You already know that, contrary to what you’ve sometimes read or heard (even, gasp!, from healthcare professionals), the menstrual cycle is no just an inconvenient, unnecessary monthly bleed. Your “period” is actually part of a complex hormonal interplay leading up to the main event of your cycle—ovulation. And, if you’ve read our Razones por las que las mujeres necesitan la menstruación, you recognize that ovulation is not “just for making babies,” but is in fact a quinto signo vital of women’s health. But how do you know if something is “off” hormonally? Could a hormonal imbalance be behind your heavy, painful, or absent periods? Here, let’s talk about signs that point to a hormonal imbalance.
Hormones make ovulation happen
Every ciclo menstrual, numerous hormones work together to support a woman’s cycle. The four primary reproductive hormones are Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estrógenoy Progesterona. At the beginning of the cycle, FSH stimulates multiple follicles (think of them as “egg containers”) to mature in one of the two ovaries in the female body. As the follicles “ripen,” estrogen rises rapidly.
This rapid pattern of rising estrogen stimulates LH to surge, causing one of the follicles to fully mature and burst, culminating in the release of an egg into a fallopian tube (the event known as ovulation). The follicle that was previously holding the egg becomes the cuerpo lúteo. The corpus luteum then produces progesterone for the remainder of the cycle. If the egg is no fertilized, the corpus luteum will begin to degenerate approximately 8-10 days following ovulation, leading to a decrease in progesterone and eventually menstruation (approximately 14 days after ovulation). At this point, a new cycle begins.
This complex hormone “phone tag” is critical for the female body to maintain healthy homeostasis. As we explained in our Razones por las que las mujeres necesitan la menstruación, the optimal balance of estrogen and progesterone is essential for healthy blood clotting, fear and anxiety control, heart function, bone formation, and more!
How can I know I’m ovulating?
By using evidence-based Fertility Awareness Methods (FAMs), also known as Natural Family Planning (NFP) methods, you can determine when you likely ovulated (though an ultrasound is the only way to definitively confirm ovulation). Depending on the method, you can track the action of the four primary reproductive hormones (or their urinary metabolites) through hormonal monitors, cervical mucus observations, temperatura corporal basal, LH strips, progesterone strips, and/or cervical position, to name the primary biomarkers. To accurately practice any of these methods, you must work with a trained FAM or NFP instructor.
(And we’ve even provided the recursos to help you find a method and instructor that is right for you!)
What are the signs of hormonal imbalance?
When you chart with a FAM or NFP method, you gain cycle knowledge and resources to detect hormonal imbalance via biomarkers that indicate anormal hormonal patterns. Think of them like the ‘check engine light’ in your vehicle. These signs include long follicular phases, short luteal phases, heavy or light periods, and too much or too little moco cervical (just to name a few examples).
Even though cycle tracking is the best initial tool for detecting hormonal imbalance, you can pay attention to other indicators even if you aren’t yet experienced in cycle charting.
Premenstrual syndrome (PMS), mood disorders, complete loss of cycles (amenorrhea), and infertility or reproductive disorders can all indicate hormonal imbalance.
Síntomas del síndrome premenstrual
Premenstrual syndrome (PMS) is typically categorized by a collection of symptoms, like mood swings, breast tenderness, bloating, fatigue, and cramps. Unfortunately, many women believe that PMS is simply an inevitable part of being female. This is far from the truth. As a FEMM Fertility Awareness Instructor, I tell my clients to chart their PMS symptoms on a scale of 1-10 (with 10 being the most severe), because these symptoms, although common, are not necessarily normal.
Mild symptoms can indicate that your body is going through normal hormonal changes, such as the surge of estrogen before ovulation or the drop of progesterone near the end of the cycle. However, if the symptoms you experience before your period are so severe as to affect your day-to-day life, you should consult a healthcare professional trained in medicina reproductiva reparadora (MRR) who will understand how to address the hormonal imbalance(s) that may be contributing to your PMS.
Amenorrhea
Amenorrhea is the loss of menstrual cycles when a woman debe normally be cycling (i.e. not during menopause, pregnancy, or, in some cases, breastfeeding). As Lauren Fleshman explains in her book, Bueno para una chica, exercise-induced amenorrhea is a common concern for female athletes and it increases their risk of injury and other health concerns.
Amenorrhea is a more obvious indicator of hormonal imbalance. If you are not having a period, you are not ovulating. De facto, you are missing out on the whole body health benefits of ovulation, including breast, brain, bone, heart, immune effects.
Reproductive disorders like PCOS and endometriosis
Hormonal imbalances are hallmark signs of the most common reproductive disorders, polycystic ovary syndrome (PCOS) and endometriosis. Endometriosis often presents with signs of estrogen dominance that can be seen through irregular biomarker patterns in FAM/NFP charting. Endometriosis also can present through gastrointestinal issues, nerve pain, fatigue, and painful sex. There are different forms of PCOS, and thus a variety of symptoms, but some common symptoms of PCOS include insulin resistance, abnormal hair growth or loss, thyroid disorders, and chronic inflammation.
Hormonal birth control is not the solution to a hormonal imbalance
Many healthcare professionals “treat” hormonal imbalance and its symptoms with hormonal birth control. But hormonal birth does not “regulate” cycles, it stops them all together (even the bleeding a woman experiences during the placebo week of birth control pills isn’t a true period!). Hormonal birth control merely puts a bandaid over the problem(s), potentially allowing the issue(s) to worsen over time. Synthetic hormones do not function the same as our bodies’ natural hormones; rather, they primarily suppress ovulation. What’s more, they come with a multitude of riesgos sanitarios.
What do I do if I think I have a hormonal imbalance?
You may be wondering, if synthetic hormones are not the proper treatment, what is? Know that addressing hormonal imbalance is not a one-and-done issue. It may be a symptom of o the cause of a variety of problems. Healthcare professionals trained in medicina reproductiva reparadora (RRM) will understand how to read your symptoms and conduct appropriate exploratory testing or imaging to identify and then treat the root cause of your hormonal imbalance.
If you are not already charting your cycle, that is a great first step to resolving your hormonal imbalance. A trained FAM instructor can help you connect with an RRM professional, and your cycle chart will be a helpful first medical record for the RRM professional to begin assessing and diagnosing your symptoms. You can also review our Guía to treating menstrual issues for holistic ways to start addressing your hormonal imbalance. Our Lista de síntomas del ciclo can be another helpful tool to fill out and bring to your doctor.
The bottom line on hormonal imbalance
Hormonal imbalance is a sign that your body is struggling to ovulate, or is not ovulating at all, which can affect your overall health and wellbeing. If you have symptoms of hormonal imbalance such as PMS, irregular cycles, amenorrhea, irregular biomarkers, or if you have been diagnosed with a reproductive disorder like PCOS or endometriosis, seek out a healthcare professional trained in restorative reproductive medicine. They can use FAM/NFP charting to assess your unique cycle and treat your hormonal imbalance at its root cause(s).
