#1.2 Hormonal inbalance

At menopause we can become aware of symptoms that we just assume are ‘part of the process’ but thereis always a reason why we are experiencing them, we don’t just get symptoms! Hormonal imbalances have many effects on our systems and whilst menopausal symptoms are not just about hormonal imbalances,identifying where the imbalances are and what you can do about them will help you have a smoother menopause.

Let’s look at the main ‘culprits’!
For each hormone we will delve in and look at where they are produced, what they do and what to look out for in terms of an imbalance. Then we can begin to identify what we can do to create more harmony.


Predominantly produced in the ovaries (and in the placenta during pregnancy). However, oestrogens are also produced in the liver, adrenal glands, breasts (in smaller quantities) and also in fat cells, specifically in belly fat. Therefore, although Oestrogen produced by the ovaries is diminished we still produce oestrogens. If we don’t metabolise them well we may become oestrogen dominant.

Functions of Oestrogen

  • Stimulates growth of Breast tissue
  • Maintains Vaginal blood flow and lubrication
  • Causes the lining of the Uterus to thicken during the menstrual cycle
  • Keeps Vaginal lining elastic
  • Other functions -including preserving Bone mass, Brain health, Cardiovascular health

NOTE: we can also suffer symptoms due to oestrogen dominance
Possible signs of low Oestrogen

  • Hot flushes/ night sweats
  • Vaginal dryness / thinning of tissues / decreased sexual response
  • Bladder infections / pelvic floor issues-incontinence
  • Mood swings / depression / irritability
  • Mental fuzziness
  • Headaches / migranes
  • Sleep disruption
  • Palpitations
  • Bone loss
  • Lower libido

What happens as we age and go through the menopause?

During perimenopause, oestrogen levels fluctuate and become unpredictable. Eventually, production falls to a very low level.

Produced in the ovaries and a crucial hormone in regulating our menstrual cycle. The balance of progesterone to oestrogen can often be significant in terms of symptoms. Therefore balancing the two is of great importance.

Functions of Progesterone

  • Prepares the lining of the uterus for a fertilized egg and helps maintain early in pregnancy

What happens as we age and go through the menopause?

We gradually produce less progesterone as we go through the perimenopause then production stops completely after our last period.
Signs of low Progesterone

  • Premenstrual Migrain type symptoms
  • Irregular and heavy periods
  • Anxiety, nervousness or depression
  • Aches & pains
  • “Itchy twitchy” legs
  • Heart palpitations

An imbalance between Oestrogen and Progesterone

Although levels naturally alter during perimenopause, many symptoms can arise due to an imbalance between oestrogen and progesterone. Read in the section ‘Oestrogen Dominance’ about ‘pregnenolone steal’ and how we may become oestrogen dominant.

Although known as the “male” hormone, testosterone is also important to women’s health: Made from cholesterol in our ovaries and adrenal glands.

Functions of Testosterone

  • Plays a key role in women’s oestrogen production
  • Contributes to libido
  • Helps maintain muscle mass

Signs of excess testosterone

  • Facial hair above lip
  • Increased dreaming or nightmares
  • Difficulty falling asleep
  • Heightened sex drive
  • Irritability
  • Explosive moods orvolatility
  • Aggressive behaviour
  • Increased muscle tension andedginess
  • Liver toxicity
  • Acne
  • Deeper voice

Possible signs of Testosterone deficiency

  • Feeling ‘blugghhh’ and lacking ‘joy’ in your life
  • Unexplained fatigue
  • Decreased libido
  • Thinning or loss of pubic hair
  • Decreased sensation sexually
  • Loss of muscle mass
  • Loss of bone density
  • Achy joints

What happens as we age and go through the menopause?

Levels peak in a woman’s 20s and decline slowly thereafter. By menopause, Testosterone level is at half of its peak. However, not all women’s levels drop, some may rise. Ovaries continue to make testosterone even after oestrogen production stops. Testosterone production from adrenal glands also declines with aging but continues after menopause.

Produced in the thyroid gland, the ‘Queen’ of the endocrine system! If it isn’thappy, the rest of the system won’t be either! The thyroid gland does not like stress! There is a strong connection with the gut, brain, adrenal glands and ovaries so harmony between them all is essential.

Functions of Thyroxin

  • Controls metabolism and regulates your body temperature
  • Produces thyroxin (WITH IMBALANCE it can be over or under active)

Possible signs of an overactive thyroid gland

  • Nervousness,anxietyand irritability
  • Mood swings
  • Difficulty sleeping
  • Persistent tiredness and weakness
  • Sensitivity to heat
  • Swelling in your neck from an enlarged thyroid gland (goitre)
  • An irregular and/or unusually fast heart rate (palpitations)
  • Twitching or trembling

Possible signs of an underactive thyroid gland

  • Sluggishness
  • Tiredness
  • Weight gain
  • Sensitivity to cold
  • Depression
  • Constipation
  • Muscle aches and weakness
  • Hair loss

What happens as we age and go through the menopause?

Hormonal changes may have an effect on thyroid function. Thyroid function issues may be responsible for symptoms when it is assumed the symptoms are as a result of declining sex hormones.

The adrenal glands produce several hormones including adrenaline and cortisol. These hormones have a connection with stress.

Adrenaline (Epinephrine)
We are all familiar with the term “adrenaline rush” or “adrenaline junkie”. I know we are NOT familiar with being chased by a tiger in the jungle or by a grizzly bear in a wood but if that happened you can be sure you would get an “adrenaline rush”!
As we go into any situation that is ‘stressful’ (a Bear chasing us) or wildly ‘exciting’ experiences or anything that creates extreme emotions the hormone adrenaline starts being pumped out by the adrenal glands. You may know this as the ‘fight or flight’ response. Our heart rate rises, pupils dilate, more blood and oxygen is pumped around the body along with glucose and then sent to our muscles to allow them to spring into action! We can suddenly find we have “superhuman powers”, we can run faster and feel like if we really needed to we could lift the weight of a car! The body’s ability to feel pain decreases so even if the Bear bit your bottom you’d still be able to run away!

However we also produce adrenaline when we are under stress and not in real danger.

Cortisol is our main stress hormone and a key hormone to be aware of in menopause. Cortisol is produced alongside Adrenaline but not as quickly as during the ‘fight or flight’ response. We have many Cortisol receptors in our body so Cortisol affects many different functions in the body.

Our Cortisol levels fluctuate. They should rise in the morning to help wake us up and levels then vary during the day lowering in the evening to naturally unwind us. We do need stress hormones to drive us on and to make sure we are reactive to situations but if our Cortisol are out of balance it can spike in the evening leading us to feeling ‘wired’ but fatigued. This is certainly a sign it is out of kilter.

Functions of Cortisol

  • Regulates blood sugar, metabolism and blood pressure. It also raises sodium levels to keep our blood pressure up
  • Helps reduce inflammation

Signs of over production of adreneline and cortisol

  • Weight gain (especially around the middle)
  • Irritability
  • Lack of concentration or memory
  • High blood pressure
  • Extreme fatigue
  • Depression
  • Headaches
  • Sleep problems
  • Anxiety
  • Thyroid imbalance

We may have ongoing stresses in our life, such as;

  • Work stresses
  • Commuting
  • Challenging children (that’s all of them sometimes!)
  • Challenging relationships
  • Elderly relatives to care for
  • Financial worries
Possible signs of Cortisol imbalance

  • Tendency to store fat around your middle
  • Increased appetite
  • Increased cravings for combination of carbs and fats
  • Mid-afternoon slump –need coffeeand/orsnacksto get going
  • Low immune system
  • Headaches
  • Blood sugar levels disrupted
  • Problematic digestive system, bloating
  • Muscle aches and pains / neck & shoulders
  • Hair loss
  • Difficulty concentrating
  • Depression or feeling blugghhh
  • Irregular or absent periods
  • Increased PMS
  • Slower metabolism
  • Tiredness but can’t sleep well
  • 2nd wind in evening; wakeful at night; tired in morning

What happens as we age and go through the menopause?

Menopause can be a time of increased stress and sleep disturbances leading to increased levels of Cortisol. If we produce too much Cortisol our adrenals can becomefatigued (adrenal fatigue). High Cortisol levels can also have an effect on our Progesterone levels, lowering them, possibly leading to pregnenelone steal creating Oestrogen dominance.

The constant revving of the engine means we have nothing left in the tank and this can affect our thyroid function.To continue providing this fast energy will result in cravings and increased appetite leading to the risk of weight gain. Insulin and Blood Sugar levels go on a roller coaster and, unless our body is making use of it, extra energy is stored as fat in the middle of our body deposited close to the liver for quick conversion to energy.


Insulin is produced by the pancreas. It regulates our blood sugar. In midlife, poor management of our blood sugar, having a diet high in refined sugar and gaining weight in our mid-section can all contribute to us developing type 2 diabetes. It is vital toour health at this stage of life that we don’t let our weight creep up to an unhealthy level, especially around our middle.

Functions of Insulin

  • Controls blood sugar

What are the signs of high blood sugar and blood sugar fluctuations?

  • Irritability
  • Aggressive outbursts
  • Palpitations
  • Lack of libido
  • Crying spells
  • Dizziness(feeling edgy)
  • Anxiety
  • Brain fog; confusion; lack of concentration
  • Fatigue
  • Insomnia
  • Headaches
  • Muscle cramps; joint aches

What happens as we age and go through the menopause?

Change of eating and drinking habits can effect Insulin levels. This may lead to high blood sugar levels and an increased risk of Diabetes. Gaining weight (especially belly fat) can also have an effect on insulin levels.

During menopause there are so many drivers to going off track and craving sugary foods, alcohol and less nutritious foods;

  • Stress
  • Poor sleep
  • Feeling low
  • Boredom
  • Having too many ‘oh blow it, you only live once’ moments!
  • More socialising

The only way to truly know what your hormones are doing is by having a complete hormonal profile test. However, hormones fluctuate and alter according to external factors so our best starting point is to check out the big picture first and determine if there are any changes we need to make.

One thing will affect another, everything is linked in some way and once we restore some balance in our life through; Optimising our nutrition, optimising our gut health, managing our stress, having a balanced approach to exercise, addressing sleep patterns and managing our weight, then we can begin to gain some hormonal balance.


Seratonin is produced predominantly in the gut, and small amounts in the brain.

Functions of Seratonin

  • Stabilizes our mood, well-being and happiness
  • Plays a role in digestion, sleep, libido and wound healing

What are the signs of decreased Seratonin levels

  • Low mood
  • Anger
  • Irritability
  • Insomnia
  • Anxiety
  • Low libido

What happens as we age and go through the menopause?

Levels decrease due to a drop in oestradiol (one of the oestrogens). If gut health deteriorates at this stage of life and if you develop gut dysbiosis (leaky gut) the production of serotonin will drop. Gut bacteria manufacture approximately 95% of the body’s serotonin.

Notes and other influences on Seratonin levels

  • Serotonin levels are a major influence on mood and emotions we may experience in the perimenopause. Many women wonder why they feel anger, anxiety and low mood as they go through this stage and serotonin can be a major influence.
  • Low levels of Vitamin D can contribute to decreased levels of serotonin
  • Lack of certain kinds of touch can affect production of serotonin to a small degree. The touch receptors we have in our skin when stimulated via stroking / massage produce small amounts of serotonin and if atmidlife if this kind of touch declines it can be an influence on mood as a result. Touch also stimulates other hormones that influence mood. Food for thought!
As we can see, the symptoms we have can be influenced by different hormones. It can be difficult to determine what is out of kilter!

For example; are you suffering with low libido because of a drop in Oestrogen? Or is it a drop in Testosterone? Or is it because of Adrenal fatigue? But it could also be due to Stress? Lack of sleep? Or less confidence in your body?

This is another reminder that we need to look at the whole big picture!