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February 24, 2014

Hormones are Out of Balance: How to Tell

hormones are out of balanceHormones Are Out of Balance?

At some point every woman’s hormones are out of balance – that is if they live long enough. So it’s not a matter of if. It’s a matter of when. For some woman critical hormone imbalances can occur during their 30s, but for others imbalances may not occur until their 50s. So every woman is different. So how do you know when your hormones are out of balance?

Hormone Lab Tests

Well, you can have your hormone levels measured either through blood tests or saliva tests. But, lab tests simply tell you where your levels are relative to a reference range of women. We sometimes call that range the normal range, but that’s inaccurate. What’s normal for one woman isn’t necessarily normal for someone else. The reference range is determined or set based on statistical analysis. The range includes the values of the middle 95% of the women. Your hormone levels can fall in that middle of that range yet you can have every known symptom of a particular hormone deficiency.

One thing that has been consistently shown in observational studies regardless of the hormone being investigated is that there is an association with hormone levels in the upper third of the reference range and better quality of life along with lower risks of heart disease and cancer.

Target Hormone Levels for Women

Below are the levels that many physicians shoot for when treating women for hormone deficiencies. Note the differences in the units of measure being used for each hormone. Testosterone is sometimes measured in other units.

  • Estradiol:   80 to 100 pg/ml
  • Progesterone:   5 to 10 ng/ml
  • Total testosterone:   50 to 70 ng/dl
  • Free testosterone:   7 to 10 pg/ml
  • DHEA:   350 to 500 mcg/dl

Symptoms of Hormone out of Balance

A  more practical way to determine whether your hormones are out of balance – either too high or too low – is by symptoms you may feel. The more symptoms you have the more likely you are low in a given hormone.

The usual sequence of hormonal decline is this. DHEA declines in early 20s. Testosterone declines in early to mid 30s. Progesterone declines in mid 30s. Estrogen declines in 40s. Progesterone declines farther and faster than estrogen creating a hormonal imbalance called estrogen dominance – too much estrogen relative to progesterone and those women can have symptoms of “excess” estrogen. But excess estrogen can occur from exposure to estrogen like chemicals found in the environment, too. Now, it’s possible to have several hormonal imbalances and you may find you have symptoms that fall into several of the below categories.

Symptoms of Low Estrogen (estradiol)

  • Vaginal dryness
  • Night sweats
  • Painful intercourse
  • Memory problems
  • Bladder infections
  • Depression
  • Lethargy
  • Hot flashes

Symptoms of Low Progesterone

  • PMS
  • Insomnia
  • Early miscarriage
  • Painful or lumpy breasts
  • Unexplained weight gain
  • Headaches
  • Anxiety
  • Infertility

Symptoms of Excess Estrogen

  • Puffiness and bloating
  • Rapid weight gain
  • Breast tenderness
  • Mood swings
  • Anxious depression
  • Migraine headaches
  • Insomnia
  • Foggy thinking
  • Heavy menstrual bleeding
  • Weepiness or crying
  • Facial flushing
  • Abnormal pap smear

Symptoms of Low Testosterone

  • Loss of sex drive or libido
  • Hot flashes
  • Loss of muscle mass (flabby arms and thighs)
  • Anxiety
  • Depression
  • Memory difficulty

Many women do not appreciate the importance of testosterone. For more information go to this article by Dr. Rebecca Glaser who specializes in testosterone replacement in women.

Symptoms of Low DHEA

  • Loss of muscle mass
  • Fat gain
  • Loss of sense of well-being
  • Insomnia
  • Joint soreness/stiffness

So, how do you know if your hormones are out of balance. Listen to your body. You know it better than anyone else.

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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