Hormone Imbalance: How to gain insight from symptoms

How do you know if your hormones are in or out of balance? I like to combine a careful history of what my patients are experiencing, their nutritional status, level of activity and sleep along with symptom questionnaires and hormone testing. If any part is left out, sometime we can miss the root cause of the hormone imbalance. Dr. John Lee’s books are helpful with understanding symptoms, and I will provide those here. If you are taking the questionnaire, check off any symptoms that you experience from each grouping, then we’ll integrate them at the end. Symptom group 1: PMS? Anxiety? Cyclical headaches (sometimes menstrual or hormonal migraine)? Insomnia? Early miscarriage? Lumpy or painful breasts? Infertility? Symptom group 2: Vaginal dryness? Painful sex? Bladder infections? Night sweats? Hot flashes? Poor memory? Depression, especially with lethargy? Low libido? Symptom group 3: Bloating and/or puffiness? Abnormal paps? Rapid weight gain? Breast tenderness? Mood swings? Heavy bleeding? Depression with anxiety? Migraines? Insomnia? Brain fog? Red flush on face? Gallbladder problems? Weepiness? Symptom group 4: Number of checks among the group 1 & 3 symptoms Symptom group 5: Acne Polycystic Ovary Syndrome Excess hair on face, chest, and/or arms Hyper- or hypoglycemia, and/or unstable blood sugar Thinning head hair Infertility Ovarian cysts Midcycle pain Symptom group 6: Low libido Debilitating fatigue Unstable blood sugar Brain fog Low blood pressure Thin or dry skin Intolerance to exercise Brown spots on skin For assessment, tally the total number of boxes in each group. If you have 2 or more symptoms from a grouping, you may have the following diagnosis. I recommend that you sort this out with the help of a qualified physician. Group 1: Progesterone deficiency. This is the most common hormone imbalance of all ages. Best approaches are to optimize diet, reduce synthetic hormones if you are taking any and switch to bioidentical progesterone if appropriate. Group 2: Estrogen deficiency. This is most common in menopausal women, especially in Skinny Minnies. Dietary changes and herbal remedies are often helpful as a first approach. Group 3: Excess estrogen. This is usually caused by synthetic estrogen use or environmental exposure to the 700+ known xenoestrogens. and can be managed by changing to bioidentical hormones, and balancing with sufficient natural progesterone. Another cause is exposure to xenoestrogens, or one of the 700+ known chemicals in the environment with estrogen-like effects such as fertilizers, pesticides and parabens. Group 4: Estrogen dominance. Usually caused by not having sufficient progesterone to balance estrogen. Sometimes it is related to progesterone deficiency, and sometimes its related to excess estrogen. Many premenopausal women have this, between age 35 and 50. Group 5: Excess androgens or male hormones. Often this is caused by insulin resistance, and we can improve this with dietary changes but other approaches can bring you into balance as well. Group 6: Cortisol deficiency. This is caused by adrenal fatigue related to chronic stress. There are few women who escape this condition when juggling work and family. For testing of hormones, the most accurate is a 24-hour urine test. The problem with a blood test is that it is only a snapshot of what is happening with your hormones in a 5-second period of your day. During the day, many of your hormone levels fluctuate in a 24-hour period. You can assess the complete daylong cycle with a 24-hour urine test. Additionally, the 24-hour urine tells us what the “free” or hormonally active levels of hormones are. Urine is not always paid for by insurance, but it may be your best ally particularly if you have hormone problems that are not easily solved. Saliva often is used, mostly because you don’t need a physician to order it in most states. Yet, it is only a snapshot as well of your total daylong picture, similar to blood. I recommend completing the questionnaire and getting a thorough evaluation by a holistic physician who knows hormones well. Not all conventionally-trained physicians know how to balance hormones, so take care to find a knowledgeable doctor in your area. Namaste!