Hormones…are confusing. They're these little invisible chemicals that ultimately control nearly every major thing our bodies do, like our metabolism, mood, sexual function, and sleep cycles. Lately, they've been getting a lot of attention, especially on the Internet. By now, your FYP has likely fed you the phrase “hormone balancing,” a trending term that’s touted as a cure-all for essentially everything.
Some creators on social media discuss them while hustling supplements (Magnesium! Folic acid! Zinc! Ashwagandha! B6! Inositol!) that allegedly balance your hormones to fix mood swings, weight gain, gut issues, lack of energy, allergies, PMS and menopause symptoms, and more. Over on Amazon, you’ll find dozens of books making similar claims; some of which also promote following a special diet to do the trick. And brick-and-mortar clinics and at-home hormone testing have popped up, offering tests that promise to check for these hormonal imbalances.
Doctors are seeing an uptick in questions about hormone levels too. "Patients are pointing to symptoms that a lot of people may feel, like fatigue, weight gain, difficulty losing weight, mood issues, and problems with sleep and libido,” says Karen Tang, MD, a board-certified gynecologist at Thrive Gynecology in Bryn Mawr, Pennsylvania, and a TikTok creator with more than 465,000 followers. But these kinds of symptoms can show up for a wide variety of reasons, really; experiencing one or more of them doesn't immediately mean that something is off with your endocrine system, aka the group of glands (think: ovaries, testicles, pancreas, thyroid, pituitary) that makes and regulates your hormones.
Most people seeking out this information are just trying to get some relief or make some type of progress on the symptoms they're experiencing. But with so many conflicting messages and grifts out there, it's hard to know what to trust. “People are taking advantage of women's genuine confusion and lack of answers from the traditional medical establishment,” says Dr. Tang, who is also the author of It’s Not Hysteria. "There's a lot of room for science to give people more accurate guidance and information. Because right now it is sort of the wild west, where people can kind of make up any sort of claim.”
We've tapped experts to bring some clarity to the table. Keep reading for the five must-know facts about hormone balancing that you probably wouldn't see on your Explore Page.
There’s actually no such thing as a hormone imbalance.
“Hormone imbalance” isn’t a recognized medical term, but you can have a hormone disorder, or what is formally called an “endocrine disorder,” aka when one or more of those glands we mentioned earlier makes too little or too much of a specific hormone, according to the NIH.
Determining an endocrine disorder can get complicated sometimes, but in general, doctors are able to see this through blood tests (because your glands pump hormones straight into your bloodstream!). Your physician will know what’s normal (if you want to get a baseline understanding for yourself, check out this infographic), but if you want a more specialized approach, you’ll need to see an endocrinologist.
In short, endocrine disorders are the more official term for what TikTokers are calling hormone imbalances. A lot of different kinds of these exist (more on that below) and they can be difficult to manage since they impact nearly every part of your body, from your reproductive organs to your mental and physical health.
Endocrine disorders aren’t as common as the internet makes it seem.
"A lot of people have endocrine disorders, but definitely not as many as you would expect based on social media," says Dr. Tang. Common endocrine disorders include PCOS, type II diabetes, insulin resistance, and hyper- and hypothyroidism. PCOS affects about 10 percent of people of childbearing age with ovaries, and about one in eight women develop thyroid disorders in their lifetime.
Your primary care doctor or gyno can usually diagnose and treat PCOS, thyroid disorders, insulin resistance, or pre-diabetes, according to Alexis Melnick, MD, an ob-gyn and reproductive endocrinologist at New York-Presbyterian in New York City. This can involve a slew of options, but generally some kind of medication will be a part of treatment (unless you go see a DO, who may provide non-medication options).
There is no "normal" hormone level.
Think of “normal” hormones like a kid’s growth bell curve, says Angela Koenig, MD, an ob-gyn at Dartmouth Hitchcock Medical Center, in Lebanon, New Hampshire: You can be on the very low or very high ends of the height range and be perfectly healthy.
And since it’s normal for hormones to fluctuate, “there's really not a clear definition of what having ‘balanced hormones’ means,” says Dr. Melnick. Hormones can vary a ton from person to person, day to day, sometimes even hour to hour, especially when the menstrual cycle is at play. Some people naturally have lower or higher baseline levels than others, without having a hard-and-fast hormone disorder.
There isn’t one test to determine your hormone levels.
"Patients will say, ‘Can you test my hormones to see if they're balanced?’ but I don't have a test for that," explains Chantel Cross, MD, a reproductive endocrinology and infertility specialist at Johns Hopkins.
Doctors only check hormone levels if you have a collection of symptoms that might point to a specific endocrine disorder. "At that point, you test the relevant hormone,” says Dr. Melnick. This is usually a blood test. For example, if you experience irregular or missed periods, your doctor may suspect PCOS or hypothyroidism and test for those hormones to determine their levels.
A doctor will also want to rule out non-hormonal conditions like autoimmune diseases and endometriosis, which sometimes can look like endocrine disorders with symptoms like fatigue, pelvic pain, bowel problems, bloating, and migraines. "A lot of people have those [symptoms] and they're like, oh, must be my hormones?" says Tang. "It’s a little dangerous to not investigate other conditions that could explain it."
Birth control isn’t always to blame.
Many influencers who talk about hormone imbalance might have negative opinions on birth control, which doctors say is misplaced. “You could make the argument that if you want to balance some of these hormones, nothing does that as well as the birth control pill because it keeps them at a constant level," says Dr. Melnick.
While birth control isn’t for everyone, for some people it can be "life-changing" when it comes to hormones, says Dr. Tang (and in general, it is a life-changing and essential medication to prevent pregnancy!). "Birth control pills are so effective because they really lower the estrogen levels that can be ‘out of balance’ in PCOS," says Dr. Cross. "It also can block the receptor for androgens at the hair follicle. So it really helps the skin."
Dr. Cross suspects birth control gets a bad rap because it tricks people into thinking their cycles are normal. When people quit birth control for whatever reason, as some have recently, they’re often frustrated when irregular periods return because the underlying condition is still there—the birth control just stops the symptom, it doesn’t cure the entire endocrine disorder.
No matter why you're experiencing your symptoms, if you don’t feel they're are being taken seriously by physicians, definitely speak up for yourself and seek out new care or a second opinion if necessary. "I think so often, especially as a woman of color, we're told [our symptoms are] ‘normal,’” says Courtney Minors, RD, a registered dietitian specializing in PCOS and the supervisor of clinical nutrition services at Bethesda Hospital in Jupiter, Florida. “But you don't have to feel that way. You can get help, you can make changes, and things can improve."
Colleen de Bellefonds is a freelance journalist and editor who covers science, health and parenting. Her reporting and writing regularly appears in Well + Good, US News & World Report, Women's Health, The Bump, What To Expect, SELF and many other publications. She lives in Paris, France with her husband and two kids. See more of her work at colleendbellefonds.com, or follow her on X @colleencync and Insta @colleendebellefonds.
