Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Apr 29, 2020
Last Modified Date: Apr 29, 2020
Published Date: Dec 05, 2018
TABLE OF CONTENTS
Chapter 1: Hormone Imbalance Introduction Chapter 2: Causes and Symptoms of Hormonal Imbalance Chapter 3: Hormonal Imbalance and Men Chapter 4: Hormonal Imbalance and Women Chapter 5: More about Cortisol
Your entire endocrine system is composed of glands and hormones. It is one of two systems that help coordinate all the functions of your body.
This managerial role, of maintaining hormone levels over time and in various situations, is important for both your survival and well being. Hormone testing has shown that hormone levels decrease with age and that hormone replacement therapies may be helpful in maintaining youthful vigor.
The other critical system that regulates the functions of your body is the nervous system. Both the endocrine and nervous system work closely together to control a number of important functions:
- Your body’s growth and development
- Your metabolism
- Sex drive and function
- Reproduction processes
- Your mood and sleeping patterns
Hormone Imbalance Introduction
What Are Hormones?
Hormones are the body’s chemical messengers. They carry vital information to the cells through blood. Typically, hormones affect only certain cells, or target cells, through receptors. They are produced by the endocrine glands and travel through the bloodstream to various tissues and organs. Each hormone has its own specific goal, carrying a key message to certain parts of the body. For example, the pineal gland produces and releases the melatonin hormone. This circulates through the bloodstream and cerebrospinal fluid around the brain where receptors will detect these hormones. Higher melatonin levels signal to the body that it's time for rest.
The body's hormones are essentially responsible for controlling and balancing nearly every major system. Hormones impact your growth and development, control your mood, determine how you'll handle stress, and influence how the body breaks down food. Hormone testing is the best way to determine if your hormone levels are adversely affecting your health.
What are the Different Types of Hormones?
Endocrine glands are located throughout the body. These glands include the:
- Hypothalamus: controls thirst, hunger, sleep, sex drive, moods, body temperature, and the release of other hormones
- Parathyroid: controls calcium
- Thymus: controls the adaptive immune system
- Pancreas: controls blood sugar levels
- Thyroid: controls heart rate and calorie burn
- Adrenal: controls stress and sex drive
- Pituitary: controls growth
- Pineal: controls sleep
- Ovaries, in women: controls female sex hormones
- Testes, in men: controls male sex hormones
There are several different types of hormones in the body. When you have a hormonal imbalance, you may have a problem in one of more of these glands. The specific hormone that's imbalanced will determine the signs and symptoms that you experience as a result. Some of the major hormones found in the body include:
- Estrogen: controls sex drive in both men and women, and regulates the menstrual cycle in women
- Progesterone: influences the body's changes through pregnancy
- Testosterone: controls sex drive in both men and women
- Cortisol: controls stress
- Melatonin: control's the body's circadian rhythm and sleep cycles
- Serotonin: controls sleep cycles, appetite, and mood
- Growth hormone: controls the reproduction of cells and their subsequent growth
- Leptin: controls appetite, signaling when you're full
- Ghrelin: controls appetite, signaling when you're hungry
- Insulin: responds to sugar in the bloodstream
If your hormones are well-balanced, you will thrive. An imbalance, however, is something you cannot afford to ignore.
What is a Hormonal Imbalance?
A hormonal imbalance occurs when your hormones are not produced at the proper levels. You can have many different types of hormonal imbalances. Sometimes, the imbalance means a deficiency in the given hormone while in other times, there might be an overflow. The kind of hormone that is imbalanced will play a major role in determining how the sign and symptoms will manifest and what would be the associated risks involved.
Though there are a few common life transitions that can cause a hormonal imbalance, such as menopause or pregnancy, you can struggle with such a problem at any point in your life. Both men and women can experience hormonal imbalances. Children, adolescents, adults, and the elderly may also find their hormones out of balance.
Because hormones and their functionalities are so varied, there's no one single way to detect a hormonal imbalance. A wide range of issues can indicate that something is amiss with your hormones. This is one of the reasons why your best bet is to get tested occasionally, especially when you start developing uncommon symptoms.
Common Symptoms of a Hormonal Imbalance?
Hormonal imbalances can cause many different symptoms. Some common issues to look out for include:
- Unexplained weight gain or weight loss
- Change in the frequency of bowel movements
- Sensitivity to heat and cold
- Increased or decreased heart rate
- Muscle weakness, tenderness, stiffness, or pain
- Pain, stiffness, and swelling in the joints
- Dry skin or skin rashes
- Thinning hair
- Depression, anxiety, or irritability
- Difficulty concentrating
- Unexplained sweating
- Changes in appetite or thirst
- Changes in heart rate
- A bulge in the neck
- Puffy face
Many symptoms of a hormonal imbalance can be misleading. For example, both weight gain and weight loss can be symptomatic of a hormonal imbalance. So, it's really difficult to just rely on symptoms to understand which specific hormone is the root of the problem. This is when getting tested becomes handy.
If you're having trouble falling asleep, you may have low progesterone levels that are usually in charge of helping you fall asleep. On the other hand, high progesterone levels could be problematic as well, as these will make you feel sleepy even if you're getting enough rest.
Low melatonin gives your body a signal that it's time to rest. Low estrogen can give you night sweats that can be unbearable for many.
If you're struggling with any symptom of a possible hormone imbalance, you need to get tested. Your hormone levels will depict the root cause of the symptoms you are experiencing; and, you will be able to target them properly.
Natural Ways to Support Healthy Hormones
While you should always speak to your doctor if you have hormonal imbalance, he might not have to give you any kind of medication to restore the balance. This is particularly true if the imbalance is caused by something like diet or stress. In general, people who have the following criteria are at higher risks of developing hormonal imbalances:
- Being overweight or obese
- Consuming an excessive amount of alcohol
- Being exposed to pesticides and toxins
- Experiencing high stress levels
- Not sleeping enough
Many of these risk factors are easily controlled when you're mindful of your diet, exercise routine, and daily habits. If you quit smoking, moderate your drinking, or avoid exposure to pesticides, you can help reduce your risk factor for hormonal imbalances and naturally keep them moderated.
Changing the way you eat can go a long way towards improving your hormonal balance. For example, when you exchange carbohydrates for healthy fats, like coconut oil and avocado, you can lower your body’s inflammation and help maintain your hormone at the right levels. Consuming enough proteins will help control the ghrelin hormone that makes you feel hungry. This gives you the feeling of fullness; and then, you will stop eating at the appropriate time and maintain a healthy weight.
While eating too much soy can lead to an overabundance of estrogen, this same food can be beneficial if you're battling low estrogen levels. Flaxseed and red clover contain phytoestrogens as well. Balancing your need for estrogen with your consumption of it may help you manage minor imbalances naturally, and without the use of medication.
Some people oppose the fact that apoptogenic herbs or essential oils can help you maintain balanced hormone levels. Essential oil therapy may help with various factors that would impact your hormone levels. You can use essential oils to fall asleep better, which will help you ultimately keep your cortisol levels under control. Essential oils may also help you with stress, which is another contributor to high cortisol levels.
Exercise is a great way to naturally manage your hormone levels. Regular physical activity will help you control your insulin levels. It may also help you manage stress as well as battle obesity, which are themselves contributors to imbalanced hormones. When you pick to have a healthy lifestyle, you are bringing your hormones back on tract. However, in some cases, these hormonal imbalances might be due to more severe causes. In that case, your physician might feel obliged to start you on medications.
Testing for a Hormonal Imbalance
There are numerous types of tests for your doctor to choose from in order to detect a hormonal imbalance. Your symptoms will surely put him in the right direction. So, you do need to fully disclose to your doctor about your signs and symptoms for him to order the right hormones to be tested.
A blood test is one of the most common ways to test hormone levels. This test can detect testosterone, estrogen, cortisol, and thyroid levels. You should order a test that's specific to your gender, as a women's hormone test will look for different levels of sex hormones than a men's test. A simple saliva test can detect several types of hormones as well. With a saliva test, you can look at your estradiol, progesterone, and testosterone levels.
If your doctor is concerned about a particular gland in your body, he or she might order an ultrasound. This can be the case of testing the pituitary gland, uterus, testicles, ovaries, and thyroid. An X-ray or MRI will offer further opportunities for imaging. Depending on the results of prior tests, additional types of testing might often be needed to have a better diagnosis. A biopsy of a problematic gland can help your healthcare provider find issues with that specific gland.
A sperm count may provide more information in case a man is worried about having certain symptoms surfacing. Women, on the other hand, might need a pap smear. Lumps, cysts, and other abnormalities in reproductive organs can help your doctor diagnose issues that are impacting your hormone balance, as well as posing a risk on your overall health status.
So, when you have doubts and worries about some symptoms that could be bothering you, your first step would be to test the hormone levels. According to the results, you might need further testing to clearly identify the underlying cause of such an imbalance to pursue the right treatment.
Treatment for a Hormonal Imbalance
There are many different treatment options for hormonal imbalances. The treatment you ultimately be given will depend on which hormone exactly is unbalance as well as the underlying cause of the imbalance. Sometimes, a life event might cause such a fluctuation in your hormones, such as menopause. In that case, your treatment would be short term one. However, if you have a genetic disorder that causes a lifelong hormonal imbalance, you will need to pursue a more prolonged course of medications.
Hormone therapy is a common treatment for hormonal imbalances. Women who are witnessing uncomfortable menopausal symptoms may choose estrogen therapy. Testosterone therapy is a common choice for men with low testosterone levels or adolescents facing delayed puberty. Taking thyroid hormones can help individuals with hypothyroidism. Such hormone replacement therapies may come in the form of pills, patches, or even injections. Your doctor will help you choose the appropriate dosage by checking your hormone levels test results. This is how he will determine the right amount of supplemented hormone you will need to recreate the balance.
There are different types of hormones that might be used for these therapies. Bioidentical hormones are synthesized in a lab. They are chemically identical to those naturally produced by the body. For instance, a chemical extracted from soy or yams is used to create a synthetic hormone that has the same molecular structure as the one found in our body. Though these hormones are manufactured in a lab, they're can be a perfect match to the hormones that you are deficient in.
Bioidentical hormones can be produced by pharmaceutical companies using different doses. Examples include bi-estrogen which is 50 to 80 percent estriol combined with estradiol, or tri-estrogen which is 10 percent estrone, 10 percent estradiol, and 80 percent estriol.
Natural hormones do not come from a lab. They are naturally occurring chemicals that originate from a plant or animal source. While some patients prefer the idea of a hormone that's not synthesized, it's important to understand that natural hormones don't offer the exact match that bioidentical hormones do.
Another kind of replacement hormone is the compounded hormone. These drugs are tailored according to every person’s needs. This way patients get a customized blend of hormones that will provide exactly what they needed. While these offer a custom approach to hormone therapy, they have drawbacks. There is no clinical testing for these compound blends and no dosing consistency with such individualized treatments.
If you suspect having hormonal imbalances; then, your best bet would be to address the issue as early as possible. You may be surprised to find out how beneficial a hormone therapy can be for such an issue as fatigue. Understanding your hormone balance can provide you with the first step toward a healthier future.
Causes and Symptoms of Hormonal Imbalance
When the endocrine system is functioning smoothly, its precise and timely release of hormones works to promote optimal health and function. The glands in this system assist in nearly every critical bodily function. So, if there is a problem with one or more glands, hormonal imbalance can occur, causing a variety of problems, some more serious than others. These changes can be detected by undergoing a hormone imbalance test, which is an opening door towards getting the right kind of treatment to address your hormonal imbalance symptoms.
What Causes a Hormonal Imbalance?
The causes of hormonal imbalances vary according to the specific hormone involved. However, in general, they are due to changes or dysfunctions of a hormone-producing gland. For instance, a thyroid gland that isn't functioning correctly may produce too much thyroid hormone, accelerating your body’s metabolism; or could produce too little. Thyroid dysfunction can be caused by autoimmune diseases, thyroid nodules, medications; or, rarely, thyroid cancer, among other potential causes. Imbalances in male or female sex hormones, such as estrogen, progesterone and testosterone, can be caused by age-related changes, such as menopause and andropause, as well as genetic disorders, stress, nutritional issues, or medications. Excessive stress, poor diet, aging and certain medications can contribute to imbalances in cortisol and other adrenal hormones.
There are many different underlying causes that can result in a hormonal imbalance. Each cause relates to different glands and hormones; and, does impact your body differently. Many diseases and other conditions can result in a hormonal imbalance.
Diabetes is characterized by an inability to properly use the insulin hormone. An insulin imbalance can lead to other related hormonal imbalances as well such as disrupting estrogen, testosterone, thyroid, progesterone, and cortisol.
Hypothyroidism or Hyperthyroidism
The thyroid releases hormones that help regulate the activity of your heart, brain, and muscles. This helps your body use energy properly, so you can make it through the day with a steady supply. Hypothyroidism is when the thyroid gland produces too little of the thyroid hormone. Hyperthyroidism is the opposite. It is when the thyroid gland produces too much of the thyroid hormone.
Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia (CAH) is a genetic disorder in which an individual is missing an enzyme in the adrenal glands. These latter produce hormones that regulate blood pressure, metabolism, and your immune system. The level of enzyme deficiency varies by individual and will determine how severe symptoms are.
Cushing syndrome occurs when the body is exposed to a large amount of cortisol over an extended period of time. Cortisol is a hormone responsible for managing your cardiovascular system and regulating your blood pressure. Individuals typically experience weight gain, stretch marks, and acne. The skin will bruise easily, and cuts or insect bites take longer to heal.
Patients with Addison's disease have underperforming adrenal glands that don't produce adequate amounts of hormones. The body suffers from too little cortisol. You may have low aldosterone as well. Fatigue, low blood pressure, weight loss, and low blood sugar are common symptoms.
Turner syndrome is a hormonal disease that's exclusive to women. This occurs when one of the X chromosomes is missing in part or in whole. Turner syndrome can be detected before birth. Patients with Turner syndrome may experience slowed growth, delayed puberty, and changes in menstrual cycles.
Prader-Willi syndrome is a genetic disorder that impacts the hypothalamus and pituitary gland. Since these are responsible for controlling hormones throughout the body, patients can experience various imbalances as a result. Patients often have low sex hormones and a deficiency of growth hormones.
Pancreatitis occurs when the pancreas is inflamed. Patients may experience abdominal pain, nausea, vomiting, and fever. The pancreas produces many hormones including insulin, glucagon, and growth hormone. These, and other hormones, can become imbalanced when you have pancreatitis.
You might also have a hormonal imbalance as a result of certain medications that you're taking, such as birth control or hormone replacement therapies. Cancer treatments can disrupt various hormones, too. An injury or trauma might cause an issue with hormones, particularly if it impacts the brain. This can disrupt how hormones are processed or released in the body. Even something as common as stress can cause a hormone imbalance if you experience it on a chronic basis or under extreme circumstances.
Even healthy individuals may have trouble with hormone disruptions as a result of their diet and lifestyle. Poor diet and nutrition can lead to many types of hormone problems. Some individuals may believe they're eating healthy while actually exposing themselves to potentially hazardous ingredients. Soy products, for instance, contain a natural plant estrogen known as phytoestrogen. If you consume too many soy products, perhaps as part of a vegetarian diet, you can suffer from a hazardous hormonal imbalance as a result.
A variety of toxins and pollutants have been known to impact hormone levels. Some of these are found in or on foods. Pesticides and herbicides can impact your hormone levels and are often found on produce that are treated with these chemicals. Farmed fish and meat raised on an unnatural diet may contain mercury, antibiotics, and PCBs. When ingested, these can disrupt estrogen and progesterone levels. Sugar is directly related to spikes in your insulin levels. Foods that contain gluten may stress the adrenal glands and decrease the hormones produced by the gonads, adrenals, and thyroid.
General Symptoms of hormonal imbalance?
Again, that depends to some degree on the specific hormones that are out of balance. That being said, here are general symptoms that may be experienced:
- Fatigue – Frequent in all common types of hormonal imbalance.
- Irritability – Common in those affected by imbalances in female, male, and stress hormones.
- Mood swings – common in sex hormone imbalances.
- Weight changes – High levels of thyroid hormones can cause weight loss, while low thyroid levels and imbalances in female hormones, male hormones or stress hormones typically cause weight gain.
- Muscle loss – Most common with male and female sex hormone imbalances.
- Reduced bone density – Thyroid and sex hormone imbalances can cause bone loss.
- Increased sensitivity to heat or cold – Abnormally high levels of thyroid hormones can cause heat intolerance, while low levels can make a person over-sensitive to cold.
- Hot flashes and/or night sweats – Very common with female hormone imbalances as well as low testosterone.
- Sexual disinterest or dysfunction – Most common with male and female sex hormone imbalances.
- Infertility – Can occur with sex hormone disturbances.
- Skin changes – The skin can be affected by all common hormone imbalances. Changes can include severe skin dryness, skin thinning, oily skin and acne outbreaks.
- Hair loss – Often seen with thyroid problems or low testosterone.
- Anxiety/depression – Can occur with all common imbalances.
- Heart rate changes or palpitations – Thyroid dysfunction, sex hormone imbalance and stress hormone imbalance can all cause these symptoms.
- Rising cholesterol levels – Low thyroid hormone levels, low testosterone and estrogen/progesterone imbalances can cause cholesterol levels to rise.
- Memory problems – Can occur in all common hormone imbalances.
- Poor focus/concentration – Common symptom of any hormone imbalance.
How and Why Do Men and Women Experience Hormonal Imbalances Differently?
Hormones impact men and women differently, particularly when you're dealing with those specific to the reproductive system. Men and women also go through different developmental stages. Women will experience hormonal changes with their menstrual cycle, pregnancy, and menopause, which men do not experience. Women may experience hormonal imbalances that present through:
- Vaginal dryness or discomfort
- Pain during sex
- Skin tags
- Changes to the menstrual cycle
- Acne, particularly on the face, upper back, or chest
- Hair loss
- Night sweats
- Skin darkening, particularly around the groin, neck, and breasts
Hormonal symptoms unique to men are typically related to an imbalance in testosterone. Testosterone is responsible for controlling male development. If this hormone level is unbalanced, men may experience:
- Tenderness in the breast area
- Increase in tissue around the breast area
- Decreased sex drive
- Trouble concentrating
- Loss of bone mass
- Decreased hair growth
- Loss of muscle mass
- Erectile dysfunction
Hormonal Imbalance in Children: does it exist?
Yes. Hormonal imbalances in children typically occur around puberty. This is when the sex hormones are first produced, signaling future growth in the body. Children whose bodies produce few or no sex hormones often have a condition known as hypogonadism.
In boys, hypogonadism stops the body from producing the muscle mass, body hair, and voice changes that are associated with puberty. The sex organs don't develop as they should, and the arms and legs will experience an excessive amount of growth compared to the trunk. Boys may also develop breast tissue. When girls have hypogonadism, they don't develop breast tissue, start their menstrual cycle, or experience the growth spurt that's typical of puberty.
Hypogonadism can occur either because the gonads are not producing the right hormone levels; or, because the pituitary gland and hypothalamus aren't signaling to the gonads to produce hormones at all. Though hypogonadism is a common cause of developmental and growth problems, there are other causes that may be causative. Always speak with your healthcare provider to gt the proper diagnosis of any abnormal development in children.
Hormonal Imbalance and Men
You may think that women are the ones facing hormonal imbalances. But this is not the case. Men, as well as women’s bodies, produce several hormones that are essential for wellbeing. One very well-known male hormone is testosterone. But, did you know that men, also, produce estrogen? Testosterone is mainly produced in the testicles; and, a small amount is produced in the adrenal glands. It is responsible for one’s manly characteristics, such as:
- Facial and Body Hair
- Muscle and Bone Density
- Deeper Voice
It also stimulates the production of sperm and affects your desire for sex. It also plays a major role in the way one gains weight (fat); and, how and where the body will end up accumulating these fat cells. Finally, red blood cells production is linked to testosterone levels.
Estrogen is made from testosterone with the help of an enzyme known as aromatase. As you age, not only do your testosterone levels naturally drop, but your estrogen levels go up simultaneously. The loss of testosterone with age is referred to by some professionals as andropause – male menopause.
However, testosterone levels can drop, even in young men, from several causes, such as:
- Injuries to Scrotum or Testicles
- Chemotherapy/ Radiation Therapy
- Pituitary or Hypothalamus tumors
- HIV / Tuberculosis (cause inflammation of the pituitary and hypothalamus)
- Anabolic Steroids
- Kidney Disease
- High Blood Pressure
- Drug Abuse
- Testicular Cancer
- Liver Disease
In fact, one study has shown that 30 percent of men who were overweight had low testosterone, as opposed to only 6.4 percent of men of normal weight. Another study found 24.5 percent of diabetic men having low testosterone as opposed to 12.6 percent of non-diabetic men.
But, testosterone and estrogen aren’t the only hormones that can get out of balance in men. You can suffer a decrease in cortisol levels if you are under a lot of stress, or even an imbalance in the thyroid hormones.
Cortisol is produced by your adrenal glands. These glands can become “fatigued” by excessive stress disrupting the proper production of adequate amounts of cortisol. This latter helps your body deal with stress. When out of balance, it can also affect your body’s production of another sex hormone, DHEA. Both men and women have difficulties focusing and feel fatigued when cortisol levels are too low.
Cortisol is responsible for very important functions in the body, including:
- Controlling blood sugar levels
- Inflammation reduction
- Regulating metabolism
- Help with memory
- Salt/Water balance
- Blood pressure regulation
- Fetus support during pregnancy
- Sleep/Wake cycle
Sometimes low cortisol levels cause a rare condition called primary adrenal insufficiency, also known as Addison disease. As you can see, all hormones play a vital role in your overall health.
Thyroid gland can malfunction due to disease, inflammation (thyroiditis) of a nodule, or eating too much iodine rich food. This will lead to an overproduction of thyroid hormone, leading to a condition called hyperthyroidism. On the other hand, the thyroid gland could, sometimes and due to a certain illness, fail to make enough thyroid hormone. This condition is called hypothyroidism, or low thyroid. Neither situation is good for your body and both need to be addressed properly.
Also, your thyroid hormone regulates your metabolism, so it is vitally important to your well-being. Thyroid hormone is just as important to a woman’s health as it is to a man’s health. The characteristics are detailed in the next parts.
What is hormonal imbalance in men?
The most common hormonal imbalances in men are related to testosterone levels. Men may experience low levels of testosterone due to disorders, like hypogonadism for example when the testes cannot produce an adequate supply of testosterone. More commonly, aging is the underlying cause, with testosterone production gradually diminishing over time, beginning around age 40. For some men, levels fall so low that the body's basic needs for the hormone cannot be fulfilled, which can lead to many of the symptoms listed above. Other factors that can contribute to low testosterone levels include excessive stress, poor diet, obesity and regular excessive alcohol use.
What are the Signs of Hormone Imbalance in Men?
Many concerns surrounding a man's bodily changes can be answered by fluctuations in the male hormonal makeup. If changes are being identified, it may be a good idea to see whether there are any deficiencies or overabundance in the body's chemistry.
1- Low Testosterone: This is also known as Low-T and is defined by the American Urology Association as testosterone in the blood accounting for less than 300ng/dL (nanograms per deciliter).
Signs of Low-T include:
- Low Sex Drive
- Lean Muscle Mass Reduction
- Bone Density Loss
- Erectile Dysfunction (Ed)
- Hot Flashes
- Trouble Concentrating
2- Increased Estrogen: An increase in estrogen production in a man’s body can cause a condition called gynecomastia. This is where you begin to develop breasts. Increased estrogen levels can also cause problems with your prostate organ that is in charge of producing one of the fluids that make up semen. Obesity can increase the production of estrogen in a man’s body.
3- Low Cortisol/Adrenal Fatigue: Men suffering adrenal fatigue often have difficulty focusing mentally and are excessively tired.
4- Hyperthyroidism/Overactive Thyroid: Signs of high levels of thyroid hormone in your body include:
- Rapid Heart Rate
- Trouble Sleeping
- Thinning/Breaking Hair
- Hair Loss
- Muscle Weakness
- Weight Loss
- Hypothyroidism/Underactive Thyroid
Signs of a deficiency in your thyroid hormone in your system include:
- Hair Loss
- Unexplained Weight Gain
- Slow Heart Rate
- Carpal Tunnel Syndrome
- Increased Sensitivity to cold
Hormone Replacement Therapy - What Men Should Know
Many think of “menopause” and “hormone replacement,” as the period when women suffer of hot flashes. But it turns out that men, too, experience effects of fluctuating hormones. Some even reported symptoms that are very similar to those of women who are in the stages of pre and full-blown menopause.
It has long been debated whether such a condition actually exist and how it could be affecting men. All this debate led to labeling the whole hormonal changes in men period as “low testosterone.” Sometimes it is called “male menopause.” Most experts agree that it is the result of a gradual decline in hormones, including testosterone and DHEA, due primarily to aging. Typically, testosterone levels in men begin to decline between the ages of 25 and 50, with up to a 50 percent reduction by the time a male reaches his 60s. However, some men can witness a simultaneous spike in their estrogen hormone levels.
How Does the Male Reproductive System Work?
While there are hundreds of hormones that control the body’s chemistry, testosterone is a versatile and critical part of the balance that specifically controls male characteristics and sex drive. When the levels dip, the result can cause a male to experience low sex drive and depression, among other complaints. “Low T” as it is commonly referred to in the media, can cause a number of symptoms, including:
- Decreased muscle and an increase in body fat
- Fatigue or generalized weakness
- Enlarged prostate
- Memory problems or lack of concentration
- Changes in mood or irritability
- Decreased sex drive
- Erectile dysfunction
Some diseases, like diabetes, can cause similar symptoms, so it can be hard to diagnose. To further complicate matters, testosterone decline in men is a slow process; and, some healthy men can produce sperm (and even father children) well into their 80s.
In addition, there are variables that affect hormonal decline and speed up the process. These include weight gain, drug use, tobacco or alcohol abuse, mental illness or severe depression, as well as stress and chronic illness. One may need to keep in mind that medical experts still disagree about the link between declining hormone levels in men and their need for HRT.
How Is Low Testosterone Diagnosed? What Treatments are Available?
Most healthcare providers will measure their testosterone levels by having a blood test, doing a physical exam and having the patient describe his symptoms. Finally, they may order additional tests to rule out other possible diagnoses.
Testosterone is sometimes prescribed for men with low testosterone. Almost all hormone supplements and testosterone treatments are available in different forms, including lozenges, patches, gels and creams.
Because of the limited knowledge regarding this condition, challenges in having a proper diagnosis, as well as the possible side effects of treatments, HRT should not administer for men without proper testing, retesting and consultation with a healthcare provider to discuss the pros and cons. One may want to consider an endocrinologist who specializes in hormones.
Men and Estrogen: what you need to know.
Estrogen is known primarily as a female hormone that helps regulate menstrual cycles, yet the hormone plays a bigger role in men’s health than most people realize. Men produce small amounts of estrogen as part of their normal functioning male reproductive system, along with the male hormone testosterone. As they age, less testosterone is produced.
Yet questions are beginning to emerge as to what specific part estrogen plays in male development, especially as a man ages. Once largely ignored, estrogen levels in men are now under the microscope as researchers are trying to determine this hormone's role in men and how it affects the body's different hormone levels.
A decrease in estrogen, for example, may be a factor in fat accumulation in men as well as women. One endocrinologist at Harvard Medical School reported in a 2013 study that some of the symptoms of testosterone deficiency in males, including a decline in libido, were at least partially caused by lower estrogen production.
How do Testosterone and Estrogen Differ?
Testosterone, the key hormone in men, is the chief regulator of muscle tone and lean body mass, or the very essence of what gives a man his masculine appearance. A “normal” level of testosterone is a broad term, making deficiencies difficult to detect. The hormone is produced by the adrenal glands and testicles, with levels highest in the mornings and decreasing throughout the day.
Testosterone also regulates a man’s sex drive. Lack of sexual desire and performance, often associated with low levels of testosterone, or “low T”, is a common complaint from men as they age and hormone levels drop. Sex drive and performance, however, require the presence of both estrogen and testosterone.
Estrogen, by contrast, is the hormone responsible for sexual and reproductive development in women and is also referred to as “the” female sex hormone. “Estrogen” is really a group of hormones that includes estrone, estradiol and estriol. Estrogen is produced in the ovaries but also by fat cells and the adrenal gland.
How Do Testosterone and Estrogen Work Together?
Recent research is suggesting that how the two work together is critical in our sexuality. In men, an abundant supply of testosterone combines with an enzyme called aromatase to produce estrogen. Just as women need a small amount of testosterone, men need small amounts of estrogen.
What are the Signs and Symptoms of Low Estrogen in Men?
In men, “male menopause” may result from too little estrogen in addition to lower testosterone levels, at least according to some recent studies. Diminished libido, strength and energy are the main symptoms. However, testosterone levels tend not to fall as sharply in aging men as estrogen does in women who are post-menopausal. Further research is needed to determine if changes that come with aging are due to hormonal declines and if so, which hormones are the culprit.
What is High Estrogen in Men?
Too much estrogen in the male body can interfere with fertility, sexual function and even raise the risk for chronic diseases. One cause of hormone imbalance in aging men is that is testosterone is converted to estrogen, which can result in an excess of estradiol. Lab testing can reveal hormonal imbalances of estrogen and testosterone.
Hormonal Imbalance and Women
Female hormones are powerful chemical messengers that regulate the reproductive system and influence many other vital systems. When they are present in the body in the proper amounts and ratios, they work in concert with one another to promote optimal health and well-being. However, when female hormonal imbalance becomes an issue, the consequences can manifest themselves throughout the body, taking a toll on a woman's health and quality-of-life. When the condition is accurately identified and treated, the balance of female hormones can be corrected, reducing the symptoms and health risks associated with hormonal imbalance.
What are Female Hormones?
Estrogen and progesterone are the primary sex hormones in females. Most of the body's supply of these hormones is produced by the ovaries, although small amounts are supplied by other tissues in the body. While best known for their primary function of regulating the reproductive system, female hormones also play a role in other aspects of women's health, including cardiac function, metabolism, bone health, skin thickness and elasticity, urinary tract health, emotional health and brain function, among others.
Cortisol and the thyroid hormone can become imbalanced for various reasons and affect both men and women. Ensuring a healthy profile means keeping abreast of your body's levels. A comprehensive hormone test can provide much needed insight.
The three primary sex hormones in women are estrogen, progesterone and testosterone.
Female Hormone Imbalance: what is it?
Hormonal imbalance occurs when the amount of estrogen, progesterone or both is altered, disturbing the delicate balance between these powerful hormones. Imbalances in these vital female hormones can stem from a number of underlying causes. The most common cause is perimenopause, the transitional phase leading up to menopause, during which the production of estrogens and progesterone begin to decline. Other common causes of hormonal imbalance include pregnancy, endocrine disorders, certain drugs, especially oral contraceptives, drugs used in hormone replacement therapy and cancer medications, and lifestyle factors that include stress, overweight or obesity, poor diet, sleep deprivation and lack of exercise.
Signs of Hormone Imbalance in Women.
So often we attribute our body's changes incorrectly. As women progress through life, the body responds differently, and it plays out in a number of ways.
1- Estrogen Imbalance
Estrogen is made by your ovaries, your adrenal glands, and to a much lesser extent, by your fat cells. It has many functions, including:
- Maintaining Bone Calcium
- Regulating HDL (good) and LDL (bad) Cholesterol in Blood
- Helping Maintain Blood Sugar Levels
- Helping with Memory
- Balancing Emotions
Estrogen imbalance can cause numerous symptoms which will depend on whether you are experiencing an overabundance of the hormone or less of it. The causes and signs can be discerned, but they take a watchful eye. Too little estrogen is often caused by:
- Hypogonadism (when ovaries are making little or no hormones)
- Hypopituitarism (when the pituitary gland makes little or no hormones)
- Failed Pregnancy
- Perimenopause and Menopause
- Polycystic Ovarian Syndrome (PCOS)
- Extreme Exercise or Training
- Certain Drugs
Some signs that you have too little estrogen in your body include:
- Hot Flashes
- Disturbances in Your Sleeping
- Low Sex Drive
- Night Sweats
- Vaginal Dryness or Atrophy
- Bone Loss
Having too much estrogen in your body can be caused by:
- Tumors on Ovaries
- Adrenal Gland Tumors
- Certain Medications
- Signs of excess estrogen in your system include:
- Swelling and Tenderness of Breasts
- Craving Sweets
- Uterine Fibroids
- Weight Gain
- Heavy, Irregular Periods
2- Progesterone Imbalance
Progesterone is made primarily in the ovaries, but also in the adrenal glands and placenta. It is usually at its highest levels while you are ovulating and just after. This is to get your uterus ready for a pregnancy to occur. It also aids in Reduction of Body Fat, Helps Relaxation, Reduces Anxiety, and Stimulates Hair Growth.
Progesterone helps with your sleep cycle; so, if your levels are too low, you may have difficulty falling asleep or going back to sleep if you wake up. It can also cause:
- Lowered Sex Drive
- Irregular Periods
- Hot Flashes
3- Testosterone Imbalance
Testosterone is not just a male sex hormone. Women also have lesser amounts of this hormone. It is produced by your ovaries and adrenal glands. Testosterone has the important function of aiding you by protecting you against developing osteoporosis. It has many other effects on your health, including sex drive, mood, energy levels and body fat percentage.
If you have too much testosterone in your body, such as when you have a condition called polycystic ovary syndrome, you could experience:
- Irregular Periods
- Increased Body or Facial Hair
- Hair Loss
Too little testosterone often occurs during menopause and can lower your sex drive, cause depression, weakness of your muscles and fatigue.
The causes, signs and symptoms for these conditions in women are essentially the same as those for men. It is important to note that, one condition could potentially mask the other, or both could be occurring at the same time. Too much or too little of a hormone can wreak havoc with your body. It is natural at times for hormone levels to rise and fall, as with aging, childbirth and menopause. Other times it may be the result of injury or disease. With so many overlapping conditions and symptoms, you must help your doctor to understand your unique situation.
One of the steps you can take, is to combat changes in hormonal chemistry through diet. There are foods that compensate quite well. Above all, staying informed and ask questions of your doctor, to safeguard your health.
Symptoms and Potential Complications
Imbalances in female hormones can have far-ranging effects on the body, producing a variety of physical, emotional and cognitive changes. These changes can cause symptoms that may include:
- Menstrual cycle changes, including shorter or longer times between periods, and periods that are longer, shorter, heavier or lighter than normal.
- Hot flashes and night sweats.
- Insomnia and other sleep disturbances
- Diminished sex drive
- Vaginal dryness
- Irritability and mood swings
- Depression and/or anxiety
- Difficulty with concentration and/or memory, a symptom often described as “brain fog.”
- Unexplained weight gain, especially in the abdominal area, hips and thighs
- Skin changes, such as thinning, dryness and wrinkling
- Dry, brittle hair
Female hormone imbalance can increase a woman's risk of a number of diseases and health problems. Among the most serious of these is heart disease, with risk increasing as estrogen levels decrease. Women with hormonal imbalances are also at greater risk for osteoporosis, since low levels of estrogens can interfere with the absorption of calcium and other nutrients essential to the maintenance of bone health and density.
Diagnosis of Women’s Hormonal Imbalance
Since the symptoms of female hormone imbalance are also common signs of a number of other diseases and health conditions, women experiencing them should see a physician for a thorough physical examination. If other underlying medical conditions are ruled out, hormone level testing is the next step. Hormone levels can be measured through saliva testing and/or blood tests. Establishing an accurate diagnosis of hormone imbalance may require several tests, done at intervals, as hormone levels fluctuate throughout a woman's menstrual cycle and may change greatly from one day to another.
Treatment of Women’s Hormonal Imbalance
In most cases, female hormones balance can be improved or corrected with treatment. Often, changes in diet and lifestyle are sufficient to improve female hormonal imbalance and offer some protection against its potential health complications. Among the common changes recommended are:
- Weight control
- 30 minutes of exercise daily, including resistance and aerobic exercise.
- Dietary changes that include replacing processed, fatty and sugary foods with lean proteins, low-fat dairy and a wide range of fresh fruits and vegetables.
- Limit alcohol consumption
- Eliminate tobacco consumption
Female hormonal imbalance that cannot be resolved with lifestyle changes is most commonly treated with hormone replacement therapy. Conventional HRT uses hormone drugs to normalize levels of estrogens or progesterone in the system, while bioidentical hormone replacement therapy enhances hormone levels as needed with plant-derived supplements. HRT has been associated with health risks with long-term use, so women considering this treatment should discuss risks and benefits carefully with their doctors.
Commonly asked questions about Female Hormones
What is the lifelong role of estrogen in female health?
Most people think estrogen is primarily responsible for reproduction, but it also helps with bone, skin and cardiovascular health. In addition, it affects thyroid hormone production. During menopause, estrogen levels decline along with the production of progesterone and testosterone. Hormone replacement therapy (HRT), which means replacing lost hormones by re-introducing them into the body, is often suggested to offset the positive benefits of estrogen and can be helpful in reducing common symptoms of menopause. But some studies show that artificial doses of estrogen carry risks and have been linked to cancer, dementia, strokes and arthritis. Never assume that hormone replacement therapy is the right thing to do without consulting your healthcare provider.
What is Puberty? Hormones that control puberty
Puberty is the time in life when children begin to show changes through hormone secretions that indicate they are about to become adults physically. In girls, the most obvious sign of puberty is the onset of menstruation. It can happen anywhere between the ages of 9 – 17, with a median age of 12. The menses, or monthly cycle, is interrupted during pregnancy and typically ends when the ovaries stop secreting steroid hormones – a stage known as menopause.
What are the hormonal milestones in a female’s life?
There are generally four times in a woman’s life when a major hormonal change takes place, all of which can have a significant impact on physical and emotional health:
1. Menstruation to Pregnancy - This is a period anywhere from age 12 to early twenties when the female body is flooded with the hormone estrogen, among other female hormones, protecting her bones and heart. Fat is deposited onto different parts of the body to create a curvier, more feminine look and moods tend to rise and fall. Even without a pregnancy, girls may appear more “feminine” with fat showing up on the breasts, hips, posterior and thighs. This so-called “essential fat” is designed to help women bear children and nourish babies after birth.
2. Reproductive Period – Once a woman reaches adulthood, she’s either married or single and with or without children. Metabolism begins to slow by age 30 and unneeded weight gain can occur. While the body is primed for pregnancy, life is generally hectic with family, careers (or both) and stress can be high. It’s important for a woman in this stage to take care of her physical and mental health in order to prepare for the major hormonal changes ahead.
3. Perimenopause – After the age of 40, the average woman begins to lose about half a pound of muscle per year; more if she doesn’t maintain a healthy lifestyle. The hormone estrogen begins depositing fat to the lower part of the body and fertility begins to decline. As hormone levels drop, extra, non-essential fat is stored internally and externally, giving the body a rounder, more “matronly” look. Moods may fluctuate due to the ebb and flow of sex hormones, especially during the period before menopause (called perimenopause) and some women complain of hot flashes, fatigue, memory loss, or “fuzziness” in the brain. This is all part of estrogen withdrawal as it ebbs and flows and the body prepares for menopause.
4. Menopause and beyond – Once thought of as a “disorder” that needed treatment, we know now that menopause is a normal part of aging. After the last menstrual period occurs, usually around the age of 50 or so, menopausal symptoms – from night sweats to vaginal dryness – may continue or even get worse. That’s when some women consider hormone replacement therapy to boost their levels of estrogen and progesterone. Always consult with a healthcare provider before taking any hormone supplements or treatment. This is also a time in a woman’s life when a healthy lifestyle, which includes diet, exercise and mental stimulation are even more critical to their overall well-being. One study found that women over the age of 60 who eat healthy and exercise are happier and more satisfied with their lives than women who don’t.
What Causes Hot Flashes?
The classic hot flush (or flash) is caused by increased blood flow, usually in the skin of the face and upper body. It appears to be similar to the way the body responds to stress during exercise when blood vessels in the skin expand and sweat glands are activated. But, exactly why it accompanies estrogen levels drop is not fully understood. Most hot flashes don’t last long and disappear following menopause. (Men who are hormone deficient can also get hot flashes).
Why do I feel so different during my monthly cycle?
Blame it on your hormone levels, which rise and fall during your cycle. In fact, the menstrual cycle is governed by hormones. It influences your physical and emotional health. Some women experience little to no major symptoms, while others report:
- Increased or decreased energy and creativity
- Positive or negative mood changes
- Body changes that include may include cramps or sensitivity to touch
While these changes are all normal and part of the female hormonal cycle, the symptoms can sometimes be minimized through self-help: exercise, health supplements like extra calcium and Vitamin B (in moderation) and by limiting salt, sugar and caffeine. Extreme mood swings, severe cramps that cause debilitating pain, fatigue and depression should be discussed with a healthcare provider.
Why don’t men have monthly cycles?
The simple answer is that men don’t menstruate because they don’t have a uterus. They do not have hormonal cycles, as women do, because of the way cells are programmed, specifically the egg cell in the female and the sperm cell in the male. The point of the female cycle is to prepare the uterus for a fertilized egg. When no fertilization occurs (absence of pregnancy) estradiol and progesterone levels drop dramatically and menstruation occurs. Then the cycle begins again.
What is Premenstrual Symptom (PMS)?
Despite the many jokes about PMS, symptoms that occur just before a woman’s monthly cycle are real and can be disruptive, including:
- Tender or swollen breasts
- Water retention (bloating)
- Disrupted sleep
- Mood swings or irritation
The cause is due to fluctuating estrogen levels, with symptoms often disappearing during perimenopause and menopause.
How can I take care of my health (and my hormones) for life?
A post-menopausal healthy diet is your answer. It all lies in how well you take care of your overall health. Since hormones and weight gain often go hand-in-hand, it stands to reason that improving your diet is a first step in weight management. Obesity undermines everything you do and can lead to heart disease, stroke, high blood pressure, sleep apnea, diabetes, kidney failure and yes – even menstrual disorders in females.
Here are some lifelong tips gleaned from numerous healthcare experts that can guard and improve your health status regardless of what hormonal stage you are in:
- Think holistic – that means mental as well as physical. Mind always affects body and vice versa.
- Be realistic about your goals. If you’re a female over 50, don’t expect to feel and look 20 all over again. But do expect to feel and look better if you can stay active and achieve an ideal weight.
- Find support through others. The average lifespan for women today is 79.5 years. That means most women you know will experience the four major hormonal milestones and may have some wisdom to impart on how they met each challenge.
- It’s never too late to start a health regimen. One woman in her 90s began a strength-training program for bone density and upper body conditioning. Though it was difficult at first, she found that by sticking to it, both her physical and mental health improved.
- Avoid smoking and excess alcohol.
- Reduce trans fats, sugars and starch. If you do eat foods that are high in calories follow strict portion control. When asked his secret to a long life, a 101-year-old said, “I never have seconds.”
- Don’t skip breakfast. It helps to jump-start your metabolism and reduces the chance you will overeat during the day.
- Avoid fad diets. If they work at all, they are short-term only and can sometimes do more harm than good.
- Make an attitude adjustment. Though female hormones can appear to wreak havoc during certain times of the month and at certain hormonal milestones throughout your life, you still have a great deal of control over your mind, your body and your health.
Can I Naturally Reverse the Aging Process?
When it comes to the aging process, there's still no way to stop it completely, despite many years’ worth of research in the matter. While medical science hasn't yet been able to stop the clock, research has yielded an ever-growing body of information on evidence-based methods that can promote healthy aging, as well as some that can help reverse some signs of aging, improving a person's health, well-being and appearance.
Step 1- Optimize Your Lifestyle for Healthy Aging
Kicking bad habits and adopting new healthy ones can slow aging or reverse signs of aging that have already begun to appear. For instance, according to a study done on 64 female smokers in Milan, Italy, quitting smoking actually reverses biological aging in the skin. When the study began, clinical and instrumental evaluations were made to determine the biological age of the skin, which averaged 9 years older than the actual chronological age of the subjects. After 9 months of smoking cessation, improvements in aging markers like lines, vascular and pigmentation state, elasticity, brightness, and texture of the skin were calculated, showing that the biological age of the skin had been reduced by an average of 13 years.
Other habits that can accelerate aging include too much alcohol, so limit it to no more than one drink per day if you're female and two if you're male. Not getting enough sleep can age both your body and mind. If insomnia or other sleep disorders are a problem for you, get treatment, because deep, restful sleep is essential to healthy aging.
Among the most important good habits to cultivate to slow or reverse aging is regular exercise, which can have anti-aging benefits for both your body and mind, helping you look and feel younger. For instance, resistance training can help prevent or reverse the loss of muscle mass and strength that typically begins around age 45 and can aid in preserving or improving bone health. Exercise has been shown to reduce depression risk, sharpen memory and improve cognitive function. Regular exercise also aids in weight control, improves energy levels and supports the health of the cardiovascular system, among many other benefits to health, well-being and vitality.
Step 2- Optimize Your Diet to Combat the Aging Process
Optimal nutrition can help in slowing or reversing aging. Among the nutrients to pay special attention to, as you reach midlife and beyond, are:
- Protein to slow muscle loss
- Calcium and vitamin D to preserve bone health
- Omega 3 essential fatty acids to support cardiovascular health, brain and nervous system function, and skin health
- Antioxidants to protect against free-radical damage that contributes to the aging process
Making sure that your body has what it needs is best done with a proper diet that includes plenty of lean protein, low fat dairy products and lots of complex carbohydrates, like whole grains, fruits and vegetables. Omega 3s can be found in oily fish, such as salmon, sardines, tuna and mackerel, so make to include these in your diet at least a couple of times per week. Last, but not least, consider looking into your nutritional status to ensure you're getting optimal nutrition, which is easily done with a blood test called a nutrition panel.
Step 3- Check Your Hormones
Hormonal imbalances are another factor that can impact physical, emotional and cognitive health, accelerating the aging process. In men, abnormal low testosterone levels can be an issue at midlife and beyond. For women, hormonal imbalances can occur during perimenopause and menopause, as levels of estrogen and progesterone production decline. Imbalances in stress hormones are fairly common during midlife as well. All of these hormonal issues can cause skin changes, increased body fat, muscle loss, bone loss cholesterol changes, muscle and joint pain, mood swings and cognitive changes, among many other symptoms.
Hormone imbalances can be treated quite successfully in most cases, reversing their effects and relieving its symptoms. Levels of stress hormones can be normalized through diet, exercise and stress reduction techniques, while imbalances in sex hormones in both men and women are often treated with hormone replacement therapy.
Unfortunately, hormonal imbalances often go undetected and their symptoms get written off as normal signs of aging. For that reason, keeping tabs on your hormone levels through regular blood testing is wise to ensure that hormonal imbalances don't make you look and feel older than you should.
Last, but not least, be sure that you're seeing your doctor regularly, and request to be screened regularly for common health issues that become a greater risk at midlife, such as heart disease, hypertension, insulin resistance, diabetes, thyroid disease and osteoporosis, among others. Catching and treating any emerging health issues early is the best way to ensure healthy aging. So, be proactive when it comes to those regular check-ups and health screenings and make sure you are regularly testing your hormone levels.
What Are Hormones and Why Does A Woman Need Estrogen in Particular?
Often associated with pregnancy, estrogen helps women maintain “normal” female traits, as well as a properly functioning reproductive organs and functions. As a woman reaches child-bearing age, estrogen prepares the uterus for a fertilized egg. It also controls how the body uses calcium to strengthen bones; and, helps raise HDL (good cholesterol) levels. It is produced in the ovaries, adrenal glands and other organs.
But estrogen isn’t the only hormone produced in the female body. Other hormones are progesterone and androgens such as testosterone. Each one has different components, some of which occur naturally and others are artificially manufactured.
What Is Hormone Replacement Therapy (HRT)?
Introduced in the U.S. in 1949, estrogen replacement set the stage for the controversial evolution of hormone replacement therapy (HRT) to come, based upon an early premise the menopausal female body was “deficient” as normal aging occurred, and therefore required a fix. Using a one-size-fits-all approach, drug manufacturers in the 1960s designed an estrogen hormone supplement called Premarin as the “magic bullet” for women seeking relief from menopause symptoms. But, there were problems. Bleeding in the uterine lining was a side effect, sometimes leading to a condition which could increase the risk for uterine cancer. (Estrogen was also used to help prevent osteoporosis).
Progesterone was introduced and then combined with estrogen. Sales of the hormone replacement soared in the 1980s and early 90s and the benefits were highly touted: heart protection, lowered bad cholesterol, depression lifted and thicker vaginal tissue.
By 2000, researchers were cautioning about a link between estrogen HRT and breast cancer. Worse, the heart protection benefits came under question. The result was mass confusion for women and their healthcare providers.
Today, we recognize there is no one-size-fits-all HRT, that menopause is not a disease to be “cured” and that some women need hormone therapy while others don’t. While the science is still evolving, there is evidence to suggest that Hormone Therapy, or HT, as it is now called, can provide real benefits for some types of cancer, as well as osteoporosis. Synthetic hormones that can match naturally occurring biochemical hormones are under clinical studies. The aim is to help develop a more individualized treatment that can be applied and tailored to precise needs. Latest research, with early results, is showing customized HT in low doses have less risk and fewer side effects
So, HRT is both estrogen and progesterone supplemental treatment that aims at helping reduce the usual symptoms of menopause. After a woman’s period stops, normal hormone levels diminishes, causing hot flashes, vaginal dryness and other common symptoms associated with the female’s “change of life”.
There are generally two types of HRT:
Estrogen therapy – often recommended in women who have had a hysterectomy. It comes in pill form, patches, vaginal ring, spray or gel.
Estrogen/Progesterone/Progestin therapy – referred to as combination therapy, it combines estrogen and progestin, which is the synthetic form of progesterone. Many healthcare providers recommend combination therapy for women who still have their uterus. Where the debate comes in is whether the risks of HRT outweigh the benefits. That argument has yet to be fully resolved.
What Are the Benefits Of HRT?
Estrogen has been shown to provide relief from hot flashes. It can also increase skin thickness and help reduce wrinkles associated with aging. Sexual function is generally improved by taking estrogen, and locally applied estrogen can help with reducing urinary tract infections.
Steroid hormones, including estrogen, suggest a moderate protection against dementia following menopause and an antidepressant effect. It also has a notable benefit on bone density which reduces the risk of osteoporosis.
What Are the Known Risks of Hormone Therapy?
Some studies in recent years have shown that women on HRT have a higher risk of heart disease, stroke, breast cancer and blood clots. Those on the combination therapy (estrogen and progestin) had a slightly higher risk. Since then, newer studies conclude that all results depend on the type of therapy, the way it is administered and at what point treatment began. Those who shouldn’t take HRT include:
- Individuals with a history of blood clots
- Those diagnosed with breast, uterine or endometrial cancer
- Heart or liver disease patients
- If you are pregnant
- If you’ve ever had a stroke or believe you are at high risk for strokes (Source: WebMD “Menopause and Hormone Replacement Therapy”)
When Should I Begin Hormone Therapy?
Healthcare specialists advise you to start the discussion about HRT when you feel that you need it. Symptoms of menopause are generally at their peak before menopause begins (a period called perimenopause); so, around the age of 30 – 35 get a baseline test to determine your “normal” hormone levels. Perimenopause can begin in a woman who is as young as 30 and as late as 50.
What Are My Options If I Choose Not to Take Hormone Therapy?
There is now a non-hormonal treatment for women who suffer from hot flashes. In 2013, the Food and Drug Administration (FDA) approved a pill called Brisdelle that relieves symptoms. In clinical trials, it was found to be effective for women who suffered from hot flashes at least seven or eight times a day. A few side effects were reported: fatigue, headache, nausea and vomiting.
What Should I Know Before I Make A Final Decision about Hormone Therapy?
Begin with knowing your health status and your medical history, including that of your family members. Have you had your ovaries removed? Is there a history of breast cancer or heart disease? What are your goals with hormone therapy – to minimize menopause symptoms or to help look and feel your best? Consider a cautious approach with low dosages to start, or look for healthy alternatives to HRT.
Most experts agree it’s best to discuss all options with your healthcare provider. Two prominent physicians, Dr. Sanjiv Chopra and Dr. Alan Lovin, offer the following suggestions before making a decision:
Don’t think of hormone treatment as a way to prevent “disease” since menopause and the hormonal changes that go along with it are not unnatural, or something to be “cured.”
Most hormone treatments can be used safely for a limited time to offset certain symptoms of menopause.
There is no single answer to the question of “should I or shouldn’t I take hormone therapy?” Each case should be considered individually. The best guideline is to use the lowest dose possible for the shortest period of time.
Menopause: What Does it Mean to You?
Medically, menopause is defined as the permanent cessation of the menstrual cycle. However, for women facing this transition, the meaning of menopause is much more than that clinical description. Often referred to as the change-of-life, menopause marks the end of the child-bearing years and the beginning of a new phase of life. Here, we'll go over the basics in terms of menopause meaning, including symptoms many women experience during the menopausal transition and common treatments for them, as well as how menopause can impact health and well-being.
What Does Menopause Mean?
Menopause is officially diagnosed when a woman has not had a menstrual period for 12 consecutive months; and, no other medical cause of that lapse is evident. However, menopause does not occur suddenly. Rather, it is the culmination of a natural process that begins with perimenopause, a transitional phase that starts up to ten years before the onset of full menopause. During perimenopause, production of hormones that regulate the reproductive system, including estrogen and progesterone, diminishes gradually. When these hormones diminish to the point that levels are too low to prompt the menstrual cycle, menstruation stops, signaling the onset of full menopause. Perimenopause typically begins between age 35 and 40, and average menopause age in the U.S. is 51 but this can be highly variable according to Gold (2012) and depends on many factors. About 1 percent of U.S. women experience premature menopause, which is defined as the onset of natural menopause at or before age 40.
How Do You Know If You Are Going Through Menopause?
While some women sail through the change of life with no discomfort, many others experience symptoms that alert them that they have begun the menopausal transition. For most, these symptoms appear late in the perimenopause phase, when full menopause is approaching and hormone levels have become significantly diminished. Among the most common menopause symptoms are:
Hot flashes/night sweats – Hot flashes are a sudden feeling of heat in the body with no obvious cause, and night sweats are hot flashes that occur during sleep. Most women – about three-quarters by some estimates – will experience these issues during perimenopause and often, for a year or two after full menopause has occurred. They vary in frequency and intensity, causing mild discomfort in some women and extreme, even debilitating, in others.
Menstrual changes – As menopause draws near, most women will notice changes in their menstrual cycle. These may include shorter or irregular menstrual cycles, skipped menstrual periods, blood flow that is heavier or lighter than usual or periods that are longer or shorter in duration than normal.
Mood changes – As hormone levels fluctuate erratically during the later stages of perimenopause, many women experience mood swings, irritability, forgetfulness and increased risk of depression and anxiety.
Insomnia and other sleep disturbances – Women undergoing hormonal changes related to menopause often have trouble getting to sleep or staying asleep. Additionally, many women experience disturbed sleep due to night sweats.
Vaginal dryness – Estrogen loss can cause vaginal tissues to lose lubrication and elasticity, causing discomfort or pain with intercourse.
While these symptoms can be an important indicator that you are going through menopause, the only way to be sure is to get your hormone level tested. By measuring levels of hormones in your system, your doctor can determine whether you've begun the menopausal transition; and, if so, just what stage of that transition you're in.
When to See Your Doctor about Menopause and Why You Should?
Menopause is a natural transition, not an illness. However, it is still very important to confirm that any symptoms you're experiencing are actually due to menopause, rather than other underlying health problems. Health issues that can present many of the same symptoms include some very serious ones, such as thyroid disease, diabetes, some forms of cancer and certain types of cardiovascular disease, among many others.
Additionally, if menopause symptoms are severe, disrupting your life significantly, there is no need to suffer in silence, since your doctor can offer treatments that can help ease them. Among the most common approaches to reducing hormonal symptoms are lifestyle changes, including increased exercise, which can help with mood swings and insomnia, and dietary changes, which can reduce the frequency and intensity of hot flashes and night sweats. If lifestyle changes don't offer adequate relief, hormone replacement therapy is often recommended to improve hormonal balance and ease discomfort.
Lastly, even if you aren't experiencing symptoms, keeping closer tabs on your health as you approach menopause age is important. Women who are going through menopause or have already completed the change-of-life are at higher risk for a number of diseases and health conditions than are premenopausal women. For this reason, regular screening tests are essential to maintaining optimal health during this phase of life, including cholesterol testing, diabetes screening and blood pressure checks, among others, as is discussing preventive measures with your doctor.
More about Cortisol
Cortisol is a hormone that is made by your adrenal glands, which are located on top of your kidneys. It is released into the bloodstream by those glands, in response to stress. Testing cortisol levels can help detect problems with that process by evaluating levels of the hormone in the body. Here, we’ll look at how to test cortisol levels and why it can be important to have these tests done.
So, what is it really?
Cortisol is a steroid hormone that is the primary hormone involved in the body’s fight-or-flight response to stress. Here is how that response happens when this system is functioning in a normal, healthy manner:
When a person feels stressed or endangered, a chemical called adrenocorticotropic hormone (ACTH) is released into the brain by the pituitary gland, which triggers the adrenal glands to release cortisol into the bloodstream.
The increased levels of cortisol produce a surge of energy, alertness and strength meant to aid the body in responding to the perceived threat. It does this by increasing the heart rate, elevating blood pressure and boosting the amount of glucose (sugars) in the bloodstream for the brain and body to use for energy.
Higher cortisol levels also slow or suppress certain bodily functions to conserve energy for the stress response, altering immune response and suppressing the reproductive and digestive systems, as well as growth processes. High cortisol levels also affect areas of the brain that regulate mood and fear response. Once the threat or situation that prompted the stress response is resolved, cortisol levels fall back to normal levels. The heart rate and blood pressure drop, and bodily functions altered by the stress reaction, return to normal.
Why Cortisol Testing Is Important
Cortisol testing is important because that system does not always function in the normal, healthy manner outlined above. Sometimes cortisone levels can stay too high for too long, which can have far-reaching effects on your health, such as:
- Digestive issues
- Sleep disturbances
- Cardiovascular disease
- Weight gain
- Problems with memory and/or concentration
Issues That Can Cause Abnormally High Cortisol Levels include:
1- Chronic stress: The body’s natural fight-or-flight stress response system is set up to manage short-term stress situations. Stress in today’s world is often a longer-term health issue. Rather than being stressed by a sudden encounter with a predator, a situation that can be resolved quickly by running away, we are more likely to face ongoing problems that cause stress, like job pressures, for instance, or financial ones. This can cause long-term activation of the stress response system, leading to chronically high levels of cortisol.
2- Problems with the pituitary gland: Tumors on the pituitary gland or excess growth of the gland can cause it to release too much ACTH, increasing cortisol levels.
3- Problems with adrenal glands: Tumors on the adrenal glands can cause overproduction of cortisol.
4- Other tumors: Growths in other areas of the body can increase cortisol production.
5- Medications: Overuse of corticosteroid medications or long-term use of them can lead to abnormally high cortisol levels.
Health Problems Caused by Abnormally Low Cortisol
- Chronic fatigue
- Muscle weakness
- Weight loss
- Abdominal pain
- Low blood pressure
- Hypoglycemia (low blood sugar)
- Digestive disorders, including nausea, vomiting, diarrhea
- Menstrual cycle irregularities
- Excessive sweating
Possible Causes of Abnormally Low Cortisol Levels
Also called primary adrenal insufficiency, this is a condition that occurs when the adrenal glands are damaged and become unable to produce enough cortisol and/or other stress hormones. This is most often caused by auto-immune activity, where the immune system attacks the body’s own tissues. Other potential causes include long-term use of steroid medications, certain blood thinners, tumors and infections.
Problems with the pituitary gland
Low cortisol levels can be caused by the pituitary gland failing to release enough ACTH. This latter is important to trigger adequate amounts of cortisol to be released from the adrenal glands. This is typically referred to as secondary adrenal insufficiency, or hypopituitarism; and, can be caused by trauma to the pituitary gland, brain tumors, pituitary gland tumors, stroke, autoimmune diseases and tuberculosis, among many other possible causes.
How to Test Cortisol Levels
Cortisol levels are measured with lab tests. These may be blood tests, which measure levels of the hormone in the bloodstream, or saliva tests, which measure cortisol levels in a saliva sample. Cortisol testing is typically done early in the morning, when levels are normally highest. Often, to produce the most accurate results, testing is repeated in the afternoon of the same day. Cortisol testing is often done in conjunction with ACTH level tests, since this pituitary gland hormone works to regulate cortisone levels. ACTH tests measure levels of the hormone in the bloodstream.
Getting tested can be done through your health care provider, who can order your tests for you, take your blood or saliva samples or send you to a lab to have them done. Then, your provider will let you know your results once they are delivered to his or her office.
You can also order these lab tests yourself online or over the phone from independent testing services, like Health Testing Centers. Ordering your own tests is generally less expensive, since you skip the cost of an office visit, and more efficient, since the results are delivered directly to you.
However, it is important to note that if your tests show that your cortisol and/or ACTH levels are abnormal – too high or too low – following up on those results with a visit to your healthcare provider is essential. Abnormal levels of these important hormones require further examination and testing.
While in most cases, abnormal levels stem from relatively minor causes that can be resolved with lifestyle changes or medication adjustments, as outlined above, many very serious health problems can potentially be at the root of abnormal cortisol levels. For this reason, it is very important to seek medical help to determine the underlying causes in your case.
How can I balance back my hormones?
If you have been diagnosed with a hormonal imbalance, your doctor can advise you on ways of bringing your body back into proper balance. Typical treatments for improved hormonal balance include hormone replacement therapy and lifestyle changes, such as dietary changes, stress management and exercise. In the case of thyroid dysfunction, medications and/or surgical intervention may be necessary to restore health levels of thyroid hormones.
Can you test hormone levels?
Yes, you can. Hormone testing is routinely done these days and is available for all types of hormones that commonly become unbalanced, including women hormones, men hormones, thyroid hormones, cortisol and much more. Most hormone imbalance tests are blood tests that measure the level of certain hormones circulating in the blood stream, and in some cases, whether complimentary hormones – estrogen and progesterone, for instance – are present in the proper ratios to work together effectively.
- Hormone tests are commonly done for the following purposes:
- To diagnose hormonal imbalances
- To help identify the underlying causes of hormonal problems.
- To aid in formulating effective treatment plans.
- To monitor progress in bring hormone levels back into balance.
If you have concerns about your hormonal balance, your doctor can order hormone testing for you, or you can use an online lab testing service, like Health Testing Centers, to order your tests yourself. The advantages of ordering your lab tests directly include the ability to choose your own tests, ensuring that all of your concerns about your health are addressed, and lower costs, since you won't have to pay for office visits to have your tests ordered or to receive your results – which will be delivered directly to you.
Medical Facts & Myths Everyone Should Know,” by Dr. S. Chopra and Dr. A. Lovin, Thomas Dunne Books, 2010.
WomensHealth.gov: “Menstruation, Menopause, and Mental Health,” "“Premenstrual Syndrome."