Hormone Imbalance

Hormone Imbalance: Overview

Alternative names: Hormonal Imbalance

A Hormone Imbalance occurs when levels of specific hormones rise or fall more than the others, creating an incorrect hormone ratio – or balance – within the body.  This in turn disrupts the various systems that are regulated by these hormones.

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Hormones are chemical messengers that carry important signals to different cells in the body.  Many factors can cause this communication system to fail, including nutritional deficiencies, stress, toxicity, and organ malfunction.

Hormone levels rise and fall, but the ratio between them should remain about the same.  When the body's endocrine glands produce too much or too little of a specific hormone, or group of hormones, these ratio(s) can change.

The so-called 'sex hormones' are steroid hormones that are responsible for controlling reproductive function and sexual development in males and females.  They are produced mainly by the testes in men and the ovaries in women.  Although men's and women's bodies share the same biochemical pathways for sex hormones, the specific hormones differ.

Androgens are the male sex hormones (controlling male characteristics), the main one being testosterone.  Androgens are also present in women but in smaller amounts; they are the precursors to estrogens in both men and women.  The main female sex hormones are the estrogens – Estrone (E1), Estradiol (E2), and Estriol – and progesterone.

Incidence; Causes and Development; Contributing Risk Factors

Hormonal imbalance can affect both men and women as adults or as adolescents.  However, it is most common during puberty, menstruation and pregnancy.

Normal hormone levels are usually maintained by the endocrine system but external factors can cause an imbalance, whereby there is too little or too much of certain hormone(s).  There are many different hormones and many possible causes of imbalance, including:

  • Aging – Common hormonal imbalances are associated with changes in life that come with from age, for example during puberty or menopause
  • Stress – Increases levels of stress hormones such as cortisol, which in turn suppress the production of sex hormones
  • Eating disorders – Hormone balance is very dependent on dietary intake
  • Environmental toxins
  • Medications
  • Endocrine disruptors – Increase or decrease production of certain hormones, imitate hormones, turn one into another, interfere with hormone signaling, signal premature cell death, compete for essential nutrients, bind to essential hormones, and accumulate in organs of the endocrine system that produce hormones.  Examples include BPA, dioxin, phthalates, lead, arsenic, mercury, and organophosphates.
  • Hypogonadism – This occurs when the gonads (testes or ovaries) produce little or no sex hormones, for example when a physical issue in the brain or the testicles stops testosterone production
  • Hypothyroidism
  • Hyperthyroidism
  • Thyroiditis – An inflammation (not infection) of the thyroid gland can directly influence the amount of hormones secreted, resulting in hypothyroidism or hyperthyroidism
  • Cushing syndrome – The body makes too much of the hormone cortisol, usually due to overuse of corticosteroid medications
  • Hormone therapy – Supplementing with external hormones directly influences hormone levels within the body
  • Congenital adrenal hyperplasia (CAH) – A group of genetic disorders that affect the adrenal glands and therefore production of cortisol and aldosterone
  • Adrenal insufficiency – Inadequate amounts of steroid hormones (primarily cortisol but possibly also aldosterone) are produced by the adrenal glands
  • Injury or trauma – Brain injury may cause damage to the hypothalamus and/or pituitary gland which are directly responsible for regulating the body's hormones.  Injury or trauma elsewhere can cause the release of certain hormones such as cortisol, which disrupt hormone balance.

There are some causes which are unique to women.  These include:

  • Menopause – Fluctuating hormones during this period can trigger hormonal imbalance
  • Pregnancy – A woman's body will experience a surge of hormones during pregnancy which can be disrupted by the slightest emotional or physical disturbance
  • BreastfeedingEstrogen levels drop while a woman is breastfeeding
  • Polycystic ovary syndrome (PCOS)
  • Hormone drugs (such as birth control) – These directly affect hormone levels within the body
  • Primary ovarian failure (POF) – Women with POF are unable to produce a normal amount of estrogen

There are some conditions – such as PCOS or Premature Ovarian Failure (POF) – linked to hormonal imbalances that an individual may be genetically predisposed to.  These conditions will increase the risk of suffering from hormonal imbalance.  Other risk factors include:

  • Depression – Levels of serotonin will be lowered
  • Weight gain – Fat cells contain an enzyme known as aromatase which changes testosterone into estrogen.  An increase in weight will result in more aromatase.
  • Smoking – A link has been identified between smoking and hormonal imbalance.  Smoking was also shown to accelerate menopause by 1-2 years.
  • Unhealthy lifestyle – Poor diet, lack of exercise, or inadequate sleep can damage overall health and interfere with hormone balance
  • Puberty – During adolescence, many changes take place, including increased and variable hormone production

Signs and Symptoms

Symptoms and their severity vary depending on which hormone(s) are affected.  Common symptoms that can affect both men and women include:

  • Weight gain or loss
  • Fatigue
  • Increased sensitivity to temperature
  • Dry skin
  • Irregular bowel movements
  • Increased or decreased heart rate
  • Frequent urination
  • Muscle weakness, aches, tenderness or stiffness
  • Joint pain, stiffness or swelling
  • Increased thirst or hunger
  • Thinning, fine or brittle hair
  • Depression
  • Decreased sex drive
  • Blurred vision
  • Sweating
  • Nervousness, anxiety or irritability
  • Infertility
  • Rounded face

Some of the symptoms specific to women include:

  • Heavy or irregular periods
  • Hirsutism (excessive body hair)
  • Acne
  • Darkening of skin (specifically along the neck, in the groin and under the breasts)
  • Skin tags
  • Vaginal dryness
  • Vaginal atrophy
  • Pain during sex
  • Night sweats
  • Hot flashes – experienced by about 23 of perimenopausal women
  • Disturbed sleep

Some of the symptoms specific to men include:

  • Development of breast tissue
  • Breast tenderness
  • Erectile dysfunction
  • Infertility
  • Loss of muscle mass
  • Decreased sex drive
  • Decreased body hair growth
  • Hot flashes
  • Osteoporosis
  • Increased difficulty concentrating

Hormonal imbalances in adolescents can result in delayed puberty.  Often children will go on to experience normal development but some children suffer with hypogonadism, which will cause the hormonal imbalance to continue.  Some of the symptoms specific to hypogonadism include:

  • In boys:

    • Lack of muscle mass
    • Voice not deepening
    • Sparse amount or lack of body hair
    • Decreased penile and testicular growth
    • Overly long arms and legs
    • Gynecomastia (development of breast tissue)
  • In girls:

    • Slow rate of growth
    • Lack of periods
    • Breast tissue doesn't develop

Diagnosis and Tests

Hormone testing is the best way to accurately determine your hormone levels.  By testing and uncovering specific hormone deficiencies or excesses, it becomes easier to make a diagnosis and begin the correct treatment.

There is a wide variety of tests for hormone imbalances.  These will vary between males and females.  Some of the tests available to females include:

Some of the tests for males include:

Treatment and Prevention

There are several treatments for hormonal imbalances.  Losing weight, exercising, and incorporating a healthy, balanced diet may be sufficient, but further measures can be taken if necessary.  Identifying a suitable solution will depend on the cause of the imbalance.  Some of the more common treatments include:

  • Estrogen therapy – a low dose of estrogen prescribed by a doctor
  • Vaginal estrogen – a local therapy in the form of cream, tablet or ring used to alleviate symptoms such as vaginal dryness or pain during sex
  • Hormonal birth control – birth control pill/patch/shot, vaginal ring, hormone-releasing intrauterine device (IUD)
  • Anti-androgen medication
  • Metformin
  • Testosterone therapy – testosterone supplements in the form of patch, gel or injection
  • Thyroid hormone therapy
  • Flibanserin (FDA-approved for the treatment of low sex drive)
  • Eflornithine – cream for the excessive hair growth

Prognosis; Complications

Fluctuations in hormones are common and the body can usually regulate itself without requiring further action.  If the body is unable to regulate itself then treatment can be given.  Without proper treatment there is a risk of serious long-term medical conditions.

Some of the complications of hormonal imbalances include:

  • Acne – due to hormonal overstimulation of the oil glands
  • Weight gain – hormonal imbalances can cause changes in the metabolism
  • PCOS (which can lead to infertility)
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Neuropathy
  • Goiter
  • Obesity
  • Sexual dysfunction
  • Sleep apnea – a study found that as many as 50% of women with PCOS also suffer from sleep apnea
  • Miscarriage – hormonal imbalances will result in higher risks during pregnancy
  • Kidney damage
  • Urinary incontinence
  • Depression and anxiety
  • Psychological disorders such as dementia
  • Infertility
  • Endometrial cancer
  • Osteoporosisestrogen helps maintain bone strength
  • Breast cancer
  • Endometrial cancer – if a woman does not have regular ovulation her uterus does not shed properly which can result in overgrowth.  This overgrowth is known as endometrial hyperplasia and can lead to endometrial cancer.
  • Prostate cancer – there is evidence that lower testosterone and higher estrogen in men can cause prostate cancer
  • Gynecomastia – men can develop enlarged breasts as a result of hormonal imbalances

Signs, symptoms & indicators of Hormone Imbalance:

Symptoms - Abdomen

Significant/slight abdominal distension

Hormonal fluctuations such as those occurring with pregnancy or at the start of a menstrual period (these raise progesterone levels) can slow down gut motility and cause food to pass more slowly through the digestive system, sometimes causing bloating and/or constipation.

Symptoms - Hair

(Recent) dry hair or (recent) oily hair

Hormone imbalance can cause skin changes resulting in oily hair or dry, brittle hair.

Symptoms - Reproductive - Female Cycle

Symptoms - Reproductive - General

Symptoms - Skeletal

(Likely) history of stress fractures

Female athletes with abnormal or absent periods might have weakened bones.  One study showed that 39% of female athletes with irregular menstruation develop stress fractures.

Conditions that suggest Hormone Imbalance:

Infections

Yeast / Candida Infection

Hormonal balance is necessary for support of friendly flora in the gut.

Metabolic

Edema (Water Retention)

Hormones regulate the amount of interstitial fluid surrounding our body's cells.  A hormone imbalance can result in too much interstitial fluid, and thus edema.

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Risk factors for Hormone Imbalance:

Childhood

Drug Side-Effect

Birth Control Pill Issues

Birth control pills usually contain the estrogen hormone.

Female-Specific

Pregnancy-Related Issues

Pregnancy can cause a significant hormonal imbalance.

Symptoms - Food - Intake

Symptoms - Reproductive - General

Recommendations for Hormone Imbalance:

Laboratory Testing

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