Hormonal ‘Ups and Downs’ Are Normal—but These 8 Symptoms Can Point to a True Imbalance

Photo: Getty Images/Daniel de la Hoz
The term "hormone imbalance" gets tossed around online a lot these days. You've likely heard that it's the culprit for a variety of vague health symptoms, or that "balancing your hormones" (via home remedies or so-called hormone-balancing products) means a one-way ticket back to optimal health—which, BTW, is not always the case. But what do true hormone imbalance symptoms actually look like? How do you even know if that's what you're dealing with?

Hormones are chemical messengers that travel through your body to control the function of your cells and organs. They're produced by your endocrine system—the system in charge of important things like metabolism, energy levels, growth and development, reproduction, mood, and stress response, per the Cleveland Clinic.

Experts In This Article

When the levels of a certain hormone abnormally skyrocket or plummet, symptoms can start to creep up—even leading to certain health conditions. If you're wondering whether you actually have a hormone imbalance, the best first step is to go to the doctor to get checked out.

In the meantime, here are the top symptoms of a hormone imbalance to look out for, and what conditions can happen as a result.

What is a hormone imbalance?

A hormone imbalance happens when your body starts making too much or too little of a certain hormone. In some cases, that over- or underproduction can signal an underlying health problem and potentially cause severe symptoms.

But hormonal imbalances aren't always "bad" or abnormal. Normal life events like puberty, pregnancy, and menopause are marked by massive hormone shifts (that eventually even out), says Rekha Kumar, MD, endocrinologist, chief medical officer at Found, and former American Board of Obesity Medicine medical director. For example, an estrogen imbalance can lead to menopause-related issues. Overall, these shifts can cause unpleasant symptoms, but they're not necessarily a sign of a health problem or disease.

Conditions caused by hormone imbalances

Because we make so many different hormones, there's a whole host of health conditions that stem from an imbalance. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Cleveland Clinic, here are some of the most common:

  • Thyroid dysfunction: Hyperthyroidism (where the thyroid makes too much thyroid hormone) and hypothyroidism (where the thyroid makes too little thyroid hormone) are among the most common hormone problems, Dr. Kumar says. An over- or underactive thyroid can lead to unexpected weight changes, sluggishness or restlessness, trouble maintaining body temperature, and other symptoms.
  • Acne: Hormonal highs and lows can cause your skin to produce more oil than normal, leading to clogged pores and pimples. Acne is notorious for hitting during puberty, but it can also strike in adulthood. Acne can even be a pregnancy or menopause symptom.
  • Fertility problems: Hormonal imbalances are a top reason for trouble conceiving. Sometimes fertility issues are caused by polycystic ovary syndrome (PCOS), marked by excessive levels of the androgen hormones. That can cause irregular or absent periods and affect a woman's ovulation.
  • Diabetes: Most people don't think of diabetes as a hormone imbalance, but that's essentially what it is. It happens when the body doesn't make enough of the hormone insulin or isn't able to use it effectively, causing blood sugar to build up in the blood stream. Some people with prediabetes or type 2 diabetes in particular can develop an insulin resistance, which means your body needs more of it to regulate your blood sugar, per the American Diabetes Association.
  • Cushing's syndrome: When the adrenal glands make too much of the stress hormone cortisol, a person may have Cushing's syndrome. Symptoms tend to come on slowly and can include unintended weight gain, a round face, easy bruising, and increased fat around the neck or shoulders.

Is menopause caused by a hormone imbalance?

Menopause is a life transition where people who menstruate will eventually stop. This happens as production of the hormone estrogen gradually declines. Your levels of estrogen and other hormones can fluctuate a lot in the years leading up to that final period (at which point, estrogen levels stay very low). That can cause symptoms like hot flashes, night sweats, vaginal dryness, mood swings, and irregular cycles, according to the Endocrine Society.

Those hormonal ups and downs are a completely normal part of aging, though. So experts don't consider the change to be an imbalance, per se. "I would say that menopause is more a hormonal transition that can be perceived as an imbalance," Dr. Kumar says. "The transition can lead to symptoms that can be unpleasant, but it's not a disease or an actual imbalance."

Symptoms of a hormone imbalance

Signs of a true hormone imbalance can vary a lot depending on which hormone you're talking about and whether it's too high or too low. High levels of certain hormones can "rev" up certain bodily processes, while low levels tend to slow things down, says Dr. Kumar. Here are some of the things you might notice, per Dr. Kumar:

1. Weight changes

Losing weight unexpectedly, gaining weight for no reason, or not being able to lose weight could all be signs of a hormone imbalance—particularly a thyroid imbalance. For other imbalances, you might notice that fat is accumulating in unexpected areas, like around your neck or between your shoulders (a common symptom of Cushing's syndrome, per the NIDDK).

2. Temperature sensitivity

Hormone problems can make you more sensitive to the surrounding temperature. You might feel weirdly cold, especially in your hands or feet, or notice that you're running hotter than usual or get hit with hot flashes or facial flushing, per the Cleveland Clinic.

3. Hair changes

Your hair may go through changes during a time of hormonal fluctuations. For example, too-little thyroid hormone can make your hair feel coarse and dry, or even start to thin and fall out. Your nails might also become more brittle or crack more often, too, per the Cleveland Clinic. But keep in mind: Hair thinning is also a common symptom of "normal" imbalances, like during and after pregnancy or during menopause. After giving birth, for instance, estrogen levels decrease and you can expect postpartum hair loss, according to the Cleveland Clinic.

4. Skin changes

Your skin's appearance and texture may be another sign of a hormone imbalance, especially in conjunction with other physical signs. For example, hormone imbalances can make your skin more oily and pimple-prone than usual, or they may make it drier. In some cases, an imbalance can also cause skin tags, dark patches, or even cause women to develop more facial hair (as is sometimes the case with PCOS), per Harvard Health Publishing.

5. Mood and cognitive changes

Mood changes—like an increase in depression and anxiety symptoms—can be a result of a hormone imbalance. An underactive thyroid for example can cause feelings of sadness or depression. It may even make it harder to remember things or think clearly. And if your thyroid is overactive, you might feel the opposite: anxious, nervous, or irritable, per the Mayo Clinic. And while it's not as common, Cushing's syndrome can cause mental symptoms like anxiety, irritability, and depression, per the Cleveland Clinic.

6. Changes in energy levels

Hormone imbalance from thyroid issues can lead to unexplained sluggishness or fatigue, per the Cleveland Clinic. On the other hand, you could also feel restless, "amped up," or have a hard time falling asleep. These changes in energy can also happen during normal hormonal changes, as well, like right before your period, during pregnancy, or in menopause.

7. Gut issues

Hormonal imbalances that affect your metabolism can have an effect on your gut. For example, you may find yourself running to the bathroom with diarrhea more often if you have an overactive thyroid. Or, you might have backed-up bowels if you have an underactive thyroid, per the Cleveland Clinic.

8. Heart issues

If your thyroid is overactive, you might get heart palpitations or feel like your heart is beating faster than normal. And if you have an underactive thyroid, you might notice your heart rate is slower than usual. Other hormone imbalances that affect your metabolism can cause heart issues, too, notes the Cleveland Clinic.

Symptoms in men vs. women

Depending on the hormone imbalance, you may also get sex-specific symptoms—especially if estrogen, progesterone, or testosterone levels are out of whack.

People who menstruate might find their periods are lighter or heavier than normal, or just that they're irregular, per the Office on Women's Health. In some cases, your periods might stop altogether until your thyroid problem is treated. That can make it tougher to get pregnant if you're trying, because it's harder to predict when you'll be ovulating.

People with penises might start to shed body hair, lose muscle mass, have erectile dysfunction, or have less interest in sex. Some people may also get gynecomastia—or enlarged breast tissue, notes the Cleveland Clinic.

How do you check your hormones?

Blood tests are typically the best way to have your hormone levels checked, because hormones are released into the bloodstream. Ideally, these tests should happen at a lab under specific conditions designed to give you the most accurate results (versus a test you order online and take at home).

Here's why: Your hormone levels naturally shift throughout the day in accordance with your body's circadian rhythm. To account for that, "some tests may need to be done first thing in the morning or at a certain time at night. Some may need to be taken while a person is standing, while others should be done while sitting," for instance, Dr. Kumar says.

That doesn't mean you have to avoid at-home tests altogether. You can definitely take one to get some preliminary results, which you can share with your doctor. Just know that your doc will likely want to confirm the findings with official lab testing, says Dr. Kumar.

Treatment for hormone imbalances

The treatment for your hormone imbalance depends on which hormone is affected and whether you're making too much or too little. The ultimate goal: To bring your hormones back into their "normal" range and alleviate your symptoms, Dr. Kumar says. That could include the following, per Dr. Kumar:

  • Medication to replace, stimulate, or block certain hormones—either in the form of a pill or an injection
  • Surgery
  • Radiation therapy

Mild hormone imbalances don't always require treatment. For levels that are just a little high or low, your endocrinologist might recommend just keeping an eye on it or making a few lifestyle tweaks, Dr. Kumar says. She encourages patients to really focus on core healthy habits like eating a wholesome diet, getting regular exercise, watching your alcohol intake, sleeping enough, and managing your stress. "In order to have hormones as balanced as you can, those things need to be in place," she says.

Also: Some hormone issues might clear up when you address specific things that can throw them off. Stress and certain medications, like steroids, are big culprits here, notes the Cleveland Clinic. Your doctor may also recommend additional testing to determine why a hormone level is imbalanced.

Is there a way to prevent hormone imbalances?

Not all hormone imbalances are preventable. And some hormone shifts, like those that happen during puberty, pregnancy (if you become pregnant), and menopause, are inevitable for women.

When it comes to hormone imbalances related to actual medical conditions, healthy lifestyle habits are your best option for prevention, Dr. Kumar says. She recommends reducing your exposure to endocrine disruptors—i.e., chemicals like BPA, phthalates, or PFAs—often found in things like plastics. (A good reminder to use a metal water bottle instead of a plastic one, for example.)

And again, don't discount the general body-supporting powers of a balanced diet, regular exercise, adequate sleep, and stress management. You don't need the latest and greatest "hormone-balancing products" out there, FYI.

When to see a doctor

The subtle symptoms mentioned above may not be cause for concern if they happen every now and then. They could be due to other causes, like vitamin and nutrient deficiencies, or poor lifestyle habits.

But if you notice these symptoms are persistent (i.e., last weeks or months) and think they may be related, reach out to your primary-care doctor. You should especially do so if the symptoms don't ease up with lifestyle adjustments, say Dr. Kumar. Together, you and your doctor can decide if you should be referred to an endocrinologist for further hormone testing.

And if you have any sudden and severe symptoms, like heart palpitations, trouble breathing, new or worsening pain, or significant changes to your period or weight, call your doctor or seek immediate medical care.


How do you fix a hormone imbalance?

Hormone imbalances that are due to natural life changes (think: puberty, pregnancy, and menopause) will even out on their own over time, though there are treatments that can help manage your symptoms (like acne meds, or estrogen therapy for menopause).

As for imbalances caused by an actual health condition or disease? While healthy lifestyle habits can support hormone function, medical care is generally needed to bring very high or low hormone levels back into the healthy range, Dr. Kumar says.

What foods to avoid to help balance my hormones?

There aren't necessarily specific hormone-balancing foods. But wholesome, minimally processed foods are your best bet for hormone health, says Dr. Kumar. Think fruits and vegetables, whole grains, low-fat dairy, seafood, eggs, lean meat and poultry, and healthy fats. When you feed your body the nutrition that it needs, you set yourself up for the healthiest possible hormone levels.

How can I check my hormone imbalance at home?

At-home finger prick tests like Let'sGetChecked or Paloma Health Complete Thyroid Home Test Kit can give you a preliminary sense of whether your levels of a certain hormone are too high or too low. But in order to get a formal diagnosis and treatment, your doctor will likely want to recheck your hormone levels with a lab blood test, Dr. Kumar says.

—reviewed by Jennifer Logan, MD, MPH

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