Hormone (im)balance-is it real?
No, you're not crazy, and yes, it could be a hormonal imbalance making you feel like you are! Let's get down to business about the balance of sex hormones.
Understanding Hormone Patterns
If I had a dollar for every time I've been asked by a client, friend, or family member about whether an imbalance of their sex hormones could be a cause of their symptoms, I likely wouldn't be writing this blog because I'd be retired!
Hormones can be TRICKY, and if the person ordering your labs doesn't have a true understanding of how they ebb and flow, the results you receive on your bloodwork may very well be a meaningless number. I actually had a conversation recently where a friend told me her general practitioner voiced that “hormone panels don't mean anything, because your hormone levels change all the time”. While the second half of that statement does hold some actual truth, if we understand HOW hormones change then we can also understand how to interpret what it means based on when they are run via bloodwork.
Knowing When and How to Test Hormones
Let's first take a look at the way hormones fluctuate during a woman's menstrual cycle. The chart above explains how female ovarian and pituitary gland hormones related to ovulation and pregnancy will change throughout a woman's menstrual cycle. This chart assumes a 28 day cycle, even though many- if not most- women do not have an exact 28 day cycle every month. If you are one of those women, don't worry, we will get to that part!
While luteinizing hormone (LH) and follicular stimulating hormone (FSH) are both important when it comes to fertility, they aren't what we measure when we are working to “balance hormones”. When working with my clients, my main focus is on progesterone, estrogen, and testosterone (not shown on the chart of course).
When measuring estrogen and progesterone, we ideally want to measure them both on days 19-21 of the cycle. You can see on the chart this is where the peak of progesterone and estrogen meet 3-5 days post-ovulation. The post ovulation part is KEY when using this timeline. If a woman's cycle is irregular, and to be honest, even if it is exactly 28 days, I always recommend using an ovulation predictor kit to get this timing right. It is entirely possible to have a 28 day cycle and ovulate on day 11 rather than 14…which could make a big difference when someone is relying on these numbers to evaluate your hormonal balance!
Measuring these two hormones, at this specific time frame, gives us information not only on the singular levels of each individual hormone, but it also tells us their ratio. The progesterone to estrogen ratio can help to measure hormonal dominance in women with results within normal ranges of progesterone and estradiol (estrogen).
Let me give an example. If a woman has normal levels of estradiol and low levels of progesterone, it is clear she is dealing with an estrogen dominance issue. Logically, if she has normal levels of progesterone, but high levels of estrogen the same can be said. But what if she has normal levels of both? This is where the ratio is critical.
In healthy women, the progesterone/estradiol ratio should be between 100 and 500. If it's higher than that, it may indicate progesterone domination, and if it's lower, then estrogen domination is more likely. You can see that measuring these two hormones on, say, day 11 of a woman's cycle, would give us incorrect information for evaluation. This is the part my friend's doctor left out of their conversation. Had she told the whole story, she would have made recommendations as to when labs should be run and how to know when the timing is right.
How do you know if you should test your hormones to see if they're optimal?
The following symptoms could be caused by hormone imbalance.
Low progesterone:
Irregular periods or short cycles
Premenstrual spotting
Mood changes, such as anxiety or depression
Trouble sleeping
Headaches or migraines
Weight gain, due to fluid retention
Breast tenderness
Hot flashes
Night sweats
Vaginal dryness
High Progesterone:
Weight fluctuations
Bloating Depression
Reduced sex drive
Anxiety or agitation
Fatigue
Breast swelling and tenderness
Discomfort in the legs
Low estrogen:
Mood swings, irritability, depression, or fatigue
Dry skin, wrinkled skin, or thinning tissues
Weak or brittle bones
Irregular periods, amenorrhea (absence of menstruation), or headaches before or during your period
Hot flashes, night sweats, bladder infections, urinary tract infections, or weight gain, especially in your belly
High estrogen:
Heavy, irregular, or light bleeding
Weight gain, especially in the hips and waist, fatigue, depression, or anxiety Headaches, migraines, hair loss, cold hands or feet, memory loss, insomnia, or sleepiness
Breast tenderness or fibrocystic lumps, fibroids (noncancerous tumors) in the uterus, endometriosis, gallbladder disease, or thyroid disorders
It's important to note that many of these symptoms can be caused by a multitude of other issues as well. This is why when a client starts working with me, we run a full spectrum lab panel rather than guessing and checking along the way. This allows us to have all the information up front, which in turn means a more effective game plan for optimizing not only sex hormones, but also thyroid hormones, micronutrient levels, liver health, metabolic function, glucose management, and inflammation. While sometimes it's clear that there is a big issue with a specific system, it is much more common for several systems to be slightly off, leading to a breakdown in overall health!
Need someone to run testing for you?
As an Integrative Clinical Nutritionist, Jade has access to affordable labs of all kind, including sex hormones! If you’re looking for a lab analysis, check out the options below.