Do You Need Hormone Testing?

It’s probably not an exaggeration to say that every woman on the planet has, at one point or another, heard someone say, “Oh, it’s probably just your hormones.” People seem to be inclined to blame just about everything — from headaches to hot flashes and all kinds of conditions in between — on good old hormones.

Sometimes it is your hormones, though. And hormonal imbalances can mean more for your health than just a grumpy day or a few zits before your period. So, how can you tell when it’s hormones and when it’s something else?

Women’s health specialist Pelin Batur, MD, talks about a few types of hormonal imbalances commonly seen in women, including symptoms you shouldn’t ignore and when to see a medical professional.

Figuring out if you need hormone testing

To decide whether you need hormone testing (and if so, what kind), your doctor will likely start by asking you lots of questions about your symptoms. This will help them put together the puzzle pieces of what might be going on.

“The workflow in my head focuses on three questions,” Dr. Batur says. “First, do these symptoms sound hormonal? If so, do they sound like they’re related to estrogen, progesterone, testosterone or some other type of hormone? And finally, is it because they’re too low or too high?”

Once your doctor has a sense of what might be happening, they’ll figure out which tests to (or not to) run.

One symptom that indicates that you may need testing is irregular periods.

“If you’re having regular menstrual cycles and not having symptoms throughout the month, I don’t usually start with lots of estrogen, progesterone or testosterone tests,” Dr. Batur says. “But if you’re experiencing a lot of irregularities in your cycle, I’m likely to do more testing.”

Common hormonal imbalances seen in women

“We have at least 50 different hormones in our body, and very complex symptoms can arise from them,” Dr. Batur says. Having too much or too little of certain hormones causes symptoms and issues with your health.

Here are some of the most common hormonal imbalances seen in people assigned female at birth (AFAB).

• Menopause: It’s natural to stop menstruating as you age. But menopause causes changing levels of estrogen and progesterone, which can lead to a slew of symptoms, including some that begin in the lead-up known as perimenopause.
• Polycystic ovary syndrome (PCOS): When your ovaries create unusually high levels of hormones of male hormones, your reproductive hormones become imbalanced.
• Thyroid disease: Your thyroid is a small organ in your neck that produces hormones that impact many organs in your body, but sometimes, it makes either too much or too little of these hormones. There are a few kinds of thyroid disease, which means there are many possible symptoms.
• Diabetes: This common condition occurs when your pancreas doesn’t make any or enough of the hormone insulin or when your body doesn’t use it properly. Diabetes is the most common hormone-related condition in the United States.

There are less-common hormonal imbalances, too, like Cushing’s syndrome and Addison’s disease. Only a doctor can help identify which hormonal imbalance you’re experiencing and what course of treatment is best.

7 common symptoms of hormone imbalances

Here’s the thing: Hormonal imbalances can have a lot of symptoms — and they can have a lot of different symptoms, depending on which ones are at the root of your issues. Those symptoms may seem muddled or initially unrelated, and they’re not always related to hormones at all.

“Hormones can cause so many symptoms, but that doesn’t mean they’re always the cause of your symptoms,” Dr. Batur says, “so it’s really important to be seen by a doctor for an individualized assessment.”

Here are some common symptoms of hormonal imbalances in women and what they might signify.

1. Irregular menstrual cycles

Weird periods are a key sign of a hormonal imbalance. Irregular menstruation can be a sign of perimenopause but can have a number of other causes, too, especially if you’re not yet nearing menopausal age.

“If your menstrual cycles are disrupted or if you’re going through menopause, you should definitely come in to be seen and to talk things out,” Dr. Batur advises.

2. Acne

“If a woman comes in complaining of acne, I’m concerned about potentially high levels of hormones such as testosterone,” Dr. Batur says. “We see this in women with polycystic ovary syndrome.”

PCOS causes higher levels of male hormones called androgens (including testosterone), which can lead to acne. And thyroid imbalances can cause acne, too.

3. Hair changes

If you start to notice differences in your hair — whether on your head, face or someplace else, like your arms and legs — it could be a sign of a hormone imbalance.

Starting to see chin hairs or a bit of a mustache? Increased testosterone can cause excess hair growth (hirsutism). This can be a symptom of PCOS or menopause, but it has other causes, too.

On the flip side, hormonal imbalances can also cause thinning hair on your head, legs and pubic region. During menopause, a drop in estrogen can lead to slower hair growth, or cause it to fall out more easily. Hypothyroidism and hyperthyroidism can cause hair loss, too. Or your hair loss may be related to something else entirely — something nonhormonal.

“It can be really complex to figure out,” Dr. Batur says. “You might assume hair loss is hormonal, but it can be related to high or low thyroid level, low estrogen, high testosterone or something else, like vitamin deficiency or lifestyle stressors.”

4. Hot flashes and night sweats

“These symptoms usually indicate that a woman’s hormones are lower, like the kind of dropping estrogen levels we see in perimenopause or postmenopause,” Dr. Batur says. They can also be a side effect of some medications and treatments.

Your doctor can help you find ways to manage your hot flashes so they don’t negatively affect your quality of life.

5. Unexplained weight gain

Weight gain can be a symptom of a variety of hormonal imbalances, as well as lifestyle-related factors, so doctors use other clues about your health to get a sense of what’s going on.

“Difficulty losing weight is a very common problem in the United States, and it’s often blamed on hormones,” Dr. Batur says. “Sometimes, it’s related to high testosterone levels, like with PCOS, and menopause is associated with weight gain, too. But if you have weight gain with regular menstrual cycles, it’s more likely to be related to something like cortisol, thyroid, insulin or lifestyle habits.”

6. Unexplained weight loss

Haven’t changed your lifestyle habits but have suddenly dropped 15 lbs.? This symptom is often a sign of an overactive thyroid, or hyperthyroidism. When your body produces too much thyroid hormone, your metabolism speeds up, which can cause weight loss along with rapid heartbeat, an intolerance to heat and other symptoms.

7. Vaginal dryness

Although vaginal dryness can be a sign of a few issues, it’s one of the most common symptoms of menopause. Your estrogen levels drop during menopause, which can to lead vaginal dryness that causes discomfort during sex.

“The vagina is quite sensitive to lack of estrogen,” Dr. Batur says. “About 50% of women have vaginal dryness that may get in the way of intercourse, and it tends to get worse over time.”

It might not be your hormones

While it’s important to advocate for your health, try not to be swayed by broad, overarching claims (looking at you, social media) that insist that everyone needs hormone testing or that every symptom you’re experiencing is related to your hormones.

Just because you’re experiencing symptoms of a hormonal imbalance doesn’t mean you have a hormonal imbalance. Nearly every symptom of a hormonal imbalance can have other causes, as well.

“It’s important to not lump everything together under hormones, and to instead break down each symptom individually,” Dr. Batur advises. “We have to take a deep dive to make sure we’re not missing anything, whether it’s lifestyle factors or another medical condition.”