Everything You Should Know About Hormonal Imbalance

A disruption in hormonal balance can produce a variety of signs, from gaining weight to persistent tiredness. Appropriate treatment can address many of the root causes.

Hormones act as your body’s chemical communicators.

Made by the endocrine glands, these potent substances circulate in your blood and direct tissues and organs on how to function. They regulate many key bodily processes, including metabolism and reproductive function.

When a hormonal imbalance occurs, you have either too much or too little of a particular hormone. Even small shifts can lead to significant effects throughout your body.

Some hormone fluctuations are normal during life stages and can result from natural aging. Other changes arise when endocrine glands produce excess or insufficient quantities of certain hormones.

Continue reading to learn more about hormonal imbalances and their potential impact on your health.

Symptoms of hormonal imbalance

Your hormones are central to overall wellbeing. Certain signs may point to a hormonal imbalance, though the exact symptoms depend on which hormones or glands are involved.

Common hormonal conditions that can cause imbalances might produce symptoms such as:

• weight gain
• a fatty hump between the shoulders
• unexplained or sudden weight loss
• fatigue
• muscle weakness
• muscle aches, soreness, and stiffness
• joint pain, stiffness, or swelling
• faster or slower heart rate
• excessive sweating
• heightened sensitivity to cold or heat
• constipation or more frequent bowel movements
• frequent urination
• increased thirst
• increased appetite
• reduced sex drive
• depression
• nervousness, anxiety, or irritability
• blurred vision
• infertility
• thinning or fine, brittle hair
• dry skin
• puffy face

Remember that these signs are not specific to hormones alone. Having one or several of them does not automatically mean a hormonal imbalance is present.

Some of these symptoms may also point to other long-term conditions. If you notice meaningful changes in your body or energy, consult your doctor.

Symptoms in people who were assigned female at birth (AFAB)

For people with ovaries, the most frequent hormonal disorder is polycystic ovary syndrome (PCOS).

Hormone patterns also shift naturally during life stages like:

• puberty
• pregnancy
• breastfeeding
• menopause

Symptoms of hormonal imbalance specific to AFAB individuals include:

• heavy or irregular periods — missed, stopped, or frequent cycles
• hirsutism, meaning excessive facial or body hair
• acne on the face, chest, or upper back
• hair thinning
• hyperpigmentation (darker skin patches), especially in neck folds, the groin, and under the breasts
• skin tags
• vaginal dryness
• vaginal thinning (atrophy)
• pain during intercourse
• night sweats
• headaches

Note that several of these problems, including hirsutism, can affect people of other sexes as well.

Symptoms in people who were assigned male at birth (AMAB)

Testosterone is crucial for development. Insufficient testosterone production can cause a range of symptoms.

Hormonal imbalance symptoms in AMAB people include:

• gynecomastia, or enlarged breast tissue
• breast tenderness
• erectile dysfunction (ED)
• reduced beard and body hair growth
• loss of muscle mass
• loss of bone density (osteoporosis)
• difficulty concentrating
• hot flashes

Keep in mind that AFAB individuals can also experience testosterone imbalances.

Symptoms in children

Children begin producing sex hormones at puberty. Many with delayed puberty will eventually progress normally, but some have a condition called hypogonadism.

People with hypogonadism may experience:

• limited development of muscle mass
• a voice that fails to deepen
• sparse body hair growth
• underdeveloped penis and testicles
• excessive limb growth relative to the trunk
• gynecomastia
• absence of menstruation
• underdeveloped breast tissue
• no increase in growth rate

Causes of a hormonal imbalance

There are numerous potential causes of hormonal imbalance, which vary based on the hormones or glands affected.

Common triggers of hormonal imbalance include:

• hormone therapy
• certain medications
• cancer treatments like chemotherapy
• tumors, benign or malignant
• pituitary tumors
• eating disorders
• chronic stress
• injury or trauma
• insulin resistance

While hormonal imbalances can initiate some of the conditions below, having these conditions can also further disrupt hormone levels:

• type 1 and type 2 diabetes
• diabetes insipidus
• hypothyroidism (underactive thyroid)
• hyperthyroidism (overactive thyroid)
• overactive thyroid nodules
• thyroiditis
• hypogonadism
• Cushing syndrome (elevated cortisol)
• congenital adrenal hyperplasia (low cortisol and aldosterone)
• Addison’s disease

Causes unique to AFAB people

Many AFAB hormonal imbalances relate to reproductive hormones. Typical causes include:

• menopause
• primary ovarian insufficiency (premature menopause)
• pregnancy
• breastfeeding
• PCOS
• hormonal medications, for example, birth control pills

Tests for hormonal imbalance

There isn’t a single definitive test to diagnose a hormonal imbalance. Start with a visit to your physician for a physical exam.

Be ready to describe your symptoms and when they began. List all medicines, vitamins, and supplements you take.

Your provider may inquire about:

• How often you have symptoms
• Whether anything eases them
• Recent weight changes
• Whether you’re experiencing more stress than usual
• The date of your last period
• Whether you’re planning pregnancy
• Problems obtaining or maintaining an erection
• Vaginal dryness or pain with sex

Depending on your symptoms, your doctor may order one or more diagnostic tests. You can also request specific tests.

Blood test

A provider can order blood tests to evaluate thyroid function and hormone levels such as estrogen, testosterone, and cortisol.

Pelvic exam

For people with a uterus, an internal exam may be performed to check for unusual lumps, cysts, or masses.

For those with testicles, a doctor may examine the testicles and scrotum for lumps or irregularities.

Ultrasound

An ultrasound uses sound waves to visualize structures inside the body. Doctors may request ultrasounds of the:

• uterus
• ovaries
• testicles
• thyroid
• pituitary gland

Additional tests

Sometimes more advanced diagnostics are needed, including:

• biopsy
• MRI
• X-ray
• thyroid scan
• sperm analysis (semen analysis)

At-home tests

If you’re noticing symptoms, you might consider a home testing kit. These are available for various conditions. While it’s best to consult a doctor, since they may recommend further evaluation, home kits can offer an initial indication.

Menopause kits typically measure follicle-stimulating hormone (FSH) in urine. FSH rises as menopause begins but also fluctuates during the normal menstrual cycle. Other factors, like hormonal birth control, can affect FSH readings.

Keep in mind these kits may suggest that menopause has started but cannot confirm it definitively. Healthcare confirmation

A disruption in hormonal balance can produce a variety of signs, from gaining weight to persistent tiredness. Appropriate treatment can address many of the root causes.

Hormones act as your body’s chemical communicators.

Made by the endocrine glands, these potent substances circulate in your blood and direct tissues and organs on how to function. They regulate many key bodily processes, including metabolism and reproductive function.

When a hormonal imbalance occurs, you have either too much or too little of a particular hormone. Even small shifts can lead to significant effects throughout your body.

Some hormone fluctuations are normal during life stages and can result from natural aging. Other changes arise when endocrine glands produce excess or insufficient quantities of certain hormones.

Continue reading to learn more about hormonal imbalances and their potential impact on your health.

Symptoms of hormonal imbalance

Your hormones are central to overall wellbeing. Certain signs may point to a hormonal imbalance, though the exact symptoms depend on which hormones or glands are involved.

Common hormonal conditions that can cause imbalances might produce symptoms such as:

• weight gain
• a fatty hump between the shoulders
• unexplained or sudden weight loss
• fatigue
• muscle weakness
• muscle aches, soreness, and stiffness
• joint pain, stiffness, or swelling
• faster or slower heart rate
• excessive sweating
• heightened sensitivity to cold or heat
• constipation or more frequent bowel movements
• frequent urination
• increased thirst
• increased appetite
• reduced sex drive
• depression
• nervousness, anxiety, or irritability
• blurred vision
• infertility
• thinning or fine, brittle hair
• dry skin
• puffy face

Remember that these signs are not specific to hormones alone. Having one or several of them does not automatically mean a hormonal imbalance is present.

Some of these symptoms may also point to other long-term conditions. If you notice meaningful changes in your body or energy, consult your doctor.

Symptoms in people who were assigned female at birth (AFAB)

For people with ovaries, the most frequent hormonal disorder is polycystic ovary syndrome (PCOS).

Hormone patterns also shift naturally during life stages like:

• puberty
• pregnancy
• breastfeeding
• menopause

Symptoms of hormonal imbalance specific to AFAB individuals include:

• heavy or irregular periods — missed, stopped, or frequent cycles
• hirsutism, meaning excessive facial or body hair
• acne on the face, chest, or upper back
• hair thinning
• hyperpigmentation (darker skin patches), especially in neck folds, the groin, and under the breasts
• skin tags
• vaginal dryness
• vaginal thinning (atrophy)
• pain during intercourse
• night sweats
• headaches

Note that several of these problems, including hirsutism, can affect people of other sexes as well.

Symptoms in people who were assigned male at birth (AMAB)

Testosterone is crucial for development. Insufficient testosterone production can cause a range of symptoms.

Hormonal imbalance symptoms in AMAB people include:

• gynecomastia, or enlarged breast tissue
• breast tenderness
• erectile dysfunction (ED)
• reduced beard and body hair growth
• loss of muscle mass
• loss of bone density (osteoporosis)
• difficulty concentrating
• hot flashes

Keep in mind that AFAB individuals can also experience testosterone imbalances.

Symptoms in children

Children begin producing sex hormones at puberty. Many with delayed puberty will eventually progress normally, but some have a condition called hypogonadism.

People with hypogonadism may experience:

• limited development of muscle mass
• a voice that fails to deepen
• sparse body hair growth
• underdeveloped penis and testicles
• excessive limb growth relative to the trunk
• gynecomastia
• absence of menstruation
• underdeveloped breast tissue
• no increase in growth rate

Causes of a hormonal imbalance

There are numerous potential causes of hormonal imbalance, which vary based on the hormones or glands affected.

Common triggers of hormonal imbalance include:

• hormone therapy
• certain medications
• cancer treatments like chemotherapy
• tumors, benign or malignant
• pituitary tumors
• eating disorders
• chronic stress
• injury or trauma
• insulin resistance

While hormonal imbalances can initiate some of the conditions below, having these conditions can also further disrupt hormone levels:

• type 1 and type 2 diabetes
• diabetes insipidus
• hypothyroidism (underactive thyroid)
• hyperthyroidism (overactive thyroid)
• overactive thyroid nodules
• thyroiditis
• hypogonadism
• Cushing syndrome (elevated cortisol)
• congenital adrenal hyperplasia (low cortisol and aldosterone)
• Addison’s disease

Causes unique to AFAB people

Many AFAB hormonal imbalances relate to reproductive hormones. Typical causes include:

• menopause
• primary ovarian insufficiency (premature menopause)
• pregnancy
• breastfeeding
• PCOS
• hormonal medications, for example, birth control pills

Tests for hormonal imbalance

There isn’t a single definitive test to diagnose a hormonal imbalance. Start with a visit to your physician for a physical exam.

Be ready to describe your symptoms and when they began. List all medicines, vitamins, and supplements you take.

Your provider may inquire about:

• How often you have symptoms
• Whether anything eases them
• Recent weight changes
• Whether you’re experiencing more stress than usual
• The date of your last period
• Whether you’re planning pregnancy
• Problems obtaining or maintaining an erection
• Vaginal dryness or pain with sex

Depending on your symptoms, your doctor may order one or more diagnostic tests. You can also request specific tests.

Blood test

A provider can order blood tests to evaluate thyroid function and hormone levels such as estrogen, testosterone, and cortisol.

Pelvic exam

For people with a uterus, an internal exam may be performed to check for unusual lumps, cysts, or masses.

For those with testicles, a doctor may examine the testicles and scrotum for lumps or irregularities.

Ultrasound

An ultrasound uses sound waves to visualize structures inside the body. Doctors may request ultrasounds of the:

• uterus
• ovaries
• testicles
• thyroid
• pituitary gland

Additional tests

Sometimes more advanced diagnostics are needed, including:

• biopsy
• MRI
• X-ray
• thyroid scan
• sperm analysis (semen analysis)

At-home tests

If you’re noticing symptoms, you might consider a home testing kit. These are available for various conditions. While it’s best to consult a doctor, since they may recommend further evaluation, home kits can offer an initial indication.

Menopause kits typically measure follicle-stimulating hormone (FSH) in urine. FSH rises as menopause begins but also fluctuates during the normal menstrual cycle. Other factors, like hormonal birth control, can affect FSH readings.

Keep in mind these kits may suggest that menopause has started but cannot confirm it definitively. Healthcare confirmation may be needed.

Other at-home kits analyze saliva or a finger-prick blood sample to assess cortisol, thyroid hormones, and sex hormones such as progesterone and testosterone. Some tests use urine.

These services usually require mailing the sample to a lab. Results commonly become available online within 5 to 9 business days.

The company LetsGetChecked offers at-home tests that have FDA approval. However, many at-home hormone tests lack FDA approval.

No matter which at-home test you choose, review the results with your healthcare provider and discuss any concerning symptoms or possible diagnoses.

Treatment options for a hormonal imbalance

Treatment depends on the underlying cause. Common approaches include:

Estrogen therapy

If menopausal symptoms like hot flashes trouble you, your doctor may suggest a low dose of estrogen.

Discuss the benefits and risks of hormone replacement therapy (HRT) with your clinician. If you need a provider, you can search for local doctors through tools like Healthline FindCare.

Vaginal estrogen

For vaginal dryness or discomfort during sex, a physician may recommend topical estrogen in the form of a cream, tablet, or ring.

Local vaginal therapy reduces many of the risks linked to systemic estrogen that circulates throughout the bloodstream.

Hormonal birth control

Hormonal contraceptives can help normalize menstrual cycles. Forms include:

• birth control pills
• patch
• shot
• vaginal ring
• intrauterine device (IUD)

Certain types of hormonal contraception may also help reduce acne on the face and body.

Anti-androgen medications

Androgens are male hormones found in all genders. Elevated androgen levels can be treated with drugs that block androgen effects.

These treatments can improve:

• hair loss
• excess facial hair
• acne

Testosterone is a key androgen linked to hair growth and loss. Research has shown that too little testosterone is associated with hair thinning and reduced growth.

Testosterone therapy

Testosterone replacement can reduce symptoms of low testosterone. In adolescents with delayed puberty, it can trigger puberty. It’s available as injections, patches, and gels.

Testosterone replacement therapy (TRT) carries risks, including cardiovascular concerns.

Thyroid hormone therapy

For hypothyroidism, synthetic thyroid hormones like levothyroxine (Levoxyl, Synthroid, Unithroid) can restore normal hormone levels.

Metformin

Metformin, a medication for type 2 diabetes, may help some people with PCOS. The FDA has not approved it specifically for PCOS, but it may reduce androgen levels and encourage ovulation. It is often used off-label for this purpose.

Flibanserin (Addyi) and bremelanotide (Vyleesi)

Flibanserin (Addyi) and bremelanotide (Vyleesi) are the only FDA-approved medications for low sexual desire in premenopausal people. Addyi is taken orally, while Vyleesi is a self-administered injection.

These medications can have serious side effects, including severe nausea and blood pressure changes. Discuss with your doctor whether they’re suitable for you.

Eflornithine (Vaniqa)

This prescription cream is intended for excessive facial hair. Applied to the skin, it slows new hair growth but doesn’t remove existing hair.

Natural remedies and supplements

Many dietary supplements claim to address menopause and hormonal imbalance, but few have strong scientific backing.

Some contain plant-derived hormones often labeled “bioidentical” because they resemble human hormones chemically. There is no evidence they outperform standard hormone therapy, and they are not regulated by the FDA to the same extent as prescription hormones.

Some people find yoga helpful for easing hormonal symptoms. Yoga supports strength, flexibility, and balance, and it may aid weight loss, which can further help hormone regulation.

You can also adopt these lifestyle measures:

• Lose weight: If advised by your doctor, weight reduction can help normalize menstrual cycles and improve fertility chances. Weight loss may also benefit erectile function.
• Eat well: A balanced diet supports overall health.
• Reduce vaginal discomfort: Use lubricants or moisturizers without parabens, glycerin, or petroleum.
• Avoid hot flash triggers when possible: Identify and limit exposure to common triggers like warm environments, spicy foods, or hot drinks.
• Remove unwanted hair: For excess facial or body hair, options include depilatory creams, laser hair removal, or electrolysis.

Hormonal imbalance and acne

Acne primarily stems from excess oil production that clogs pores. It tends to occur in oil-rich areas such as the:

• face
• chest
• upper back
• shoulders

Acne is commonly related to the hormonal shifts of puberty, but hormones influence acne across the lifespan.

Acne and menstruation

The menstrual cycle is a frequent acne trigger. Many people develop breakouts the week before their period and then see improvement afterward.

Dermatologists may recommend hormone testing for individuals who have acne along with other signs like irregular periods or excess facial/body hair.

Acne and androgens

Androgens worsen acne by overstimulating oil glands.

Children of all genders have elevated androgen levels during puberty, which is why acne is common then. These levels usually stabilize in the early 20s.

Hormonal imbalance and weight gain

Hormones are essential to metabolism and how your body uses energy. Treating weight gain caused by a hormone disorder requires treating the underlying condition.

Some hormonal disorders, such as Cushing syndrome, raise the risk of overweight or obesity. Cushing syndrome involves high cortisol levels, which increase appetite and fat storage.

Severe hypothyroidism can also lead to weight gain.

Mild hormone shifts during menopause can contribute to weight gain as metabolism slows, and you may notice increased weight despite unchanged diet and exercise habits.

Hormonal imbalance and pregnancy

Normal pregnancy involves major hormonal changes that differ from a pathological hormonal imbalance.

Pregnancy and PCOS

Hormonal imbalances like PCOS are a leading cause of infertility. In PCOS, hormone disruption can interfere with ovulation. While lack of ovulation prevents pregnancy, irregular ovulation in PCOS can still result in conception.

If you have PCOS and are trying to conceive, your doctor may suggest strategies to boost fertility, including weight loss if recommended. Prescription drugs can stimulate ovulation and improve chances of becoming pregnant.

In vitro fertilization (IVF) is an option if medications don’t work. Surgery can sometimes temporarily restore ovulation as a last resort.

PCOS can raise the risk of complications during pregnancy for both parent and baby, such as:

• gestational diabetes
• miscarriage
• preeclampsia
• cesarean delivery (C-section)
• high birth weight
• neonatal intensive care admission and longer stays

Having PCOS does not guarantee any of these outcomes. Following your doctor’s guidance is the best way to support a safe pregnancy and delivery.

Pregnancy and hypothyroidism

Babies born to people with untreated hypothyroidism are at increased risk for developmental problems, including intellectual and developmental disabilities.

Managing hypothyroidism under your doctor’s care can reduce these risks.

Hormonal imbalance and hair loss

Most hair loss, like male pattern baldness, is hereditary but can be influenced by hormonal disturbances. Hormone changes sometimes cause temporary hair shedding.

In AFAB individuals, hair loss is often linked to:

• pregnancy
• childbirth
• the onset of menopause

Both overproduction and underproduction of thyroid hormones can also lead to hair loss.

Other complications

Hormone imbalances are associated with many chronic health problems. Without appropriate treatment, you may be at risk for serious medical issues such as:

• type 1 and type 2 diabetes
• diabetes insipidus
• high blood pressure
• high cholesterol
• heart disease
• neuropathy
• obesity
• sleep apnea
• kidney damage
• depression and anxiety
• endometrial cancer
• breast cancer
• osteoporosis
• loss of muscle mass
• urinary incontinence
• infertility
• sexual dysfunction
• goiter

The bottom line

Hormones govern many of your body’s central processes. When they fall out of balance, symptoms vary widely.

Because hormonal imbalances can lead to multiple complications, seeking care early is important. Talk with your doctor as soon as you notice changes in your body or energy to address a hormonal imbalance promptly.