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Do younger women need 'hormone balancing'? Experts clear up the hype

Women with regular periods may be confused about whether they need to “balance their hormones” for optimal health.
Body landscape
Hormone fluctuation is normal and varies throughout a woman's monthly cycle, doctors say.Getty Images
/ Source: TODAY

The concept of “hormone balancing” is hot — but is it necessary?

Everywhere women turn, books, articles and tweets are urging them to try “hormone-balancing” diets and treatments, with promises of everything from feeling better to making weight loss easier.

The messages aren’t just intriguing for menopausal women, whose bodies naturally produce less estrogen.

Younger women may be confused about whether they need to “balance their hormones” for optimal health.

It’s not uncommon now to see a healthy 30-year-old woman telling her OB/GYN: “I want to you to measure my hormone levels,” referring to her estrogen and progesterone, said Dr. Lauren Streicher, an associate clinical professor at Northwestern University’s Feinberg School of Medicine and director of the Center for Sexual Medicine and Menopause at Northwestern Memorial Hospital in Chicago.

Streicher tells patients who have not yet entered perimenopause or menopause that barring specific symptoms that indicate a hormone issue (more on that later), worries about being “out of balance” are based on misconceptions and hype.

“Hormone fluctuation is normal and it varies throughout the cycle. So this whole nonsense about how you have to balance your hormones to feel better is just that: it’s quite frankly just nonsense,” Streicher, author of “Sex Rx: Hormones, Health and Your Best Sex Ever,” told TODAY.

In most cases, as long as a woman has a regular period, there’s no reason for her to need to do anything, added Dr. Leah S. Millheiser, director of the Female Sexual Medicine Program at Stanford University School of Medicine’s Department of Obstetrics and Gynecology.

“We don’t, as gynecologists, recommend having your hormones checked in a healthy, normally cycling woman,” Millheiser said.

‘It’s not a balance thing’

For women who have not entered perimenopause or menopause, it’s normal for levels of three key hormones — estrogen, testosterone and progesterone — to rise and fall in patterns throughout the monthly cycle.

“There’s no ‘in balance,’” Streicher said. “It’s not a balance thing.”

When you measure a person’s thyroid levels, for example, there’s a very specific window of what’s considered normal. But that doesn’t exist for estrogen or testosterone, Streicher said. They may be low or high depending on where a woman is in her cycle and that’s perfectly normal, she added.

Testing concerns

Both experts were skeptical about women getting their hormone levels checked in compounding pharmacies or other venues outside doctors’ offices.

“I have yet to see the woman who goes to one of those places who is not told that there’s something wrong,” Streicher said. “They do $2,000 worth of lab work, whether blood or saliva, and everyone is told they have a hormone imbalance… because there’s a lot of money to be made.”

Many of the compounding pharmacies perform saliva testing, but that’s not a reliable way to check hormone levels, Millheiser added.

“If we ever do need to measure hormone levels in someone, we measure through their blood, recognizing that there is variation throughout the day in someone’s level,” she said.

Symptoms to watch out for:

There are recognized conditions that signal hormone issues in younger women. They include:

Polycystic ovarian syndrome — Triggered when a woman produces more male hormones than normal. Symptoms include: irregular periods, weight gain, acne, facial hair, pelvic pain and infertility.

Hypothalamic amenorrhea — the absence of a period, typically experienced by thin and active women who are exercising too much, eating too little or dealing with too much stress. This condition, often found among female athletes, happens when the hypothalamus doesn’t send signals to tell the body to ovulate, Millheiser said.

In general, women should see a board certified gynecologist if:

• they’re not having regular periods

• experience excessive hair growth or acne

• are trying to get pregnant and aren’t able to.

Those are all indications their hormones may be off. A doctor will take history, perform an exam, order bloodwork and perhaps use ultrasound to look at the patient’s ovaries to establish what’s going on and decide on a treatment, “as opposed to these clinics that just take your money and start measuring hormone levels,” Streicher said.

‘Hormone-balancing’ recipes

Both doctors were skeptical of “hormone-balancing” recipes and cookbooks. Streicher laughed at the concept that women should eat a certain way to influence their hormones.

“If it tastes good, sure, but it’s not going to do anything for them,” she said. There’s no science behind "hormone-balancing" diets, Millheiser added.

If younger women want to improve their hormonal health, it’s better to focus on managing stress, both experts said. Stress can affect the brain and disrupt the normal pathway between the pituitary gland and the ovaries, which can cause a woman to stop ovulating or have irregular periods.

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