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MUKILTEO, WA
Fatigue, mood changes, weight gain low libido, irregular menstrual patterns, trouble sleeping, hair loss, unwanted facial hair. It doesn't have to be that way
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UNDERSTANDING THE CONDITION
Hormones are chemical messengers that help regulate many important functions throughout your body, including metabolism, reproduction, sexual function, mood, sleep, and energy.
Hormone levels naturally change and fluctuate throughout life, and a change in a hormone level does not automatically mean that something is wrong. Symptoms can develop when hormone production changes because of menopause, perimenopause, aging, thyroid disease, medications, another medical condition, or other factors affecting your health.
Because many symptoms associated with hormonal changes can also have non-hormonal causes, evaluation should consider the complete clinical picture rather than relying on symptoms or a single laboratory value alone.
signs and symptoms
Hormonal changes can affect people differently. Depending on the hormones involved and the underlying cause, symptoms may include:
These symptoms are not specific to hormone imbalance only, however an evaluation can help determine whether your symptoms are related to only hormonal changes, or a combination of another medical condition, medications, lifestyle factors, or several factors together that may be contributing.
CAUSES & TRIGGERS
Hormone levels can change for many reasons. Normal life stages such as perimenopause, menopause, and aging can alter hormone production. Hormonal changes may also occur with diet, thyroid disorders, polycystic ovary syndrome (PCOS), metabolic conditions, certain medications, changes in body weight, activity levels and other medical conditions.
The significance of a hormone level depends on the hormone being evaluated, your age and life stage, symptoms, medications, medical history, and other clinical findings.
The goal of evaluation is not simply to identify whether a laboratory result is high or low. It is to determine whether a hormonal change helps explain what you are experiencing and whether treatment is right for you.
Assessment
Your evaluation begins with a detailed discussion of your symptoms, medical history, medications and supplements, previous treatment, menstrual or reproductive history when applicable, and other factors relevant to your health.
Laboratory testing is an essential evaluation tool that looks at your hormones and other blood markers along with your symptoms. Testing may include thyroid function, reproductive or sex hormones, and other laboratory studies based on your individual presentation.
I interpret laboratory findings alongside your symptoms and medical history rather than treating an isolated laboratory number. Additional evaluation or referral may be appropriate when your findings suggest another condition requiring further investigation.
Individualized approach
Hormone imbalance is an umbrella term that describes a condition in which the ratio of hormones is either higher or lower than the optimal ratio balance. When one or more hormones ore either over productive or in a deficient it will often times produce unwanted symptoms. Common hormone imbalances involve estrogen, progesterone, testosterone, thyroid hormones, or other endocrine systems, and more than one factor may be involved at the same time.
Different hormonal presentations require different approaches. Treatment is based on what is actually contributing to your symptoms rather than applying the same hormone regimen to every patient.
treatment options
Treatment for hormone imbalance depends on what is causing your imbalance. The results of your evaluation will either provide a most likely answer or will help point us in a direction to look for more answers. There are many options for hormone therapy ranging from oral, topical, and pellet therapy the modality of delivery is based on patient comfortability along with optimal benefit.
Once hormone therapy is initiated it is necessary to establish ongoing monitoring of labs, symptoms and medication management . Hormone therapy is not appropriate for every symptom or every patient.
Differential Diagnosis
Your symptoms are meaningful and a thoughtful evaluation helps distinguish symptoms that may be related to hormonal changes from those that require a different approach.
Symptoms of fatigue, weight changes, mood changes, sleep problems, decreased libido, hair changes, and difficulty concentrating can have many possible causes, they may be associated with metabolic disorders, thyroid disease, nutritional or vitamin deficiencies, medications, sleep disorders, mental health conditions, or other medical concerns and more than one factor may also be contributing at the same time.
Mechanism of treatment
Bioidentical hormones are hormones that have the same chemical and molecular structure as hormones naturally produced by the human body. Examples include estradiol, progesterone, and testosterone. They may be manufactured as FDA-approved medications or prepared by a compounding pharmacy when an individualized formulation is clinically appropriate.
The term synthetic hormone can be confusing because bioidentical hormones are also manufactured rather than taken directly from the human body. The important distinction is their molecular structure. Some hormone medications are structurally identical to human hormones, while others are synthetic hormone analogs with a different molecular structure that produce hormone-like effects in the body.
When hormone therapy is appropriate, the medication, dose, route of administration, and monitoring plan depend on the hormone being treated, your symptoms, medical history, laboratory findings, treatment goals, and response to therapy.
Treatment may need to change over time. Follow-up allows us to evaluate whether your symptoms are improving, monitor treatment safety, review laboratory findings when indicated, and make adjustments based on your response.
Goals for treatment
The therapudic goals are established according to what is affecting you while using evidence based treatments to safely balance your hormones and other health markers. Treatment should address clinically meaningful symptoms while considering your overall health and the safety and limitations of therapy.
For some patients, improvement may mean better control of hot flashes, sleep disruption, sexual symptoms, or other concerns associated with a documented hormonal change.
progress tracking
Response to hormone therapy is carefully evaluated by looking at changes in the symptoms we are treating, your overall health, medication tolerance, and laboratory findings.
Follow-up also provides an opportunity to identify side effects, reassess whether treatment remains appropriate, and determine whether medication adjustments are necessary.
The frequency of follow-up and laboratory testing depends on the treatment you receive and your individual clinical needs.
Self care corner
Hormonal health is one part of your overall health. Regular physical activity, adequate sleep, balanced nutrition, appropriate weight management, limiting tobacco exposure, and addressing other medical conditions can support your health alongside any prescribed treatment.
Take medications as directed and let me know about supplements, over-the-counter products, or hormones obtained elsewhere because these may affect your symptoms, laboratory results, or treatment safety.
Hormonal symptoms should not automatically be treated with supplements or hormones without determining what may be causing them.
Provider note
I know how frustrating it can be when you do not feel like yourself and you keep hearing that your symptoms are simply part of getting older or that your laboratory results are “normal.” Your symptoms deserve to be taken seriously.
Your symptoms, medical history, medications, life stage, and laboratory findings together are considered when determining a diagnosis. Sometimes hormones are an important part of the answer, and sometimes we find another factor that needs attention.
My goal is to get to the root of what is happening to you and your body, explain your options clearly, and develop an individualized plan that supports both how you feel and your long-term health and quality of life.
— Elizabeth Hagen, ARNP
Saftey Note
Hormone therapy is safe when prescribed and monitored based on your individual health history, symptoms, laboratory findings, medications, and risk factors. Treatment requires appropriate follow-up to evaluate your response, monitor for side effects, and determine whether your dose or treatment plan should be adjusted.
Your pathway
We review symptoms, when it started, your medical history, medications, previous treatment, life stage, and other factors that may be contributing
Laboratory testing and additional evaluation may be used when appropriate to assess hormonal changes and rule out other potential causes of your symptoms.
When treatment is appropriate, we develop an individualized plan, monitor your symptoms, treatment response, safety, and laboratory findings when indicated.
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* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.
