Menopause is a time of change—some expected, some completely unpredictable. As estrogen, progesterone, and testosterone levels decline, the body starts responding in ways that might feel foreign. One moment you’re burning up with a hot flash, the next you’re inexplicably irritable or exhausted. But what happens when hormone levels aren’t just declining naturally but become imbalanced? And how does adjusting them—either through hormone replacement therapy (HRT) or lifestyle changes—affect how you feel?
Let’s break it down so you can better understand what’s happening in your body and how to regain balance.
Estrogen: The Power Player
Estrogen is the dominant hormone throughout most of a woman’s reproductive years. It influences everything from mood to metabolism, bone density, and heart health. When estrogen levels begin to decline, the body notices—sometimes dramatically.
-
Too Low: Expect intense hot flashes, night sweats, vaginal dryness, mood swings, brain fog, fatigue, and even joint pain. Low estrogen is also linked to increased risk of osteoporosis and heart disease.
-
Too High (via HRT or natural fluctuations in perimenopause): Symptoms can include bloating, breast tenderness, headaches, irritability, and even anxiety. Some women also experience heavy or prolonged periods during perimenopause as estrogen spikes unpredictably.
-
Balanced: When estrogen is in a good place, hot flashes ease up, mood stabilizes, sleep improves, and vaginal health is maintained. Energy levels tend to feel more consistent as well.
Progesterone: The Calming Hormone
Progesterone plays a critical role in balancing estrogen, promoting relaxation, and supporting sleep. It naturally declines with age, and if a woman has had a hysterectomy, it disappears completely unless supplemented.
-
Too Low: Women often report feeling wired but tired—difficulty falling asleep, increased anxiety, and mood swings. Progesterone also helps regulate estrogen, so low levels can contribute to estrogen dominance symptoms (like heavy periods and bloating).
-
Too High (from supplementation): Fatigue, drowsiness, and even depressive symptoms can emerge. Some women feel slowed down mentally and physically when taking too much progesterone.
-
Balanced: When progesterone is at a good level, sleep improves, anxiety decreases, and mood feels more stable.
Testosterone: The Overlooked Hormone
Testosterone isn’t just for men—it plays a key role in muscle strength, energy, motivation, and libido in women. While levels naturally decline with age, some women experience more pronounced drops, especially after surgical menopause.
-
Too Low: Low libido, fatigue, decreased muscle tone, and even a loss of motivation or drive are common. Some women also experience a sense of weakness or slower recovery from exercise.
-
Too High (from supplementation): Acne, increased body hair, oily skin, irritability, and in rare cases, hair thinning on the scalp.
-
Balanced: Energy levels improve, muscle tone is easier to maintain, and libido is healthier. Women often report feeling more motivated and mentally sharp.
Finding the Right Balance
Navigating menopause isn’t just about recognizing that hormone levels are shifting—it’s about identifying when they’re out of sync. Symptoms often overlap, making it difficult to determine which hormone is too high or too low without tracking how you feel over time.
If you’re struggling to find that balance, whether through lifestyle changes or HRT, know that you don’t have to figure it out alone. As a menopause coach, I help women fine-tune their approach to hormone health through movement, strength training, and evidence-based strategies while learning how to advocate for themselves.
If your symptoms feel out of control, let’s work together to bring them back into balance. Reach out today and start feeling like yourself again.