8 surprising hormone imbalance symptoms you won't expect even if you're going through menopause

As we age, it can start to feel like our hormones can really start to go haywire - but it’s not just fluctuating oestrogen and progesterone that can cause changes to our mental and physical health. Scientists have identified over 50 different hormones in our bodies that affect everything from our metabolism to sleep and moods.

A hormonal imbalance happens when you have too much or too little of a certain hormone in your body - most famously, the symptoms of menopause are caused by an imbalance of oestrogen and progesterone. In more serious cases, a hormone imbalance can require medical treatment but many symptoms are temporary and should go away on their own or with other treatments, like HRT and its alternatives. So, first thing's first, speak to your doctor if you have any concerns about your health.

The key stages in life when we can experience hormonal imbalances are puberty, pregnancy and perimenopause. However, stress, emotional burnout, poor sleep, nutritional deficiencies, and even certain medications can also cause low or elevated hormone levels.

Mike Kocsis is a hormone health expert with 20 years in the industry. Much of that time has been spent working with those experiencing hormone imbalances. He says even the smallest fluctuations in our oestrogen, progesterone, testosterone and cortisol levels can cause symptoms. While we know that weight gain, mood swings, and hot flushes are all signs of a menopause-related hormone imbalance, these signs might be harder to spot.

Hormone imbalance symptoms in women

1. Feeling 'off' but not knowing why

Kocsis, who is an expert at Balance My Hormones, says: “Sometimes, you might feel an overall sense of imbalance, feeling unmotivated, drained, or just generally not yourself. It could be a result of subtle hormonal shifts that deeply affect your energy levels, mood, and overall wellbeing.”

He says if your oestrogen levels are too high or too low you might find that you feel emotionally flat and lacking in enthusiasm for things you normally enjoy.

“Progesterone changes can lead to restlessness, fatigue, or an underlying tension, which can make it feel like your body is telling you things aren't right, but you can't quite pinpoint why,” he adds. High cortisol levels can make you feel mentally foggy and drained, while low testosterone can lower your energy and self-confidence levels.

2. Vivid nightmares

During the luteal phase of your menstrual cycle, progesterone levels will rise. The same thing happens in pregnancy. Kocsis says this can impact other hormones such as cortisol, which can lead to disrupted sleep.

“This emotional intensity can lead to more dramatic, intense, and sometimes even terrifying, dreams,” he explains.

3. Obsessive thinking

Cortisol is known as the stress hormone for good reason. It can have a big impact on your mood and anxiety levels if it’s elevated.

Kocsis says cortisol levels are meant to dip in the evenings as your body prepares for sleep but if you’re stressed, this might not happen. He says the stress can leave your brain in “fight-or-flight mode, making it harder to quieten the mind”. If you can't get a mindless comment made by a colleague or one thought out of your head as you lie awake in bed, this could be why.

It's a symptom that can also be caused by high thyroid hormone levels (hyperthyroidism) which can lead to insomnia and racing thoughts. Low thyroid levels (hypothyroidism) can also cause similar symptoms of restlessness. However, this is something a doctor has to test for before diagnosis, so be sure to book an appointment if you have concerns.

4. Feeling drunk or hungover without drinking at all

If you're sticking to alcohol alternatives to prevent a hangover but waking up feeling groggy anyway, it's not just unpleasant, it's confusing too. This symptom can be caused by an imbalance in your insulin levels though, explains Kocsis.

Insulin is the hormone responsible for turning blood glucose into energy. “For those with insulin resistance, or if your blood sugar drops too low, you might get the 'drunk' feelings of feeling unsteady, trouble focusing, slurred speech, and confusion," he says.

This can also happen if you have an imbalance in oestrogen and aldosterone “which help control blood pressure by regulating fluids and electrolytes”, he notes.

As we’ve mentioned above, high levels of cortisol can disrupt your sleep which can make you feel anxious and dehydrated the next day in a similar way to how you’d feel if you had a hangover.

5. Body smelling different

Imbalances in your oestrogen, testosterone or cortisol levels can affect how you smell, making your body odour stronger or different, says Kocsis.

“Oestrogen helps to regulate the production of oils and sweat in your body, so when levels drop - for example, in menopause and perimenopause, or after pregnancy - sweat production can increase, especially in the armpits and groin, which mixes with bacteria on the skin and results in a stronger odour,” he explains.

People with conditions such as PCOS (polycystic ovary syndrome) may also have a stronger body scent because of higher levels of testosterone in the body. But again, it's important to see a doctor to check for this if you have concerns as it needs to be diagnosed.

6. Feeling breathless or yawning all the time

If your progesterone levels are too low, you might start to have difficulty regulating your breathing. Kocsis says this could lead to shallow breaths, frequent yawning when you’re not tired, and feeling breathless.

7. Bruising easily

Noticing unexplained bumps and bruises? Kocsis says it could be linked to low cortisol levels, which can be just as disruptive as high levels, or an oestrogen imbalance.

He explains that “oestrogen affects your blood vessels, helping to maintain their health and elasticity, which prevents them from breaking easily. When oestrogen levels are imbalanced the walls of your blood vessels can weaken, making them more prone to breaking under pressure, which can result in you bruising from slight impacts that wouldn't usually cause an injury”.

Low cortisol levels can mean bruises take longer to heal or are larger and more severe than normal.

What's the treatment for hormone imbalances in women?

Treatment for hormone imbalances in women depend on the cause and the severity of symptoms. Diseases such as diabetes and conditions like PCOS will require long-term medical treatment, while high-stress levels can normally be resolved in a few weeks - providing you haven't hit burnout.

Hormone replacement therapy (HRT) might be the best course of action for some people. This could be used for women going through perimenopause and experiencing fluctuating levels of oestrogen and progesterone. It can also be used for people with hypothyroidism or if your body is lacking adequate levels of growth hormone. Lifestyle changes such as lowering your cortisol levels and doing more steady, mindful exercise like walking yoga or Pilates every day may also help manage hormone imbalances.

Always speak to your doctor about the best course of treatment. They might refer you to an endocrinologist (hormone specialist) who will be able to diagnose the issues you’re having.