Because everyone experiences a unique combination of symptoms, we begin our approach to bio-identical hormone replacement by evaluating each patient’s unique symptom picture. We then use comprehensive lab testing to measure baseline thyroid, adrenal, and sex hormones, and we look at lifestyle factors such as diet, stress, and activity levels which are vital to hormone health. After taking every factor into consideration, we then design a personalized treatment plan which may include bio-identical hormone replacement therapy, supplementation and/or nutrition and exercise modification.

Following are the classic symptoms of hormone imbalance:

Fatigue isn’t just a sign that you aren’t getting enough sleep. Disruption of any one of the pillars of hormone health – the adrenals, thyroid, or sex glands – can cause fatigue. Fatigue may be a sign of:

Low thyroid function

Depressed cortisol levels

Elevated cortisol levels at night

Progesterone deficiency

A suboptimal estrogen to progesterone ratio

The common story that hot flashes and night sweats are a byproduct of declining estrogen levels is false. It’s actually more due to a shift in the estrogen to progesterone ratio that occurs in some women. That is why hormone evaluation through lab work is essential. Not only do we measure the absolute values of these hormones in your system, but we are aware of the imbalance in their ratio.

This is why many over the counter preparations and prescriptions made without testing do not work. They are not addressing the imbalance in the estrogen to progesterone ratio, which cannot be determined without testing.

Our therapies are geared toward moving you to an optimal ratio.

Many women wonder if their fruitless attempts at weight loss are a hormone imbalance. Our answer is that weight loss is often tied to our hormones. For example, we all understand that the reason men have a much easier time losing weight is their higher levels of the hormone testosterone.

Disruptions in many hormone systems can cause a difficulty in losing weight:

Low thyroid hormone levels can cause an overall decrease in the body’s metabolism

Elevated adrenal activity causes elevated amounts of stress hormone, which keeps excess fat on the body as a protective measure to stress

Depressed progesterone, also a thermogenic (heat producing) hormone, can decrease overall metabolism, and lead to increased body fat

Why is it that we are a nation plagued by insomnia? From clinical experience, so many of our patients are exhausted, but when it comes time to sleep, they have problems such as:

Racing thoughts before going to sleep

Restless sleep – tossing and turning without going into a deep sleep

Waking up at 2:00 or 3:00 am and not being able to go back to sleep

Hot flashes and night sweats which prevent sleep

Insomnia can be a sign of hormonal imbalance. If you do not wake refreshed, there is a need to investigate possible causes. Sleep is the time when the body heals – from illness, as well as overall rejuvenation. Sleep deprivation ultimately ages us.

Vaginal dryness is a common complaint – and not just in postmenopausal women. Symptoms often include painful intercourse, itching, burning, and a feeling of pressure. Again, hormone imbalance is usually responsible, although side effects from medications and some autoimmune diseases can cause this symptom. Many treatments include naturopathic suppositories and the use of estrogen creams applied to the vagina.

We would like to stress the fact that estrogen applied to the vagina is absorbed into the bloodstream and affects the total load of hormone that the body is exposed to. Once again, making sure there is an optimal estrogen to progesterone ratio is vital for other health parameters like sleep, mood, and energy level. Our approach is always to measure hormone levels in the body before ever prescribing hormones.

Many factors can contribute to low libido:

General fatigue, which may be linked to an imbalance in adrenal or thyroid hormone

Declining testosterone levels, linked to adrenal exhaustion and declining ovarian function

Side effects of prescription drugs

Issues with body image

Monotony in relationships and dissatisfaction with a partner’s behavior

We often ask our patients if they’ve noticed a decrease in finding strangers attractive, a decrease in daydreaming about sex, and an overall decrease in interest. These signs may indicate a hormone imbalance more than psychosocial factors.

There are many ways that the immune system, which mediates inflammation in the body, interacts with our hormones:

High levels of cortisol can depress the immune system, making us more prone to chronic infections

Several autoimmune conditions affect the thyroid causing hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid)

Even though it is not completely understood, scientists recognize the link between female sex hormones and autoimmune disease; compared to males, there is a much higher predisposition for autoimmune disease in females

While the ultimate cause is unknown, there are several hypotheses as to why women have fibroids:

Increased amounts of xenoestrogens in the diet, which are processed ultimately by the liver

Increased total estrogen and progesterone, which stimulate fibroid growth, may be due to the liver’s inability to process these hormones fast enough

An imbalance in the estrogen to progesterone ratio

Along with other naturopathic treatments, bioidentical hormones can play a part in shrinking fibroids.

Approximately 85% of women of child bearing age suffer from PMS at some point during their lives. PMS is considered a collection of symptoms that occurs cyclically around the beginning of menstruation. The most common symptoms we see are:

Fluid retention



Mood swings





Because these symptoms occur at one point in the month, they are very likely to be related to imbalances in sex hormones. In our clinical practice, we’ve found that estrogen and progesterone must be in the correct ratio at all times during a woman’s cycle. Some women have high levels of estrogen and normal levels of progesterone, while other women have normal levels of estrogen and low levels of progesterone. The only way to know is through accurate testing.

As women, sometimes we are taught that depression is all in our heads. It’s time to “get it together.” Many are not aware that depression can have a physical cause. In our practice, we are well aware of the interplay between emotional and physical causes for depression. Hormone imbalance can play a part. For example:

Low levels of thyroid hormone can produce depression, fatigue, and mental fog

Elevated levels of cortisol can produce an anxiety/depressive picture

Depressed levels of cortisol can produce mental fog, fatigue, and blue feelings

An imbalance of sex hormones – estrogen and progesterone – can contribute to feelings of depression

Many of the female patients that we see do not even realize they suffer from constipation. We educate them that healthy bowel movements should be occurring 1-3 times a day. Any less frequent than that is considered constipation.

One factor that must be ruled out is a deficiency of thyroid hormone, a very common cause of constipation in women.

Another reason to consider learning your hormone profile is to ensure your bones are protected. Many of the hormones we test play a role in the metabolism of bone. And healthy bones will prevent fractures later in life that can severely decrease quality of life. Suprisingly, 20% of people who suffer a major fracture will die within one year.

Studies with estrogen and progesterone supplementation show a reduction in bone loss

Testosterone deficiency has also been linked to an increased risk of osteoporosis

High levels of thyroid hormone increase the risk of bone loss

Increased cortisol levels are linked to an increased risk of osteoporosis

Hair loss is a symptom we are very familiar with, and studies show it may affect up to 30% of all peri and postmenopausal women.

At this transitional time, we are acutely sensitive to issues of self-esteem and beauty. Fortunately, the cause of hair loss is oftentimes linked to a hormonal imbalance and can be corrected.

Hair loss can be caused by:

General increases in testosterone

Decreases in estrogen and progesterone, in relationship to normal testosterone levels

Elevated cortisol levels

Elevated or deficient thyroid hormone levels

Menopause is a transitional time when the energy of the body is being shifted from focus on bearing children and taking care of others to focus on self. And this shift is based in the physical world – where there is a hormonal shift – as well as in the spiritual world. For many women, it is a time of self discovery.

For many of our patients, we see fatigue as a major contributor to irritability. Insomnia and night sweats often lead women to be sleep deprived. A thyroid imbalance can also easily lead to fatigue and the overall decease in energy. Depressed cortisol levels from the adrenal glands signify adrenal fatigue and the body’s inability to cope with stress.

If you are experiencing any of these symptoms, you may have a hormone imbalance. Aletris physicians can find a solution just for you, which may include bio-identical hormone balancing and naturopathic treatments.