By Poppy Daniels, MD
Sometimes it’s easier for me to talk about who doesn’t have a hormonal imbalance than to discuss who does. Granted, I am a hormone specialist so I tend to have a skewed population of patients that are aware that they have hormonal issues. But given the amount of hormone or endocrine disruptors in the environment, the never-ending flood of stress, the adulterated food supply, the frequent exposure to synthetic hormones through birth control and other drugs, and the obesity epidemic, it’s no surprise that hormonal imbalance is exceedingly common.
Common signs & symptoms of hormone imbalance include:
- Heavy/clotty and/or prolonged periods (more than 7 days of full flow)
- Long cycles >33 days or skipping cycles
- Mood swings, irritability, anxiety particularly if occurring the 2 wks before menses
- Night sweats
- Hot flashes
- Vaginal dryness
- Decreased sex drive
- Cyclical migraines
- Hair growth on face
- Thinning hair on head
- Rapid weight gain despite no dietary or exercise changes
Medical conditions frequently indicating hormone imbalance include:
- Uterine fibroids
- Premenstrual syndrome/PMDD
- Preterm birth
- Post-partum mood disorders
Charting your cycles is an excellent way to begin to ascertain whether you may have a hormonal imbalance. FertilityFlower can help pinpoint hormonal imbalance and registration is free. Besides long cycles, other charting irregularities pointing to hormonal imbalance include a shortened luteal phase, lack of temperature shift or zig-zag temperature pattern , or no egg white mucous days.
Once you’ve decided to pursue testing, make sure that you work with someone who is knowledgeable about the complexity of sex hormones. Serum hormone levels are often not reflective of the active, bioavailable or tissue hormone levels. Urinary hormone tests are usually measuring hormone metabolites. Saliva testing is accurate for baseline hormone levels and in those women using topical or vaginal creams, suppositories or patches. Saliva testing is not accurate for those using sublingual hormones. Bloodspot or capillary blood testing is accurate for those women who are taking sublinguals. For those with regular cycles, cycle Day 20 is the optimal day for testing. I highly recommend testing diurnal cortisol levels to assess adrenal function, as well as targeted thyroid and vitamin testing. If you don’t know of a hormone specialist near you, you can go to www.zrtlab.com and plug in your zip code, and find a local practitioner who performs saliva and bloodspot hormone, thyroid and Vitamin D testing.
Dr. Poppy is an Ob/Gyn who diagnoses and treats a wide spectrum of hormonal issues across all age groups. She has a holistic approach utilizing bioidentical hormone therapy, nutrition and targeted supplementation. She is also a natural birth and VBAC advocate, and supports a birth model incorporating collaborative physician/midwifery care. Visit her at www.drpoppy.com, “Dr. Poppy” on Facebook, and @drpoppyBHRT on Twitter.