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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Woman to Woman Woman to Woman
 

Women's Health: Could The Problem Be Hormonal?


January 14, 2013

By Alice Y. Chang M.D.

Harvard Medical School

Women can have a wide range of physical and mental symptoms related to hormonal changes in their bodies. Hormones are the way the body’s organs communicate to coordinate normal functions in an orderly manner. Any hormonal change can affect that natural balance.

During the reproductive years, women’s hormones cycle up and down naturally every month. There are also normal hormonal changes that occur during two major events in a woman’s life: pregnancy and menopause. In addition, certain hormonal diseases, such as low and high thyroid (hypothyroidism and hyperthyroidism) are more common in women than men.

Among other functions, hormones promote changes that need to happen in a woman’s metabolism and reproductive system. So when hormone levels change, going too low or too high, women tend to experience symptoms related to metabolism and the reproductive system. The following list includes the most common signs of a hormonal condition:

  • Irregular periods — Are your periods becoming irregular? Are you skipping periods or having heavier or lighter flow? Many different hormonal conditions can cause this symptom.
  • Fertility problems — Because hormonal conditions can affect your normal reproductive hormones, they often interfere with the hormonal signals preparing your ovary to release an egg. When you see your health care professional about difficulties becoming pregnant, she or he will check for many different hormonal conditions.
  • Weight changes — Have you gained or lost weight and don’t understand why? Weight loss can be a sign of many different conditions, some hormonal and others not. You should always see your health care professional if you experience unexplained weight loss. Unexplained weight gain could be caused by a low thyroid condition as well as high corticosteroid (“steroid”) levels.
  • Mood changes — Have you been more irritable, angry, depressed, or anxious? Does it seem to happen at certain times of the month? Any normal or abnormal change in your hormones could bring on these symptoms. Possible conditions include premenstrual syndrome (PMS), with symptoms clustering before your period; low thyroid; high thyroid; high steroid levels; pregnancy and menopause.
  • Hair changes — Have you noticed an increase in hair on the body in unwanted places? High androgen (“male” hormone) levels or high steroid levels can lead to an increase in hair on the face, back, chest and abdomen. A condition called polycystic ovary syndrome is characterized by high androgen levels, irregular periods and multiple ovarian cysts. Have you been losing hair? Many women notice hair loss on the hairbrush or in the shower drain. Your hair stylist might also notice this before you do. Hair loss can be a sign of thyroid disease.
  • Skin changes — Acne or dryness also might signal hormone changes. Causes can be any of the hormonal conditions listed already.
  • Bowel changes — New constipation or diarrhea, or increasing frequency of stools could be a sign of thyroid disease — too low or too high.
  • Nipple discharge — This is normal during pregnancy and breast feeding, but not at other times. The pituitary gland normally secretes a small amount of prolactin, a hormone that stimulates breasts to produce milk. During pregnancy and breast feeding, milk production is expected. But at other times, a milky discharge from both the breasts may indicate a tumor of the pituitary gland called a prolactinoma. This pituitary tumor can secrete high levels of prolactin into the blood, causing irregular periods and problems with fertility. Discharge from only one nipple, especially if it is pink or bloody, is also worrisome. Call your doctor for an evaluation, this can be a sign of cancer.
  • Change in libido — An increase or decrease in your sex drive could both be related to hormones. Indirectly, changes in your hormone levels could lead to vaginal dryness, resulting in a decreased interest in sex.
  • Temperature changes — Increased sweating and hot flashes can be a sign of menopause. Cold intolerance is a sign of low thyroid.

If you have any of the symptoms above, you should make an appointment to see your health care professional. Fortunately, there is treatment for all the conditions mentioned. So listen to your body and consider your hormones when things just don’t seem right. And if someone asks you, “Is it hormonal?” stop to find out what they are noticing. It may be that a family member, friend or co-worker has noticed a change that could in fact be hormonal and that needs your attention.

Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.

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