Top 15 Signs of Hormone Change:
1. Difficulty Sleeping
2. General Fatigue
3. Brain Fog, Memory lapses and Forgetfulness, Poor Focus
4. Urinary Leakage and Incontinence
5. Low Sex Drive
6. Headaches
7. Dry Vagina
8. Rapid Aging with Skin, Hair and Nail Changes
9. Dry Eyes
10. Dry Vagina
11. Hot Flashes / Night Sweats
11. Mood Swings, Sadness, Anxiety, Irritability and Panic Attacks
11. Weight Gain
12. Gas and Bloating
13. Heart Palpitations
15. Aches, Pains and Stiff Joints

1 - Sleep

The first symptom you should be aware of is ongoing persistent lack of good solid sleep. Many women experience insomnia or some form of sleeping problems for a long time before they even realize that they are sick of it. At first it is something you may just push off as stress or a busy time in your life. But then, for many women, it doesn’t improve. Different types of problems with sleep can be different for different women, and include difficulty falling asleep, staying asleep or waking too early and not being able to go back to sleep. Some women have something I call “Brain Chatter!” That is when your mind just yaks at you all night, blab blab blab, preventing your from feeling like you ever get a good stretch of real sleep!

These can be signs of Progesterone decline. Progesterone is our CALMING sex hormone, and actually the first sex hormone to decline, starting in your mid to late 30’s – which is usually a big surprise to many women.

2 - Fatigue

The second symptom to be aware of is General Fatigue. Fatigue is extremely common with hormone changes. If you are one of the lucky ladies who sleep well, despite declining Progesterone, fatigue can still occur. Testosterone is our vital energy-forming sex hormone. And it starts declining around age 35 as well. In fact, it declines about 50% between the ages of 30 and 50. That’s a lot! The decline of Progesterone is also a factor in your reduced energy levels.

Progesterone helps your thyroid hormone’s ability to function properly. And our Thyroid hormones play a large role in our energy level. In fact, about 50% of all women by the time they reach their 50’s have low thyroid function.

3 - Brain Fog

The third symptom is termed “Brain Fog” or plain ole memory loss. This can be rather embarrassing and frustrating when you can’t come up with what you want to say in a conversation. It’s as if your vocabulary knowledge base just disappeared! Organizing your day and projects becomes more difficult and the projects take longer to accomplish. Some women secretly worry they may be developing early signs of dementia because they frequently find they lose their train of thought, forget things easily, and simply feel their thinking is “fuzzy.” There is an explanation to these changes. Estrogen is very active in our brain! It works in the areas of the brain that control memory, organization, and communication.

Women are generally great communicators. But, as our Estrogen declines, coming up with the words becomes more challenging.

4 - Urinary Leakage and Incontinence

The fourth symptom you should be aware of is Urinary Leakage and Incontinence. Estrogen AND Testosterone are very important for pelvic floor strength. And as these hormones decline, your pelvic floor muscles get weaker, making urinary leakage a real possibility. You might experience some leakage when you cough or sneeze. Or you might notice a little leakage when your bladder starts filling up and it is time to take a bathroom break. This is called stress incontinence.

Another form of leakage, or incontinence, is when a very strong urge to urinate suddenly comes on and you have difficulty making it to the bathroom on time. This can be extremely frustrating because you are always needing to scope out all the nearby bathrooms when you are away from home.

5 - Low Sex Drive

The fifth symptom of hormone decline is: Low - Sex - Drive. Have you ever thought that your once sizzling sex drive kind of fizzled out? Well, it might surprise you that it’s not all about just Testosterone. Though we automatically think that Testosterone is the culprit here, there is more to our drive than that. Our Estrogen drives our femininity and our feeling of being sexy, and desired, just as much as Testosterone does. (Also, our Adrenal hormones, DHEA and cortisol, play a huge role in our sex drive.)

6 - Migraine Headaches

The sixth symptom of hormone decline is Migraine Headaches. This is a big one. Migraine headaches are so common in women, particularly right before your period starts, or right in the middle of your monthly cycle. Again, clearly hormonal. Progesterone once again plays a huge role in this debilitating problem. Migraine headaches commonly worsen or even appear for the first time when you enter into your mid to late 30’s, right at the time Progesterone starts to decline. If you start experiencing Migraine Headaches in your 30’s - think hormone imbalance, particularly Progesterone decline. This happened to me, and I have treated many women with the same. Fortunately, the solution is simple and easily fixed.

7 - Skin, Nails and Hair

The seventh symptom of hormone change you should be aware of is the Skin, Nails and Hair changes that occur as our hormones change. Estrogens affect skin thickness, wrinkle formation, and our skin’s moisture. Estrogens increase substances called glycosaminoglycans. Hyaluronic Acid is an example of glycosaminoglycans which helps retain moisture in your skin. I added Hyaluronic Acid to Young Hormones for all of you ladies out there who want to dab just a bit onto the skin around your eyes and cheeks! Estrogen also increases collagen production in the skin, which helps with the thickness of our skin. Together, Glycosaminoglycans and collagen help keep our skin plump and hydrated with far less wrinkle formation as we age. As our Estrogen levels decline, our skin gets thinner and dryer and we notice increased fine lines, wrinkles and an appearance of less fullness. Estrogen also helps our hair grow, appear healthy and nourished with moisture just as it does with our skin. Unfortunately, if you experience a sudden drop in your Estrogen levels at menopause, you may also experience an unusually high amount of hair loss all at once. Hair loss can also occur in some women due to an imbalance between their Testosterone and Estrogen levels. If the ratio of Testosterone to Estrogen is high, excessive hair loss can occur. This is called female pattern baldness.

8 - Dry Eyes

The eighth symptom of hormone change is Dry Eyes. Some women think they are developing allergies and that this is causing their eyes to burn. But dry eyes are very common in women as our hormones decline. When our eyes are dry, they feel scratchy, irritated and burn. They also can look red, which makes us look older than we really are.

I can attest to that, since I have a genetic eye condition that requires me to use a medication in my eyes daily which causes red eyes! Though there are many causes of dry eyes that are not hormonal, about 60% of postmenopausal women will experience dry eyes due to declining hormones. Historically it was felt that Estrogen decline was the main cause of dry eyes in women, since women by far outnumber men with this condition. However, it is now known that a decline in Testosterone and, likely, DHEA are also hormone culprits for Dry Eyes.

9 - Vaginal Dryness

Let’s move on to symptom number nine, the Dreaded Dry Vagina. Many women experience a drying of vaginal tissues at different times of their hormonal change. If you are a thin woman, you are likely to experience this at an earlier age than if you are a heavier set woman. This is because Estrogen is the main hormone that maintains the elastic nature of the vagina and the moistness within the tissues. Fat cells produce Estrogen, and, so, if you are naturally thin, you have a lower Estrogen production than women who have a higher percentage of body fat.

There are some serious complications of a dry vagina. It is not just about discomfort during intercourse that can be so discouraging… though… that is certainly enough to deal with by itself. There is another condition called lichen sclerosis of the vaginal tissues that can occur with low Estrogen levels that cause scarring of the inner labia and vaginal tissues, and this scarred tissue becomes whitish in appearance, stiff, and loses its elasticity. It is serious and difficult to reverse… and it results in very uncomfortable intercourse. It is best to catch a dry Vajayjay early on and take care of the problem at the source – low Estrogen!

10 - Mood Swings

The tenth symptom that your hormones are changing is Mood Swings, Irritability and Feelings of Sadness. Mood Swings, sadness, anxiety, irritability and even panic attacks are linked directly to our sex hormones. Estrogen, Testosterone AND Progesterone all affect our brains by influencing chemical messengers called neurotransmitters such as dopamine, serotonin, acetylcholine and Gamma amino butyric acid. PMS or premenstrual syndrome, is caused by fluctuations that are expected during very specific times of our menstrual cycle.

Since these fluctuations are at specific times, they are considered “normal fluctuations” or “expected fluctuations.” We all know what that means. At certain times of the month, usually in the middle of the month when you’re ovulating or at the end of the month right before your period, these expected fluctuations occur and you are more likely going to experience mood changes.

However, when we start moving into perimenopause – age 40 to 50’ish, these fluctuations are no longer occurring at reliable and specific times of the month, and INSTEAD start happening at UNexpected times – and, thus, we experience mood swings and the “emotional rollercoaster” at just about any time – sometimes without any rhyme or reason to its occurrence. As I mentioned earlier when talking about brain fog, Estrogen is very active in the brain. It has very specific anti-depressive effects in the brain by stimulating serotonin and dopamine – two brain chemicals that improve our moods.

However, that doesn’t mean that the higher the Estrogen, the happier we are. It isn’t that simple because it is still all about balance between Estrogen and Progesterone. Progesterone is also very active in the brain. In fact, it may be as high as 20 times more active in the brain than it is in the blood. Progesterone has calming effects on the brain and stimulates GABA, or Gamma aminobutyric acid, our calming neurotransmitter. As levels of Estrogen go unbalanced from low Progesterone, we are more prone to feel tension, anxiety and panic attacks. On the other hand, as our levels of Estrogen decline, we can experience episodes of depression.

11 - Hot Flashes

Symptom eleven is Hot Flashes and Night Sweats! Hot flashes and night sweats are one of the most common signs of hormone imbalance that women easily recognize. Sometimes we can recognize a trigger that sets off a hot flash such as spicy foods, wine, smoking, caffeine, sugar and starches. These are all very common triggers. Stress is also a common trigger. And if you are accustomed to exercise, and suddenly go without, you may set off a string or series of hot flashes as well.

Hot flashes usually are initially provoked by a Progesterone to Estrogen ratio imbalance – called “Estrogen Dominance.” This may seem counter-intuitive to you because you might think that an Estrogen dominance would protect you from hot flashes, but this is not the case at all.

12 - Weight Gain

Symptom number twelve! You guessed it! Weight Gain! Yuk! And it seems to be directly applied to our stomachs! Gaining weight can be a serious game changer for your self esteem, and I truly understand how detrimental this can be when you feel you have no control over what is happening to your body. I assure you it doesn’t have to be this way. There is no reason you must accept weight gain during premenopause, perimenopause, menopause and beyond. But to prevent weight gain, you must know the facts, and how to overcome them. Because yes, just as you suspected, sex hormone changes DO INCREASE our likelihood of gaining weight.

Though there have not been studies done in humans, numerous studies in animals have shown that Estrogen helps control body weight. In animal studies, Estrogen decline has been shown to result in lab animals EATING more and becoming LESS PHYSICALLY active. The cause of this is not known. However, one clue is that research has demonstrated that reduced Estrogen causes a reduction in thyroid hormone production and function. This means that your metabolic rate, the rate in which you burn calories, DECLINES as your Estrogen declines. There is also evidence that declining Estrogen results in the body’s inability to use starches and sugars as effectively as it once did. (Another reason for belly bloat with carbohydrates!) Both issues result in increased fat storage, as well as create a much more difficult time for you to lose weight and keep the weight off. However, with all that bad news, there is research that suggests Estrogen hormone therapy can increase your metabolism.

13 - Gas and GI Disturbance

Gas and GI disturbance – Yep! Those annoying days of feeling bloated or like being five months pregnant may be hormone decline. In fact, gas and bloating is more commonly complained about than Hot Flashes! And rarely do people realize this is a symptom of hormone decline.

Instead women will do everything right to help themselves, including eating a perfect diet while everyone else around them is indulging on the foods they want to eat… and still feel bloated with the tiniest “cheat food.” Most women who search out an answer end up deciding that they are gluten intolerant and go gluten free. I was one of them. I didn’t start adding Estrogen to my bioidentical hormone regimen fast enough and I constantly just felt like a blimp-o!

Though it is true that gluten is becoming more commonly problematic, have you ever wondered why women seem to try everything to stop their bloating while their male partner doesn’t seem to have the same problems? Or why these problems suddenly start showing up in the mid 40’s or so? Once again, Estrogen is a huge player in bloating. As Estrogen declines, the stomach produces less gastric fluid to digest food. This causes digestion to slow down and the food to sit in the stomach, and even pass through the entire bowel system more slowly.

Thus… you guessed it.
Bloating and gas.

14 -Heart Palpitations

Symptom number 14 is heart palpitations. This is really a tough one because no one wants to take heart palpitations lightly. Heart palpitations can be serious and caused by something totally unrelated to hormone decline. But for most women in their midlife years, the million-dollar cardiac workup leads to no cause of the symptom. Though I could never say that it isn’t worth the work up, I can say with confidence that it is not difficult for me to offer reassurance to most of my female patients who are in premenopause, perimenopause or menopause. I have a specific cardiologist who is my favorite in town to refer these ladies to. If you have diabetes, heart disease, smoke or are significantly overweight, heart palpitations may more likely be associated with a heart condition. But if you are the average woman of midlife years, and are experiencing heart palpitations, and they are not continuous, or persistent, the likelihood of them being related to a cardiac condition is low.

15 - Joint, Aches, Pains and Stiffness

Symptom number 15 is Joint Aches, Pains and Stiffness. This is so common that doctors have coined the term “menopause arthritis.” Just as Estrogen plays a major role in collagen for your skin, it also plays this same role in the collagen of your ligaments and tendons. In fact, frozen shoulders are very common in our perimenopausal years. Particularly in women who also have a low thyroid.