Depending upon the underlying cause, there are several hormonal imbalance treatments available for you. Your doctor will begin by: Encouraging you to bring lifestyle changes. Research has shown that tweaking habits and lifestyle improves hormonal balance in many individuals. Who knows you may be one.
Hormonal Imbalance Treatment
Nature is your best friend. There is evidence that hormonal imbalance can be restored with the help of natural treatments such as:
- Dumping endocrine disrupting chemicals (EDCs)
- Exercising in moderation
- Changing diet
- Avoiding caffeinated drinks and drinking alcohol in moderation
- Stressing less
- Sleeping more
Dump Toxic Home Chemicals And EDCs
Always watch the label before buying any product, be it food cans, food containers, or make up. Avoid products made of parabens DEA, sodium lauryl sulfate, and propylene. These ingredients are normally present in shampoos, conditioners, deodorants, toothpastes and hair products.
If possible, replace plastic bottles with glass or stainless steel. Plastic contains bisphenol-A (BPA) which is an EDC. Xeenohormones leech out of the water bottle into the water you drink.
Although the FDA gave PBA a green signal in 2008, concerns have been raised about whether BPA remains safe in food-contact materials. It’s better to err on the side of caution. Do not microwave food in plastic containers, plastic wrap or cellophane. Heat induces the plastic to release harmful chemicals that go directly into the food.
Environmental Working Group has taken a wonderful initiative where they have assessed over 70,000 products for safety and toxicity. Visit their website, or better still, download the app to see whether products you are using are safe and not disrupting your hormones.
Go Easy On Exercise – Practice Moderation
It seems everywhere you look, you see new exercise programs enticing you to lose weight and look like a super model in 42 something days, but extreme exercise, we have learned before can be bad for your fertility.
Your body is not made for extremes, give it the bliss of moderation for it works best when it’s in the state of homeostasis. The US National Health Services recommends healthy adults to be physically active for at least 150 minutes a week. Exercise should be in moderation and include brisk walking, cycling, swimming, aerobics.
The NHS recommends that strength exercises of all muscles should not exceed twice or thrice per week. hour is a much better plan for maintaining hormonal balance. The US Centers for Disease Control and Prevention (CDC) has nicely outlined the duration of exercise per week. It says, an adult aged 19-64 should indulge in 2 hours and 30 minutes (150 minutes) of moderate-intensity exercise per week.
If your training requires vigorous activity, the CDC advises that you not exert your body for more than 1 hour 15 minutes (75 minutes) per week. However, if you are overweight, you must lose weight. Weight loss is an extremely effective approach for managing symptoms of PCOS.
Since PCOS affects overweight and obese women more, a weight loss of about 5-10% results in menstruation regulation and reduced insulin resistance.
Hormonal Imbalance Treatment: Diet Does Matter
If you are not feeding your body the daily required nutrients, you are putting it at a risk of hormonal upset. Correct your diet. Eat food rich in Zinc, omega-3 fatty acids, and fiber.
Zinc naturally increases testosterone level and found in dark chocolate, peanuts, beef, lamb, oysters and crab. Omega-3 fatty acids are found in salmons, tuna, trout, sardines, oysters, eggs and walnuts. Fiber is found in raw fruit, vegetables and raw grains.
Avoid Excess Of Caffeine And Alcohol
Evidence shows they mess with your hormones. A University of Utah study published in American Journal of Nutritious found caffeine to have a tendency to alter estrogen levels in women. Moderate consumption of coffee (not more than 2-3 cups per day), researchers say, is best to maintain estradiol (a type of estrogen).
Alcoholic beverages, on the other hand, contain estrogen-like substances – called phytoestrogens – as congeners that can mess your hormones. Ginsburg et al found that excessive ethanol consumption to elevate estradiol levels by up to 300%.
Detrimental effects of excessive alcohol consumption are well-documented in medical literature. A large 2005 Women’s Health Initiative (WHI) study found that alcohol increases risk of breast cancer in women.
Nutrition and Metabolism has catalogued all studies regarding alcohol consumption and hormonal alternations. Higher doses of alcohol or binge-drinking has been shown to suppress testosterone level in men. It also has a negative effect on LH. Moderate consumption, however, increases testosterone level.
Again, moderation is the key. The Dietary Guidelines of America 2015-2020 recommend: “If alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men.”
Reduce Stress, A Key Factor In Hormonal Imbalance Treatment
Believe it or not, you are doing your body the greatest damage by being stressed. It’s not just a feeling in your head; each and every organ of your body is being affected by stress.Natural to assume that it disrupts the natural hormonal balance.
Stress disrupts LH-releasing hormone, LH, and FSH, and increases cortisol – the mother of all stresses. Try indulging in stress-relieving activities like playing games, watching TV or listening to music every day. Having sex has been shown to reduce stress.
It’s a powerful stress-reliever and regulates periods. Male sweat has also been shown to work as an anti-depressant for women. Research shows that that men who ejaculate more frequently are at a lower risk of prostate cancer.
Sleep More: Your Harmon’s Need Rest
Getting the required amount of sleep helps put your body in rhythm and regulate hormones. Sleep is particularly more important for men because their body boosts testosterone production during REM.
The American Academy of Sleep Medicine recommends that “adults should sleep 7 or more hours per night on a regular basis to promote optimal health.” The above mentioned lifestyle modifications should help a great deal in naturally toning up your hormones. You may also need simultaneous medical assistance to completely regulate your hormones.
Hormonal Imbalance Treatment With Medical Therapy
The medical treatment varies according to the gender and medical condition you have. Let’s have a look at them individually.
- Pharmacotherapy of hormonal imbalance in women
- Pharmacotherapy of hormonal imbalance in men
- Male Hypogonadism
- Pharmacotherapy Of Hormonal Imbalance In Women
The Treatment Of PCOS Includes
- Oral contraceptives
- Hirsutism treatment
- Fertility Medicines
Treatment Of PCOS With Oral Contraceptives
Treatment typically begins with oral contraceptives (OCs) with combined estrogen and progestin. OCs helps prevents the risk of endometrial hyperplasia or cancer in women with PCOS.
These regulate periods and curb symptoms of androgen overload such as acne and hirsutism. OCs work by curbing androgen levels in the body. They provide an additional benefit of protection against conception. For women who wish to get pregnant, therapy preferences differ and include medicines that induce ovulation and increase fecundity.
OCs only control the symptoms of PCOS; these in no way cure the condition. PCOS currently has no cure because the exact cause is unknown. Once OCs are stopped, menstrual irregularity ensues.
Side effects of OCs include weight gain, nausea, breast tenderness and bloating but these symptoms subside after a couple of months. The pills are overall safe, although they slightly and rarely increase the risk of blood clots in the legs or lungs particularly in women who are obese or old.
Treatment Of PCOS With Progestin
Progestin is a pill that regulates period in almost all of the women. It is to be taken for 10-14 days for a period of 1-3 months. It reduces the risk of uterine cancer.
Treatment Of PCOS With Metformin (Glucophage)
Metformin is an antidiabetic drug that was originally developed to treat type 2 diabetes but it also regulates period and subtly increases the chances of pregnancy; however,it is not an effective as a replacement for ovulation inducing drug – clomiphene. Metformin is category B drug in pregnancy and generally considered safe.
It works by improving insulin resistance in the body. Metformin also helps in weight loss. Studies have shown that women who maintain a low-calorie diet while they are on metformin lose sustainable weight.
Excessive hair on chin and other body parts can be managed with shaving, waxing and using depilatories, electrolysis and laser.
Hormonal Imbalance Treatment And Fertility Medicines
- Clomiphene: is an FDA approved drug that stimulates ovaries to produce and release one or more eggs per month. It successfully produces ovulation in about 80% of women; out of whom about 50% will conceive.
Evidence shows that taking metformin with clomiphene increases rate of ovulation and chances of conception. Legro RS et al from Pennsylvania State University College of Medicine, US, found that live birth rate was 22.5% with clomiphene in 626 infertile women; and 7.2% in metformin group.
When a combination of both drugs was given, the live birth rate escalated to 26.8%. The study was published in NEJM. But since Metformin belongs to category B, women who take it before pregnancy are advised to stop it once they conceive to reduce risk to fetus.
- Letrozole: is anti-cancer that is used to treat breast cancer in women but studies have shown that letrozole is effective in obese women and increases chances of live birth rate.
However, it is not yet approved. Fertility treatments work best in women who are not obese. Even a modest reduction in weight not only increases chances of fertility but such women respond better to treatment. If clomiphene fails, gonadotropin therapy with FSH injections is given. Almost all women ovulate with gonadotropin therapy; out of which 60% conceive.
Primary Ovarian Insufficiency (POI)
is not just an ovarian failure; it is much more and takes a heavy toll on your whole being. It affects emotional and physical well-being of a woman. Its management includes:
- Estrogen Replacement
- In vitro fertilization (IVF)
- Psychological counseling
aims at replenishing your body’s lack of the vital hormone. Without estrogen, women not only “not” menstruate but they are also at a heightened risk of osteoporosis. Evidence suggests that women younger than 50 years of age who have estrogen deficiencyare more likely to suffer from a heart disease.
Estrogen replacement therapy includes estradiol which is available in the form of pills, vaginal ring or a patch. Experts believe estradiol best mimics the natural hormones in your body and is also effective in controlling symptoms of the menopause.
Some women worry that estrogen replacement therapy will increase their risk of breast cancer but it is important to know that a lack of therapy puts at an increased risk of coronary artery disease, osteoporosis, dementia and death.
Furthermore, their risk of developing cancer is much lower than older women – aged 50 and above – on hormone replacement therapy (HRT).
Nick Panay, consultant gynecologist at West London Menopause and PMS Center, and other experts believe women with POI should replace the hormones that their ovaries are not producing. Estrogen replacement therapy should continue till the normal age of menopause – 50 years.
ERT also improves sexual function among women with POI.
In Vitro Fertilization (IVF)
Women who wish to conceive can opt for IVF with donor eggs. A study of 61 women undergoing IVF treatment cycles showed chances to pregnancy to 90% after three cycles. Embryo donation is also an effective treatment for women who wish to conceive.
Psychological functioning is poor in women with POI. They have high scores of depression, anxiety and other emotionally traumatic tendencies. Any form of psychological support and help can do wonders for them in regaining confidence, emotional wellbeing and a sense of control.
Dr. Lawrence Nelson, Head of Scientific Integrative Reproductive Medicine Group and Human Development, National Institutes of Health, US, writes in a review:
“The young woman with premature ovarian failure brings many concerns to her clinician’s office.
It is important that the clinician validates the patient’s appropriate concerns and, by the same token, educate the patient to help allay any concerns that might be ill-founded.”
Women with POI also have androgen deficiency but Dr. Gioia Guerrieri, women’s Behavioral Health Consultant and Medical Officer, Center for Drug Evaluation and Research at FDA andother experts do not recommend androgen replacement therapy because it can result in acne and hirsutism.
Menopausal Hormone Therapy (MHT)
Normal women have menopause at the age of 51. Almost 95% women become menopausal between 45-55 years. Estrogen or estrogen combined with progestin is an effective treatment to prevent chronic conditions in women going through menopause.
However, it’s controversial and long-term use is not recommended. MHT is a broad term used for two types of hormonal therapy in menopausal women:
Estrogen Therapy (ET): for women who have undergone hysterectomy – surgical removal of uterus. Estrogen + Progestin Therapy (EPT): for women with intact uterus to prevent the risk of estrogen-induced endometrial hyperplasia. The goal of MHT is to relieve menopausal symptoms, particularly hot flashes (vasomotor symptoms).
Other menopausal symptoms include mood lability or depression, sleep disturbances, vaginal atrophy (termed: genitourinary syndrome of menopause – GSM) and pain in joints. Here is how MHT is used to treat menopausal symptoms:
Your vagina is highly absorptive and sensitive to estrogen. A deficiency of estrogen leads to the thinning of vaginal epithelium resulting in GSM (vaginal dryness, vaginal atrophy or atrophic vaginitis, itching and painful sexual intercourse called dyspareunia).
To curb these symptoms, low-dose vaginal estrogen is given.
MHT alone or in combination with antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
Mood disorders and depression are common among women going through menopausal transition.
Two clinical trials by researchers from UCLA Medical Center and Medical College of Wisconsin, USA have shown that either combined EPT or ET alone can provide relief in joint aches.
In the past, MHT was also used to prevent risk of coronary heart disease and osteoporosis; however; it is no longer recommended.
Women’s Health Initiative (WHI) – a set of two large 15-year research program involving 161,808 healthy menopausal women aged 60 and above – has demonstrated an increased incidences of breast cancer in women on MHT.
Ever since, use of MHT has dramatically decreased. The hormone regimen studied in WHI was conjugated estrogens and medroxyprogesterone acetate (MPA) which is called progestin.
WHI assigned 16,608 with a uterus to receive oral estrogen plus progestin for a period of 5.6 years; and 10,739 women with a prior hysterectomy to receive estrogen for 7.2 years.
In estrogen + progestin trial, an increase in breast cancer incidence was seen. In the estrogen alone trial, the incidence of breast cancer decreased.
The latest analysis of WMI, published in JAMA on April 16, 2014, suggests a pattern of changing influences over time on breast cancer.
The U.S. Preventive Services Task Force has not found sufficient beneficial evidence to extend support to HRT and recommended against the use of estrogen and progestin in postmenopausal women for the prevention of chronic conditions.
However, the USPSTF has not issued any recommendations about use of hormone therapy for the management of menopausal hot flashes, vaginal dryness and night sweats. It leaves the decision on best clinical assessment.
The North American Menopause Society (2012), endorse uses of HT for perimenopausal and postmenopausal women when it has the clear-cut benefits.
MHT is highly effective in treating menopausal symptoms such as hot flushes, night sweats, mood swings and vaginal atrophy.
The American Endocrine Society (2015) recommends an individual-based treatment approach after calculating a woman’s risk of cardiovascular disease and breast cancer.
For menopausal women who are less than 60 or have been menopausal for less than 10 years who have bothersome menopausal symptoms but do not excess cardiovascular disease (CVD) or breast cancer risk should be treated with EPT if they have an intact uterus; ET if do not.
Menopausal women who are at high risk of CVD, nonhormonal therapies should be used.
Menopausal women who are at moderate risk of CVD should be treated with transdermal estradiol alone if they’ve had a hysterectomy; or with a combination of estradiol +micronized progesterone if their uterus is intact.
Menopausal women who are at high or intermediate risk of breast cancer should opt for non-hormonal therapies over MHT.
Menopausal women who have osteoporosis should be treated with bisphosphonates. However, menopausal women with troublesome persistent symptoms, who cannot tolerate first and second-line therapies for osteoporosis, estrogen can be a viable option.
Pharmacotherapy Of Hormonal Imbalance In Male
Male Hypogonadism Treatment depends on the cause and whether a man is concerned about fathering a child.
- Testosterone Replacement Therapy (TRT)
- Hormone Therapy
- Assisted Reproduction
- Testosterone Replacement Therapy (TRT): TRT is employed for testicular failure. It makes up for testosterone deficiency, increases muscle strength, stamina and sex drive and prevents bone loss.
TRT can induce puberty in young boys and inculcate secondary sex characters including growth of penis, deepening of voice, growth of beard and increasing muscle mass.
American Association of Clinical Endocrinologists 2002 update says that “the goals of TRT are to:
- Restore sexual function, libido, well-being, and behavior
- Produce and maintain virilization
- Optimize bone density and prevent osteoporosis
- In elderly men, possibly normalize growth hormone levels
- Potentially affect the risk of cardiovascular disease
- In cases of hypogonadotropic hypogonadism, restore fertility”
Oral TRT is not encouraged since it can cause irreversible liver damage. Instead TRT can be provided in the form of:
- IM Injections: Testosterone cypionate (Depo-Testosterone), testosterone enanthate (Delatestryl). The FDA also approved Testosterone undecanoate (Aveed)injection – a product of Endo Pharmaceuticals, US – in 2014. Aveed is a long-acting testosterone injection formulated in castor oil and benzyl benzoate that is injected IM once at initiation of therapy, at 4 weeks, and then every 10 weeks thereafter.
- Patch: such as Androderm – a transdermal patch – is applied on thigh, upper arm, back or abdomen every night where it delivers continuous levels of testosterone round the clock. Transdermal patches are more expensive than injections but they are convenient and help maintain testosterone level 24-hours a day.
However, they can cause skin irritation including itching, blistering and allergic dermatitis; in one study conducted by Dr. Susan Parkar, department of Endocrinology, Royal Bournemouth and Christchurch Hospitals NHS Trust, US, 60% of the males with hypogonadism discontinued the transdermal TRT patch on one account of skin irritation.
- Gel: AndroGel, Testim, Vogelxo, Axiron, Fortesta. Gels are applied in the morning to allow the normal circadian pattern of the hormone. Researchers from Harbor-University, California found in 2000 that compared to patches, testosterone gels provide longer-lasting elevations in serum testosterone. Side effects include; headache, insomnia, acne, hot flushes, and elevated blood pressure
- Gums And Lozenges: Striant helps achieve testosterone levels rapidly. It’s taken twice daily. These are well tolerated but have bitter taste and can make your mouth dry, give you a toothache and inflammation of tongue but the effects are short-lived.
- Implantable Pellets: Testopel
- Hormonal Replacement: If hypogonadism is due to pituitary deficiency, hormonal replacement with pituitary hormones may replenish sperm production and fertility.
- Assisted Reproduction: is used when no other effective treatment is available and the man is concerned about fertility. It is most commonly used in primary hypogonadism.