If you were born with ovaries, at some point you’ve probably had someone inform you that your hormones are making you irrational, sad, and/or angry. Which probably made you even more annoyed. But sexist comments aside, sometimes hormones do get out of balance, which can lead to some undesirable side effects. Here’s how to tell if your hormones really are unbalanced, and what you can do about it.

Thoughtful woman looking away

How Your Sex Hormones Work

The two main hormones produced in the ovaries are estrogen and progesterone. To understand why your sex hormones are important, you have to understand what a hormone is. “Hormones are chemicals in the blood that act as the messaging system to coordinate appropriate function among parts of the body that are not close to each other,” explains Joshua U. Klein, FACOG, co-founder and chief medical officer of Extend Fertility Medical Practice in New York. In this case, he says, the hypothalamus and pituitary gland coordinate the release of estrogen and progesterone in the ovaries.

The basic job of these two hormones is to prepare your uterus for pregnancy every month. Estrogen’s role is to build up the uterine lining that will either host a fertilized egg or be shed as your period. The first day of your period is also day one of your menstrual cycle, when your estrogen levels are lowest (about 40 pg/ml), explains Mary Jane Minkin, clinical professor of OB/GYN at Yale University School of Medicine. Estrogen gradually builds up over the month, she says, eventually peaking, around day 22 or so, when your estradiol — a form of estrogen — levels may be as high as 350 pg/ml.

Meanwhile, progesterone isn’t released until you ovulate. “Progesterone levels are almost zero until about day 14 or 15 of your cycle, when you ovulate and they increase dramatically,” Minkin says. “By day 22 or so, your progesterone levels will be 30 ng/dl.” Progesterone is released by the corpus luteum, a temporary gland that forms in the ovary, and it thickens up that uterine lining to make it hospitable for a fertilized egg. If no fertilization occurs at that day 22 peak, your estrogen and progesterone levels drop off, the uterine lining and the egg leave (that’s your period), and it all starts again.

Symptoms and Causes of a Hormonal Imbalance

If you have working ovaries, it’s normal to have fluctuating hormone levels throughout the month. “Hormones vary by the individual, the stage of life, and the time of the month in people of reproductive age,” says Daniel Kort, an OB/GYN and associate medical director of Neway Fertility. “Furthermore, many of these hormones ‘pulse’ up and down many times throughout the day — in some cases, every hour. Therefore, what is ‘normal’ varies drastically between people, and for any individual over the course of their life.”

However, sometimes your body simply isn’t getting your hormone levels right. This is particularly true, says Minkin, for people with Polycystic Ovary Syndrome (PCOS): “In general, they’ll have high levels of estrogen all month, as many will not ovulate regularly, and because they are not ovulating, they have low progesterone,” she explains. And because estrogen is what promotes the uterine lining to grow, “they occasionally can bleed very heavily.” Sandra Fleming, FACOG, an OB/GYN in Wellesley, MA, also points to premature menopause and thyroid disorders as two other endocrine disorders that can throw your estrogen and progesterone out of whack. “This can result in irregular or heavy menses, acne, unwanted hair growth, thinning hair, weight gain, infertility, and mood changes,” she explains.

Unsurprisingly, given how much variation there can be between different people’s natural hormone levels, symptoms that you’re experiencing an imbalance “vary depending on the individual,” says Kort. “But the most common symptoms are irregular vaginal bleeding, pelvic fullness, and temperature dysregulation, or feeling too hot or too cold.” Although Kort says that depression and irritability often aren’t necessarily symptoms of a sex hormone imbalance, Klein points out that symptoms aren’t always connected directly to your uterus. Women and people assigned female at birth “also sometimes perceive a reproductive hormone imbalance in secondary ways, for example, headaches, fatigue, decreased libido,” he says. “The role of hormone balance in mental health should also not be overlooked. Estrogen and progesterone levels have a significant role in regulating mood and one’s sense of well-being.” We’re not saying that your bad moods are always a byproduct of your hormones: But if you are experiencing emotional swings and feeling depression or anxiety, especially at similar times of your cycle every month, it could be connected — and you should see a doctor anyway.

What You Can Do

On top of these symptoms and the health implications of PCOS, there can, unfortunately, be long-term impacts from a progesterone and estrogen imbalance. “A direct result of irregular ovulation would be difficulty getting pregnant, since a regular ovulation is a necessary prerequisite to pregnancy,” Dr. Klein cautions. It goes beyond your reproductive organs: “The biggest or most well-known implications are for bone health, heart health, and cognitive function,” Kort adds. “Women with serious dysfunction of the ovary and ovarian hormones need a full evaluation to see if treatment is necessary.”

Luckily, for many people, there are treatments available. “Depending on the cause of the hormonal imbalance, different treatments can establish the appropriate hormone levels,” Kort reassures us. “Sometimes something as simple as birth control pills can help. In other cases, hormonal replacement therapy with hormone patches are necessary. In still others, medications can be given to induce normal ovarian function, which will correct the underlying problem.”

Ultimately, if something feels wrong, go to a medical provider you trust. “If you are concerned about any of these issues, do see your gynecological health care provider, who can help sort out exactly what is causing any menstrual irregularities,” Minkin encourages. People with ovaries are often silently or subtly told that we should just deal with whatever our hormones throw at us, from heavy periods to headaches and feeling depressed or anxious. But if you’re experiencing any disruptive and/or painful symptoms that you think are related to the way your hormones are working, know that you don’t have to put up with it.

Have you found a solution to your misbehaving hormones? Share your experience with us @BritandCo.

(Photo via Getty)