Understanding your symptoms

A guide to demystifying hormonal imbalance

Tharni Vasavan

Written by

Dr Tharni Vasavan, BSc (hons), MSc, PhD

Published June 6, 2022

Last medically reviewed June 6, 2022

Do you put up with not feeling your best at certain times? Do you just accept pain, heavy bleeding or acne as part and parcel of having periods?

Don’t worry, many of us do, but symptoms like these could be your body’s way of telling you that your hormones are out of whack or you have an underlying health condition. We’re here to help you tune into your hormonal health, spot when something is not quite right and take action to get you feeling your best again.

Are you experiencing symptoms?

Here’s what you need to know.

If you think something is up, it usually is

The majority (72%) of women feel their symptoms are dismissed by healthcare professionals, yet 64% of our users who thought something wasn’t right, had at least one hormone out of range.

Symptoms can be hard to understand (until now)

Getting a diagnosis for a reproductive health condition such as PCOS can take over 2 years, however our at-home hormone and fertility test can flag 9 of the most common gynae conditions in 10 days.

The key is finding the right expert(s)

The key is finding the right expert(s) to treat or manage your symptoms. That’s why we have a team of specialists in female health, medicine, fertility, nutrition and mental health to provide a science-backed eco-system of care.

The basics

What are symptoms?

Put simply, a symptom is a physical or mental indicator that something in the body isn’t working as it should be. The reality is, most of our bodies are not in perfect order, so the likelihood is the majority of us will be experiencing at least one symptom on a regular basis. Whilst some symptoms are worse than others, we believe every symptom, big and small, warrants investigation.

Hormonal imbalance vs underlying condition

Even if one hormone is slightly higher or lower than it should be (what we call hormonal imbalance) the effects can be huge, resulting in symptoms that can be hard to make sense of. Using specialist guidelines and the expertise of renowned gynaecology and fertility consultants, our online health assessment identifies which hormones we need to test in order to to understand precisely what’s going on.

A Understanding your reproductive health is essential to understanding your overall health, that’s why we don’t just look out for symptoms of a hormonal imbalance. This is why our online health assessment also checks for symptoms (and specific combinations of symptoms) associated with other reproductive health conditions which are not hormone-related.

What is your body trying to tell you?

If you’re here, you’ve probably been experiencing symptoms that are getting in the way of you feeling your best. The fact that you’ve found us means you’re listening to your body and looking to do something about it, which is great, but what is it that your body is trying to tell you? The only way to know for sure is to test your hormone levels! In the meantime, here’s a run down of the most common symptoms and what they could be signs of.


Fatigue & hair loss

Symptoms such as fatigue, hair loss and feeling cold all the time can be a sign of an underactive thyroid. This means your thyroid isn’t producing enough thyroid hormone (thyroxine), which is crucial for your body’s metabolism to function day to day. Too little thyroxine can therefore slow down these metabolic processes, making you feel tired, stopping the growth of new hair and affecting how your body regulates its temperature. Hair loss and irritability are also signs of an overactive thyroid, meaning your body is producing too much thyroxine, which again disrupts your body’s metabolic processes and its delicate homeostasis.item

Your options

How can you manage your symptoms?

It all boils down to what is causing your symptoms. Sometimes it’s possible to treat the underlying cause and other times it’s more about receiving treatment to manage your symptoms. For example, some hormone-related conditions, such as PCOS and menopause, cannot be “cured” in the traditional sense - so doctors usually offer options which aim to improve quality of life by reducing or alleviating symptoms.

Some causes of symptoms

Polycystic Ovary Syndrome (PCOS)

For people with PCOS, ovary-stimulating medications such as Clomid and Metformin may help to induce your periods, which is particularly useful if you are trying to conceive. A doctor may also suggest using hormonal contraception to help with regulating your period. Metformin is used to treat poor blood sugar control (which many women with PCOS have) and can therefore help with weight issues. In some cases, a surgery called laparoscopic ovarian drilling may be suggested if you are trying to conceive. Anti-androgen medication such as Spironolactone (and some forms of the pill such as Co-cyprindiol or Dianette) can be effective for improving symptoms of high testosterone such as acne and hirsutism (excess hair growth). Cosmetic treatments such as laser hair removal are also often used by women with PCOS to manage hirsutism if they don’t respond well to medication or prefer not to use it. You may be offered lifestyle and dietary advice to help with common PCOS symptoms such as weight gain or difficulty losing weight. Support with mental health, such as medication, counselling, CBT and mindfulness, can also be used to improve symptoms of anxiety and low moods, both of which are frequently seen in women with PCOS.'

Understand your symptoms

Test your fertility

The journey to getting to the bottom of your symptoms and then finally getting them under control can feel daunting. But this is where we come in. At Hertility, we’re advocates for your health and well being. We listen to every symptom you have and won’t stop until we know why you’re experiencing it and who the best health experts are to help. All you have to do is tell us what’s going on.

Check in with your body with an at-home test

Take our online health assessment and receive a personalised hormone blood test and comprehensive report from a private gynaecologist without leaving the house.

Understand if an underlying condition is the cause

Hertility’s at-home tests can signpost 9 of the most common gynaecological conditions which impact fertility, such as PCOS, hypothalamic amenorrhea and thyroid imbalances.

Receive fast-track access to the right experts

Quick referrals to specialist care for pelvic ultrasounds, fertility counselling, nutritional support, or fertility and egg freezing treatment if required.

Get answers fast, without breaking the bank

Forget lengthy waiting lists. Get answers (or an action plan for further investigations) in 10 days. Private fertility clinics cost over £1,200 but we’re making it accessible with our £149 test.

test your fertility

We’ve helped many women find answers to their health that they deserve


How we’re doing this

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FAQS about fertility

What are hormones?


Hormones are chemicals that travel around your body, sending messages and signals to various organs and body parts to regulate their function.

What causes hormonal imbalance and how do you fix it? This depends on which hormone(s) are imbalanced and what the underlying cause is. There are medications available to treat imbalances of hormones such as thyroxine, estrogen, progesterone and testosterone 23 17. But some medications themselves can actually cause a hormonal imbalance, in which case the doctor who prescribed it may be able to adjust your dosage or offer an alternative option. In some cases, lifestyle interventions, such as improving diet or stress levels, are helpful for correcting a hormonal imbalance, particularly in cases of hypothalamic amenorrhea5. In rare cases, a hormonal imbalance might be due to a tumour, in which case surgery and/or medication can normalise your hormone levels. It’s important to note that the root cause of some imbalances, such as menopause or PCOS, cannot be fixed but there are medications and other treatment options available to help manage the symptoms.

Does female masturbation cause hormonal imbalance?


Orgasms from masturbation and sex are thought to temporarily change hormones such as adrenaline, prolactin and oxytocin. However, there is very little evidence to support it and any hormonal changes were shown to be short-lived. There is also no evidence to show that they will actually cause a hormonal imbalance.

Why do I feel cold all the time?


Hypothyroidism, or an underactive thyroid, is one of the most common causes of feeling cold. It’s caused by your thyroid not producing enough hormones and leads to your body struggling to maintain its temperature3. Feeling cold, coupled with irregular or absent periods, can also be a sign of hypothalamic amenorrhea, which can be caused by not eating enough, over- exercising or feeling stressed5. Iron-deficiency anaemia is also a common cause of feeling cold and can be caused by an iron-deficient diet, heavy periods or a problem with your digestive system28. Finally, feeling cold can also be due to a problem with your blood circulation. This is because less blood is pumped to your extremities which can make you feel cold, particularly in your hands and feet. Problems with circulation are usually caused by an underlying condition, such as diabetes, Raynaud’s disease or atherosclerosis.

How to get rid of hormonal acne?


Treatment for hormonal acne depends on its severity and what your preferences are. Your doctor may prescribe a benzoyl peroxide cream (which may contain an antibacterial medication) as a first line treatment. This can be enough to get rid of mild acne in many people, however, your acne may come back if the hormonal imbalance causing it is not addressed. If topical creams don’t work then your doctor may suggest a combined oral contraceptive pill that contains an anti-androgen medication (which may be called Co-cyprindiol, Clairette or Dianette) instead, which is useful in many people with PCOS who have acne due to excess androgens in their body. Other anti-androgen medications, such as Spironolactone, may be offered to you and can help with clearing up acne. People with severe acne are sometimes prescribed Isotretinoin (sometimes called Roaccutane) as a treatment. However, this will not treat the underlying hormonal cause of acne, which again means that if your hormonal imbalance is still present when you stop taking the medication, your acne may return. It’s important to know that many oral medications for acne either do not allow you to get pregnant or can cause severe birth defects so it’s important to take precautions when on these types of medication. Your doctor at Hertility will go through your medical history to see what you have already tried and what might be the best prescription or treatment option for you. Regardless of which treatment you end up opting for, you will also receive general skincare advice about which products you should avoid to reduce the occurence of flare ups.

Why are my periods so heavy?


Doctors in the UK are advised to investigate heavy periods (heavy menstrual bleeding or menorrhagia) based on whether they have a substantial impact on your quality of life as opposed to how much blood you lose. That being said, many people with heavy periods need to change their period products very frequently (every 1-2 hours), need to use 2 period products at a time (i.e. a tampon with a pad), and often bleed onto their clothes and bedsheets or bleed for more than a week. Periods vary substantially from one person to another, and at least 50% of people will have heavy periods without any particular reason. However, in some cases, heavy periods can be due to an underlying condition. Blood clotting disorders, such as Von Willebrand’s disease, can be the cause of heavy periods, particularly if your periods have always been heavy since going through puberty. Pre-existing conditions, such as hypothyroidism, diabetes and liver or kidney disease can also be the cause of heavy periods. Women with fibroids, polyps, endometriosis and adenomyosis also often have heavy periods which may get worse as time goes on. If your periods are heavy, a doctor will check your virtual health assessment answers and blood test results to rule out any common causes, and may also refer you for a further pelvic ultrasound or a procedure known as a hysteroscopy (which involves examining your uterus with a small telescopy) to see whether they are being caused by problems such as fibroids or polyps.

What does a pcos belly look like?


Many women with PCOS have issues with their metabolism which means they have trouble processing the food and drink they consume to make energy. The impaired metabolism that many women with PCOS have can lead to a higher risk of conditions such as diabetes, hypertension and heart disease. People with metabolic issues often have what is known as central adiposity. This is when you have fat tissue that is not evenly distributed but accumulates around your abdomen. PCOS belly refers to this central adiposity, and is especially common in women of South Asian origin8. It can be easily assessed by measuring the circumference of your waist and hips and calculating the ratio between the two numbers; according to WHO, a normal waist to hip ratio is less than 0.85.

How to diagnose endometriosis


Unfortunately there are no blood tests currently available that can accurately diagnose endometriosis. Your doctor may suggest that you have endometriosis based on the symptoms you indicated in our virtual health assessment. If this is the case, you will be invited to have a pelvic ultrasound at one of our clinics. Depending on the doctor, they may first choose to do a clinical - examination by inspecting and pressing down on your abdomen to check for signs of endometriosis. They will then image your uterus via a pelvic ultrasound, and possibly also refer you for an MRI. Not all types of endometriosis can be found via imaging techniques, so as a final investigation, you may be referred for a laparoscopy. This is a keyhole surgery where a small telescope is inserted into an incision in your abdomen to look at your internal organs and tissue. Small tissue samples may be taken during the laparoscopy so they can be checked under a microscope for markers of endometriosis.

About the author

hertility authorhertility author

Written by

Dr Tharni Vasavan, BSc (hons), MSc, PhD

Contributed to by

Ruby Relton BSc (hons) MSc, Brid Ní Dhonnabháin BSc (hons) MSc, Zoya Ali BSc (hons) MSc

Medically reviewed by

Dr Benjamin Jones, MBChB BSc (Hons) MRCOG PhD

Published 09.05.22.

Last medically reviewed 09.05.22


Results of the ‘women’s Health - Let’s talk about it’ survey, Gov.uk (2022): https://www.gov.uk/government/consultations/womens-health-strategy-call-for-evidence/

Gibson-Helm et al, 2017. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Endocrinol Metab 102(2).: https://pubmed.ncbi.nlm.nih.gov/27906550/

Gordon et al, 2017. Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism 102(5).: https://academic.oup.com/jcem/article/102/5/1413/3077281