Between allopathic and integrative practitioners there is sometimes a disagreement with what constitutes a true hormone imbalance. There are the diagnosable conditions such as premature ovarian failure, hypo or hyperthyroidism, Cushing’s disease, androgen insufficiency, the presence of hormone-releasing tumors, etc which are clear cut with a straight forward treatment. However, what integrative and wellness practitioners are frequently talking about are the more sub-clinical imbalances. This can be in regards to premenstrual symptoms, perimenopause symptoms, general fatigue, insomnia, low libido, exercise intolerance, weight difficulties, etc. In these situations, labs may be clinically within “normal” range, but the complaints still have functional ties to how hormones work in the body. This suggests a more relative abnormality, ie. estrogen is high relative to progesterone, or testosterone is low relative to the age of the individual; clinical snapshot values are likely normal, but the person is still having symptoms related to hormone function and therefore have a goal of ‘balancing’ their hormones.

That being said, an example in women where there is no blatant excess or deficiency, but symptoms are related reproductive hormone function is premenstrual syndrome, or PMS. Some will say the bloating, irritability, sleep disturbances, fatigue, cramps, and weight fluctuations are ‘normal’ because so many experience them prior to the onset of menses, but then why would the birth control pill resolve many of them? In reality, some mild symptoms can be normal, but those with debilitating symptoms can benefit from hormone balancing techniques. For example, a study in 2018 by Bahraini et al found that high dose supplementation with vitamin D was able to reduce mental and physical PMS symptoms as well as menstrual related pain (dysmenorrhea) in adolescent age girls (1). Another study in 2022 by Huang et al was able to report that young patients with diabetes mellitus had worse PMS related symptoms due to how insulin and high blood sugar levels interact with the body (2). Therefore, it is a myth that nothing can be done to improve these hormone related complaints or that more intense symptoms are normal. Integrative and wellness practitioners can help support metabolism (ie. Insulin function), vitamin and mineral levels (ie. Vitamin D levels), stress, etc that all can contribute to these symptoms, thereby aiming to balance the patients hormones and improve their symptoms.