The Ultimate Guide to Female Hormone Imbalance
Who runs the world?! GIRLS! And what runs girls?! Hormones!
Hormones basically rule a female’s physiology, or doesn’t it seem so?! You have most likely been enlightened through the early years of sex education about the concept of female hormones such as estrogen and progesterone and their role in the menstrual cycle. But the extent to which these hormones impact the body systemically has been universally undermined.
- Mood swings through the roof?
- Period cramps so unbearable you’re forced to “cancel life” for a week?
- Waking up multiple times with a racing mind?
- Sex-drive non-existent?
- Sugar-cravings got you grazing on chocolate and cookies all day?
- Gaining weight despite intense exercise and dieting?
Oh and the list is just beginning there…
Guess what?! You’re not crazy, you don’t have low willpower, and your body isn’t broken. You are not alone, in fact, you could be in the majority, as 70-80% of women experience some form of hormonal imbalance that often goes unaddressed.
There exists no singular cause of one’s hormones getting jacked up, which can be annoying, frustrating, and tedious. Ever wonder why hormonal birth control is the holy grail to “fixing” hormonal imbalance symptoms?
Societally, identifying and addressing the culprit to female hormone imbalance is portrayed as an undesirable task in comparison to jumping straight to hormonal birth control, which simply fixes the problem for us. Or does it?… that’s a topic for another day.
The first step in getting to the root of hormonal imbalance symptoms in females and getting control of your own body is actually knowing what you’re looking for. And if you have no idea where to start, you’ve landed yourself in the right place. Today we are going to take a deep dive into the most common female hormonal imbalance symptoms as well as their likely causes and why they may have you feeling like a crazy person!
Hormones and Their Role in Hormonal Imbalance Symptoms in Females
First and foremost, let’s do a quick review on what hormones are and which are the most important female hormones to have balanced.
Hormones are chemical substances that affect the activity of another part of the body. Hormones serve as messengers, controlling and coordinating activities throughout the body affecting a variety of processes like growth and development, reproduction, and sexual characteristics.
Now just as a disclaimer, there is one group of hormones that we will not dive into today. These include the thyroid hormones thyroid-stimulating hormone (TSH), free and total T4, free and total T3, and reverse T3. The thyroid hormones are a huge piece of the puzzle because they highly influence all hormones discussed in this post; however, they are super complex and nuanced and deserve an entire post to themselves. Stay tuned!
Oh, there she is! Our most feminist of female hormones! Basically, thank you estrogen for your boobs, your butt, and of course our so highly desired monthly gift, Aunt Flow (but actually, a period = the body is happy!)
Now to get into the nitty-gritty. There are technically 3 forms of the steroid hormone estrogen, which promote the development and maintenance of female characteristics and the reproductive function of the body.
The forms of estrogen include estrone (E1), estradiol (E2), and estriol (E3).
- E1 – most potent and dominant of the three. When speaking in regards to low estrogen in women or “estrogen dominance”, E1 is what what we are referring to and is most available for everyday functions in the body
- E2 – produced by the cells lining the ovarian follicles in response to FSH. E2 is highly involved in ovulation, or the release of an egg in the middle of a female’s reproductive cycle.
- E3 – produced in higher concentrations in pregnant women
Estrogen in excess can elicit some gnarly, unfavorable symptoms, but low levels are equally as disruptive to homeostasis in the body.
Our performance will also suffer when estrogen is too low, as this hormone works in conjunction with growth hormone to build lean muscle during the follicular phase, which is the first half of menstrual menstrual cycle prior to ovulation.
Progesterone is our female calming hormone. It is secreted after ovulation and helps to maintain the uterine lining. Estrogen and progesterone work very closely together, balancing each other out. In a way, this hormone has an anti-estrogen effect, so when levels are low, estrogen can take over.
Follicle Stimulating Hormone (FSH)
Estrogen and progesterone always want to steal the show when it comes to female reproduction, but before these primary hormones can do their job, follicle-stimulating hormones must be present.
Follicle-stimulating hormone is dominant in the follicular phase or the first few weeks of the cycle. It receives input from gonadotropin-releasing hormone (GnRH) in the brain, which signals to start developing follicles into an egg. For several weeks these eggs develop until one is fully matured and is released into the fallopian tubes from the ovary. This marks ovulation.
This hormone also stimulates estrogen production! So before jumping right to estrogen as the problem of not getting your menstrual cycle, think about why FSH production might be impaired.
Women with infertility or irregular menstrual cycles can request FSH levels from their doctor to better understand why estrogen levels are low
- High FSH levels may indicate primary ovarian insufficiency (POI)
- Low FSH levels may indicate hypothalamic amenorrhea or PCOS
I’ll give you a hint, STRESS. Stress of all kinds including, extreme exercise, inadequate sleep, emotional stress/trauma, inadequate calorie intake, and excessive caffeine intake can impair signaling in the brain for FSH pulses to happen.
Luteinizing Hormone (LH)
Another important contributor to hormonal balance is luteinizing hormone. LH must be present for estrogen and progesterone to do their job. Oh and for pregnancy to even happen in the first place!
LH is produced in the pituitary gland and also works in response to gonadotropin-releasing hormone (GnRH) to control the menstrual cycle. Its pulses stimulate the release of an egg from the ovary. When GnRH pulses are not strong enough to generate strong enough LH pulses, an egg will not be released and ovulation will not occur.
Now, if nutritional fueling is adequate, exercise is not excessive and stress is well-managed, LH will surge and release the egg. After this egg is released, it travels to the fallopian tubes to unite with sperm and make a baby, YAY! (or nay?)
If no sperm is present, the egg ruptures to create a “corpeus luteum” in the uterus, which is responsible for making our calming hormone, progesterone.
Now, hopefully, you better understand the need for systemic hormone balance far beyond just estrogen and progesterone.
If you’re experiencing irregular or absent cycles, getting blood work ordered by your physician can be helpful in determining the underlying cause of your female hormonal imbalance symptoms.
- High LH levels may indicate premature ovarian insufficiency (POI) or polycystic ovarian syndrome (PCOS) (especially if higher than FSH)
- Low LH (especially levels lower than FSH) are common in women with hypothalamic amenorrhea or anovulatory cycles where you have a monthly bleed but you do not release an egg)
Hold the phone. Testosterone? I thought that was a male hormone?
Well, you’re correct, we often think of men when we hear testosterone because it’s the primary sex hormone, similar to how estrogen is the primary hormone in females, but women also produce this androgen hormone, testosterone in their ovaries and adrenal glands.
You need small amounts of testosterone as it plays a role in mood, energy levels, muscle growth, sex drive, and other biological functions.
DHEA is another major player and when out of whack can create female hormone imbalance. This hormone is produced in the adrenal glands, is converted into estrogen, and is valued for its protective effect in times of stress.
The brain signals for the adrenal glands to produce cortisol, DHEA is made along with cortisol in response to stress. So, think of cortisol as a player in the major leagues of baseball and DHEA as the player that comes up from the minor leagues to provide help when needed.
DHEA comes as a package deal with cortisol to balance the effects of cortisol’s potency. It can essentially act as a cellular antioxidant to hinder the potentially harmful effects of cortisol on cells. So having imbalance levels is not ideal!
DHEA’s effects on the body are similar to those of testosterone, thus high levels will be consistent with those of elevated testosterone including:
High DHEA can look like:
- Changes in tone of voice (typically deeper)
- Menstrual irregularities
- Abnormal hair growth around the chin, back, arms/legs, and chest.
- Hair loss
One study demonstrated that DHEA-S levels were 23% lower in the subjects who reported stress at work compared to the non-stressed group.
In acute or short-term stress, DHEA may rise in an effort to counterbalance the effects of cortisol, however, these levels will take a plunge when stress becomes long-term.
Low DHEA can look like:
- Extreme fatigue
- Poor mood
- Impaired immune function
- Decreased bone density
- Decrease in muscle mass
If your blood work reveals both elevated testosterone and DHEA, it is best to contact your doctor to investigate the possibility of having PCOS.
If you’ve been around here awhile, you know that we love to talk shop all things cortisol! Read more on how to reduce cortisol naturally when it gets out of control, but just to give you a brief overview, this hormone is the hormone that saves our life!
It quite literally evokes a physiological response to getting out of danger in a way that we would not be capable of otherwise.
This includes a spectrum of potential “threats” to the body such as running from a bear in the woods or even stepping in as a fuel source for our body when calories from food are sparse.
Cortisol deserves an entire post in its own right, but in regards to female hormone imbalance symptoms, it’s often the underlying factor that throws the rest of the system off.
Keep reading for more signs that cortisol is out of balance.
What Causes Female Hormone Imbalance Symptoms?
It would be impossible to list all of the potential hormonal imbalance causes but to scratch the surface, here are some of the most common. I’ll give you a hint, chemicals and food are the root of many hormonal imbalances
- Hormonal birth control
- Excessive sugar intake
- Low protein intake
- Lack of microbially diverse and nutrient-rich diet
- Dieting/low-calorie intake
- Ketogenic diets
- Intermittent fasting
- Exposure to toxins, pollutants, and endocrine-disrupting chemicals, including pesticides and herbicides
- Personal care products (makeup, lotions, etc.)
- Gut infections
- Chronic and extreme stress
Common Symptoms of Hormone Imbalance
Now that you’ve got a better understanding of the individual hormones and what they do in your body, let’s cover some general signs of hormonal imbalance that may be being driven by a number of hormones that are out of whack.
1. Irregular menstrual cycles
As you may expect, the female cycle is highly dependent on properly producing, signaling, and receiving hormones in the brain and ovaries. The type of irregularity can give you insight into the type of imbalance you’re having but some options include:
- Primary amenorrhea: absence of menses occurring at 15 years in the presence of normal growth
- Secondary amenorrhea: menses stop for 3 months or longer after already cycling regularly
- Oligomenorrhea: infrequent menses that go more than 35 days
- Bleeding multiple times per month
- Cycle length changes from month to month (ex: 24 days, then 40 days, then 60 days)
*PSA to all females who have been told by your physician that “it’s fine you’re not getting your period as long as you’re not ready to have kids.”
LADIES, IT’S NOT FINE! Run the other way and seek a new physician.
There are benefits to having a natural cycle that go far beyond pregnancy.
2. Hair Loss
Hair loss can be a clear indication of nutrient deficiencies and suggest that hormones are out of whack.
Oftentimes, women with a sluggish thyroid (i.e hypothyroidism or Hashimoto’s) will experience hair thinning and loss, but it can also indicate an imbalance in the androgenic hormones, DHEA, and testosterone as well.
3. Weight Gain or Inability to Lose Weight
Sweating away on the elliptical daily and counting calories, yet still seeing no progress in your body composition? Weight gain or difficulty losing weight despite making changes to our diet and exercise is one of the major signs of hormone imbalance.
We always want to focus on calories in vs in calories out, but let’s be honest… the body is WAY too smart for that.
Calories do not completely control metabolism. If you’re eating 200 calories worth of candy and 200 calories worth of chicken and broccoli, those calories are going to impact your appetite, blood sugar, and hormone, and your overall body composition completely differently.
If you’ve given an honest effort to losing weight by tracking calories and exercising, yet the scale is not budging, it is time to look at the potential hormonal disruptions from your food quality, timing, and environment that could be driving these unwanted symptoms!
4. Premenstrual dysphoric disorder (PMDD)
As your menstrual cycle approaches, it’s common (and normal) to feel a little more introverted, low energy, tired, bloated, and feel slightly discouraged. Physiologically, your body is going through hormonal changes in an effort to prepare for menstruation.
However, some women will experience premenstrual dysphoric disorder or PMDD, which is extreme PMS.
PMDD symptoms include:
- Feeling majorly depressed for 1-2 weeks before your period starts
- Anger or irritability.
- Poor focus or brain fog
- Feeling uninterested in socializing
- Feeling uninspired and down on yourself
- Trouble sleeping, insomnia
- Anxiety and feeling out of control
If these are symptoms you’re experiencing, don’t suffer alone! Link up with a qualified nutrition professional that works with females and seek help from your physician.
5. Painful Periods
When it comes to the first few days of your menstrual cycle, it is normal to feel some slight discomfort, cramping, bloating, and fatigue; however, you should NOT be doubled over in pain and unable to get off the couch for days when your period arrives.
If your cycles are so debilitating that life gets put on hold, we have got to dig deeper! You do NOT need to suffer and shouldn’t!
There is likely an imbalance of estrogen and progesterone, which can be addressed with diet and lifestyle with the health of a nutrition expert.
As we preached from the choirs about numerous times, everything is connected in the body and many of these female hormones impact one another. But there are some hallmark symptoms that may separate one imbalance for another, which can be instrumental in helping you address your individual symptoms of hormone imbalance.
Estrogen Imbalance hormonal imbalance symptoms in females
Estrogen dominance can be a result of sluggish liver detox, gut infections, toxic exposure, or poor nutrition and exercise habits, just to name a few.
It can become dominant itself, even when progesterone levels are normal, OR you can experience estrogen dominance symptoms when levels are in the normal range yet progesterone levels are low.
What Happens When Estrogen Levels Are High?
High estrogen levels can lead to a host of different issues! One of the most common issues found in women with elevated estrogen is thyroid dysfunction, in particular hypothyroidism, which decreases the ability to lose weight, increases fatigue, and more.
High levels of estrogen may increase the risk for blood clots, stroke, and cancer.
But even on the most basic level, estrogen dominance makes for unfavorable day-to-day symptoms in women.
Estrogen Dominance Symptoms List
- Irregular periods
- Painful periods
- Heavy periods
- Breast tenderness/pain
- Mood swings
- Weight gain and inability to lose weight
- Decreased sex drive
- Histamine intolerance
- Blood sugar imbalance
Ladies who are not getting a cycle or who have very light cycles, do you suffer from GI distress during workouts and overall deal with more gut issues?!
You’re not crazy!
This could be because of your low estrogen levels. Estrogen modulates paracellular permeability and tight junction function integrity in the gut in a positive way. In other words, estrogen helps keep unfamiliar food proteins and toxins from food out of the bloodstream.
When those tight junctions do not have estrogen on board sealing them up tight, symptoms of leaky gut often start setting in. You may start noticing bloating and bubble guts after eating the most random foods! Foods that you had no problem tolerating for years and years in your child and early adolescent years.
We also want to be thinking about stress when it comes to low estrogen levels. The brain will sense if stress is present and if it’s enough of a threat, FSH and LH pulses will be hindered. Remember then FSH and LH are precursors to estrogen!
Symptoms of Low Estrogen
- Increase in UTIs
- Irregular or absent periods
- Painful sex
- Hot flashes and night sweats
- Extreme coldness
- Mood swings
We know that when the body is stressed, it produces more of the stress hormone cortisol, which has been known to negatively affect progesterone levels.
Also, as mentioned, progesterone and estrogen work very closely together, balancing each other out, so when progesterone levels are low, estrogen levels can “dominate”.
Women on hormonal birth control may also experience symptoms of low progesterone, as ovulation is suppressed. When ovulation is not happening, the body is not experiencing that generous release of progesterone after the egg is released.
Signs of Progesterone Deficiency
- Anxiety and anxiousness
- Menstrual irregularities
- Brittle hair and nails
- Mood swings
- Low libido
- Brain fog
- Heavy periods
- Debilitating menstrual cramps
- Night sweats
- Vaginal dryness
- Anovulatory menstrual cycles (not releasing at egg)
What Are The Symptoms of High Estrogen and Low Progesterone?
High estrogen and low progesterone typically go hand in hand, especially for women who are under a great deal of stress.
- Heavy menstrual cycles
- Painful cramping and other signs of PMS
- Feelings of anxiety and depression
- Mood swings
- Breast tenderness
- Weight gain or inability to lose weight
Wait, women have testosterone?!
Surprisingly, this is a male dominant hormone, responsible for male aggression, increased muscle growth, and sexual desire is still present in females but in smaller quantities.
The majority of testosterone produced in women is converted to estrogen, so low levels of testosterone are often overlooked in regard to female hormone imbalance.
Symptoms of Low Testosterone
- Thinning hair
- Dry hair
- Dampened libido (sex drive)
- Inability to gain muscle and muscle weakness
- Muscle mass loss
- Weight gain or inability to lose weight resistance
- Memory loss: preliminary studies have shown that testosterone supplementation in post-menopausal women improved spatial and verbal memory. 
On the contrary, we can see elevations of this hormone in women, which is often seen alongside elevated levels of DHEA, another androgenic hormone, in women with PCOS.
Symptoms of High Testosterone and DHEA
- Acne (often cystic)
- Oily skin
- Irregular menstrual cycles
- Hirsutism (facial hair growth on chest, chin, and back)
- Low libido
- Hair loss
There are clear symptoms that can help you speculate whether you’re dealing with some degree of cortisol imbalance or need to improve adrenal dysfunction by looking for symptoms such as:
Symptoms of Cortisol Excess
- Sugar craving
- Abdominal obesity
- Insulin resistance
- Feeling shaky between meals
- Easy bruising
- Erectile Dysfunction
- Oily skin
- Sleep disturbances (difficulty falling or staying asleep)
Many of you’ve been on the stress train for months and months or even years, your cortisol levels might have finally taken a dive.
Symptoms of Cortisol Deficiency
- Chronic weakness
- Decrease stress tolerance
- Alternating diarrhea and constipation
- Salt craving
- Muscle or joint pain
- Low blood pressure
It’s a tough and confusing topic but we want you to know we have your back here at FWDfuel when it comes to dealing with hormonal imbalance symptoms in females. In case you haven’t picked up on it yet, we’ve dealt with these issues, we’ve learned from experts on how to treat these issues, and we’ve helped countless clients overcome them too.
We know this information can be overwhelming and will take time to eventually get to the root of these symptoms. However, learning how to balance hormones starts with first identifying where the problem is!
Identifying where the problem lies in regard to hormone imbalance is crucial because it can better inform you on how you should eat and exercise. The diet and lifestyle prescription for somebody with heavy menstrual bleeding, weight gain, and acne is going to look different than the female dealing with night sweats, absent menstrual cycles, and brittle hair.
It’s important to understand that there is no perfect prescription to balancing hormones. Each person must be treated individually with the help of a trained physician and nutrition professional.
If you feel you’re having hormonal imbalance symptoms but aren’t sure where to begin in the treatment of these symptoms, it may be time to set up virtual coaching to help get to the root of your constant fatigue, stress, anxiety, and menstrual irregularities.
You can work one-on-one with Abby✨, our functionally trained female hormone registered dietitian, to get the personalized attention ❤️ you need and work to get to the root of your health issues! 👉Schedule your FREE 15-minute call today👈 to create a strategy for testing your hormones and finding a personalized approach to your nutrition!💃