Feeling hormonal? If you're extra-tired or moody, the answer could very well be yes.

Shifts in our body-regulating hormone levels happen as we age, and even the smallest dip or spike can impact our physical and mental well-being. These chemicals are like molecular orchestra conductors: After being pumped out by our endocrine glands (thyroid, pituitary, ovaries, pancreas, adrenal), they travel through the body, directing nearly all our biological processes, from how fast we think to how happy we feel. When they're in harmony, our brain, muscles, reproductive system, metabolism, and mood flow like Beethoven's Ninth. But when even one is out of sync, it can throw off the whole concert.

Russian nesting dolls with various facial expressions on blue
Credit: Yasu + Junko

Get familiar with these four common signs of hormonal dissonance—if they sound familiar, consider the lifestyle and medical tips you need to feel better.

None of your clothes fit.

Sure, you're eating and exercising as usual. But because your metabolism starts to slow down in your 30s, you may see an uptick on the scale unless you adjust your diet and work out more to compensate, says E. Dale Abel, MD, PhD, president of the Endocrine Society and endocrinology and metabolism division director at the University of Iowa. If you keep your habits the same but put on more than a few pounds a year, there's a small chance that you're not producing enough thyroid hormones.

Another possibility? Perimenopause, the mercurial lead-up to your final menstrual period that usually begins in your 40s. As your levels of estrogen, testosterone, and progesterone taper, "your body sees the loss as a stress and produces more cortisol," says Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic. "Increased cortisol tells your body not to let go of energy, so you burn fewer calories and use up fewer fat stores." To add to the frustration, the extra weight tends to settle around your middle.

So, how do you rectify this? Lift weights, hike, swim, or dance it out—regular exercise boosts your metabolism by burning calories and building muscle. Small diet tweaks can also have a big impact: Findings from a Duke University School of Medicine trial published in July found that healthy, lean, or slightly overweight adults who cut only about 300 calories of any food daily—say, ordering a fried egg on wheat toast instead of a bacon, egg, and cheese sandwich; or eating a cup and a half less pasta at dinner—lost 10 percent of their body weight, and had lower blood pressure and less inflammation, as well as better cholesterol and blood-sugar control. A simple blood test can detect hypothyroidism, says Angela Leung, MD, an endocrinologist and associate professor of medicine at the UCLA David Geffen School of Medicine. If it's to blame, a thyroid-replacement pill, like levothyroxine, should kick-start your levels, and potentially your metabolism.

Your mind is suddenly blank.

Brain fog isn't a medical term, but that hardly matters to a perimenopausal woman who can't tell you the title of the book she just read. "Your estrogen levels are fluctuating and falling, and that can interfere with your ability to concentrate," says Dr. Hatipoglu. It can also disrupt sleep, leaving you feeling doubly sluggish. Hypothyroidism, which is more common in older women but can occur in your 20s and 30s, may also lead to muddled thinking and mild short-term memory loss. Two more troublemakers to rule out: an iron or vitamin B12 deficiency.

To fight brain fog, first double down on efforts to sleep well, get regular aerobic exercise, follow a Mediterranean diet (high in fish, olive oil, fruits, greens, and whole grains), and moderate alcohol: for women, up to one drink a day, and no more than five a week. Research has found that all these habits can sharpen memory and cognition, says Dr. Hatipoglu. Medication can help clear fuzziness related to low thyroid hormones or estrogen, and supplements or dietary shifts can reverse an iron or B12 deficit. Quick tip: On your daily trip to Salads, Inc., order dark greens like raw spinach (0.81 milligrams of iron per cup) and broccoli (0.66 milligrams).


You have a diminished sex drive.

Exhaustion, weight gain, certain meds, and (of course) relationship problems can send your libido packing. But hormones play a part, too. Suspect number one: combination birth-control pills. "When you swallow estrogen, your liver produces sex-hormone-binding globulin, which makes testosterone unusable," says Becky Lynn, MD, an associate professor of obstetrics and gynecology at the Saint Louis University School of Medicine. "When testosterone levels drop, some women experience vaginal dryness, while others find that their desire all but disappears." Suspect number two: naturally declining estrogen and testosterone levels during peri- and postmenopause.

Reclaim that drive through movement. Per a 2018 University of Texas at Austin study, exercise may revive sexual arousal by heightening blood flow and nerve connections to the areas that count (the other one's your brain), and by improving body image and mood. You can also try non-oral birth control, which won't affect your testosterone; or if you're peri- or postmenopausal, low-dose estrogen can help with dryness.

You're experiencing mood swings.

Fiery rage, exhilarating joy, crushing anxiety, weepy sadness. Did we just describe your morning? Emotional swings can be tied to estrogen drops, which happen in the second half of your menstrual cycle, right after ovulation, and irregularly during peri- and postmenopause. Estrogen is linked to the brain neurotransmitters associated with mood, including serotonin.

Yet again, exercise is the fix. Research shows aerobic activity is one of Mother Nature's best mood stabilizers, reducing irritability, anxiety, and depression while hiking up happiness. Birth control pills can also temper menstrual cycle swings for some women. If you have pre-menstrual dysphoric disorder (PMDD, a severe version of PMS), you may want to try an SSRI antidepressant, like Sarafem, for the last two weeks of your cycle. Yo-yoing around menopause? Hormone therapy may help—a small University of North Carolina at Chapel Hill study published in 2018 found it prevented depressive symptoms for some women—but more research needs to be done.


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