11 Signs of Hormonal Imbalance in Women: Causes, Tests & Treatment

If you’ve ever felt like your body is sending mixed signals of exhaustion no matter how much you sleep, mood swings that give you whiplash, or a period that shows up whenever it feels like it, you're not just imagining it. One in three women report symptoms tied to hormone shifts, but the pattern often hides in plain sight. Your hormones are powerful chemical messengers, and when they’re out of sync, you feel it everywhere. Our guide will help you connect the dots between what you’re feeling and what might be happening inside. We’ll walk through the common signs of hormonal imbalance in women, what causes them, and what testing and treatment actually look like.

• Key Takeaways:
  • Hormone symptoms often cluster together. Tracking them as a group, not in isolation, is key to seeing the full picture.
  • Conditions like Polycystic Ovary Syndrome (PCOS), thyroid disorders, and the transition to menopause (perimenopause) are behind most cases of hormonal imbalance in women.
  • Getting the right diagnosis which combines your personal health story, lab tests, and sometimes imaging makes finding an effective treatment plan much more straightforward.

What Is a “Hormonal Imbalance,” Really?

Think of your endocrine system as your body’s internal text-messaging service. Hormones are the messages sent from glands to organs to coordinate everything from your mood and energy to your metabolism and menstrual cycle. A hormonal imbalance happens when you have too much or too little of one or more of these crucial messengers hormonal shifts are a completely normal part of life, like the cycles of puberty, pregnancy, and perimenopause But when symptoms become persistent and disruptive, it signals that something more is going on. Even small changes in hormone levels that might look insignificant on a lab report can have a huge impact on how you feel day-to-day.

Quick Symptom Map

• Irregular periods
• Fertility trouble
• Hot flashes or night sweats
• Persistent weight changes
• Hair changes (loss or growth)
• Heavy bleeding or pelvic pain
• Mood changes & brain fog
• Fatigue & sleep problems
• Skin changes (acne or dryness)
• Breast changes or discharge
• Vaginal dryness & low libido

The 11 Signs of Hormonal Imbalance and What to Do

1. Irregular Periods

When your period goes rogue arriving much earlier or later than usual, or skipping months altogether it’s a classic sign of a hormone imbalance . A typical cycle for an adult lasts between 24 and 38 days. If your cycles are consistently shorter than 21 days or longer than 35, your body is trying to tell you something.

• Likely Drivers: The most common cause is Polycystic Ovary Syndrome (PCOS), which involves androgen excess and insulin resistance. Other causes include thyroid disorders, high prolactin levels, perimenopause, extreme stress, or significant weight changes.
• The Brain Connection: Your brain is the true conductor of your menstrual orchestra. It sends signals to your ovaries to manage your cycle. When stress, illness, or other factors disrupt this brain-body communication, your period is often the first thing to go off-key.
• First Steps: Start tracking your cycle dates and symptoms. The Samphire app is designed to help you spot these patterns, giving you a clear record to share with a healthcare provider.

2. Trouble Getting Pregnant

If you’ve been trying to conceive for over a year (or over six months if you’re 35 or older) without success, a hormonal issue could be the cause.

• Likely Drivers: Many cases are linked to anovulation (not releasing an egg), which is common in PCOS. Thyroid imbalances, high prolactin, and other hormonal issues can also interfere with fertility First Steps: It’s important for both partners to be evaluated. A provider can order tests to see if you are ovulating and check key hormone levels.

3. Hot Flashes & Night Sweats

That sudden, intense wave of heat spreading through your chest and face isn’t just for menopause.

• Likely Drivers: While fluctuating estrogen during perimenopause and menopause is the classic cause, an overactive thyroid or, in rare cases, primary ovarian insufficiency can also trigger them.
• The Brain Connection: Your brain’s internal thermostat (the hypothalamus) becomes more sensitive to slight temperature changes when estrogen levels fluctuate, causing it to overreact and trigger a hot flash to cool you down.
• First Steps: Track the frequency of your hot flashes and any potential triggers, like alcohol, caffeine, or stress.

4. Persistent Weight Changes

If you’re gaining weight despite your best efforts or losing it without trying, your hormones could be the culprit Likely Drivers: Insulin resistance (common in PCOS) and an underactive thyroid (hypothyroidism) are often linked to unexplained weight gain, especially around the middle. An overactive thyroid (hyperthyroidism) can cause weight loss. Dysregulated cortisol (the stress hormone) also plays a big role.

• First Steps: Pay attention to other clues. Are you also experiencing intense sugar cravings or changes in your resting heart rate? Share these observations with your doctor.

5. Hair Changes

Hormones can affect your hair in two opposite ways: causing it to thin on your head or to grow in places you don’t want it, like your chin or upper lip.

• Likely Drivers: Excess androgens (a type of hormone) are a hallmark of PCOS and a primary cause of unwanted facial or body hair (hirsutism). Hair loss, on the other hand, can be caused by thyroid imbalances or the major hormonal shifts that happen postpartum.
• First Steps: Note whether you’re shedding more hair or if the strands themselves seem thinner. A doctor will likely want to check your iron and ferritin levels in addition to your hormones.

6. Heavy Bleeding or Pelvic Pain

Periods that are debilitatingly painful or so heavy they interfere with your life are not normal.

• Likely Drivers: Conditions like uterine fibroids and endometriosis are common causes of heavy bleeding and severe pelvic pain . Thyroid issues and bleeding disorders can also contribute. Dysmenorrhea, the medical term for painful periods, is incredibly common but often dismissed .
• Red Flag: Soaking through a pad or tampon every hour for several hours, or passing clots larger than a quarter, warrants an immediate call to your doctor.

7. Mood Changes, Anxiety & Brain Fog

If you feel irritable, anxious, or like you’re walking through a mental fog, it’s not just “in your head” It’s in your brain, and hormones are often involved.

• Likely Drivers: The rise and fall of estrogen and progesterone directly impact mood-regulating brain chemicals like serotonin and dopamine. These fluctuations are behind the symptoms of PMS and the more severe PMDD . Thyroid imbalances and high cortisol can also cause significant mood shifts.
• eThe Brain Connection: Your brain’s ability to adapt to these hormonal shifts is called neuroplasticity. When this process is strained, you can experience brain fog, poor focus, and emotional dysregulation. This is where brain-first care comes in. Rather than adding more hormones, we can support the brain’s ability to manage these signals.
• A Hormone-Free Solution: For those in the US, the Lutea™ wellness device is a hormone-free, drug-free wearable designed to support your brain. It uses gentle neurostimulation to promote a sense of calm, focus, and clarity during hormonally sensitive times, working with your brain’s natural ability to adapt .

8. Fatigue & Sleep Problems

Feeling exhausted all the time is one of the most common signs of a hormonal imbalance Likely Drivers: An underactive thyroid can sap your energy, while excess progesterone can make you feel sleepy . At the same time, a drop in progesterone before your period can cause insomnia. Low iron (anemia), often a result of heavy periods, is another major cause of fatigue.

• First Steps: Notice if you’re just tired or if you feel “wired but tired.” Tracking your energy levels with the Samphire app can reveal if your fatigue is cyclical.

9. Skin Changes

Persistent adult acne, especially cystic bumps along the jawline, is a strong indicator of a hormone imbalance .

• Likely Drivers: Excess androgens rev up oil production, leading to clogged pores and breakouts. This is a key symptom of PCOS. On the flip side, low estrogen levels, common in perimenopause, can lead to dry, thinning skin.
• First Steps: Note where and when you break out. Jawline acne that flares before your period is a classic hormonal pattern.

10. Breast Changes or Milky Discharge

Any changes to your breasts, including tenderness that isn’t just pre-period soreness or any discharge when you are not breastfeeding, should be checked out.

• Likely Drivers: A milky discharge from the nipple (galactorrhea) can be caused by high levels of the hormone prolactin. This can be due to a benign pituitary tumor, an underactive thyroid, or a side effect of certain medications.
• Red Flag: If you experience milky discharge along with new headaches or vision changes, seek an urgent medical evaluation.

11. Vaginal Dryness & Low Libido

A dip in your sex drive or discomfort during intimacy can often be traced back to your hormones Likely Drivers: Low estrogen, which is common during perimenopause, menopause, and breastfeeding, is a primary cause of vaginal dryness. Low testosterone (yes, women need it too!) can contribute to a lagging libido.

• First Steps: Don’t be afraid to bring this up with your provider. There are effective treatments, from lubricants and moisturizers to local vaginal estrogen, that can make a world of difference.

How Doctors Diagnose Hormonal Imbalance

Getting a diagnosis is a process of detective work. Here’s what to expect:

1. Your Health Story: Your doctor will ask detailed questions about your menstrual cycle, symptoms, weight history, and family medical history. This is why tracking your symptoms beforehand in an app like Samphire is so valuable.
2. Lab Tests: A blood test is the most common way to check hormone levels. Depending on your symptoms, your doctor might test:
   • Thyroid: TSH, Free T4, Free T3
   • Reproductive Hormones: LH, FSH, Estradiol, Progesterone (this one must be timed to the second half of your cycle)
   • Androgens: Total & Free Testosterone, DHEA-S
   • Other Markers: Prolactin, Fasting Glucose/Insulin, A1C, and a complete blood count (CBC) to check for anemia.
3. Imaging: A pelvic ultrasound is often used to look for cysts on the ovaries (a sign of PCOS) or for uterine fibroids.

Evidence-Based Treatments for Hormonal Imbalance

Treatment depends entirely on the cause, but here are some of the most common evidence-based approaches:

• For PCOS: Lifestyle changes focusing on nutrition and exercise are foundational. Hormonal birth control can regulate cycles, and medications like metformin (for insulin resistance) or spironolactone (to block androgens) are also used.
• For Hypothyroidism: Daily replacement with a thyroid hormone medication called levothyroxine is the standard of care.
• For Perimenopause/Menopause: Menopausal Hormone Therapy (MHT) is a highly effective option for many women to relieve hot flashes and other symptoms. Non-hormonal options like certain antidepressants can also help.
• For Endometriosis/Fibroids: Treatment can range from NSAIDs for pain, to hormonal methods like the pill or a hormonal IUD to control bleeding, to surgery in more severe cases .
• A Brain-First Approach: For symptoms like brain fog, mood swings, and pain, brain-based therapies offer a hormone-free alternative. The Lutea™ device is designed to support your brain’s own regulatory systems, helping you feel clearer and calmer without altering your natural cycle .

Lifestyle That Actually Moves the Needle For Your Hormonal Imbalance

• Nourish Your Body: Focus on meals that include protein, high-fiber carbohydrates, and healthy fats. This helps stabilize blood sugar and provides the building blocks for hormones.
• Move with Intention: Aim for a mix of cardio and resistance training. Movement is fantastic for insulin sensitivity and stress relief, but over-exercising can be a stressor itself. Listen to your body.
• Prioritize Sleep & Stress Resilience: Aim for 7–9 hours of sleep per night. A consistent wind-down routine can work wonders. Practices like mindfulness or breathwork help calm your nervous system, which has a direct, positive effect on your hormonal axis.

When to See a Doctor For Hormonal Imbalance

Book an appointment soon if you experience:

• Cycles that are consistently shorter than 21 days or longer than 35 days.
• Heavy bleeding that forces you to change your routine.
• New or worsening acne or facial hair.
• Unexplained weight changes.
• You’ve been trying to conceive for 6-12 months without success.

Seek urgent care if you have:

• Milky breast discharge accompanied by headaches or vision changes.
• Severe pelvic pain, especially with a fever.
• Bleeding that soaks a pad or tampon every hour.
• Chest pain or shortness of breath.

If a few of these signs are ringing bells, you’re not “overreacting” you’re noticing patterns. Track them for two cycles, book the appointment, and let data lead the next move. You’ve got this.