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We Need to Talk About Hormone Imbalance and Why They’re so Tricky to Test


Writers note: This article was originally published in August 2020 and has been updated in July 2021

My grandpa, a navy orthopedic surgeon turned country GP, always said: “eyes, ears and hands should be the first tools of the physician”. It has always stuck with me. Medicine, and increasingly naturopathy, rely on lab tests to determine diagnosis and treatment. The thing is when it comes to hormones, testing has many limitations:

  • Hormone blood levels do not always match tissue levels
  • Many hormones follow a cyclical cadence and time of day surges
  • False positives and negative are common.
  • Female hormones vary in relation to ovulation (this is especially tricky for people with irregular cycles)
  • Cost and time involved

In the spirit of my wise grandfather, I’ve put together some simple guidelines. These only need your sensing self to help determine if a hormone imbalance may be at play for you. See these as broad brushstrokes, then work with a practitioner to get an accurate diagnosis from there.


What even is a hormone imbalance?

The hormonal system is complex. Its job is to send messages all around the body. Each hormone has its unique message, and like any good conversation when hormones are balanced, there’s a smooth flow of communication. Everyone is listening to one another and responding.

Yet, sometimes that conversation might not be going through as smoothly. In some circumstances, hormones might start getting rowdy and loud. Shouting but not listening. Others may go quiet and shrink into the corner only managing to whisper. When communication gets tripped up like this, a hormonal imbalance is experienced.

Factors that can cause a hormone imbalance are manifold, but some of the major ones are:

  • Stress
  • Inflammation and immune system dysregulation
  • Imbalances within the microbiome
  • Overburdened detoxification pathways
  • Hormone-disrupting chemicals
  • Diet and lifestyle factors
  • And certain medications (especially contraceptive medications).

Let’s take a look at the ups and downs of six essential hormones and understand what they do in the body.


Estrogen Hormone Imbalance

Estrogen is an umbrella term for a group of hormones important for womxn’s health. They’re involved in the maturation and the healthy functioning of all the female reproductive organs and tissues.

During our reproductive years – from puberty to menopause – estrogen is chiefly formed from the ovaries.
The three types of estrogen are:

  1. Estradiol – the ovarian hormone of the premenopausal years
  2. Estrone – the ovarian hormone of the menopausal years
  3. Estriol – a weak estrogen that is present at high levels during pregnancy.

High levels of estrogen…

Can result in nausea, breast tenderness, insulin resistance, fluid retention, anxiety, heavy menstrual bleeding, fibrocystic or tender breasts, irregular periods and loss of memory.

Low levels of estrogen…

Can result in depression, low libido, difficulty climaxing, vaginal dryness, night sweats and scanty periods.


Progesterone Hormone Imbalance

The ovaries produce progesterone following ovulation. It rises 1400% during the luteal phase (the second half of the cycle post ovulation). Progesterone acts on specific receptors in every tissue in the body that estrogen also acts upon. Its primary job is to help mature and stop the growth caused by estrogen. I often refer to progesterone as the Yin to estrogen’s Yang.

Progesterone’s primary job is to develop the lining of the womb, so that is ready for an egg to implant. If fertilization and implantation do not occur, both estrogen and progesterone levels will decrease, and a period will follow.

High levels of progesterone…

High levels of progesterone only occur in pregnancy. This is not considered an imbalance; it’s one of the few situations where high levels of progesterone are sustained.

If there are high levels of progesterone that are picked up on lab work that is outside of the luteal phase and you’re not pregnant, this needs to be investigated by an endocrinologist.

Low levels of progesterone…

Common signs include breakthrough bleeding, spotting, period pain, fibrocystic breasts, fluid retention, low libido, difficulty climaxing, hot flashes, irregular periods, mood swings and miscarriage. If progesterone remains low for long periods, it can also compromise bone health.


Testosterone Hormone Imbalance

Testosterone is a major androgen (a.k.a male hormone) made by the adrenal glands and ovaries in womxn. The testicles produce testosterone in men.

High levels of testosterone in womxn…

High levels of testosterone in womxn is a hallmark the condition anovulatory androgen excess (AAE), also known as polycystic ovarian syndrome (PCOS). Signs include irregular periods, acne, male pattern hair loss, and facial hair.

Low levels of testosterone…

Results in low libido, depression, fatigue, lack of muscle tone, loss of memory and vaginal dryness.

Printable moon map and fertility chart by Clara Bitcon Bailey Naturopath

Cortisol Hormone Imbalance

Cortisol is a hormone made by the adrenal glands in response to stress. This doesn’t need only to be mental and emotional stress. This is any kind of stress, including dietary restraint, illnesses or intense exercise.

High levels of cortisol…

Include irritability, anxiety, feeling tired and wired, insomnia, irregular periods, multiple attempts of ovulation, overwhelmed or simply feeling “stressed out”.

Low levels of cortisol…

Low cortisol can occur after cortisol levels have been high for an extended period, and then the body has to downregulate its production and response. Signs include low libido, night sweats, weight gain around the middle, brain fog, low-stress tolerance, weak immunity, fatigue and depression.


Cycle Charting Tip: If you notice, based on your fertile science that you can see your cervical mucus is indicating that your body is making multiple attempts of ovulation. This pattern is a hallmark of a stress pattern cycle and is most commonly linked with cortisol and in some cases thyroid hormone. If you see this sign in your chart, it’s a good idea to focus on addressing your stress levels and prioritizing rest and replenishment.

Hormone Imbalance by Clara Bitcon Bailey Naturopath

Thyroid Hormone Imbalance

Thyroid hormones are produced by the thyroid gland, which is a small butterfly-shaped gland that sits at the front of the windpipe. It governs energy metabolism, which is closely linked with heart rate, body temperature and extracting energy from food. Low thyroid function is a widespread condition in womxn. An autoimmune disease called Hashimoto’s thyroiditis is one of the most common causes of an under-functioning thyroid.

It can also be caused by long periods of stress, as thyroid hormone is protectively decreased when a person is an undernourished, very stressed or experiencing illness.

High levels of thyroid hormone…

High levels of thyroid hormone s a sign of hyperthyroidism. Symptoms include anxiety, fast metabolism, always feeling hot and sweaty, heart palpitations, hyperactivity, irregular cycles and scanty periods.

Low levels of thyroid hormone…

Low levels of thyroid hormones are a sign of hypothyroidism. And is associated with low libido, depression, fatigue, weight gain, hair loss, cold intolerance, dry skin, constipation, menstrual cycle disturbances (typically irregular or short cycles and heavy flow).


Charting Tip: A sign that your thyroid may be under-functioning is recording three consecutive readings of your basal body temperature in the first half of your cycle (before ovulation) that is 36.4C/97F or below. If this is accompanied with a luteal phase that is less than 11 days and you experience any of the symptoms of low thyroid function, it’s a good idea to talk with your doctor about these symptoms and discuss getting a more thorough test done.


Insulin Hormonal Imbalance

I can’t talk about hormonal imbalances without mentioning insulin! Insulin is a hormone made by the pancreas, which is an organ that operates half as a digestive organ and half as a hormone organ. Insulin handles the metabolism of sugar; allowing sugar to be moved into the cells so that it can form energy.

A complete lack of insulin is the cause of type I diabetes. What we see more and more in the West is type II diabetes and insulin resistance. These latter two occur when too much sugar is being consumed, and insulin has had to overwork. The body’s response to insulin becomes blunted and resistant.

It’s a good idea to get your blood glucose checked and your insulin levels checked if you:

  • Have a waist circumference of over 88 centimetres as a women, (or 100 centimetres as a man)
  • Experience up and down energy throughout the day
  • Holding on abdominal belly fat Experiencing any of the other hormonal imbalances.


Charting your cycle provides terrific insight into hormone imbalance

Charting your two main fertile signs, cervical mucus and basal body temperature is my favourite way to understand someone’s hormonal landscape. It allows us to get a very clear idea of what imbalances may be occurring, and then from there, inform further testing or adjustments you can make in your diet and lifestyle to help re-correct those imbalances.

If you would like to start charting your cycle and beginning to see what your patterns are, you can download my free fertility chart bundle, which includes an email series that will teach you the basics of cycle charting — download over here.


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References & Resources:

Billings, E. L., Brown, J. B., Billings, J. J., & Burger, H. G. (1972). SYMPTOMS AND HORMONAL CHANGES ACCOMPANYING OVULATION. The Lancet, 299(7745), 282–284.

Brown, J. B. (2011). Types of ovarian activity in women and their significance: The continuum (a reinterpretation of early findings). Human Reproduction Update, 17(2), 141–158.

Hopkinson, Z. E. C., Sattar, N., Fleming, R., & Greer, I. A. (1998). Polycystic ovarian syndrome: The metabolic syndrome comes to gynaecology. BMJ : British Medical Journal, 317(7154), 329–332.

Joseph, D. N., & Whirledge, S. (2017). Stress and the HPA Axis: Balancing Homeostasis and Fertility. International Journal of Molecular Sciences, 18(10), 2224.

Kalantaridou, S. N., Makrigiannakis, A., Zoumakis, E., & Chrousos, G. P. (2004). Stress and the female reproductive system. Journal of Reproductive Immunology, 62(1), 61–68.

Briden, L. (2015). Period Repair Manual: Natural Treatment for Better Hormones and Better Periods (First Edition January 2015 edition). CreateSpace Independent Publishing Platform.

Norwitz, E. R., & Schorge, J. O. (2010). Obstetrics and Gynecology at a Glance (3 edition). Wiley-Blackwell.

Romm, A. (2009). Botanical Medicine for womxn’s Health, 1e (1 edition). Churchill Livingstone.

Trickey, R. (2004). Women, Hormones & the Menstrual Cycle: Herbal & Medical Solutions from Adolescence to Menopause (Fully revised and updated edition edition). Allen & Unwin.

We Need to Talk About Hormone Imbalance and Why They’re so Tricky to Test by Clara Bailey, Naturopath and Herbalist 3

Fertility & Conception

July 28, 2021

  1. […] Urine and saliva tests are typically provided by private labs and can come with a hefty price tag. So unless you’re very clear on when you ovulate (and if you’re ovulating), the results won’t provide you with much clarity. If you’d like to read more on hormonal imbalances in general and why testing can be tricky, make sure you read this article. […]

  2. […] Now that you understand how profoundly connected our nervous systems and our mindsets are for registering and mediating stress let’s take a look at the other side of the equation: the hormone system. […]

  3. […] If you’re unable to find a holistic practitioner to work with, informing yourself and then opening up a discussion with your doctor may lead to your symptoms being taken seriously and these labs getting done for you.  I’ve written more about the subtleties of testing for hormones over here. […]

  4. […] We Need to Talk About Hormone Imbalance and Why They’re so Tricky to Test […]

  5. […] We Need to Talk About Hormone Imbalance and Why They’re so Tricky to Test […]

  6. […] We Need to Talk About Hormone Imbalance and Why They’re so Tricky to Test […]

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