Hormonal Imbalance
What It Is // Symptoms // Causes // Tips // Conclusion
Hormone health is a hot topic, and for good reason: Hormonal imbalance is experienced by an estimated 80 percent of women*, and can have profound effects on overall health. Everything from stress, cognition, mood, and energy to weight, skin, digestion, and sleep can be impacted by hormones.
Operating like messengers within the body, hormones are chemicals that tell cells, tissues, and organs what to do. They help manage a myriad of processes, such as metabolism, sex drive, sleep, mood, and digestion.
If you’ve struggled with any of the above functions, you may have wondered: Are hormone health and wellness to blame?
What Is Hormonal Imbalance?
A hormonal imbalance occurs when there is too much or too little of one or more hormones in the body. There are more than 50 different hormones, all dictating different functions. Even tiny changes in the levels of certain hormones can have a cascading effect in the body with serious potential outcomes.
If, say, you don’t consume a rounded diet and subsequently lack key macro- or micronutrients, aren’t getting adequate sleep, or experience excessive stress, your hormone health can be disrupted. Other processes such as aging or certain medical conditions can also throw off natural hormone balance.
Some of these imbalances require medical attention and consultation with your physician. But others can be impacted by lifestyle changes and supplementation.
For example, stress can influence cortisol levels, which, over time, may negatively impact sleep, blood sugar and key hormone levels. This can lead to numerous symptoms and unwanted effects.
Achieving hormone balance for women includes strategies to lower stress, help support healthy blood sugar levels through a healthy diet, and exercise to aid overall health and better hormone receptivity.
Symptoms of Hormonal Imbalance
Hormonal imbalance symptoms in women can manifest in many ways. If you are experiencing some of these symptoms, you may have a hormone imbalance:
- Fatigue
- Mood swings
- Brain fog
- Hot flashes
- Weight gain
- Problems sleeping
- Excessive/unusual sweating
- Headaches
- Irregular periods
- Bloating
- Low libido
- Acne/skin issues
- Irregular bowel movements
- Hair loss/thinning
“Women should monitor for changes in menstrual cycles, mood, energy levels, weight, skin, hair growth, sleep patterns, libido, and digestion to distinguish between their normal variations and signs of hormone imbalance,” says Julie Pace, RDN, a registered dietitian who specializes in women’s health and hormone-related conditions.
Some hormonal imbalance symptoms are much more serious than others, in which case those experiencing them should consult a healthcare provider.
There are also normal changes that take place during perimenopause and menopause. But if you are in this phase of life, that doesn’t mean you should brush off symptoms that are disrupting your quality of life.
Dr. Jolene Brighten, board certified naturopathic endocrinologist and author of Is This Normal, says, “The transition into menopause brings many unwanted hormone symptoms that typically begin with trouble sleeping, additional PMS mood symptoms, and in some cases, heightened anxiety. But while it is normal to experience these symptoms, it should never be considered normal for them to interrupt your daily activities.”
What Causes Hormonal Imbalance?
Hormonal imbalance can be the result of numerous influences. Some key hormones and factors to focus on include estrogen, insulin/elevated blood sugar levels, cortisol, and progesterone.
1. Stress
Stress triggers the release of cortisol and adrenaline to help the body cope with perceived threats; adrenaline to increase heart rate and make the body more high-functioning, cortisol to release glucose — blood sugar — for additional fuel.
Left unmanaged, however, this can affect the relationship between the body’s stress response system (called the hypothalamic-pituitary-adrenal axis) and its reproductive health system (the hypothalamic-pituitary-gonadal axis).
When the endocrine system is functioning properly, the HPA axis and the HPG axis release the right hormones at the right times. But during chronic stress, illness, or injury, the stress center may send out “alarm signals” in the form of cortisol.
When cortisol levels are chronically elevated, this can cause issues that include heightened blood sugar levels, weight gain, and trouble sleeping, among others. The result can disrupt hormone production, including estrogen.
Finally, if there are problems arising within the HPG axis, this can lead to period issues (such as missed and irregular periods), mood changes and other symptoms including decreased sex drive.
2. Menopause
As women near menopause, especially around the late 40s to early 50s, the HPG axis naturally slows production of sex hormones such as estrogen and progesterone. This can lead to hot flashes, sleep problems, and mood swings.
Additionally, if the HPA axis is concurrently sending out those “alarm signals” in the form of elevated cortisol, this can compound some corresponding issues like elevated blood sugar and weight gain.
3. Excessive carbohydrate intake
Consuming foods high in refined carbohydrates (such as sugary snacks, white bread, candy, and juices) can cause rapid spikes in blood sugar because of how quickly these simple carbs are metabolized.
Over time, this bombardment of blood sugar can dull sensitivity to insulin, the hormone responsible for directing glucose into cells. With fewer and fewer cellular takers for the circulating glucose, the result can be chronically elevated blood sugar, weight gain, and even issues of the pancreas, where insulin is released.
Further exacerbating this effect, cortisol can make you crave sugary foods. So, elevated stress causes elevated cortisol, which can lead to elevated glucose levels, which can lead to weight gain… which can further elevate stress, perpetuating a cycle in which millions of people have become stuck.
4. Lack of physical activity
The more sedentary your lifestyle, the likelier you are to see a decrease in insulin sensitivity and a subsequent increase in blood sugar levels.
Insulin makes cells — like those in your muscles — receptive to glucose for energy. And every move you make places demands on your muscles that glucose helps to fuel.
But if you don’t ask much of your muscles, that glucose will instead stay in the blood, requiring more and more insulin to coax it into cells. The result is decreased insulin sensitivity and, over time, the consequences of elevated blood sugar.
5. Overtraining
On the flip side, excessive exercise is another form of stress that can cause hormonal changes. Under normal circumstances, intense physical activity spikes cortisol levels, mobilizing insulin and elevating blood sugar to fuel working muscles.
But without sufficient recovery between workouts, lengthy periods of overtraining can tax this process, acclimating the body to sustained levels of high blood sugar. In addition, low body fat can disrupt hormonal balance and ultimately reduce estrogen levels.
6. Disordered eating/undereating
Conditions like anorexia nervosa or extreme weight loss through dieting can affect hormone production, including estrogen and progesterone. Without sufficient fuel, the body will dedicate what little energy it metabolizes to essential functions. This can result in disruption of menstruation among disordered eating’s other perils.
7. Other lifestyle factors
- Poor sleep habits (less than seven hours per night)
- Excessive caffeine intake (more than 400 mg per day)
- Irregular eating patterns (undereating, overeating)
How to Support Healthy Hormonal Balance
Lifestyle interventions and the right supplementation can be incredibly helpful in supporting healthy hormonal balance. Of course, if you’re dealing with disease symptoms or think you may have a disease, you should always consult a physician.
The main areas to focus on include nutrition, exercise, sleep, and supplementation.
Nutrition
Proper nutrition is critical for proper hormone health. After all, the building blocks of hormones come from the foods we consume, so if there are gaps in your diet, your body may not have the right building blocks for some essential functions.
- Regulate timing: Aim for regular meal times (e.g., breakfast, lunch, dinner) and avoid skipping meals, as irregular eating patterns can affect blood sugar function and cortisol levels.
- Get your macros: At each meal, focus on consuming high-fiber carbohydrates (such as whole grains, legumes, whole fruits, and starchy vegetables), lean proteins (like poultry, fish, and tofu), and heart-healthy fats (found in nuts, seeds, avocados, and olive oil).
- Limit glucose spikes: If you’re consuming simple carbs (e.g., white rice and bread), pair them with fiber, fat, or protein to reduce the resultant blood sugar impact.
- Eat intentionally: Practice mindful eating to reduce stress and improve digestion, which can positively impact blood sugar and cortisol levels. For example, eat free of distractions, use a plate rather than the container, and tune into fullness cues.
- Emphasize fiber: Incorporate plenty of dietary fiber (25 to 38 g per day) from foods like whole grains (oats, brown rice, quinoa), legumes (beans, lentils), fruits (prunes, dates, apples, pears), nuts, and seeds to slow down the absorption of glucose and support digestive health.
- Don’t fear healthy fats. Instead, incorporate healthy fats like avocado, olive oil, salmon, tuna, nuts, and seeds, as these are essential for hormone balance in the body.
“To ensure that we have the raw materials to make the hormones we need, we should be eating a nutrient-dense diet with adequate calories and fat, including cholesterol,” says Melissa Azzaro, RDN, LD, a.k.a. The Hormone Dietitian.
She continues: “To support our bodies’ own natural detoxification pathways, eating a high-fiber diet with emphasis on cruciferous vegetables, dark leafy greens, and berries can help. Hydration is important to keep those pathways flowing.”
Exercise
Insulin sensitivity increases with exercise. This can help support healthier blood sugar levels: Instead of letting glucose build up in the blood, when you’re more physically active your muscles use it to power movement.
In fact, just one moderate-intensity workout has been found to increase glucose uptake by 40 percent. And the more muscle you have, the more glucose it’ll use.
Many experts recommend a combination of both cardio- and strength-focused workouts for optimal health and hormone support. Aim for at least 150 minutes of moderate-intensity aerobic activity per week. And avoid overtraining, which can lead to hormonal imbalances, especially if you already have a lower body fat percentage.
Azzaro adds: “Lifestyle is important for hormone balance. Getting enough (but not too much) movement… can help bring hormones into better balance.”
Sleep
A majority of adults require seven to nine hours of sleep each night. Keep in mind that time in bed doesn’t necessarily equal the number of hours of sleep. It’s common to lie in bed for eight hours but to only sleep for six and a half to seven of them.
And then there’s the variability in sleep quality. If you get seven hours of poor quality sleep, you won’t reap the same benefits as those from higher quality sleep.
Importantly, research has shown that women need more sleep than men, especially during certain parts of their cycle. Tracking your sleep, with apps and/or wearable devices, can be incredibly helpful in identifying areas for improvement, both in the quality and quantity of sleep. Regardless of how you monitor it, you may be surprised to learn that you aren’t getting as many hours as you think.
Supplements
Certain adaptogenic herbs can help the body combat the effects of stress, and some vitamins and minerals may be helpful in supporting healthy hormone levels.
- Rhodiola rosea root extract is used to help resist the effects of stress.
- Ashwagandha has been clinically studied for its impact on fatigue, stress management, and sleep support.
- Vitamin B-12 helps to support normal nervous system function.
- Vitamin D plays a role in glucose metabolism.
- Chromium is an essential trace mineral that may play a role in carbohydrate, lipid, and protein metabolism.
- Mulberry is high in flavonoids, compounds with antioxidant-like properties.
Conclusion
Women’s hormone balance is a complex topic with a lot of nuance and a big impact on quality of life and overall health. Fortunately, there are many steps women can take to support optimal hormone health and wellness.
Starting with small, achievable goals like improving the quality of your diet, learning about the right supplements for your needs, improving sleep, and finding time for healthy movement can reap huge benefits and help support hormone health.
*2024 McKinsey & Company study: “The trends defining the $1.8 trillion global wellness market in 2024”