Everything You Think You Know About Hormone Balance Is Probably Wrong

I have been talking about hormones for years and I recently realized I could not actually define what one is.

So I asked Dr. Gillian Goddard, endocrinologist and author of The Hormone Loop, to start from the very beginning. 

Her answer: a hormone is just a message from one part of the body to another. That is it. And once I understood that, everything else in our conversation clicked into place.

Here is what I think every woman needs to know from this conversation…

1. Hormone balance is not a thing you need to fix.

The biggest misconception Dr. Goddard sees online is the idea that women need to actively balance their hormones. Hormone balancing diets, supplements, seed cycling, cortisol face. The list is endless and most of it is built on a false premise.

Hormones are self-balancing. They are designed to shift and change in response to your environment. They are not supposed to be fixed at a specific level, they are supposed to move. The goal is to understand what the messages mean.

2. There is a stage most doctors are completely missing.

This is the most important thing I learned. There is a stage called the late reproductive stage that sits between peak reproductive years and early perimenopause. About 50% of women enter it between 37 and 45. Their periods are still regular, but they are experiencing off the charts PMS, irritability, night waking, hot flashes, and anxiety that feels like it came out of nowhere.

They go to their doctor. The doctor asks one question: are your periods regular? They say yes. The doctor says it is not perimenopause.

But it is the beginning of the shift and these women are absolutely eligible for treatment. The name of the stage is less important than validating how a woman feels and discussing her options.

3. You CAN do something about it.

If this sounds like where you are, here are the practical steps Dr. Goddard recommends:

• Track your symptoms and when they happen. The most common time for symptoms in the late reproductive stage is around ovulation and around your period because those are the moments when estrogen is particularly low. Come to your doctor with data, not just a general feeling that something is off.
• Say what you need at the start of the appointment. Most doctors have ten to fifteen minutes. If you do not state your goal for the visit in the first two minutes you will run out of time. Say directly, “I want to talk about my hormonal symptoms and my options for treatment.”
• Ask about a low dose birth control pill specifically. Dr. Goddard often recommends this for women in the late reproductive stage because it suppresses the erratic signaling from the hypothalamus and pituitary that is driving the big hormonal swings, while also providing contraception if needed. Traditional hormone therapy can sometimes create unpredictable results at this stage because it does not suppress that underlying drive.
• Do a little research before you go. She actually encourages patients to come in knowing what questions to ask. Not to self diagnose but to be able to ask: is a birth control pill right for me? What would hormone therapy look like at my stage? How does my IUD factor in? You cannot ask the right questions if you do not know the options exist.

It is not an accident that the most common time for women to develop thyroid problems is puberty, pregnancy, and perimenopause. The hormonal shifts at those transitions stress the immune system which can trigger the thyroid. If you are in any of these stages and dealing with unexplained weight changes, fatigue, or mood disruption that is not responding to anything, ask your doctor to check your thyroid specifically.

If you have been dismissed, told your bloodwork is normal, or told it is not perimenopause because your periods are regular, that is information about your doctor and whether they are the right person managing this with you. You are not too young for this conversation. You are not being dramatic and you deserve real answers.

Listen to "The Hormone Doctor: The Truth About Cortisol, Estrogen and Balancing Your Hormones" here or you can watch it here.