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Most Common Female Hormone Imbalances Part 1

Female health is something I am extremely passionate about. I feel that women are underserved in too many areas (work, healthcare, etc.) and things need to change. I am part of that change and I couldn’t be more proud.

One major area that women are underserved in is understanding their bodies–specifically their cycles and hormones. The female body is amazing. It is cyclical in nature and follows a beautiful pattern of hormones that fluctuate throughout the month.

What I love most about the female body is that it is delicate and intentional while also being resilient. It takes time for the imbalances below to occur because our bodies want to be in balance and will try to compensate in other areas, but eventually imbalances can happen.

I share symptoms and signs that you may have these and the recommended testing you can do. I will be sharing a part 2 on how to fix these imbalances so look out for that!

Female Hormone Imbalances

Below are the 4 most common imbalances along with a list of associated symptoms. Just because you have these symptoms doesn’t mean you have these exact imbalances. That’s the tricky thing with hormones. You really need to get them tested (at the right time in your cycle if you’re cycling) in order to understand how to support balance.


Estrogen Dominance

What is estrogen dominance? It’s when our estrogen is higher than our progesterone. That’s right, we are talking ratios not just overall estrogen levels.

You can have low hormone levels and still experience estrogen dominance. We need estrogen, it’s not a bad thing. But like most things too much of it can be problematic. 

Estrogen should be dominant in the 1st two weeks of menstrual cycle, but then is balanced with progesterone during second half.

Common Symptoms of Estrogen Dominance:

  • Increased PMS symptoms
  • Mood swings
  • Breast tenderness and/or fibrocystic breasts
  • Fat gain around hips and thighs
  • Menstrual migraines or headaches, especially right around your period
  • Irritability or depressed mood
  • Hair loss
  • Brain fog
  • Acne (especially cystic)

It is also important to note that not everyone will experience these symptoms meaning estrogen dominance could be an issue for you, but you won’t truly know until you test. I recommend the DUTCH test. 

Root Causes of Estrogen Dominance:

  • Not ovulating (can happen with PCOS, hormonal birth control, amenorrhea–not getting your period)
  • Hormonal birth control usage (the pill, hormonal IUDs)
  • Poor liver detoxification
  • Gut dysfunction/constipation/low fiber diet AKA not pooping every day- estrogen is excreted in bowels
  • Hormone disrupting chemicals (toxic personal care products, plastic, water, conventional meat, etc)
  • Chronic stress (typically lowers progesterone and can create estrogen dominance)
  • Inflammation
  • PCOS
  • Endometriosis
  • High androgens (male hormones can be converted to estrogen by an enzyme in the body)
  • Excessive body fat—gives off more estrogen
  • Xenoestrogens in your environment: toxic compounds in personal care, cleaning, plastics, etc. that mimic estrogen in the body

High Androgens (Male Hormones)

Androgens are male hormones but I’m still including them here because they are an important part of female hormone balance and health. We need male hormones like testosterone but the key is to have it in the right amount.

I see high androgens most often in women with PCOS and women that recently got off hormonal birth control.

Common Symptoms of High Androgens:

  • Acne
  • Excessive hair growth (facial, nipples, chin, abdomen)
  • Oily skin
  • Irregular menstrual cycles
  • Lack of menstrual periods (amenorrhea)
  • Hair loss
  • Enlarged clitoris
  • Decreased breast size
  • Deepening of voice
  • Low libido

Root Causes of High Androgens:

  • Post Birth Control Syndrome: it’s common for androgens to increase after getting off the pill
  • PCOS (Polycystic Ovarian Syndrome)
  • Hirsutism: a hormonal condition where there is an imbalance in androgens (male hormones) that can cause excessive hair growth. It has been shown to be genetic.
  • Congenital Adrenal Hyperplasia: Dysfunction in the adrenal glands that impacts hormones, specifically causing the body to overproduce androgens.

Low Progesterone

Another common female hormone imbalance is low progesterone. This is often what causes estrogen dominance since low progesterone makes a normal (or even low) estrogen level appear high in the body. It’s all about that delicate hormone balance.

Progesterone increases the second half of our cycle and reaches its highest point during ovulation. It’s main job is to get your uterus ready for pregnancy by thickening the uterine lining to prepare for the fertilized egg. If the egg doesn’t get fertilized by sperm then your progesterone levels drop and boom–menstruation!

Common Symptoms of Low Progesterone

  • Headaches or migraines
  • Mood changes–especially anxiety or depression
  • Irregular menstrual cycles
  • Spotting prior to your period
  • Miscarriages
  • Difficulty getting pregnant
  • Hot flashes
  • Low libido
  • Insomnia
  • Bloating
  • Uterine fibroids

Root Causes of Low Progesterone

  • Hormonal birth control use
  • Not ovulating
  • Excessive stress
  • Hypothyroidism
  • Ovary dysfunction
  • Menopause
  • Xenoestrogens

One of the best things you can do for low progesterone is work on reducing your stress and improving how your body handles stress. You’re basically working on making small changes so your body can become more resilient. Identifying hidden stressors in the body like leaky gut, parasites, pathogens, or yeast is really helpful with this.

Low Estrogen

We don’t want estrogen to be high but we definitely need enough in order to feel our best. Estrogen is an important hormone. It controls the growth of our uterine lining, is important for healthy bones,

It’s easy to have too much estrogen but low estrogen is also extremely common.

Common Symptoms of Low Estrogen

  • Irregular periods
  • Painful sex (due to vaginal dryness)
  • Hot flashes or Night sweats
  • Headaches or migraines
  • Mood swings
  • Depression
  • Low libido
  • Breast tenderness
  • Difficulty concentrating
  • Fatigue

Root Causes of Low Estrogen

  • Excessive exercise
  • Under eating
  • Poor pituitary function
  • Turner syndrome
  • Premature failure of the ovaries
  • Poor liver or kidney health


As you can see, many of the imbalances have common symptoms. That’s why I recommend testing your hormones instead of guessing.

Testing Options

Dutch Test

There are a few different options for testing your hormones and they all have pros and cons. I prefer dried urine testing since it allows me to work deeper to the root cause with clients, but you have to go with what feels best for you.

Bloodwork From Your Doctor

You can opt to get bloodwork done from your doctor so that it is covered by insurance, but I do want you to know the difference between this type of testing and more functional tests like saliva and urine. One bonus of blood tests is that you can test your SHBG or steroid hormone binding globulin, which binds to hormones and makes them inactive. It can also bind to thyroid hormone. SHBG is increased with hormonal birth control (HBC),which is why HBC can cause thyroid problems. One downside is that you don’t get to see the specific pathways your hormones are going down and most doctors don’t have you test them at the right time.

IMPORTANT: If you do go this route (which is totally fine and you should if you feel good about it) just make sure you test your hormones at the right time in your cycle. You want to test them 4-5 days after ovulation or 7 days before you get your period. 

Saliva Testing

Measures the amount of free (unbound) hormones in the body. Almost 99% of steroid hormones in the bloodstream are bound to carrier proteins that make them inactive. We want to see the level of free hormone since that’s what is actually impacting the body. The downside is it can be difficult for some people to produce enough saliva to fill all the tubes that need to be filled and also time consuming. It also doesn’t show you what pathways your hormones are going down, and we want that info!

Dried Urine Testing (my favorite)

Dried urine testing is newer and not as well known as blood or saliva, but I actually prefer this type of testing for hormones. Why? For one, it shows you the free hormone availability (similar to saliva). And two, because it shows you the pathways that the hormones are going down and provides more information on what is actually happening in the body not just if things are high or low. There’s new research showing it is reliable when compared to saliva testing that you can read about here.  I personally use the DUTCH test with my clients and find it extremely effective. It’s also much easier than completing a saliva test and you can do it right at home.

Skeptical about urine testing and how it compares to blood/saliva? Watch this video. 



Want Help With Your Hormones?

This is what I do! If you want to find answers and restore hormone balance so you can feel good once and for all fill out this discovery call form. You will get an email with the link to schedule for free, 30 minute call and we can see if we are a good fit to work together.







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