Hormonal Imbalance

What are hormones?

Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it. Hormones are essential for life and your health.

Scientists have identified over 50 hormones in the human body so far.

Hormones and most of the tissues (mainly glands) that create and release them make up your endocrine system. Hormones control many different bodily processes, including:

• Metabolism.
• Homeostasis (constant internal balance).
• Growth and development.
• Sexual function.
• Reproduction.
• Sleep-wake cycle.
• Mood.

What is a hormonal imbalance?

A hormonal imbalance happens when you have too much or too little of one or more hormones. It’s a broad term that can represent many different hormone-related conditions.

Hormones are powerful signals. For many hormones, having even slightly too much or too little of them can cause major changes to your body and lead to certain conditions that require treatment.

Some hormonal imbalances can be temporary while others are chronic (long-term). In addition, some hormonal imbalances require treatment so you can stay physically healthy, while others may not impact your health but can negatively affect your quality of life.

What conditions are caused by hormonal imbalances?

Dozens of medical conditions are caused by hormone issues. For most hormones, having too much or too little of them causes symptoms and issues with your health. While many of these imbalances require treatment, some can be temporary and may go away on their own. Some of the most common hormone-related conditions include:

• Irregular menstruation (periods): Several hormones are involved in the menstrual cycle. Because of this, an imbalance in any one or several of those hormones can cause irregular periods. Specific hormone-related conditions that cause irregular periods include polycystic ovary syndrome (PCOS) and amenorrhea.
• Infertility: Hormonal imbalances are the leading cause of infertility in people assigned female at birth. Hormone-related conditions such as PCOS and anovulation can cause infertility. People assigned male at birth can also experience hormonal imbalances that affect fertility, such as low testosterone levels (hypogonadism).
• Acne: Acne is primarily caused by clogged pores. While many factors contribute to the development of acne, hormone fluctuations, especially during puberty, are a significant factor. Oil glands, including those in the skin on your face, get stimulated when hormones become active during puberty.
• Hormonal acne (adult acne): Hormonal acne (adult acne) develops when hormonal changes increase the amount of oil your skin produces. This is especially common during pregnancy, menopause and for people who are taking testosterone therapy.
• Diabetes: In the United States, the most common endocrine (hormone-related) condition is diabetes. In diabetes, your pancreas doesn’t make any or enough of the hormone insulin or your body doesn’t use it properly. There are several different kinds of diabetes. The most common are Type 2 diabetes, Type 1 diabetes and gestational diabetes. Diabetes requires treatment.
• Thyroid disease: The two main types of thyroid disease are hypothyroidism (low thyroid hormone levels) and hyperthyroidism (high thyroid hormone levels). Each condition has multiple possible causes. Thyroid disease requires treatment.
• Obesity: Many hormones can affect how your body signals that you need food and how your body uses energy, so an imbalance of certain hormones can result in weight gain in the form of fat storage. For example, excess cortisol (a hormone) and low thyroid hormones (hypothyroidism) can contribute to obesity.

What are the signs and symptoms of hormonal imbalance?

Because your body makes over 50 different hormones — all of which contribute to important bodily functions — you could experience several different symptoms depending on which hormonal imbalance you have.

It’s important to know that many of the following symptoms could be caused by other conditions, not just from a hormonal imbalance. If you ever notice a change in your day-to-day health and are experiencing new, persistent symptoms, it’s important to talk to your healthcare provider — no matter what you think the cause might be.

Hormone imbalance symptoms that affect your metabolism

Common hormonal imbalances include those that affect your metabolism. Your metabolism consists of the chemical reactions in your body's cells that change the food you eat into energy. Many different hormones and processes are involved in metabolism.

Symptoms of hormonal imbalances that affect your metabolism include:

• Slow heartbeat or rapid heartbeat (tachycardia).
• Unexplained weight gain or weight loss.
• Fatigue.
• Constipation.
• Diarrhea or more frequent bowel movements.
• Numbness and tingling in your hands.
• Higher-than-normal blood cholesterol levels.
• Depression or anxiety.
• Being unable to tolerate cold temperatures or warm temperatures.
• Dry, coarse skin and hair.
• Thin, warm and moist skin.
• Irregular body fat distribution.
• Darkened skin in your armpit or the back and sides of your neck (acanthosis nigricans).
• Skin tags (small skin growths).
• Extreme thirst and frequent urination.

Sex hormone imbalance symptoms for people assigned female at birth

People assigned female at birth (AFAB) can have imbalances of the sex hormones estrogen and progesterone, which the ovaries produce. They can also have excess testosterone and androgens. An imbalance in sex hormones can cause the following symptoms in people AFAB:

• Acne on your face, chest and/or upper back.
• Hair loss.
• Heavy periods.
• Hirsutism (excess body hair).
• Hot flashes.
• Infertility.
• Irregular periods.
• Loss of interest in sex.
• Vaginal atrophy.
• Vaginal dryness.

Sex hormone imbalance symptoms for people assigned male at birth

People assigned male at birth (AMAB) can have an imbalance of testosterone, which the testes produce, and other sex hormones, which can cause the following symptoms:

• Decrease or loss of body hair.
• Erectile dysfunction (ED).
• Gynecomastia (enlarged breast tissue).
• Infertility.
• Loss of interest in sex.
• Loss of muscle mass.

Can hormone imbalance cause weight gain?

Yes, certain hormone imbalances can cause weight gain, including:

• Hypothyroidism: This condition happens when you have low levels of thyroid hormone, which causes your metabolism to slow down. This can cause weight gain.
• Cushing’s syndrome: This is a rare condition that happens when your body has too much of a hormone called cortisol. It results in rapid weight gain in your face (sometimes called “moon face”), belly, back of your neck (sometimes called “buffalo hump”) and chest.
• Menopause: During menopause, many people assigned female at birth gain weight due to hormonal changes that cause their metabolism to slow down. It’s important to remember that this type of “hormonal imbalance” is natural and an expected part of life.

Several other factors contribute to weight gain. If you’re experiencing unexpected weight gain or are concerned about your weight, talk to your healthcare provider.

Can hormone imbalance cause anxiety?

Yes, certain hormonal imbalances can cause anxiety, including:

• Hyperthyroidism: If you have hyperthyroidism, it means your body has too much thyroid hormone. Excess thyroid hormone speeds up your metabolism. This can cause anxiety, in addition to unusual nervousness, restlessness and irritability.
• Cushing’s syndrome: While it’s not as common of a symptom, Cushing’s syndrome (excess cortisol) can cause anxiety, as well as depression and irritability.
• Adult-onset growth hormone deficiency: Adults with growth hormone deficiency often report having anxiety and/or depression.

Several other conditions and factors can cause anxiety. It’s important to talk to your healthcare provider if you’re experiencing anxiety.

What causes hormonal imbalances?

Throughout your life — and even throughout the day — your hormone levels naturally rise and fall.

Certain periods of life cause more dramatic changes and fluctuations in hormones, including:

• Puberty.
• Pregnancy.
• Menopause.

However, there are several other reasons why your hormone levels may be irregular at unexpected times. Some of the most common causes of fluctuating or imbalanced hormone levels include:

• Stress.
• Certain medications.
• Steroid use.

These hormonal imbalances are more likely to be temporary or fixable with a change in medication or properly managing stress.

Chronic hormone-related conditions can have several different possible causes. In general, the main conditions or situations that cause medically significant hormone imbalances include:

• Tumors, adenomas or other growths.
• Damage or injury to an endocrine gland.
• Autoimmune conditions.

Tumors, adenomas and growths

Any kind of growth on a gland or organ that produces hormones, such as a tumor, adenoma or nodule, could affect its ability to do so.

Tumors

Rare endocrine tumors form in glands or in cells that produce hormones and can cause hormone imbalances. Some of the rare endocrine tumors include:

• Adrenocortical carcinoma: An adrenocortical carcinoma (ACC) is a cancerous adrenal tumor that forms in the adrenal cortex. It sometimes causes excess hormone production.
• Carcinoid tumors: Carcinoid tumors are a type of neuroendocrine tumor (NET) that grows from neuroendocrine cells. Neuroendocrine cells receive and send messages through hormones to help your body function.
• Medullary thyroid cancer: Medullary thyroid cancer (MTC), is cancer that forms in the inside of your thyroid (the medulla). The medulla contains special cells called parafollicular C cells that produce and release hormones.
• Pheochromocytoma: A pheochromocytoma is a rare tumor that forms in the middle of one or both of your adrenal glands (adrenal medulla). The tumor is made of a certain type of cell called chromaffin cells, which produce and release certain hormones. They’re usually benign but can be cancerous.
• Paraganglioma: A paraganglioma (also known as an extra-adrenal pheochromocytoma) is a rare neuroendocrine tumor that forms near your carotid artery, along nerve pathways in your head and neck and in other parts of your body. The tumor is made of chromaffin cells, which produce and release certain hormones.

Adenomas

An adenoma is a benign (noncancerous) tumor. Many adenomas are nonfunctioning, meaning they don’t produce hormones. But some can produce excess hormones. These are called functioning adenomas. Adenomas that affect your endocrine system and cause hormone imbalances include:

• Pituitary adenomas: Pituitary adenomas can cause an imbalance in any of the hormones your pituitary gland makes. For example, pituitary adenomas are the most common cause of acromegaly (excess growth hormone in adults).
• Adrenal adenomas: The most common cause of Cushing’s syndrome (excess cortisol) is an adrenal adenoma on the adrenal cortex.
• Parathyroid adenomas: A parathyroid adenoma can cause primary hyperparathyroidism (excess parathyroid hormone).

Other growths

Growths other than tumors and adenomas on endocrine glands can cause hormone imbalances. For example, thyroid nodules, an unusual growth (lump) of cells in your thyroid gland, can cause hyperthyroidism or hypothyroidism.

Damage or injury to an endocrine gland

Any kind of damage or injury to an endocrine gland can cause hormone imbalances — usually a lack (deficiency) of hormones. Damage could result from the following conditions or situations:

• Accidental damage from surgery: For example, approximately 75% of hypoparathyroidism (low parathyroid hormone) cases are from accidental damage to your parathyroid glands from neck or thyroid surgery.
• Excessive blood loss or lack of blood flow to an endocrine gland: Lack of blood flow can cause tissue to die (necrosis). For example, Sheehan’s syndrome, a cause of hypopituitarism, can happen when a person experiences severe blood loss after childbirth.
• Bacterial or viral illness: For example, hypopituitarism can be a complication of bacterial meningitis, though this is rare.
• Radiation therapy: Radiation therapy for cancer treatment can damage endocrine glands. For example, up to 50% of people treated for head and neck cancer with radiation therapy develop hypothyroidism.
• Brain or head trauma (also called traumatic brain injury, or TBI): Situations such as a vehicle accident, a fall or contact sports can cause head trauma and brain injuries, which can cause damage to your pituitary gland or hypothalamus.

Autoimmune conditions

An autoimmune disease happens when your immune system accidentally attacks a part of your body instead of protecting it. It's unclear why your immune system does this. If your immune system attacks a gland or organ that produces hormones, it causes a hormonal imbalance. Autoimmune endocrine conditions include:

• Hashimoto’s disease.
• Graves’ disease.
• Type 1 diabetes.
• Addison’s disease.
• Polyglandular syndromes.

How are hormonal imbalances diagnosed?

Healthcare providers typically order blood tests to check hormone levels since your endocrine glands release hormones directly into your bloodstream.

Certain hormone levels vary drastically throughout the day, so providers may order other tests to measure your levels, such as a glucose tolerance test or insulin tolerance test.

Your provider will also ask you about your medical history and symptoms and perform a physical exam.

How are hormonal imbalances treated?

Treatment for a hormonal imbalance will depend on what’s causing it.

If you have lower-than-normal hormone levels, the main treatment is hormone replacement therapy. Depending on which hormone is deficient, you may take oral medication (pills) or injection medication.

For example, if you have low thyroid hormone levels (hypothyroidism), your provider can prescribe synthetic thyroid hormone pills. If you have growth hormone deficiency, you’ll likely have to take injections (shots) of synthetic growth hormone.

If you have higher-than-normal hormone levels, there are many treatment options depending on the cause. Options include medication, surgery, radiation therapy or a combination of any of these.

For example, if you have a prolactinoma, a benign (noncancerous) tumor that causes excess prolactin (a hormone), your provider may prescribe a medication to shrink the tumor or you may need surgery to remove it.

How do you fix hormonal imbalance?

Many health conditions that involve hormonal imbalances, such as diabetes and thyroid disease, require medical treatment.

Many nutritional supplements in stores claim to treat different hormonal imbalances, but few of them have been scientifically proven to have a beneficial effect. It’s important to always talk to your healthcare provider first about taking supplements.

Aside from medical treatment, your provider may recommend certain lifestyle changes to help manage a hormonal imbalance, such as managing your stress levels and getting routine exercise.

What kind of doctors treat hormonal imbalances?

Primary healthcare providers can diagnose and help you manage many hormonal imbalances, but you may benefit from seeing an endocrinologist.

An endocrinologist is a healthcare provider who specializes in endocrinology, a field of medicine that studies conditions related to your hormones. They can diagnose endocrine (hormone) conditions, develop treatment and management plans and prescribe medication.

How can I prevent a hormonal imbalance?

While many hormonal imbalances aren’t preventable, there are certain things you can do to optimize your overall health, which could help keep your hormones balanced, including:

• Maintaining a healthy weight.
• Eating a balanced, healthy diet.
• Exercising regularly.
• Managing your stress.
• Getting enough quality sleep.
• Managing your chronic health conditions well (if applicable).
• Quitting smoking or using tobacco products, if you smoke.

When should I see my healthcare provider about a hormonal imbalance?

If you’re experiencing new, persistent symptoms, it’s important to talk to your healthcare provider. They can order tests to help determine the cause of your symptoms.

A note from Cleveland Clinic

Hormones are complex and powerful chemicals. If one or more of them goes out of whack, it can cause certain symptoms that make you feel like you’re not in control of your body. If you have new and persistent symptoms, it’s important to talk to your healthcare provider. They can order some tests to see if a hormonal imbalance or another condition is the cause. The sooner you reach out for help and treatment, the sooner you’ll be able to feel like yourself again.