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Hormonal imbalance is a condition that can affect both men and women, with a multitude of contributing factors. In this article, we provide an overview of hormonal imbalance, its symptoms, and available treatments, with a specific emphasis on its impact on weight. Understanding the role of hormones in the body and how their imbalances can lead to various health issues is crucial for informed decision-making and effective management.
Hormone Imbalances: An Overview
Hormones, originating from diverse glands and tissues within the intricate endocrine system of the human body, serve as pivotal chemical messengers. Their primary function lies in the meticulous regulation and orchestration of a myriad of physiological processes and functions.
Depending on which hormone is involved, there can be several causes of hormonal imbalance. Usually, hormonal imbalance or endocrine imbalance occurs when specific hormones in the human body are either excessively abundant or deficient.
The importance of keeping hormones in balance in our bodies is huge because they help us stay healthy and maintain our body’s stability. If our hormones get out of balance, it can cause various health problems and symptoms, which depend on the particular hormones that are not working correctly.
The Impact of Hormone Imbalances on Weight
The management of weight can be significantly impacted by hormonal abnormalities. Hormones are essential to many physiological functions, such as appetite regulation and metabolism. Depending on the exact hormonal imbalances, being out of balance might result in either weight gain or loss. Let us understand about weight gain due to hormonal imbalance:
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Leptin and Ghrelin
Leptin tells the brain when you are full, and it is time to stop eating; thereby reducing appetite and promoting weight loss. When your stomach is empty, it releases the hormone ghrelin, which tells your brain when it’s time to eat. Hence, ghrelin increases appetite, contributes to weight gain, and causes obesity (Klok, et al, 2007; Dornonville, et al 2005).
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Insulin
Insulin lowers your blood sugar without making you eat fewer calories, so your body stores more fat. You might also start eating more because you're worried about low blood sugar, which can lead to weight gain (Ludwig DS and Ebbeling 2018).
Metabolic conditions such as polycystic ovary syndrome (PCOS) in females lead to insulin resistance in the body. This leads to an elevated level of insulin (hyperinsulinemia) in the body, thereby promoting fat deposition and obesity (Barber, et al. 2019).
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Cortisol
It has been noted that patients with abdominal obesity have elevated cortisol levels (Hewagalamulage, et al 2016). Excessive cortisol (hypercortisolism) may result in Cushing syndrome which can lead to weight gain (Salehi, et al. 2005).
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Thyroid Hormones
An increased level of thyroid hormone (hypothyroidism) is linked to weight gain and decreased metabolic rate (Knudsen, et al. 2005) while a decreased level of thyroid hormone (hyperthyroidism) is associated with weight loss, anxiety, increased heart rate, etc (Guerri, et al. 2019).
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Estrogen and testosterone
Elevated levels of estrogen have been associated with obesity (Bélanger, et al. 2002). Testosterone helps in limiting fat accumulation and efficient metabolism (Blouin, et al. 2010). Low testosterone levels can cause hypogonadism in men (Mauras, et al. 1998). Numerous research studies have regularly demonstrated a robust correlation between men's low levels of circulating testosterone and obesity (Fui 2014).
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Hormonal imbalance disorders (signs and symptoms)
Typically, routine signs and symptoms of hormonal imbalance include fatigue, weight gain or loss, increased thirst and hunger, weakness, depression, insomnia, hot flashes, menstrual problems, infertility, etc.
There are different signs and symptoms of hormonal imbalance disorders in males and females.
Hormonal imbalance symptoms in females
Common hormonal imbalance symptoms in females are disused below:
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Acne:
Androgens like testosterone and DHT stimulate sebum and acne formation. Excess of androgen can lead to severe acne (Elsaie, et al. 2016).
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Hair loss:
Hair development and loss are influenced by several hormones, and changes in these hormonal systems can result in different types of hair loss. Hormones associated with hair loss in females include testosterone, specifically dihydrotestosterone, thyroid hormone, cortisol, prolactin, etc (Hasan, et al. 2022).
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Heavy periods:
heavy menstrual bleeding is defined as bleeding which exceeds 80 mL per menstrual cycle (Warner, et al. 2004). Variations in the timing of female hormones like estrogen and progesterone exposure to the estrogen-prepared uterine lining, along with the subsequent cessation of progesterone after the menstrual cycle, can affect the regularity and severity of the menstrual period (Hapangama and Bulmer 2016).
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Hot flashes:
A decline in estrogen level can lead to hot flashes in women (Stearns, et al. 2002)
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Infertility:
Any imbalance in hormones like estrogen, progesterone, FSH, LH, and thyroid hormone can result in infertility in women. Common signs include irregular menstrual cycle, PCOS, thyroid disorders, etc (Alexander and Cotanch 1980). -
Irregular periods:
Causes of the irregular periods can be thyroid imbalance, elevated prolactin, elevated cortisol (Cushing syndrome), etc (Sweet, et al. 2012).
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Loss of interest in sex:
The 3 ovarian steroids–estradiol, testosterone, and progesterone modify women’s libido or their level of sexual desire. A decrease in these ovarian steroids decreases sexual desire in women (Cappelletti and Wallen 2016). Testosterone plays a major role in genital lubrication, sensation, and engorgement. Hence, low testosterone can impact women’s libido (Davis and Tran 2001). Both under and overactive thyroid hormone has been associated with the impairment of libido in women (Gabrielson, et al. 2019). and increased prolactin level have been associated with loss of libido (Maseroli E, et al. 2023).
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Vaginal atrophy and dryness:
Estrogen deficiency in women during postmenopausal years can lead to vaginal discomfort (vaginal dryness and atrophy) and can impact libido (AlAwlaqi A, et al. 2017).
Hormonal imbalance symptoms in males
Common hormonal imbalance symptoms in males are discussed below:
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Erectile dysfunction (ED):
ED can result from low levels of androgens (male sex hormones) like testosterone (Shabsigh, et al. 2006). Our already-published article entitled “Unveiling the Truth: Erectile Dysfunction - Causes, Symptoms, Diagnosis, and Treatment” details more about ED.
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Low Sperm Count:
Follicle-stimulating hormone stimulates the testes to produce sperm. A deficiency of FSH can lead to low sperm count. Another hormone associated with low sperm count is testosterone (O'Donnell L, et al. 2017).
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Gynecomastia (enlarged male breast tissue):
Gynecomastia can happen in men when their estrogen is too high, or their testosterone is too low. This hormonal imbalance can cause gynecomastia (Cuhaci, et al 2014).
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Infertility:
Low testosterone (also called hypogonadism) is associated with infertility in males (Ohlander, et al. 2016).
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Loss of interest in sex:
Low testosterone levels (Schubert M and Jockenhovel 2005) and high levels of prolactin (Maggi, et al. 2013) are associated with a decrease in male libido.
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Loss of muscle mass (Sarcopenia):
Testosterone, along with growth hormone, and insulin-like growth factors (IGFs), plays a vital role in maintaining muscle mass and strength. Epidemiological studies have shown that when testosterone levels are lower, it can lead to weaker muscles or loss of muscle mass (Shin, et al. 2018). Growth hormone deficiency has also been associated with loss of muscle mass (Chikani and Ho 2003). Growth hormone helps in the production of IGFs which helps in the growth repair of muscle and overcoming muscle weakness (Ahmad, et al. 2020).
How are hormonal imbalances diagnosed?
Hormonal imbalances are usually diagnosed with blood or urine tests. Sometimes imaging (like X-ray, MRI, etc) is required to detect any cyst or tumor that could lead to abnormal hormone production.
How are hormonal imbalances treated?
Majorly, hormonal abnormalities are treated in the following ways:
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Medication:
Medical treatment typically focuses on replacing or supplementing hormones in the body to treat hormonal imbalances or deficiencies. Examples of such hormonal replacement therapies (HTRs) includes supplements of testosterone, estrogen, and thyroid in the form of tablets, capsules, creams, injection, implantables, etc (Johnkennedy, et al. 2011). Male hormonal imbalance treatment includes testosterone replacement therapy for ED; danazol and tamoxifen for the treatment of gynecomastia (Khan and Blamey 2003) etc. Female hormonal imbalance treatment includes estrogen and progestin for acne (Ebede, et al. 2009), estrogen and progesterone for hot flashes, etc (Freedman 2014).
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Lifestyle and dietary changes:
Making changes to one's lifestyle, such as adjusting diet, engaging in exercise, and modifying behavior, can have a positive impact on correcting hormonal imbalances. For example, for those with PCOS who are overweight or obese, their first line of treatment includes lifestyle changes (diet, exercise, good sleep, and behavioral modification) (Panidis, et al. 2013).
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Surgery:
Sometimes the surgical option is chosen to alter or remove the gland like in the case of hyperthyroidism (Boger and Perrier 2004).
In cases of hormonal imbalance, seeking guidance and advice from a healthcare professional is imperative to ensure accurate diagnosis and appropriate treatment. Consultation with a doctor is crucial for addressing hormonal imbalances effectively and safely.
References
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