Women of all ages can experience hormonal imbalances, as contributing factors such as diet, stress, lifestyle, sleep and exercise can all play a role in how our bodies feel.

Lyla Keeler, LMT/MMP, a Colorado-based massage therapist, always had trouble with her periods. One of the issues she constantly had to struggle with were ovarian cysts. In her late 30s, the pain she experienced because of them hit a peak. During an appointment with her OB-GYN, her doctor told her to get her clothes on and meet him at the local hospital. She had a 10-centimeter cyst on her right ovary and it needed to be removed immediately.

That surgery, five years ago, plunged her into a health care nightmare and, after more surgeries, including a hysterectomy and the removal of her remaining ovary, immediate menopause. She couldn’t take a birth control pill to get her estrogen because of concerns about blood clots so she was prescribed estrogen patches, but they kept falling off.

She was miserable. She felt lost and alone trying to get relief but not finding anyone who understood what she was experiencing: She had no energy and was depressed. Her skin, hair and nails were dry and brittle. Her sex drive plummeted.

“Your body type just changes drastically,” she said. “You don’t have the energy you had any more. You don’t feel, I think, in ways, like a woman anymore when your estrogen and progesterone and testosterone are that low.” She finally found some relief from her symptoms when she began using a multi-symptom dietary supplement.

Most commonly, women experience lower estrogen (and lower progesterone and testosterone) during perimenopause and menopause, but low estrogen can happen to younger women (and even men), too.

“Women of all ages can experience hormonal imbalances, as contributing factors such as diet, stress, lifestyle, sleep and exercise can all play a role in how our bodies feel,” said Katie Bressack, a Los Angeles-based certified holistic health coach who specializes in hormone health.

Hormone Health: Estrogen, Progesterone and Testosterone

While many people tend to focus on estrogen, this hormone works in conjunction with progesterone and testosterone. “When you’re assessing for the health of your reproductive cycle or the hormones, you can’t really look at one hormone in isolation,” said Lisa Lewis, ND, a naturopathic and functional medicine doctor based in New Jersey. “It has to be relative.”

Estrogen, progesterone and testosterone are the three major sex hormones that regulate a woman’s reproductive system. They work together to keep you feeling good and things operating as they should.

Besides perimenopause and menopause, causes of low estrogen include excessive exercise (think elite-level athletes), eating disorders, a low-functioning pituitary gland, ovary conditions, chronic kidney disease, and extreme dieting.

When estrogen, progesterone and testosterone are lower than they should be or are out of balance, you are likely to experience some unpleasant symptoms, such as mood swings, depression, anxiety, hot flashes, decreased bone density, migraines, dryness (skin, hair, nails, and vaginal, too) and the walls of the vagina may thin, causing painful sex, said Bressack.

“We must remember that our health is unique, so not everyone will have the exact same symptoms,” she said.

No matter whether you are a younger woman experiencing low estrogen or are in perimenopause or menopause, there are many management options. But before you jump into those, it’s important to get a good perspective on how all your hormones—not just estrogen, progesterone and testosterone, but also cortisol and your thyroid hormones—are working together, say Bressack and Lewis.

“All [hormones] have different functions in the body and they all tell us something beautiful about where we are in our process [and] in our symptoms,” said Lewis. Saliva and urine tests should be enough to give you a good picture.

(If you’re trying to get pregnant but haven’t been able to, Lewis also recommends an assessment of your reproductive structures to see if there are physical issues with, for example, your ovaries or fallopian tubes.)

Once you have your hormone levels tested, then your medical provider can assess what areas need to be targeted and you can work together to chart a plan for balancing any imbalances and relieving symptoms.

Hormone Replacement Therapy?

It might be tempting to leap into hormone replacement therapy, said Lewis and Bressack, but there are other options you may want to try first. “The con for Western medication is that it may solve an immediate issue but not the long-term cause,” said Lewis.

“There are benefits in each approach, but I would strongly suggest starting with diet and lifestyle changes first before jumping into hormone replacement therapy,” said Bressack.

Assessing your current diet is a good place to begin, she said, followed by an evaluation of your stress levels and sleep patterns.

“We must look at the fundamentals of your life and your health and start there before just jumping into hormone treatments,” she said. “We can support your body so much with specific foods, supplements and lifestyle changes, and I think that is a really good place to start and then add other hormone treatments in if needed.”

If hormone replacement therapy is considered, you should discuss with your medical provider whether to go the synthetic hormone route or to use “bioidentical” hormones, they said.

“Bioidenticals” are a form of hormone replacement therapy that is often called “natural” because, while created by scientists in a lab, these hormones are chemically similar or identical to the molecules of the hormones made by the body.

Pre-made bioidenticals produced by pharmaceutical companies are FDA-approved, but you can also have custom-made forms compounded by pharmacists based on a doctor’s prescription. The custom-made forms generally haven’t been tested or approved by the Food and Drug Administration, however, and many major medical organizations say that not enough research has been done on them to provide sufficient information about their effectiveness and safety.

That said, it’s important to “investigate, investigate, investigate,” said Lewis, when you are working with your medical provider to find the best options for you.

About the Author:

Stephanie Bouchard is a freelance writer and editor based on the coast of Maine. She frequently reports news and features for MASSAGE Magazine, and her articles include “Corporate Massage of the Future: Wellness Programs are Revolutionizing On-Site Services” and “Become a Sleep Warrior and Reap the Benefits of Deep Rest.”