“She’s so hormonal,” “Get your hormones checked,” “Must be my hormones causing me to act this way.” We’ve all heard these phrases uttered among people and in the media; hormones are blamed for all manner of ill-health and poor behavior but how much truth really lie in these claims? It’s a great question and one that we encounter almost daily in caring for women.

At their most basic level, hormones are chemical messengers. They are released by glands throughout the body and make just about every aspect of life take place. Hormones not only regulate periods, pregnancy and menopause, but they cause your heart to beat, maintain your blood pressure, help digest and process all that you eat and drink, induce sleep and wakefulness, provide energy, make children grow and then stop growing, and more. Within this, it is true that hormones can affect mood and the overall sense of well-being and so the question of whether your hormones are “out of balance” when you are not feeling up to par is a very reasonable one to ask. The answer, however, is not entirely straightforward.

‘Female hormones,” specifically, are often cast in a negative light and blamed for depression, anxiety, irritability, fatigue and libido issues. As such, women are often encouraged by society to have these hormones checked and treated. The truth is, however, that there is only rarely a need to check the multitude of hormones that run the female reproductive cycle and in those instances, the labs frequently come back normal. In fact, the menstrual cycle alone, is a very accurate indicator of normally functioning hormones. If a woman is getting regular monthly periods, it is very unlikely to find hormonal abnormalities in blood work.

Then what about cyclic mood changes?

There is no question that the menstrual cycle can really contribute to feeling both emotionally and physically unwell. The significant point, though, is that the hormone levels are typically not “abnormal” (and so labwork won’t show anything) but rather that the natural fluctuations of hormones throughout the cycle and the declining hormone levels of ageing can cause some very unpleasant symptoms. Furthermore, it’s not at all uncommon for women to tolerate their cycles at some points in life and then have a completely different experience with their hormone fluctuations at a different point; many women report different periods after they’ve had children, for example.

In truth, it would be easier for both patients and clinicians if hormone irregularities showed up in everyone with the above mentioned symptoms because then treatment would be fairly obvious. But bodies are more complex than that and what we find is usually that experiences of mood changes, low energy, libido issues arise out of a combination of challenges in life including, but not limited to, normal fluctuations in the hormones. Humans are so good at taking life in stride but the constant stress of our modern existence can subtly wear anyone down and when we lose resilience (which everyone does), we can experience a host of difficult changes. As such, a more comprehensive approach that includes healthy nutrition, healthy sleep, healthy exercise habits, positive relationships with good boundaries, rejuvenating activities and medications, if necessary, tends to be a more successful approach to managing these issues than merely focusing on hormone levels.

But what about saliva testing and natural hormone replacement?

This is an extremely popular topic. Many complementary and alternative health care providers offer personalized hormone testing through the saliva and treatment regimens catered to an individual’s unique hormonal profile. Patients who have tried this method report varying degrees of satisfaction. Insurance will rarely pay for saliva-based hormone testing and/or bioidentical hormones and so this can be a costly endeavor.

We recognize that medicine, as we practice it, still has so much to learn about the miraculous human body and the complexity of the endocrine (i.e. hormone) system. We also value each patient’s right to learn as much as possible and pursue a health care plan that suits her personal needs. Currently, by the standards of mainstream medicine, there does not exist any evidence that indicates that this alternative approach to managing hormones is superior to what is generally offered for testing and management. There is ongoing research into this topic as well as the pursuit of new/different information about vitamin D (which acts like a hormone in the body), human growth hormone, DHEA (a precursor to estrogen and testosterone), testosterone levels in women and cortisol levels. We look forward to learning and utilizing reliable information as it becomes available.

In summary, hormones are a fascinating and complex network of signals in the body that contribute to every life system. In women, hormones initiate and regulate the entire reproductive system and then shut it down at the time of menopause. There are significant fluctuations of hormones levels throughout each day and each month of a woman’s life and these fluctuations may well contribute to feelings of physical and emotional ill health. In cases where the menstrual cycle is irregular or there are other physical manifestations of a possible hormone irregularity, your provider will likely order blood work. However, laboratory testing of most female hormones is rarely necessary in the presence of a normal menstrual cycle. Rather, a comprehensive treatment approach that may include standardized doses of hormone replacement (in the form of birth control or post-menopausal hormone replacement therapy) along with lifestyle modifications is usually successful on it’s own.