Are your hormones trying to tell you something?

Mood swings, excess hair, night sweats… Hormone imbalance is at the root of many of our health problems. But, says Jo Macfarlane, groundbreaking treatments mean we no longer need to suffer in silence.

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From the moment of our first period to the slings and arrows of the menopause and beyond, hormones play a huge role in our everyday health. They influence everything from joie de vivre to weight and fertility. For that reason, hormone replacement therapy (HRT) has long been a helpful solution, upping levels of the female sex hormones oestrogen and progesterone which naturally decline with age.

Contrary to popular belief, though, HRT is not just for the menopause– different forms of the medication can be used to address an imbalance of other hormones in the body at any time of life.

As Dr Gareth Nye, ambassador for the Society for Endocrinology explains, our bodies have around 50 major hormones, known as the ‘endocrine system’– all excreted by our glands and which instruct cells to perform a particular task.

‘Our hormones are all linked; they’re a network, so changes in one area have knock-on effects elsewhere,’ Dr Nye says.

Hormones are a form of signalling molecule which govern all the systems of the body, including how efficiently they run. When they are imbalanced, the effects can be significant– and this is when it might be time to go to your GP. Here are some of our most common problems– and the hormones that may be causing them…

HAS YOUR LIBIDO GONE FLAT?

It might be time to think about replenishing your testosterone levels. While it’s often assumed to be an exclusively male sex hormone, women actually produce three to four times more testosterone than oestrogen during their 20s and 30s. It’s still at far lower levels than in men, but it plays a crucial role in brain health by increasing the amount of dopamine in the body– a chemical messenger which plays a role in thinking, decision-making and pleasure.

Just as oestrogen and progesterone levels plummet with age, so do those for testosterone. Not all women will notice the effects, but experts say that, if after starting on standard HRT treatment, you’re still left with symptoms such as low mood, insomnia, anxiety and a lacklustre libido, then testosterone replacement might be the answer. It’s been credited with restoring women’s sex drive and ‘transforming’ our mental health.

There is also evidence that men and women with low testosterone could be more likely to have heart problems. Upping levels might not only protect against that, say experts, but could also protect women’s muscle mass and brittle bones from osteoporosis. The advice is to try standard HRT first, but if symptoms such as low libido, anxiety and insomnia persist, you can ask to be prescribed testosterone cream.

Women who think they could benefit from testosterone should contact their GP and ask to be referred to a menopause specialist. Many private menopause doctors will also prescribe their own formula. The availability of testosterone to British women is set to increase with the advent of an Australian cream developed especially for women called AndroFeme – the company behind it plans to submit an application for a UK licence later this year.

ARE YOU TOO HAIRY?

This time it might be too much testosterone. Some of this crucial hormone is produced in the brain, while the rest comes from the ovaries and the adrenal glands. It means that, if the ovaries are not functioning properly, normal levels of testosterone can be disrupted.

The one in ten women with polycystic ovary syndrome, which causes ovaries to enlarge and makes it harder to release eggs, may find that they over-produce testosterone as part of this ovarian malfunction. This causes excess hair on the body and face. Some medications, such as steroids and anti-inflammatories, which affect the adrenal gland, can also trigger a similar effect. Treatments include taking a contraceptive pill to balance out the male hormones, and a cream called eflornithine, which can slow the growth of unwanted facial hair.

TUMMY FAT HARD TO SHIFT?

This may be a sign of reduction in oestrogen levels as the menopause approaches. Oestrogen helps to regulate the body’s metabolism and body weight by acting on another hormone called leptin.

The more leptin in the body, the more full you feel after eating. But as oestrogen levels naturally decline, those for leptin also fall and appetite ramps up as a result. Studies have also found that the way fat is distributed round the body changes as we approach the menopause, too. Even if we don’t put on weight, fat stores are shifted to the abdomen. Stress can also cause extra weight around the middle thanks to the release of another hormone, cortisol.

It’s important to take steps to prevent or reverse this weight gain. Excess weight around the abdomen is known to increase the risk of heart disease and type 2 diabetes, and some types of cancer including breast, colon and endometrial.

A Mediterranean diet based on whole foods, with limited processed carbohydrates and sugary products, will help – as will regular exercise and reducing stress.

FEELING THIRSTY AND TIRED?

You may be resistant to insulin, a hormone produced by the pancreas to keep blood sugar or glucose levels in check. Normally, insulin works as the ‘key’ to unlock the cells in our muscles, fat and liver, allowing glucose to enter and provide energy.

But if we’re storing too much fat around the pancreas and liver, and regularly have high blood sugar, our cells can become ‘insulin resistant’, which means they no longer take in glucose and the sugar stays in the blood. This ends up in our urine, pulling more water out of the body and causing dehydration and thirst. What results is type2 diabetes, a condition which affects four million of us and can cause serious problems such as heart disease, high blood pressure and damage to the nerves and eyes.

It’s important to see your GP if you’re feeling very tired or thirsty all the time, and have an increased need to urinate. Other symptoms include blurred vision and itchy genitals. You don’t have to be overweight– although obesity is a major risk factor for type 2, it is thought to be linked to how and where individuals store fat.

Losing weight can send the condition into remission, and blood-sugar-lowering medication, such as metformin, can help manage the effects.

NOTICED UNUSUAL BLEEDING?

It could be a sign of too much oestrogen and should always be checked by your GP, as this has been linked to an increased risk of uterine cancer.

The endometrium – the tissue which lines the uterus – is particularly sensitive to oestrogen. This grows during the menstrual cycle to prepare for an egg to be released, and is shed– prompting menstruation – when that egg isn’t fertilised.

Too much oestrogen can cause too much tissue to grow, potentially leading to endometrial cancer which affects nearly 10,000 women a year in the UK. Women who have never been pregnant are particularly at risk.

‘It’s as though your body knows what normal growth is to support a pregnancy, but if you haven’t been pregnant, the endometrium thinks it has to keep on growing,’ Dr Nye says.

There are other explanations: unusual bleeding can also be linked to fibroids, chlamydia or polycystic ovary syndrome. It’s also normal to have some irregular bleeding in the first few months after starting a new contraceptive pill. See your GP about any changes that are not normal for you – such as bleeding in between periods, very heavy periods or bleeding after the menopause.

IS YOUR FACE PUFFY?

You might be overproducing cortisol. Stress activates the body’s ‘fight or flight’ mechanism. When that happens, the hypothalamus, a gland in the brain, instructs the adrenal gland to release cortisol. Known as the ‘stress hormone’, it causes blood pressure to rise– an important mechanism designed to prepare us to react.

But regularly releasing too much cortisol can lead to a condition called Cushing’s syndrome. The main symptom is a distinctive pattern of weight gain on the chest and tummy, with a build-up of fat on the back of the neck and shoulders, and a red, puffy and rounded face. The most common cause alongside stress is medication – anything that works on the adrenal gland, such as anti-inflammatories and steroids taken to treat asthma, rheumatoid arthritis or eczema.

People with the condition are four times more likely to die from heart disease, but symptoms can be managed with drugs. It’s also advisable to reduce stress levels and avoid high-fat foods.

For more expert information about hormones and your health, visit the Society for Endocrinology’s You and Your Hormones pages at yourhormones.info