Steroid Hormones Part 5: Hormonal Imbalances

At the core of many symptoms suffered by both men and women are hormonal imbalances. Imbalances occur several ways. There are deficiencies, there are excess, and there are relational imbalances. We have previously mentioned “estrogen dominance” which is an example of a relational imbalance. Relational imbalances are challenging as they can be a combination of deficiencies and excesses.

To begin our understanding let’s start with some basic lists. Estrogen imbalances include estrogen deficiency and estrogen excess.

Symptoms of Estrogen Deficiency

· Hot flashes

· Night sweats

· Insomnia

· Mood swings

· Mental fogginess, poor memory

· Dry eyes, nose, sinuses

· Vaginal dryness, dry skin

· Vaginal wall thinness, vaginal dysplasia

· Vaginal and/or bladder infections

· Incontinence, urethral irritations, urinary frequency

· Headaches, migraines

· Decreased sexual response

· Loss of ambition or drive

· Depression

· Lack of stamina

· Decreased breast size

· Wrinkling of skin

· Osteoporosis

· Loss of subcutaneous fat

· Increased risk of cardiovascular disease

Symptoms of Estrogen Excess

· Heavy bleeding

· Clotting, cramping

· Water retention, bloating

· Breast tenderness, lumpiness, cystic breasts, enlarged breasts, fibrocystic breasts

· Weight gain

· Headaches, migraines

· Emotional hypersensitivity

· Depression, irritability, anxiety, anger, agitation

· Decreased sexual response

· Thyroid dysfunction (resembling hypothyroidism)

· Cold hands and feet

· Blood sugar instability, sweet cravings

· Insomnia

· Gall bladder dysfunction (coagulated bile)

· Acne

Progesterone imbalances include progesterone deficiency and progesterone excess.

Symptoms of Progesterone Deficiency


· Heavy bleeding

· Clotting, cramping

· Inability to concentrate

· Short term memory impairment

· Muscle tension, spasm, Fibromyalgia

· Water retention, bloating

· Insomnia

· Breast tenderness, lumpiness, cystic breasts

· Weight gain

· Thyroid dysfunction (resembling hypothyroidism)

· Acne

· Headaches, migraines

· Anxiety, irritability, nervousness, moodiness

· Hot flashes

· Depression

· Decreased sexual response

· Osteoporosis

· Amenorrhea (no periods at all)

· Oligomenorrhea (infrequent periods)

· Spotting

· Endometriosis, adenomyosis (uterine endometriosis)

· Fibroids

Symptoms of Progesterone Excess (usually from overdose resulting from progesterone replacement therapy)

· Sleepiness

· Bloating or constipation (excess progesterone slows the digestive tract)

· Candida (excess progesterone can inhibit anti-candida immune system response)

· Depression

· Ligament laxity which can cause: persistent back pain; other joint pains and problems; incontinence; or mitral valve prolapse.

· Progressive progesterone deficiency symptoms (Progesterone overdose, especially with creams and gels down-regulates and eventually shuts down progesterone receptors.)

· High levels of free (unbound) cortisol which can lead to: high blood sugar; insulin resistance; weight gain; low thyroid function; sleep problems; osteoporosis; immune system dysfunction; and GI system problems. (Progesterone and cortisol compete for the same binding protein. When free progesterone floods the system long enough, it can compete with cortisol for the binding protein and release excessive amounts of cortisol into the system.)

· Loss of hormonal feedback loop coordination which disrupts multiple other hormones balances.

Testosterone imbalances can occur in both men and women.

Symptoms of Testosterone Deficiency

· Decreased stamina and energy.

· Low or absent libido.

· Poor muscle tone.

· Weakened, osteoporotic bones.

· Trouble with balance and coordination.

· Decreased sense of well-being.

· Decreased armpit and body hair.

Symptoms of Testosterone Excess

· Acne, oily skin.

· Loss of head hair (male patterned baldness).

· Excess facial hair, excess body hair.

· Mood disturbance, excessive aggressiveness, irritability.

· Deepened voice.

Estrogen Dominance

Estrogen dominance is a condition in which a woman or man can have deficient, normal, or excessive levels of estrogen, but has too little progesterone to balance the estrogen level. Estrogen Dominance has become common in both cycling and menopausal women, and men. So, why is this?

Estrogen dominance has become so predominant due to many of our modern lifestyle choices. One of the main causes is stress which sets off a whole range of hormonal chain reactions. The increased need for cortisol to handle the stress response causes more progesterone to be converted to cortisol. This may cause a shortage of progesterone to balance estrogen.

As cortisol rises insulin rises increasing fat storage. As cortisol rises thyroid hormones decrease, thus slowing metabolism and leading to fat storage. Fat cells make estrogen, exacerbating the imbalance.

Weakened glands are another reason. The adrenals may be fatigued from cortisol production and slow down progesterone production. The ovaries may not produce sufficient progesterone during the luteal phase of the cycle. Or there may be anovulatory cycles (cycles where menstruation occurs, but no ovulation) resulting in no ovarian progesterone being produced. Low thyroid function may slow down the adrenals and the ovaries as well. All these activities can create a shortage of progesterone to balance estrogen.

The use of oral or injected contraceptives by its very nature is disruptive to the production of progesterone. Remember contraceptives to not “regulate” the cycle, they “suppress” it. Their usage can have both short term and longer term impacts on progesterone production.

For menopausal women conventional hormone replacement therapy has been to provide estrogen. As we have seen, progesterone is also needed in menopause. Therefore an unbalanced replacement approach may lead to estrogen dominance.

There are also dietary and nutritional deficiency concerns. The typical American diet: usually high in carbohydrates, low in good fats, high in trans-fats, and low in vegetables and healthy sources of protein leads to nutritional deficiencies and obesity. Deficiencies in magnesium, zinc, copper, iodine, and B complex vitamins play a major role in the health of the endocrine glands and their production of hormones. Obesity is a concern as estrogen is made in fat cells and excess fat cells make excess estrogen.

Last, but certainly not least is exposure to external hormones. This includes xenohormone exposure and plant and animal hormones. The animal hormones are found in our food supply while other hormones are typically found in health and beauty products (a small amount does not have to be labeled!). Xenohormones are chemicals that disrupt our hormonal balance. These are found in health and beauty products, cleaning products, plastics, and many other unsuspecting places as well as pesticides, fungicides, and medications.

Symptoms of Estrogen Dominance

· Anxiety, irritability, anger, agitation

· Cramps, heavy or prolonged bleeding, clots

· Water retention/weight gain, bloating

· Breast tenderness, lumpiness, enlargement, fibrocystic breasts

· Mood swings, depression

· Headaches/migraines

· Carbohydrate cravings, sweet cravings, chocolate cravings

· Muscle pains, joint pains, back pain

· Acne

· Foggy thinking, memory difficulties

· Fat gain, especially in abdomen, hips and thighs

· Cold hands and feet (low thyroid function because estrogen blocks thyroid hormones)

· Blood sugar instability, Insulin Resistance

· Irregular periods

· Decreased sex drive

· Gall bladder problems (bile becomes thick and sluggish)

· Infertility

· Insomnia

· Osteoporosis

· Endometriosis, Adenomyosis

· Functional ovarian cysts; Polycystic ovaries

· Uterine fibroids

· Cervical dysplasia

· Allergic tendencies

· Autoimmune disorder

· Breast, uterine, cervical, or ovarian cancer

Natural solutions for estrogen dominance include dietary modifications, stress reduction techniques, animal glandular extracts without hormones, specific nutrients, and herbal remedies. As you can see, estrogen dominance is even more complex than the previous hormonal imbalance issues we have discussed. It is multi-faceted as it includes multiple organs and hormones. We can use the symptom lists as guides to identify which hormones are in excess or deficient, yet for long term health and healing we want to support all the affected glands.

There are times when a form of hormone replacement therapy is needed. At those times the more natural solution is “bioidentical” hormones. Here too, just providing hormones does not address the underlying deficiencies and ultimately the health of the glands. We are dealing with multiple glands and hormones so supplementing with specific hormones may throw the entire system even more out of balance, by creating additional communications challenges for the endocrine system. Therefore, except for extreme cases, it may be best to start with glandular and nutrient support and allow the body to bring itself back into balance naturally.

Bernard Rosen, PhD is a Nutrition Consultant and Educator. He works with individuals, groups, and at corporations to create individualized nutrition and wellness programs. His office is in Coeur d’Alene, ID. To learn more or to schedule an appointment, e-mail at, call (208) 771-6570 or go to