June 20, 2024

The Complete Guide to Hormonal Imbalance in Women

photo of Adam Felman

Written By

Adam Felman

photo of Kimberly Hartzfeld, DO

Medically Reviewed By

Kimberly Hartzfeld, DO

Lifeforce Physician

The Complete Guide to Hormonal Imbalance in Women

Hormones are proteins and steroids that link to every part of your being, including your mood, sleep, energy, and your reproductive system. Even slight hormone imbalances in women can have a far-reaching impact, and they’re surprisingly common. 

One survey of 2,000 women, commissioned by OB/GYN Dr. Anna Cabeca, MD, found that 47% of women experienced symptoms like low energy, reduced libido, mood swings, and weight gain without realizing they were suffering from a hormone imbalance.

Understanding these symptoms and leveraging the available solutions can help you reclaim the years so often overshadowed by this condition.

woman stretching47% of American women ages 30-60 have experienced the symptoms of a hormonal imbalance, yet 72% say they didn’t know it until later in life. Even the slightest imbalance can cause fatigue, reduced sex drive, difficulty losing weight, and more. Our at-home blood test measures the 40+ biomarkers that impact your health, hormones, and quality of life, including:

  • Better Sleep

  • Reduced Weight Gain

  • Increase Libido

  • Improved Focus & Energy

Common Symptoms of Hormonal Imbalance in Women

A network of 50 interconnected human hormones regulates all your vital bodily processes. During the reproductive years, menopause, and daily life, a hormone imbalance can cause several symptoms that impact how you feel and perform. The good news? There are ways to control some of the effects at home, with a few effective lifestyle and natural remedies that treat hormone imbalance in women.


Acne is a common reaction to hormonal changes in women. One study suggests that acne affects 41% of adult females, with 78% of those affected reporting worse symptoms during their premenstrual period. Excessive levels of androgens like testosterone — commonly from polycystic ovary syndrome (PCOS) — can increase oil levels in the skin, causing bacterial buildup and pimples. The stress hormone cortisol can also make acne worse

The following measures can help women manage hormonal acne:

  • Gentle cleansing with mild soap

  • Omega-3s

  • Avoiding dairy

  • Reducing sugar

  • Stress reduction techniques like meditation

  • Avoiding skin products that cause irritation

  • Antibiotics 

  • Other drugs like benzoyl peroxide to reduce antibiotic resistance

Consult with a dermatologist before treating acne.

Weight Gain

Hormones like leptin, insulin, androgens, estrogens, and growth hormones impact your appetite, metabolism, and body fat distribution. A hormonal imbalance in women can drive weight gain too, intensifying menopause, PCOS, metabolic syndrome, or thyroid deficiency.

Though menopause doesn’t cause obesity, at least 43% of menopausal women are obese, and menopause does make it more likely you’ll gain weight, particularly around the midsection. About 38-88% of women with PCOS live with being overweight or obese.

For many women, the key to effective weight management often starts with restoring hormone balance. You may be able to achieve this through:

  • Healthy lifestyle choices around diet, exercise, sleep, and stress

  • Early evaluation with an endocrinologist

  • Medications

The Lifeforce Diagnostic includes a full hormone panel, telehealth visit, clinical report, and a personalized plan to help you optimize your health.

woman sleepingSleep Problems

A hormonal imbalance in women can affect your sleep in several ways, since reproductive hormones like progesterone and estrogen are linked to the sleep cycle. Around 66% of women with PMS, 60% of menopausal women, and 51.6% of postmenopausal women report disrupted sleep. Pregnancy can also increase sleep disturbances. Sleep difficulties often become more frequent and last longer as pregnancy progresses. 

To manage these exhausting hormonal sleep issues:

  • Keep a regular sleep schedule.

  • Avoid late meals.

  • Maintain a cool, comfortable, device-free bedroom.

  • Speak to a doctor if sleep problems persist.

Mood Changes

If you live with premenstrual syndrome (PMS), you’re probably familiar with the mood shifts that can accompany female hormone imbalance. Estrogen and serotonin may interact to affect your mood.

Hormonal imbalance in women — especially around menstruation, menopause, and pregnancy — can cause rapid and sometimes severe mood changes. For example, late menopause may make depressive symptoms 14 times more likely.

Aside from taking steps to balance female hormones, the following treatments may help to stabilize your mood:

  • Talk therapy (including cognitive behavioral therapy)

  • Antidepressant medications

  • Stress reduction techniques like meditation

  • Managing your sleep schedule

If you’re experiencing low mood or depression, it’s important that you talk to a healthcare professional.

Low Libido

Hormonal imbalance in women might lead to a downturn in sexual desire. Around 40% of women experience low libido during menopause. Reduced desire due to vaginal dryness is common, since dryness can make sex uncomfortable and even painful. Pregnancy, insulin imbalances like diabetes, or thyroid disease can also cause low libido

If you notice a lower sex drive impacting your mood, interfering with your relationships, or affecting your quality of life, speak to a doctor. They may prescribe hormone replacement therapy, natural supplements, or medications that can help. Other ways to relieve the burden of low libido include:

  • Regular exercise

  • Effective stress management

  • Open communication and experimentation with your partner

Learn more about improving your libido in our article: 14 Libido Boosters to Get You Back in the Mood.

woman resting in the sunIrregular/Heavy Periods

Heavy periods that happen too often (or too infrequently) might be another sign of a female hormone imbalance. Health problems affecting periods include:

  • PCOS

  • Endometriosis

  • Fibroids

  • Pelvic inflammatory disease

  • Thyroid and pituitary gland disorders

  • Excessive stress

  • Weight changes

  • Pregnancy complications

  • Birth control side effects

Heavy exercise can also affect your periods.

The most suitable treatment option will depend on the type of condition you have. However, pain relief medication, hormone therapy, or switching to non-hormonal birth control may help soften the impact of irregular periods. You can help reduce your risk through:

  • Moderate exercise

  • A nutritious diet

  • Stress reduction

  • Regular gynecology check-ups to rule out underlying health problems

Vaginal Dryness

A hormone imbalance from menopause, birth control, surgical removal of the ovaries, and certain medications can reduce estrogen levels and cause uncomfortable vaginal dryness.

Natural remedies and hormone therapies include:

  • Vaginal lubricants and moisturizers

  • Staying hydrated and applying natural oils like olive or coconut oil

  • Supplementing estrogen via creams, rings, or patches

  • Hyaluronic acid vaginal suppository (Revaree)

Other treatments include dehydroepiandrosterone (DHEA) and ospemifene. These options mimic estrogen’s effects on the body

Unexpected or Excessive Hair Growth

Excessive bodily hair, or hirsutism, most often occurs due to excess androgens resulting from PCOS. Around 5-10% of sexually active women develop hirsutism. A thyroid hormone or cortisol imbalance can also lead to excessive body hair. A drop in estrogen production during pregnancy and menopause may also contribute.

The following measures can help women manage hirsutism and feel their best:

  • Weight management — losing even 5% of body weight can reduce androgens

  • Medications like birth control and androgen suppressants to lower androgen levels

  • Cosmetic options like electrolysis, laser hair removal, waxing, shaving, and bleaching

  • Certain foods like green tea, bananas, and carrots can help block DHT (via inhibiting 5-alpha reductase)

Difficulty Conceiving and Fertility Problems

Infertility can be devastating, and it’s often the direct result of a female hormone imbalance. PCOS, excess prolactin production, and thyroid disorders can disrupt egg production or interfere with your menstrual cycle. Some medicines may reduce the fertility-impairing effects of PCOS and reduce prolactin levels. These include:

  • Clomiphene citrate

  • Letrozole

  • Hormonal therapies like human menopausal gonadotropin (hMG) or follicle-stimulating hormone (FSH)

bloodwork diagnostic testing“I've lost weight. My mind is a lot more focused. I can process a lot more information quickly. I definitely feel like I have more power in my workouts. I have an energy level that is back to who I have been my whole life.” — Michelle L., Lifeforce Member, Age 52


Throbbing or stabbing migraine symptoms can accompany hormone changes in women, especially related to menstruation. Around 70% of migraine sufferers are women, and 60-70% of all women who experience migraine attacks report a link between their symptoms and their menstrual cycle.

These regular and often literally blinding headaches can be debilitating, but home remedies can soothe the discomfort and help you through. These include:

  • Applying an ice pack

  • Reducing stress triggers by practicing relaxation techniques

  • Non-steroidal anti-inflammatory drugs (NSAIDs) and prescription pain medication

  • Acupuncture

  • Prescribed headache medications like Triptans and Gepants

  • Biofeedback

  • Avoiding dietary triggers like red wine or lectins

Weak Bones

Estrogen is closely linked to bone strength, reducing the natural breakdown of bones and helping the body absorb calcium. Low estrogen during and after menopause can increase bone loss and the risk of osteoporosis. High cortisol and thyroid hormone imbalance can also lead to more fragile bones and more frequent fractures.

You can keep your bones strong during menopause by:

  • Using regular bone density scanning to identify a high fracture risk

  • Strength training 

  • Consuming enough vitamin D and calcium in your diet 

  • Hormone therapy, particularly as you age

  • Medications like risedronate or bisphosphonates if you’re over 60

Learn more about how to spot a hormone imbalance in our article: Think You Have a Hormone Imbalance? How to Know if Your Levels Are Off.

What Causes Hormonal Imbalance in Women?

There are several causes of hormonal imbalances in women, including menopause and perimenopause, pregnancy, poor diet, sedentary lifestyle, weight gain, birth control pills, PCOS, and primary ovarian insufficiency. Most of these causes of female hormone imbalance are rooted in the endocrine system.

Your endocrine glands pump hormones throughout your body. They adjust their output to meet changing physical demands from certain health conditions, medications, and life events like pregnancy or menopause. 

These shifts can trigger the many symptoms of hormonal changes in women that are listed above. 

woman smilingMenopause/Perimenopause

Menopause signifies 12 consecutive months without a period. The average age of natural menopause in the U.S. is 51, preceded by perimenopause, which lasts an average of four years. Before reaching menopause, women may encounter changes in their monthly cycles, hot flashes, vaginal dryness, and other symptoms, known as perimenopause — the result of estrogen and progesterone levels fluctuating wildly.


As an embryo grows in the womb, a woman’s hormones adjust to nourish the fetus, thicken the uterine lining, stimulate milk production in the breasts, and maintain a healthy pregnancy. These hormones include estrogen, progesterone, human placental lactogen (hPL), and human chorionic gonadotropin (hCG).

Birth Control Medications, Implants, and IUDs

Some women use hormonal birth control pills, rings, or patches to prevent pregnancy. These usually provide a combination of estrogen and progestin (or progestin only) to prevent ovulation and egg implantation or make access difficult for sperm. However, these birth control techniques can also lead to hormonal changes in women, sometimes causing headaches, mood changes, and spotting.


PCOS is a condition that affects 6-12% of women in the U.S. It causes higher-than-usual levels of androgens and is the most common cause of infertility. PCOS can also increase insulin resistance — another type of hormone imbalance, linked to unwanted weight gain and an increased risk of diabetes, high blood pressure, and stroke.

Primary Ovarian Insufficiency (POI)

Doctors use POI to describe ovaries that stop functioning before a woman is 40 years of age. Women with POI often don’t get a period every month and may experience infertility. POI leads to low estrogen levels. The causes of POI can include genetic disorders, chemo, radiation and other toxins, autoimmune disease, although the cause is often unknown. 

Diseases that Affect Female Hormones

Several diseases and health conditions can severely impact your hormones, including:

Diagnosis: What to Do When You’ve Had Enough

The symptoms of hormonal imbalance in women are both disruptive and unpredictable. A doctor can help you identify the hormone that’s responsible, usually with a blood test. They may also ask about your medical history, including symptoms and menstrual cycle regularity.

Since levels fluctuate throughout the day (and throughout your cycle for women who are menstruating), you may need more than one test to confirm imbalances of some hormones, like testosterone or progesterone.

Your doctor may also perform a physical exam, possibly requesting an ultrasound scan to check your ovaries, uterus, thyroid, or pituitary gland for abnormalities or tumors.

FSH home-testing kits are available that claim to indicate your menopause status. However, they don’t accurately confirm menopause, as FSH levels change during the menstrual cycle and perimenopause.

woman doing yogaHormonal Imbalance in Women: Treatment with Supplements and Medications

Hormone optimization starts with recognizing the symptoms, and often ends with supplementing the low hormones. After measuring your hormone levels with a blood test, your doctor can prescribe the following hormones to help you balance female hormones. There are natural supplements that can help with symptoms if you’re unable to go on hormones, or if you prefer a natural option for symptom relief.

Transdermal Estrogen

Transdermal estrogen may help correct a hormonal imbalance in women, via patches and creams. Transdermal estrogen can help keep your hormone levels in a steady state, and ,and studies suggest transdermal estrogen is safer than oral estrogen tablets.


Doctors may prescribe a combination of estrogen and oral micronized progesterone to boost your levels of these hormones and restore regular periods. Oral micronized progesterone capsules can also treat premenopausal bleeding and premature labor. 


As a crucial building block of estrogen, supplemental testosterone may improve your estrogen production. Women experiencing mood swings, low energy, and low libido because of low testosterone may benefit from testosterone therapy.


This hormone is a precursor to both estrogen and testosterone. Many perimenopausal women rely on DHEA to relieve symptoms that affect their energy, skin tone, and sex drive, and it may also help with vaginal dryness.


This oral medication may help people with increased insulin resistance control their blood sugar and reduce their risk of diabetes complications like stroke and heart disease. It can also help insulin-resistant women manage weight gain.

Desiccated Thyroid

People with hypothyroidism can supplement their levels with desiccated thyroid. Studies have shown that taking this supplement can significantly resolve symptoms, although it may take several weeks to notice an improvement.

Learn more in our guide: How to Balance Hormones: 9 Natural Methods.


A hormonal imbalance in women can cause unwanted changes to skin, sleep, and sex drive, as well as mood swings and weight gain. Many hormonal changes in women are a natural but uncomfortable part of female biology, such as menstruation and menopause. Others result from medical conditions that need active treatment. 

However, even if you do experience a hormone imbalance, you can still enjoy a high quality of life and start feeling like you again — by seeking support and finding the best treatment plan for you.

woman stretching47% of American women ages 30-60 have experienced the symptoms of a hormonal imbalance, yet 72% say they didn’t know it until later in life. Even the slightest imbalance can cause fatigue, reduced sex drive, difficulty losing weight, and more. Our at-home blood test measures the 40+ biomarkers that impact your health, hormones, and quality of life, including:

  • Better Sleep

  • Reduced Weight Gain

  • Increase Libido

  • Improved Focus & Energy

This article was medically reviewed by Kimberly Hartzfeld, DO, ABOG American Board of Obstetrics and Gynecology, IFMCP Institute for Functional Medicine Certified Practitioner.

Originally published on July 25, 2023. Updated on June 20, 2024.

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