Hormone Imbalance

Whether you are 73 or 37, hormone imbalances can have you suffering from a multitude of symptoms such as moodiness, depression, hot flashes, breast tenderness, sleeplessness, acne, bloating, weight gain, fatigue, anger, decreased libido (sex drive), vaginal dryness, and inability to achieve orgasm. If you have a hormonal imbalance, you know it! You’ll be saying things like “I never used to feel this way”, or “suddenly, I’ve packed on 25 pounds when I used to be able to eat anything,” or “I just don’t have any interest in having sex anymore.” These are statements heard often from the woman who has even a slightly imbalanced hormonal status. Usually by the age of 34 a woman is experiencing at least a few of these symptoms.

What are the hormones and what roles do women’s hormones play in her day to day life?

There are a few dominant hormones in the female body. The most commonly recognized is Estrogen. Another is Progesterone. Testosterone, oxytocin, and prolactin also play a part as well. These hormones work in a balanced way to help regulate ovarian function, mood states (including aggression, sex drive, wellbeing, etc.), metabolism, ability to sleep, protection of bone mass, protection from heart disease and other blood vessel related issues, lowering cholesterol, as well as many other processes and functions.

How can you know if you have an imbalance?

Often women know that they themselves have an imbalance because they feel poorly, or in a different way than how they used to feel. There are also blood and saliva tests that can be done to help detect imbalances. Sometimes, a test result will be “normal” even though the woman feels abnormal. In that case, we listen to the patient and treat the symptom. After all, what may be “normal” in the lab, may not be “normal” for your body.

What test would be done to detect hormonal imbalance?

First, you would be screened for diabetes, anemia, and low thyroid; as those medical issues can often mimic hormonal states. At the same time, you will be tested for hormone levels called follicle stimulating hormone, estradiol, progesterone, leutenizing hormone, testosterone, vitamin D, iron and cortisone. It’s a lot of blood work, but it also tells us a lot about your body’s processes. The values will help dictate what treatment options will be best for you.

What are the Treatment options?

Treatment comes in many forms: Medicines may be used to help correct medical problems that exist. For instance, if you have an underactive thyroid, it will be treated first with thyroid medicine. We would also treat anemia, diabetes, or any other disease states that are detected. Then, the body can be supplemented with the hormones that are out of balance. For example, you can give a woman a very small dose of testosterone cream to apply 1 hour prior to intercourse, and she will have an increased libido and heightened pleasure during and after intercourse.

Hormone supplements can be taken as a pill, lotions to put on the skin, creams to insert into the vagina, suppositories, etc. You are able to choose which method you prefer most. Treatment is individualized. Supplements are dosed very specifically to what your body needs. This ensures you will not get too much of one hormone and not enough of another. Treatment is based in large part around your symptoms so be sure to communicate well with the provider.

Is Hormone Supplementation Safe?

The treatments that are available mimic your body’s very own hormones. Therefore, the risks to taking hormones are about the same risk of simply being alive. There is risk in everything, but hormone use does not add to the risk of living. In fact, research shows that risks of sickness, poor bone health, blood vessel problems, and mood problems are far worse in women with hormonal imbalances, compared to the women who have balanced bodies.

The decision is yours to make regarding hormone supplements, though. Ask questions and get answers before you make your decision. Your provider can sit down and consult you one these issues.
Suggested questions are:

Is there any person who should not use hormones?

Absolutely. If you smoke, and are over the age of 35, Darien Women’s Health strongly urges you to not used hormonal supplementation. However, we’d be happy to help you stop smoking so that you CAN use the supplementation in the future. Just think of the benefits to not smoking any more… healthy lungs, whiter teeth, fresher breath… and LOTS of saved money!! Smoking cessation can be easy if you do it the right way, and have the support you need. Ask for help with this, we can surely help you accomplish this task! … Now, back to hormones…

What are some common examples of a problem, and what would be its solution?

Below is a table of some solutions to common problems associated with hormonal change.

Common Problem Possible Solution
Decreased Libido Balancing testosterone and progesterone levels
Lack of Orgasm Balancing testosterone and increasing blood flow to tissues
Vaginal Dryness Balancing estrogen levels
Hot Flashes Balancing estrogen and progesterone levels
Moodiness / PMS Balancing estrogen, progesterone, testosterone and norepinephrine
Anger Balancing estrogen, progesterone, testosterone and norepinephrine
Fatigue Enhancing energy levels, balancing thyroid levels
Depression Balancing progesterone and norepinephrine
Acne Balancing estrogen, progesterone and testosterone
Sleeplessness Enhancing energy levels and balancing estrogen
Weight Gain Balancing progesterone, enhancing energy levels
Bloating Balancing progesterone
Breast Tenderness Balancing estrogen and progesterone
Cystic Breast Changes Balancing estrogen and progesterone
Infertility Balancing weight, sugar levels, and estrogen

What’s the next step in treatment?

You have a few options. If you need more education to make a decision, you can schedule a question and answer session with the provider. That session does NOT include a history or physical or prescription. It is merely an educational session. Most insurance companies will cover this cost for you. You will owe your normal deductible or copay.

If you have the information you already need, and you are ready to start the treatment process, you can schedule a history and physical exam appointment. Most insurance companies will cover the cost for this appointment. If you are overdue for an annual exam, it will also be done that same day. Therefore, you will get added benefit of having your PAP and mammogram done; if you are overdue.

A prescription for supplementation will be given to you after your lab results are back and interpreted by the provider. The turn around time is usually one week from appointment time to treatment. Follow up will take place every 3 months or more often if needed, according to your response to treatment. We hope this has been helpful information. Feel free to ask more questions if needed!