Female Hormone Imbalance Symptoms, Inflammation, and Adrenal Fatigue – Part 3

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM

Read Part 1 | Part 2

Recovery Considerations and Cautions

Acne is part of the female hormone imbalance symptomsTo start your recovery from female hormone imbalance symptoms you need to start with hormone rebalancing. Hormone rebalancing needs to start with good nutrition, because food is the primary building block of estrogen and progesterone. Of critical importance is optimization of the microbiome in the gut and the need for adequate and effective foods to nourish our GI tract.

It is important to understand that any remedy, especially when attempting to relieve or correct female hormone imbalance symptoms, must be considered from the whole body or NEM model. Keeping in mind how the various systems in our bodies interact will allow a successful solution.

The fact is that all our inner systems are connected and that they all communicate with hormones are important. When hormones are out of balance, the symptoms they create are your body’s way of telling you it’s not getting the support needed for optimum functioning.

Prescription Synthetic Hormones

Most often these female hormone imbalance symptoms are treated with prescription medications. This is in spite of evidence of significant side effects of these medications. For instance, giving estrogen orally may increase inflammation and bring on all the unwanted effects of this increase.

A longitudinal study, called the Women’s Health Initiative, of a total of approximately 27,000 women over a period of about eight years found significant detrimental effects from the use of synthetic hormones. One finding of increased risk of breast cancer led to the stopping of one part of the study, the part where women were treated with estrogen and progestin compounds. The estrogen only study appeared to increase the risk of stroke also. The risk of dementia and mild cognitive impairment were seen to be increased in both parts of the study.

As might be expected, physicians stopped prescribing these medications for their female patients and about 65 percent of women already taking the medicines stopped. It does appear that there were some flaws in this study that may have skewed the findings in a negative direction.

There are some new studies that seem to indicate usefulness of synthetic hormones for women who are early in menopause. Unfortunately, there is no indication that this benefit would continue if women continue taking these hormones as they age.

Some of the possible benefits for younger women of synthetic hormones are prevention of heart disease, hip fractures, and osteoporosis, along with a 30 percent decrease in the risk of developing diabetes.

Thus, the age at which women begin taking synthetic hormones may make a difference in the beneficial effects they experience. Healthy women in their 50s may have a slight risk of blood clots, but researchers feel this risk is not likely to cause problems. On the other hand, women first taking synthetic hormones in their 60s may have more risk.

This factor of age and assumed health is one of the possible flaws in the Women’s Health Initiative study. The study investigated women whose average age was 63. Possibly, the researchers were studying women who were already ill. The researchers involved in the study reported their intent to be looking at whether hormone therapy would protect older women against becoming ill. Clearly, it did not.

How to help your female hormone imbalance symptomsIn spite of what appear to be disturbing long-term side effects of synthetic hormone replacement therapy, the FDA still says this should be the treatment of choice for women with severe female hormone imbalance symptoms; the research is still divided regarding long-term use. For certain, continued and regular physical exams should remain part of every woman’s schedule when they’re on hormone replacement therapy with synthetics.

Bioidentical Hormones

So, if synthetic hormone replacement is so dangerous, what are the other options? One is bioidentical hormone replacement (bHRT)

These substances are biochemically the same as human hormones and are made from natural materials. Typically, they are compounded individually by a pharmacist to give a unique dose to each patient. Delivery methods are also individualized, making these hormones more tolerable for many patients.

Bioidentical hormones have been researched and used for several years by millions of women. Results of use of these hormones has nearly uniformly been positive.

Bi-estrogen (commonly called Bi-est)

Has been shown to be very effective in the relief of vaginal dryness, painful intercourse, and UTIs. These are common symptoms of estrogen deficiency. The estriol in the bi-estrogen deals with these female hormone imbalance symptoms. Estradiol, the second ingredient in bi-estrogen, also brings relief from vaginal dryness. Also, it relieves night sweats and hot flashes, increases mood and sleep, brings more energy, improves memory and thinking, and reduces the risk of developing type 2 diabetes.

Tri-estrogen (commonly called Tri-est)

Adds estrone to the combination of estriol and estradiol seen in bi-estrogen. This bioidentical hormone is typically used with women who are either underweight or of low normal weight.

Natural progesterone

Often given to women who have a surplus of estrogen compared to progesterone. This is also known as estrogen dominance. Natural progesterone appears to increase bone density, thus possibly lowering the risk of osteoporosis. Sleep is improved, libido increased, blood pressure lowered, and it helps to regulate blood glucose.


Used with women to help increase libido, increase bone mass, lower cholesterol and triglycerides, increase alertness, and give a sense of well-being.


Can improve libido, increase bone mass, improve mood and sense of well-being, lower cholesterol and triglycerides, and help regulate blood glucose levels.

Even with the many benefits outlined above, bioidentical hormones also have some side effects that may not be pleasant. Any side effects with these hormones typically will be related to dosage, so adjustments in dosage may be necessary after a period of time if these side effects occur.

With testosterone treatment, both men and women have experienced increased aggression, irritability, and outbreaks of acne. These side effects typically happen in the early stages of therapy and usually resolve once the level of testosterone is balanced.

Estrogen therapy may lead to some side effects in some women. These side effects include tenderness in the breasts, spotting, cramping, and bloating. Once again, these typically occur in the early stages of therapy and usually resolve once balanced levels of the hormone are achieved.

With some of the bioidentical hormones, some patients complain of itching or redness at the site of injection or insertion. Once their bodies adjust, these female hormone imbalance symptoms typically disappear.

Other Approaches to Balancing Hormones to Recover from Female Hormone Imbalance Symptoms

What you can take to help your female hormone imbalance symptomsSome people choose not to use either synthetic or bioidentical hormones because of significant or potential side effects. Herbal remedies are sometimes used.

These herbal remedies are the most commonly chosen alternative ways of balancing hormone levels. They may be the easiest route to follow, and they appear to be the only good way to get directly to the source of the hormonal imbalance and rectify it.

Basically, there are two types of herbs used for this purpose: phytoestrogenic and non-estrogenic herbs. The phytoestrogenic herbs have estrogenic ingredients made by plants. Thus, they work to change the hormone imbalance by bringing the plant-based estrogens into the body. One potential difficulty with this approach is that by adding outside sources of estrogen, women’s bodies may produce less estrogen on their own. If this happens, it adds to the decrease of the body’s own estrogen.

Black cohosh is one of the phytoestrogenic herbs. It appears to decrease spasms and inflammation. As we have seen, inflammation is implicated in both female hormone imbalance symptoms and AFS. This herb helps relax the uterine muscles, easing menstruation and the cramping that often comes with it. It also can help regulate menstrual periods. Herbs, however, are foreign to the body. The risk of developing toxic reactive metabolite overload tends to be much higher than that of normal naturally occurring compounds like magnesium.

Non-estrogenic herbs stimulate the woman’s production of hormones by providing nourishment to the pituitary and endocrine glands, helping them to produce natural hormones better. This herb not only brings about a balance of estrogen, it also helps balance progesterone and testosterone. Using these herbs may be the safest way to improve the balance of female hormones naturally. They don’t add any outside hormones to the body, relying on stimulation and nourishment of the body’s own production of hormones.

Other herbs that may help in balancing female hormones are not as easy to classify as those above. One of these is chasteberry. It supports women’s menstrual cycle and has some benefits for PMS symptoms and menopause. It does contain progesterone. Chasteberry appears to help regulate how much prolactin is secreted by the pituitary gland, thus decreasing breast tenderness and soreness.

Ashwagandha root is another herb used to counter some of the female hormone imbalance symptoms. An adaptogen, ashwagandha root nourishes bones and muscles, decreasing joint movement discomfort. It also calms the mind and helps people go to sleep. An improvement in cognitive function has been seen with use of this herb. Unfortunately, this compound can worsen those with adrenal fatigue.

Lifestyle changes are another approach to be considered in striving to change imbalanced hormone levels. We are what we eat is a common saying that holds a great deal of truth. Food intake in the U.S. is often made up of foods that are fast, but not good or good for us. Making changes in what we put in our bodies can make a change in our bodies.

Making changes in lifestyle is the type of recommendation for imbalanced hormones that holds the least risk, but requires the most self-discipline. Food choices are not the only element involved in this kind of change. Reducing stress in our lives is important, as is regular physical exercise.

Taking vitamin B6 can help female hormone imbalance symptomsIncreasing foods high in omega-3 and omega-6 fatty acids will begin changing the imbalance in hormone levels. Foods like flax seeds, pumpkin seeds, and sunflower seeds will increase omega-3 levels. Eggs, nuts, and poultry contain omega-6 nutrients.

Reducing salt intake is another factor in reducing bloating and easing both physical and emotional symptoms. This may be counterproductive for those with AFS. Limiting sugar and caffeine intake can decrease PMS symptoms. Avoiding or at least decreasing foods with aspartame and MSG (both excitotoxins) will improve brain functioning and decrease PMS symptoms.

Vitamin B6, zinc, and magnesium are all necessary for improving hormone imbalance. Eating whole grains, nuts, legumes, seafood, poultry, and vegetables will add these nutrients to your body.


Female hormone balancing is a complex subject. Positive clinical outcome requires a personalized approach. Traditional synthetic hormones have their place, and natural bioidentical hormones have their defects. The capable practitioner also must factor in the gut microbiome and inflammatory ramifications of hormone replacement. Sufferers with adrenal fatigue face more difficulty. Each compound has its pros and cons. Navigating through this maze successfully requires much clinical experience.

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© Copyright 2017 Michael Lam, M.D. All Rights Reserved.

Female hormone imbalance symptoms