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Hormonal Imbalance In Women – Signs, Symptoms and Treatments

Hormones play a key role in women's health, so an imbalance can cause a variety of symptoms.

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Hormonal imbalances in women can greatly impact physical, mental, emotional, and reproductive health. That’s why it is important to understand the function of hormones in a woman’s body and the signs and symptoms to look out for.

Hormones are the body’s chemical messengers. They are produced by endocrine glands and travel around the body via the bloodstream to cells and tissues, carrying out their designated functions. Hormones are involved in many major bodily processes and aren’t just about fertility.

How Do Hormones Impact Women’s Health?

When it comes to women’s health, hormones are a vital factor.

The female sex hormones, follicle-stimulating hormone, luteinizing hormone, oestrogen and progesterone play a crucial role in women’s reproductive health. But these hormones also play a huge role across all aspects of women’s health, impacting energy, mood, and metabolism.

Hormones play a role throughout all of a woman’s life from puberty to menopause. So, when they become “imbalanced” in terms of mistiming or levels it can cause a wide range of issues.

Learn more about the menstrual cycle.

What Are The Signs & Symptoms Of Hormone Imbalance In Women?

The signs and symptoms of hormone “imbalance” will depend on the cause and the hormones involved but can include a range of symptoms such as:

  • irregular or absent periods (amenorrhoea)
  • acne
  • anxiety/depression
  • blurred vision
  • digestive issues, constipation or diarrhoea
  • difficulty concentrating
  • dry skin
  • excess hair growth (hirsutism)
  • fertility issues
  • frequent peeing
  • increased thirst
  • hair loss
  • heart palpitations
  • heavy, long periods
  • intolerance to the cold or heat
  • low sex drive
  • memory problems
  • mood changes
  • muscle weakness, cramps, aches
  • oily skin
  • pins and needles
  • puffy face
  • slow heartbeat
  • slow movements, thoughts, and speech
  • sweating
  • tiredness
  • weight gain
  • weight loss [8, 9, 10]

Top 3 Causes of Hormone “Imbalance” in Women

The most common causes of hormone “imbalance” in women are:

  1. Perimenopause/Menopause
  2. Low energy availability
  3. PCOS

1. Perimenopause/Menopause

The perimenopause and menopause is not a disease or condition, it is a natural part of a woman’s life.

It is caused by the ovaries becoming less responsive to the control hormones – FSH and LH – which leads to a decline in ovarian response hormones – oestrogen and progesterone. Ultimately, this leads to a woman’s periods stopping altogether.

The decline of oestrogen levels is the main cause of the symptoms associated with perimenopause.

You can find out more about menopause on our Guide to the Menopause blog.



2. Low energy availability

Exercise can also play a crucial role in endocrine dysfunction, especially in women. Some research shows that half of exercising women included in one study, had subtle disruptions in their menstrual hormones, while one third experienced no periods at all [11].

The underlying cause is low energy condition caused by an inadequate calorie intake and/or excessive energy expenditure [12]. This is in turn results in the clinical syndrome of relative energy deficiency in sport (RED-S). This includes in women irregular cycle and amenorrhoea (lack of periods). Dr Nicky Keay explains that female exercisers are at a greater risk of internal and external changes because their endocrine/hormonal system is more finely balanced than in men. So, it can lead to disruption to the menstrual cycle as well as increased cortisol levels and lower thyroid hormone levels. All of which can have a direct impact on, not only performance but general health [13].

3. Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common condition affecting ovarian function. The ovaries are responsible for producing two of the hormones needed for regulating the menstrual cycle.

In PCOS, many small, fluid-filled follicles appear on the ovaries, each containing an immature egg. However, none of these eggs develop enough to trigger ovulation, causing low progesterone levels and abnormally high male hormones, especially testosterone.

The symptoms of PCOS, include:

  • Irregular or absent periods
  • Excess hair growth (hirsutism)
  • Weight gain
  • Hair loss
  • Thinning hair
  • Oily skin and acne
  • Fertility issues [8]

How Is Female Hormonal “Imbalance” Diagnosed?

The underlying cause of female hormone “imbalance” is diagnosed by a combination of symptoms and blood analysis.

Perimenopause/Menopause and Low Energy Availability

Our advanced female hormone blood test, MyFORM™, has been specifically designed to indicate if symptoms are related to perimenopause or low energy availability in athletes.

This ground-breaking new product uses artificial intelligence combined with blood analysis and clinical expertise to map all 4 female hormones across an entire menstrual cycle. It also provides a score to indicate how responsive your ovaries are to the control hormones
FSH and LH.

Learn more about MyFORM™>>

Polycystic Ovary Syndrome

PCOS is generally diagnosed by symptoms, having ruled out other conditions.

The Rotterdam diagnostic criteria for diagnosing PCOS requires that 2 out of the following 3 are confirmed:

  1. Infrequent periods (oligoovulation) or lack/absence of periods (anovulation)
  2. Excessive amounts of testosterone otherwise known as hyperandrogenism
  3. polycystic ovaries on ultrasound

Other conditions or diseases must ruled out, these include:

  • Genetic disorders affected the adrenal glands
  • Androgen secreting tumours of the ovaries or adrenal glands that are rare causes of excessive testosterone levels that often mimic PCOS
  • Cushing syndrome
  • Thyroid dysfunction
  • Abnormally high levels of prolactin (hyperprolactinaemia)

How To Fix Hormonal “Imbalance” In Women

The treatment options available to women who have a hormonal “imbalance” will depend on the underlying cause.

If the diagnosis is perimenopause, then it’s recommended that women take HRT to help replenish their levels of oestrogen and progesterone.

Learn more about the benefits of HRT.

As well as medication, an important factor in the treatment and management of hormonal “imbalances” is lifestyle. Eating a healthy, balanced diet, getting lots of exercise, reducing stress, getting good sleep, limiting alcohol intake, and giving up smoking are all positive steps you can take to improve hormone health.


Hormones play a huge role in women’s overall health as well as fertility, so it’s important that any symptoms of hormone imbalance are investigated.

Understanding what’s normal for you is a good first step in managing your hormone health. With MyFORM™ you can track the 4 key female hormones over time to develop a unique map personalised to you of these hormones across an entire menstrual cycle. Helping you to gain deeper insights into your body and overall health.

Read Next: ‘What Is MyFORM™?’>>

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MyFORM™ is the most scientifically advanced test available to women who want to check if their hormones are fluctuating in the correct pattern over the entire course of their menstrual cycle. This test is suitable for women who want to check their fertility, those who want to identify or manage a hormone related condition such as PCOS, sportswomen who may be at risk of RED-S or any woman who wants to check their female hormone network is healthy.
MyFORM™ is the most scientifically advanced test available to women who want to check if their hormones are fluctuating in the correct pattern over the entire course of their menstrual cycle.


  1. You and Your Hormones. (2021). Hormones.
  2. Mihm, M., Gangooly, S and Muttukrishna, S. (2011). The Normal Menstrual Cycles in Women. Animal Reproduction Science: 124, pp 29-23
  3. Reed, B, G and Carr, B, R. (2018). The Normal Menstrual Cycle and the Control of Ovulation.
  4. Jacobson, M, H et al. (2019). Thyroid Hormones and Menstrual Cycle Function in a Longitudinal Cohort of Premenopausal Women. Paediatr Perinat Epidemiol: 32(3), pp 225-234.
  5. You and Your Hormones. (2019). Cortisol.
  6. Fugate Woods, N., Sullivan Mitchell, E and Smith-DiJulio, K. (2010). Cortisol Levels During Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause: 16(4), pp 708-718.
  7. Woods, N et al. (2006). Increased Urinary Cortisol Levels During the Menopause Transition. Menopause: 13(2), pp 212-221.
  8. National Health Service. (2019). Symptoms Polycystic Ovary Syndrome
  9. British Thyroid Foundation. (2018). Hyperthyroidism.
  10. De Souza, M, J et al. (2010). High Prevalence of Subtle and Severe Menstrual Disturbances in Exercising Women: Confirmation Using Daily Hormone Measures. Hum Reprod: 25(2), pp 491-503.
  11. Statuta, S, M., Asif, I, M & Drezner, J, A. (2017). Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine: 51(21).
  12. Keay, N. (2018). Cumulative Endocrine Dysfunction in Relative Energy Deficiency in Sport (RED-S)
  13. Rymer, J., Brian, K and Regan, L. (2019). HRT and Breast Cancer Risk. BMJ: 367.
  14. Ladrón de Guevara, N, M et al. (2016). Benefits of Physical Exercise in Postmenopausal Women. Maturitas.
  15. British Nutrition Foundation. (2018). Healthy Eating and the Menopause.
Medically Reviewed
Dr Nicky Keay
Chief Medical Officer, BA, MA (Cantab), MB, BChir, MRCP.​
This article has been medically reviewed by Forth's Chief Medical Officer, Dr Nicky Keay.
Nicky has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas’ Hospital.


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