Hormonal imbalances can have lasting impacts on your entire body if left unaddressed. We recently covered several of the factors that can lead to hormone imbalances, including diet, stress levels, inflammation, blood glucose irregularities, thyroid function, medications and endocrine disruptors. These can each throw your reproductive, stress, hunger and other hormones out of balance – particularly given how finely-tuned your hormone levels need to be in relation to one another to maintain optimal bodily function and health. So what are the potential consequences of these hormone imbalances when they do occur? If they’re chronic and severe, hormonal imbalances can manifest as various reproductive health conditions or complications. It’s important to be aware of these in order to monitor what’s showing up in your own body, and to allow you to identify potential causes and contributors if you are experiencing any of these symptoms or health conditions.
1 – Endometriosis
Endometriosis is an inflammatory condition whereby endometrial tissue, similar to that which your uterus, begins to grow outside of the uterus, causing painful periods, pain during intercourse, or chronic pelvic or abdominal pain, which can vary in its severity. Other symptoms of endo include irregular periods or bleeding, infertility, subfertility, and digestive complications. This condition affects around 1 in 10 women around the world, yet is often misdiagnosed or left undetected due to a lack of awareness in both patients and health professionals.
Hormonal imbalances are a key driver of the development of endo in some cases, in particular an excess of oestrogen production and secretion. Oestrogen stimulates the growth of endometrial tissue, and can also contribute to inflammation, both of which are common symptoms of endo. While researchers have yet to be certain of the causes of endo, it’s thought that women who suffer from the condition often experience disrupted menstrual cycles as a result of imbalances in oestrogen and progesterone function, which can lead to menstrual blood (containing endometrial cells) to flow backwards into the pelvic cavity instead of being expelled through the vagina as it is in a normal period. This potentially leads to the growth of endometrial tissue outside of the uterus, causing endometriosis.
There are other theories about the causes of endo too, however there’s a general consensus within the research suggesting women with endometriosis tend to have higher levels of oestrogen and lower levels of progesterone (the reproductive hormone which counteracts or balances out oestrogen), highlighting the impact of hormone imbalance on this condition. This hormonal imbalance can worsen symptoms and speed up the progression of endo, and while we’re still uncertain of the exact mechanisms behind these hormonal imbalances, it’s clear that their existence has a crucial role in the development and progression of endo.
In fact, many of the treatments used for endo involve regulating a woman’s hormones to help manage and reduce symptoms, and slow the growth of the endometrial tissue – particularly by decreasing oestrogen production. This may involve using hormonal contraceptives, or GnRH analogues (which block the production of hormones related to the menstrual cycle, and significantly lower oestrogen secretion), as well as surgical removal of endometrial lesions or of the uterus and/or ovaries in rarer cases.
2 – Polycystic Ovarian Syndrome (PCOS)
PCOS is another health condition often caused by hormone imbalances, including excessive production of androgens (“male” hormones such as testosterone) and insulin resistance in women. This condition impacts the ovaries and can lead to irregular menstrual cycles, ovarian cysts, and sub- or infertility, as well as headaches, mood swings, weight gain, and acne. The imbalanced androgens in PCOS often lead to irregular or absent periods, making it more difficult to fall pregnant. It can also lead to unwanted hair growth on your face or body, or alternatively to hair loss. PCOS can also increase your risk of developing other health conditions like diabetes and cardiovascular disease.
In women with PCOS, the hormonal imbalances they experience mean their follicles containing an immature egg often don’t mature enough to trigger ovulation. In normal circumstances, having a regular period relies on these follicles developing into a dominant follicle which houses an egg every month, and this egg goes on to be fertilised by sperm or is alternatively discarded by the body, triggering your period. However, in the case of PCOS, the absence of ovulation (caused by excess production of androgens) also affects your production of oestrogen, progesterone, follicle stimulating hormone (FSH) and lutenising hormone (LH). Your body produces less progesterone and more androgens than normal, disrupting your menstrual cycle. This is why most women with PCOS have fewer than eight periods per year (or sometimes none at all), and these periods tend to involve very heavy bleeding as the uterine lining builds up for a much longer time than a normal menstrual cycle allows for.
While excessive production of androgens is one cause of PCOS, it can also be triggered by insulin resistance – another form of hormone imbalance. Insulin is the hormone responsible for breaking down your food into energy for use by the body. However, insulin resistance occurs if your body’s cells don’t respond normally to insulin. This results in high blood glucose levels, as insulin can’t perform its role of “mopping up” excess sugar in your bloodstream. Over time, your body produces more and more insulin in an attempt to correct the problem. Yet excess insulin causes the body to produce even more androgens, again being the primary driver of PCOS. Unhealthy eating habits, carrying extra bodyweight, low physical activity, or family history of diabetes can worsen your risk of this hormone imbalance, and over time insulin resistance can develop into type 2 diabetes if unaddressed – in addition to PCOS.
In essence, PCOS is a perfect storm of hormonal imbalances. Most women with the condition will have elevated LH and GnRH production, as well as insulin resistance, all of which can cause an absence of ovulation and contribute to excessive androgen levels. One main form of “treatment” is addressing lifestyle interventions such as dietary and exercise changes to address their symptoms.
3 – Premenstrual Syndrome (PMS) Symptoms
PMS symptoms is the term used for the collective physical and psychological symptoms some women experience in the lead up to their period. These can include bloating, pain and cramping, mood swings, appetite changes, depression or anxiety, cravings and trouble concentrating. Hormonal imbalances – specifically changes in the production of oestrogen and progesterone – have been shown to drive these symptoms.
Throughout the menstrual cycle, a woman’s production of oestrogen and progesterone fluctuate to accommodate the different phases and changes happening within the body. Essentially, prior to ovulation you begin to produce more oestrogen and progesterone to prepare your body for the implantation of a healthy embryo, should fertilisation occur. However if the egg isn’t fertilised, these hormones are no longer necessary in the same quantities, so they begin to decline, triggering your period. Interference with healthy production of both hormones can throw the system out of whack, leading to imbalances in oestrogen and progesterone, but also in other hormones like prolactin and serotonin. These imbalances can lead to the physical and mental symptoms of PMS.
For example, serotonin is a neurotransmitter responsible for mood regulation, so low levels can lead to mood swings and irritability. Similarly, prolactin is a hormone which stimulates milk production in pregnancy, so excessively high levels of prolactin can lead to bloating or water retention.
While more research into the causes of PMS is needed, it’s believed that the action of progesterone on neurotransmitters like serotonin is a key driver – particularly in women with pre-existing serotonin deficiencies or progesterone sensitivity. Increases in prolactin can also cause glucose metabolism changes, insulin resistance, and other factors contributing to PMS and its symptoms. Clearly, the causes of PMS all stem from imbalances in hormone production. These hormonal imbalances can also contribute to other PMS symptoms including fatigue, cramping and headaches.
Dysmenorrhea is a term used to describe very painful menstrual periods, and is yet another result of hormone imbalances in women – in particular an excessive production of prostaglandins, hormones produced by the body which cause uterine contractions. Prostaglandins are produced by the uterus lining during your period, causing the uterus to contract and expel your monthly bleed. However in women who suffer with dysmenorrhea, high levels of prostaglandins cause stronger, more regular contractions in the uterus, which often leads to severe pain during your period – particularly during the first two days of bleeding.
Other symptoms of dysmenorrhea, including bloating, fatigue, poor sleep quality, anxiety and depression, and headaches, are also triggered by the hormonal imbalances occurring in women who suffer from this condition. A significant number of women experience dysmenorrhea, with an estimated 45-93% of women of reproductive age being affected, yet it often goes unreported as many females believe pain is a “normal” symptom accompanying periods. Please always remember that excessive or debilitating pain isn’t normal – particularly if it’s affecting your quality of life! If you’re experiencing severe or ongoing pain, you deserve support and help, so don’t hesitate to reach out to a dietitian or health professional for the relief you need.
5. Uterine Fibroids
Uterine fibroids are non-cancerous growths found in the uterus, which can lead to heavy bleeding during your period, as well as feelings of pain and pressure in the uterus. Other side effects of fibroids include irregular uterine bleeding, pelvic pain, infertility, recurrent miscarriage, and reproductive complications. Once again, this condition is caused by hormonal imbalances – specifically excessive production of oestrogen, and is often accompanied by insufficient progesterone levels too.
Oestrogen is responsible for stimulating the growth of your uterine lining at the appropriate stage of your cycle each month, however, excessively high levels of oestrogen can lead to the growth of fibroids. Progesterone counteracts the effects of oestrogen, so low levels of progesterone can also contribute to an imbalance in oestrogen. This can again exacerbate the growth and development of uterine fibroids, as your body can’t prevent fibroids as it normally would when your hormones are balanced. Emerging research has also suggested that women who experience a heightened conversion of androgens to oestrogen are at greater risk of fibroids, as this can again lead to oestrogen and hormone imbalances. Together, these imbalances can interfere with regular menstrual cycles and hormone production, causing symptoms such as heavy bleeding, absent or irregular periods, bloating, and pain during intercourse.
Perimenopause refers to the period before menopause, during which a woman’s hormone production begins to drop. Imbalances in hormones including oestrogen have been found to contribute to the development of perimenopause. During perimenopause, your ovaries start to produce less and less oestrogen, which can also cause imbalances in other crucial hormones like progesterone, worsening your symptoms. These symptoms may include hot flushes, sweats during the night, mood swings or irritability, poor sleep, low libido, brain fog and vaginal dryness.
Unfortunately, perimenopause is fairly normal, and is simply part of the natural process whereby your ovaries gradually stop producing hormones and your reproductive years begin to come to an end. Most women notice their menstrual cycle gets longer and more irregular before eventually they stop ovulating and having a period altogether. On average, perimenopause may last for three to four years, though it affects each woman differently. While it’s a natural part of ageing, the hormonal imbalances which bring on perimenopause symptoms can be distressing and uncomfortable for some women, with treatment options including hormone replacement therapy to rebalance the affected hormones and reduce symptoms.
As you can see, hormonal imbalances affecting any hormone in the body – in particular your reproductive hormones – can have far-reaching effects on various other hormones and systems in your body, potentially causing any number of these health conditions. It’s important to be aware of the impact of hormonal imbalances, so you’re empowered by the knowledge that you can take steps to rebalance your hormones and address any symptoms you experience which may be associated with any of the above conditions. You deserve support and medical attention, so if you’re struggling or unsure of how to manage your symptoms, book in a consultation with me today and we’ll determine how best to get you the relief you need.
Book a consultation with me today if you’re concerned about your hormone production or potential imbalances, and we can work to restore your body and hormone health and return you to a balanced state.