Hormonal Imbalance Symptoms in Women: Signs, Causes, Tests and What Helps (UK)

Common signs of hormonal imbalance in women

Many of these signs are common and have other causes too, which is why it’s worth looking at the pattern: when they started, whether they follow your cycle, and what else is going on.

What causes hormonal imbalance? The main conditions

Premenstrual syndrome (PMS)

Mood swings, bloating, breast tenderness, tiredness and irritability in the 2 weeks before a period, easing once it starts. A severe form, PMDD, can cause intense depression or anxiety before periods. See PMS symptoms.

Perimenopause and menopause

Falling oestrogen levels, usually from your mid-40s, can cause irregular periods, hot flushes, night sweats, poor sleep, anxiety, low mood, brain fog and joint aches, sometimes for years before periods stop. See perimenopause symptoms, perimenopause and sleep and menopause weight gain.

PMOS (formerly PCOS)

The NHS now calls polycystic ovary syndrome polyendocrine metabolic ovarian syndrome (PMOS). It’s a hormone condition that usually starts around puberty. The main symptoms are irregular periods or long gaps between them, excess hair growth or hair loss, weight gain or difficulty losing weight, difficulty getting pregnant, depression or anxiety, oily skin and acne, feeling very tired, and dark patches of skin on the neck or armpits.

Thyroid problems

An underactive thyroid causes tiredness, feeling cold, weight gain, low mood and heavy periods. An overactive thyroid causes anxiety, a racing heart, weight loss and feeling hot. See underactive thyroid symptoms.

Other causes

• Pregnancy, after birth and breastfeeding
• Hormonal contraception, starting or stopping it
• Very low body weight, under-eating or over-exercising, which can stop periods
• Diabetes and insulin resistance
• Rarer conditions affecting the pituitary or adrenal glands

Symptoms by life stage

Stress, sleep and cortisol

Cortisol, the main stress hormone, gets talked about a lot online. Long-term stress and poor sleep can affect your periods, mood, sleep and appetite, and can make other hormone symptoms feel worse. True cortisol disorders, such as Cushing’s syndrome, are rare and need medical tests. For most people, managing stress and sleep is what helps. See high cortisol symptoms in women, how to lower cortisol naturally and stress symptoms.

Tests for hormonal imbalance

There isn’t a single “hormone imbalance test”. Your GP chooses tests based on your symptoms, for example:

• Thyroid function (TSH and T4) for tiredness, weight and mood changes.
• Hormone and insulin levels and sometimes an ultrasound scan if PMOS is suspected.
• Pregnancy test if periods have stopped.
• Blood count, iron, vitamin B12 and vitamin D if tiredness is the main symptom. See iron deficiency.
• Blood sugar if diabetes is possible.

For perimenopause, NICE guidance says women over 45 with typical symptoms can usually be diagnosed from their symptoms, without a blood test. Keeping a symptom and period diary for 2 to 3 months is one of the most useful things you can bring to an appointment.

What you can do yourself

No food or supplement can “balance your hormones” on its own, and claims that they do should be treated with caution. But everyday habits make a real difference to how you feel:

• Track your cycle and symptoms to spot patterns.
• Eat regular, balanced meals with plenty of fibre, protein and vegetables. See food and mood and sugar cravings.
• Move most days. Strength training helps muscles and bones, especially around menopause. See creatine for women.
• Protect your sleep. See how to sleep better.
• Manage stress with small daily habits. See how to relieve stress.
• Cut back on alcohol and caffeine, which can worsen hot flushes, sleep and anxiety.
• Take vitamin D in autumn and winter, as the NHS advises for everyone in the UK.

A calming evening ritual can help with sleep. Our Magnesium Glycinate Sleep Complex is a berry bedtime drink with L-theanine. Magnesium contributes to normal psychological function, the reduction of tiredness and fatigue, and normal muscle function. Many women also take our Flow CBD Oil, with ashwagandha and maca, as part of their routine. The FSA’s 10mg a day figure for CBD is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication, including HRT or contraception. See best supplements for menopause.

Treatments

Treatment depends on the cause. For example:

• Perimenopause and menopause: HRT is the main treatment for many symptoms. NICE also recommends CBT for low mood, anxiety and hot flushes linked to menopause.
• PMOS: the NHS lists options such as the combined pill or an IUS for irregular periods, medicines for hair growth and fertility, metformin, and lifestyle changes.
• PMS and PMDD: lifestyle changes, the combined pill, and sometimes antidepressants.
• Thyroid problems: levothyroxine for an underactive thyroid.

When to see a GP

iSee a GP if:

• your periods are irregular, very heavy, very painful or have stopped (and you’re not pregnant)
• you have perimenopause symptoms affecting your life
• you have extra hair growth, acne or hair loss with irregular periods
• you’re tired all the time, gaining or losing weight without trying, or feel low
• you’re struggling to get pregnant
• you have bleeding after sex, between periods or after the menopause, which always needs checking

Related guides

• Stress and hair loss.
• Adrenal fatigue vs Addison’s disease.
• Not sure if your spots are hormonal or stress-related? See stress acne vs hormonal acne.
• Why PCOS was renamed PMOS.
• Premenstrual dysphoric disorder (PMDD).
• If you’ve seen inositol recommended online, our guide to what inositol can and can’t do looks at the evidence honestly.
• Vitamin B6, including the NHS advice on supplement doses.
• For sleep that dips before each period, see insomnia before your period: why it happens and what helps.
• For forgetfulness and poor concentration in midlife, see menopause brain fog.
• For missed or late periods, see our guide to stress and late periods.
• Ashwagandha and women’s hormones: what the evidence says.
• Some women notice mouth ulcers around their period; see the common causes and what helps.
• Magnesium for PCOS (PMOS): what the trials show.
• How long menopause lasts and the average age in the UK.
• Hair falling out: causes, normal shedding and when to see a GP.
• Endometriosis: symptoms, tests and treatment in the UK.
• If your energy dips at the same points each month, our guide to tiredness on your period and during ovulation explains how the cycle affects sleep.
• If you’ve wondered whether CBD fits in, our guide to CBD for menopause and perimenopause sets out the evidence and the safety checks.