So you know something is not right, but you can’t quite put your finger on it. You’re eating (reasonably) well, nothing has changed lifestyle-wise BUT you’re constantly tired, your mood often low, you’re not losing weight no matter how hard you try, and your brain feels like it’s playing tricks on you.
No matter how many times you get a blood test, you’re told the same thing: it’s all fine. But it’s not fine because you don’t feel fine and something isn’t quite right. You feel like a shadow of yourself.
Trust your instincts. The most common culprit behind a cluster of vague, hard-to-pin-down symptoms is an imbalance in your hormones. Here, I’m sharing five common signs that your hormones may be out of balance. Including one that is misunderstood and underdiagnosed. If you recognise yourself in any of these, keep reading. There is an explanation and there is a way forward.
What are the signs your hormones are out of balance?
Sign One: You’re exhausted, no matter how much you sleep.
This is the kind of fatigue that’s still there when you wake up. The kind that makes getting through a normal day feel like an achievement. The kind that doesn’t improve no matter how early you go to bed or how long you sleep.
This level of exhaustion is a hallmark of hormonal imbalance, and it can have several different hormonal drivers.
The hormonal connection
Cortisol is your primary stress hormone and it naturally rises in the morning to get you ready for the day ahead. In a healthy pattern, it’s high in the morning and gradually lowers throughout the day. But when you’ve been under chronic stress, this could be physical, emotional or lifestyle-related, then this pattern becomes disrupted. Many women find their cortisol is either too low in the morning or too high at night, leaving them unable to wind down.
Low progesterone and higher oestrogen also play a main role in energy. Progesterone has a naturally calming, sleep-supporting effect, so when it drops, as it does in perimenopause, or in response to stress, sleep quality deteriorates and fatigue becomes ingrained.
If you’re doing everything right and still exhausted, the problem isn’t your effort. It’s likely your hormones.
The key is to identify which part of your hormonal system is out of balance, because the solution for low cortisol is very different from the solution for high nighttime cortisol.
Sign Two: Your mood has changed or anxiety and/or irritability have taken over.
Anxiety that appears from nowhere. Irritability that feels disproportionate. A low mood that you can’t shake. Feeling emotionally fragile in ways that are out of character for you. These are physiological signals.
The hormonal connection
Oestrogen has a direct relationship with serotonin, dopamine, and GABA. These are your key mood-regulating neurotransmitters. When oestrogen fluctuates or drops, so does your mood. This is why many women notice a marked worsening of anxiety or low mood in the week before their period, during perimenopause, or in the months after giving birth.
Progesterone acts on the GABA receptors in your brain, the same receptors targeted by anti-anxiety medications. Low progesterone means there is less natural calm, more anxiety, poorer sleep and greater emotional reactivity.
Cortisol’s impact on mood is also significant. Chronically elevated cortisol is strongly associated with anxiety, while chronically depleted cortisol is associated with depression and emotional flatness.
If your mood has shifted in ways that feel hormonal, likely cyclical or linked to hormonal transitions, or if it is accompanied by other physical symptoms then it’s worth looking at the full hormonal picture rather than treating the mood symptoms in isolation.
Sign Three: You’re Gaining Weight in Specific Areas.
Weight gain linked to hormonal imbalance has a particular character. It tends to accumulate around the middle, hips, upper arms or the thighs. It feels stubborn and resistant to the usual approaches and it’s often accompanied by bloating, puffiness like your cells are holding on to fluid.
The hormonal connection
Oestrogen dominance, where oestrogen is high relative to progesterone, is a common driver of weight gain around the hips, thighs, and abdomen.
High cortisol drives the accumulation of visceral fat around the middle. If you notice you’re carrying more weight around your waist and it’s linked to a period of high stress, cortisol is almost certainly involved. There is a strong link between trauma and subsequent weight gain.
Thyroid hormones regulate metabolic rate. Even subclinical thyroid dysfunction, where levels are within the normal range but not optimal, can make weight management significantly harder.
Insulin resistance, often linked to elevated cortisol or oestrogen imbalance, makes it much harder for your cells to use glucose efficiently, which promotes fat storage and makes weight loss feel almost impossible.
One pattern in particular is important to highlight below, because it is often dismissed or misunderstood.
Sign Four: You Have Disproportionate Fat on Your Legs, Hips, or Arms That Feels and Looks Different.
This sign deserves its own section, because it is one of the most under-recognised and underdiagnosed conditions linked to hormonal imbalance: lipoedema.
Lipoedema is a chronic condition characterised by the symmetrical accumulation of fat tissue, most commonly in the legs, hips, buttocks, and sometimes the arms. It almost exclusively affects women and it is strongly connected to hormonal shifts. It usually emerges or worsens at puberty, pregnancy or perimenopause.
What makes lipoedema different from ordinary weight gain?
There are some key distinguishing features that separate lipoedema from general fat accumulation:
- It is symmetrical. Both legs or both arms are affected equally.
- It is disproportionate. The upper body may look completely different to the lower body.
- It is painful or tender. The affected tissue is often sensitive to pressure or touch, and bruises easily.
- It does not respond to diet or exercise. This is one of the most distressing aspects for women with lipoedema; restricting food and increasing exercise does not shift the fat in the affected areas.
- It worsens with oestrogen fluctuations. Many women notice it deteriorates during hormonal transitions like perimenopause.
Many women with lipoedema have spent years being told to lose weight and exercise. This advice is not only ineffective for this condition it is harmful.
The hormonal connection
While the exact mechanisms of lipoedema are still being researched, the strong correlation with oestrogen suggests that hormonal imbalance, particularly oestrogen dominance and disrupted oestrogen metabolism plays a significant role in the development and progression of the condition.
If you recognise this pattern in your body it is important to get a thorough hormonal assessment. Lipoedema requires an informed approach. Understanding your hormonal landscape is a critical first step.
Sign Five: You Have Brain Fog And Your Thinking Feels Slow or Unreliable
You forget words mid-sentence. You lose your train of thought. You read the same paragraph three times and it still doesn’t sink in. You feel mentally slow, distracted and unlike the sharp, capable person you know yourself to be.
Brain fog is one of the most debilitating symptoms of hormonal imbalance, and one of the most commonly dismissed.
The hormonal connection
Oestrogen supports cognitive function, memory and neurological health. Fluctuating or declining oestrogen is strongly associated with memory difficulties, word-finding problems and reduced concentration.
Elevated cortisol has a direct negative effect on the hippocampus, the area of the brain most involved in memory and learning. If you’ve been running on stress for a prolonged period, your cognitive function will reflect that.
Progesterone also supports the nervous system and has a neuroprotective role. Low progesterone can leave you lacking mental sharpness and feeling emotionally unsettled.
Brain fog is not inevitable and it is not just part of getting older It is a signal that your brain’s hormonal environment needs support.
So What Can You Do About It?
If you’ve recognised yourself in some of the signs above, the most important thing I want you to take away from this is: you are not imagining it, and there is a way forward.
The challenge with hormonal imbalance is that the symptoms overlap significantly with other conditions, and standard blood tests often miss the nuance. Two women with identical oestrogen levels can have completely different experiences depending on how their bodies are metabolising that oestrogen. This is something a standard GP panel will never show you.
This is precisely why I use the DUTCH Complete Test with clients who are experiencing these symptoms.
What is the DUTCH Complete Test?
DUTCH stands for Dried Urine Test for Comprehensive Hormones. It is the gold standard in functional hormone testing, measuring:
- Sex hormones and their metabolites specifically oestrogen, progesterone, testosterone and crucially, how your body is processing and clearing them
- The full cortisol and cortisone pattern across the day
- Melatonin and sleep hormones
- DHEA and other adrenal markers
- Key organic acid markers affecting mood, neurotransmitter function, B vitamin status, and oxidative stress
This level of detail means we can build a picture of not just what your hormones are doing, but why and identify the specific, targeted changes to nutrition, lifestyle, and supplementation that will actually make a difference for your unique hormonal profile.
If you’ve been trying to manage symptoms in the dark, this test can help you move forward.
Find out more about the DUTCH Complete Test and order yours here
Hormonal health is complex, and symptoms rarely have a single cause. But the women I work with who finally get answers, often after years of being told everything is ‘fine’, consistently describe a profound sense of relief. Not because the work is done, but because they finally know what they’re dealing with.
If you have questions or would like to talk about whether the DUTCH Complete Test is right for you, you can get in touch here.
