What Causes Hormonal Imbalance in Women?


Have you ever felt like your body is speaking a language you can't quite understand? From unexpected mood swings to unexplained fatigue, the signals can be perplexing. But what if these signs are your body's way of signaling a hormonal imbalance?

Hormones, those powerful chemical messengers, play a crucial role in our overall well-being, especially for women. In this article, we're focusing on the sex hormones - estrogen, progesterone, and testosterone - and their profound impact on your health.

We also can't talk about what causes hormonal imbalances in women without discussing the thyroid and adrenal hormones.

Imagine hormones as the conductors of a grand symphony, orchestrating various functions in your body. When they're in harmony, the music is beautiful – you feel energetic, balanced, and in control.

But when they're out of tune, it can feel like a cacophony of symptoms wreaking havoc in your life.

This article is your guide to understanding these hormonal fluctuations. We'll explore signs to watch out for, delve into the causes of imbalances, and empower you with knowledge.

Because when you understand what's happening inside your body, you're better equipped to restore balance and harmony. 

Key Take-Aways

  • Identify the symptoms of hormonal imbalance, understand whether they are there constantly or whether it is connected to your cycle
  • Find out the best tests to identify a hormone imbalance
  • What other testing is essential, like assessing gut health as this can affect metabolism of hormones
  • What are the best diet, lifestyle and supplements to help you improve the balance of your hormones.

Which Hormone Is Out Of Balance?

There are many different types of hormones in the body, which all have different functions, but they are all influenced by each other. This article is about the sex hormones estrogen, progesterone and testosterone, signs to look for and what causes hormone imbalance in women.

When you are addressing the sex hormones you must remember that there are other hormones in your body, and they all influence each other.

You have hormones made by the adrenals that control the stress response, inflammation, blood sugar, and blood pressure …. when these hormones are out of balance they can have a negative influence on many other hormones.

You have the thyroid hormones that control your metabolism and influence every aspect of your body from energy production, mood and weight management. 

There are hormones like insulin, ghrelin, and leptin that control blood sugar, hunger, and metabolism but today we are going to talk about the sex hormones.

Hormone Fluctuations

From puberty to menopause your hormones are constantly fluctuating and this is a part of the natural life cycle, this gets the body ready for ovulation, and possible pregnancy, if this does not occur then the menstrual cycle begins and the process starts over again.

Once a woman gets past 40 years of age hormone levels start to decline, this will eventually lead to menopause at around 50-52 years of age.

While hormones are naturally fluctuating, problems start to occur when the fluctuations go out of balance …. this can cause a lot of symptoms in both your body and your mind.


The most common imbalance is an excess of estrogen compared to progesterone which is known as estrogen dominance, this can obviously be caused by the body making too much estrogen or you may have normal estrogen but not enough progesterone. 

This may cause similar symptoms but the treatment to correct the problem will be different, depending on whether the estrogen levels are high or normal

Signs of estrogen and progesterone imbalance


There are many different signs and symptoms of estrogen dominance and it is important to remember that some of these symptoms can be caused by imbalances with other hormones. This is why testing the sex hormones, adrenal hormones and the thyroid hormones are so important, this helps to identify the problem and treat the underlying cause.

Signs and Symptoms Include

  • Weight gain
  • Fluid retention
  • PMS mood changes like anger, irritable and anxiety which can last from a day or so to two weeks
  • Migraines and headaches
  • Breast tenderness
  • Heavy periods, or very light periods if you have low estrogen/ progesterone
  • Low libido/ low sex drive
  • Irregular periods
  • Breast lumps and cysts
  • Infertility
  • Cramping pains, back pains
  • Peri-menopause symptoms - hot flashes, vaginal dryness, hair loss, weight gain, dry skin, brain fog
  • Menopause symptoms - bone loss, muscle weakness, hot flashes from a decreased estrogen level

Sometimes women have one or two of these symptoms or you could have them all, and while they are common they are not “normal” and are a sign of imbalance.

Some months symptoms are really bad, while other times things are “ok”. Let’s look at why your hormones change.

What causes your hormones to go out of balance?


Stress is one of the biggest causes of hormonal imbalance.

Stress can be emotional stress like relationships and work stress, or physical stress like pain, injury or lack of sleep which is a major cause of stress. Also, there is dietary stress from a processed food diet or eating foods which are causing an inflammatory reaction in your body like gluten.

This leads to an increased production of cortisol (main stress hormone) which will lead to a depletion of progesterone.

Cortisol can also create an inflammatory response that will block the progesterone receptors, so even if you have enough progesterone the high cortisol will stop it from working.

High cortisol will affect the messages coming from your hypothalamus and pituitary gland in the brain which are the master controllers of the hormones.

Stress is the number one thing to address and getting a DUTCH hormone test will understand how stress is affecting your hormone levels and overall health.


Digestion function problems like constipation, diarrhea, gas, bloating and reflux are all signs of inflammation and dysbiosis (imbalance of your good and bad bacteria) in the gut. This is known as Irritable bowel syndrome (IBS) and can affect hormonal health.

This inflammation suppresses the hypothalamus and pituitary which tell the body to produce the sex hormones, adrenal hormones, and thyroid hormones, this is why a poor gut function can have a negative impact on many aspects of your health.

The liver is where estrogen and progesterone get metabolized if you are having issues with phase one or phase 2 detoxification this can lead to excess estrogen.

Poor liver metabolism of estrogen can also lead to the unhealthy forms of estrogen being produced like 4 and 16 hydroxy estrone which are associated with breast cancer.

The liver has to deal with the increasing xenoestrogens which are in the environment, these are found in food containers, cosmetics, personal care products, and even our food due to herbicides and pesticides that are being used.

Finally, high levels of beta-glucuronidase can lead to estrogen and other toxins getting reabsorbed back into the body. The high levels of b-glucuronidase are caused by dysbiosis and can be tested with the Gut Zoomer or GI Map stool tests.

Thyroid Function

Thyroid function can also suppress the production of progesterone, so it is really important to assess thyroid function when assessing a sex hormone balance.

However when you go to the doctor you will find that they usually only test for TSH which is a thyroid-stimulating hormone, and this is a very poor test for underactive thyroid.

Many times I see a normal TSH but due to some underlying inflammation or nutrient deficiencies the body is not producing enough of the active T3 hormone, and commonly producing too much reverse T3, which is why an extensive thyroid test is essential.

To test thyroid hormone levels you need to assess TSH, Free T4, Free T3, reverse T3 and the thyroid antibodies. Checking the thyroid antibodies can rule out a thyroid disease like Hashimoto's which is autoimmune.

Medications and Hormones

Certain pharmaceutical drugs can impact estrogen and progesterone levels, and potentially leading to hormonal imbalance in women. Here's a list of some common categories and examples of such drugs:

  • Hormonal Contraceptives:
    • Birth control pills, patches, and vaginal rings often contain synthetic hormones that can affect natural estrogen and progesterone levels.
  • Antidepressants:
    • Some antidepressants, particularly Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), can influence hormone levels and menstrual cycles.
  • Antipsychotics:
    • Drugs like risperidone and olanzapine can interfere with hormone regulation.
  • Steroids and Corticosteroids:
    • Medications like prednisone used for inflammation can disrupt the balance of sex hormones.
  • GnRH Agonists:
    • Drugs such as leuprolide, used for conditions like endometriosis, can affect hormone production.
  • Chemotherapy Drugs:
    • Some chemotherapy medications used in cancer treatment can impact ovarian function and hormone levels.
  • Opioids:
    • Long-term use of opioids for pain management can lead to changes in hormone production.
  • Antihypertensives:
    • Certain blood pressure medications, such as spironolactone, can have hormonal effects.
  • Antiepileptics:
    • Medications for epilepsy, like phenobarbital and valproate, can alter hormone levels.
  • Hormone Replacement Therapy (HRT):
    • Although used to manage menopause symptoms, HRT can sometimes cause imbalances in hormone levels if not properly monitored.

It's important to note that the extent and nature of the impact of these drugs can vary greatly among individuals. The specific effects depend on factors like dosage, duration of use, individual physiology, and whether other medications are being taken concurrently. Any concerns about the effects of medication on hormone levels should be discussed with the prescribing doctor.

What about Testosterone

Testosterone is often associated with men but it is very important for women too, in the right amount.

Too little can lead to low libido and low energy while too much will deplete progesterone, lead to increased weight, acne or facial hair, this is often associated with the polycystic ovarian syndrome (PCOS).

This is another reason why testing your hormones is beneficial because it is important to know exactly what is causing the problem before you can effectively start treating it.

Testing Hormone Function

Testing your hormones can be done with a blood test through your GP, but often they are reluctant to do hormone tests and just put hormonal imbalances down to being part of life, or they only do limited tests.

I test the sex hormones and adrenal hormones through a test called the DUTCH hormone test, this test is the most detailed way to test all aspects of the adrenal and sex hormones.

I still think blood testing is important as this can assess Luteinizing hormone (LH) and Follicle Stimulating hormone (FSH) which are the messages from the brain to the ovaries to make hormones. Sex hormone binding globulin (SHBG) helps to understand the free hormone levels or how much is bound and not accessible to use.

Combining the extensive thyroid test with the sex hormones in a pathology test is a great way to assess these hormone levels. Combined with the DUTCH hormone test and you will also understand the cortisol rhythm, estrogen metabolism and a lot of other hormone markers.

Extensive thyroid testing is also available which measures all aspects of thyroid health, including TSH, T3, T4, reverse T3, thyroid antibodies and thyroid receptor antibodies. All tests are available throughout Australia, North America and the U.K/ Europe, email me at michael@planetnaturopath.com to find out more information, all the tests include a consultation to go through the results and work out a treatment plan.


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03/18/2024 07:40 am GMT

The Next Step

If you have tried to improve your diet, and have found that supplements/medications are not helping  I would first recommend a DUTCH hormone test to find out exactly what is happening with your hormones. Testing and not guessing helps to give you a specific treatment plan.

If you would like individual help to help optimize your hormones and health you can schedule an appointment on the consultation page.

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