In this article:
- What does “normal” even mean when you’re talking about hormones?
- If you’re starting from zero, here are the hormones you should pay attention to
- The connection between anxiety, depression, and your hormones
- Non-hormonal factors can reflect your hormone health
- Finding your baseline is the first step in improving hormonal balance
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Modern medicine can tell you if your hormone levels are too high or too low, but you can still suffer from hormonal imbalance even if you’re technically within the “normal” range. Establishing your own hormonal baseline through testing will give you more than just numbers on a page; it’s the first step in working toward long-term hormonal balance.
Takeaways:
- It’s easy to know whether or not your hormone levels fall within a normal range, but you need more information if you want to see the big picture.
- While all kinds of factors can cause imbalanced hormones, stress is one factor that gets frequently overlooked.
- Regaining hormonal balance isn’t just about getting back into the reference ranges; you need to figure out what your own version of “normal” is.
Before we dive in, a quick note: when Base uses gendered language we’re talking about physiological gender assigned at birth, not someone’s preferred pronouns.
What does “normal” even mean when you’re talking about hormones?
Just like every other part of the human body, hormones don’t come with a user manual; whatever we know about them has come from years of observation and research. When you get your hormones tested, your results will be compared to reference ranges, or the typical minimum/maximum hormone levels that a healthy person would have. It’s a useful metric, but being within the reference range doesn’t necessarily mean your hormones are perfectly balanced.
This is partly because of the way that hormonal reference ranges are calculated. A large group of healthy people are tested for a particular hormone, and the results are taken as a snapshot of what “normal” ranges should be. The problem is, you can still suffer from imbalances even if your levels are within range.
1. If you’re starting from zero, here are the hormones you should pay attention to
If you’re reading this, you probably already know that estrogen is “the female hormone” and testosterone is “the male hormone”. But did you know that women have testosterone, and men have estrogen? Plus, progesterone - another vital sex hormone that’s typically higher in women - often gets left out of the discussion altogether.
Then there’s one of your thyroid hormones, T3; the reference range is the same for women and men. Lastly, you have cortisol, or the “stress hormone”; normal cortisol levels are the same for both women and men. If you want to find out what’s going on with your hormones, getting these tested is a solid start.
You’ve already heard about reference ranges several times; maybe it’s time you actually saw some of them!
- Estrogen: 30 - 400 pg/ml for adult women, 5,500 - 30,000 pg/ml during pregnancy, and <30 for post-menopausal women
- Progesterone: <0.89 - 24 ng/ml during a menstrual cycle, 11 - 214 ng/ml during pregnancy
- Testosterone: 15 - 70 ng/dl in adult women
- T3: 75 - 195 ng/dl (total T3), 0.2 - 0.5 ng/dl (free T3)
- Cortisol: 138 - 635 nmol/L in the morning, 83 - 359 nmol/L in the evening
The numbers themselves might not mean much at this point, but one thing that stands out is the sheer span of some of these reference ranges. If there’s that much variation within the healthy populations used to calculate the ranges, then surely these numbers can be flexible, right? This question actually came up during the 2021 Olympics, when two female runners were disqualified for an event due to elevated testosterone levels. However, this year’s Olympics also saw the first transgender woman compete as a female weightlifter - with one of the parameters being sufficiently low testosterone levels.
What if you’re going through perimenopause and experiencing things like irregular periods, vaginal dryness, and mood swings? Your estrogen is definitely dropping at this point, but you’ll probably still be at a normal level. Do you accept that you’re still doing fine on paper, or do you try to figure out what you could do to help your body adjust? Think of the symptoms that can occur with PMS - some women even experience body dysmorphia before they start their periods. The PMS symptoms are due to estrogen fluctuations, but this hormone could still stay within the reference range the whole time.
2. The connection between anxiety, depression, and your hormones
There are a hundred ways in which hormonal fluctuations can cause anxiety or depression, but here’s the simple version: it often happens when your sex or thyroid hormones are too low, or when your cortisol is too high. Certain lifestyle factors can also contribute to the problem; even something as trivial as your morning coffee could be setting you up for a day filled with anxiety.
Some cortisol is necessary, but too much can interfere with the production of other hormones - including sex hormones and thyroid hormones. Plus, you could experience all kinds of unwanted side effects, like anxiety, loss of libido, or weight gain. Even hair loss, something that usually happens as a woman’s estrogen drops during menopause, can be caused at any age by too much stress.
3. Non-hormonal factors can reflect your hormone health
The more you learn about hormones, the more you realize how much they really do. Most people know that they encourage the growth of healthy hair, nails and skin, but did you know that even your blood pressure and heart rate variability (HRV) can speak to the state of your hormones?
It’s been observed that long-term exposure to high estrogen levels is associated with hypertension in women, which may provide a link between menopause and high blood pressure. Yes, estrogen levels fall sharply during this time, but many women also use hormone replacement therapy to combat menopause symptoms.
HRV is a measure of how much variation in time there is between each heartbeat; you want that number to be as close to zero as possible. It’s been observed that a woman’s HRV can change over the course of her menstrual cycle, and estrogen replacement therapy has been shown to improve HRV in postmenopausal women.
4. Finding your baseline is the first step in improving hormonal balance
There are so many hormones in the female body; why talk about just these few? Simply put, because they’re among the most important hormones to track if you’re interested in learning about your overall state of health. You’re probably already familiar with what happens when a woman’s estrogen levels start to tank; that’s what happens with both PMS and menopause. Low progesterone and high testosterone can result in infertility in women; that’s what you see with Polycystic Ovarian Syndrome. Low T3 is present in hypothyroid patients, and high T3 in people with hyperthyroidism. And if it weren’t complicated enough to keep track of those individual hormones, elevated cortisol can come in and disrupt every single one.
Millions of women develop hormonal imbalances each year, and not all of them are satisfied with conventional treatments. Some of them turn to functional medicine, which focuses on finding the underlying cause - be that genetics, chronic illness, or inflammation. Another alternative is integrated medicine (a form of holistic medicine), which looks at the patient’s physical, mental, and emotional needs, and addresses their issues with a combination of holistic and conventional methods.
Integrated medicine is especially pertinent for hormonal issues. Say you’re dealing with high cortisol: you would explore science-backed ways to get your levels down, but you’d also address the lifestyle factors that are leading to stress or anxiety. Base uses this two-pronged approach for hormonal imbalance with their at-home lab tests and their app. With these tests, you get crucial information on key biomarkers, plus explanations of what the results mean in the app. It doesn’t end there, though; each test includes recommendations for common-sense solutions that will move you and your health forward. You’ll be able to see not only where your individual hormones fall within reference ranges, but also how each one could affect the others. Once you’ve established your own baseline, you’ll be well on your way to finding hormonal balance!
