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11 unexpected signs of hormonal imbalance

A young girl holding a cup of coffee looks out the window with a concerned look on her face. She's wearing a colorful plaid shirt.

On top of all the pressures and stressors of everyday life, women in their teens, 20s and 30s are often faced with the physical, mental and emotional effects of hormonal imbalance. These imbalances manifest primarily in the levels of two hormones in particular: estrogen and progesterone. Irregular menstrual cycles, pelvic pain and uterine fibroids are just a few of the symptoms that can occur when the balance of these two hormones is off. Statistics show that 80 percent of women suffer from hormonal imbalance. Some women live with these imbalances without even realizing it; in fact, 70 percent are unaware of conditions like PCOS that may have manifested due to hormonal irregularities. Christine Mullin (MD, FACOG, IVF Director at Northwell Health Fertility) is here to help you recognize the 11 unexpected signs of hormonal imbalance.  

1. Irregular menstrual cycles

A woman’s menstrual cycle typically ranges from 21 to 35 days. If this doesn’t quite add up with your normal monthly cycle, it could be a sign of hormonal imbalance and you should see your OB/GYN. They will work with you to develop a treatment plan that addresses this variance. Irregular periods can also be a sign of polycystic ovary syndrome (PCOS), a hormonal disorder that typically comes to light in early adulthood and can cause enlarged ovaries, cyst-like follicles surrounding the eggs. Women experiencing PCOS often don’t ovulate regularly, or at all. They may also experience prolonged menstruation cycles.

For women who are not trying to conceive, the typical treatment for PCOS is birth control. Birth control contains progestin, which can help alleviate some of the symptoms associated with PCOS. For women who are trying to conceive, things get a little more complex. Your OB/GYN might recommend medications like clomiphene, or metformin, which deliver a similar dose of hormones, helping to regulate ovulation and menstrual cycles.

2. Infertility

Some women in their 20s and 30s may start thinking about settling down and having a family. Hormonal imbalance can make that major life milestone a little tricky. If you’ve been trying to conceive for six months without success, it may be time to speak with your doctor and to undergo an evaluation.

3. Hot flashes and night sweats

Are you experiencing random hot flashes throughout the day, or waking up covered in sweat? These symptoms are a major red flag for hormone imbalance and are mostly likely due to a drop in estrogen levels. Although its rare, these symptoms could also be a sign of ovarian failure. Don’t put off seeing your doctor if you’re experiencing these symptoms.

4. Persistent weight gain

Weight gain or trouble losing weight is one of the many uncomfortable and frustrating symptoms of hormonal imbalance. Many women experience this issue even if they workout four or five times a week and are mindful of their calorie intake. This can be attributed to stressed out adrenals or an imbalance associated with PCOS.

5. Hair loss

There are a wide range of conditions that cause hair loss, some of the most common being pregnancy and PCOS. Skin conditions such as psoriasis and seborrheic dermatitis can also cause hair loss.

6. Pelvic pain

If you’re experiencing pelvic pain during your period or during intercourse, it is imperative that you visit your doctor. These symptoms could be signs of a hormonal imbalance creating endometriosis (implants of tissue outside the uterus), fibroids (which are estrogen driven), or ovarian cysts. All can be either medically, or surgically removed. Your doctor will work with you to uncover the treatment plan that best fits your individual condition.

7. Fatigue

Relying on one too many cups of coffee to get you through the day? While this could be attributed to a change in sleep, diet or exercise, hormonal changes in the brain that control your thyroid can also lead to ongoing fatigue. Fatigue can also be linked to depression. In fact, people who suffer from depression are more than four times as likely to feel tired.

8. Cold hands and feet

If you have cold hands and feet on occasion, don’t be alarmed. However, if it is persistent and associated with changes in skin color, you may have an issue with nerves or blood circulation. This can also be linked to hormonal conditions like diabetes or lupus.

9. Premenstrual syndrome (PMS)

Premenstrual syndrome, or PMS, refers to the symptoms that occur right before your period, such as cramps, breast tenderness and changes in your mood. This hormonal imbalance can be treated with a number of medications and remedies. Your doctor will work with you to come up with a customized plan that addresses your particular symptoms.

10. Heavy menstrual periods

Unusually heavy menstrual cycles are fairly common and often become the norm for most women, but they still warrant an evaluation. Heavy periods can be due to fibroids, benign masses in the uterus fueled by estrogen. These can be controlled through medical and surgical treatments.

11. Breast discharge

If you are not currently breastfeeding and you’re experiencing milky colored discharge from your breasts, this could be attributed to overproduction of hormones from your brain. This can lead to visual changes and issues with ovulation and the length of your menstrual cycle. Medical treatment is usually effective.

Hormone imbalance is a common condition that can affect many aspects of a woman’s life. It’s important to communicate any and all symptoms you’re experiencing with your doctor, so they can come up with a treatment plan that best addresses your situation.

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