If you’ve spent any time at all on social media recently, you’ve likely seen a content creator (many of which are not credentialed health experts) telling you that things like headaches, weight gain, acne, or brain fog are all related to “hormone imbalance” and that if you just eat the right foods at the right times, follow the right exercise routine, eliminate stress, and take the right supplements, your problems will magically disappear.
A casual Google search of the term “hormone balancing” yields a cool 11+ million results—and a barrage of ads for supplements—capsules, gummies, injections, and more—promising (in very vague terms) to help balance your hormones. Content and advertisements commonly target consumers seeking relief from symptoms related to issues like PMS, irregular periods, PCOS, infertility, and menopause. Some supplements are specifically geared toward managing issues of hormonal acne, bloating, mood swings, and weight gain.
While hormonal abnormalities are real, diagnosable medical conditions that require treatment through medication, dietary interventions, lifestyle approaches, or a combination, what concerns healthcare providers most is the abundance of misinformation and bogus supplements being perpetuated online. In this article, we’ll focus primarily on menstrual health and fertility-related hormonal issues but know that these are not the only hormonal issues in question.
Which Hormones Need “Balancing,” Anyway?
Cory Ruth, MS, RDN (aka The Women’s Dietitian) helps clients navigate polycystic ovary syndrome (PCOS), fertility issues, and weight management. She says, “Polycystic Ovary Syndrome (PCOS), hypothyroid issues (like Hashimoto’s Thyroiditis), endometriosis, and hypothalamic amenorrhea are among some of the most common endocrine (AKA hormone) disorders that may impact our periods and fertility.”
Shawn Tassone MD PhD, is the author of The Hormone Balance Bible. Another abnormality he commonly sees in his gynecology practice is testosterone deficiency, which can lead to low sex drive. He also sees a lot of “subclinical hypothyroid, where the thyroid level may be ‘normal’ but the thyroid is functioning in a low normal aspect” which can affect ovulation, overall fertility, and weight.
“The most common imbalances that I see in practice,” says Dr. Taz. Bhatia, a nationally recognized integrative medicine physician and author of The Hormone Shift: Thriving Through Midlife and Menopause, “include high insulin levels, undetected thyroid dysfunction, high androgens, and low progesterone.”
How To Tell If Your Hormones Are Out Of Balance
You are the expert on what is and is not normal in your body, so pay attention to any changes. When it comes to sussing out symptoms related to hormonal issues, says Ruth, “It depends on which issue you’re experiencing, but some symptoms to look out for are missing or irregular periods, fatigue, weight gain, facial or body hair growth, acne, painful periods, pelvic pain, heavy bleeding, hair loss or thinning on the head, bloating, intolerance to cold, insomnia, anxiety, depression, mood swings, and breast tenderness.”
Potential Symptoms of Imbalanced Hormones
- Missing or irregular periods
- Fatigue and/or decreased energy
- Weight gain
- Facial or body hair growth
- Acne
- Painful periods
- Pelvic pain
- Heavy bleeding
- Hair loss or thinning on the head
- Bloating
- Intolerance to cold
- Insomnia, anxiety, depression, irritability, or mood swings
- Breast tenderness
- Hot flashes
In addition to these symptoms, Dr. Tassone adds that irritability, hot flashes, and decreased energy, especially in the afternoons, may be related to hormonal function. These symptoms, he explains, may be reflective of a hormone imbalance “if and when it becomes a problem and interferes with how a woman wants to live her life.”
Because these symptoms can be related to a wide variety of other conditions, it’s important to get to the root cause. Before you order a supplement from a targeted ad on your social feed, always speak with a healthcare provider to discuss the next steps, which may entail lab tests or other screening protocols to help pinpoint what may be contributing to your symptoms.
The Importance of Hormone Testing
It’s important to understand the specific imbalance you’re treating. “I think hormone supplements have to target the hormone pattern—or the dominant hormone pattern for each woman—or they are often rendered ineffective when in fact, they were simply used incorrectly,” says Dr. Taz. “Knowing your hormone pattern is key- understanding where all the levels are for the 7 major hormones in your body and how these hormones shift and change is essential to knowing your body and then determining what it needs.”
Ruth agrees, “It’s important you first understand which hormones are high or low before seeking out a supplement to ‘balance hormones!’ For example, a supplement could be designed to lower a hormone you’re already deficient in!”
Some examples of labs to ask your doctor for, according to Ruth and Dr. Tassone include:
- A full hormone panel (ex: DHEA, Estradiol, Total Estrogens, Progesterone, Sex Hormone Binding Globulin, Free and Total Testosterone)
- A full thyroid panel (ex: TSH, Free T3, Free T4, possibly thyroid peroxidase antibodies if Hashimoto’s is suspected)
- Vitamin D
- Fasting insulin and glucose
- Hemoglobin A1C
- AMH
- Iron
- Vitamin B12
- A comprehensive metabolic panel that includes kidney and liver function tests
- A complete blood count
- Cortisol (If chronic stress is suspected to be at work, but because a blood or serum test won’t reveal much, saliva or urine tests may be utilized)
Medical Gaslighting: Advocating For Yourself
It’s also important to note that some of these tests, such as hormone tests, may need to be done at certain points in the menstrual cycle, so talk to your provider about timing these tests appropriately. If you get pushback, don’t be afraid to advocate for yourself. Medical gaslighting, especially around women’s health issues, has been a prevalent issue for a long time.
“If you ask your doctor to check your hormones and they say you don’t need to, that’s gaslighting,” says Dr. Tassone. “If you ask your doctor to test your hormones and they say why, your hormones are fluctuating all the time, that’s gaslighting. If they say hormone imbalance isn’t real, that’s gaslighting. There’s absolutely no reason the doctor shouldn’t order those labs for you. It doesn’t affect their bottom line. It doesn’t come out of their pocketbook. If you feel like you’re being gaslit, you need to push or find someone else.”
What to Do If You Do Have an Imbalance
If a medical workup does reflect that you have an imbalance in certain hormone levels, asking the right follow-up questions can help you decide what to do next. Here are a few important questions to ask:
- Which hormones do you believe may be contributing to my symptoms?
- How do you suggest I go about lowering or raising levels of these hormones?
- What other testing (if any) can you recommend? How often should this testing be repeated?
- Are there any diet or lifestyle factors that may be contributing to this issue?
If your provider recommends a supplement, ask them:
- What dosage do you recommend?
- What time of day should I take this?
- Are there any potential interactions with food or medications I need to know about?
- Can I take it at the same time as any other supplements and/or medications?
- Are there any side effects?
- Are there any specific brands or products you recommend that your patients have found helpful?
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