Hormonal Imbalance

A woman suffering from a hot flash due to a Hormonal Imbalance

Hormonal imbalance in women occurs when there is too much or too little of the female sex hormones in the bloodstream. Hormones are a natural substance produced in the body to help relay messages between cells and organs and affect many bodily functions. The two main female sex hormones are estrogen and progesterone. Females also produce and need a small amount of testosterone.

Estrogen

Estrogen is the major female hormone. It is primarily produced by the ovaries and small amounts are produced in the adrenal glands and fat cells. During pregnancy, the placenta also makes estrogen.

Estrogen promotes the development and maintenance of female characteristics in the human body, including breasts, pubic and armpit hair, and the regulation of the menstrual cycle and reproductive system.

Estrogen also plays a big role in reproductive and sexual development, including puberty, menstruation, pregnancy, and menopause.

Progesterone

Progesterone is produced by the ovaries after ovulation. During pregnancy, the placenta also produces progesterone.

Progesterone is responsible for

  • Preparing the lining of the uterus for a fertilized egg
  • Supporting pregnancy
  • Suppressing estrogen production after ovulation

Testosterone

Testosterone is produced by the adrenal glands and ovaries.  This hormone is produced in small amounts and is responsible for 

  • Sexual desire
  • Regulation of the menstrual cycle
  • Bone and muscle strength

Normal Levels of Female Sex Hormones

Estrogen levels can be determined by a blood test. Normal ranges are measured in picograms per milliliter (pg/mL):

  • Adult female, premenopausal: 15-350 pg/mL
  • Adult female, postmenopausal: <10 pg/mL

Levels may vary greatly throughout the menstrual cycle.

Progesterone levels can be determined by a blood test. Normal ranges are measured in nanograms per milliliter (ng/mL):

  • Before puberty: 0.1-0.3 ng/mL
  • During the first (follicular ) stage of the menstrual cycle: 0.1-0.7 ng/mL
  • While ovulating (luteal stage of cycle): 2-25 ng/mL
  • First trimester of pregnancy: 10-44 ng/mL
  • Second trimester: 19.5-82.5 ng/mL
  • Third trimester: 65-290 ng/mL

Testosterone levels are also determined by a blood test. Normal ranges for females is 15 to 70 nanograms per deciliter (ng/dL).

Hormones Change Over Time

It is quite normal for your hormones to change as you leave childhood and enter puberty, as you become pregnant, give birth, and breastfeed, and as you near menopause. This is natural and expected.

Puberty

During puberty, the production of your female sex hormones increases, especially estrogen, which results in

  • Breast development
  • Growth of pubic and armpit hair
  • Growth spurt
  • Increase in body fat in the hips and thighs
  • Maturation of the ovaries, uterus, and vagina
  • Start of the menstrual cycle

Most females enter puberty between the ages of 8 and 13.

Menstruation

Most females get their first period between the ages of 10 and 16. The menstrual cycle lasts around 25 to 36 days, and bleeding lasts between 3 and 7 days. 

Pregnancy

As conception takes place, you start to produce human chorionic gonadotropin hormone (hCG)–the hormone that shows up in your urine and is used to test for pregnancy. During pregnancy, estrogen and progesterone levels increase, preventing menstruation and helping to sustain the pregnancy.

Childbirth and Breastfeeding

After childbirth, your hormone levels start to fall immediately, returning to your pre-pregnancy levels.  Breastfeeding lowers estrogen levels and can prevent ovulation, but not always, so you’ll need birth control to prevent another pregnancy.

Perimenopause and Menopause

During perimenopause, hormone production in your ovaries slows down–estrogen levels start to fluctuate and progesterone levels start a steady decline. As you near menopause, your vagina may become less lubricated,  you may experience a decrease in your libido (sexual desire), and your menstrual cycle becomes irregular.

You’ve reached menopause when you have gone 12 months without a period. Menopause usually occurs around age 50. Estrogen and progesterone levels remain steady at low levels.

Hormonal Imbalance

While it is normal for hormones to fluctuate throughout the various stages of a woman’s life–puberty, pregnancy, breastfeeding, perimenopause, and menopause–a hormone imbalance can be a sign of something more serious. 

Hormonal Imbalance FAQs

Women who have hormonal imbalance may experience one or more of the following symptoms:

  • Heavy, irregular or painful periods
  • Osteoporosis (weak, brittle bones)
  • Hot flashes and night sweats
  • Mood swings and/or depression
  • Weight gain
  • Fatigue
  • Increased sensitivity to cold or heat
  • Dry skin
  • Puffy face
  • Vaginal dryness
  • Painful sex due to a lack of vaginal lubrication
  • Decreased sex drive
  • An increase in urinary tract infections (UTIs) due to a thinning of the urethra
  • Breast tenderness
  • Indigestion
  • Headaches
  • Constipation and diarrhea
  • Acne during or just before menstruation

There are numerous possible causes of hormonal imbalance in women. Some causes are due to external factors, such as stress and hormone medications, and other causes may be due to medical conditions such as

  • Diabetes
  • Polycystic Ovary Syndrome
  • Androgen Excess (an overproduction of male hormones that cause menstrual irregularities, infertility, acne, and male pattern baldness)
  • Hormone Replacement or Birth Control Medications
  • Early Menopause
  • Primary Ovarian Insufficiency
  • Ovarian Cancer
  • Eating Disorders
  • Thyroiditis
  • Hyperthyroidism
  • Hypothyroidism
  • Medications
  • Cancer Treatments

During your consultation, your Women’s Health Specialist may order a blood test for you that checks your estrogen, progesterone, and testosterone levels, as well as your thyroxin (thyroid hormone), insulin, and cortisol levels. There may be more tests ordered based on your symptoms.

Your doctor will also conduct a pelvic exam to check for any lumps or cysts. A biopsy may be taken of any abnormally appearing tissue. If required, your doctor may order imaging tests such as an ultrasound, MRI, or thyroid scan for an accurate diagnosis.

Treatment for hormonal imbalance depends on the cause. Once your doctor figures out what is causing your hormonal imbalance, treatment recommendations may include:

  • Hormone control or birth control regulate menstrual cycles and symptoms
  • Vaginal estrogen reduce symptoms of vaginal dryness
  • Hormone replacement medications reduce symptoms associated with menopause like hot flashes and night sweats
  • Eflornithine slows excessive facial hair growth in women
  • Anti-androgen medications help limit severe acne and excessive hair growth or loss
  • Clomiphene (Clomid) and Letrozole (Femara) help stimulate ovulation for women suffering from PCOS
  • Gonadotropin injections increase the chances of pregnancy 
  • Metformin helps manage or lower blood sugar levels
  • Levothyroxine helps improve symptoms of hypothyroidism 
  • In vitro fertilization may help those with PCOS complications get pregnant
  • Lifestyle changes (e.g., losing weight, keeping a healthy diet, avoiding stress, getting enough sleep)

Hormonal Imbalance Treatment Available at WHS of Dallas

Don’t wait for your annual well-women exam to seek treatment for hormonal imbalance. Our board-certified OB/GYN physicians at Women’s Health Specialists of Dallas are here to help. Give us a call at (214) 363-4421 to schedule an appointment or you may request an appointment online.