase
- menstrual cramps
- hair loss
- poor sleep
Estrogen and progesterone are like yin and yang. Not only do we want them both produced in the right amounts, but also we want a healthy ratio of estrogen to progesterone.
When estrogen is too high relative to progesterone, it is referred to as “estrogen dominance.” You’ll notice that many of the low progesterone symptoms are similar to the high estrogen symptoms because these go hand-in-hand.
Most often, estrogen dominance is due to excess estrogen, which is caused by either increased estrogen production by your ovaries or impaired estrogen metabolism, or both. Estrogen metabolism is the removal or detoxification of estrogen from your body.
The liver and gut play crucial roles in this process, so a healthy liver and beneficial intestinal bacteria are key for getting rid of metabolized hormones. Estrogen dominance could also be a result of normal estrogen levels when progesterone is on the low side.
Low progesterone does not cause acne if the estrogen levels are normal or elevated. And excess progesterone makes one more prone to acne if estrogen is normal.
Estrogen dominance is the most common hormonal imbalance I see in my practice.
Some common causes of estrogen dominance (high estrogen relative to progesterone):
Excess body fat (> 28%) – hormones play a role in your weight loss efforts and contribute to estrogen dominance because body fat actually produces estrogen! So the more body fat you have, the higher your baseline estrogen levels will be. PCOS is also associated with estrogen dominance and obesity.
Stress – stress reduces progesterone, which counterbalances estrogen.
Constipation and inadequate dietary fiber intake – regular bowel movements are crucial for helping your liver and bowels get rid of excess estrogen.
Abnormal or poor liver function – your liver is the main site of hormone detoxification.
Exposure to environmental xenoestrogens – these chemicals increase your body’s toxicity burden and put a strain on the liver to continuously detoxify.
Nutrient insufficiencies – you need a variety of micronutrients for optimal hormone detoxification and elimination.
Excess alcohol intake – when your liver is so busy detoxifying the alcohol, it can’t work on clearing any other body toxins.
What About Testosterone?
Although testosterone is thought of primarily as a male hormone, it is an important hormone for women, too. It is produced by the ovaries and adrenal glands and spikes around the time of ovulation [source].
Testosterone helps women maintain muscle mass and bone strength [source], enhances sex drive, and provides an overall sense of vitality. Just like with estrogen and progesterone production, the Goldilocks principle applies – we want testosterone not to be too high or too low, but just right!
Low testosterone symptoms:
- low libido
- brain fog
- joint pain
- difficulty building muscle
Low testosterone can be caused by high estrogen, which suppresses the hormone that stimulates testosterone production. It can also be due to adrenal dysfunction – read more about that here.
High testosterone symptoms:
- hair loss
- oily skin
- increased body and facial hair
- feelings of aggression
- sleep disturbance
The most common cause of elevated testosterone levels in women is PCOS. Blood sugar dysregulation and high insulin levels (due to insulin resistance) are also found in women with PCOS.
Keeping testosterone at optimal levels is all about supporting your body’s production of the hormone so that it can work in tandem with the other sex hormones (like estrogen and progesterone) and neurotransmitters.
Hormone imbalances can really throw you for a loop sometimes. So if you have symptoms that make you think something’s up with your levels, consult your doctor for an evaluation.
This post was medically reviewed by Dr. Kimberly Langdon, M.D., a university-trained obstetrician/gynecologist with 19 years of clinical experience. Learn more about Hello Glow’s medical reviewers here. As always, this is not personal medical advice, and we recommend that you talk with your doctor.93