Hormone Conditions
PMS
Premenstrual Syndrome (PMS) encompasses a variety of physical, emotional, and behavioural symptoms occurring in the luteal phase of the menstrual cycle. Understanding the specific type of PMS can aid in effective management.
PMS-A (Anxiety)
This type is characterised by heightened feelings of anxiety, irritability and nervous tension. Individuals may experience mood swings and feel on edge. These symptoms are often linked to an imbalance between oestrogen and progesterone, as well as fluctuations in neurotransmitters like serotonin.
PMS-C (Cravings)
This type involves intense cravings for sweets, carbohydrates or salty foods. It may also be accompanied by headaches or fatigue. These symptoms are thought to be related to blood sugar fluctuations and hormonal imbalances affecting appetite regulation.
PMS-D (Depression)
Individuals with PMS-D may experience feelings of sadness, hopelessness, or low self-esteem. Symptoms can include fatigue, sleep disturbances, and difficulty concentrating. This type is associated with low serotonin levels and may be exacerbated by stress or thyroid imbalances.
PMS-H (Hyperhydration)
This type is marked by water retention leading to bloating, breast tenderness, and weight gain. These symptoms result from hormonal changes that cause the body to retain sodium and water.
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Recognising your specific PMS type can empower you to implement targeted strategies for relief.
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PMDD
Premenstrual Dysphoric Disorder (PMDD) is a severe, hormone-related mood disorder affecting individuals during the luteal phase of their menstrual cycle (typically 7-10 says before menstruation). Unlike typical premenstrual syndrome (PMS), PMDD symptoms are intense and can significantly disrupt daily life and relationships.
Common symptoms include:
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Severe mood swings, irritability or anger and rage.
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Depression or feelings of hopelessness
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Anxiety or tension
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Fatigue or low energy
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Changes in appetite or sleep patterns
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Physical symptoms like bloating, breast tenderness or headaches
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These symptoms typically resolve shortly after menstruation begins. PMDD is recognised in the DSM-5 as a mental health condition, highlighting its psychological impact. Diagnosis often involves tracking symptoms over multiple cycles.
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If you suspect you may be experiencing PMDD, be in touch for a proper assessment and support.
Endometriosis
Endometriosis is a chronic condition where tissue similar to the lining of the womb grows outside the uterus, commonly affecting areas such as the ovaries, fallopian tubes, bladder, and bowel. This misplaced tissue responds to hormonal changes during the menstrual cycle, leading to inflammation, scarring, and pain.
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Key symptoms include:
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Painful or heavy periods
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Pelvic or lower back pain
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Pain during or after sex
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Pain when urinating or passing bowel movements
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Fatigue and digestive issues
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Difficulty conceiving
Endometriosis affects approximately 1 in 10 women and those assigned female at birth. Despite its prevalence, diagnosis can be delayed, with an average wait time of nearly nine years.
Adenomyosis
Adenomyosis is a chronic condition where tissue similar to the lining of the womb (endometrium) grows into the muscular wall of the uterus. This tissue continues to act as it normally would during the menstrual cycle - thickening, breaking down, and bleeding - leading to an enlarged uterus and painful, heavy periods.
Common symptoms include:
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Heavy or prolonged menstrual bleeding
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Severe menstrual cramps
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Pelvic pain or pressure
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Pain during intercourse
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An enlarged or tender uterus
Some individuals may experience no symptoms, while others find the condition significantly impacts their daily life. Adenomyosis is most commonly diagnosed in women over 30 and is thought to affect around 1 in 10 women.
PCOS
Polycystic Ovarian Syndrome (PCOS) is prevalent hormonal disorder affecting women of reproductive age. While traditionally diagnosed based on criteria like irregular periods, elevated androgens and polycystic ovaries, emerging research and clinical insights have identified several subtypes of PCOS, each with distinct underlying causes and treatment considerations.
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1. Insulin-Resistant PCOS
This is the most common form of PCOS, affecting approximately 70% of individuals with the condition. It is characterised by the body's reduced ability to respond to insulin, leading to elevated insulin levels. This can stimulate the ovaries to produce more androgens (male hormones), disrupting ovulation. Symptoms often include weight gain, especially around the abdomen, sugar cravings, fatigue, and skin changes like acanthosis nigricans (darkened skin patches).
2. Post-Pill PCOS
Some individuals experience PCOS symptoms after discontinuing oral contraceptives. The pill can suppress androgen production and upon cessation, there's a temporary surge in androgens leading to symptoms like acne, irregular periods and excess hair growth. This type is usually transient and may resolve with time, but supportive treatments can aid in symptom management.
3. Adrenal PCOS
In this subtype, the adrenal glands produce excess androgens, particularly DHEA-S, rather than the ovaries. It's often linked to chronic stress and an overactive stress response. Individuals may not exhibit insulin resistance but can experience symptoms like acne, hair thinning and irregular periods.
4. Inflammatory PCOS
Chronic low-grade inflammation can stimulate the ovaries to produce excess androgens. This subtype is associated with symptoms like fatigue, headaches, joint pain, and skin conditions. Inflammation markers, such as elevated C-reactive protein (CRP), may be present.
Understanding the specific type of PCOS is crucial for effective management.
Primary Ovarian Insufficiency (POI)
Primary Ovarian Insufficiency (POI), also known as premature ovarian failure, is the loss of normal ovarian function before age 40, leading to reduced oestrogen production, irregular periods and potential infertility.
Amenorrhoea
1. Primary Amenorrhoea
This condition is diagnosed when a girl has not begun menstruating by:
Age 15, despite normal development of secondary sexual characteristics (such as breast development and pubic hair), or
Age 13, if there is an absence of secondary sexual characteristics.
Common causes include:
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Genetic or chromosomal abnormalities: Conditions like Turner syndrome can affect ovarian development.
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Anatomical anomalies: Such as Müllerian agenesis, where the uterus or parts of the reproductive tract are absent.
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Hormonal imbalances: Issues with the hypothalamus or pituitary gland affecting hormone production.
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Constitutional delay of puberty: A variation of normal development where puberty is delayed but eventually occurs naturally.
2. Secondary Amenorrhoea
This occurs when a woman who has previously had regular menstrual cycles stops menstruating for:
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Three consecutive months, or
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Six months, in women with previously irregular cycles.
Common causes include:
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Pregnancy: The most common cause and should be ruled out first.
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Polycystic Ovary Syndrome (PCOS): A hormonal disorder causing enlarged ovaries with small cysts.
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Hypothalamic amenorrhoea: Often due to stress, significant weight loss, or excessive exercise leading to decreased hormone production.
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Thyroid disorders: Both hyperthyroidism and hypothyroidism can disrupt menstrual cycles.
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Hyperprolactinaemia: Elevated levels of prolactin hormone affecting ovulation.
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Premature ovarian insufficiency: Early loss of normal ovarian function before age 40.
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Hormonal imbalances: Issues with the hypothalamus or pituitary gland affecting hormone production.
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Uterine scarring: Conditions like Asherman's syndrome, often resulting from surgical procedures.
​Understanding the type and underlying cause of amenorrhoea is crucial for effective management
Hyperprolactinaemia
Elevated levels of prolactin hormone can disrupt ovulation, leading to irregular periods or amenorrhoea, and may cause galactorrhoea (unexpected milk production).
Elevated prolactin levels can manifest differently in individuals:
Women: Irregular or absent menstrual periods (amenorrhoea), infertility, galactorrhoea (unexpected milk production) and vaginal dryness.
Men: Reduced libido, erectile dysfunction, infertility and in some cases, gynecomastia (breast tissue enlargement).
Both sexes: Headaches and visual disturbances, especially if a large pituitary tumour is present.
Peri-menopause
Perimenopause, often referred to as "second puberty," is the transitional phase leading up to menopause, typically spanning 2 to 10 years.There are four distinct phases of perimenopause, each characterised by specific hormonal changes and symptoms
Phase 1: Very Early Perimenopause
Cycle Characteristics: Menstrual cycles remain regular but may shorten (e.g., from 30 to 26 days).
Hormonal Changes: Progesterone levels begin to decline due to more frequent anovulatory cycles, while oestrogen levels may remain high or fluctuate.
Common Symptoms:
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Heavier menstrual bleeding
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Increased menstrual cramps
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Breast tenderness
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Sleep disturbances
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Mood swings
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Weight gain without changes in diet or exercise
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Increased frequency of migraines
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Night sweats
This phase typically begins in the late 30s to early 40s and can last 2 to 5 years.
Phase 2: Early Menopause Transition
Cycle Characteristics: Menstrual cycles become irregular, with variations in cycle length exceeding 7 days.
Hormonal Changes: Oestrogen levels fluctuate more dramatically, leading to a mix of high and low oestrogen symptoms.
Common Symptoms:
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Mood swings
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Hot flushes
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Sleep disturbances
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Increased anxiety
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Decreased stress tolerance
Phase 3: Late Menopause Transition
Cycle Characteristics: Periods become increasingly irregular, with intervals of 60 days or more between menstruations.
Hormonal Changes: Oestrogen levels decline more consistently, leading to more pronounced low-oestrogen symptoms.
Common Symptoms:
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Vaginal dryness
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Hot flushes
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Night sweats
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Sleep disturbances
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Mood changes
This phase typically lasts around 1 to 3 years.
Phase 4: Late Perimenopause
Cycle Characteristics: This phase encompasses the final menstrual period and the 12 months following it.
Hormonal Changes: Oestrogen and progesterone levels stabilise at lower levels.
Common Symptoms:
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Continuation of low-oestrogen symptoms
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Potential improvement in mood and sleep as hormonal fluctuations subside.