When Your Internal Orchestra Falls Out of
Tune: Understanding & Tackling Hormonal
Imbalance in People Born Female

Hormones are the body’s chemical messengers – tiny molecules with outsized influence. More than 50 different hormones work together like instruments in a symphony, keeping time so your heart beats, your bones grow, and your moods stay (more or less) predictable. When even one instrument plays out of key, the music can feel chaotic. That discord is what doctors call hormonal imbalance – too much or too little of one or more hormones circulating through your bloodstream.

Hormonal fluctuations are normal during life‑events such as puberty, pregnancy, or menopause, but persistent imbalances may point to an underlying health issue that deserves attention. This deep‑dive unpacks why people assigned female at birth (AFAB) are especially prone to hormonal swings, seven tell‑tale symptoms you should never ignore, and science‑backed strategies to regain harmony.

What Exactly Is a Hormonal Imbalance?
Every hormone leaves the gland where it is produced (thyroid, ovaries, adrenals, pancreas, and more) and travels through the bloodstream to “target” tissues. There it docks on receptors and triggers an action – speed up metabolism, calm inflammation, release another hormone, etc.  A hormonal imbalance occurs when the level of one messenger is chronically higher or lower than your body’s blueprint. Because hormones act in cascades – cortisol influencing insulin, estrogen modulating serotonin – a shift in one often sparks domino effects in others.

Systems at Stake
• Growth & development – childhood growth spurts, bone density, muscle mass
• Metabolism – how efficiently you burn food for energy
• Mood & cognition – neurotransmitter balance, focus, memory
• Reproduction & sexual function – menstrual cycle, fertility, libido
• Stress resilience – blood‑pressure regulation, blood‑sugar control

Even subtle deviations can create symptoms that seem unrelated until you connect them back to the endocrine system.

Common Root Causes in People born Female
Certain life phases naturally tilt hormone production: puberty primes estrogen and progesterone; pregnancy raises human chorionic gonadotropin (hCG); and perimenopause ushers a gradual decline in sex hormones. Yet several medical conditions – some rare, others widespread – can push levels far beyond “normal” ranges.

                Condition                                         Primary Hormones Affected                                     Quick Snapshot
Polycystic Ovary Syndrome (PCOS)            ↑ Androgens (testosterone)                     Irregular cycles, cystic ovaries, insulin
                                                                                                                                              resistance
Thyroid disorders (hypo/hyper)                    ↓ or ↑ T3 & T4                                           Weight change, hair loss, fatigue,
palpitations
Addison’s disease ↓ Cortisol, ↓
Aldosterone Salt cravings, dizziness, skin darkening
Cushing’s syndrome ↑ Cortisol Central weight gain, bruising, osteoporosis
Congenital Adrenal
Hyperplasia (CAH)
Abnormal Cortisol
& Androgens Ambiguous genitalia at birth, early puberty
Diabetes (Type 1 & 2) Insulin
dysregulation High blood sugar, thirst, slow healing
Eating disorders (e.g.,
Anorexia nervosa)
↓ Estrogen, altered
cortisol Amenorrhea, bone loss, low mood
Other triggers include tumors or cysts that secrete hormones, prescription drugs (e.g.,
birth‑control pills, chemotherapy), endocrine‑disrupting chemicals found in plastics or
pesticides, and chronic psychological stress, which keeps cortisol perpetually high.
Seven Key Signs Your Hormones May Be Out of Balance
Experiencing one of the signs below occasionally isn’t cause for alarm; experiencing several, or
one that persists, warrants a conversation with your healthcare provider.
1. Period Problems
If your menstrual rhythm suddenly shifts – skipping months, arriving twice in a month, becoming
dramatically heavier, or lasting far longer – estrogen‑progesterone feedback loops could be
misfiring. PCOS, thyroid disorders, extreme exercise, and perimenopause are frequent culprits.
2. Hair Drama (Loss or Excess)
Hormones dictate both hair density and hair distribution. Thinning along the part line often
signals low thyroid output, iron deficiency, or high stress. Coarse dark hairs sprouting on the
chin or chest (hirsutism) usually point to elevated androgens, as seen with PCOS. Research
shows that inadequate thyroid hormones disrupt the hair growth cycle and delay regrowth after
shedding.
3. Skin Surprises
Sudden acne along the jawline, unexplained melasma (dark facial patches), or velvety
discoloration in skin folds may accompany progesterone or estrogen flux. Rising progesterone
during pregnancy is notorious for back and chest breakouts, while waning estrogen after
menopause can thin skin and slow wound healing.
4. Shifts in Sexual Health
Lower estrogen means thinner vaginal tissues and reduced lubrication, making intercourse
uncomfortable. A simultaneous drop in testosterone can tank libido. Conversely, testosterone
excess may elevate desire but invite acne and scalp oiliness.
5. Unwanted Weight Fluctuations
Stubborn midsection weight after 40 often reflects a natural decline in sex hormones coupled
with increasing insulin resistance. Unexpected weight loss, on the other hand, can occur with
hyperthyroidism or untreated diabetes. Conditions such as Cushing’s syndrome (high cortisol)
promote central fat while thinning limbs.
6. Mood, Memory & Sleep Troubles
Estrogen stimulates serotonin production – the neurotransmitter that steadies mood. When levels
dip, anxiety, low mood, or irritability can appear. Night sweats, hot flashes, or an “always‑on”
fight‑or‑flight state sabotage restorative sleep, which in turn worsens hormone balance.
7. Digestive Distress
Bloating before your period isn’t “just IBS” – estrogen and progesterone receptors line the gut.
Imbalance can slow motility (constipation) or speed it (diarrhea). Emerging studies link
fluctuating ovarian hormones with higher prevalence of irritable bowel syndrome in people
AFAB.
How Professionals Diagnose Hormonal Imbalance
1. Comprehensive history & physical exam – symptom timeline, medications, family
history
2. 3. 4. 5. Targeted blood, urine, or saliva panels – e.g., day‑3 FSH/LH for fertility, diurnal
rhythm testing of cortisol for adrenal function, TSH/T4 for thyroid health
Pelvic or neck ultrasound – evaluate ovaries, uterus, thyroid, or pituitary gland
Imaging (MRI/CT) – identify tumors affecting the hypothalamic‑pituitary‑adrenal axis
Specialized stimulation or suppression tests – dexamethasone suppression for
Cushing’s, ACTH stimulation for adrenal insufficiency
Because hormones fluctuate during the day and across the menstrual cycle, timing matters. Your
provider may order repeat labs or a 24‑hour urine collection to catch peaks and valleys.
Evidence‑Based Treatment Options
“Testing tells us where you are; treatment gets you where you want to be.”
1. Conventional Medical Therapies
Therapy Goal Typical Candidates
Bioidentical Hormone
Replacement (BHRT)
Restore estrogen,
progesterone, ± testosterone
Perimenopause, menopause,
premature ovarian insufficiency
Thyroid hormone
(Levothyroxine) Replace low T4/T3 Hypothyroidism, Hashimoto’s
Insulin / GLP‑1 agonists Control blood sugar Diabetes, severe insulin resistance
Hydrocortisone or
Fludrocortisone
Substitute adrenal
hormones Addison’s disease
Anti‑androgens
(spironolactone) Lower excess testosterone PCOS with hirsutism/acne
Topical vaginal hormone creams alleviate dryness and pain without significantly affecting
systemic levels – ideal for those who cannot take oral hormones.
2. Nutritional & Lifestyle Interventions
• Anti‑inflammatory diet emphasizing colorful plants, quality protein, and omega‑3 fats
• Timed strength training to improve insulin sensitivity and raise bone‑protective growth
hormone. If diagnosed with Osteoporosis or Osteopenia, consult your healthcare
professional for guidance.
• Mind‑body stress reduction – mindfulness, breath‑work, yoga (lowers evening cortisol)
• Sleep hygiene – cool room, consistent bedtime, blocking blue light 2 hours before bed
• Environmental detox – choose BPA‑free containers, natural cleaning products, avoid
microwaving plastics
3. Practitioner‑Guided Detox Protocols
Short‑term cleansing programs using targeted nutrients can support the liver’s Phase I and
Phase II detox pathways, which conjugate and excrete excess estrogen. Important: Such
protocols should only be undertaken under the supervision of a qualified clinician.
Over‑the‑counter “detox kits” may do more harm than good.
4. Botanicals & Supplements (Proceed with Professional Guidance)
Herbs like black cohosh, chaste tree berry and nutrients (maca, vitamin D, magnesium) show
promise for mild symptoms. Purity has been shown to vary greatly (some don’t have ANY of
what is advertised on label) in big box store offerings (2015 Study), so make sure to purchase
from a reputable source (healthcare practitioner directed) where storage temperatures are
consistent. Always discuss with your provider to avoid interactions with prescribed hormones.
A Roadmap to Re‑Balancing
1. 2. 3. 4. Track symptoms – apps or paper journals reveal patterns across the cycle.
Prioritize labs – baseline panels before beginning any treatment create an objective
reference.
Personalize therapy – one size does not fit all; your optimal estrogen dose or thyroid pill
may differ from your friend’s.
Re‑test regularly – 3-6 months after initiating treatment is typical for salivary BHRT
testing.
5. Tweak as needed – lifestyle first, then fine‑tune medication or supplement dosages.
Take the Next Step Toward Hormone Harmony
Knowledge is power, but action is freedom. If any of the signs above resonate, consider
partnering with an integrative or functional medicine practitioner, like a Naturopathic Doctor,
who can look at the whole picture – not just one lab value.
Our clinic offers comprehensive hormone panels (blood (for Thyroid), urine, and/or saliva)
interpreted in the context of your unique goals. To learn more or schedule testing, email us at
contact@rushforhealth.com with the subject line “Hormone Testing.” Your body’s orchestra
deserves to play in perfect tune – let’s conduct it together.
Disclaimer: This article is for educational purposes only and is not a substitute for
individualized medical advice. Always consult a qualified healthcare professional before starting,
stopping, or changing any treatment.