11 Hormonal Imbalance Symptoms in Women

Hormonal imbalances can occur throughout a woman’s life, causing a variety of symptoms, including changes in the menstrual cycle, infertility, metabolic disruptions, mood changes, and poor skin health. The feedback loops that control estrogen and progesterone levels are complex and change throughout a woman’s lifetime.

Medical conditions, some medications, stress, and some environmental factors can affect hormonal balance and cause symptoms in susceptible women.

Whether you have menstrual irregularities, unexpected weight gain, brain fog, mood changes, or infertility, understanding how hormonal imbalances can contribute to your symptoms is a first step toward better health.

1. Irregular menstrual cycle

The menstrual cycle is controlled by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Estrogen levels gradually increase in the first half of the menstrual cycle to stimulate the growth of the uterine lining and egg maturation.

LH levels surge mid-cycle and trigger ovulation. After ovulation, progesterone levels rise and peak to maintain the uterine lining for a pregnancy. If pregnancy does not occur, progesterone levels fall, and the uterine lining is shed during menstruation.

An imbalance in these hormones can cause irregular or missed periods, excessive bleeding, mid-cycle bleeding, and infertility.

2. Hot flashes

Vasomotor symptoms, including hot flashes and night sweats, are the most commonly reported symptoms during menopause. Hot flashes are described as a sudden, intense sensation of heat in the upper body, especially the face, neck, and chest. Cold chills may follow hot flashes.

Hot flashes that occur at night are called night sweats. They can disrupt sleep, worsening the symptoms associated with hormonal imbalances.

3. Hair loss

Decreasing estrogen levels during perimenopause and changes in the ratio of estrogen to androgens can cause hair thinning on the scalp and unwanted hair on the face.

Thyroid hormones regulate metabolism. Changes in thyroid hormone production can also contribute to hair loss.

4. Mood swings

Fluctuating estrogen and progesterone levels throughout the menstrual cycle and perimenopause contribute to mood swings. Though the exact mechanism is not understood, estrogen influences brain chemical levels, which impact mood, attention, and concentration.

Changes in thyroid hormone levels can also contribute to anxiety, depression, and mood disorders.

5. Fatigue

Decreased estrogen and progesterone levels during perimenopause and menopause can cause fatigue—an unrelenting feeling of exhaustion that does not go away with rest. Fatigue can be short-lived or chronic. Fatigue can be mental, physical, or both. Talk to your doctor if you have chronic fatigue symptoms to receive an accurate diagnosis and learn about your treatment options.

6. Weight gain

Estrogen suppresses appetite. Dips in estrogen levels in the second half of the menstrual cycle and perimenopause may contribute to increased hunger.

During perimenopause, sex hormone levels decline. Androgen levels decrease with age. These hormonal changes can cause an increase in total and abdominal fat, a decrease in lean body mass, and sudden weight gain in women.

Cortisol and the sex hormones also interact to control appetite. After a stressful event, high cortisol levels increase fat breakdown for conversion to glucose for energy and increase fat deposition in the abdomen.

Increased abdominal fat increases your risk for insulin resistance and elevated insulin levels, which may further contribute to obesity and difficulties with blood sugar control.¹

Polycystic ovary syndrome (PCOS) affects between 6% and 12% of women.² It causes irregular menstrual periods, excessive hair growth on the face, chest, abdomen, and upper thighs, severe acne, and patches of darkened skin. Though the underlying pathophysiology of PCOS is not fully understood, PCOS increases insulin resistance and androgen production, and increased androgens worsen insulin resistance. These hormonal changes contribute to weight gain and other symptoms. Successful weight loss can improve these symptoms.³

Low thyroid hormone can also contribute to weight gain and other symptoms of hormonal imbalance.

7. Decreased libido

Low libido is a lack of interest in sex that is bothersome to the person experiencing it. A decrease in estrogen or testosterone levels can cause a decrease in female libido. Testosterone is a crucial hormone regulating sexual desire. Estrogen increases vaginal blood flow and lubrication.

Other hormones important in the female sexual response include norepinephrine and oxytocin, which increase libido and sexual desire, and 5-hydroxytryptamine, serotonin, and endocannabinoids, which decrease it. An imbalance in these hormones is thought to cause hypoactive sexual desire syndrome.⁴

8. Acne/dryness

When androgen-to-estrogen ratios are out of balance, a relative increase in androgens (like testosterone) can signal sebaceous glands to produce more sebum. Increased sebum and oil production causes clogged pores and acne. Sebaceous glands are most prominent on the face, upper chest, and upper back.

The dermis, the supporting layer of the skin, is rich in estrogen receptors. When estrogen levels decrease, collagen levels decline, causing skin sagging and wrinkles. Skin thins and loses its elasticity. Together, these factors can make it difficult for skin to retain moisture, resulting in skin drying.

9. Vaginal dryness

Perimenopausal and postmenopausal decreases in estrogen contribute to the genitourinary syndrome of menopause (GSM). GSM is a collection of vaginal and urinary symptoms associated with hormonal imbalance. Common GSM symptoms include dryness, irritation, burning, urinary urgency and frequency, pain with urination, and recurrent urinary tract infections.⁴

Vaginal dryness and irritation can cause pain with sex, contributing to decreased libido.

10. Breast tenderness

Changes in hormone levels throughout the menstrual cycle and around menopause can cause breast tenderness.

11. Sleep disturbances

Difficulty sleeping or insomnia is among the most common symptoms associated with hormone imbalances, especially around menopause. Insomnia is defined as sleeping difficulties at least three days per week for at least three months that are associated with poor daytime functioning.

Hot flashes, mood disorders, and urinary symptoms can also contribute to nighttime awakening and exhaustion. Sleep is essential for maintaining optimal mental health. Poor sleep and hormonal imbalance symptoms can feed on each other.

Treatment options

Treatment for hormone imbalances depends on the cause and stage of life.

Medications for treating hormonal imbalances include:

• Estrogen therapy
• Combination estrogen and progesterone pills
• Anti-androgen medications
• Thyroid hormone therapy
• Metformin
• Flibanserin or bremelanotide
• Eflornithine

Lifestyle changes that can help reduce symptoms associated with changing hormone levels include:

• Consuming a nutritious diet
• Working on sleep hygiene
• Decreasing stress
• Losing excess weight
• Exercising regularly

While fluctuating hormone levels can be expected, if you have concerns or persistent symptoms, contact a treatment specialist at Invigor Medical to discuss your symptoms and determine whether medications such as semaglutide, a GLP-1 receptor agonist with proven weight-loss benefits, can help with perimenopausal symptoms associated with changing hormone levels. 

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Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References

1. Hirschberg, A. L. (2012). Sex hormones, appetite and eating behaviour in women. Maturitas, 71(3), 248–256. https://doi.org/10.1016/j.maturitas.2011.12.016
2. Centers for Disease Control and Prevention. (2020) PCOS (Polycystic Ovary Syndrome) and Diabetes. Retrieved September 26, 2023, from:  https://www.cdc.gov/diabetes/basics/pcos.html
3. Centers for Disease Control and Prevention. (2020) PCOS (Polycystic Ovary Syndrome) and Diabetes. Retrieved June 3, 2022, from:  https://www.cdc.gov/diabetes/basics/pcos.html
4. The North American Menopause Society (NAMS). Crandall, C. [Ed]. (2019). Menopause Practice. A Clinician’s Guide 6th Edition. https://www.menopause.org

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