March 22, 2024

The Complete Guide to Hormonal Imbalance for Everyone

photo of Lifeforce

Written By


photo of Vinita Tandon, MD

Medically Reviewed By

Vinita Tandon, MD

Lifeforce Medical Director

The Complete Guide to Hormonal Imbalance for Everyone

Table of contents:

The Complete Guide to Hormonal Imbalance in Women

  • Estrogen Dominance Symptoms

  • Progesterone Deficiency Symptoms

  • Excess Testosterone in Women

  • Low Testosterone in Women

  • Signs of Hormonal Imbalance After Pregnancy

  • Signs of Hormonal Imbalance After Menopause

  • Symptoms of PCOS in Females

  • Symptoms of Hormonal Imbalance After a Hysterectomy

  • Common Symptoms of Hormonal Imbalance in Women

  • Diseases that Affect Female Hormones

  • Treatments for Hormonal Imbalance

  • Transdermal Estrogen

  • Progesterone

  • Testosterone

  • DHEA

  • Metformin

Men's Guide to Hormonal Imbalance

  • Common Hormonal Issues and their Symptoms

  • Hormonal Imbalance Symptoms in the Metabolism

  • Early Male Hormonal Imbalance Symptoms

  • Metabolic Symptoms of Hormonal Imbalance in Men

  • Causes of Male Hormonal Imbalance

  • Male Hormone Imbalance Test & Diagnosis

  • Treatment for Low Testosterone

  • Is Testosterone Therapy Safe?

  • Treatment for Insulin Imbalance

  • Treatment for Thyroid Hormone Imbalance


  • How to Test for a Hormone Imbalance

  • Can you Test Hormones at Home?

  • How to Treat a Hormone Imbalance

If you lack energy and have trouble sleeping, look to your hormones. Dealing with hormone imbalance symptoms can be demotivating, uncomfortable, and disruptive. Hormones regulate everything from mood and metabolism to weight and libido. A delicate hormonal balance supports an energized, active day.

When this tightly controlled equilibrium falls out of line, symptoms can develop. Even if a hormone imbalance hasn’t reached the stage of a diagnosable condition, it can still serve as a barrier between you and peak performance.

“Many hormones interplay with each other, and when one goes out of whack, it can cause a ripple effect,” says Dr. Vinita Tandon, Lifeforce’s Medical Director and board certified endocrinologist. “Imbalances cannot be ignored since they get worse, negatively impact health and quality of life, and then need to be aggressively addressed down the road.

In this article, we'll discuss the most common warning signs of imbalances in major hormones like testosterone, estrogen, and ghrelin, and what to do about them.

The Most Common Signs of Hormonal Imbalance

Hormonal imbalance symptoms vary depending on the hormones involved and the severity of the imbalance. However, common warning signs include:

The signs of a hormone imbalance may develop due to aging. However, factors beyond aging, like pregnancy, substances in your environment, genetics, medication side effects, the monthly menstrual cycle, and various health conditions, can affect hormones and lead to more severe symptoms.

The Complete Guide to Hormonal Imbalance in Women

namaste hands

Hormones are proteins and steroids that link to every part of your being. 

“Hormones affect far more than just our sex organs. They can impact our sleep, memory, thinking, metabolism, body composition, and mood,” says Lifeforce Physician Kimberly Hartzfeld, DO. “And that's just the tip of the iceberg. In fact, our ability to sustain life and maintain well-being depends on our hormones.” 

Even slight hormone imbalances in women can have a far-reaching impact, and they’re surprisingly common. 

One survey of 2,000 women, commissioned by OB/GYN Dr. Anna Cabeca, MD, found that 47% of women experienced symptoms like low energy, reduced libido, mood swings, and weight gain without realizing they were suffering from a hormone imbalance.

Understanding these symptoms and leveraging the available solutions can help you reclaim the years so often overshadowed by this condition.

“Since hormones are vital to our existence and our happiness, you want to know where your levels are at in an effort to optimize your health,” says Dr. Hartzfeld. “What you don’t know could be holding you back from feeling your best.” 

woman stretching47% of American women ages 30-60 have experienced the symptoms of a hormonal imbalance, yet 72% say they didn’t know it until later in life. Even the slightest imbalance can cause fatigue, reduced sex drive, difficulty losing weight, and more. Our at-home blood test measures the 40+ biomarkers that impact your health, hormones, and quality of life, including:

  • Better Sleep

  • Reduced Weight Gain

  • Increase Libido

  • Improved Focus & Energy

Common Hormonal Issues and Their Symptoms

Hormonal imbalance in women can significantly impact quality of life. It can commonly occur due to menstruation, pregnancy, and menopause

Symptoms usually develop due to changing estrogen and progesterone levels, as well as changes to other hormones that stimulate egg production, control the thickness of the uterus lining, and fulfill other vital functions in female sexual development and reproduction.

Estrogen Dominance Symptoms

Estrogen dominance occurs when estrogen levels are too high compared to progesterone. Both hormones collaborate to control the menstrual cycle and prepare the body for pregnancy.

Progesterone and estrogen work together to regulate the uterine lining. However, medications like birth control or premenopausal polycystic ovary syndrome (PCOS) can increase estrogen in the body. Stress can also suppress progesterone by circulating cortisol, leading to excess estrogen.

Signs of estrogen dominance may include:

  • Extreme tiredness

  • Low libido

  • Feelings of depression or anxiety

  • Weight gain in the waist, thighs, and hips

  • Lighter or heavier periods than usual

  • Severe premenstrual syndrome (PMS)

  • Noncancerous lumps and tumors in the breasts and uterus

Progesterone Deficiency Symptoms

Low progesterone levels can also cause hormonal imbalance symptoms beyond estrogen dominance. 

Produced in the ovaries, progesterone’s “main functions are to support the menstrual cycle and pregnancy,” says Dr. Hartzfeld. “It also impacts mood, sleep, and cognition, which is especially important in menopause when levels drop.”

Progesterone deficiency can lead to irregular periods, and low progesterone also increases the risk of miscarriage or preterm delivery in pregnant women. Progesterone deficiency impacts wider health by leaving levels too low to counteract estrogen dominance symptoms. 

Pregnant women with low progesterone might also experience spotting during pregnancy and abnormal uterine bleeding.

Excess Testosterone in Women

While testosterone is the primary male sex hormone, women’s bodies do have some testosterone. 

“Testosterone is a crucial hormone for women’s biology,” says Lifeforce Physician Samuel C. Winter, DO. “It has far-reaching effects and can have a dramatic impact on their quality of life.” 

However, some women produce too much of this sex hormone and experience signs of hormonal imbalance. Testosterone is a crucial driver of male reproductive development, and symptoms of excess testosterone in women might include:

Excess testosterone can also lead to the onset of PCOS.

couple in natureLow Testosterone in Women

Some women’s bodies produce too little testosterone. Levels may decrease during natural aging, just as in men. 

“For women, the decline starts in your 30s and is gradual over time,” says Dr. Hartzfeld. This culminates with menopause. A study found that 10 years after the onset of menopause, circulating testosterone levels are half of premenopausal levels.

In women, testosterone levels can also drop following the surgical removal of the ovaries. Symptoms of low testosterone in women include:

  • Mood changes

  • Fatigue

  • Low libido

  • Cognitive changes

  • Vasomotor symptoms

  • Bone loss

  • Weaker muscles

Signs of Hormonal Imbalance after Pregnancy

Hormonal imbalances are common after pregnancy, with 7-20% of women developing postpartum depression. Levels of estradiol (a potent form of estrogen) and progesterone undergo huge shifts immediately before and after delivery, which can lead to depressive symptoms.

Other hormonal imbalance symptoms after pregnancy include:

  • Fatigue. Aside from sleep deprivation in the days following childbirth, tiredness could have a hormonal cause. Postpartum thyroiditis may disrupt levels of the thyroid-stimulating hormone for around one in 20 women, leading to symptoms like depression and tiredness. 

  • Irregular periods. A hormone called prolactin that helps the breasts produce milk circulates after delivery. This suppresses how ovaries respond to menstruation-linked hormones. It can take four to 24 months for menstruation to continue as before pregnancy.

Signs of Hormonal Imbalance After Menopause

Menopause is a leading cause of hormonal imbalance in women. During menopause, the ovaries no longer respond to follicle-stimulating hormone (FSH) and luteinizing hormone (LH). They also no longer make eggs, estrogen, or progesterone. Many major effects of postmenopause relate to estrogen deficiency. These symptoms include:

  • Hot flashes and night sweats. During menopause, 50-82% of women in the U.S. experience vasomotor symptoms like hot flashes and night sweats. 

  • Vaginal dryness. Postmenopausal women commonly experience dryness, inflammation, and thinning in the vagina walls. Estrogen supports vaginal lubrication, so a shortfall of this hormone can cause these symptoms. Several population studies report that more than half of all women experience vaginal dryness after menopause. “Many women don’t expect how this causes uncomfortable intercourse, which can affect libido,” Dr. Tandon says. Another side effect: more common urinary tract infections. When vaginal walls are dry, bacteria can more easily enter, she explains. 

  • Anxiety and moodiness. The decline of estrogen and progesterone impacts brain chemistry and neurochemical signaling, which affects mood. “I hear from a lot of women who have always been calm and able to cope with stress, but when they start to experience perimenopause, they become more anxious,” says Dr. Tandon. 

  • Brain fog. Some women begin to feel foggy and unfocused and think, ‘well, this is just my 40s.’ In reality, hormones are the likely culprit. Estrogen impacts the production of BDNF (brain derived neurotrophic factor), a growth factor that enhances memory and cognition, explains Dr. Hartzfeld. 

  • Sleep disturbances. “Perimenopause and menopause wreak havoc on sleep,” says Dr. Tandon. In addition to hot flashes keeping women up at night, dips in progesterone also disrupt the REM cycle. “When you don’t have deep restorative sleep, this sets off a vicious cycle,” says Dr. Tandon. “The next day, you’ll be tired and unfocused so you may want a nap or reach for sugary snacks to try and increase your energy.” 

  • Changes in body composition. “Some women are surprised when they see more belly fat come on, especially if they haven’t changed their diet or exercise routine,” says Dr. Tandon. She explains that lower testosterone can lead to a decrease in lean muscle mass. When estrogen levels drop, metabolic health also declines, which can cause abdominal fat, Dr. Hartzfeld adds.

Learn more in our article: 3 Things Women Over 30 Should Know About Their Health with Dr. Kathryn Rexrodet.

Symptoms of PCOS in Females

Polycystic ovary syndrome (PCOS) affects 6-12% of reproductive-age women in the U.S. The condition increases how many male sex hormones the ovaries make. Hormonal imbalance symptoms due to PCOS include:

  • Irregular periods or no periods at all

  • Excessive hair growth on the face or body

  • Acne 

  • Weight gain or difficulty losing weight around the belly

  • Darkening of the skin in certain areas like the neck, underneath the breasts, or underarms

Symptoms of Hormonal Imbalance after a Hysterectomy

Removal of the uterus — and particularly procedures that include an oophorectomy, or removal of the ovaries — triggers the onset of early menopause in women who are not yet of menopausal age.

The same vasomotor, vaginal, and cognitive hormonal symptoms that impact women during and after menopause can occur after a hysterectomy. However, a 2011 research paper suggested that genetic factors and a woman’s age at the time of surgery may contribute to the cognitive symptoms of an oophorectomy alongside estrogen deficiency.

Common Symptoms of Hormonal Imbalance in Women

A network of 50 interconnected human hormones regulates all your vital bodily processes. During the reproductive years, menopause, and daily life, a hormone imbalance can cause several symptoms that impact how you feel and perform. The good news? There are ways to control some of the effects at home, with a few effective lifestyle and natural remedies that treat hormone imbalance in women.


Acne is a common reaction to hormonal changes in women. One study suggests that acne affects 41% of adult females, with 78% of those affected reporting worse symptoms during their premenstrual period. Excessive levels of androgens like testosterone — commonly from polycystic ovary syndrome (PCOS) — can increase oil levels in the skin, causing bacterial buildup and pimples. The stress hormone cortisol can also make acne worse

The following measures can help women manage hormonal acne:

  • Gentle cleansing with mild soap

  • Omega-3s

  • Avoiding dairy

  • Reducing sugar

  • Stress reduction techniques like meditation

  • Avoiding skin products that cause irritation

  • Antibiotics 

  • Other drugs like benzoyl peroxide to reduce antibiotic resistance

Consult with a dermatologist before treating acne.

Weight Gain

Hormones like leptin, insulin, androgens, estrogens, and growth hormones impact your appetite, metabolism, and body fat distribution. A hormonal imbalance in women can drive weight gain too, intensifying menopause, PCOS, metabolic syndrome, or thyroid deficiency.

Though menopause doesn’t cause obesity, at least 43% of menopausal women are obese, and menopause does make it more likely you’ll gain weight, particularly around the midsection. About 38-88% of women with PCOS live with being overweight or obese.

For many women, the key to effective weight management often starts with restoring hormone balance. You may be able to achieve this through:

  • Healthy lifestyle choices around diet, exercise, sleep, and stress

  • Early evaluation with an endocrinologist

  • Medications

The Lifeforce Diagnostic includes a full hormone panel, telehealth visit, clinical report, and a personalized plan to help you optimize your health.

woman sleepingSleep Problems

A hormonal imbalance in women can affect your sleep in several ways, since reproductive hormones like progesterone and estrogen are linked to the sleep cycle. Around 66% of women with PMS, 60% of menopausal women, and 51.6% of postmenopausal women report disrupted sleep. Pregnancy can also increase sleep disturbances. Sleep difficulties often become more frequent and last longer as pregnancy progresses. 

To manage these exhausting hormonal sleep issues:

  • Keep a regular sleep schedule.

  • Avoid late meals.

  • Maintain a cool, comfortable, device-free bedroom.

  • Speak to a doctor if sleep problems persist.

Learn more in our article: 3 Tips to Optimize Your Sleep From a Women’s Hormone Expert.

Mood Changes

If you live with premenstrual syndrome (PMS), you’re probably familiar with the mood shifts that can accompany female hormone imbalance. Estrogen and serotonin may interact to affect your mood.

Hormonal imbalance in women — especially around menstruation, menopause, and pregnancy — can cause rapid and sometimes severe mood changes. For example, late menopause may make depressive symptoms 14 times more likely.

Aside from taking steps to balance female hormones, the following treatments may help to stabilize your mood:

  • Talk therapy (including cognitive behavioral therapy)

  • Antidepressant medications

  • Stress reduction techniques like meditation

  • Managing your sleep schedule

If you’re experiencing low mood or depression, it’s important that you talk to a healthcare professional.

Low Libido

Hormonal imbalance in women might lead to a downturn in sexual desire. Around 40% of women experience low libido during menopause. Reduced desire due to vaginal dryness is common, since dryness can make sex uncomfortable and even painful. 

“Women lose estrogen in menopause, so their vaginal mucosa dries up,” explains Dr. Tandon. “It can become very dry and sensitive, so any type of penetration will hurt.”

Pregnancy, insulin imbalances like diabetes, or thyroid disease can also cause low libido

If you notice a lower sex drive impacting your mood, interfering with your relationships, or affecting your quality of life, speak to a doctor. They may prescribe hormone replacement therapy, natural supplements, or medications that can help. Other ways to relieve the burden of low libido include:

  • Regular exercise

  • Effective stress management

  • Open communication and experimentation with your partner

Learn more about improving your libido in our article: 14 Libido Boosters to Get You Back in the Mood.

Woman Sun Bathing Vitamin DIrregular/Heavy Periods

Heavy periods that happen too often (or too infrequently) might be another sign of a female hormone imbalance. Health problems affecting periods include:

  • PCOS

  • Endometriosis

  • Fibroids

  • Pelvic inflammatory disease

  • Thyroid and pituitary gland disorders

  • Excessive stress

  • Weight changes

  • Pregnancy complications

  • Birth control side effects

Heavy exercise can also affect your periods.

The most suitable treatment option will depend on the type of condition you have. However, pain relief medication, hormone therapy, or switching to non-hormonal birth control may help soften the impact of irregular periods. You can help reduce your risk through:

  • Moderate exercise

  • A nutritious diet

  • Stress reduction

  • Regular gynecology check-ups to rule out underlying health problems

Vaginal Dryness

A hormone imbalance from menopause, birth control, surgical removal of the ovaries, and certain medications can reduce estrogen levels and cause uncomfortable vaginal dryness.

Natural remedies and hormone therapies include:

  • Vaginal lubricants and moisturizers

  • Staying hydrated and applying natural oils like olive or coconut oil

  • Supplementing estrogen via creams, rings, or patches

  • Hyaluronic acid vaginal suppository (Revaree)

Other treatments include dehydroepiandrosterone (DHEA) and ospemifene. These options mimic estrogen’s effects on the body

Lifeforce also offers Vaginal Estradiol, which is applied topically to help re-epithelialize and lubricate the vaginal wall. Apply it daily for two weeks and then just three times a week, advises Dr. Tandon. “Within three to four weeks, you’ll start to get some relief.” 

Unexpected or Excessive Hair Growth

Excessive bodily hair, or hirsutism, most often occurs due to excess androgens resulting from PCOS. Around 5-10% of sexually active women develop hirsutism. A thyroid hormone or cortisol imbalance can also lead to excessive body hair. A drop in estrogen production during pregnancy and menopause may also contribute.

The following measures can help women manage hirsutism and feel their best:

  • Weight management — losing even 5% of body weight can reduce androgens

  • Medications like birth control and androgen suppressants to lower androgen levels

  • Cosmetic options like electrolysis, laser hair removal, waxing, shaving, and bleaching

  • Certain foods like green tea, bananas, and carrots can help block DHT (via inhibiting 5-alpha reductase)

Difficulty Conceiving and Fertility Problems

Infertility can be devastating, and it’s often the direct result of a female hormone imbalance. PCOS, excess prolactin production, and thyroid disorders can disrupt egg production or interfere with your menstrual cycle. Some medicines may reduce the fertility-impairing effects of PCOS and reduce prolactin levels. These include:

  • Clomiphene citrate

  • Letrozole

  • Hormonal therapies like human menopausal gonadotropin (hMG) or follicle-stimulating hormone (FSH)

Diagnostic Homocysteine Levels“I've lost weight. My mind is a lot more focused. I can process a lot more information quickly. I definitely feel like I have more power in my workouts. I have an energy level that is back to who I have been my whole life.” — Michelle L., Lifeforce Member, Age 52


Throbbing or stabbing migraine symptoms can accompany hormone changes in women, especially related to menstruation. Around 70% of migraine sufferers are women, and 60-70% of all women who experience migraine attacks report a link between their symptoms and their menstrual cycle.

These regular and often literally blinding headaches can be debilitating, but home remedies can soothe the discomfort and help you through. These include:

  • Applying an ice pack

  • Reducing stress triggers by practicing relaxation techniques

  • Non-steroidal anti-inflammatory drugs (NSAIDs) and prescription pain medication

  • Acupuncture

  • Prescribed headache medications like Triptans and Gepants

  • Biofeedback

  • Avoiding dietary triggers like red wine or lectins

Weak Bones

Estrogen is closely linked to bone strength, reducing the natural breakdown of bones and helping the body absorb calcium. Low estrogen during and after menopause can increase bone loss and the risk of osteoporosis. High cortisol and thyroid hormone imbalance can also lead to more fragile bones and more frequent fractures.

You can keep your bones strong during menopause by:

  • Using regular bone density scanning to identify a high fracture risk

  • Strength training 

  • Consuming enough vitamin D and calcium in your diet 

  • Hormone therapy, particularly as you age

  • Medications like risedronate or bisphosphonates if you’re over 60

Learn more about how to spot a hormone imbalance in our article: Think You Have a Hormone Imbalance? How to Know if Your Levels Are Off.

What Causes Hormonal Imbalance in Women?

There are several causes of hormonal imbalances in women, including menopause and perimenopause, pregnancy, poor diet, sedentary lifestyle, weight gain, birth control pills, PCOS, and primary ovarian insufficiency. Most of these causes of female hormone imbalance are rooted in the endocrine system.

Your endocrine glands pump hormones throughout your body. They adjust their output to meet changing physical demands from certain health conditions, medications, and life events like pregnancy or menopause. 

These shifts can trigger the many symptoms of hormonal changes in women that are listed above. 

woman smilingMenopause/Perimenopause

Menopause signifies 12 consecutive months without a period. The average age of natural menopause in the U.S. is 51, preceded by perimenopause, which lasts an average of four years. Before reaching menopause, women may encounter changes in their monthly cycles, hot flashes, vaginal dryness, and other symptoms, known as perimenopause — the result of estrogen and progesterone levels fluctuating wildly.


As an embryo grows in the womb, a woman’s hormones adjust to nourish the fetus, thicken the uterine lining, stimulate milk production in the breasts, and maintain a healthy pregnancy. These hormones include estrogen, progesterone, human placental lactogen (hPL), and human chorionic gonadotropin (hCG).

Birth Control Medications, Implants, and IUDs

Some women use hormonal birth control pills, rings, or patches to prevent pregnancy. These usually provide a combination of estrogen and progestin (or progestin only) to prevent ovulation and egg implantation or make access difficult for sperm. However, these birth control techniques can also lead to hormonal changes in women, sometimes causing headaches, mood changes, and spotting.


PCOS is a condition that affects 6-12% of women in the U.S. It causes higher-than-usual levels of androgens and is the most common cause of infertility. PCOS can also increase insulin resistance — another type of hormone imbalance, linked to unwanted weight gain and an increased risk of diabetes, high blood pressure, and stroke.

Primary Ovarian Insufficiency (POI)

Doctors use POI to describe ovaries that stop functioning before a woman is 40 years of age. Women with POI often don’t get a period every month and may experience infertility. POI leads to low estrogen levels. The causes of POI can include genetic disorders, chemo, radiation and other toxins, autoimmune disease, although the cause is often unknown. 

Diseases that Affect Female Hormones

Several diseases and health conditions can severely impact your hormones, including:

Diagnosis: What to Do When You’ve Had Enough

The symptoms of hormonal imbalance in women are both disruptive and unpredictable. A doctor can help you identify the hormone that’s responsible, usually with a blood test. They may also ask about your medical history, including symptoms and menstrual cycle regularity.

Since levels fluctuate throughout the day (and throughout your cycle for women who are menstruating), you may need more than one test to confirm imbalances of some hormones, like testosterone or progesterone.

Your doctor may also perform a physical exam, possibly requesting an ultrasound scan to check your ovaries, uterus, thyroid, or pituitary gland for abnormalities or tumors.

FSH home-testing kits are available that claim to indicate your menopause status. However, they don’t accurately confirm menopause, as FSH levels change during the menstrual cycle and perimenopause.

The Lifeforce Diagnostic tests for key hormone balance biomarkers, including testosterone, estrogen, progesterone, DHEA, and more. 

Learn more about the essential hormone balance biomarkers in our article: 8 Biomarkers You Need to Know for Hormone Balance.

Woman Yoga Stretching 1000Hormonal Imbalance in Women: Treatment with Supplements and Medications

Hormone optimization starts with recognizing the symptoms, and often ends with supplementing the low hormones. 

When you bring your hormones back into balance, “it changes everything!” says Dr. Tandon. 

Medically speaking, “we see improvements in people’s metabolic and cardiovascular labs,” Dr. Tandon says. Cholesterol and blood sugar levels start to normalize. Dr. Hartzfeld also notes that hormone treatment improves insulin sensitivity, reduces inflammation, and lowers the risk of metabolic syndrome.

After measuring your hormone levels with a blood test, your doctor can prescribe the following hormones to help you balance female hormones. 

There are also natural supplements that can help with symptoms if you’re unable to go on hormones, or if you prefer a natural option for symptom relief.

Transdermal Estrogen

Estrogen is one of two main female sex hormones responsible for reproduction and female characteristics, such as breasts. This is also the hormone that makes you feel confident, attractive, and sensual. But there are actually many types of estrogen. Some focus on female sex organs or only pop up during pregnancy. Some, such as estradiol, have over 300 roles in the body, including the health of your brain, breasts, bones, and cardiovascular system. 

Transdermal estrogen may help correct a hormonal imbalance in women, via patches and creams. Transdermal estrogen can help keep your hormone levels in a steady state, and studies suggest transdermal estrogen is safer than oral estrogen tablets.


Progesterone is produced by the ovaries to prime and maintain the womb for pregnancy. It is also crucial for bone health and preventing breast and uterine cancer. This hormone also chills you out, which is why its sharp decline during perimenopause can result in anxiety, depression, and irritability. 

Doctors may prescribe a combination of estrogen and oral micronized progesterone to boost your levels of these hormones and restore regular periods. Oral micronized progesterone capsules can also treat premenopausal bleeding and premature labor. 


Although we typically think of testosterone for men, it’s essential for women’s health and quality of life, too. In both sexes, testosterone is key for libido, mood, cognition, and lean muscle mass. It’s the hormone that gives you your get-up-and-go drive, and when your levels are off, you may feel sluggish and unmotivated. 

As a crucial building block of estrogen, supplemental testosterone may improve your estrogen production. Women experiencing mood swings, low energy, and low libido because of low testosterone may benefit from testosterone therapy.


“DHEA is a hormone produced by the adrenal glands in both men and women. It has androgenic or ‘male type’ influences on the body,” explains Dr. Hartzfeld, but it’s essential for both sexes. One of the reasons that DHEA is so important is that it’s converted to testosterone or estrogen. 

“DHEA supports mood, energy, cognition, and muscle mass,” says Dr. Hartzfeld. “In women, it also improves vaginal tissue when used locally to help decrease vaginal dryness in menopause.” Like with many hormones, DHEA peaks in early adulthood and declines with age. 

Many perimenopausal women rely on DHEA supplements to relieve symptoms that affect their energy, skin tone, and sex drive, and it may also help with vaginal dryness.


This oral medication may help people with increased insulin resistance control their blood sugar and reduce their risk of diabetes complications like stroke and heart disease. It can also help insulin-resistant women manage weight gain.

Desiccated Thyroid

People with hypothyroidism can supplement their levels with desiccated thyroid. Studies have shown that taking this supplement can significantly resolve symptoms, although it may take several weeks to notice an improvement.

Learn more in our guide: How to Balance Hormones: 9 Natural Methods.

Is Hormone Therapy Safe? 

When we talk about hormone therapy, the first question we often hear is, “But is it safe?” Unfortunately in the medical community, there is a lot of “misinformation and confusion about hormone therapy and its safety,” says Dr. Tandon. 

Here’s why: An alarming study in 2002 by the World Health Initiative (WHI) found that animal-derived estrogen plus synthetic progesterone increased the risk of breast cancer, heart attack, and stroke among women. 

This study was later discovered to be fundamentally flawed and imprecise. “The WHI study participants were older women, with an average age of 63, many of whom were more than 10 years from their last menstrual cycle, meaning they were in menopause for years, allowing time for disease processes to already set in,” Dr. Hartzfeld explains. “This can be a very different picture when compared to women close to onset menopause.” 

Another major issue: Participants in the study received synthetic progesterone, which is not what we use today. “At Lifeforce, we prescribe micronized progesterone, which is bioidentical, meaning it is molecularly identical to the progesterone our ovaries make,” says Dr. Tandon. “The synthetic progesterone in the old study has a different chemical structure and is associated with the increased breast cancer risk. However, many people and physicians lump all progesterone products under one umbrella.” 

The truth is that multiple newer studies find that micronized progesterone does not cause breast cancer, and it may even help prevent it.

47% of American women ages 30-60 have experienced the symptoms of a hormonal imbalance, yet 72% say they didn’t know it until later in life. Even the slightest imbalance can cause fatigue, reduced sex drive, difficulty losing weight, and more. Our at-home blood test measures the 40+ biomarkers that impact your health, hormones, and quality of life, including:

  • Better Sleep

  • Reduced Weight Gain

  • Increase Libido

  • Improved Focus & Energy

The Complete Guide to Hormonal Imbalance in Men

Man surfingWomen aren’t the only ones who go through a ‘change’ in midlife. If you’ve been lacking energy, motivation, and libido lately, listen up because we’re here to spill the tea on T and hormone imbalance in men. 

“Low testosterone is one of the most underdiagnosed conditions in American men,” says Dr. Tandon. “An epidemiological study found that out of a group of men who visited their primary care doctor with a variety of symptoms, up to 55% of them tested positive for low testosterone," says Dr. Tandon. 

Your total testosterone drops by roughly 1.6% each year after you reach age 40. And more than a third of men over 45 see a doctor for low T. 

But low testosterone isn’t the only midlife change in men. As just one example, diabetes risk also increases with age and affects more men than women. Given the slow and often silent growth of male hormonal changes, being proactive about your hormone health can help replenish your energy levels, improve your relationships, and optimize your health.


Stop guessing, start addressing. Our at-home blood test measures 40+ biomarkers that drive your mental and physical performance in these key areas: 

  • Hormone Balance

  • Metabolic Condition

  • Critical Nutrients

  • Organ Health

  • Key Health Risks

Common Hormonal Issues and Their Symptoms

Symptoms of Hypogonadism

In males, low testosterone (hypogonadism) causes direct symptoms such as:

  • Reduced sex drive

  • Erectile dysfunction

  • Low energy 

  • Infertility, or the inability to conceive a child.

  • Decreased muscle mass and strength

  • Osteoporosis or bone loss

  • Hot flashes or night sweats.

  • Loss of body or facial hair

  • Breast tissue enlargement (gynecomastia)

  • Smaller testicles

Hypogonadism might also indirectly cause cognitive issues with memory, focus, word choice, and professional performance.

Total testosterone levels fall by around 1.6% every year. As testosterone drives sexual development, bone and muscle strength, and sperm production, deficiency may impact these areas in aging men.

Older males are particularly likely to live with sexual symptoms of low testosterone like erectile dysfunction.

Symptoms of Hormone Imbalance After a Prostatectomy

Men with prostate cancer sometimes require a prostatectomy to remove the prostate. However, this can reduce testosterone and increase levels of LH and FSH. 

As a result, men may experience erectile dysfunction — a common outcome of low testosterone. However, hypogonadism may also contribute to urinary incontinence, as testosterone might support improved control of smooth muscle like that of the bladder.

In one study, testosterone levels recovered to pre-operational levels within three weeks of surgery.

Hormone Imbalance and Weight Gain

Weight gain is one of the more common hormonal imbalance symptoms in both men and women. The hormones related to weight gain control hunger, feelings of fullness, calorie burning, muscle metabolism, and fat storage.

Cortisol Imbalance and Weight Gain

Animal studies have shown that the urge to eat more food in response to stress may be a biological impulse that links to high cortisol. Chronic stress appears to increase a preference for energy-dense, sugary, fatty foods. Cortisol also has links to the storage of fat around the abdomen, possibly for use as energy later. 

Hunger Hormones that Fuel Weight Gain

Ghrelin lets you know when your body needs food, stimulating feelings of hunger. People with obesity tend to have lower levels of ghrelin but may be more sensitive to this hormone, naturally making them feel more hungry more of the time. 

Obesity, in turn, may numb the nervous system’s ghrelin-reducing response to eating, meaning that ghrelin doesn’t decrease after meals

Resistance to Fullness Hormones Can Increase Weight

Your body fat releases leptin to help you feel full after eating. Leptin is your body’s hormonal counterbalance to ghrelin, letting you know when you’ve had enough food. 

People with obesity also have high leptin levels but reduced sensitivity to this hormone, meaning they may not feel full after eating. This can drive further weight gain.

Low Levels of Sex Hormones Can Lead to Weight Gain

Testosterone and estrogen both impact how the body burns fat, so decreasing levels over time may contribute to fat buildup. Low testosterone reduces muscle mass, which makes your body less efficient at burning fat. 

Estrogen has a complex relationship with energy metabolism, appetite control, and fat distribution, and a drop in postmenopausal levels of the hormone may make obesity three times as likely.

man strength training in gymHormonal Imbalance Symptoms in the Metabolism

An insulin imbalance can affect how your body uses and circulates blood sugar. Insulin is a vital hormone that allows cells to remove glucose from your blood, bringing down blood sugar levels and providing energy for bodily functions.

However, if your blood sugar levels stay elevated for too long, your muscle, fat, and liver cells become less sensitive to insulin — a development known as insulin resistance. This means that blood sugar stays consistently raised, meaning that your body makes less insulin over time.

No hormone operates in isolation. Other hormones can impact insulin’s effectiveness and blood sugar control, such as:

Here are optimal levels of total testosterone:

In men: 700 - 1,200 ng/dL

In women: 50 - 80 ng/dL

  • Low estrogen. Estrogen plays a direct role in balancing glucose levels. When levels drop during and after menopause, this can lead to insulin resistance and disrupt the metabolism.

Here are optimal levels of estradiol, a form of estrogen: 

In men: 10 - 50 pg/mL

In women: This depends on age and timing of the menstrual cycle. In menopausal

women on hormone therapy, the optimal range is 50 - 100 pg/mL. In women in the

reproductive age range, normal levels are 30 - 400 pg/mL. Optimal levels depend on the

timing of the cycle. 

  • Consistently high cortisol. Cortisol reduces your insulin levels and makes more glucose available from the liver. Short-term, this can help you survive a stressful situation with increased energy. However, chronic stress can interfere with how much insulin your body makes and how your cells respond.

For most tests that measure cortisol levels in your blood, the normal ranges are:

6 a.m. to 8 a.m.: 10 to 20 micrograms per deciliter (mcg/dL).

Around 4 p.m.: 3 to 10 mcg/dL.

The tricky aspect of insulin resistance is that it doesn’t cause symptoms until blood sugar levels become dangerously high. For this reason, regular blood sugar monitoring is vital to ensure your body responds to insulin. Sustained high blood sugar can lead to type 2 diabetes and an increased risk of heart disease, stroke, and kidney failure.

Early Male Hormonal Imbalance Symptoms

If something feels off with your health, but you can’t quite put your finger on it, it might be time to look into your testosterone levels. Diabetes can cause similar symptoms, increasing the risk of testosterone deficiency. Thyroid problems and other hidden health issues can also drive hormonal imbalances in men.

Low Libido

Reduced sex drive is one of the main signs of hormone imbalance in men. When it strikes, it can cause depression and distress, affecting your body image and relationships. One study of 1,475 men found that about 28% have extremely low T.

​​For men, testosterone and DHEA levels drop with age, which can lead to lower arousal, desire, and sometimes difficulty achieving and maintaining an erection, according to Lifeforce Physician Russell Van Maele, DO. 

However, testosterone supplementation may help improve libido, along with other strategies like individual or couples therapy, communicating with your partner, and managing your stress.

We also offer FDA-approved products for sexual optimization. Learn more about them in our article: How To Have a Healthier, More Satisfying Sex Life

Low Energy

You may have noticed that you don’t tackle challenges the way you used to. Low energy is one of the earliest and most common signs of hormonal imbalance in men. Hypogonadism and thyroid problems can impair your cognitive ability, increase body fat, disrupt sleep, and cause muscle loss, draining your energy and reducing your ability to complete important tasks.

Learn more about boosting your energy in our article: 17 Energy Boosters to Level Up Your Day

Low Mood

Male hormonal changes can affect your mood, as your levels fluctuate from day to day, month to month, and even with the seasons. In a massive review of 124 studies, hypogonadism — when the body’s sex glands produce little or no hormones — increased irritability, mood swings, and depression. 

Testosterone replacement therapy (TRT) may help manage depression for some. Exercise, a consistent sleep schedule, staying social, and regular relaxation can all help boost your mood.

Discover other natural daily mood boosts here:17 Quick Pick-Me-Ups to Improve Your Day

Man tired from working outMale Hormonal Imbalance Symptoms that Develop Later

If you fail to notice and treat hormonal imbalances when they first appear, they may develop into symptoms like erectile dysfunction (ED), muscle loss, and infertility. But if you check your hormone levels regularly, you’ll have a better chance to treat the condition before it causes harmful or irreversible changes. (Get started by checking your levels with the Lifeforce Diagnostic.) 

Erectile Dysfunction (ED)

ED can leave you depressed and anxious. It’s defined as a reduced ability to achieve and maintain an erection. It’s unclear whether low T causes ED, but a doctor may prescribe TRT for ED before exploring other causes.

Muscle Loss

Muscular strength is a key part of your performance and your self esteem. Yet it peaks in your 30s, dropping 1-3% each year. Testosterone supplementation can help increase the size of muscle fibers and may help you retain muscle mass.

One placebo-controlled study gave TRT to men over 60 for three years. The therapy significantly improved muscle mass and modestly boosted muscle strength and function.


Several types of hormonal imbalances in men can lead to infertility. Testosterone is central to healthy sperm production, so declining levels over time can severely impact your reproductive ability.

Other examples of male hormonal imbalance that can lead to infertility include disorders of the:

  • Hypothalamus

  • Pituitary glands

  • Thyroid glands

  • Adrenal glands

Diabetes — an insulin hormone imbalance — can lead to neuropathy or nerve damage, which in severe cases can result in retrograde ejaculation. This is a condition where...' semen enters the bladder instead of leaving the penis during sex. This can drive fertility problems and increase the stress, emotional burden, and relationship difficulties that accompany infertility.


Men can experience gynecomastia — enlarged breast tissue — at any age, but the condition affects 24 - 65% of men aged 50 and over. The most common cause is a male hormonal imbalance that’s part of the natural aging process. 

Like women, men also produce estrogen, the female sex hormone. If your testosterone levels aren’t high enough to balance your estrogen levels, you may see an increase in female traits like breast tissue growth.

Metabolic Symptoms of Hormonal Imbalance in Men

Hormonal changes in men can affect many different systems in the body, including the metabolism. This can lead to:

  • Slow or rapid heartbeat

  • Unexpected weight gain or loss

  • Digestive issues like constipation or diarrhea

  • High blood cholesterol

  • Irregular body fat distribution

Several hormone imbalances in men can affect metabolism: 

  • Hypothyroidism can slow down the metabolism due to a shortfall in thyroid hormone.

  • Hyperthyroidism speeds up the metabolism.

  • Diabetes can make your cells struggle to remove glucose from the bloodstream for energy.

  • Low testosterone can increase body fat and reduce muscle mass.

These changes aren’t sex-specific, but they’re worth monitoring before you see a doctor for hormonal imbalance.

older-man-on-tabletCauses of Male Hormonal Imbalance

Hormonal imbalance is complex. Your body’s hormones closely interact, and the causes of imbalance aren’t always clear. Various conditions can drive hormonal imbalance in men, and you may not be able to rebalance your hormones until a physician identifies the underlying cause.


Your hormone levels will naturally change throughout your life. Aging decreases testosterone, but it also reduces aldosterone and cortisol levels. Aldosterone helps your body control fluid and electrolyte balance, so lower levels can lead to orthostatic hypotension, making you feel faint shortly after standing up. Cortisol is part of your body’s stress response, and while a low level is generally a good thing, when cortisol is consistently low, it can be associated with decreased energy, decreased cognitive performance, and impaired glucose regulation. 

Discover how science is responding to aging here: Can Science Really Reverse Aging? What the Future Looks Like


Diabetes is the leading hormonal condition in the U.S. It develops when the body can’t make or use enough insulin, affecting how much glucose your body can use. Men are more likely to develop type 2 diabetes than women, as they store more belly fat — a known risk factor. Diabetes may also increase your testosterone deficiency risk.

Thyroid Disorders

Your thyroid gland produces hormones that moderate your metabolism. When it makes too little (hypothyroidism) or too much (hyperthyroidism), it can affect your metabolism and sexual function. In women, these conditions are often caused by autoimmune disorders, but in men, the underlying causes, such as goiter, are generally unrelated to the immune system

Hormone Therapy

Some people with prostate cancer take androgen suppressors to reduce their levels of androgens — male sex hormones like testosterone. Androgens can feed the growth of prostate cancer cells. However, androgen suppressors can also drive a hormonal imbalance in men who take them.

Cancer Treatments

Some cancer treatments can damage the endocrine glands. For example, radiation therapy can injure the thyroid. Up to 50% of people who receive radiation treatment for head and neck cancers develop hypothyroidism. Also, surgery to remove the prostate for prostate cancer may trigger a significant drop in testosterone levels.

Tumors and Growths

A benign or malignant growth on the endocrine glands like the thyroid, pituitary, and adrenal glands can lead to a hormone imbalance in men. Tumors affecting your neuroendocrine system, which sends signals throughout the body using hormones, can also affect your levels. Tumors either reduce or increase hormone production.


Stress is a natural reaction to challenges, but when it’s prolonged and constant, it can impact other hormones by elevating your cortisol levels. When that happens, it can lead to a drop in testosterone, which recovers during lower-stress periods. Chronic stress, however, can affect the cells that make testosterone and reduce production. 

Pro Tip: A few conscious deep breaths at strategic times throughout the day can help zap your stress. See our article: 5 Science-Backed Ways to Reduce Stress

Injuries, Damage, and Trauma

Surgical injuries, restricted blood flow, bacterial and viral illnesses, and head trauma can damage different endocrine glands. Damage to the pituitary gland, hypothalamus, or thyroid can lead to production issues and cause changes to hormone levels. Men have a higher rate of traumatic brain injuries than women.

Tony Robbins“The importance of hormones can't be overstated. These natural messengers regulate our growth and development, our blood pressure, our sex drive, our sleep, and just about all our body's core functions.”- Tony Robbins, LIFE FORCE

Male Hormone Imbalance Tests & Diagnosis

If your hormones are out of balance, there are now effective ways to spot the problem and treat it. If your physician suspects that your symptoms result from a male hormone imbalance, they’ll likely request blood tests to measure your serum levels. 

In some cases, you may need to test more than once. Your levels of testosterone, insulin, and glucose change throughout the day, so your physician may order multiple tests for maximum accuracy.

Your doctor will likely perform a physical exam too, and ask about your medical history and symptoms.

You can take a proactive approach by getting an at-home blood test with the Lifeforce Diagnostic. You’ll then have a consultation with a Lifeforce physician to review your results and create a personalized plan of action.  

What are optimal levels of testosterone? 

At Lifeforce, our mission is to optimize your health, not just improve it. That is why we look at optimal levels in our blood tests, instead of simply normal levels. 

Most blood tests are checked against “normal” levels based on the average of the people who go to that lab. These ranges are typically focused on highlighting serious health conditions, not on helping people understand how their levels compare to what’s optimal for performance.

At Lifeforce, these are what we consider optimal levels of testosterone in men: 

  • Total testosterone (the total amount of testosterone in your body): 700 - 1,200 ng/dL

  • Free testosterone (the portion of testosterone that is not bound to proteins, and is therefore available to act on cells and tissues throughout the body): 150 - 190 pg/mL

Learn more in our article: Testosterone Optimization: What Every Man Over 30 Needs to Know 

man having his blood drawnTreating Hormonal Imbalance in Men

The treatment for a male hormonal imbalance depends on the particular hormone causing symptoms. Generally, treatment involves supplementing a deficient hormone and restoring hormone balance for men, but conditions like diabetes require daily management through healthy lifestyle choices.

The good news is that several well-established, clinically validated strategies exist to pause or reverse testosterone decline. “People are becoming less tolerant of the conventional aging process,” says Dr. Tandon. “They still want to maximize their potential. They are out there in their 40s, 50s, 60s, living full and demanding lives. It's pretty amazing to see what a role testosterone replacement can play in that.”

Treatment for Low Testosterone

TRT is the flagship treatment for low T. It’s done in a lifelong supplementation process that physicians can administer in several ways, including:

Learn more about Lifeforce’s Hormone Optimization For Men Program here

Learn about natural ways to increase testosterone here: 12 Ways to Naturally Increase Testosterone

Is Testosterone Therapy Safe?

“I always want to reassure people that testosterone therapy is super safe,” says Dr. Tandon. “We've come a long way in terms of our finesse in dosing, treating, and monitoring to ensure people are not having any side effects or lab changes that we need to address.”

“In terms of benefits versus risks,” Dr. Tandon says, “this is a very attractive therapy and new research is only supporting that further.”

Treatment for Insulin Imbalance (Diabetes)

Controlling diabetes involves managing your blood sugar, cholesterol, and blood pressure. This includes:

  • Following a meal plan (usually set by a dietitian) packed with whole grains, beans, lean white meat, and low-fat dairy.

  • Engaging in more than 30 minutes of physical activity on most days.

  • Regularly monitoring blood glucose.

  • Taking Metformin as advised by your physician.

Your physician should consistently monitor your insulin and glucose levels to gauge improvement.

Treatment for Thyroid Hormone Imbalance

If you feel sluggish and cold, you’re gaining weight, you feel depressed, and your face is puffy, your thyroid hormones may be out of line. Thyroid hormone therapy provides synthetic substitutes that boost thyroid hormone levels in those who don’t produce enough. You’ll need to keep seeing your physician to monitor this condition, as your levels can continue to drop over time.

Lifeforce’s pharmaceutical offerings include Desiccated Thyroid, a combination of hormones that are normally produced by the thyroid gland to regulate your body's energy and metabolism. We prescribe this when the thyroid does not produce enough of this hormone on its own.

If you need treatment for a different condition, let your provider know about your thyroid therapy, since other medications might affect the dosage.


Awareness of hormone change symptoms can help you take the vital next steps in optimizing your hormone levels. This will involve discovering which hormones are either deficient or excessive and speaking to a physician about how to correct levels.

How to Test for a Hormone Imbalance

A range of tests can help a doctor identify imbalanced hormones, including:

  • Blood tests. Testosterone and estrogen levels will show up on certain blood tests. For example, an estradiol test shows levels of the main form of estrogen made by the ovaries. Testosterone tests most commonly test levels of total testosterone. Testing blood glucose may indicate low insulin or insulin resistance. The Lifeforce Diagnostic at-home blood test measures 40+ biomarkers including testosterone, estradiol, DHEA, FSH, TSH, and IGF-1. 

  • Urine tests. This can help a doctor identify levels of hormones related to the menstrual cycle and menopause. For example, if a test for FSH shows elevated levels, it might be a sign that you’ve entered a stage of menopause. This provides extra information to bring to your doctor that supports further diagnostics.

Scans like X-rays and ultrasounds can also identify physical issues like tumors on glands that might be causing a hormone imbalance.

Can You Test Hormones at Home?

Home testing is available to measure hormone levels, blood glucose, and many other measurements of hormonal imbalance. To ensure accuracy, make sure you take the following precautions:

  • Use test kits approved for use by the Food and Drug Administration (FDA).

  • Follow the instructions provided.

  • Avoid using expired kits.

  • Follow up with a medical professional to gain perspective, further testing, and actionable next steps. 

A home test isn’t a guarantee of a diagnosis, nor will it explain the underlying cause of a deficiency. However, it can serve as a helpful signpost for the next step of your journey toward more comfortable and energized aging.

However, if a hormone imbalance occurs due to aging or menopause, a Lifeforce Diagnostic panel can show levels of over 40 biomarkers and create a picture of your overall health. If your symptoms are due to a hormone imbalance, our clinicians can identify and recommend a supplement regimen to return you to healthy levels for your age.

You can do the Lifeforce Diagnostic at home, though the blood draw is performed by a licensed and experienced phlebotomist, then sent to a lab for analysis, with the results reviewed by our team of doctors.

How to Treat a Hormone Imbalance

The right way to treat a hormone imbalance depends on which hormone is deficient or excessive. Your physician may prescribe hormone replacement therapy to supplement low levels of a particular hormone. Medication is also available for high hormone levels, although some imbalances like hyperthyroidism may require surgery or radiation therapy.

Your hormones will change throughout your life, and some periods of imbalance are inevitable. However, a balanced approach to managing hormones includes maintaining a healthy weight through exercise and diet, stress management, and good sleep hygiene. 

For example, treating estrogen dominance involves:

  • Maintaining a healthy weight

  • Eating a high-fiber, anti-inflammatory diet full of cruciferous vegetables like broccoli and cauliflower 

  • Eating plenty of whole soy products that can affect estrogen metabolism

  • Limiting alcohol intake

  • Avoiding compounds like phthalates and bisphenol A (BPA) that act like estrogen in the body, known as xenoestrogens

If lifestyle changes don’t improve hormonal imbalance symptoms, consider seeking medical advice.

Find out more about natural ways to balance your hormones.


Hormonal imbalances can affect people at different stages of life, commonly affecting mood, energy levels, weight gain, metabolism, and sexual function. Common culprits are estrogen, testosterone, cortisol, insulin, and appetite hormones, including ghrelin and leptin. 

Hormones are a cocktail — they regularly interact, and a fine balance is necessary to operate at peak health. Diagnosing hormone imbalance typically involves blood tests, although scans may be necessary to rule out underlying conditions.

Older Man Cardio Training WorkoutLIVE BETTER, LONGER

85% of Lifeforce members report improved quality of life within their first three months.

Optimize your health and longevity with the Lifeforce Diagnostic blood test plus Membership, based on research from the Tony Robbins bestseller, Life Force. We’ll measure 40+ biomarkers that drive your mental and physical health, then get you on the path to optimized health.

  • Biomarker testing every three months

  • Expert clinical support

  • 1-on-1 health coaching

  • Members-only hormone optimization

This article was medically reviewed by: 

Susan Grabowski, DO, ABAARM Board Certified in Anti-Aging and Regenerative Medicine

Kimberly Hartzfeld, DO, ABOG American Board of Obstetrics and Gynecology, IFMCP Institute for Functional Medicine Certified Practitioner

Alex Antoniou, MD, ABNM Board Certified in Nuclear Medicine

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